Computer-assisted simulation of treatment with QuickCeph Studio™
Question :
Hello,
I have a convex profile. To correct this, I’m considering genioplasty to correct a weak chin.
I also happen to suffer from slight retrognathia, that is a normal but yet not perfect occlusion.
Is it preferable esthetically to undergo a mandibular osteotomy + genioplasty or genioplasty only?
Personally, I would prefer genioplasty because the surgery is less serious than mandibular surgery.
I point out that I have no functional problem, my occlusion has never caused me any problems.
Sincerely
Réponse :
Thank you, Hadrien, for sending me your pictures and X-rays so I can offer you a better response.
I thus performed a cephalometric tracing and I evaluated both scenarios.
First, I would like to point out that you suffer more from retrognathia than you believe so. Your X-ray shows a shift of 8° between both jaws whereas the normal is 2°. There is a shift on the occlusal plane of 10 mm. The normal is 0 mm.
The distance between the upper and lower teeth is from 5 to 7 mm (green circle on simulation #1).
Simulation #1 shows an advancement genioplasty of 6.8 mm to bring the profile back to normal. The distance between the upper and lower teeth does not change. The lower teeth are still too far back or the upper ones are too advanced.
Simulation #2 shows a mandibular advancement osteotomy of 3.5 mm and an advancement genioplasty of 4.5 mm. This will have the benefit of obtaining a normal gap between the upper and lower teeth.
You can show these tracings to the surgeon and orthodontist that you have met. If you lived in Quebec, I would probably recommend simulation #2. I always aim for an optimal treatment.
I offer you the simulations on morph pictures. There is little difference visually. The bulk of the difference will be in your occlusion.
Like I have already said, “a skeletal malformation is rarely isolated” and in your case, you seem to suffer from mandibular retrognathia and underlying Class II division 1 malocclusion that you should not underestimate.
PS: Orthosurgery simulation of treatment with the QuickCeph Studio™ software.
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