RESUMO
Considering the esthetic goals involved in orthognathic surgeries, one of the challenges is to define the horizontal projection of the jaws. Most of the cephalometric analyses are focused on the position of the upper incisor and upper lip. Planning the correction of a mandibular retrognathism can be simplified by clinical simulation asking the patient to project their mandible. A forced esthetic position protocol is presented as a starting point for the planning in orthognathic cases.
RESUMO
This study aims to evaluate the use of bone substitute blocks (BSBs) in minimally invasive orthognathic surgery for the maxilla, mandible, and chin, highlighting their impact on jaw stability and bone healing. A retrospective analysis was conducted on 47 consecutive patients (33 females, 14 males; mean age: 27 y) who underwent bimaxillary advancement surgery. Procedures employed the minimally invasive orthognathic surgery approach. Bovine BSBs (Bio-Oss Collagen) were used to fill gaps in all cases. Postoperative follow-up included computed tomography scans at immediate and 1-year intervals. All patients achieved the desired clinical outcomes without complications such as wound dehiscence, infection, or nonunion. Visual Analog Scale scores indicated high levels of bone formation, with mean scores of 9.1 in the chin, 8.5 in the maxilla, and 7.9 in the mandible. The study supports the routine use of BSBs in orthognathic surgeries, though further research is needed to validate these findings and explore long-term outcomes.