Osseous genioplasty versus chin implants: early complications and patient satisfaction.

Osseous genioplasty and chin augmentation with implants are the two main treatment options for retrognathia. This retrospective cohort study was performed to compare the prevalence of complications and patient satisfaction following osseous genioplasty and chin augmentation by implant. Eighty patients were included: 38 underwent advancement osseous genioplasty and 42 received chin implants (alloplastic, either Medpor or Silastic) intraorally or extraorally. The patients were assessed for complications 12 months after surgery, including neurosensory disturbances, infection or extrusion, wound dehiscence, and the need for reoperation. Patient satisfaction was evaluated using a visual analogue scale. The infection rate was significantly higher in the chin implant group than in the genioplasty group (P = 0.028). Moreover, dehiscence and the need for reoperation appeared to be more common following chin augmentation with implants. However, there was no significant difference in the prevalence of neurosensory disturbances between the two groups (P = 0.137). In the chin implants group, the extraoral approach resulted in a lower dehiscence rate than the intraoral approach. Patients in the genioplasty group had significantly higher satisfaction scores than those in the chin implant group (P = 0.001). Overall, the rates of the complications assessed were lower and patient satisfaction was higher after osseous genioplasty when compared to chin augmentation with implants.

Can platelet-rich fibrin accelerate neurosensory recovery following sagittal split osteotomy? A double-blind, split-mouth, randomized clinical trial.

Neurosensory disturbance (NSD) is common following sagittal split osteotomy (SSO) surgery. The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) on neurosensory recovery following SSO. This double-blind, split-mouth, randomized clinical trial was performed on patients undergoing bilateral SSO. PRF was applied to one side (selected using computer randomization) after the osteotomy and before fixation. The other side served as the control. The two-point discrimination test and a brush directional stroke test were used to assess NSD at 6 and 12 months postoperative. Self-reported paresthesia was documented using a 10-point visual analogue scale (VAS). Twenty-one patients were included in the study. The results of the two-point discrimination test and the number of subjects who reported a true direction in the brush directional stroke test differed significantly between the treatment and control sides (P=0.001). The recovery of NSD (self-reported paresthesia) was better on the treatment side than on the control side (P=0.001). PRF may enhance the recovery of paresthesia following SSO.