Single-Stage Mandibular Curved Ostectomy on Affected Side Combined with Bilateral Outer Cortex Grinding for Correction of Facial Asymmetry: Indications and Outcomes.

ABSTRACT

BACKGROUND: Facial asymmetry combined with a prominent mandibular angle is common in the population. Its treatment involves two or three stages of surgeries. Generally, orthognathic surgery is a top priority. However, some patients with no severe occlusion disorders focus on the appearance and could not accept complex therapeutic procedures. This study evaluated the surgical effect of en bloc mandibular angle-body-chin curved ostectomy (MABCCO) combined with traditional mandibular angle curved ostectomy (MACO) and bilateral outer cortex grinding (OCG) to correct facial asymmetry and a prominent mandibular angle. METHODS: From September 2013 to November 2017, a total of 40 patients with facial asymmetry and prominent mandibular angle were chosen for this study. The authors performed single-stage surgery of en bloc MABCCO combined with traditional MACO and bilateral outer cortex grinding to correct facial asymmetry. Patient satisfaction was investigated by questionnaires at 6 months postoperation. The effectiveness was then evaluated through cephalometric radiographs, three-dimensional computed tomography, and preoperative and postoperative standard facial photographs. RESULTS: The postoperative results of all 40 cases showed that facial asymmetry was effectively corrected without serious complications, and the square face was also significantly improved with a harmonious mandibular contour. There was a statistical difference between the patient's preoperative and postoperative satisfaction scores (p < 0.05). The objective esthetic outcomes evaluated by both surgeons and patients were quite satisfactory. CONCLUSION: Single-stage surgery of en bloc MABCCO combined with traditional MACO and bilateral OCG was an adaptable option for correction of facial asymmetry and prominent mandibular angle with slight occlusion disorders, which can both largely shorten treatment time and shape a harmonious face. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .