Neurosensory disturbances (NSD) are the most widely recognized complication of bilateral sagittal split ramus osteotomy (BSSRO), but predictors of NSD remain unclear. The aim of this study was to identify factors predicting NSD following BSSRO. A retrospective cohort study of 129 consecutive patients with dentofacial deformities (median age 24.0 years; 76.0% female), who underwent BSSRO (95 without genioplasty, 34 with genioplasty), was conducted. The presence of NSD was evaluated at 6 months postoperatively and was found in 97 patients (absent in 32 patients). Potential NSD-related factors investigated were age, sex, genioplasty, mandibular canal type, inferior alveolar nerve (IAN) exposure, mandibular movement, and laterality. Multivariate binary logistic regression analysis was conducted to elucidate factors predicting NSD, with calculation of odds ratios (OR) and 95% confidence intervals (CI). The dependent variable was defined as NSD after BSSRO. Independent variables were those with P < 0.100 in the univariate analysis. In the multivariate binary logistic regression analysis, NSD showed a significant association with BSSRO with genioplasty (adjusted OR 3.87, 95% CI 1.21-12.26; P = 0.022) and left IAN exposure (adjusted OR 4.69, 95% CI 1.49-14.73; P = 0.008). The study findings may lead to enhanced clinical outcomes for BSSRO.

UNASSIGNED: We aimed to assess the satisfaction level of patients with the outcome of genioplasty and the influential parameters in this respect.
UNASSIGNED: This retrospective study was conducted on 70 patients between 18 to 59 years, who underwent genioplasty in the Oral and Maxillofacial Surgery Department at Shariati and Sina Hospitals, Tehran, Iran, between 2010 and 2020. Patient records were evaluated and a questionnaire was filled out over the phone to assess the influential parameters on the satisfaction level of patients with the outcome of genioplasty. Data were analyzed by PASS 11 (alpha=0.1).
UNASSIGNED: Seventy patients were evaluated including 56 (80%) females and 14 (20%) males. Forty patients (52.6%) had no complaint with regard to the outcome of genioplasty. Postoperative chin deviation (not correcting the initial complaint) (10.52%), postoperative pain in the chin area (10.52%), and lower lip paresthesia (9.21%) were the most common patient complaints. The minimum and maximum satisfaction scores were 22 and 80, respectively. Number of follow-up sessions had a significant effect on satisfaction with the outcome of genioplasty (P=0.076). Patients who underwent advancement genioplasty alone had the highest level of long-term satisfaction with the outcome while those who underwent setback genioplasty alone had the lowest level of long-term satisfaction.
UNASSIGNED: Advancement genioplasty had the highest rate of patient satisfaction, and chin asymmetry in the frontal view was the most common patient complaint after genioplasty.

BACKGROUND: Mandibular genioplasty, a central procedure in oral and maxillofacial surgery, has traditionally relied on surgeon experience with potential limitations in precision. The advent of digital methods, particularly computer-aided design/computer-aided manufacturing (CAD/CAM), offers a promising alternative. This study aims to evaluate the efficacy of digital surgical guides in improving the precision of mandibular genioplasty.
METHODS: A prospective analysis of 50 patients undergoing genioplasty was performed, 30 in the experimental group using digital surgical guides and 20 in the control group using traditional methods. Three-dimensional reconstructions were obtained using cone-beam computed tomography (CBCT) and digital scans. Osteotomy guides were 3D-printed based on group assignment. Postoperatively, accuracy was assessed by measuring distances between landmarks.
RESULTS: The experimental group showed significantly reduced horizontal positioning errors in genioplasty advancement, with no significant differences in vertical errors. For genioplasty retraction, the experimental group showed fewer vertical positioning errors, while horizontal errors remained consistent.
CONCLUSIONS: The use of digital surgical guides in mandibular genioplasty significantly improves surgical accuracy, resulting in improved outcomes and patient satisfaction. This study highlights the potential of digital methods in refining oral and maxillofacial surgical procedures.
METHODS: 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.

Genioplasty is a widely used surgical approach to address chin deformities by performing an osteotomy on the inferior border of the mandible to allow for comprehensive repositioning of the chin. This study aimed to compare the accuracy of freehand chin repositioning with a guided technique that employed specialised surgical guides. For this retrospective study, data from 30 adult patients who underwent orthognathic surgery to correct dentofacial deformities were analysed. All patients underwent virtual planning before surgery, with half of them treated using freehand chin repositioning and the other half using the guided technique. The surgical outcomes were measured and compared with the virtual plan to assess the positional and rotational accuracy of the techniques. In terms of translational assessment, noteworthy values that exceeded clinically acceptable limits were observed only in sagittal movement in the freehand group (0.97 mm, interquartile range (IQR) 0.73-2.29 mm). Regarding rotational accuracy, both groups exhibited an IQR that surpassed acceptable limits for pitch (3.26°, IQR 2.06-5.20 for the guided group and 2.57°, IQR 1.63-4.24° for the freehand group). The Mann-Whitney test indicated no statistical differences between the groups in any translational or rotational assessment. In conclusion, although there was no statistical difference, the guided technique proved effective in achieving clinically acceptable accuracy in all positions and almost all rotations, displaying superior results in sagittal positioning compared with the freehand technique. To fully harness the advantages of guides and to guarantee accuracy in all rotations, we recommend further research involving guides made of more rigid materials, and customised implants.

OBJECTIVE: Conventional orthognathic surgical planning has limitations in accurately transferring the relationship between soft tissue and bone. Virtual planning offers enhanced accuracy and visualization through computer simulation. This study aimed to compare the need for reoperation between patients who underwent conventional and virtual surgical planning for orthognathic surgery.
METHODS: The study included 352 patients who underwent orthognathic surgery. Reoperation rates and reasons for reoperation were evaluated in patients with conventional model surgery planning (143 patients) and virtual planning (209 patients).
RESULTS: The reoperation rate was 7.69% for conventional surgery patients and 3.82% for virtual planning patients. Malocclusion was the most common reason for reoperation in both groups. Bilateral sagittal split ramus osteotomies (BSSO) and genioplasty were the most frequently performed revision procedures.
CONCLUSIONS: Virtual planning in orthognathic surgery may lead to a reduced reoperation rate compared with conventional planning methods. The accuracy, visualization, and interdisciplinary collaboration offered by virtual planning can improve surgical outcomes.

The present study assessed the efficacy of photobiomodulation (PBM) following leukocyte-platelet rich fibrin (L-PRF) application for recovery of mental nerve neurosensory disturbances (NSDs) caused by genioplasty. This randomized triple-blind split-mouth clinical trial was conducted on 20 female patients (40 quadrants) requiring genioplasty. In each patient, one random side of the mandible served as the intervention (laser), and the other side as the control group. After genioplasty and L-PRF application, the intervention side underwent GaAIAs diode laser irradiation (880 nm, 500 mW, 15 J/cm2, 0.5 cm2 spot size, continuous-wave). Each point was laser irradiated for 15 s. Unilateral extraoral PBM was performed at 1, 3, 7, 14, 21, and 28 days, postoperatively. Laser in off mode (sham laser) was used for the control side. A visual analog scale (VAS) was used for general sensitivity, and 2-point discrimination, directional discrimination, pain discrimination, and thermal discrimination tests were used to assess the neurosensory recovery at 2 days, 2 weeks, 4 weeks, and 2 months, postoperatively. Statistical analyses were performed using two-way repeated measures ANOVA, Bonferroni test, and generalized estimating equation (alpha = 0.05). Time had a significant effect on improvement of all sensory variables (P < 0.05). Neurosensory recovery was significantly better in the intervention than the control group at all time points according to the two-point discrimination test (P = 0.0135) and brush test (P = 0.025) results. The interaction effect of time and intervention was not significant on any dependent variable (P > 0.05). Application of L-PRF + PBM resulted in significantly greater sensorineural recovery according to the two-point discrimination and brush test results.

OBJECTIVE: To compare different types of genioplasty techniques (chin advancement, rotation and advancement, setback, and reduction) in terms of neurosensory deficit and haematoma formation.
METHODS: Comparative analytical study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January 2022 to April 2023.
METHODS: Patients requiring genioplasty and fulfilling the inclusion criteria i.e. both genders aged 16-60 years were included and divided into 4 groups according to the type of genioplasty performed. Genioplasty was planned as per the ortho treatment plan and performed under general anaesthesia. Setback genioplasty was performed on 8 patients, advancement genioplasty on 11 patients, reduction genioplasty on 3, and advancement with rotation genioplasty on 16 patients. Postoperatively neurosensory deficit was recorded on follow-up after 1 month by subjective and objective assessments, and haematoma formation was assessed clinically on the 7th day after the procedure.
RESULTS: Advancement with rotation genioplasty showed the highest frequency of neurosensory deficit (almost 50%) and reduction type genioplasty showed the least frequency of neurosensory deficit (<1%, p = 0.49). The frequency of haematoma formation was maximum in the advancement with rotation genioplasty (62.5%) and minimum in equal setback genioplasty (25%, p = 0.61).
CONCLUSIONS: Advancement with rotation genioplasty had the highest rate of postoperative neurosensory deficit and haematoma formation when compared with other techniques of genioplasty.
BACKGROUND: Genioplasty, Neurosensory deficit, Haematoma, Advancement with rotation genioplasty, Setback genioplasty.

Genioplasty, a key technique for dentofacial abnormalities, is essential for establishing facial harmony. This surgical procedure entails an osteotomy of the chin, which alters its three-dimensional location to restore overall face equilibrium. Modern genioplasty, which is frequently performed alone or in combination with rhinoplasty, facelifts, and orthognathic surgery, employs a variety of materials for chin augmentation, ranging from autologous to alloplastic. Recent improvements include porous graft materials such as high-density polyethylene. Despite the need for secure osteotomy segments, soft tissues around the mandible have a natural propensity to return to their original anatomical position. In the discipline of genioplasty, face esthetics and facial evaluation have been a prominent emphasis, with historical evidence emphasizing the relevance of the chin in harmony, balance, and character perception. Customized implants provide a single therapy for rare anatomical defects, generally with lower morbidity, making them critical for patients undergoing many procedures or suffering from syndromic disorders. Virtual surgical planning advances will continue to give dependable solutions for small and complex chin position issues. Modern surgeons will continue to combine history, anatomy, rigorous evaluation, excellent execution, and technological breakthroughs to achieve the best possible outcomes for their patients, raising their social standing.

Genioplasty is a common procedure in plastic surgery, with various alloplastic biomaterials utilized for chin augmentation. Despite their advantages, complications such as neuropraxia of the mental nerve can occur, leading to temporary or persistent sensory disturbances. This case report describes a 35-year-old female who sought correction of a small chin. Preoperative evaluation revealed a retrognathic profile, and the patient underwent genioplasty with high-density porous polyethylene implantation. Postoperatively, she experienced mild paresthesia, which improved over time. Neurosensory assessments, including mechanical and light touch tests, showed no abnormalities in A-beta and C fibers but decreased sensitivity in A-delta fibers. This case report emphasizes the importance of evaluating larger nerve fibers during postoperative assessments and the need for standardized testing methodologies to comprehensively assess nerve damage after genioplasty. Further research should explore strategies to standardize neurosensory assessment and optimize therapeutic interventions for nerve damage after genioplasty.

BACKGROUND: Facial balance significantly impacts aesthetics, particularly in the middle and lower thirds. Patients with chin retrusion often benefit from sagittal plane chin advancement in rhinoplasty, enhancing surgical outcomes and satisfaction.
OBJECTIVE: This article presents a method for analyzing chin deformities and discusses a hybrid treatment approach to harmonize facial features, complementing rhinoplasty.
METHODS: The chin positions of patients treated by the senior author were assessed. A retrospective analysis included 49 patients with chin retrusion of 2.5-6 mm. Among them, 22 patients initially offered chin implants declined, leading to planned chin augmentation. Fat grafting was exclusively performed for 20 patients lacking sufficient cartilage. The \"Hybrid Chin Advancement\" technique involved supporting tissues beneath muscles with nasal septum cartilage and fat injections and tissues above muscles with fat injection alone.
RESULTS: Pre- and postoperative Legan angle measurements and chin advancements were compared across three groups. While preoperative Legan angles were statistically similar, postoperative Legan angles and advancement changes were significantly higher in the implant group (p < 0.0001). Comparing hybrid chin advancement and fat grafting groups, postoperative Legan angles and advancement changes were significantly higher in the hybrid chin group (p < 0.0001).
CONCLUSIONS: Fat grafting suffices for mild advancements (~ 2 mm), while the hybrid chin method is effective for moderate advancements (~ 4 mm). For advancements exceeding 6 mm, implants or osseous genioplasty are optimal. Our study\'s hybrid approach offers an easy, safe, and reliable method for achieving facial harmony in the lower two-thirds without compromising patient expectations.
METHODS: 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 .