Mandibular advancement of anterior segmental osteotomy for aesthetic correction of mandibular retrusion.

[PURPOSE] Advancement genioplasty to achieve aesthetic improvement was performed; however, the more genioplasty was advanced, the worse the depth of the labiomental fold became. Therefore, our hospital applied not only advancement of genioplasty but also rotational advancement of anterior segmental osteotomy (ASO) for satisfactory aesthetic lines.

[MATERIALS AND METHODS] From January 2008 to March 2010, our hospital operated on 10 patients who showed not only convexity profile with posterior divergent but also small SNB and microgenia in the cephalometric analysis. Their mean age was 24.8 years, and we had them followed up for at least 6 months. The surgical technique was contrary to the ASO setback, which means a rotational advancement and an average 5-mm advancement of the ASO segment, adding an average of 6- to 7-mm advancement of genioplasty.

[RESULTS] Postoperative results in the cephalometric analysis showed a good balance of the lower part of the face. Average SNB was increased from 69.96 to 72.88 degrees. The pogonion of the soft tissue came forward on an average of 7.18 mm and superiorly on an average of 1.93 mm. The inclination of L(1)MP was decreased from 100.00 to 91.99 degrees, but it was within the reference range. The labiomental fold was not deeper. We checked that spaces created by the anterior segmental osteotomy and advancement of genioplasty were filled with new bone through follow-up x-ray density images.

[CONCLUSIONS] If balance of the lower part of the face with mandibular retrusion is insufficient using advancement of genioplasty, our hospital also applied rotational advancement of ASO. This operative technique not only was relatively simple and applied less pressure but also made a new B point.