Resumo

Objectives: The aim of our study is to share the working protocol for genioplasty by comparing our experience between virtually planned surgery performed using cutting guides and customized plates vs. conventional surgery. Introduction: Genioplasty as an isolated surgical technique is a highly demanded procedure in maxillofacial surgery area. Advances in facial reconstructive surgery allow less morbidity and more predictable results. In this paper, “conventional” genioplasty and genioplasty by means of virtual surgical planning (VSP), CAD-CAM cutting-guides and patient custom-made plates are compared. Materials / method: Descriptive observational study. 43 patients were treated, differentiating two groups according to the technique: 18 patients were treated by conventional surgery and 25 patients were treated through virtual surgical planning (VSP), CAD-CAM cutting guides, STL models and titanium patient-specific plates. Results: The operation time ranged from 35 to 107 minutes. The mean operative time in the conventional group was 60.06 + 3.74; in the custom treatment group it was 42.24 + 1.29 min (<0.001). The difference between planned and obtained chin change in cases of advancement or retrusion was not statistically significant (p 0.125; p 0.216). In cases of chin rotation due to asymmetry, guided and personalized surgery was superior to conventional surgery (p 0.01). The mean hospital stay was equal in both groups. A decrease in surgical complications was observed in the group undergoing VSP treatment. Conclusion: Multi-stage implementation of VSP with CAD-CAM cutting guides, STL models and patient specific plates increases the accuracy in the genioplasty surgery, particularly in cases of chin asymmetry, reducing operation time and potential complications.