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Osteotomy in Genioplasty by Piezosurgery

Bertossi, Dario, MD*; Albanese, Massimo, MD*; Mortellaro, Carmen, MD, DDS; Malchiodi, Luciano, MD, DDS*; Kumar, Narendra, MSc; Nocini, Riccardo, MD§; Nocini, Pier Francesco, MD, DDS*

doi: 10.1097/SCS.0000000000004773
Clinical Studies

Background: The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow the authors to avoid or reduce the immediate genioplasty complications.

Methods: Fifty-five patients of defective chin have been treated from January 2006 to April 2008. Intraoral genioplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments.

Results: Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill.

Conclusion: Genioplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In the authors’ experience, piezoelectric scalpel, compared with saw and drill, enables them to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients’ satisfaction.

*Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Verona

Department of Health Sciences “A. Avogadro,” University of Eastern Piedmont, Novara, Italy

Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK

§ENT Department, University of Verona, Verona, Italy.

Address correspondence and reprint requests to Dario Bertossi, MD, Department of Maxillofacial Surgery and Dentistry, University of Verona, University Hospital of Verona, Piazzale L.A. Scuro 10 – 37134 Verona, Italy; E-mail:

Received 25 January, 2018

Accepted 13 May, 2018

The authors report no conflicts of interest.

© 2018 by Mutaz B. Habal, MD.