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Mandibular Augmentation With a New Sandwich Osteotomy

A Morphologic Study

Tan, Wuyuan, MD, PhD*; Yu, Bing, MD; Niu, Feng, MD; Gui, Lai, MD

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1314–1317
doi: 10.1097/SCS.0000000000005097
Scientific Foundations
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Objective: Facial asymmetry is one of common complaints in plastic and craniofacial surgery in Orient. Hemimandibular dysplasia has considered to be the key role in facial asymmetry. Despite of the undergrow of mandibular length and height, the lackness of mandibular thickness contributes to the asymmetry. The aim of this study was to describe the therapeutic efficiency of mandibular augmentation with a new sandwich osteotomy with interpositional natural coral and coralline hydroxyapatite (CHA).

Methods: Nine goats were randomly divided into 3 groups and observed at 6, 12, and 18 months after surgery. All goats received splitting of bilateral mandibular outer cortex and interpositional grafting with natural coral and CHA, respectively (sandwich osteotomy). Data were evaluated and statistically analyzed by t-test.

Results: All goats were observed at 3 different time points. The computed tomography images show that the area of operation was healed and the thickness of the mandible was increased in 3 time points. In the 3 groups, mandibular thickness and volume were significantly different compared with those before operation (P < 0.05). The volume of CHA group improved better than coral group (P < 0.05).

Conclusion: This study provides a promising alternative method for mandibular augmentation with a sandwich osteotomy and interpositional grafting with natural coral and CHA. The thickness and volume of mandible had been effectively increased in follow-ups.

*Department of Plastic and Aesthetic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan

The Craniofacial Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Address correspondence and reprint requests to Lai Gui, MD, The Craniofacial Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33 Ba Da Chu road, Shi Jing Shan district, Beijing, China 100144; E-mail: guilai111111@163.com

Received 28 February, 2018

Accepted 5 September, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.