3D-guided Mentoplasty: Advantages of the Technique and Morphometric Analysis

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Background: We aimed to describe a protocol and related surgical treatment for mentoplasty using virtual surgical planning (VSP) and piezosurgery. Methods: Twelve patients requiring mentoplasty underwent VSP based on preoperative computed tomography. Virtual osteotomy was defined and the bone fragment was repositioned. Cutting and repositioning guides were exported as STL files and created using a 3-dimensional (3D) printer with biocompatible material. Plates were preblended on the printed model. Postoperatively, morphometric analysis was performed by comparing the planned and postoperative 3D models: distance between the apex of the cusp of 43 and 33 and lower edge of the chin; distance between the lower edge of the right and left mental foramen and osteotomy; and distance between the mandibular lingual fossa and pogonion. Results: Six cutting guides were made composite and six were monobloc. The repositioning guides were all made monobloc. No adverse intraoperative events were observed. Postoperative transient hypoesthesia was reported in 1 case. The average distance between the planned and postoperative 3D models of the chin was recorded in translation (1.91 mm), rotation (right, 1.38 mm; left, 1.30 mm), and cranial-caudal repositioning (right, 1.39 mm; left, 1.23 mm). VSP and 3D printing have improved surgical precision and reproducibility; they help the surgeon decide the extent of chin movement and the most suitable type of surgical guide in advance. Conclusions: Mentoplasty using 3D-printed guides and piezosurgery is simple, accurate, and safe. The costs of guide production are reduced using 3D printers by approximately €400-€800 per case compared with industrial printers.

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