Osseous genioplasty with the use of a “Foundation Screw”

Introduction: Osseous genioplasty is a versatile procedure which can predictably influence the profile, vertical length and esthetics of the chin. It can be performed as an isolated procedure or in conjunction with orthognathic surgery. With recent advances in imaging technology, three-dimensional computer assisted surgical simulation with images obtained from cone beam computed tomography are routinely used in treatment planning orthognathic surgery and genioplasty. To accurately duplicate the planned genioplasty movement on the operating table can be challenging due to strong muscle attachments on the genioplasty segment. We are proposing the use of a “foundation screw” which is a bone screw inserted perpendicular to the chin segment to provide better control of the genioplasty segment and improve surgical accuracy during fixation. Method: In this retrospective study, thirty consecutive patients with bimaxillary orthognathic surgery and advancement genioplasty with the use of a “foundation screw” were included. The planned genioplasty advancement is compared with the actual advancement measured on lateral cephalometric radiographs. Result: The mean value of the planned genioplasty advancement was 3.92 ± 1.86 mm. The actual advancement was 3.79 ± 1.81 mm. There is a good correlation between the planned and actual advancement (Pearson correlation r = 0.99, p < 0.001). Conclusion: “Foundation screw” is a simple, yet effective tool in aiding fixation of the genioplasty segment. Surgeons can replicate the planned surgical movement on the operating table with ease using this technique.