Thank you for visiting our website.
This site is exclusively reserved for health professionals.

Une professionnelle de santé en train de travailler

I am a healthcare professional

Un patient est au téléphone

I would like to access the ‘patient’ dental implant website.

Access patient website
Un patient est au téléphone

I would like to access the ‘patient’ website for jaw surgery.

Access patient website
Accédez offres de recrutement

Chin Wing Genioplasty

Genioplastie Chin Wing Global D

The Chin Wing genioplasty is a continuous basilar osteotomy that allows repositioning of the mandibular line from the right to the left angle, with three-dimensional correction of projection, height, and mandibular inclination.

This technique ensures harmonious and stable reshaping of the lower third of the face while preserving bone continuity.

                                             

Origin of the Technique

Mandibular wing osteotomy was first described by Prof. Albino Triaca (Zurich, Switzerland) in 2009 (Triaca et al., IJOMS 2009). It:

  • Corrects the projection and height of the chin along the entire length of the mandible.
  • Redefines bone continuity and the mandibular line.
  • Adapts the slope of the mandibular plane according to the patient’s aesthetic and functional needs.

Surgical Indications for surgery

  • Retrognathia with desired mandibular advancement.
  • Vertical deficit of the lower third requiring lowering of the mandibular plane.
  • Mild to moderate asymmetries of the mandibular border.
  • Overall aesthetic improvement without the need for a plastic or titanium symphyseal or mandibular angle prosthesis.

Operative technique

  • Vestibular access with complete subperiosteal dissection of the mandibular border.
  • Continuous mandibular osteotomy (most often with a piezotome; option of using the NSK VarioSurg 4).
  • Mobilisation of the mandibular segment according to elevation, depression and rotation.
  • Osteosynthesis using the Global D Chin Wing plate, a standard genioplasty plate at the front at the level of the symphysis and as a complement laterally, in order to maintain the posterior spacing and avoid recurrences.

Global D Chin Wing plate

In chin wing genioplasty, fixation of the inferior bone flap is achieved using a standard genioplasty plate at the front. Laterally, surgeons have the option of performing a bone graft.

To address certain cases of recurrence, particularly in cases of significant posterior depression, Global D and its team of surgical designers have developed a compact osteosynthesis plate designed to perfectly meet the technical and anatomical constraints of this surgery.

Technical variant: Mini Wing Osteotomy

  • Limited osteotomy of the symphysis extending to the anterior portion of the mandibular body.
  • Preserves the inferior alveolar nerve and reduces the risk of posterior paresthesia.
  • Indicated when a full Chin Wing is not required or when a sagittal split is also performed.
  • Allows for the elevation and/or depression of the chin and the anterior portion of the mandibular line.

Technical difficulties and areas of vigilance

  • Osteotomy trajectory: avoids the mandibular canal and maintains sufficient bone thickness.
  • Extensive subperiosteal dissection: complete exposure of the angle to the required angle, vascular preservation.
  • Mobilisation of the mandibular segment: delicate manipulation to avoid secondary fractures or steps.
  • Stable osteosynthesis: precise plate adaptation, bicortical screw fixation respecting nerve structures.
  • Post-operative management: consolidation, position maintenance, and paresthesia prevention.

The learning curve is significant: osteotomy precision, control of the mandibular plane and correct plate adaptation are crucial.

Digital Surgical Planning (DSP)

Digital surgical planning improves safety and precision:

  • 3D visualisation of the mandibular canal, dental roots, symphysis and angles.
  • Virtual simulation of the osteotomy and repositioning (full Chin Wing or Mini Wing).
  • 3D printed surgical guides: saw/piezotome direction and optimal placement of the Global D plate.
  • Communication and planning: facilitates team/patient discussion and integration with a sagittal split or other osteotomies.
  • Advantages: reduced intraoperative errors, improved aesthetic and functional predictability and optimised operating time.

 

• Triaca A., Minoretti R., Merz B.R. (2009). Mandibular wing osteotomy for the correction of the mandibular plane. Int J Oral Maxillofac Surg., 38:1210–1215.
• Cavalcanti de Almeida Júnior O. et al. (2019). Mini-wing osteotomy: a useful procedure in orthognathic surgery. Int J Oral Maxillofac Surg., 48:1487–1494.

Pratice