Está en la página 1de 71

Mentoplasta

Propedutico Ciruga Oral y Maxilofacial UNAM C. D. Juan Amzquita

C. D. Ignacio Arce
C. D. Adair Buenda C. D. Javier Paz

Antecedentes Histricos

Hofer (1942)

Trauner y Obwegeser (1957)

Converse y WoodSmith (1964)

Reichenbach (1965)

Hinds y Kent (1969)

JM. SYKES,JL FRODEL. GENIOPLASTY. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY, VOL 6, NO 4 (DEC), 1995: PP 319-323 http://maxilofacialsanvicente.obolog.com/Geniplasta-1304701

Geniplasta
Ciruga con cambios en sentido antero-posterior de los tejidos blandos mentonianos y labio inferior.

Espesor aproximadamente de 10-12mm

Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188.

GENERALIDADES
A) Posicin Ideal B) Microgenia C) Retrogenia

D)Pseudoretrogenia (clase II mandibular retrognathia , pero un mentn normal)


E) Macrogenia

F)Pseudomacrogenia (causada por exceso de tejido blando mentn , no por el hueso )

Judy L. Ward, The Osseous Genioplasty, Clin Plastic Surg 34 (2007) 485500

ANATOMIA DE LA REGION MENTONIANA.

LIMITES.
Superior: surco ment-labial. Inferior: borde inferior de la mandbula. Lateralmente: surco ment-geniano.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

Mentn.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

INERVACION.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

IRRIGACION ARTERIAL.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

IRRIGACION VENOSA.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

Drenaje linfatico.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

Musculatura.

Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005.

PLANIFICACIN

Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188

EXAMEN CLNICO
Equilibrio Facial

Relacin Nasal
Competencia Labial Surco mentolabial

Relacin intermaxilar
Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188

A) Proporciones faciales aceptables B ) Microgenia, Tercio es verticalmente deficiente

ANLISIS TERCIOS FACIALES

C) Retrogenia , las proporciones verticales pueden seguir siendo la misma , como se ilustra
Judy L. Ward, The Osseous Genioplasty, Clin Plastic Surg 34 (2007) 485500

ANLISIS
Lnea en tejido blando, Nasion, Perpendicular a la lnea horizontal de Frankfort. Esta lnea se denomina cero meridiano ''

A) Pogonion del mentn debe estar en o justo por detrs al meridiano cero
B) Mentn es significativamente posterior
Judy L. Ward, The Osseous Genioplasty, Clin Plastic Surg 34 (2007) 485500

EVALUACIN RADIOGRFICA
Radiografa cefalomtrica lateral, proporciona: Posicin del mentn Inclinacin de la osteotoma en relacin con el borde mandibular, foramen mental, y el plano oclusal
Judy L. Ward, The Osseous Genioplasty, Clin Plastic Surg 34 (2007) 485500

Tipos de Geniplasta osea

Ward JL, Garri JI. The Osseous Genioplasty. Clin Plastic Surg 34 (2007) 485500

Tcnica quirrgica

Tcnica quirrgica

Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188

Tcnica quirrgica

Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188

Tcnica quirrgica

Ward JL, Garri JI. The Osseous Genioplasty. Clin Plastic Surg 34 (2007) 485500

Tcnica quirrgica

Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188

Tcnica quirrgica

Ward JL, Garri JI. The Osseous Genioplasty. Clin Plastic Surg 34 (2007) 485500

Fijacin con placas y tornillos

Ward JL, Garri JI. The Osseous Genioplasty. Clin Plastic Surg 34 (2007) 485500

Cambios esteticos producidos por las diferentes tecnicas de Geniplasta

Injerto Aloplastico

Cambios a corto plazo

Osteotomia con injerto

Aumento vertical

Osteotoma horizontal
Con tcnica de avance

Geniplasta de aumento. Osteotomia de avanze

Tcnica Quirrgica
Incisin Labial

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Tcnica Quirrgica
Musculo Mentoniano

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Tcnica Quirrgica
Nervio Mentoniano

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Tcnica Quirrgica
Osteotoma Horizontal

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Tcnica Quirrgica

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Avance horizontal completo

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Sutura msculos mentoneano

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187

Osteotoma horizontal
Reduccin Transversal

Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010

CASO 1

Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010

CASO 1

Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010

CASO 2

Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010

CASO 2

Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010

Osteotoma horizontal
Osteotoma de reduccin vertical

J. Rustemeyer, A. Lehmann: Reduction genioplasty enhances quality of life in female patients with prognathism and maxillary hypoplasia undergoing bimaxillary osteotomy. Int. J. Oral Maxillofac. Surg. 2013; 42: 10831092

J. Rustemeyer, A. Lehmann: Reduction genioplasty enhances quality of life in female patients with prognathism and maxillary hypoplasia undergoing bimaxillary osteotomy. Int. J. Oral Maxillofac. Surg. 2013; 42: 10831092

Geniplasta En forma de M
Una tcnica quirrgica para el aumento de Mentn Sagital y Vertical

Reduccin sagital

Reduccin sagital

Ostectomia con reposicionamiento del borde inferior de la sinfisis

Reduccin sagital

Ostectomia de la cara anterior de la sinfisis

Reduccin sagital

E. R. E. THOMSON, Sag&al genioplasty: a new technique of genioplasty, British Journal of Plastic Surgery (1985) 38, 7&74

Reduccin Sagital

E. R. E. THOMSON, Sag&al genioplasty: a new technique of genioplasty, British Journal of Plastic Surgery (1985) 38, 7&74

Referencias bibiogrficas
JM. SYKES,JL FRODEL. GENIOPLASTY. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY, VOL 6, NO 4 (DEC), 1995: PP 319-323 http://maxilofacialsanvicente.obolog.com/Geniplasta-1304701 Brett A. Miles, DDS, Osseous genioplasty: Technical considerations Operative Techniques in Otolaryngology (2007) 18, 181-188. Judy L. Ward, The Osseous Genioplasty, Clin Plastic Surg 34 (2007) 485500 Rouviere H. Delmas A. Anatoma humana descriptiva, topogrfica y funcional, tomo 1 cabeza y cuello.. 11 edicin. Editorial Masson. Espaa 2005. B.M. Jones ,M.J.J. Vesely. Osseous genioplasty in facial aesthetic surgery e a personal perspective reviewing 54 patients. Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1177e1187 Uckan S, Soydan S. Transverse Reduction Genioplasty to Reduce Width of the Chin: Indications,Technique, and Results. J Oral Maxillofac Surg 68:1432-1437, 2010 J. Rustemeyer, A. Lehmann: Reduction genioplasty enhances quality of life in female patients with prognathism and maxillary hypoplasia undergoing bimaxillary osteotomy. Int. J. Oral Maxillofac. Surg. 2013; 42: 10831092. E. R. E. THOMSON, Sag&al genioplasty: a new technique of genioplasty, British Journal of Plastic Surgery (1985) 38, 7&74 Edwards R, Jiely K, Eppley B, Resorbable Fixation Techniquesfor Genioplasty, J Oral Maxillofac Surg 58:269-272, 2000 Clark C, Baur D, Management of Mentalis Muscle Dysfunction After Advancement Genioplasty: A Case Report, J Oral Maxillofac Surg 62:611-613, 2004 Schnendel S, Sagittal Split Genioplasty: A New TechniqueJ Oral Maxillofac Surg 68:931-934, 2010 A. Triaca, T. Furrer, R. Minoretti: Chin shield osteotomy a new genioplasty technique avoiding a deep mento-labial fold in order to increase the labial competence. Int. J. Oral Maxillofac. Surg. 2009; 38: 12011225. Y. Park et al. / Journal of Cranio-Maxillo-Facial Surgery 41 (2013) 657e664