Radiographic assessment of soft tissue changes with PEEK onlay versus conventional osteotomy protocol in advancement genioplasty: A randomized clinical trial

Abstract Background The breakthroughs in virtual planning and computer guided surgeries improved the accuracy and predictability of guided surgical procedures and enhanced the use of patient specific implants. The aim of this study was to describe a radiographic method for assessment of soft tissue gain with patient specific PEEK chin implants versus computer guided advancement genioplasty in patients with retruded chins. Materials and methods Patients with retruded chins indicated for corrective genioplasty were recruited and randomly allocated into two equal groups; Group A received a patient specific onlay PEEK chin implant, while group B received fully computer guided advancement genioplasty. The preoperative and the one-year postoperative CT scans were superimposed and the 3D generated soft tissue contours were compared. Results Each group included ten patients. The mean amount of chin advancement in the osteotomy group was 8.12 mm ± 0.69 which was significantly higher than 5.22 mm ± 1.18 for the PEEK group. The mean one-year soft tissue gain in the osteotomy group was 7.63 mm ± 0.49 which was also significantly higher than 3.72 mm ± 1.7 for the PEEK group. Conclusion Radiographic soft tissue assessment is a reliable way of evaluation of soft tissue changes. Also, Computer guided advancement genioplasty could provide better net soft tissue gain than PEEK chin implants. Clinical relevance: This study emphasized the reliability of CT based soft tissue assessment and set the base for using facial laser scanning in future studies. It also proved that autogenous genioplasty is still the gold standard.