Sliding Genioplasty

Q: Dr. Eppley, I have read some of your posts pertaining to hardware removal for a sliding genioplasty and couldn’t help but wonder what the difference between removing hardware after a genioplasty and wearing a retainer post orthodontic treatment would be. My dentist has me wear a retainer to maintain the orthodontic treatment induced position of my teeth to help prevent shifting. Wouldn’t the chin need to rely on a similar form of permanent fixation?

A: The stability of orthodontically moved teeth is very different than that of a chin bone osteotomy. (sliding genioplasty) Retainers are needed in orthodontics because teeth that have been moved through bone have ‘memory’ since they have been pushed through bone. (a bone remodeling process) Such a bone process is very different biologically from that of any facial osteotomy. A sliding genioplasty cuts the bone and moves the inferior segment into a new forward position where the bone then heals. Once the bone is healed, it has no memory. This is why plates and screws used to initially hold the bone in its new position are no longer needed after the bone healing process. This is essentially like comparing osseous distraction to that of bone osteotomies…two very different craniofacial procedures and healing processes.

Dr. Barry Eppley

Indianapolis, Indiana