When Will The Bone Cuts From A Sliding Genioplasty Heal By X-Ray?

Q: Dr. Eppley, My sliding geniopasty surgery was in early September.  I recently had a panoramic dental x-ray and noticed that the line of bone where it was cut for the genioplasty is dark – doesn’t look like there is mineralization there yet.  Is that normal or anything to be concerned about?  I would imagine that malunion would be very rare, but apparently rare things do happen.  Maybe it just takes longer?  It’s been about 6 months now…  I am getting Invisalign to straighten my bottom teeth and thought this could help a bit if they could sink my bottom teeth in a tiny bit so that even less would show above my bottom lip.  I have been considering the second surgery we talked about, but am leaning against it.  I worry about possible complications and probably at this point, things are good enough.  While not perfect, after the surgery you did, things are very much improved.  I do still hold my lip up a bit and have a constant awareness of this part of my body, but it is easier to manage.  I hope you are well.  And thank you again.

A: Mineralization of bone, as seen in x-rays for facial osteotomies of any type, is very delayed by radiographic assessment compared to what actually happens in the body. And it may never have the same density as the chin bone did before because the bone along the osteotomy line is thinner. (less bone thickness from front to back) But I have yet to see a chin osteotomy that did not go on to full bony healing. (it would be interesting for me to see a picture of that panorex x-ray)

Dr. Barry Eppley

Indianapolis, Indiana