Piezotome Genioplasty Reduces Postsurgical Morbidity and Enhances Patient Satisfaction: A Randomized Clinical Trial.

PURPOSE: Recent clinical studies have shown piezotomes might establish the new "state of the art" for osteotomies in maxillofacial surgery. The author hypothesized genioplasty surgery with piezotomes might decrease postsurgical morbidity and increase overall patient satisfaction compared with genioplasty with traditional instruments.

MATERIALS AND METHODS: The author implemented a randomized clinical trial. The sample was composed of patients undergoing reductive genioplasty. The predictor variable was genioplasty performed with traditional instruments and a traditional sliding genioplasty protocol (control group) or ultrasonic surgical devices (Piezotome II and Piezotome SOLO M+) with a piezotome-adapted 3-dimensional curved osteotomy surgical protocol (test group). The primary outcome variable was overall long-term patient satisfaction determined by the Genioplasty Outcome Evaluation. Other study variables were postsurgical morbidity assessed by the Universal Pain Assessment Scale, analgesic intake, neurosensory 2-point discrimination test of the lip and chin, and surgery duration. Descriptive and bivariate statistics were computed by SPSS 22.0 and the P value was set at .05.

RESULTS: The sample was composed of 48 patients undergoing reductive genioplasty with a piezotome (10 men and 13 women; age, 24 to 56 yr) or traditional sliding genioplasty (11 men and 14 women; age, 26 to 54 yr). No statistically relevant difference was found for surgery duration between the test and control groups. There was a statistically significant association between decreased postsurgical morbidity (P < .05) and higher overall long-term patient satisfaction with genioplasty outcome (P < .05) when piezotomes were used for performing the genioplasty.

CONCLUSION: The results of this study suggest the use of piezotomes and piezotome-adapted surgical protocols is advantageous in genioplasty surgery compared with traditional surgical instruments and traditional surgical protocols.