Surgical technique of implantation of the mandible
Last reviewed: 23.04.2024
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The chin implants described here can be installed either through the oral cavity or through the sub-chin. The basic equipment consists of a Bernstein nasal retractor, thin blunt dissectors, direct clamps and isotonic saline solution of gentamicin for soaking the implant before injection. The sub-chimp is performed anterior to the sub-chin; superficial tissues, muscle and periosteum separate, exposing the central part of the chin. Then a dissection is performed in the subperiosteal plane.
In this case, one hand lies on the dissector, and the other hand guides the tool from the outside, thus protecting against any movement above the boundary of the intended pocket. The dissection of the pocket in the lateral direction should be approximately 6 cm from the midline and be performed below the level of the chin opening. After the pocket is transformed, the implant is removed from the solution of gentamicin and inserted into the pocket with a clamp.
After the introduction of half of the implant, it folds at an acute angle and is guided by clamps and a retractor in the opposite direction of the pocket. Then, the uniformity of the location of the implant on the jaw and the absence of curvature at the ends are checked. The implant has multiple openings and a blue label designating the middle of the implant. The holes allow the ingrowth of the connective tissue, which stabilizes the implant. A blue mark helps the surgeon to install the implant symmetrically.
Fixation of the implant to the periosteum is done by the sutures; muscle and superficial tissues are sewn over it. And the muscle and subcutaneous tissue are carefully sutured separately. The results of the chin increase are evaluated in the lateral and oblique projections.
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