826 final Novel Surgical Method for Contour Restora7on in Pa7ents with Micrognathia Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.826 h#p://den*stry3000.pi#.edu Novel Surgical Method for Contour Restoration in Patients with Micrognathia Sabah Hassan Faculty of Dentistry, Al-Mansour University College, Baghdad, Iraq Abstract The bone gra+ procedure is the most popular approach that has been u5lized to repair and shape the micrognathia. Several other treatments have also been employed. The new surgical technique is a comprehensive technique, it gives a ridge and permanent chin with a normal esthe5c appearance. Keywords: Facial Asymmetry; Mandibular Bone; Facial Trauma. Cita:on: Hassan S. (2025) Novel Surgical Method for Contour Restora:on in Pa:ents with Micrognathia. Den:stry 3000. 1: a001 doi:10.5195/d3000.2025.826 Received: January 14, 2025 Accepted: February 12, 2025 Published: February 14, 2025 Copyright: ©2025 Hassan S. This is an open access ar:cle licensed under a Crea:ve Commons AWribu:on Work 4.0 United States License. Email: Sabahbedi1@gmail.com Introduction In this procedure, a novel surgical technique has been utilized, which involves the utilization of a newly modified problast, which is an artificial substance that is primarily utilized in plastic surgery [1]. In addition to having a low crashing strength and being resorbed by any direct external pressure, the newly redesigned problast is a porous substance that is between 70 and 90 percent porous by volume. Subperiosteal implants have been utilized to sculpt the aesthetic of the micrognathia, and the new modified problast has been employed for this purpose. Surgical Procedures 12 patients have been hospitalized to our center. Clinical finding, patients with micrognathia, no other complain, all vital signs are normal. Patients have no drug allergy Surgery was conducted on ten patients under general anesthesia with nasotracheal intubation. An incision made at the interior border of the mandible, to avoid the scar which may be a large and agley looking especially in a dark skin patient. The chine bone exposed by reflecting the periosteum and the mentalis muscle by a periosteal elevator [2]. The new modified prosthesis, fully immersed in a biocompatible mixture [3-4] was utilized to facilitate fibrous and bone formation through the porous prosthesis in the operating theatre, the modified implant was autoclaved and adapted as a subperiosteal implant to restore and reconstruct a normal aesthetic chin [5-6]. Injecting a biocompatible mixture by dental syringe into the Subperiosteal prosthesis may enhance and promote bone formation through the porous implant. The modified sub-periosteal implant does not require fixation to the bones; instead, fibrous ingrowth through the ultra-porous implant provides temporary fixation. Bone in- growth through the porous material leads to a robust permanent fixation of the implant, ensuring a lasting aesthetic appearance. Before suturing a Novel Surgical Method for Contour Restora7on in Pa7ents with Micrognathia Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.826 h#p://den*stry3000.pi#.edu primary stabilization of the Subperiosteal implant an achieved by resorbable Suturing, wound closed in layers without tension Results and Discussion Post-operative follow-up reveals that the clinical assessment of the implant demonstrates an aesthetically pleasing appearance of the restored chin. The prosthetic implants are radiolucent; in the initial phases of follow-up, no abnormalities were observed on the plain X-ray. Bone spicules infiltrate the porous Problast implant approximately three months post-surgery. Three to four years' post-surgery, bone seen within the porous Problast implant via a plane X-ray. After five years, the Subperiosteal Problast implant is fully resorbed and replaced by normal bone, followed by remodeling those results in a permanent, normal structure. This novel surgical approach may be executed intraorally under local anesthesia, by bilateral injections to the inferior dental nerve, mucosal infiltration sometimes needed to reduce any pain or hemorrhage. Two cases were conducted intraorally, both resulting in failure owing to postoperative infection. Table 1. Surgical approach. This novel surgical treatment is straightforward, non-traumatic to the patient, and highly recommended for individuals who are contraindicated for bone graft surgery or those who have declined such procedures. The surgeon spends less time in the operating room, there is no fixation of the modified problast implant needed as in other techniques Conclusion The novel surgical procedure provides a satisfactory and enduring cosmetic outcome, with no failures seen when executed via an extra oral route under general anesthesia. References 1. U.S. Patent 3,992,725 and 4,129,470 Corresponding foreign patents and pending applications. TX: Proplast is Registered Trademark of Vitek, Inc Houston; 1984. 2. Puzovic D, Konstan\novic VS, and Dimitrijevic M. Evalua\on of maxillofacial weapon injuries: 15 -year experience in Belgrade. J Craniofac Surg. 2004; 15:543–546. haps://doi.org/10.1097/0000 1665-200407000-00003 3. Podaropoulos L, Veis AA, Papadimitriou S, et al. Bone regeneration using beta-tricalcium phosphate in a calcium sulfate matrix. J Oral Implantol. 2009; 35: 28 –36. https://doi.org/10.1563/1548- 1336-35.1.28 4. Shiria Y, Okuda K, Kubota T, et al. The comparative effectiveness of granules or blocks of super-porous hydroxyapatite for treatment of intrabony periodontal defects. Sci Res. 2012; 2:81–87. No. of patient Surgical approach Result 2 adult patients Intraoral approach Failure 10 adult patients Extra oral approach Good result Novel Surgical Method for Contour Restora7on in Pa7ents with Micrognathia Vol 13 No 1 (2025) DOI 10.5195/d3000.2025.826 h#p://den*stry3000.pi#.edu https://doi.org/10.4236/ojst.2012. 22015 5. Earl OW, Stephen MP, Joe BD. Mandibular replacements a review of embedded implants, The Journal of Prosthetic Dentistry. 1976;35(2):207–210. https://doi.org/10.1016/0022- 3913(76)90281-X 6. Owens BD, Kragh JF Jr., Wenke JC, et al. Combat wounds in operation Iraqi Freedom and operation enduring freedom. J Trauma. 2008; 64:295–299. https://doi.org/10.1097/TA.0b013 e318163b875