Computer-assisted mandibular curved osteotomy: An automatic method to design the new aesthetic gonion and osteotomy line

Background: Digital technology has been widely used in mandibular curved osteotomy to improve accuracy. However, the planning process still highly dependent on the experience and judgement of the surgeon. This study describes an automatic method to design the new gonion and osteotomy line based on the aesthetic standards in attractive women, and assesses its clinical outcomes.Methods: An automatic surgical planning method for mandibular curved osteotomy was developed based on our previous research of mandibular angle aesthetics. A prospective clinical study was conducted from April 2016 to April 2018. Twenty-five female patients with prominent mandibular angle were enrolled. Pre- and postoperative skull computed tomography (CT) was performed. Three-dimensional (3D) CT data were obtained and processed by Mimics 18.0. Surgical templates were designed according to the automatic surgical planning method and 3D printed for the surgery. Preoperative measurements, surgical simulation and postoperative measurements were taken to evaluate the surgical outcomes.Results: There were significant differences between the preoperative and the postoperative groups' results (p < 0.01). There was no difference between the surgical simulation and the postoperative results. All postoperative measurements were consistent with aesthetic features of mandibles. Patients were satisfied with their outcomes in terms of outline, symmetry and lower facial width.Conclusions: Our study developed an automatic method to position the new aesthetic gonion and osteotomy line for prominent mandibular angle patients. We proved that this method is safe, effective and reliable. (C) 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.