Sliding Genioplasty Using Fresh-Frozen Bone Allografts

Figure 1. Preoperative patient front view (A) and profile (B).

Figure 2. Intraoperative view of the final result of a sliding genioplasty and interpositional bone grafting using corticospongious fresh-frozen allografts.

Figure 3. Postoperative patient front view (A) and profile (B).

Figure 4. Preoperative (A) and postoperative (B) cephalograms showing the good result of the genioplasty without any radiological sign of bone resorption.

Figure 5. Front views 12 months after surgery and bone biopsy site. A, Postoperative front view of the vestibular aspect of the chin 12 months after surgery. Complete osteointegration of the interpositional allograft is evident. B, After plates removal, the allograft was undetectable, as shown in this postoperative front view. C, Bone biopsy was performed to examine the quality of bone through the entire width of the allograft.

Figure 6. Histological analysis. A, Histological section of entire bone biopsy specimen with evidence of homogeneous bone regeneration, graft reabsorption, and normal vascularization (hematoxylin-eosin, original magnification ×5). B, Magnified view of a grafted bone chip invaginated by a continued layer of newly formed bone. Osteocytes are observed inside the vital bone, while grafted bone is characterized by empty lacunae (hematoxylin-eosin, original magnification ×30). C, Histological findings 7 months after surgery. A continued front of bone apposition is evident all around the newly formed bone boundaries (CD 56/NCAM–clone 123c3.D5 [NeoMarkers, immunostaining], original magnification ×10). D, Histological section showing the mature aspect of the bone architecture and a normal well-vascularized inner space (Clone 49 [Novocastra], original magnification ×50). E, CD34 immunostaining demonstrated effective angiogenesis and no sign of inflammation or foreign body reaction (Clone QBEND/10 [Novocastra], original magnification ×50).