Do I Need A Sliding Geniopasty Or A Mandibular Advancement?

Q: Dr. Eppley, I am a 25 year old male who currently has braces. Wondering if I should have BSSO mandibular advancement or  sliding genioplasty. My jaw is strong but my chin is weak especially when biting.

A: The answer to the choice between a mandibular advancement or a sliding genioplasty to improve your profile is literally ‘between your teeth’. Since you are in braces, the key question is what is your bite relationship and what does your orthodontist to tell you? Is your bite correctable by orthodontics alone or is the discrepancy between your upper and lower teeth significant enough that the lower jaw needs to be brought forward to put your bite together properly and, if so, how much does it need to be moved forward.

There are three possibilities. #1 Your bite is going to be corrected by orthodontics alone and then a sliding genioplasty is needed. #2 Your bite is far enough apart that the lower jaw need to come forward significantly (7 to 10mms) and the profile will be corrected completely by that movement alone. #3 Your bite correction requires a small amount of mandibular advancement and a small sliding genioplasty will be needed as well.

Regardless of the type of mandibular or chin movement needed, I have attached a prediction of the type of change needed for normalizing your facial profile.

Dr. Barry Eppley

Indianapolis, Indiana