British Journal of Oral and Maxillofacial Surgery 54 (2016) 965–966 Available online at www.sciencedirect.com ScienceDirect Technical note New incision to harvest mandibular symphysis bone Mohammad Jafarian a , Farshid Rayati b,* , Elnaz Najafi c a Associate Professor, Department of Oral and Maxillofacial Surgery, Dental Research Center, Dental School and A. Taleghani Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran b Assistant Professor of Oral and Maxillofacial Surgery, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran c Private Practice, Tehran, Iran Accepted 18 June 2016 Available online 2 July 2016 Keywords: Mandibular; Symphysis; Genioplasty; Bone After routine local anaesthesia we make a vertical incision in the midline of the mandibular labial mucosa just apical to the mucogingival junction, and close to the bone near the symphysis (Fig. 1). If the frenum is tightly attached we may first do a frenectomy before we extend a full-thickness sub- periosteal dissection bilaterally to expose the whole area of the symphysis from canine to canine (Fig. 2). When we have exposed enough bone to place the trephine drills, we can har- vest bony blocks the size of the diameter of the bit, or particles of bone, by overlapping the drilling (Fig. 3 and 4). We then use bone curettes to harvest sufficient cancellous bone. After we have thoroughly inspected the donor bed for bleeding, we can manage the bony defect and use resorbable, running sutures to close the incision in the soft tissue (Fig. 5). Another advantage of this vertical incision is better tissue perfusion, which considerably increases the ability to heal, and it allows us to detach (but not sever) the muscle fibres and the regional vasculature, and enables the blood supply to reach the osseous and soft tissues. 1–5 * Corresponding author at: Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Bahonar Blvd., Qazvin, Iran. Tel.: +98 9121004794; fax: +98 28 33353066. E-mail address: frayati@qums.ac.ir (F. Rayati). Fig. 1. The vertical incision from the mucogingival junction inferiorly to the symphysis. Fig. 2. The subperiosteal dissection horizontally and bilaterally. http://dx.doi.org/10.1016/j.bjoms.2016.06.016 0266-4356/© 2016 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.