Treacher Collins syndrome, mandibulofacial dysostosis is a rare genetic disorder characterized by dysgenesis of the hard and soft tissues of the first and second branchial arches. The main clinical symptoms are hypoplastic facial bones （zygoma and mandible）, palpebral fissures, ear deformities, hearing loss, and cleft palate. Chin augmentation with a silicone implant is a relatively common practice in esthetic surgery. Although silicone appears to be a durable and safe material, it has been implicated in a variety of adverse inflammatory reactions.
We herein report a case of Treacher Collins syndrome with a silicone implant removed from the chin because of odontogenic infection during a long period after augmentation genioplasty. A 58-year-old woman was referred to our hospital for the treatment of abscesses in her submental region. The patient had a history of esthetic surgery with silicone implantation for chin augmentation about 41 years prior. The postoperative course had been uneventful until recently when purulent discharge was noted through the skin in the submental region.
On initial examination, numerous abscesses with orocutaneous fistulas were noted in the submental region and peripheral periodontitis of the mandibular anterior teeth. The biopsy showed granular tissue caused by persistent chronic infection due to the silicone implant. The subsequent surgical intervention included the removal of the implant with repair of the orocutaneous fistulas and peripheral periodontitis of the mandibular anterior teeth.
The importance of regular maintenance for oral hygiene is essential to prevent secondary infection in a case of augmentation genioplasty with a silicone implant.

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Acromegaly is an endocrine disease caused by excessive secretion of growth hormone （GH） after the end of the growth period, due to a pituitary adenoma. Mandibular prognathism, tongue hypertrophy, and bulging of the eyebrow arch are observed in the maxillofacial region. We describe a case with acromegaly for which surgical orthodontic treatment was performed after excision of the pituitary adenoma. A 47-year-old woman who became aware of enlargement of the size of the hands and feet from 35 years old was diagnosed with acromegaly by the Department of Neurosurgery because of a high GH level and a pituitary tumor on MRI. In September 2014, chemotherapy was performed after tumor resection via the nasal cavity. In March 2016, she was referred to the Department of Orthodontics of our hospital for further examination and treatment of malocclusion. Overjet and overbite were −5.0mm and ＋2.5mm, respectively. The occlusal relationship of the molars was Angle class Ⅲ. Angular analysis of lateral cephalometric analysis showed SNA: 80.0°, SNB: 77.0°, ANB: 3.0°, and FMA: 37.9°. Mandibular prognathism was diagnosed based on a Wits appraisal of −7.1. Since there was no clinical activity of acromegaly and hypertrophy of the hard and soft tissues due to acromegaly had stopped, and serum insulin-like growth factor-1 was well controlled by chemotherapy, orthognathic treatment was started in April 2016 and bimaxillary surgery was performed in January 2019. The occlusal relationship was stable and there was no recurrence at 2 years after the surgery. Since acromegaly has various complications, it is necessary to create a treatment plan considering the complications, and to perform extended follow-up due to the potential for recurrence of the disease.

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In Japan, the aging rate exceeds 25％ and a super-aging society has developed; the situation is expected to continue in the future. Not only adolescents but also middle-aged and/or elderly patients undergoing orthognathic surgery are gradually increasing. There are reports on orthognathic surgery for jaw deformity patients with multiple teeth defects, but no reports on two-jaw surgery in maxillomandibular edentulous patients in Japan.
Although the present maxillomandibular edentulous patient was in their 30s, two-jaw surgery was performed to acquire stable occlusion, enable the use of stable dentures, and improve esthetics.
A denture fitting the current alveolar ridge was created for surgical planning, then a duplicate denture in which the crown of the denture had been replaced with a contrast-enhanced resin was used. The patient wore the denture and an X-ray photograph was taken. This method made it possible to plan the amount of movement and intermaxillary fixation during surgery. In addition, the patient had a risk of dialysis, but there were no problems during the perioperative period. The patient was postoperatively very satisfied with the treatment outcome.
It is thought that the number of maxillomandibular edentulous cases in whom orthognathic surgery is applied will increase in the future.

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