Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

Dario Bertossi,Luca Calogero Carletta,Massimo Albanese,Riccardo Nocini,Giulia Ricciardi,Dario Donadello,Alessandra Lucchese

doi:10.3390/app11094271

Abstract

Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery®. Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported. A retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and genioplasty technique using Piezosurgery®. The complications taken into consideration were disorders of the temporomandibular joint (TMJ), paraesthesia and hypoesthesia, asymmetries, nose enlargement, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency, gingival recession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatricial outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature reviews. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods.

Highlights

The aims of orthognathic surgery are numerous: correction of malocclusions, health of the temporomandibular joint, maintenance or increase of upper airway space, improvement of dental relationships, correction of reverse bites, improvement of muscle function, facial aesthetic harmonization, and patient satisfaction
We performed this retrospective study in order to identify their onset and frequency during or following orthognathic surgery and their severity, assess patient perception about the problem, and determine whether the frequency of our postoperative complications are consistent with those reported in the literature [6,7]
This retrospective study involved all patients accepted in the Department of Maxillofacial Surgery and Dentistry of the University Hospital (AOUI) of Verona from 2004 to 2017 that fulfilled the following inclusion criteria: age ≥18 years, intervention made by the same surgical team, intervention of bilateral sagittal split osteotomy (BSSO) of the mandibular branch, and/or maxillary or multi-segmented Le Fort I surgery

Summary

Introduction

The aims of orthognathic surgery are numerous: correction of malocclusions, health of the temporomandibular joint, maintenance or increase of upper airway space, improvement of dental relationships, correction of reverse bites, improvement of muscle function, facial aesthetic harmonization, and patient satisfaction. It is important to ensure adequate stability of the long-term results [1,2,3,4,5] Such complex therapies may present complications, the most common are temporomandibular disorders (TMD), paraesthesia, and hypoesthesia [1]. Despite careful planning and the low risk associated with this type of intervention, we can register many mild or more severe complications. We performed this retrospective study in order to identify their onset and frequency during or following orthognathic surgery and their severity, assess patient perception about the problem, and determine whether the frequency of our postoperative complications are consistent with those reported in the literature [6,7]

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Conclusion