Abstract
BackgroundBotulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent post-operative complication after orthognathic surgery. The purpose of this study was (1) to evaluate BTX-A injection into the masseter muscle on the prevention of plate fracture and (2) to compare post-operative relapse between the BTX-A injection group and the no injection group.MethodsSixteen patients were included in this study. Eight patients received BTX-A injection bilaterally, and eight patients served as control. All patients received bilateral sagittal split ramus osteotomy for the mandibular setback and additional surgery, such as LeFort I osteotomy or genioplasty. Post-operative plate fracture was recorded. SNB angle, mandibular plane angle, and gonial angle were used for post-operative relapse.ResultsTotal number of fractured plates in patients was 2 out of 16 plates in the BTX-A injection group and that was 8 out of 16 plates in the no treatment group (P = 0.031). However, there were no significant differences in post-operative changes in SNB angle, mandibular plane angle, and gonial angle between groups (P > 0.05).ConclusionsBTX-A injection into the masseter muscle could reduce the incidence of plate fracture.
Highlights
Botulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent postoperative complication after orthognathic surgery
The plate fracture was more frequently observed in the no treatment group than in the BTX-A injection group (Fig. 1)
No treatment group showed little higher change compared to the BTX-A injection group, the difference between groups were not significantly different (P > 0.05)
Summary
Botulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent postoperative complication after orthognathic surgery. Once injected to the muscle, BTX-A binds to the presynaptic terminal end and releases acetylcholine. With these reactions, BTX-A can reduce the activity of muscles effectively and safely [2]. The first is improper bony interference after surgery on sagittal split ramus osteotomy (SSRO) techniques [9]. This unavoidable bony interference leads to displacement of the proximal segment and results in early relapse [10]. The improper condyle position or excessive torque to the condyle results in relapse [8]. Excessive torque on the condyle is the cause of relapse and long-term
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