Clinical Analysis on Orthognathic Surgery for 15 Years from 2002 to 2016 at the Department of Oral and Maxillofacial Surgery, Nara Medical University

Yamamoto, Kazuhiko; Kawakami, Masayoshi; Horita, Shoichiro; Matsusue, Yumiko; Nakayama, Yohei; Shimomura, Takahide; Ueyama, Yoshihiro; Kirita, Tadaaki

doi:10.5927/jjjd.27.206

Cited by 8 publications

(1 citation statement)

References 16 publications

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“…The patient with hemophilia A in this study was managed with several strategies planned preoperatively, including shortening the operative time to minimize bleeding, careful hemostasis by applying local hemostatic agents, and collecting autologous blood for transfusion. The operative time was not significantly prolonged, and the blood loss was not significantly increased compared with those of other institutions [14], indicating the effectiveness of the preventive measures. Furthermore, autologous blood transfusion was not necessary.…”

Section: Discussionmentioning

confidence: 72%

Clinical investigation of patients with jaw deformity with comorbidities

Kasahara

Hoshino

Sugiura

et al. 2022

Maxillofac Plast Reconstr Surg

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Background With improvements in the safety and stability of surgeries, the number of orthognathic surgeries is increasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeries for patients with comorbidities is also increasing. We report a survey and clinical investigation of patients with comorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathic surgery. Results The participants included 296 men and 712 women, with a mean age of 28 years (13–19 years, n=144; 20–29 years, n=483; 30–39 years, n=236; 40–49 years, n=102; 50–59 years, n=39; ≥60 years, n=4). In total, 347 patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwent SSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent other surgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases (n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologic diseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrine diseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases (n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses (hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder), and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia was managed with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetes mellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventful course. Conclusions The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacial surgeons should adequately manage cases requiring cautious perioperative control and highlight the importance of preoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oral surgeons should adopt appropriate additional preventive measures for patients with comorbidities.

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Section: Discussionmentioning

confidence: 72%

Clinical investigation of patients with jaw deformity with comorbidities

Kasahara

Hoshino

Sugiura

et al. 2022

Maxillofac Plast Reconstr Surg

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Factors Affecting Intraoperative Blood Loss in Orthognathic Surgery : A Monocentric Retrospective Study

Sayaka,

Hirotoshi,

Shigeru

2024

J. Stomatol.Soc.,Jpn.

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Ⅰ．IntroductionOrthognathic surgery(OGS)is widely recognized as a form of orthodontic treatment and was previously performed chiefly on the mandible, but in the quest for better outcomes, an increasing number of orthognathic surgeries are now being performed on the upper or lower jaw 1) . With improvements in surgical technique, ready availability of autologous blood, and the introduction of hypotensive anesthesia, surgery can be performed without recourse to allogeneic blood transfusions 1) . To date, a nationwide survey 1,2) by the Japanese Society for Jaw Deformity Research and clinical statistics 3 5) from various institutions have been published, but there are few studies of differences in blood loss due to anesthetic management methods. Therefore, the present, retrospective, observational study examined anesthesia management method as an explanatory variable, analyzed intraoperative blood loss as an outcome, and examined factors independently affecting the amount of intraoperative blood loss. This study was approved by the Ethics Review Board of the study center(No. 5 12)and adheres to the tenets of the Helsinki Declaration and STROBE guideline. Ⅱ．Objects and Methods Intotal, 157 patients who underwent a Le Fort I osteotomy (LFI) plus sagittal splitting ramus osteotomy (SSRO)or SSRO alone between April 2010 and March 2023 at Tokyo Metropolitan Tama Medical Center were included. Intraoperative blood loss in the anesthesia records of patients was used as the objective variable. The explanatory variables, including basic patient information(age, sex, height, weight, and BMI) , anes-

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Effects of the Le Fort I osteotomy with a U-shaped osteotomy on posterior and superior maxillary movement in skeletal Class Ⅱ malocclusion

MURATA,

TAKASU,

YAMASHITA

et al. 2024

Jpn. J. Oral. Maxillofac. Surg.

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A U-shaped osteotomy around the descending palatal artery has been developed to increase the posterior and superior movement of the maxilla after Le Fort I osteotomies in orthognathic surgery. This retrospective study evaluated the amount of maxillary movement after Le Fort I osteotomies with U-shaped osteotomies to elucidate an indication of the technique for posterior and superior movement of the maxilla. A total of 33 cases (4 men and 29 women) who underwent a Le Fort I osteotomy combined with a U-shaped osteotomy at Yokohama City University Medical Center from 2013 to 2019 were included. The duration of surgery, bleeding amount, and movement of the incisor (U1) and the first molar (U6) using lateral cephalograms before, immediately following, and one year following surgery, were evaluated. The mean duration of surgery and amount of bleeding were 413 minutes and 433.8 mL, respectively. The average and maximum posterior movements of U1 were 2.4 mm and 9.8 mm, respectively. The average and maximum superior movements of U6 were 4.0 and 8.5 mm, respectively. The accuracies of the U1 posterior and U6 superior movements were 2.4 and 1.9 mm respectively, and only the superior movement of U6 was significant compared to the preoperative position. Postoperative changes in the U1 forward-posterior direction and U6 superior-inferior direction immediately following and one year following surgery were 0.04 and 0.73mm respectively. No complications such as damage to the descending palatine artery or tooth roots were observed. These results indicated that the Le Fort I with U-shaped osteotomy can be a useful technique, securing approximately 8 mm of planned superior movement with posterior movement of the maxilla. 1) 独立行政法人地域医療機能推進機構横浜保土ヶ谷中央病院歯科口腔外科 (主任：村田彰吾部長) 2) 横浜市立大学附属市民総合医療センター歯科・口腔外科・矯正歯科 (主任：廣田誠部長) 3) 横浜市立大学大学院医学研究科顎顔面口腔機能制御学 (主任：光藤健司教授)

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Clinical Analysis on Orthognathic Surgery for 15 Years from 2002 to 2016 at the Department of Oral and Maxillofacial Surgery, Nara Medical University

Cited by 8 publications

References 16 publications

Clinical investigation of patients with jaw deformity with comorbidities

Clinical investigation of patients with jaw deformity with comorbidities

Factors Affecting Intraoperative Blood Loss in Orthognathic Surgery : A Monocentric Retrospective Study

Effects of the Le Fort I osteotomy with a U-shaped osteotomy on posterior and superior maxillary movement in skeletal Class Ⅱ malocclusion

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