Complications after orthognathic surgery: our experience on 423 cases

Friscia, Marco; Sbordone, Carlo; Petrocelli, Marzia; Vaira, Luigi Angelo; Attanasi, Federica; Cassandro, Francesco Maria; Paternoster, Mariano; İaconetta, Giorgio; Califano, Luigi

doi:10.1007/s10006-017-0614-5

Cited by 65 publications

(40 citation statements)

References 21 publications

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“…Maxillary advancement and extrusion movements generate inter-segmental bone spaces, with a requirement for bone grafting, proportional to the size of the resulting gaps 4,[6][7][8] . Our study investigated 25 cases of bone gaps requiring bone grafting, in view of the significant surgical maxillary advancement that resulted in the incidence of considerable gaps, especially in G1 (Table 1, 2,3). We wanted to verify S53P4 applicability to linear defects resulting from Le Fort I.…”

Section: Discussionmentioning

confidence: 99%

“…Orthognathic surgery mobilizes and repositions the jaw bone base via osteotomy, to ensure functional and aesthetic results for dental-skeletal discrepancies 1 – 3 . Tridimensional surgical movements of the upper jaw are considered unstable with larger bone gaps, thus increasing the need for bone grafts, especially in upper jaw advances of > 4 mm, which normally generate bone discontinuities of > 3 mm 1 – 7 .…”

Section: Introductionmentioning

confidence: 99%

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Bioactive glass granules S53P4 in osteotomy Le Fort I

Cruz

Souza

Menezes³

et al. 2020

Sci Rep

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We evaluated bioactive glass graft (S53P4) in patients undergoing Le Fort I osteotomy, with nongrafted patients as controls. Computed tomography facial scans of the 25 patients submitted for Le Fort I were divided into two groups: Group 1-S53P4 group and Group 2-without grafting. CT scans were analyzed in the immediate postoperative period (T1) and 6 months later (T2), for linear bone gap measurements, tomographic radiodensity and behavior of the maxillary sinus. A Kruskal-Wallis test on bone gap data adopted α significance levels (p ≤ 0.05). The Friedman test (p ≤ 0.05) was used to evaluate sinus reaction cores. For gap measurements, we observed a decrease in median data between T1 and T2 in both groups, with statistical significances observed between groups in T0; G1 presented statistical difference in its two studied times (p ≤ 0.0001). For bone density, the studied data behaved inversely. G1′s bone density decreased from T1 to T2, whereas in G2 there was an increase from T1 to T2. S53P4 did not elicit increased reactions and/or sinus infections in the G1 group (p ≥ 1.00). S53P4 did not impact on Le Fort I osteotomies as a coadjuvant and a favorable factor in bone formation, and appeared innocuous in the maxillary sinus. Orthognathic surgery mobilizes and repositions the jaw bone base via osteotomy, to ensure functional and aesthetic results for dental-skeletal discrepancies 1-3. Tridimensional surgical movements of the upper jaw are considered unstable with larger bone gaps, thus increasing the need for bone grafts, especially in upper jaw advances of > 4 mm, which normally generate bone discontinuities of > 3 mm 1-7. Autogenous grafts minimize large bone discontinuities in the osteotomy line 4,6-8. Similarly, several bone substitutes have been created to decrease morbidity in patients 9-11. This follows recent technological innovations that cater for increased tissue regeneration and pathogen inhibition 12-14. In 1969, Hench et al. developed materials based on bioactive glass 12,13. Since then, these materials have been used in modern clinical applications such as dentistry, orthopedic surgeries and otorhinolaryngology 12. S53P4 produces osteoconductive biological responses at tissue-biomaterial interfaces, by forming silica gel layers that attract and differentiate osteoblasts into bone. The material interacts with growth factors to stimulate angiogenesis and pathogen inhibition via elevated pH and osmotic pressure 12,13,15-17. No studies have yet explored S53P4 in linear bone defects of few walls as in Le Fort I osteotomies, considering the anatomical proximity to the maxillary sinus and its behavior in front of bioactive glass. Therefore, we evaluated S53P4 in patients undergoing Le Fort I osteotomies, with non-grafted patients as controls. Materials and methods This retrospective observational case-control study evaluated data from medical records and CT scans of individuals who underwent Le Fort I osteotomy using a bioactive glass graft, when compared with non-grafted individuals. Ethical considerations...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bioactive glass granules S53P4 in osteotomy Le Fort I

Cruz

Souza

Menezes³

et al. 2020

Sci Rep

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“…Infections complications in orthognathic surgery are lower only to those caused by nerve injury [168]. The incidence of surgical site infections was limited to 1% of patients after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery and under antibiotic treatment [162].…”

Section: Focus On Orthodontia-associated Surgerymentioning

confidence: 99%

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 1

Barenghi¹,

Barenghi²,

Blasio³

2020

Surgical Infections - Some Facts

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Using molecular biological methods and retrospective investigations, some outbreaks in dental settings have been proven to be caused by mainly blood-borne viruses and water-borne bacteria. Nowadays, drug-resistant bacteria seem further hazards taking into account the worldwide overuse of antibiotics in dentistry, the limited awareness on infection prevention guidelines, and the lapses and errors during infection prevention (reported in more detail in Part 2). We chose MRSA and VRE as markers since they are considered prioritized bacteria according antibiotic resistance threats. Antibiotic-resistant bacterial infections inside of dental setting are relevant, and we argue about some hazards in dentistry, including dedicated surgeries. MRSA has a key role for its colonization in patients and dental workers, presence on gloves, resistance (days-months on dry inanimate surfaces), the contamination of different clinical contact surfaces in dental settings, the ability of some strains to produce biofilm, and finally its estimated low infective dose. For better dental patient and healthcare personnel safety, we need evidence-based guidelines to improve education and training initiatives in surgery.

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“…Orthognathic surgery is used to correct congenital and acquired dentofacial discrepancies with various implications regarding masticatory function, facial pain and aesthetics (Friscia et al, 2017). An interdisciplinary management that includes an orthodontic-surgical planning and monitoring is required (Espeland et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Management of Tooth Discoloration after Orthognathic Surgery Complications: Report of Two Cases

Galvani

Coaguila‐Llerena

Bordini

et al. 2021

Int. J. Odontostomat.

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Orthognathic surgery is performed for the correction of craniofacial discrepancies. However, complications, such as tooth discoloration are possible. This case report presents two patients who underwent bilateral sagittal split ramus osteotomy associated with segmental Le Fort I osteotomy and genioplasty. During surgeries, the apical region of anterior teeth was accidentally injured in both cases. After three-week surgery follow-up, the injured teeth showed a change in color to dark pink. In both teeth, the root canal treatment was performed followed by the non vital tooth bleaching. Three sessions were necessary to achieve a significant color change of the teeth. The two-year follow-up showed that both teeth preserved an acceptable color. It was concluded that tooth discoloration after orthognathic surgery is a possible complication, which could be overcome following a conservative approach. Additionally, patients should be informed preoperatively.

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Complications after orthognathic surgery: our experience on 423 cases

Cited by 65 publications

References 21 publications

Bioactive glass granules S53P4 in osteotomy Le Fort I

Bioactive glass granules S53P4 in osteotomy Le Fort I

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 1

Management of Tooth Discoloration after Orthognathic Surgery Complications: Report of Two Cases

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