Clinical ArticlesIncidence of complications and problems related to orthognathic surgery: A review of 655 patients*,**,*
Section snippets
Patients and methods
The clinical records and radiographs of 655 patients operated on in Vaasa Central Hospital, Finland during a 13-year period between 1983 and 1996 were examined. The mean age of the patients at the time of operation was 30.3 years (median, 29.5 years; range, 15 to 60 years), and there were 475 females and 180 males. Most patients had had preoperative orthodontics; the few exceptions were operated on to improve their preprosthetic dentoalveolar status. The distribution of preoperative diagnoses
Preoperative phase
Symptomless resorption of the roots of the teeth was found in 22 patients. This was probably caused by orthodontics. One patient had had root resorption even before orthodontic treatment. In some patients with relapse, incorrect preoperative tilting of the posterior teeth was assumed to have caused the relapse in the presence of open bite. No other specific preoperative errors or complications could be identified.
Preoperatively, 273 patients (46%) had TMJ problems; however, the notes on 60
Discussion
The most common problem was neurosensory disturbance of the IAN, which was mild in 32% and disturbing in 3% of patients with an osteotomy in the mandible. Older patients appeared to suffer from this problem more often than younger subjects. As Westermark et al30 point out, patients should be informed of the relatively high risk of sensory disturbances, especially in view of the report43 that the occurrence of paresthesia may reduce the overall satisfaction with the outcome of treatment. As an
References (47)
- et al.
The LeFort I osteotomy as a surgical approach for removal of tumours of the midface
J Craniomaxillofac Surg
(1999) - et al.
Transfacial access for neurosurgical procedures: An extended role for the maxillofacial surgeon. I. The upper cervical spine and clivus
Int J Oral Maxillofac Surg
(1991) - et al.
Functional and morphologic changes after combined maxillary intrusion and mandibular surgery
J Oral Maxillofac Surg
(1996) - et al.
The TMJ dysfunction syndrome before and after sagittal split osteotomy of the rami
J Maxillofac Surg
(1985) - et al.
Changes in temporomandibular joint pain-dysfunction after surgical correction of dentofacial anomalies
Int J Oral Maxillofac Surg
(1986) - et al.
Function of the masticatory system in 20 patients with mandibular hypo- or hyperplasia after correction by a sagittal split osteotomy
Int J Oral Maxillofac Surg
(1990) - et al.
A comparison of surgery and orthodontics in “borderline” adults with Class II, Division 1 malocclusions
Am J Orthod Dentofac Orthop
(1993) - et al.
Orthognathic surgery: The patients' perspective
Br J Oral Maxillofac Surg
(1998) Orthognathic surgery versus orthodontic camouflage in the treatment of mandibular deficiency
J Oral Maxillofac Surg
(1995)- et al.
Life-threatening, delayed epistaxis after surgically assisted rapid palatal expansion: A case report
J Oral Maxillofac Surg
(1999)
Major vascular complications of orthognathic surgery: False aneyrysms and arteriovenous fistulas following orthognathic surgery
J Oral Maxillofac Surg
Hemorrhage following mandibular osteotomies: A report of 21 cases
J Oral Maxillofac Surg
Carotid-cavernous sinus fistula following maxillofacial trauma and orthognathic surgery
Int J Oral Maxillofac Surg
Endotracheal tube damage during orthognathic surgery
Int J Oral Maxillofac Surg
Intraoperative complications in sagittal and vertical ramus osteotomies
Int J Oral Maxillofac Surg
Condylar resorption in orthognathic surgery. The role of intermaxillary fixation
Oral Surg Oral Med Oral Pathol
Condylar resorption after bicortical screw fixation of mandibular advancement
J Oral Maxillofac Surg
Condylar resorption after orthognathic surgery. Evaluation of treatment in 8 patients
J Craniomaxillofac Surg
Condylar remodelling and resorption after LeFort I and bimaxillary osteotomies in patients with anterior open bite. A clinical and radiological study
Int J Oral Maxillofac Surg
A Retrospective analysis of lingual nerve sensory changes after mandibular bilateral sagittal split osteotomy
J Oral Maxillofac Surg
Facial nerve injuries associated with orthognathic surgery: A review of incidence and management
J Oral Maxillofac Surg
Inferior alveolar nerve function after sagittal split osteotomy of the mandible: Correlation with degree of intraoperative nerve encounter and other variables in 496 operations
Br J Oral Maxillofac Surg
Infection after orthognathic surgery, with and without preventive antibiotics
Int J Oral Surg
Cited by (269)
Assessing the Efficacy of Allogeneic Nerve Grafts in Trigeminal Nerve Repair: A Systematic Review
2024, Journal of Oral and Maxillofacial SurgeryCase report: Rare latent postoperative pseudoaneurysm of internal maxillary artery after Le Fort osteotomy
2024, Oral and Maxillofacial Surgery CasesOptimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide
2024, Journal of Stomatology, Oral and Maxillofacial SurgeryThe online attention analysis on orthognathic surgery research
2024, Journal of Stomatology, Oral and Maxillofacial SurgeryNovel Machine Learning Algorithms for Prediction of Treatment Decisions in Adult Patients With Class III Malocclusion
2023, Journal of Oral and Maxillofacial SurgerySurgical Correction of Maxillofacial Skeletal Deformities
2023, Journal of Oral and Maxillofacial Surgery
- *
†Senior Oral Surgeon and Head, Oral and Maxillofacial Unit, Vaasa Central Hospital, Vaasa, Finland.
- **
‡Professor and Head, Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Oulu, Finland; and Oral and Maxillofacial Department, Oulu University Hospital, Oulu, Finland.
- *
Address correspondence and reprint requests to Dr Panula: Oral and Maxillofacial Unit, Vaasa Central Hospital, Hietalahdenkatu 2-4, 65130 Vaasa, Finland; e-mail: [email protected]