Complications in orthognathic surgery: An expeditious appraisal

https://doi.org/10.53730/ijhs.v6nS3.5409

Authors

  • Adil M. Mevawala Post Graduate Trainee, Department Of Oral And Maxillofacial Surgery, Bharati Vidyapeeth Dental College And Hospital, Pune, Maharashtra, India 411043
  • Vaishali B. Pagare Assistant Professor, Department Of Oral And Maxillofacial Surgery, D.Y Patil Dental School, Pune, Maharashtra, India 412105
  • Shandilya Ramanojam Associate Professor, Department Of Oral And Maxillofacial Surgery, Bharati Vidyapeeth Dental College And Hospital, Pune, Maharashtra, India 411043
  • Saurabh Khandelwal Assistant Professor, Department Of Oral And Maxillofacial Surgery, Bharati Vidyapeeth Dental College And Hospital, Pune, Maharashtra, India 411043
  • Akanksha Singh Post Graduate Trainee, Department Of Oral And Maxillofacial Surgery, Bharati Vidyapeeth Dental College And Hospital, Pune, Maharashtra, India 411043
  • Ananya Mittal Post Graduate Trainee, Department Of Oral And Maxillofacial Surgery, Bharati Vidyapeeth Dental College And Hospital, Pune, Maharashtra, India 411043

Keywords:

complications, orthognathic surgeries, lefort 1 osteotomy, bilateral sagittal split osteotomy (BSSO), rare complications

Abstract

Orthognathic surgery is a aesthetic as well as functional correction surgery of jaw and face. Since it is an elective procedure it comes with its due benefits and complications. There should be a clear distinction between malpractics and complications. The complications could be foreseen if the cause is detected early and adequate treatment provided. The role of oral and maxillofacial surgeons comes into play with a proper understanding of the types, causes and treatment of complications and should deliver this information to patients who develop these complications.

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References

Benefield LE. Implementing evidence-based practice in home care. HomeHealthc Nurse 2003;21(12):804–9.

Mendes KDS, Silveira RC, de CP, Galvão CM. Revisão integrativa: método depesquisa para a incorporac¸ ão de evidências na saúde e na enfermagem. TextoContexto – Enferm 2008;17(4):758–64.

Souza MTde, Silva MDda, Carvalho Rde. Integrative review: what is it? How todo it? Einstein 2010;8(1):102–6.

Van Sickels JE, Dolce C, Keeling S, Tiner BD, Clark GM, Rugh JD. Technical factors accounting for stability of a bilateral sagittal split osteotomy advancement: wire osteosynthesis versus rigid fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:19-23.

Schwartz HC. Simultaneous removal of third molars during sagittal split osteotomies: the case against. J Oral Maxillofac Surg 2004;62:1147-9.

Lee JH, Lee IW, Seo BM. Clinical analysis of early reoperation cases after orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2010;36:28-38.

Moroi A, Yoshizawa K, Iguchi R, Kosaka A, Ikawa H, Saida Y, et al. Comparison of the computed tomography values of the bone fragment gap after sagittal split ramus osteotomy in mandibular prognathism with and without asymmetry.Int J Oral Maxillofac Surg 2016;45:1520-5.

Ellis E 3rd, Hinton RJ. Histologic examination of the temporomandibular joint after mandibular advancement with and without rigid fixation: an experimental investigation in adult Macaca mulatta. J Oral Maxillofac Surg 1991;49:1316-27.J Korean Assoc Oral Maxillofac Surg 2017;43:3-1512

Ueki K, Degerliyurt K, Hashiba Y, Marukawa K, Nakagawa K, Yamamoto E. Horizontal changes in the condylar head after sagittal split ramus osteotomy with bent plate fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:656-61.

Baek SH, Kim TK, Kim MJ. Is there any difference in the condylar position and angulation after asymmetric mandibular setback? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:155- 63.

Yoshida K, Rivera RS, Kaneko M, Kurita K. Minimizing displacement of the proximal segment after bilateral sagittal split ramus osteotomy in asymmetric cases. J Oral Maxillofac Surg 2001;59:15-8.

Kang MG, Yun KI, Kim CH, Park JU. Postoperative condylar position by sagittal split ramus osteotomy with and without bone graft. J Oral Maxillofac Surg 2010;68:2058-64.

Ellis E 3rd. A method to passively align the sagittal ramus osteotomy segments. J Oral Maxillofac Surg 2007;65:2125-30.

Yang HJ, Hwang SJ. Evaluation of postoperative stability after BSSRO to correct facial asymmetry depending on the amount of bone contact between the proximal and distal segment. J Craniomaxillofac Surg 2014;42:e165-70.

Uckan S, Buchbinder D, Orhan M, Mutlu N. Management of early relapse after a sagittal split ramus osteotomy by gradual callus distraction: a case report. J Oral Maxillofac Surg 2000;58:220-3.

Chang HP, Tseng YC, Chang HF. Treatment of mandibular prognathism. J Formos Med Assoc 2006;105:781-90

Al-Riyami S, Moles DR, Cunningham SJ. Orthognathic treatment and temporomandibular disorders: a systematic review. Part 1. A new quality-assessment technique and analysis of study characteristics and classifications. Am J Orthod Dentofacial Orthop2009;136:624.e1-15; discussion 624-5.

Gunson MJ, Arnett GW, Milam SB. Pathophysiology and pharmacologic control of osseous mandibular condylar resorption. J Oral Maxillofac Surg 2012;70:1918-34.

Handelman CS, Greene CS. Progressive/idiopathic condylar resorption: an orthodontic perspective. Semin Orthod 2013;19:55-70.

Jung HD, Kim SY, Park HS, Jung YS. Orthognathic surgery and temporomandibular joint symptoms. Maxillofac Plast Reconstr Surg 2015;37:14.

De Clercq CA, Abeloos JS, Mommaerts MY, Neyt LF. Temporomandibular joint symptoms in an orthognathic surgery population. J Craniomaxillofac Surg 1995;23:195-9.

Panula K, Somppi M, Finne K, Oikarinen K. Effects of orthognathic surgery on temporomandibular joint dysfunction. A controlled prospective 4-year follow-up study. Int J Oral Maxillofac Surg 2000;29:183-7.

Hellsing G, Holmlund A. Development of anterior disk displacement in the temporomandibular joint: an autopsy study. J Prosthet Dent 1985;53:397-401.

Legrell PE, Isberg A. Mandibular length and midline asymmetry after experimentally induced temporomandibular joint disk displacement in rabbits. Am J Orthod Dentofacial Orthop 1999;115:247-53.

Toll DE, Popović N, Drinkuth N. The use of MRI diagnostics in orthognathic surgery: prevalence of TMJ pathologies in Angle Class I, II, III patients. J Orofac Orthop 2010;71:68-80.

Kim YK, Yun PY, Ahn JY, Kim JW, Kim SG. Changes in the temporomandibular joint disc position after orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:15-21.

Van Sickels JE, Tucker MR. Management of delayed union and nonunion of maxillary osteotomies. J Oral Maxillofac Surg 1990;48:1039-44.

Chow LK, Singh B, Chiu WK, Samman N. Prevalence of postoperative complications

after orthognathic surgery: a 15-year review. J Oral Maxillofac Surg 2007;65:984-92.

Kramer FJ, Baethge C, Swennen G, Teltzrow T, Schulze A, Berten J, et al. Intra- and

perioperative complications of the LeFort I osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg 2004;15:971-7.

Yen CY, Kuo CL, Liu IH, Su WC, Jiang HR, Huang IG, et al. Modified alar base cinch suture fixation at the bilateral lower border of the piriform rim after a maxillary Le Fort I osteotomy. Int J Oral Maxillofac Surg 2016;45:1459-63.

Shams MG, Motamedi MH. A more effective alar cinch technique. J Oral Maxillofac Surg 2002;60:712-5.

Monnazzi MS, Mannarino FS, Gabrielli MFR. Extraoral alar basecinch. A modification for the technique. J Oral Maxillofac Surg Med Pathol 2014;26:142-4.

Shin YM, Lee ST, Kwon TG. Surgical correction of septal deviation after Le Fort I osteotomy. Maxillofac Plast Reconstr Surg 2016;38:21.

Lee KH, Lee SH. A clinical study of orthognathic surgery patients' satisfaction and psychologic change. J Korean Assoc Oral Maxillofac Surg 1999;25:151-64.

Lee JY, Kim YK, Yun PY. Evaluation of the patients' subjective satisfaction about the orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2009;35:94-100.

Yu CN, Chow TK, Kwan AS, et al: Intra-operative blood loss and operating time in orthognathic surgery using induced hypotensive general anaesthesia: Prospective study. Hong KongMed J 6:307, 2000

Lanigan D, West R: Management of postoperative hemorrhage following the Le Fort I maxillary osteotomy. J Oral Maxillofac Surg 42:367, 1984

MacIntosh RB: Experience with the sagittal osteotomyof the mandibular ramus: a 13-year review. J Maxillofac Surg 9: 151–165, 1981

TurveyTA: Intraoperative complications of sagittal osteotomyof the mandibular ramus: incidence and management. J Oral Maxillofac Surg 43: 504–509, 1985

Pappa H, Richardson D, Niven S. False aneurysm of the facial artery as complication of sagittal split osteotomy. J Craniomaxillofac Surg 2008;36:180–2

Smith KS, Heggie AA. Vomero-sphenoidal disarticulation during the Le Fort I maxillary osteotomy: report of case. J Oral Maxillofac Surg 1995;53:465-7.

Emshoff R, Kranewitter R, Gerhard S, Norer B, Hell B. Effect of segmental Le Fort I osteotomy on maxillary tooth type-related pulpal blood-flflow characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:749–52.

MacIntosh RB: Experience with the sagittal osteotomyof the mandibular ramus: a 13-year review. J Maxillofac Surg 9: 151–165, 1981

Mehra P, Castro V, Freitas RZ, Wolford LM. Complications of the mandibular sagittal split ramus osteotomy associated with the presence or absence of third molars. J Oral Maxillofac Surg 2001;59:854-9.

El Deeb M, Wolford L, Bevis R. Complications of orthognathic surgery. Clin Plast Surg 1989;16:825-40.

Kriwalsky MS, Veras RB, Maurer P, Eckert AW, Schubert J. Risk factors for a bad split during sagittal split osteotomy. Br J Oral Maxillofac Surg 2008;46:177-9.

Precious DS, Lung KE, Pynn BR, Goodday RH. Presence of impacted teeth as a determining factor of unfavorable splits in 1256 sagittal-split osteotomies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:362-5.

Stott DG. Reflex bradycardia in facial surgery. Br J Plast Surg 1989;42:595-7.

Precious DS, Skulsky FG. Cardiac dysrhythmias complicating maxillofacial surgery. Int J Oral Maxillofac Surg 1990;19:279-82.

Green JG, Wood JM, Davis LF. Asystole after inadvertent intubation of the orbit. J Oral Maxillofac Surg 1997;55:856-9.

Tomasetti BJ, Broutsas M, Gormley M, Jarret W: Lack of tearing after Le Fort I osteotomy. J Oral Surg 34: 1095–1097, 1976

Rubens BC, West RA. Ptosis of the chin and lip incompetence: consequences of lost mentalis muscle support. J Oral Maxillofac Surg 1989;47:359Y366

Lee UL, Lee EJ, Seo HY, Han SH, Choi WC, Choi YJ. Prevalence and risk factors of tooth discolouration after orthognathic surgery: a retrospective study of 1455 patients. Int J Oral Maxillofac Surg 2016;45:1464-70.

Al-Din OF, Coghlan KM, Magennis P. Sensory nerve disturbance following Le Fort I osteotomy. Int J Oral Maxillofac Surg 1996;25:13-9.

Hasegawa T, Tateishi C, Asai M, Imai Y, Okamoto N, Shioyasono A, et al. Retrospective study of changes in the sensitivity of the oral mucosa: sagittal split ramus osteotomy (SSRO) versus intraoral vertical ramus osteotomy (IVRO). Int J Oral Maxillofac Surg 2015;44:349-55.

Hemmig S, Johnson R, Ferraro N: Management of a ruptured pseudoaneurysm of the sphenopalatine artery following a Le Fort I osteotomy. JOral Maxillofac Surg 45:533, 1987

Solomons N, Blumgart R: Severe late-onset epistaxis following Le Fort I osteotomy: Angiographic localization and embolizaton. J Largngol Otol 102:260, 1988

Rosnagle R, Allen W, Kier E, et al: Use of selective arteriography in the treatment of epistaxis. Arch Otolaryngol 106:137, 1980

Van Sickels JE, Tucker MR. Management of delayed union and nonunion of maxillary osteotomies. J Oral Maxillofac Surg 1990;48:1039-44.

MacIntosh RB: Experience with the sagittal osteotomyof the mandibular ramus: a 13-year review. J Maxillofac Surg 9: 151–165, 1981

Jonsson E, Svartz K, Welander U: Sagittal split technique. III. Postoperative rest conditions. A radiographic follow-up study. Int J Oral Surg 8: 89–94, 1979

Grammer FC, Meyer MW, Richter KJ: A radioisotope study of the vascular response to sagittal split osteotomyof the mandibular ramus. J Oral Surg 32: 578–582, 1974

Park CM, Choi KY, Heo SJ, Kim JS. Unilateral otitis media with effusion caused by retained surgical gauze as an unintended iatrogenic complication of orthognathic surgery: case report. Br J Oral Maxillofac Surg 2014;52:e39-40.

Tomasetti BJ, Broutsas M, Gormley M, Jarrett W. Lack of tearing after Le Fort I osteotomy. J Oral Surg 1976;34:1095-7.

Lanigan DT, Romanchuk K, Olson CK. Ophthalmic complications associated with orthognathic surgery. J Oral Maxillofac Surg 1993;51:480-94.

Carroll W J et al : the effect of the lefort 1 osteotomy on the periodontium. J Oral and maxillofac surgery 1992;50 :128 – 32

BuckleyMJ, Tulloch JF, White Jr. RP, Tucker MR: Complications of orthognathic surgery: a comparison between wire fifixation and rigid internal fifixation. Int J Adult Orthodon Orthognath Surg 4: 69–74, 1989

V. Panwar, D. Kumar Sharma, K.V. Pradeep Kumar et al., Experimental investigations and optimization of surface roughness in turning of en 36 alloy steel using response surface methodology and genetic algorithm, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.03.642

M. Kaosar Ahamed, A. Babu, S. Babu et al., Layout map in facility layout planning: A fuzzy methodology, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.06.091

S. T. Jagtap, K. Phasinam, T. Kassanuk et al., Towards application of various machine learning techniques in agriculture, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.06.236

C.M. Thakar, S.S. Parkhe, A. Jain et al., 3d Printing: Basic principles and applications,Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.06.272

S.P. Deshmukh, R. Shrivastava and C.M. Thakar, Machining of composite materials through advance machining process, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.10.495

G. Saravanan, S.S. Parkhe, C.M. Thakar et al., Implementation of IoT in production and manufacturing: An Industry 4.0 approach, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.11.604

E. Ramirez-Asis, J. Vilchez-Carcamo, C.M. Thakar et al., A review on role of artificial intelligence in food processing and manufacturing industry, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.11.616

P.P. Shinde, V.P. Desai, S.V. Katkar et al., Big data analytics for mask prominence in COVID pandemic, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.11.620

V. Kumar, H. Pallathadka, S. Kumar Sharma et al., Role of machine learning in green supply chain management and operations management, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.11.625

C.D. Pawar, S.P. Deshmukh and C.M. Thakar, Design and development of miniature vibration shaker, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2021.12.410

S.V. Warake, S.P. Deshmukh, C.M. Thakar et al., Design and development of XY scanning stage for cutting operation in additive manufacturing system, Materials Today: Proceedings, https://doi.org/10.1016/j.matpr.2022.02.043

Khongdet Phasinam, Thanwamas Kassanuk, Priyanka P. Shinde, Chetan M. Thakar, Dilip Kumar Sharma, Md. Khaja Mohiddin, Abdul Wahab Rahmani, "Application of IoT and Cloud Computing in Automation of Agriculture Irrigation", Journal of Food Quality, vol. 2022, Article ID 8285969, 8 pages, 2022. https://doi.org/10.1155/2022/8285969

S. T. Jagtap, C. M. Thakar, O. El imrani, K. Phasinam, S. Garg and R. J. M. Ventayen, "A Framework for Secure Healthcare System Using Blockchain and Smart Contracts," 2021 Second International Conference on Electronics and Sustainable Communication Systems (ICESC), 2021, pp. 922-926, doi: 10.1109/ICESC51422.2021.9532644.

Ishiguro K, Kobayashi T, Kitamura N, Saito C. Relationship between severity of sleep-disordered breathing and craniofacial morphology in Japanese male patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:343-9.

Hasebe D, Kobayashi T, Hasegawa M, Iwamoto T, Kato K, Izumi N, et al. Changes in oropharyngeal airway and respiratory function during sleep after orthognathic surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 2011;40:584-92.

Gu G, Gu G, Nagata J, Suto M, Anraku Y, Nakamura K, et al. Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal Class III. Clin Orthod Res 2000;3:67-77.

Kim S, Kim SY, Kim GJ, Jung HD, Jung YS. Partial necrosis of the mandibular proximal segment following transoral vertical ramus osteotomy. Maxillofac Plast Reconstr Surg 2014;36:131-4.

Hwang JM, Min BM, Park SC, Oh SY, Sung NK. A randomized comparison of prism adaptation and augmented surgery in the surgical management of esotropia associated with hypermetropia: one-year surgical outcomes. J AAPOS 2001;5:31-4.

Williams B, Indresano AT, O'Ryan F. Venous thromboembolism in oral and maxillofacial surgery: a review of the literature. J Oral Maxillofac Surg 2011;69:840-4.

Forouzanfar T, Heymans MW, van Schuilenburg A, Zweegman S, Schulten EA. Incidence of venous thromboembolism in oral and maxillofacial surgery: a retrospective analysis. Int J Oral Maxillofac Surg 2010;39:256-9.

Pappa H, Richardson D, Niven S. False aneurysm of the facial artery as complication of sagittal split osteotomy. J Craniomaxillofac Surg 2008;36:180-2.

Dediol E. Pseudoaneurysm of the facial artery as a complication of the sagittal split osteotomy. Oral Surg Oral Med Oral PatholOral Radiol Endod 2010;110:683; author reply 683-4.

Madani M, Veznedaroglu E, Pazoki A, Danesh J, Matson SL. Pseudoaneurysm of the facial artery as a late complication of bilateral sagittal split osteotomy and facial trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:579-84.

Beshkar M, Hasheminasab M, Mohammadi F. Benign paroxysmal positional vertigo as a complication of orthognathic surgery. J Craniomaxillofac Surg 2013;41:59-61.

ollin, S.A., Hayashi, H., and Gross, S.W. Intracranial abscesses of odontogenic origin. Oral Surg. Oral Med. Oral pathol. 23; 277, 1967

Baddaour, H.M ,Dust. N.L. and tilson, H.B. Frontal lobe abscesses Of odontogenic origin. Oral Surg. Oral Med. Oral pathol. 47; 303, 1979

Yen, P. T., Chan, S.T and Hung, t s brain abscess; with special references to Otolaryngologic soureces of infection. Otolaryngol. Head and neck surg.113; 15 , 1995

Chepla KJ, Totonchi A, Hsu DP, Gosain AK. Maxillary artery pseudoaneurysm after Le Fort I osteotomy: treatment using transcatheter arterial embolization. J Craniofac Surg 2010;21: 1079–81

Zachariades N, Rallis G, Papademetriou G, Papakosta V, Spanomichos G, Souelem M. Embolization for the treatment of pseudoaneurysm and transection of facial vessels. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92: 491–4

Roe PG. The upper airway and post-operative hypoxaemia. In: Jones JG, editor. Hanning CD. Bailliere’s clinical anaesthesiology. London: WB Saunders; 1995. p. 337–57.

Aziz SR, Agnihotri N, Ziccardi VB. Lobar collapse immediately after orthognathic surgery. J Oral Maxillofac Surg 2010 Sep;68(9):2335–8.

Kim MJ, Park I, Park JM, et al. Systematic review and meta-analysis of initial management of pneumothorax in adults: intercostal tube drainage versus other invasive methods. PloS One 2017 Jun 22;12(6):e0178802.

Published

01-04-2022

How to Cite

Mevawala, A. M., Pagare, V. B., Ramanojam, S., Khandelwal, S., Singh, A., & Mittal, A. (2022). Complications in orthognathic surgery: An expeditious appraisal. International Journal of Health Sciences, 6(S3), 659–670. https://doi.org/10.53730/ijhs.v6nS3.5409

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Peer Review Articles