scholarly journals Analysis of the Complications in Patients Undergoing Orthognathic Surgery by Piezosurgery®: A 13 Years Retrospective Study

2021 ◽  
Vol 11 (9) ◽  
pp. 4271
Author(s):  
Dario Bertossi ◽  
Massimo Albanese ◽  
Dario Donadello ◽  
Luca Calogero Carletta ◽  
Riccardo Nocini ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Orthognathic Surgery ◽  
Surgical Techniques ◽  
Clinical Work ◽  
Gingival Recession ◽  
Bilateral Pneumothorax ◽  
Masticatory Efficiency ◽  
Maxillary Surgery ◽  
Bimaxillary Surgery

Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery®. Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported. A retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and genioplasty technique using Piezosurgery®. The complications taken into consideration were disorders of the temporomandibular joint (TMJ), paraesthesia and hypoesthesia, asymmetries, nose enlargement, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency, gingival recession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatricial outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature reviews. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods.

scholarly journals Orthognathic Surgery for the Maxilla-LeFort I and Anterior Maxillary Osteotomy

2021 ◽  
pp. 1513-1548
Author(s):  
Ashok Dabir ◽  
Jayesh Vahanwala
Keyword(s):  
Orthognathic Surgery ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Three Dimensions ◽  
Maxillary Osteotomy ◽  
Wisdom Teeth ◽  
Tissue Changes ◽  
General Guide ◽  
Bimaxillary Surgery ◽  
Soft Tissue Changes

AbstractThe chapter reviews the history and technique of maxillary orthognathic surgical procedures and highlights the sequence of bimaxillary surgery. A maxillary surgical procedure and its modification can be employed to correct skeletal deformities of the maxilla. With presently available surgical techniques, the maxilla may be independently repositioned in three dimensions. Segmentalization of the maxilla in turn allows repositioning different portions in different three dimensional planes, when done under direct vision. The changes in the position of the maxilla also causes soft tissue changes of the lips, cheeks, and nose. Changes in the nasal complex after orthognathic surgery, with the exception of nasal width, are complicated, and cannot be predicted. Having listed a general guide, the authors reiterate that no dogma should be given regarding the sequence of maxillary or mandibular surgery. Any surgical decision must be made after in-depth planning, preparation, and flexibility. If this is done, sequencing will follow logically.The chapter also includes key considerations in orthognathic surgery viz., adjustment to the base of the Nose and ANS; effect of changing the inclination (slope) of the osteotomy cut; impacted / erupted wisdom teeth; preoperative/intraoperative difficulties and proper positioning. An in-depth account of nutritional support and dealing with complications rounds off the discussion.

scholarly journals Effects of different surgical techniques and displacement distances on the soft tissue profile via orthodontic-orthognathic treatment of class II and class III malocclusions

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Stephan Christian Möhlhenrich ◽  
Florian Kötter ◽  
Florian Peters ◽  
Kristian Kniha ◽  
Sachin Chhatwani ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Surgical Techniques ◽  
Class Ii ◽  
Class Iii ◽  
Lower Lip ◽  
Facial Profile ◽  
Maxillary Advancement ◽  
Soft Tissue Profile ◽  
Bimaxillary Surgery

Abstract Background Orthognathic surgery can be carried out using isolated mandibular or maxillary movement and bimaxillary procedures. In cases of moderate skeletal malocclusion, camouflage treatment by premolar extraction is another treatment option. All these surgical procedures can have a different impact on the soft tissue profile. Methods The changes in the soft tissue profile of 187 patients (Class II: 53, Class III: 134) were investigated. The treatment approaches were differentiated as follows: Class II: mandible advancement (MnA), bimaxillary surgery (MxS/MnA), upper extraction (UpEX), or Class III: maxillary advancement (MxA), mandible setback (MnS), bimaxillary surgery (MxA/MnS), and lower extraction (LowEX) as well as the extent of skeletal deviation (moderate Wits appraisal: − 7 mm to 7 mm, pronounced: Wits <− 7 mm, > 7 mm, respectively). This resulted in five groups for Class II treatment and seven groups for Class III treatment. Results In the Class II patients, a statistically significant difference (p ≤ 0.05) between UpEX and moderate MnA was found for facial profile (N′-Prn-Pog’), soft tissue profile (N′-Sn-Pog’), and mentolabial angle (Pog’-B′-Li). In the Class III patients, a statistically significant differences (p ≤ 0.05) occurred between LowEX and moderate MxA for facial profile (N′-Prn-Pog’), soft tissue profile (N′-Sn-Pog’), upper and lower lip distacne to esthetic line (Ls/Li-E-line), and lower lip length (Sto-Gn’). Only isolated significant differences (p < 0.05) were recognized between the moderate surgical Class II and III treatments as well between the pronounced Class III surgeries. No statistical differences were noticed between moderate and pronounced orthognathic surgery. Conclusions When surgery is required, the influence of orthognathic surgical techniques on the profile seems to be less significant. However, it must be carefully considered if orthognathic or camouflage treatment should be done in moderate malocclusions as a moderate mandibular advancement in Class II therapy will straighten the soft tissue profile much more by increasing the facial and soft tissue profile angle and reducing the mentolabial angle than camouflage treatment. In contrast, moderate maxillary advancement in Class III therapy led to a significantly more convex facial and soft tissue profile by decreasing distances of the lips to the E-Line as well as the lower lip length.

scholarly journals Use of PRP, PRF and CGF in Periodontal Regeneration and Facial Rejuvenation—A Narrative Review

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 317
Author(s):  
Eitan Mijiritsky ◽  
Haya Drora Assaf ◽  
Oren Peleg ◽  
Maayan Shacham ◽  
Loredana Cerroni ◽  
...  
Keyword(s):  
Growth Factors ◽  
Platelet Rich Plasma ◽  
Periodontal Regeneration ◽  
Clinical Work ◽  
Gingival Recession ◽  
Vital Role ◽  
Facial Rejuvenation ◽  
Cochrane Library ◽  
The Past ◽  
Autologous Platelet

Growth factors (GFs) play a vital role in cell proliferation, migration, differentiation and angiogenesis. Autologous platelet concentrates (APCs) which contain high levels of GFs make them especially suitable for periodontal regeneration and facial rejuvenation. The main generations of APCs presented are platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and concentrated growth factor (CGF) techniques. The purpose of this review is to provide the clinician with an overview of APCs’ evolution over the past decade in order to give reliable and useful information to be used in clinical work. This review summarizes the most interesting and novel articles published between 1997 and 2020. Electronic and manual searches were conducted in the following databases: Pubmed, Scopus, Cochrane Library and Embase. The following keywords were used: growth factors, VEGF, TGF-b1, PRP, PRF, CGF and periodontal regeneration and/or facial rejuvenation. A total of 73 articles were finally included. The review then addresses the uses of the three different techniques in the two disciplines, as well as the advantages and limitations of each technique. Overall, PRP is mainly used in cases of hard and soft tissue procedures, while PRF is used in gingival recession and the treatment of furcation and intrabony defects; CGF is mainly used in bone regeneration.

Changes of Periodontal Tissues Because of Orthodontic Treatment: A Retrospective Study

2021 ◽  
pp. 232020682110034
Author(s):  
Hamad Alzoman ◽  
Khalid Alamoud ◽  
Waad K. Alomran ◽  
Abdullazez Almudhi ◽  
Naif A. Bindayel
Keyword(s):  
Retrospective Study ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Positive Impact ◽  
Demographic Data ◽  
Gingival Recession ◽  
Confounding Factors ◽  
Crown Height ◽  
Periodontal Tissues ◽  
Before And After

Aim: To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it. Materials and Methods: The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables. Results: Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements. Conclusions: The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.

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