BACKGROUND: There is a scarcity in the published literature which evaluates the postoperative inflammatory response and patients’ immunity following orthognathic surgery. AIM: The present prospective study aimed to evaluate the changes in two immunological callipers to measure the traumatic effect of orthognathic surgery METHODS: In the present prospective cohort study, we included women (age range 16-30 years) with severe dentofacial deformities who were scheduled for bimaxillary osteotomy. Blood samples were collected for measurement of transforming growth factor beta one (TGF-β1) and osteoprotegrin (OPG) levels. The statistical analysis was carried with SPSS software. RESULTS: In the present study, nine patients with severe dentofacial deformity were operated successfully under general anaesthesia. All patients reported decreased energy and fatigue in the early days after surgery and had difficulties with nutrition due to pain, oedema and paresthesia; however, no massive weight loss was reported. The levels of OPG started to increase immediately postoperatively (mean = 0.46 ± 0.08; p = 0.001). A significant increase in the concentration of OPG begun postoperatively and continued to rise significantly until the six weeks to reach 2.24 ± 0.30 ng/mL (p < 0.001). Similarly, the concentration of TGF-β1 increased at three days postoperatively and continued to rise until the six weeks to reach 1.28 ± 0.19 ng/mL (p <0 .001). CONCLUSION: In conclusion, orthognathic surgery is associated with a significant rise in the pro-inflammatory cytokines until the six weeks postoperatively. These observed results may indicate a significant alteration in the immunity of the patients to undergoing orthognathic surgery.

Temporomandibular joint bony ankylosis, Gap arthroplasty,major blood vessels related to ankylosis.Background:-Gap arthroplasty is a one of the techniques used to release TMJ bony ankylosis with reported many advantages and disadvantages. The aim of this study was to present and evaluate newsemi-sagittal split osteotomy of ankylosing bony massto release temporomandibular joint bonyankylosis. It was intended to minimize the disadvantage of gap arthroplasty. Patient and methods:-Twelve patients suffering from TMJ bony ankylosis were included in the present study. New semi-sagittal split osteotomy of ankylosing bony mass was implemented. This cut was extended from the most superior point of ankylosing bone mass laterally and directed downward and medially towards the most inferior point of the most constricted part just above the mandibular foramen.Pterygomasseteric sling release was performed.Six quantitative and qualitative calipers were used to assess the technique. Results:-Postoperative interincisal opening was increased significantly and the lower jaw displaced downward without shortening of the mandibular ramus.Only one case out of twelve (8.3%) represented postoperative anterior open bite. Conclusion:-Semi-sagittal split osteotomy of ankylosing bony mass was recommended to preserve the major vital structures at the base of the skull in long standing and recurrent temporomandibular joint bony ankylosis especially with bulbous bony mass.