Postoperative stability following maxillary downward movement with Le Fort I inclined osteotomy at the lateral nasal cavity wall

Yang, Hye-Won; Hwang, Soon Jung

doi:10.1016/j.jcms.2012.02.017

Cited by 12 publications

(4 citation statements)

References 12 publications

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“…26 Most studies on post-operative relapse and stability only record data until 1 year after the surgery as authors assume relapse would occur within this timeframe. 27 The present case and review of the literature aids surgeons in conceptualizing the importance of pre surgical evaluation in high risk patients undergoing elective orthognathic surgery at a longer duration of 22 months. The patient presented benefited greatly from her orthognathic surgery from a functional as well as aesthetic perspective.…”

Section: Discussionmentioning

confidence: 89%

Orthognathic Surgery in Ehlers-Danlos Syndrome: Review of the Literature and Case Report

DeLeonibus

Bogart

Gharb

et al. 2023

The Cleft Palate Craniofacial Journal

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EDS (Ehlers-Danlos Syndrome) is a heterogenous group of inheritable connective tissue disorders that commonly precludes patients from being elective surgical candidates. Patients with EDS are at a higher risk of increased bleeding, delayed wound healing, and temporomandibular joint pain refractory to treatment. Historically, patients with EDS and TMJ disorders are considered inappropriate surgical candidates due to a higher risk of delayed wound healing, increased risk for uncontrolled post-surgical bleeding, and unsubstantiated outcomes in regards to elective orthognathic surgery. A review of the literature demonstrates a paucity of data accounting the use of orthognathic surgery and maxillary-mandibular advancement in patients with EDS. The present study reports on the use of orthognathic double jaw surgery in a patient with a known diagnosis of hypermobile EDS, history of TMJ subluxation and pain. This case describes a 47-year-old woman with a history of hypermobile EDS who presented with Angle Class II malocclusion, Class II skeletal pattern, and clockwise rotation of the occlusal plane associated with pain at the bilateral TMJs. She underwent maxillary-mandibular advancement with counterclockwise rotation of the occlusal plane and genioplasty. The surgery was without complications, and at 22 months follow up, the patient healed uneventfully with improvement of pain and range of motion. This case report demonstrates that with diligent patient selection, orthognathic surgery in patients with EDS can be safe and effective and should not be an absolute contraindication.

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Section: Discussionmentioning

confidence: 89%

Orthognathic Surgery in Ehlers-Danlos Syndrome: Review of the Literature and Case Report

DeLeonibus

Bogart

Gharb

et al. 2023

The Cleft Palate Craniofacial Journal

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“…Hence, more in-depth studies with MRI-based follow-ups are needed to determine the full effect. Skeletal stability after orthognathic surgery is controversially discussed in the literature and it was shown that postsurgical relapse mainly develops within the first 6 months after surgery [33]. Late relapse on the other hand tends to develop from 6 to 12 months after surgery and is believed to occur due to individual patient characteristics, such as condylar resorption as well as type, direction and magnitude of surgical displacements [34,35].…”

Section: Discussionmentioning

confidence: 99%

Complications or rather side effects? Quantification of patient satisfaction and complications after orthognathic surgery—a retrospective, cross-sectional long-term analysis

Thiem

Schneider

Hammel³

et al. 2020

Clin Oral Invest

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Objectives The aim of this clinical analysis was to evaluate intraoperative and early postoperative complications as well as late findings and the overall patient satisfaction following orthognathic surgery. Materials and Methods In a retrospective, cross-sectional study, 119 patients after orthognathic surgery were included. Surgical approaches were single bilateral sagittal split osteotomy (BSSO (n = 52)), single LeFort-I osteotomy (n = 5) and bimaxillary osteotomy (LeFort-I + BSSO (n = 62)). Intraoperative and early (0–4 weeks postoperative) complications were investigated retrospectively (n = 119), whereas late findings and quality of life were assessed via clinical follow-up and survey (mean: 59 months postoperative) on 48 patients. Results Bad split (n = 4/114) was the most common intraoperative complication followed by one case of severe bleeding. Regarding early postoperative complications, temporary damage of the inferior alveolar nerve after BSSO was most common (n = 33/114), followed by facial nerve dysfunction (n = 3), failed osteosynthesis (n = 2) and one case of postoperative dyspnoea. Permanent hypaesthesia of the lower lip was the most prevalent (n = 28/45(BSSO and LeFort-I + BSSO)) late finding with varying extent, followed by temporomandibular dysfunction (TMD) (n = 25/48). Skeletal relapse mostly occurred after class II treatment, followed by class III, posterior crossbite and open bite. Overall, the surgery improved the patients’ self-perception (85.4%), with 60.4% of patients opting for surgery again. Conclusions Long-term complications after orthognathic surgery occurred more frequently than commonly described in the literature, and analyses of the quality of life show the need for more comprehensive preoperative patient education. Clinical relevance Hypaesthesia of the lower lip presented less as complication but rather as side effect following BSSO. As orthognathic surgery is mostly elective, preoperative patient education is of pivotal importance and should include proactive risk stratification.

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“…Studies have shown that postsurgical relapse mainly occurs in the first few months after surgery (Quejada et al, 1987;Yang et al, 2012). Existing data from other orthognathic centers show stable skeletal landmarks within 2 mm or 2° of the immediate postsurgical position in 90% of patients in the first year after orthognathic surgery (Mihalik et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Long-term skeletal and dental stability after orthognathic surgery of the maxillo-mandibular complex in Class II patients with transverse discrepancies

Brandtner

Hachleitner

Rippel

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Postoperative stability following maxillary downward movement with Le Fort I inclined osteotomy at the lateral nasal cavity wall

Cited by 12 publications

References 12 publications

Orthognathic Surgery in Ehlers-Danlos Syndrome: Review of the Literature and Case Report

Orthognathic Surgery in Ehlers-Danlos Syndrome: Review of the Literature and Case Report

Complications or rather side effects? Quantification of patient satisfaction and complications after orthognathic surgery—a retrospective, cross-sectional long-term analysis

Long-term skeletal and dental stability after orthognathic surgery of the maxillo-mandibular complex in Class II patients with transverse discrepancies

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