Three-Dimensional Evaluation of Upper Airway Changes After Bimaxillary Surgery of Skeletal Class 3 Patients.

The aim of this study was to evaluate the 3-dimensional changes in upper airway space of class 3 patients after surgery with sleep-related breathing disturbance. This is a retrospective cohort study included 25 patients who had undergone bimaxillary orthognathic surgery with maxillary advancement and mandibular setback for skeletal class 3 deformity. The changes in minimum axial area, nasopharyngeal and oropharyngeal airway volume were determined by cone-beam computed tomography images, as well as the sleep parameters by polysomnography preoperatively and postoperatively. The impacts of mandibular setback and maxillary advancement amounts on the airway structures were evaluated and compared with other parameters. The results show that pharyngeal volume measurement means were found to be significantly increased postoperatively ( P <0.05). No significant difference was observed in the mean values of minimum axial area and sleep parameters after the operation ( P> 0.05). A positive relationship was determined between the oropharyngeal volume and minimum axial area changes at a rate of 60% ( r : 0.600). No relationship was revealed between airway volume changes and polysomnographic parameters. An increase in the total airway volume and no postoperative sleep-related disturbance symptoms were observed in the patients treated by maxillary advancement and mandibular setback surgery.

Complications Associated With Anterior Iliac Bone Grafting for the Reconstruction of Dentoalveolar Defects.

The aim of this study is to evaluate donor- and recipient-site complications of iliac bone grafting for the reconstruction of atrophic jaws.Our study includes 86 consecutive patients with atrophic jaws who underwent iliac bone grafting surgery. At the donor site, hematoma, infection, paresthesia, chronic pain, prolonged gait disturbance, fracture of the ilium, and esthetic concerns; at the recipient site, hematoma, infection, prolonged pain, graft exposure, graft loss, and loss of the implants were evaluated.Grafting was successfully performed in all patients. The mean follow-up period was 35 months. Prolonged gait disturbance (20.9%) and paresthesia (9.3%) were the most frequently observed donor-site complications. At the recipient site, hematoma (8.1%), infection (12.8%), prolonged pain (11.6%), partial graft exposure (33.7%), total graft exposure (7%), partial graft loss (17.4%), and total graft loss (5.8%) were observed.Reconstruction of atrophic jaws can be achieved successfully with iliac bone grafting. However, there are possible donor- and recipient-site complications that have to be taken into consideration.