Comparative study of stability between two different fixation systems after orthognathic surgery in mandibular prognathism skeleton.

OBJECTIVE: This study is intended to compare the skeleton stability of bioabsorbable and titanium systems after orthognathic surgery in mandibular prognathism patients. STUDY DESIGN: A Retrospective study of 28 mandibular prognathism patients who underwent BSSRO setback surgery at Chulalongkorn University. Both titanium and the bioabsorbable group would take lateral cephalometrics immediately postoperative in 1-week(T0), 3(T1), 6(T2), and 12(T3) months. These radiographs were analyzed with Dolphin imaging programTM. The vertical, horizontal, and angular indices were measured. To compare immediately postoperative and follow-up periods within the group, the Friedman difference was used, and the Man-Whitney U test was used between the two groups. RESULT: The measurements within the group presented no statistically significant differences. But this study showed that at T0-T1, there was a statistically significant difference between the two groups in the mean of Me in horizontal linear measurement. T0-T2 found differences between Me in both horizontal and vertical linear measurements, and the difference between ANB. The differences between B-point, Pog, and Me in vertical linear measurements at T0-T3 were also reported. CONCLUSION: The significant difference values were within the normal range which indicated that using the bioabsorbable system could be well maintained as well as the titanium system. STATEMENT OF CLINICAL RELEVANCE: The second operation for removing titanium plate and screw after conventional orthognathic surgery may leads patient discomforts. While a resorbable system might be the role change if the stability is place on the same level.

Complications related to orthognathic surgery: A 10-year experience in oral and maxillofacial training center.

This article aimed to review adverse events and complications to orthognathic surgery based upon 10 years. This study was a retrospective investigation between 2009 and 2018. Independent variables such as sex, age, pre-operative conditions, diagnosis, type of surgery, bleeding volume, surgery duration, and hospitalization were recorded. The data regarding orthognathic surgery adverse events and complications were evaluated and statistically analyzed with a significance level of p < 0.05. A total of 891 patients were included in this study (male 39.1%, female 60.9%) with a mean age of 26.4 ± 6.09 years. A neurosensory disturbance was found as immediate post-operative sequelae as 93.5%. The four most frequent complications had a relapse (6.4%), post-operative TMD (5.7%), unfavorable osteotomy (5.5%), and infection (4.9%), which seem to be more common in males. An average blood loss was 497 ± 371 ml and the average operative time was 401 ± 109.3 min. Complication rates were statistically affected by bleeding volume (p-value = 0.01), operative time (p-value = 0.03), and type of skeletal deformity (p-value = 0.01). Although numerous complications were recorded, no fatal complications were experienced. Bleeding time, operative time, and skeletal classification have significant influence on orthognathic surgery complications. However, a multitude of factors could be modified to reduce the complication rate and improve the result of the treatment. One of the most significant factors was the operative time.

Comparison of the accuracy of implant position for two-implants supported fixed dental prosthesis using static and dynamic computer-assisted implant surgery: A randomized controlled clinical trial.

BACKGROUND: Computer-assisted implant surgery (CAIS) can facilitate accuracy of single implant placement, but little is known with regards to parallelism between multiple implants. PURPOSE: To compare the accuracy of position and parallelism of two implants, using static and dynamic CAIS systems. MATERIALS AND METHODS: Thirty patients received two implants (60 implants) randomly allocated to two different CAIS systems. Optimal implant position and absolute parallelism was planned based on preoperative cone beam CT (CBCT). Patients received implants with a surgical guide (static CAIS, n = 30) or real-time navigation (dynamic CAIS, n = 30). Implant three-dimensional deviation and parallelism was calculated after surgery. RESULTS: The mean 3D deviation in the static and dynamic CAIS group at implant platform were 1.04 ± 0.67 vs 1.24 ± 0.39 mm, at apex were 1.54 ± 0.79 vs 1.58 ± 0.56 mm and angulation were 4.08° ± 1.69° vs 3.78° ± 1.84°, respectively. The angle deviations between two placed implants (parallelism) in static and dynamic CAIS groups were 4.32° ± 2.44° and 3.55° ± 2.29°, respectively. There were no statistically significant differences in all parameters between groups. CONCLUSION: Static and dynamic CAIS provides similar accuracy of the 3D implant position and parallelism between two implants.