de Santana Santos Thiago, Albuquerque Keylla Marinho, Santos Marconi Eduardo Sousa Maciel, Laureano Filho José Rodrigues
Ribeirão Preto School of Dentistry, Universidade de São Paulo (FORP/USP), Ribeirão Preto, São Paulo, Brazil.
J Craniofac Surg. 2012 Sep;23(5):e423-30. doi: 10.1097/SCS.0b013e31825e49c1.
Orthognathic surgery is performed to correct dentofacial and craniofacial deformities and improve facial aesthetics, occlusal relations, and the functionality of the stomatognathic apparatus. However, complications in orthognathic surgery may occur at any time during the course of treatment: in the preoperative judgment and planning, during perioperative orthodontic care, or intraoperatively. The aim of the current study was to survey oral and maxillofacial surgeons regarding the main complications of orthognathic surgery.
One hundred oral and maxillofacial surgeons with at least 5 years of experience in dentofacial management were interviewed during a Brazilian national oral and maxillofacial surgery meeting by 2 calibrated postgraduate students, using a questionnaire addressing complications of orthognathic surgery.
No significant differences were found regarding educational background or postgraduate degrees among the oral and maxillofacial surgeons (P > 0.05). A total of 28.0% had no experience with vertical osteotomy of the mandibular ramus, 35.0% had no experience with subapical osteotomy of the mandible, and 4.0% had no experience with genioplasty. All participants had experience with sagittal osteotomy of the mandibular ramus. Among mandible procedures, the most common complication was nerve damage, followed by unfavorable osteotomy. The most common Le Fort I complication was also nerve damage (40%), followed by hemorrhage (29%). Regarding osteosynthesis fixation, fractures of the material were more frequent in the mandible (23%) and maxilla (10%).
Most oral and maxillofacial surgeons experienced similar orthognathic surgery complications to those reported in retrospective studies.
正颌外科手术用于矫正牙颌面及颅面畸形，改善面部美观、咬合关系以及口颌系统的功能。然而，正颌外科手术的并发症可能在治疗过程中的任何时候出现：术前判断和规划阶段、围手术期正畸治疗期间或手术过程中。本研究的目的是就正颌外科手术的主要并发症对口腔颌面外科医生进行调查。
在巴西全国口腔颌面外科会议期间，两名经过校准的研究生使用一份关于正颌外科手术并发症的问卷，对100名在牙颌面治疗方面至少有5年经验的口腔颌面外科医生进行了访谈。
口腔颌面外科医生在教育背景或研究生学位方面未发现显著差异（P>0.05）。共有28.0%的医生没有下颌升支垂直截骨术的经验，35.0%的医生没有下颌根尖下截骨术的经验，4.0%的医生没有颏成形术的经验。所有参与者都有下颌升支矢状劈开截骨术的经验。在下颌手术中，最常见的并发症是神经损伤，其次是截骨不良。Le Fort I型手术最常见的并发症也是神经损伤（40%），其次是出血（29%）。关于骨合成固定，下颌骨（23%）和上颌骨（10%）的材料骨折更为常见。
大多数口腔颌面外科医生经历的正颌外科手术并发症与回顾性研究报告的相似。
