Jaeger Filipe, Chiavaioli Gustavo Marques, de Toledo Guilherme Lacerda, Freire-Maia Belini, Amaral Marcio Bruno Figueiredo, Mesquita Ricardo Alves
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Lasers Med Sci. 2018 Jan;33(1):51-56. doi: 10.1007/s10103-017-2333-4. Epub 2017 Sep 26.
The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.
正颌外科手术中的切口传统上是用传统手术刀或电灼术进行的。考虑到与传统切口技术相比，高功率二极管激光手术可能具有优势，本研究旨在展示一组接受环前庭切口进行Le Fort I型截骨术患者的前瞻性病例系列。10例接受快速上颌扩弓辅助或双颌正颌手术的牙颌面畸形患者纳入本研究。所有切口均由一名外科医生使用808纳米二极管激光进行，光纤为600μm，功率为2.5W，采用连续波模式。通过切口速度、出血、水肿、继发感染、临床愈合和疼痛来评估切口的性能。切口速度范围为0.10至0.20mm/s（平均0.13±0.03mm/s）。考虑到软组织切口时的出血情况，所有手术均归类为无出血。所有患者手术伤口的临床愈合时间为3至5周，随访期间均出现肿胀。平均而言，术后第三周后约50%的肿胀消退，术后2个月后仍有28.8%的肿胀。疼痛在术后2天和3天后减轻，90.0%的患者在术后7天报告无疼痛。在正颌手术中，高功率二极管激光在环前庭切口进行Le Fort I型截骨术时有效且安全，可减少正颌手术后的出血、手术时间、疼痛和水肿。
