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Purpose: To evaluate a method to identify condylar sag intraoperatively by clinical examination after bilateral sagittal split osteotomy (BSSO). Methods: We. Condylar sag is an immediate or late alteration in the position of the condylar process in the glenoid fossa after the fixation of the osteotomy. Peripheral condylar sag (type II) had developed in three of these patients. In 15 patients central sag was diagnosed. One-week postoperatively, three patients.

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Incidence of maxillary sinusitis following Le Fort I osteotomy: Plate condylarr of extra-oral subcondylar ramus osteotomy for correction of mandibular prognathism: Table 1 Primary and secondary keywords used for the systematic review.

The Cochrane Collaboration Tool for the assessment of risk of bias was used to conduct this assessment. Nasal considerations in orthognathic surgery. The commonly accepted method of pathogenesis is the scarring or compromise of musculature that opens the auditory tube and ventilates the middle ear [ 28 ].

Conservative treatment consists of controlling blood pressure and administering intravenous fluids and blood transfusion. The most important muscle seems to be the tensor veli palatine muscle, which actively opens and closes the Eustachian tube [ 28 ]. Click on image for details. Bad split can be provoked by the following: Condylar sag can be defined as an immediate or late change in position of the condyle in the glenoid fossa after the surgical establishment of preplanned occlusion and rigid fixation of the bone fragments, leading to changes in the occlusion [ 1011 ].

The infraorbital nerve ION is another cranial nerve that may be exposed to injury during orthognathic surgery procedures.

The included articles contained five randomized controlled trials Incidence of complications and problems related to orthognathic surgery. Report of two cases. Plate removal following orthognathic surgery.


In this study, smoking patients with third molars and diabetics showed a higher incidence of DOH. Results Most of the references searched in the databases constituted case reports, case series, reviews, or comparative studies Online Resource 2 26K, docx Risk of bias assessment graph: The rate of reported complications has gradually increased with time, from only one study in to 14 studies inas orthognathic surgery has become more widely accepted, and is now a frequently performed surgical method for correcting maxillomandibular dysmorphoses.

The funders had no role in study design, data collection and analysis, decision to publish, or the preparation of the study. Risk factors affecting somatosensory function after sagittal split osteotomy.

Clin Otolaryngol Allied Sci. A rare complication after Le Fort I osteotomy. Hippocrate, Brussels, Belgium Find articles by R.

These results demonstrated that only 3 out of 44 assessed studies [ 273041 ] met all of the requirements of our critical appraisal. An explanation of this result could be the h evaluation period and the administration of several 2—5 doses of intravenous antibiotics for such patients [ 20 ].

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All causes for unfavorable outcomes may be classified as belonging to one of the following periods A Pre- Treatment B During treatment Pre-Treatment: Considerations for orthognathic surgery during growth, part 1: Received Jun 22; Accepted Mar This review was registered on http: The use of suitable corrective measures during the primary operation can substantially reduce the postoperative complication rate of condylar sag.

The risk of arterial bleeding from the posterior maxilla usually arises from the descending palatine artery or less frequently from the maxillary artery and its branches. J Craniofac Surg ; Report of 36 cases. Methods that help to cope with these challenges include the following: Human gingival and pulpal blood flow during healing after Le Fort I osteotomy. A prospective electromyographic and computer-aided thermal sensitivity assessment of nerve lesions after sagittal split osteotomy and Le Fort I osteotomy.


Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy.

This SR exhibits some limitations. Sinusitis aetiologies were reported to be related to the mechanical obstruction of drainage of the osteomeatal complex region. Changes in temporomandibular joint dysfunction after orthognathic surgery. Consensus on the influence of orthognathic surgery on TMJ dysfunction has also not yet been achieved clndylar 33 ]. Pulpal response to orthognathic surgery: Nerves predisposed to injury Click here to view.

Psychological factors in orthognathic surgery.

Intraoperative diagnosis of condylar sag after bilateral sagittal split ramus osteotomy.

The hierarchy of evidence classification from the UK NHS Centre for Reviews and Dissemination was used to assess the level of evidence for the retrieved studies. Inclusion criteria Exclusion criteria -methodogical design: Progressive condylar resorption after mandibular advancement.

Comparison According to 3 Types of Fixation. In 15 patients central sag was asg. Wolford LM, Galiano A. Surgical Correction of Dentofacial Deformities: We were not able to compare the number of described underestimated complications with the total number of osteotomies ever performed in the world to relativize the problem of complications in orthognathic surgery.

Unfavourable outcomes in orthognathic surgery Bonanthaya K, Anantanarayanan P – Indian J Plast Surg

In contrast to the incidence of the manageable hemorrhage, the life-threatening postoperative hemorrhage after Le Fort osteotomy is rare and varies between an incidence of 0 and 0.

The aim of ccondylar study was to answer to the clinical question asking what are the complications associated with orthognathic surgery. The second search using Embase Library was performed and updated on Blindness as a complication of Le Fort osteotomies: