Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Comparison of postoperative paresthesia after sagittal split osteotomy among different fixation methods: a one year follow-up study

  • Tabrizi, Reza (Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences) ;
  • Bakrani, Kousha (Oral and Maxillofacial Surgery Department, School of Dentistry, Shiraz University of Medical Sciences) ;
  • Bastami, Farshid (Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences)
  • Received : 2019.01.15
  • Accepted : 2019.05.12
  • Published : 2019.08.31
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Abstract

Objectives: Postoperative paresthesia is a common complication after sagittal split osteotomy (SSO). This study aimed to compare paresthesia among different fixation methods one year postoperative. Materials and Methods: This prospective cohort study assessed subjects in four groups: class II with miniplate fixation (Group 1), class II with three-screw fixation (Group 2), class III with miniplate fixation (Group 3), and class III with three-screw fixation (Group 4). Paresthesia was evaluated one year postoperative based on a 0-10 visual analogue scale. Pearson correlation was used to evaluate associations of age and mandibular movement with paresthesia. ANOVA was used to compare paresthesia among groups. Results: A total of 80 subjects were enrolled, with 20 subjects in each of the four groups. The Pearson correlation test demonstrated a significant correlation between mandibular movement and paresthesia (P=0.001). Comparison of paresthesia among the groups showed significant differences among groups 1 and 2, 2 and 3, and 3 and 4 (P<0.05). Conclusion: The three-screw fixation method led to more paresthesia one year postoperative compared with miniplate fixation. In addition, the magnitude of mandibular movement had a positive correlation with paresthesia.

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References

  1. Kim SG, Park SS. Incidence of complications and problems related to orthognathic surgery. J Oral Maxillofac Surg 2007;65:2438-44. https://doi.org/10.1016/j.joms.2007.05.030
  2. Al-Bishri A, Barghash Z, Rosenquist J, Sunzel B. Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patients' records. Int J Oral Maxillofac Surg 2005;34:247-51. https://doi.org/10.1016/j.ijom.2004.06.009
  3. Bruckmoser E, Bulla M, Alacamlioglu Y, Steiner I, Watzke IM. Factors influencing neurosensory disturbance after bilateral sagittal split osteotomy: retrospective analysis after 6 and 12 months. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:473-82. https://doi.org/10.1016/j.oooo.2012.08.454
  4. Kuroyanagi N, Miyachi H, Ochiai S, Kamiya N, Kanazawa T, Nagao T, et al. Prediction of neurosensory alterations after sagittal split ramus osteotomy. Int J Oral Maxillofac Surg 2013;42:814-22. https://doi.org/10.1016/j.ijom.2012.11.016
  5. Strauss ER, Ziccardi VB, Janal MN. Outcome assessment of inferior alveolar nerve microsurgery: a retrospective review. J Oral Maxillofac Surg 2006;64:1767-70. https://doi.org/10.1016/j.joms.2005.11.111
  6. Politis C, Sun Y, Lambrichts I, Agbaje JO. Self-reported hypoesthesia of the lower lip after sagittal split osteotomy. Int J Oral Maxillofac Surg 2013;42:823-9. https://doi.org/10.1016/j.ijom.2013.03.020
  7. Westermark A, Bystedt H, von Konow L. Inferior alveolar nerve function after mandibular osteotomies. Br J Oral Maxillofac Surg 1998;36:425-8. https://doi.org/10.1016/S0266-4356(98)90457-0
  8. Phillips C, Essick G. Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues. J Oral Rehabil 2011;38:547-54. https://doi.org/10.1111/j.1365-2842.2010.02176.x
  9. Antonarakis GS, Christou P. Quantitative evaluation of neurosensory disturbance after bilateral sagittal split osteotomy using Semmes-Weinstein monofilaments: a systematic review. J Oral Maxillofac Surg 2012;70:2752-60. https://doi.org/10.1016/j.joms.2012.08.002
  10. Poort LJ, van Neck JW, van der Wal KG. Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies. J Oral Maxillofac Surg 2009;67:292-300. https://doi.org/10.1016/j.joms.2008.06.076
  11. Teerijoki-Oksa T, Jaaskelainen S, Forssell K, Virtanen A, Forssell H. An evaluation of clinical and electrophysiologic tests in nerve injury diagnosis after mandibular sagittal split osteotomy. Int J Oral Maxillofac Surg 2003;32:15-23. https://doi.org/10.1054/ijom.2002.0325
  12. Jacks SC, Zuniga JR, Turvey TA, Schalit C. A retrospective analysis of lingual nerve sensory changes after mandibular bilateral sagittal split osteotomy. J Oral Maxillofac Surg 1998;56:700-4;discussion 705. https://doi.org/10.1016/S0278-2391(98)90799-6
  13. Roychoudhury S, Nagori SA, Roychoudhury A. Neurosensory disturbance after bilateral sagittal split osteotomy: a retrospective study. J Oral Biol Craniofac Res 2015;5:65-8. https://doi.org/10.1016/j.jobcr.2015.04.006
  14. Essick GK, Phillips C, Kim SH, Zuniga J. Sensory retraining following orthognathic surgery: effect on threshold measures of sensory function. J Oral Rehabil 2009;36:415-26. https://doi.org/10.1111/j.1365-2842.2009.01954.x
  15. Phillips C, Kim SH, Essick G, Tucker M, Turvey TA. Sensory retraining after orthognathic surgery: effect on patient report of altered sensations. Am J Orthod Dentofacial Orthop 2009;136:788-94. https://doi.org/10.1016/j.ajodo.2008.07.015
  16. Seo K, Tanaka Y, Terumitsu M, Someya G. Efficacy of steroid treatment for sensory impairment after orthognathic surgery. J Oral Maxillofac Surg 2004;62:1193-7. https://doi.org/10.1016/j.joms.2004.06.033
  17. Epker BN. Modifications in the sagittal osteotomy of the mandible. J Oral Surg 1977;35:157-9.
  18. Hu J, Zhao Q, Tang J, Zheng Z, Qi MC. Changes in the inferior alveolar nerve following sagittal split ramus osteotomy in monkeys: a comparison of monocortical and bicortical fixation. Br J Oral Maxillofac Surg 2007;45:265-71. https://doi.org/10.1016/j.bjoms.2006.08.008
  19. Rajchel J, Ellis E 3rd, Fonseca RJ. The anatomical location of the mandibular canal: its relationship to the sagittal ramus osteotomy. Int J Adult Orthodon Orthognath Surg 1986;1:37-47.
  20. Yamamoto R, Nakamura A, Ohno K, Michi KI. Relationship of the mandibular canal to the lateral cortex of the mandibular ramus as a factor in the development of neurosensory disturbance after bilateral sagittal split osteotomy. J Oral Maxillofac Surg 2002;60:490-5. https://doi.org/10.1053/joms.2002.31843
  21. Yamauchi K, Takahashi T, Kaneuji T, Nogami S, Yamamoto N, Miyamoto I, et al. Risk factors for neurosensory disturbance after bilateral sagittal split osteotomy based on position of mandibular canal and morphology of mandibular angle. J Oral Maxillofac Surg 2012;70:401-6. https://doi.org/10.1016/j.joms.2011.01.040
  22. Ylikontiola L, Kinnunen J, Oikarinen K. Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy. J Oral Maxillofac Surg 2000;58:1234-9; discussion 1239-40. https://doi.org/10.1053/joms.2000.16621
  23. Akal UK, Sayan NB, Aydogan S, Yaman Z. Evaluation of the neurosensory deficiencies of oral and maxillofacial region following surgery. Int J Oral Maxillofac Surg 2000;29:331-6. https://doi.org/10.1016/S0901-5027(00)80046-6