COMPLICATIONS ASSOCIATED WITH ORTHOGNATHIC SURGERY: A RETROSPECTIVE INSTITUTIONAL STUDY

Abstract

Orthognathic Surgery is performed in people affected by congenital or growth related or post traumatic craniofacial deformities who expect improvement in facial aesthetics and/or function. Restoration of deformities using surgical techniques carry an inadvertent risk of encountering complications ranging from physical to psychological shortcomings. The aim of this study was to identify and quantify the complications of orthognathic surgery based on the Clavien-Dindo Classification, among patients who underwent orthognathic surgical procedures in Saveetha Dental College and hospital. This hospital-based retrospective study was conducted at Saveetha Dental College, Department of Oral and Maxillofacial Surgery, Chennai, Tamil Nadu, from July 2019 to March 2020. Consecutive case records of all patients who underwent orthognathic surgical procedures were included in the study. Patients' data was retrieved from the hospital digital data registry and the demographic details of the patients, type of orthognathic surgical procedure, and the postoperative complications were recorded. The Clavien-Dindo Classification which consisted of five grades was used to grade the postoperative complications. Statistical analysis was performed using the SPSS software (version 19.0; SPSS, Chicago, IL, USA). Descriptive statistics was done and chi-square tests were used to compare the categorical variables. Probabilities of P < 0.05 were considered statistically significant. In our study 20 patients were included. 7 patients underwent bi-jaw surgery and the remaining 13 underwent correction in a single jaw. Females underwent more orthognathic surgeries than males. The most frequent orthognathic procedures performed was Anterior maxillary osteotomy in maxilla followed by Bilateral sagittal split ramus osteotomy in mandible. In our study there was no statistically significant association observed between the type of orthognathic surgery performed and the postoperative complications observed. (p value - 0.209). 95% of the patients had Grade I complication of Clavien-Dindo Classification during their postoperative period and one patient had Grade II complication which was managed uneventfully by blood transfusion. Within the limits of this study, nerve injury was noted in higher frequencies in mandibular procedures. Although lip injuries, tooth injury, gingival recession and infection due to fixation material have also been reported, considering the severity, all of them were categorised as minor complications. 95% of the postoperative complications were Grade I of Clavien- Dindo Classification. Though a higher rate of complication was observed in this study, they were only minor complications. It is imperative to have a good knowledge of complications associated with orthognathic surgery for refining the surgical procedures and to prevent the occurrence of such untoward sequelae in the future.Copyright © 2020 Wolters Kluwer Medknow Publications. All rights reserved.