Piezoosteotomy in orthognathic surgery versus conventional saw and chisel osteotomy

摘要: Piezoosteotomy was assessed as alternative osteotomy method in orthognathic surgery regarding handling, time requirement, nerve and vessel impairment. In this comparative clinical experience, 90 patient’s procedures were performed typical distribution prospectively by piezoosteotomy: 34 (38%) monosegment, 47 (52%) segmented LeFortI osteotomies, 94 sagittal split 11 (12%) symphyseal, 4 (2%) mandibular body osteotomies. As controls served retrospective patients with conventional saw chisel osteotomy: 58 (64%) 27 (30%) 130 (72%) split, (4%) symphyseal Piezoosteotomies individually designed to interdigitate the jaw segments after repositioning. The pterygomaxillary suture weakened angulated tools; auxiliary chisels required 100% of cases for nasal septum lateral walls, 33% pterygoid processes. dorsal maxilla process easily reduced; 15% osteotomies sawing, while lingual manual feedback due limited visibility. Bloodloss decreased from average 537 ± 208 ml vs. 772 ± 338 ml (p = 0.0001). Operation remained unchanged: 223 ± 70 min 238 ± 60 min (p = 0.2) a bimaxillary procedure. Clinical courses reossification unobtrusive. Alveolar inferior sensitivity retained 98% piezoosteotomy collective versus 84% (p = 0.0001) at 3 months postoperative testing. Piezoelectric did not prolong operation reduced blood loss alveolar A few additional sawing or chisel. screw insertion complex may be initiated simplify procedure increase segment interdigitation repositioning minimize osteofixation dimensions.