< Back to previous page

Publication

On complications of Orthognatic Surgery

Book - Dissertation

Surgeons are fallible both in how they wield their scalpel and in the language they use. Between the patient’s expectations and satisfaction with the result lies a journey where both the patient and surgeon will participate with intensity and trust. In case of difficulties or complications, the negatives will pervade the surgeon’s practice and occupy thoughts about the cause of these outcomes and the ways to treat them and prevent their occurrence in the future. Evidence-based literature in orthognathic surgery is scarce. The large volume of published literature is difficult to compare because of different methods used, their rapid pace of technological evolution, and the difficulty in carrying out prospective randomised studies. In many cases, the level of evidence is usually low and seldom free of bias. Because orthognathic surgery allows patients to benefit from relief of their complaints, they understand that the effort undertaken will carry risks and possible complications. Krause et al (2001) pointed out that lawsuits mainly were associated with a discrepancy between the expected and achieved results of treatment and faulty information given to the patient and were less the result of faulty treatment. They further pointed out that among the main complaints in oral and maxillofacial surgery causing litigation were infection, pain, poor scar formation, postoperative hemorrhage, and disturbance of sensibility. If poor scar formation is replaced by an unsatisfactory aesthetic outcome, we then have summarised the majority of the difficult complications that accompany orthognathic surgery. With the background of more than 2000 orthognathic surgical treatments, this investigation selected topics in the presurgical orthodontics phase, the intraoperative period, and the postoperative period. About 80%–95% of the patients undergoing a surgical orthodontic treatment seem to be satisfied with the final result. The journey is long and involves presurgical orthodontics, a surgical procedure, and postoperative orthodontics before the final result is achieved. The way is paved with pitfalls and opportunities for error or misjudgement. Every opportunity to look at complications is an opportunity to open a surgeon’s eyes. Quantification of incidence and risk factors in large series allows for identification of subgroups of patients or problems that need a specific approach. Life-threatening complications are rare but necessitate that this kind of surgery be executed in well-equipped medical centres with a skilled multidisciplinary approach.
Number of pages: 328
Publication year:2012
Accessibility:Open