title: Incidence and consequences of bur breakage in orthognathic surgery: a retrospective study with discussion of 2 interesting clinical situations.
abstract: OBJECTIVE
  To determine the incidence of bur breakage in routine orthognathic surgery, as well as its postsurgical sequela, and to illustrate 2 cases with more than 6 months' follow-up.
  
  
  METHODS
  We performed a retrospective evaluation of case records of 76 consecutive orthognathic surgical procedures performed by a team of 2 surgeons over a period of 16 months, between January 2009 and July 2010, at a single center.
  
  
  RESULTS
  Surgical bur breakage was reported in 5 patients in the series. Of these, 3 were retrieved whereas 2 were not, 1 of which caused a foreign body reaction in the patient, which persisted for a duration of almost 1 year.
  
  
  CONCLUSIONS
  Instrument breakage may be a relatively common occurrence with the use of surgical burs in orthognathic surgery but its incidence is seldom recorded or reported. This study gives insight into the probability of postoperative sequela of these instruments when left in situ and a protocol for management of broken instruments.
authors.affiliation: Cleft & Craniofacial Unit, Meenakshiammal Dental College & Hospital, Maduravoyal, India.
authors.forename: Ramanathan
authors.initials: R
authors.lastname: Manikandhan
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Anantanarayanan
authors.forename: Pynamoottil Cherian
authors.initials: PC
authors.lastname: Mathew
authors.forename: Jayakumar Naveen
authors.initials: JN
authors.lastname: Kumar
authors.forename: Vivek
authors.initials: V
authors.lastname: Narayanan
mesh_terms: D000293:Adolescent; D002985:Clinical Protocols; D003762:Dental Instruments / Q000009:adverse effects; D004868:Equipment Failure / Q000706:statistics & numerical data; D005547:Foreign Bodies / Q000601:surgery*; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation; D019340:Osteotomy, Le Fort / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D017973:Tungsten Compounds; D014481:United States; D055815:Young Adult
chemical_list: D017973:Tungsten Compounds; C002802:tungsten carbide