title: Our experience in complications of orthognathic surgery: a retrospective study on 3236 patients.
abstract: OBJECTIVE
  From 1989 to 2009, at the Department of Cranio-Maxillo-Facial Surgery, Umberto I Polyclinic, "Sapienza" University of Rome, 3236 patients affected by maxillo-mandibular malformations were submitted to orthognathic surgery, by means of rigid internal fixation. Follow-up highlighted the surgical complications and the possible functional and/or esthetical disorders in the treatment of those pathologies. The data collected have been compared with the ones reported in the literature.
  
  
  METHODS
  3236 patients were evaluated clinically and radiographically. The X-rays have been performed before the study, after 24-48 hours, at 6 months and year after surgery.
  
  
  RESULTS
  The most frequent surgical complication was the mandibular nerve sensitivity deficit (19%), irreversible only in 2% of the cases. Temporomandibular joint disorders (TMD), which are widely reported in the international literature, have been relevant in our study too. In particular, TMD occurred in those patients who were already affected by the disorder (from 28.3% to 18.1%); besides, in 11% of cases the symptom appeared after surgery and was treated by means of splint or physiotherapy. Infectious complications occurred in 2% of cases and fractures of the bone elements in 1.5% of cases. The other complications quoted internationally occurred in an irrelevant percentage in our study.
  
  
  CONCLUSIONS
  We believe that orthognathic surgery complications are quite rare and the percentages reported both in our study and in the literature have to be considered as surgical mistakes related to the surgeon experience or as real complications of the orthognathic surgery. Furthermore, as the success of this kind of surgery depends upon many factors, surgical complications represent only one of the causes of the failure. Other causes could be mistakes in planning, unsuitable orthodontic treatment and, finally, an unsuitable assessment of the patients' esthetical and functional problems.
authors: Department of Cranio-Maxillo-Facial Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy.
authors: G
authors: G
authors: Iannetti
authors: T M
authors: TM
authors: Fadda
authors: E
authors: E
authors: Riccardi
authors: V
authors: V
authors: Mitro
authors: F
authors: F
authors: Filiaci
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D061221:Trigeminal Nerve Injuries / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult