title: Influence of osteotomy procedure and surgical experience on early complications after orthognathic surgery in the mandible.
abstract: BACKGROUND
  This study evaluated the influence of osteotomy procedure and surgical experience on early complication rates following orthognathic surgery in the mandible.
  
  
  METHODS
  In a retrospective study, patients who underwent a mandibular osteotomy (Obwegeser-Dal Pont (ODP) and Hunsuk-Epker (HE)) were included. Incidence of "bad splits", "bleeding episodes", "delayed wound healing", "failed osteosynthesis" and "nerve lesions" at 2 months post-operatively were recorded. Surgical experience was classified as: beginner (<10), intermediate (10-40) and expert (>40). Complications were correlated to the surgical approach and the experience level of the surgeon.
  
  
  RESULTS
  400 patients were included. 200 underwent a bimaxillary approach. 186 patients were operated using the ODP technique, 214 according to HE. Multivariate analysis confirmed significantly more unwanted fractures and bleeding events for ODP when compared to HE (p = 0.28, p = 0.003). Experienced surgeons had more osteosynthesis failures (0.047) and significantly more nerve lesions than the other groups (p = 0.01).
  
  
  CONCLUSIONS
  The HE osteotomy showed a more reliable fracture mechanism with less relevant bleeding episodes. Differences between the surgeons of varying training status were marginal with exception of a higher rate of osteosynthesis failure and temporary hypoesthesia in the experienced group.
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Bilal
authors.initials: B
authors.lastname: Al-Nawas
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany. Electronic address: peer.kaemmerer@gmx.de.
authors.forename: Peer W
authors.initials: PW
authors.lastname: Kämmerer
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hoffmann
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Moergel
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Felix P
authors.initials: FP
authors.lastname: Koch
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wriedt
authors.affiliation: Department of Oral, Maxillofacial and Plastic Surgery, (Head: Univ. Prof. Dr. Med. Dr. Med. Dent Wilfried Wagner), University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Walter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D019186:Mandibular Advancement / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D024343:Open Bite / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000009:adverse effects / Q000379:methods*; D057887:Overbite / Q000601:surgery; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
keywords: Early complications; Experience; Hunsuk–Epker; Mandibular osteotomy; Obwegeser–Dal Pont; Orthognathic surgery