title: Effectiveness of piezoelectric surgery in reducing surgical complications after bilateral sagittal split osteotomy.
abstract: Our aim was to investigate the effectiveness of piezoelectric surgery, where the osteotomy is made using ultrasonic vibration, in reducing surgical complications after bilateral sagittal split osteotomy (BSSO). Fifty-nine patients with skeletal mandibular prognathism who had mandibular setback with BSSO between January 2009 and April 2011 were included in the study. Piezosurgery was used in 29 cases, and the bone was split using a separator. In the remaining 30 cases, a Lindeman bur was used for the osteotomy and a chisel was used to split the bone. The amount of intraoperative bleeding and the Semmes Weinstein test scores were used as objective variables to evaluate the degree of neurosensory disturbance, and sex, age, use of piezosurgery, degree of setback, operating time, and method of fixation were used as explanatory variables. We used analysis of covariance (ANCOVA) to assess the significance of differences. Intraoperative bleeding was significantly less with age (p=0.003), and longer when operating time was prolonged (p=0.017), and was not influenced by the use of piezosurgery. The Semmes Weinstein test score significantly increased with age (p=0.01), and was significantly greater when piezoelectric surgery was used (p=0.008), and at 3 months, there were signs of more neurosensory disturbance in older patients and those who had had piezoelectric surgery. In this retrospective non-random study piezoelectric surgery reduced neither blood loss nor the incidence of neurosensory disturbance in BSSO.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, 2-1-1, Kita-senzoku, Ohta-ku, 145-8515 Tokyo, Japan. Electronic address: tshirota@dent.showa-u.ac.jp.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Shirota
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, 2-1-1, Kita-senzoku, Ohta-ku, 145-8515 Tokyo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kamatani
authors.affiliation: Department of Orthodontics, School of Dentistry, Showa University, 2-1-1, Kita-senzoku, Ohta-ku, 145-8515 Tokyo, Japan.
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Information Science, Faculty of Arts and Sciences at Fujiyoshida, Showa University, 4562, Kamiyoshida, Fujiyoshida, 403-0005 Yamanashi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogura
authors.affiliation: Department of Orthodontics, School of Dentistry, Showa University, 2-1-1, Kita-senzoku, Ohta-ku, 145-8515 Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Maki
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, 2-1-1, Kita-senzoku, Ohta-ku, 145-8515 Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Shintani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D063168:Mandibular Osteotomy / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D065228:Non-Randomized Controlled Trials as Topic; D061646:Operative Time; D059229:Osteotomy, Sagittal Split Ramus / Q000295:instrumentation / Q000379:methods*; D059745:Piezosurgery / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011378:Prognathism / Q000601:surgery; D012189:Retrospective Studies; D012684:Sensory Thresholds / Q000502:physiology; D020886:Somatosensory Disorders / Q000209:etiology / Q000517:prevention & control; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bilateral sagittal split osteotomy; Piezosurgery; Surgical complication