Complicaciones de cirugía ortognática mandibular: revisión de la literatura a propósito de un caso.

Abstract

Bilateral Sagittal Split Ramus Osteotomy (BSSRO) is a commonly employed technique for correcting dental-maxillofacial anomalies. Despite its effectiveness, this surgical approach can entail potential complications, which have been documented and categorized in the literature. In this study, a clinical case analysis with a 10-year follow-up is presented involving a patient who experienced an unresolved intraoperative complication during orthognathic surgery. The patient remains asymptomatic but displays a significant mandibular deviation to the right. The individual sought a solution due to aesthetic discomfort caused by a failure of mandibular orthognathic surgery. Evaluations indicated that complications stemmed from the absence of the condylar head in the right hemimandible and an unintentional fracture at the condylar level, possibly arising from a bad split. When not rectified, this situation led to the displacement of the proximal mandibular segment. Additionally, a literature review is presented, outlining potential intraoperative fractures. This review considers articles published from 2013 to 2023, contributing to the understanding that assessing the precise frequency of unwanted fractures due to mandibular osteotomy is complex, as it depends on several factors. However, it was found that such occurrences are relatively infrequent, ranging from 0.9% to 20% depending on the case series.