Complications after orthognathic surgery: our experience on 423 cases

Oral Maxillofac Surg. 2017 Jun;21(2):171-177. doi: 10.1007/s10006-017-0614-5. Epub 2017 Mar 2.


Introduction: Orthognathic surgery is widely used to correct dentofacial discrepancies. However, this procedure presents numerous possible complications. The aim of our study is to review intraoperative and postoperative complications related to orthognathic surgery based upon a 10-year period in the Maxillofacial Surgery Department of Federico II University of Naples.

Materials and methods: Medical records of 423 patients who undergone orthognathic surgery in a 10-year period were retrospectively analyzed and complications was noted. Statistical analysis was conduced in order to understand if the type of surgical procedure influenced complications rate.

Results: One hundred eighty-five complications in 143 (33.8%) of the 423 treated patients were reported. Complications detected were nerve injury (49 cases, 11.9%), infections (10 cases, 2.4%), complications related to fixation plates or screws (30 cases, 7.1%), bad split osteotomy (8 cases, 1.9%), secondary temporo-mandibular joint disorders (36 cases, 8.5%), dental injuries (21 cases, 5%), condilar resorption (2 cases, 0.5%), and necessity of a second-time surgery (24 cases, 5.7%).

Conclusions: Serious complications seem to be quite rare in orthognathic surgery. Some of the surgical complications found are related to the surgeon experience and not strictly to the risks of the operation itself. Understanding potential complications allows the surgeon to guarantee safe care through early intervention and correctly inform the patient in the preoperative colloquy.

Keywords: Inferior alveolar nerve injuries; Le Fort 1 osteotomy complications; Orthognathic surgery; Orthognathic surgery complications; Sagittal split ramus osteotomy complications.

MeSH terms

  • Adult
  • Female
  • Humans
  • Intraoperative Complications / etiology*
  • Lingual Nerve
  • Male
  • Malocclusion / surgery*
  • Mandibular Nerve
  • Orthognathic Surgery*
  • Postoperative Complications / etiology*
  • Postoperative Hemorrhage / etiology
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / etiology
  • Trigeminal Nerve Injuries / etiology