COMPARATIVE STUDY OF CONVENTIONAL SAW VERSUS PIEZOSURGERY AT “LOW AND SHORT” MEDIAL CUT FOR BSSRO PROCEDURES (RANDOMIZED CONTROLLED CLINICAL TRIAL)

Mohammed Khaled Mansour*, Ashraf Abdul-Fattah Mahmoud, Mohamed Alaa El-Din Mohamed El-Sayed and Mohamed Ashraf Abdel Fattah Mahmoud

ABSTRACT

Statement of problem: One of common osteotomies to correct mandibular deformities is Bilateral sagittal split ramus osteotomy (BSSRO) for dentofacial deformities. The aim of this study was to compare Neurosensory Recovery and Operative time of Conventional Saw versus Piezosurgery at “Low and Short” Medial Cut at BSSRO procedures (clinically and radiographically). Materials and Methods: Twelve patients with skeletal class II or III deformity who seek orthognathic surgery were selected from outpatient clinic of Oral and Maxillofacial Surgery Department of Al-Azhar Dental University (Assiut Branch). Patients were allocated into 2 groups, each group contained 6 patients prepared for surgical mandibular advancement or setback for correction of skeletal Class II or Class III deformity. Group (I) (Control): Six patients of eligible sample were selected to proceed for Low and Short medial cut modification using conventional saw. Group (II): using piezosurgery. Assessment of Neurosensory Recovery was performed by objective and subjective examination on all patients post-operatively, on first and seventh day, then on first, third and sixth months after surgery. Reference points were determined over inferior lip and chin. The right and left sides were examined separately. As for operative time, it was assessed by stop watch from start of osteotomy till mobilization and fixation of segments. Results: Results showed that the duration of Piezo group (38.50 ± 4.42) was longer than that of the conventional saw (31.50 ± 3.27) with a statistically significant difference at p=0.016. As for IAN (inferior alveolar nerve) affection, it was only observed at one case of piezo group (16.7%, n=1) while saw group had showed no affection at all after the procedure (100%, n=6) with no statistical significance difference between groups at p= 1.00. Conclusion: It can be concluded that both techniques showed similar results regarding neurosensory recovery of IAN. However, conventional saw method showed less operative time than piezosurgery as usage of piezosurgery demands more experienced surgeon to minimize surgical time.

Keywords: BSSRO, Conventional rotary saw, Orthognathic surgery, “Low and Short” Medial Cut, IAN, NSD, Piezosurgery, Operative time, TPD.