CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2020 December;4(3):117-23

DOI: 10.23736/S2532-3466.19.00202-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Orthognathic treatment failures: the team-based approach of complications

Luca VISCONTI ¹, Francesco DALEFFE ¹ ✉, Stefano NEGRINI ², Umberto ZANETTI ¹, Carlo TIAN ¹, Andrea CASTELLANI ²

¹ Dental School, University of Brescia, Brescia, Italy; ² Department of Maxillofacial Surgery, Civil Hospital, Brescia, Italy

The last years have shown profound changes in the final target of orthognathic therapy: surgeon-related objectives, often strictly bound to mere cephalometric parameters, has lost importance in favor of the aesthetical patient’s needs. Moreover, surgical and orthodontic technique have stepped far forward in achieving a long-term stability, granting an adequate result over time. Our intent is to present some different cases, treated by the same surgical-orthodontic team, asserting the primary role of cooperation. An intraoperative complication, as a mandibular “bad split” during sagittal osteotomy, was orthodontically solved without hindering the final outcome; on the contrary, a successful surgery led to a spoiled result without a whole-team cooperation. Working as a multidisciplinary unit grants a comprehensive model of the patient, which is the successful way to manage complications. Moreover, we confirm the central role of the patient: his compliance, together with his psychological attitude over the whole therapy, are of primary importance to the final result. According to the international literature, the patient experience comes first and nowadays he tends to consider esthetichs results at first, followed by occlusal proportions and masticatory function.

KEY WORDS: Orthognathic surgery; Treatment failures; Complications