Malunited Maxilla Fracture, Maxilla Fracture
Conditions
Brief summary
To compare the outcomes of piezosurgery and conventional osteotomy in Le Fort I osteotomy for old malunited maxillary fractures in terms of mean duration of surgery and intraoperative blood loss.
Detailed description
The development of Piezosurgery was fueled by the need for greater precision and safety in bone surgery than when the standard bur and saw are used. Ultrasonic vibrations have been used to cut tissue for two decades .However, it is only in the last 18 years that it has been used routinely for standard clinical applications in many different fields of surgery. Piezosurgery decreases the risk of damage to the surrounding soft tissues and critical structures (nerves, vessels, and mucosa), particularly during an osteotomy. Although, in theory, execution of the osteotomy itself is faster if made with the reciprocating saw, the total surgical time is actually shorter when a piezoelectric device is used because less maneuvers to protect the soft tissues are required and a clearer surgical field and increased visibility is produced. Microvibrations of 60 to 200 m/s at 24 to 29 kHz are applied to cut in mineralized tissue while soft tissue remains unharmed.The literature reports the following possible causes of post bilateral sagittal split osteotomy facial nerve injury direct trauma to the nerve by the osteotomy, direct trauma to the nerve when the mandibular ramus is moved posterior, and postoperative hematoma at the operation site causing pressure necrosis of the nerve. The objective of the present study was to compare the outcome of Piezosurgery in Lefort I osteotomy of patients having old Malunited Lefort I maxillary fracture as compared to the conventional method in terms of mean operative time and intraoperative blood loss. In this regard, the present survey was conducted from the patients of Department of Oral and Maxillofacial Surgery, Allama Iqbal Medical College, Lahore. Therefore, 60 patients were included by using non-probability consecutive sampling who were undergoing dental treatment after fulfilling the inclusion criteria.
Interventions
PROCEDUREPIEZO ELECTRIC DEVICE (PIEZOSURGERY)
Previously for various maxillofacial procedures osteotomy was performed with rotary burs, In our study patients with Old Malunited Maxillary Fractures , osteotomy will be performed with PIezoelectric device.
PROCEDUREGROUP B CONVENTIONAL METHOD ( Mallet and OSTEOTOME
In group B Intraoperative blood loss and mean duration of surgery will be measured after perfoming Lefort I osteotomy in patients having Maxillary Old Malunited fractures using bur and chisel/mallet. outcomes wiil be compared with Group A
Sponsors
Allama Iqbal Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Study Model comprise of two arms. In Group A patients having Old Malunited Maxillary Fractures their osteotomy will be done with Piezoelectric device whereas In Group B for such patients osteotomy will be planned with Conventional method using rotary bur and chisel/mallet. Duration of surgery and intraoperative blood loss will be compared in both ARMS.
Eligibility
Sex/Gender
ALL
Age
15 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* Malunited Lefort I Fracture of Maxilla for more than three weeks old * Untreated Maxillary Fractures. * Lefort I fracture on CT SCAN FACE with 3D reconstruction * Individuals with ASA1 and ASA2
Exclusion criteria
* Previous Maxillofacial Treatment * Lactating mothers and Pregnant Females * Any Bone pathology or bone disease determined on Xray
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| INTROPERATIVE BLOOD LOSS | DURING SURGERY from the start of osteotomy | It was measured in millilitres of increase in irrigation fluid collected during surgery and subtracting the amount of irrigation fluid from the total volume of blood and fluid in the suction bottle. it was classified as low 300 cc medium 400cc high 500cc or more |
| Mean Duration of Surgery | During surgery from the start of maxillary vestibular incision till maxilla is disimpacted post bone osteotomy | It was measured in minutes from the start of maxillary vestibular incision till the disimpaction of maxilla post bone osteotomy during surgery |
Countries
Pakistan
Outcome results
None listed