Dental and Medical Problems
2020, vol. 57, nr 1, January-March, p. 111–116
Publication type: clinical case
Sagittal mandibular osteotomy in a patient with Eisenmenger’s syndrome: A case report
Strzałkowa osteotomia żuchwy u pacjenta z zespołem Eisenmengera – opis przypadku
1 Department of Oral and Maxillofacial Surgery, Danylo Halytsky Lviv National Medical University, Ukraine
2 Ward of Maxillofacial Surgery, Lviv Regional Clinical Hospital, Ukraine
3 Department of Prosthetic Dentistry, Danylo Halytsky Lviv National Medical University, Ukraine
The various abnormalities of occlusion cause significant discomfort to the patient suffering from them. Currently, the surgical treatment of malocclusion in healthy patients is a routine process. The situation is completely different when the patient has a serious disease of the respiratory or cardiovascular system – a condition which may contraindicate such treatment. A 30-year-old female patient, with a class III skeletal defect (open bite and progeny) and Eisenmenger’s syndrome was chosen as a clinical case. The DDS-Pro software was selected to plan the operation. The bilateral sagittal split osteotomy of the mandible was selected as the method of surgery. At the time of the initial examination, the patient had been denied surgical treatment several times in several other clinics. Before the treatment began, the patient underwent intensive preparation in the cardiac surgery unit for 2.5 months. Using the software, a surgical intervention was planned with the production of a surgical template. The operation was then performed; the treatment period was unremarkable. The resulting occlusion and changes in the shape of the face fully met the patient’s psychological and esthetic expectations. In conclusion, a complicated cardiovascular pathology does not always deprive patients with malocclusion of the possibility to undergo surgical treatment.
orthognathic surgery, malocclusion, progeny, Eisenmenger’s syndrome, osteotomy of the mandible
chirurgia ortognatyczna, wada zgryzu, progenia, zespół Eisenmengera, osteotomia żuchwy
- Houpt MI. Growth of the craniofacial complex of the human fetus. Am J Orthod Dentofacial Orthop. 1970;58(4):373–383.
- Gwinnutt CL. Lecture Notes: Clinical Anaesthesia. 3rd ed. Hoboken, NJ: Wiley-Blackwell; 2008:9–15,26–31.
- Eisenmenger syndrome. https://www.mayoclinic.org/diseases-conditions/eisenmenger-syndrome/symptoms-causes/syc-20350580. Published August 9, 2018. Accessed March 31, 2019.
- Bloomquist DS, Lee JJ. Principles of mandibular orthognathic surgery. In: Miloro M, Ghali GE, Larsen PE, Waite PD, eds. Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd ed. London, UK: BC Decker Inc.; 2004:1135–1179.
- Kwon TG, Na KM, Lee SH. Obwegeser II osteotomy (transoral angle osteotomy) for open bite with skeletal class III deformity. J Craniomaxillofac Surg. 2014;42(7):1382–1388.
- Pessa JE. The potential role of stereolithography in the study of facial aging. Am J Orthod Dentofacial Orthop. 2001;119(2):117–120.
- Santoro M, Jarjoura K, Cangialosi TJ. Accuracy of digital and analogue cephalometric measurements assessed with the sandwich technique. Am J Orthod Dentofacial Orthop. 2006;129(3):345–351.
- Vares YE, Got ІМ, Filipskyi AV, Filipska TA. Application of the DDS PRO software for planning of bilateral sagittal split osteotomy of the mandible: Clinical case description [in Ukrainian]. Acta Med Leopol. 2017;23(4):40–45.
- Champy M, Loddé JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978;6(1):14–21.
- Hupp JR. Superselective angiography with digital subtraction and embolization of a maxillary hemangioma in a patient with Eisenmenger’s syndrome. J Oral Maxillofac Surg. 1986;44(11):910–916.
- Raines DE, Liberthson RR, Murray JR. Anesthetic management and outcome following noncardiac surgery in nonparturients with Eisenmenger’s physiology. J Clin Anesth. 1996;8(5):341–347.
- Puri GD, Pradhan A, Kumar B, Hegde HV, Singh A, Prasad GRV. Anaesthetic management of a patient with Eisenmenger syndrome for lower abdominal surgery. Curr Anaesth Crit Care. 2011;1(1):51–53.
- Van Strijen PJ, Breuning KH, Becking AG, Perdijk FB, Tuinzing DB. Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy. J Craniomaxillofac Surg. 2003;31(1):42–45.
- Baas EM, van Gemert BP, Bierenbroodspot F, Milstein DM, de Lange J. Patient discomfort and other side effects after bilateral sagittal split osteotomy or distraction osteogenesis of the mandible: A randomized clinical trial. Int J Oral Maxillofac Surg. 2015;44(9):1119–1124.
- Vos MD, Baas EM, de Lange J, Bierenbroodspot F. Stability of mandibular advancement procedures: Bilateral sagittal split osteotomy versus distraction osteogenesis. Int J Oral Maxillofac Surg. 2009;38(1):7–12.
- Collins CP, Pirinjian-Leonard G, Tolas A, Alcalde R. A prospective randomized clinical trial comparing 2.0‑mm locking plates to 2.0‑mm standard plates in treatment of mandible fractures. J Oral Maxillofac Surg. 2004;62(11):1392–1395.