Department of Maxillofacial Surgery and Implantology, University of Medicine and Pharmacy "Iuliu Hațieganu", 37 Cardinal Iuliu Hossu Street, 400029 Cluj-Napoca, Romania.
Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania.
Int J Environ Res Public Health. 2022 Nov 30;19(23):16028. doi: 10.3390/ijerph192316028.
This study aims at evaluating and categorizing patients’ objective and subjective postoperative recovery symptoms after bimaxillary orthognathic surgery assigning the healing process. The patients were monitored throughout the recovery process, and their symptoms were managed. A prospective, observational study was performed. Patients with Class II and III malocclusion (aged 18 to 35) were evaluated and monitored preoperatively, and postoperatively at 48 h, 2 weeks, 1 month, and 3 months postsurgery. A questionnaire was used to assess pain and anesthesia/hypoesthesia. The most common objective and subjective signs that were correlated with the healing process were edema, hematoma, trismus, pain, and anesthesia/hypoesthesia. Edema peaked at 48−72 h postoperatively (distance between eye’s external canthus and gonion, mean difference = 4.53, between tragus and cheilion, mean difference = 7, between tragus and gnathion, mean difference = 4.65, p < 0.001); mouth opening amplitude was significantly decreased during the first two weeks postsurgery (class II, mean difference = 32.42, p = 0.006, class III, mean difference = 44.57, p < 0.001), but it steadily and considerably improved over three months. The nose tended to widen postsurgery. The most severe pain experienced by patients was of medium intensity in the mandibular body, described as pressure, and usually did not spread. Patients were most severely and persistently impacted by anesthesia/hypoesthesia.
本研究旨在评估和分类双颌正颌手术后患者的客观和主观术后恢复症状,并分配愈合过程。在整个恢复过程中对患者进行监测,并对其症状进行管理。进行了一项前瞻性、观察性研究。评估和监测了患有安氏 II 类和 III 类错(牙合)(年龄 18 至 35 岁)的患者,术前、术后 48 小时、2 周、1 个月和 3 个月。使用问卷评估疼痛和麻醉/感觉减退。与愈合过程相关的最常见的客观和主观迹象是水肿、血肿、牙关紧闭、疼痛和麻醉/感觉减退。术后 48-72 小时水肿达到高峰(外眼角和下颌角之间的距离,平均差异=4.53,耳屏和下唇之间的距离,平均差异=7,耳屏和下颌之间的距离,平均差异=4.65,p<0.001);术后前两周开口幅度明显减小(安氏 II 类,平均差异=32.42,p=0.006,安氏 III 类,平均差异=44.57,p<0.001),但在三个月内逐渐显著改善。术后鼻子往往会变宽。患者经历的最严重疼痛是下颌体中度强度的疼痛,表现为压力,通常不会扩散。患者受麻醉/感觉减退的影响最为严重和持久。