Piezotome-Genioplasty reduces post-surgical morbidity and enhances patient satisfaction: a randomized clinical trial

Publication date: Available online 27 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Troedhan Angelo
PurposeRecent clinical studies have shown piezotomes to possibly establish the new "state-of-art" for osteotomies in maxillofacial surgery. The investigator hypothesized genioplasty-surgery with piezotomes might decrease post-surgical morbidity and increase overall patient satisfaction when compared to genioplasty with traditional instruments.MethodsThe investigator implemented a randomized clinical trial. The sample was composed of patients undergoing reductive genioplasty. The predictor variable was genioplasty performed with traditional instruments and traditional sliding genioplasty protocol (control-group) or ultrasonic surgical devices "Piezotome II" and "Piezotome SOLO M+" with a piezotome-adapted 3D-curved osteotomy surgical protocol (test-group). The primary outcome variable was overall long-term patient-satisfaction determined by Genioplasty Outcome Evaluation (GOE). Other study variables were postsurgical morbidity staged by Universal Pain Assessment Scale (UPAS), analgesic intake, neurosensory two-point-discrimination-test of lip and chin and surgery duration. Descriptive and bivariate statistics were computed by SPSS 22.0 and the p value was set at .05.ResultsThe sample was composed of 48 patients undergoing reductive genioplasty either with "Piezotome" (10 male / 13 female, aged from 24-56 yrs) or traditional sliding genioplasty ( 11 male / 14 female, aged from 26-54 yrs). No statistically significant difference was found for surgery duration between test- and control-group. There was a statistically significant association between reduced postsurgical morbidity (p<0,05) and higher overall long-term patient satisfaction with genioplasty outcome (p<0,05) when piezotomes were used for performing the genioplasty.ConclusionThe results of this study suggest the use of piezotomes and piezotome-adapted surgical protocols to be advantageous in genioplasty-surgery compared to traditional surgical instruments and traditional surgical protocols.

Graphical abstract

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