Orthognathic surgery considerations for patients with undiagnosed type I osteogenesis imperfecta.

PURPOSE: This study reports the senior author's experience of orthognathic surgery in patients with prognathism and undiagnosed type I osteogenesis imperfecta and includes a review of the literature.

PATIENTS AND

METHODS

Two patients with undiagnosed type I osteogenesis imperfecta underwent orthognathic surgery for correction of prognathism at Chang Gung Craniofacial Center, Taipei, Taiwan. The initial surgical plan was to perform 2-jaw orthognathic surgery in both patients.

RESULTS

The bone quality was found to be fragile during the operation, and the original plan was changed intraoperatively to 1-jaw mandibular surgery. Both operations were performed without complications, and wound healing progressed normally. Both the final facial profile and occlusal outcome were satisfactory in 1 patient, with mild relapse occurring in the second patient.

CONCLUSIONS

For patients with type I osteogenesis imperfecta, the orthognathic surgery plan should be simplified as much as possible. Prolonged intermaxillary fixation is recommended to facilitate bone union. Complications could possibly be avoided.