The Use of Demineralized Bone Matrix for Grafting During Le Fort I and Chin Osteotomies: Techniques and Complications

Purpose

To examine the use of demineralized bone matrix (DBM) in maxillary and chin orthognathic surgery. The use of DBM in orthognathic surgery has not been reported in the literature.

Patients and Methods

A retrospective review of the orthognathic surgeries performed in 1 university was conducted. Medical records were assessed to determine the materials used, complications, and details of re-operations required.

Results

There were 113 suitable patients identified. The DBM group (88 patients) consisted of 61 Le Fort I osteotomies and 46 genioplasties; the non-DBM group (25 patients) consisted of 25 Le Fort I osteotomies and 4 genioplasties. The mean follow-up period was 5.9 months for the DBM group and 6 months for the non-DBM group. There was only 1 technique of applying DBM to genioplasties, but a variety of different graft material combinations was used in the Le Fort I osteotomies. The only significant Le Fort I complication was maxillary sinusitis; its incidence was 3.3% (2 out of 61) for the DBM group, versus 8% (2 out of 25) in the non-DBM group. All the genioplasties had no complications. There were 4 cases of Le Fort I osteotomies which were re-entered (2 cases for suspected infection and 2 cases for re-osteotomies due to occlusal malalignment) and they showed good bony healing.

Conclusion

The use of DBM does not significantly increase complications and is suitable to be used in both the maxilla and chin during orthognathic surgery.