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Orthognathic surgery and pulpal blood flow: a pilot study using laser Doppler flowmetry
D S Ramsay1, J Artun, D Bloomquist
1School of Dentistry, University of Washington, Seattle 98195.
Summary
Le Fort I osteotomy significantly reduced pulpal blood flow in some patients, with variable individual responses observed. While transient ischemia and hyperemia occurred, complete pulpal blood flow absence was not detected post-surgery.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Research
- Vascular Biology
Background:
- Le Fort I osteotomy is a common surgical procedure for midface correction.
- Understanding its impact on dental pulp vascularity is crucial for patient outcomes.
Purpose of the Study:
- To investigate the effects of Le Fort I osteotomy on pulpal circulation.
- To assess changes in blood flow in maxillary and mandibular teeth following surgery.
Main Methods:
- Utilized laser Doppler flowmetry to measure pulpal blood flow in 14 volunteers.
- Measurements were taken pre-surgery and at multiple intervals up to 6 months post-surgery.
- Custom splints ensured precise and repeatable probe placement.
Main Results:
- A significant reduction in pulpal vascular supply was observed at the 6-month follow-up.
- Individual blood flow patterns exhibited high variability, with some experiencing transient ischemia.
- Hyperemia was noted in numerous teeth at later intervals; no subjects showed complete pulpal blood flow absence.
Conclusions:
- Le Fort I osteotomy can lead to a significant decrease in pulpal blood flow over time.
- Individual patient responses vary, with potential for both ischemia and hyperemia.
- While concerning events like tooth discoloration and periodontal issues occurred, complete pulpal necrosis was not observed in this cohort.