A Comparative Assessment of Right-Angle Screwdriver Versus Conventional Screwdriver for Orthognathic Surgeries

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery Techniques
• Surgical Instrumentation

Background:

• Bilateral orthognathic surgery presents unique challenges, particularly with ramus osteotomy.
• Conventional linear instruments can lead to malalignment and structural weakness during surgery.
• A right-angle drill offers a more ergonomic approach by ensuring perpendicular instrument placement.

Purpose of the Study:

• To compare the efficacy of a right-angle screwdriver versus a conventional screwdriver in orthognathic surgery.
• To assess differences in ease of fixation, osteotomy, and surgical time.
• To evaluate postoperative screw angulation relative to the bone.

Main Methods:

• A prospective observational study involving 12 patients using a split-mouth design.
• Right-angle screwdriver used for the right side, conventional screwdriver for the left.
• Evaluation of osteotomy ease, fixation ease, fixation time, and screw angulation via cone-beam computed tomography.

Main Results:

• The right-angle screwdriver demonstrated significantly easier fixation (p < 0.001) and more consistent perpendicular screw angulation (p < 0.001).
• Osteotomies and fixations were generally easier with the right-angle tool.
• Surgical time showed an insignificant difference between the two methods (p = 0.13).

Conclusions:

• The right-angle screwdriver provides more stable fixation and simplifies screw placement in posterior mandibular regions.
• It effectively addresses challenges associated with conventional instruments in orthognathic procedures.
• This tool enhances precision and potentially improves outcomes in complex surgeries.