Segmental Mandibular Resection during Orofacial Surgery: Analysis of Hand Mallet/Osteotome and Dental Drill/Bone-Cutting Bur Osteotomies

Abstract

Objective: To determine if there was advantage on the use of dental drill/bone-cutting burs osteotomy technique over hand mallet/osteotome in relation to tissue repair, treatment outcome and morbidity/complication after ablative surgery. Methods: This study was retrospective and comparative of cohort subjects diagnosed with mandibular ameloblastoma treated by segmental mandibular resection over 23 years at a tertiary health institution. Patients were grouped into two: those whose mandibular resection was done with hand mallet/osteotome formed the study group, and those treated with dental drill/bone-cutting bur, control group. Data for analysis were categorized into demographic, clinical and histopathological variables. Bivariate and descriptive statistics were computed. Results: Overall, 63 patients were evaluated, 33 in the study and 30, control. Subjects’ age ranged between 31 and 48 years. There was equal distribution of subjects in the two groups if gender, age, histopathological variants of ameloblastoma and span of surgical defect are considered. The operation time was found to be 0.4 min longer in the control group. The distribution of early (P = 0.68) and late (P = 0.58) morbidities and complications between the two cohorts after surgery was insignificant. However, subcutaneous emphysema (0.9%, P= 0.89) in the control category was the only morbidity/complication related to armamentarium used for osteotomy. Conclusions: The study shows no significant advantage of one armamentarium over the other. They are not independent variables affecting tissue healing and treatment outcome.