_Applied_  
_sciences_  
_Article_  
**Analysis of the Complications in Patients Undergoing**  
**Orthopathic Surgery by Piezosurgery(r): A 13 Years**  
**Retrospective Study**  
**[PERSON] \({}^{1,\star}\), [PERSON] \({}^{1}\), [PERSON] \({}^{1}\), [PERSON] \({}^{1}\), [PERSON] \({}^{2}\), [PERSON] \({}^{1}\) and [PERSON] \({}^{3,4,5}\)**  
\({}^{1}\) Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy; [EMAIL_ADDRESS] (M.A. ); [EMAIL_ADDRESS] (D.D. ); [EMAIL_ADDRESS] (L.C.C. ); [PERSON](G.R)  
\({}^{2}\) Section of ENT, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37219 Verona, Italy; [EMAIL_ADDRESS]  
\({}^{3}\) Unit of Orthodontics, Division of Dentistry, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; [EMAIL_ADDRESS] or [EMAIL_ADDRESS]  
\({}^{4}\) Unit of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, 20132 Milan, Italy  
\({}^{5}\) Unit of Dentistry, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy  
\({}^{\star}\) Correspondence: [EMAIL_ADDRESS]. Tel. : +39-045-812-4251; Fax: +39-045-812-7437  
**Abstract** Orthopathic surgery is a branch of maxilla-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery(r). Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported. A retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and geniolplasty technique using Piezosurgery(r). The complications taken into consideration were disorders of the temporomandibular joint (TM), paraesthesia and hypoesthesia, asymmetries, nose enlargement, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency, gingival accession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatrical outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature reviews. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods. **Keywords**: orthognathic surgery; piezosurgery; complications; bilateral sagittal osteotomy; Le Fort  
**1. Introduction**  
The aims of orthognathic surgery are numerous: correction of malocclusions, health of the temporomandibular joint, maintenance or increase of upper airway space, improvement of dental relationships, correction of reverse bites, improvement of muscle function, facial aesthetic harmonization, and patient satisfaction. It is also important to ensure adequate stability of the long-term results [1, 2, 3, 4, 5]. Such complex therapies may present complications, the most common are temporomandibular disorders (TMD), paraesthesia, and hypoesthesia [1]. Despite careful planning and the low risk associated with this type of intervention, we can register many mild or more severe complications.