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Uppada UK, Tauro D, Senthilnathan KP. Patient Satisfaction Following Orthognathic Surgery: A Systematic Review. J Maxillofac Oral Surg 2023; 22:762-769. [PMID: 38105865 PMCID: PMC10719194 DOI: 10.1007/s12663-023-02066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023] Open
Abstract
Objective This study is intended to review data pertaining to patient satisfaction following orthognathic surgery through a systematic literature survey. Methods and Materials An electronic search was done on Medline, EMBASE and CENTRAL databases. The inclusion criteria considered were as follows: (1) assessment of patients' satisfaction, (2) one-stage orthognathic surgery, and (3) follow-up period of 8 weeks or more in English literature. The exclusion criteria considered were as follows: (1) presence of craniofacial syndromes, cleft lip and palate or traumatic injuries, (2) previous facial surgery, and (3) psychological problems before surgery. The data were extracted and analyzed under three categories: function, esthetics and overall satisfaction. Results Eighteen studies met the inclusion criteria. Esthetic and function were improved in majority of patients; however, it was not possible to assess the overall satisfaction levels statistically. Overall satisfaction analysis revealed that 70-87% of patients were satisfied, while nearly 15% of patients were dissatisfied with the treatment outcome. Conclusion Most of the patients were satisfied with the surgical outcome. However, satisfaction seemed to be multifactorial and it was not possible to predict satisfaction prior to the surgery.
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Affiliation(s)
- Uday Kiran Uppada
- Department Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, India
| | | | - K. P. Senthilnathan
- Department Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, India
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Mishra M, Singh G, Gaur A, Mondal S, Singh A, Bharti P. Assessment of soft- and hard-tissue changes following combined anterior segmental bi-jaw orthognathic surgery. Natl J Maxillofac Surg 2023; 14:233-241. [PMID: 37661970 PMCID: PMC10474553 DOI: 10.4103/njms.njms_435_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 09/05/2023] Open
Abstract
Background Anterior segmental Bi-jaw orthognathic surgery is indicated primarily for the correction of dentoalveolar protrusion. They are also indicated for correcting apertognathia, closing interproximal spaces between segments and can be incorporated with other osteotomies to obtain better results. Aim The aim of this study was to analyze and compare the soft- and hard-tissue changes in patients who underwent combined anterior segmental bi-jaw orthognathic surgery. Settings and Design To compare and evaluate soft- and hard-tissue changes before and after combined anterior segmental bi-jaw orthognathic surgery by assessing (a) parameters in vertical dimension and (b) parameters in horizontal dimension and patient satisfaction was also assessed following surgery at 6 months' time interval. Materials and Methods It is a prospective, single center and analytical study with sample size of 20 patients. It required routine setup for orthognathic surgery and manual tracing of lateral cephalograms. The surgical outcomes were assessed by hard tissue (Sella Nasion Point A (SNA) angle, Sella Nasion Point B (SNB) angle, Point A Nasion Point B (ANB) angle, NAPg, U1-NF, L1-MP angles; NA, NB, B-Pg, Nasion-Anterior nasal spine (N-ANS) distance, Anterior nasal spine-Gnathion (ANS-Gn) distance, and overjet and overbite) and soft tissue (facial convexity, NL, LM angles; LM fold, UL and LL protrusions, Upper lip length (ULL), Lower lip length (LLL), Sn-A, Si-B, Pg-Pg*, Ls-U1, Li-L1 distances, interlabial gap, and U1 exposure) variables pre and postsurgery. Statistical Analysis Descriptive statistics involved the mean and standard deviation, and recorded data were subjected to the statistical analysis using IBM SPSS 20 statistical package. The paired t-test, Pearson correlation coefficient were used. The level of significance P < 0.05 was taken as statistically significant and P < 0.01 as very significant. Results Overall improvement after surgery in both hard- and soft-tissue parameters was observed and significant changes were seen in every variable, except Si-B (P > 0.05). Correlations between soft- and hard-tissue changes were significant in both sagittal and vertical planes. Patients' satisfaction score showed that all patients had the high overall rate of satisfaction. Conclusions Our study concludes that combined anterior segmental bimaxillary orthognathic surgery is a simple technique with minimal postoperative complications and limited relapse. The changes in facial esthetics and occlusion following orthognathic surgery depend highly on the stability achieved during the postoperative period.
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Affiliation(s)
- Madan Mishra
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gaurav Singh
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Gaur
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shubhamoy Mondal
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pallavi Bharti
- Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Derombise B, Ben Slama N, Desbarats C, Bastien AV, Trost O. Measurement of quality of life in orthognathic surgery using an original questionnaire: About a series of 123 cases. ANN CHIR PLAST ESTH 2023; 68:123-130. [PMID: 36642633 DOI: 10.1016/j.anplas.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The aim of this study was to measure changes in the quality of life of patients who had orthognathic surgery using an original questionnaire, designed for this purpose. MATERIAL AND METHOD This single-center retrospective study included all patients who had orthognathic surgery in our center between 2014 and 2019. An original questionnaire comprising 13 items in 4 domains was sent to patients postoperatively by email after telephone contact and obtaining their consent. Items were scored on a 5-point scale ranging from (-1), worse than before surgery, to (+3), better than before surgery. RESULTS All data were collected in a standardized way. In total, 123 patients responded. The mean score for all surgeries combined was +1.14, indicating an improvement in QOL considered to be "low to moderate". A total of 118 patients (95.9%) reported an improvement following surgery, including 18 patients (14.6%) who reported a marked improvement. The greatest improvement was observed for psychosocial aspects and morphology. CONCLUSION This study shows a positive effect of orthognathic surgery on patients' QOL, including self-perception, relationships with others, or functional aspects as mastication and breathing. We propose an original tool that is easy to use by patients to measure quality of life following orthognathic surgery.
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Affiliation(s)
- B Derombise
- Department of maxillofacial surgery and stomatology 1, Rouen Health UFR, CHU, Hospital of Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - N Ben Slama
- Department of maxillofacial surgery and stomatology 1, Rouen Health UFR, CHU, Hospital of Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - C Desbarats
- Department of maxillofacial surgery and stomatology 1, Rouen Health UFR, CHU, Hospital of Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - A V Bastien
- Department of maxillofacial surgery and stomatology 1, Rouen Health UFR, CHU, Hospital of Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - O Trost
- Department of maxillofacial surgery and stomatology 1, Rouen Health UFR, CHU, Hospital of Rouen, 37, boulevard Gambetta, 76000 Rouen, France; Anatomy Laboratory2, Rouen Health UFR, University of Rouen-Normandy, 22, boulevard Gambetta, 76083 Rouen cedex 1, France; Laboratory of medical informatics and knowledge engineering in e-Health, LIMICS 3, Inserm, University of Rouen-Normandy, Sorbonne University, Paris 13 University, 75006 Paris, France.
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Hillerup S. Orthognathic surgery treatment injuries reported to the Danish Patient Compensation Association: A 25-year retrospective observational study. J Craniomaxillofac Surg 2020; 48:1094-9. [DOI: 10.1016/j.jcms.2020.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/13/2020] [Accepted: 10/30/2020] [Indexed: 11/22/2022] Open
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Ramanathan M, Kiruba GA, Christabel A, Parameswaran A, Kapoor S, Sailer HF. Distraction Osteogenesis Versus Orthognathic Surgery: Demystifying Differences in Concepts, Techniques and Outcomes. J Maxillofac Oral Surg 2020; 19:477-489. [PMID: 33071493 DOI: 10.1007/s12663-020-01414-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction The popularity and interest evoked by orthognathic surgery and distraction osteogenesis are undisputed in the field of oral and maxillofacial surgery. However, questions regarding the individual identities of either of them with clarity in their concepts, techniques and outcomes have remained unanswered. The aim of this review is to shed light on these questions. Methods This review is structured as a narrative review of thirty years of literature available in the specialities of orthognathic surgery and distraction osteogenesis. Conclusion The authors present a review of existing literature combined with contrasting experience gained over the years in providing an overview of the merits and demerits of the two surgical techniques which will aid the clinician in justifying the use of one technique over the other.
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Affiliation(s)
- Manikandhan Ramanathan
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | - Godwin Alex Kiruba
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, India
| | | | | | - Sanjanaa Kapoor
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, India
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Geramy A, Sheikhzade S, Nazarifar AM. Cephalometric and Anthropometric Changes and Their Relation to Patients' Satisfaction After Orthognathic Surgery. J Craniofac Surg 2020; 31:1022-1025. [PMID: 32049917 DOI: 10.1097/scs.0000000000006193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this prospective study was to evaluate the correlation between cephalometric and anthropometric facial changes and satisfaction level of class III patients after bimaxillary orthognathic surgery. METHODS AND MATERIALS Totally, 29 class III patients (mean age = 24.23 ± 4.2) undergoing one-piece Lefort 1 osteotomy and mandibular setback were included. Pre- and postoperative lateral cephalograms were taken. Thirteen cephalometric and 17 anthropometric facial measurements were evaluated. A 6-item questionnaire of Rustemeyer's study was used to assess patient's satisfaction after surgery. The Wilcoxon signed-rank test, paired sample t test and Spearman's correlation analysis were used as statistical analysis. RESULTS Facial aesthetic and masticatory improvement was highly significant (P < 0.001), while opinion differences between patients and relatives/friends were not significant (P = 0.334). Increased upper lip length (P = 0.037) and decreased nasal tip protrusion-nose height index (P = 0.017) correlated positively with aesthetic improvements after surgery. CONCLUSION Although the association between parameters and satisfaction questionnaire was found, other influential factors should be considered before surgery as well.
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Affiliation(s)
- Allahyar Geramy
- Dental Research Center Dentistry Research Institute, Tehran University of Medical Sciences, Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran
| | - Sedighe Sheikhzade
- Dental Material Research center, Institute Of health, Babol University of Medical Sciences; Department of Orthodontics, School of Dentistry, Babol University of Medical Sciences, Babol
| | - Arezoo Mazaheri Nazarifar
- Department of Prosthodontics, School of dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
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Engelmann J, Fischer C, Nkenke E. Quality assessment of patient information on orthognathic surgery on the internet. J Craniomaxillofac Surg 2020; 48:661-665. [PMID: 32518020 PMCID: PMC7255739 DOI: 10.1016/j.jcms.2020.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/03/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the quality of online information for patients on orthognathic surgery. MATERIALS AND METHODS A selection of search terms specific for orthognathic surgery was chosen and 150 websites were identified using the Internet search engines Google, Yahoo and Bing. Irrelevant websites were excluded. The remaining websites were assessed with a modified Ensuring Quality Information for Patients (EQIP) tool. EQIP evaluates the quality of medical patient information by measuring the three key aspects of content, structure, and identification data. RESULTS 48 relevant websites were identified. EQIP values ranged between 2 and 28 (median 13.65). While 37 of the 48 websites described details of the surgical procedures, only 13 mentioned possible risks and complications of the surgery. No differences were found between the websites of private practices, dentists and public hospitals, universities, or others (p = 0.66). Websites found by Google had a significantly lower EQIP score compared with Yahoo and Bing (11.12 vs. 16.60 for Yahoo and 16.23 for Bing; p = 0.012). The better the rank of the website, the higher the EQIP score (r = -0.411, p = 0.004). CONCLUSIONS The results of this study reflected a large variation of quality of information on orthognathic surgery on the Internet. Therefore, surgeons must be aware that they might be confronted with unrealistic expectations of patients, who may underestimate the potential risks and drawbacks of orthognathic surgery.
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Affiliation(s)
- Johannes Engelmann
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria.
| | - Carmen Fischer
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria
| | - Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Austria
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Promerat A, Touzet-roumazeille S, Schlund M, Ferri J. Assessing Quality of Life After Orthognathic Surgery in Disabled Patients: . J Craniofac Surg 2019; 30:2404-7. [DOI: 10.1097/scs.0000000000005698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Abstract
INTRODUCTION Mandibular osteotomies aim to displace the dental arch to the necessary position, ideally without limitation, while preserving inferior alveolar nerve (IAN) function. Supraforaminal osteotomies offer nerve safety but limit the extent of advancement, whereas Epker and Obwegeser-Dal Pont osteotomies enable unchallenged mandibular advancement but are associated with an inferior border notch. Here, we describe a new technique to avoid such disadvantages. TECHNICAL NOTE The beginning of the procedure was similar to Epker's technique, with sectioning of the lingual cortex up to the level of the lingula. Sectioning of the buccal cortex was stopped 3 to 4 mm above the inferior border and then performed horizontally up to the gonial angle in total thickness. The inferior border periosteum and muscles attachments were conserved and hence, appropriately vascularized. DISCUSSION This technique offers 4 advantages: absence of the inferior border notch, lower risk of damage to the IAN than with Epker's technique, sufficiently large bony surface to obtain bone healing as in Epker's technique, and no limitation to setback movement in contrast to Obwegeser-Dal Pont's or the supraforaminal osteotomy techniques.
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Lee KC, Berg ET, Jazayeri HE, Chuang SK, Eisig SB. Online Patient Education Materials for Orthognathic Surgery Fail to Meet Readability and Quality Standards. J Oral Maxillofac Surg 2019; 77:180.e1-180.e8. [DOI: 10.1016/j.joms.2018.08.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/03/2018] [Accepted: 08/29/2018] [Indexed: 11/29/2022]
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Emadian Razvadi ES, Soheilifar S, Esmaeelinejad M, Naghdi N. Evaluation of the Changes in the Quality of Life in Patients Undergoing Orthognathic Surgery: A Multicenter Study. J Craniofac Surg 2017; 28:e739-43. [PMID: 28922243 DOI: 10.1097/SCS.0000000000003887] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Orthognathic surgery can affect patients' quality of life. The aim of the present study was to assess changes in quality of life during combined orthodontics-surgery treatment and effect of orthodontist-surgeon teamwork on final patient's satisfaction. Twenty-six orthognathic patients who were referred to oral and maxillofacial department of 3 hospitals in Tehran were included in the study. Orthognathic quality of life questionnaire (OQLQ) was given to patients 1 week before, 4 weeks and 4 months after surgery. Two self-designed forms were used for evaluating mood and comfort of patients 1 week before surgery and 4 days after surgery. Self-designed forms were given to the orthodontists and the maxillofacial surgeons to assess quality of teamwork and difficulty of the procedure. Twenty-four patients (15 females and 9 males) with the mean age of 22.62 ± 3.57 completed the study. Quality of life increased from 1 week before surgery to 4 months after surgery (P < 0.013) and the difference was statistically significant between OQLQ score at 1 week before surgery and that of 4 months postoperative. Esthetic and social domain showed significant changes during the studied period. Orthognathic quality of life questionnaire at 4 months postoperative was correlated with surgery difficulty and duration. It can be concluded that orthognathic surgery can improve quality of life, especially in esthetic and social aspects.
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Wagner F, Figl M, Cede J, Schicho K, Sinko K, Klug C. Soft Tissue Changes in Patients Undergoing Intraoral Quadrangular Le Fort II Osteotomy Versus Conventional Le Fort I Osteotomy. J Oral Maxillofac Surg 2018; 76:416-25. [DOI: 10.1016/j.joms.2017.07.158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/12/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022]
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