The Comparison of Patient Satisfaction after “Surgery First” and Conventional Orthognathic Surgery: An Original Research

Patient Satisfaction Following Orthognathic Surgery: A Systematic Review

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.

Treatment of an adult skeletal class II patient with a modified surgery-first approach

This case report presents an 18-year-old female patient who had skeletal Class II relationship due to a mandibular retrognathia, decreased lower anterior facial height and proclined incisors with increased overjet and overbite. Her main complaints were protruding upper incisors and decreased distance between the tip of the nose and chin. A modified surgery-first approach was performed with two months of presurgical orthodontics to achieve 8mm mandibular advancement. The total treatment time was 11 months. Improved aesthetics, a balanced facial profile and a stable and functional occlusion were obtained in less treatment time due to accelerated tooth movement.