A Clinical Analysis of Orthognathic Surgery for the Last 48 Years in the Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences

Hasebe, Daichi; Suda, Daisuke; Asai, Yusuke; Kojima, Takao; Kato, Yusuke; Kobayashi, Tadaharu

doi:10.5927/jjjd.26.266

Cited by 10 publications

(2 citation statements)

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“…Patients with a systemic condition that prevents safe operation under general anesthesia as per the screening test before the preoperative orthodontic treatment are treated for the primary disease before initiating orthodontic treatment. Many patients with jaw deformity who consult orthognathic departments for surgical treatment to achieve normal occlusion also hope to improve facial appearance, which may explain the predominance of female patients [12]. The same trend in the sex ratio was observed among patients who consulted our department.…”

Section: Discussionsupporting

confidence: 60%

Clinical investigation of patients with jaw deformity with comorbidities

Kasahara

Hoshino

Sugiura

et al. 2022

Maxillofac Plast Reconstr Surg

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Background With improvements in the safety and stability of surgeries, the number of orthognathic surgeries is increasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeries for patients with comorbidities is also increasing. We report a survey and clinical investigation of patients with comorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathic surgery. Results The participants included 296 men and 712 women, with a mean age of 28 years (13–19 years, n=144; 20–29 years, n=483; 30–39 years, n=236; 40–49 years, n=102; 50–59 years, n=39; ≥60 years, n=4). In total, 347 patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwent SSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent other surgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases (n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologic diseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrine diseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases (n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses (hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder), and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia was managed with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetes mellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventful course. Conclusions The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacial surgeons should adequately manage cases requiring cautious perioperative control and highlight the importance of preoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oral surgeons should adopt appropriate additional preventive measures for patients with comorbidities.

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Section: Discussionsupporting

confidence: 60%

Clinical investigation of patients with jaw deformity with comorbidities

Kasahara

Hoshino

Sugiura

et al. 2022

Maxillofac Plast Reconstr Surg

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“…As a result of their enhanced appearance and chewing function, 67.5% of patients experienced a significant boost in self-esteem (9). Female preponderance has been observed in the majority of research since the majority of patients with jaw deformities who contact orthognathic departments for surgical treatment to achieve normal occlusion also expect to improve their facial appearance (10). More male patients (89%) reported functional improvement than female patients (59%); alternatively, more females (77%) than males (44%) reported self-confidence satisfaction (5).…”

Section: Functionality Aesthetic Satisfaction and Psychosocial Impact...mentioning

confidence: 99%

Effect of Orthognathic Surgery on the Quality of Life

Alsaadi¹,

Alyousif²,

Alwathnani³

et al. 2023

JOHS

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Dentofacial deformities have an effect on the quality of life (QoL) by affecting numerous elements of an individual's life and oral health. Orthognathic surgery is generally performed to correct facial abnormalities related to the maxilla and/or mandible. Several observational studies have looked at how orthognathic surgery and other factors affect the QoL of adults. The reported overall satisfaction in observational studies is high, ranging from 70% to 87%. Satisfaction in terms of aesthetic outcome is higher compared to functional improvement, especially in female patients. Additionally, orthodontic surgery resulted in remarkable improvements in social adjustment, social functioning, self-esteem, selfconfidence, and facial appearance changes, as well as positive life improvement. Finally, it has been determined that orthognathic surgery results in physical and psychosocial quality of life improvements after surgery and is connected with high patient satisfaction ratings. Psychological variables and aesthetics exerted a considerable influence on the patient's QoL and were more influential in determining large changes than functional considerations.

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