Orthognathic Surgery in Patients Over 40 Years of Age: Indications and Special Considerations

Peacock, Zachary S.; Lee, Cameron C. Y.; Klein, Katherine P.; Kaban, Leonard B.

doi:10.1016/j.joms.2014.03.020

Cited by 59 publications

(21 citation statements)

References 32 publications

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“…Studies show that women are more likely to seek OS because for esthetic reasons. 8,22,[29][30][31] This was not seen in the current study. More men than women answered that an esthetic reason was the indication for OS.…”

Section: Discussioncontrasting

confidence: 76%

“…[6][7][8] Generally, high satisfaction after OS is described. 4,9 -12 For the surgeon, OS is a routine procedure, but from the patient's point of view it is a big, unknown, time-consuming treatment.…”

mentioning

confidence: 99%

“…8,16 The purpose of this study was to investigate Facebook group members' satisfaction after OS and the factors that may have had an influence on the satisfaction including SSC, beauty, and attractiveness. Regarding the findings in other studies, different variables were compared.…”

mentioning

confidence: 99%

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Orthognathic Surgery

Larsen

Thygesen

2016

Journal of Craniofacial Surgery

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The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were enrolled in the study. The respondents consisted of 12 men and 93 women, with a mean age of 27 ± 9 years. Fifty-four percent replied that esthetic concerns were the reason for the OS. Eighty-four percent reported improvement in facial esthetics after the OS. Men indicated a higher degree of improvement in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform for qualitative scientific research in certain age groups. Further prospective and objective studies about the esthetic improvement after OS should be performed.

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Section: Discussioncontrasting

confidence: 76%

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confidence: 99%

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Orthognathic Surgery

Larsen

Thygesen

2016

Journal of Craniofacial Surgery

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“…Two-jaw surgeries can also help prevent aggravating sleep apnea by advancing the maxilla, thus limiting the amount required to set back the mandible. [19][20][21] This study's predominance of two-jaw approaches for correction of skeletal Class III malocclusion may be due to the fact that this investigation was performed in an academic center. Referrals from general dentists play an important role in maintaining the number of orthognathic surgery patients.…”

Section: Discussionmentioning

confidence: 99%

Modern trends in Class III orthognathic treatment: A time series analysis

Lee¹,

Park²,

Lee

2016

The Angle Orthodontist

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Objective: To examine the current trends in surgical-orthodontic treatment for patients with Class III malocclusion using time-series analysis. Materials and Methods: The records of 2994 consecutive patients who underwent orthognathic surgery from January 1, 2004, through December 31, 2015, at Seoul National University Dental Hospital, Seoul, Korea, were reviewed. Clinical data from each surgical and orthodontic treatment record included patient's sex, age at the time of surgery, malocclusion classification, type of orthognathic surgical procedure, place where the orthodontic treatment was performed, orthodontic treatment modality, and time elapsed for pre-and postoperative orthodontic treatment. Results: Out of the orthognathic surgery patients, 86% had Class III malocclusion. Among them, two-jaw surgeries have become by far the most common orthognathic surgical treatment these days. The age at the time of surgery and the number of new patients had seasonal variations, which demonstrated opposing patterns. There was neither positive nor negative correlation between preand postoperative orthodontic treatment time. Elapsed orthodontic treatment time for both before and after Class III orthognathic surgeries has been decreasing over the years. Conclusion: Results of the time series analysis might provide clinicians with some insights into current surgical and orthodontic management. (Angle Orthod. 2017;87:269-278)

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“…Age has also previously been shown to be a risk factor for increased length of stay and need for hardware removal. 38 …”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Rates After Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

Pásseri

Choi

Kaban

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Purpose To compare morbidity and mortality rates in obstructive sleep apnea (OSA) versus dentofacial deformity (DFD) patients undergoing equivalent maxillofacial surgical procedures. Patients and Methods Patients with OSA who underwent maxillomandibular advancement with genial advancement (MMA), at Massachusetts General Hospital Department of Oral and Maxillofacial Surgery, from December 2002 to June 2011, were matched to patients with DFD undergoing similar maxillofacial procedures during the same time period. They were compared with regards to demographic variables, medical comorbidities, perioperative management, intraoperative, early and late postoperative complications and mortality. Results A study group of 28 patients with OSA and a control group of 26 patients with DFD were compared. The patients with OSA were older (41.9±12.5 vs. 21.7±8.6years), had a higher ASA classification (2.0±0.5 vs. 1.3±0.6) and BMI (29.6±4.7 vs. 23.0±3.1kg/m2). They also had a greater number of medical comorbidities (2.4±2.3 vs. 0.7±1.0). More OSA than DFD patients had complications (28, 100% vs.19, 73%, p=0.003) and the total number of complications in the OSA group was higher (108 vs. 33, p<0.001). In the OSA group, 13.9% and in the DFD group 3.0% of the complications were classified as major. The absolute risk of a complication for the OSA group was 3.9 vs . 1.3 for the DFD group. The relative risk of complications in OSA compared to DFD was 3.0. No difference in mortality was found. Conclusions OSA patients were older, had more comorbidities and ultimately had a greater number of early, late, minor and major complications than those in the DFD group. The incidence of mortality in both groups was zero. MMA appears to be a safe procedure with regards to mortality but OSA patients should be counseled preoperatively regarding the relative increased risk of complications.

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Orthognathic Surgery in Patients Over 40 Years of Age: Indications and Special Considerations

Cited by 59 publications

References 32 publications

Orthognathic Surgery

Orthognathic Surgery

Modern trends in Class III orthognathic treatment: A time series analysis

Morbidity and Mortality Rates After Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

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