Effects of oral nutritional supplement on postoperative orthognathic surgery patients’ nutritional status: a randomised clinical trial

Abstract

Background Orthognathic surgery limits oral intake and increases metabolic demand, leading to decreased muscle mass. To mitigate these effects, incorporating oral nutritional supplements (ONS) into a nutritional therapy plan is recommended. However, nutrition therapy has not received much attention in orthognathic surgery. This study aimed to assess the effect of ONS on postoperative orthognathic surgery patients’ nutritional status. Methods A 12-week randomised controlled trial was conducted between June and December 2022 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok. Patients were included if they were 18 years of age or older, underwent orthognathic surgery involving at least one jaw, and had no metabolic-related diseases, milk or soy allergies, or galactosemia. Patients who underwent segmental procedures or genioplasty alone were excluded. The predictor variable was ONS. Subjects were randomly assigned by the block randomisation method into two groups: 1) subjects who received ONS, and 2) subjects who did not receive ONS. The primary outcome variable was nutritional status, which was measured using anthropometric, biomarker, and muscle strength assessments at 5 time points: a day before surgery (T0), the day of discharge (T1), 2 weeks (T2), 4 weeks (T3), and 12 weeks postoperatively (T4). Covariates were subjects’ demographics, oral health-related quality of life, and dietary record assessment. The T-test, or Mann-Whitney U test, was used to compare the mean difference of continuous data, where appropriate. The differences were considered statistically significant when the p-value was less than 0.05. Results A total of 36 subjects were included in the study. Subjects receiving either nutritional counselling alone or both nutritional counselling and ONS experienced postoperative weight and muscle mass loss, with no significant differences observed across all nutritional status parameters after the 12-week postoperative mark. Conclusion These results suggest the need for more personalised and intensive nutrition therapy plans to reduce the negative impact of muscle mass loss and the associated risk of postoperative infection in orthognathic surgery patients. Trial registration: This study has been registered with the Thai Clinical Trial Registration (https://www.thaiclinicaltrials.org/), with the registration number TCTR20220624006, registered on June 24, 2022.