Influence of systemic comorbidities on the complications of orthognathic surgery: A scoping review

Risk Assessments in Orthognathic Surgery: A National Inpatient Sample (NIS) and Nationwide Ambulatory Surgery Sample (NASS) Analysis

“…Prior studies have also shown that diabetes, hypertension, obesity, and a prolonged hospital stay are associated with an increased risk of readmission after surgery. 2,4,9 Our study also found that those with longer lengths of stay had more comorbidities and more complex procedures. There is also a growing body of research demonstrating that racial and socioeconomic factors, such as unemployment or underemployment, limited access to preventable healthcare, and environmental factors contribute to disparities in orthognathic surgery.…”

“…6,7 However, in our study, the majority of maxillary and mandibular procedures were performed in teaching hospitals and were associated with extended length of stay due to complex patient populations with significant comorbidities. 4 As noted by several studies, there are racial and ethnic disparities in access to orthognathic surgery, outcomes, and costs. 6,7,8 A main finding of our study is that non-White patients, particularly Black patients, have significantly higher LOS and hospital-associated costs in both the inpatient and ambulatory databases, as a result of orthognathic surgery.…”

“…There is also a growing body of research demonstrating that racial and socioeconomic factors, such as unemployment or underemployment, limited access to preventable healthcare, and environmental factors contribute to disparities in orthognathic surgery. 2,4,8,14 The disparity in cost and LOS can also be attributed to social and systemic factors, such as preoperative comorbidities, health care quality, recovery, and discharge processes. 16 The findings of this study are supported by other studies which have revealed that Hispanic patients have a higher rate of postoperative complications resulting in extended length of stay in the hospital compared to non-Hispanic White patients.…”

“…3 There has not been much research conducted on the postoperative complications of orthognathic surgery based on the impact of systemic comorbidities on surgical and/or patient outcomes. 4 The consequences of such complications not only affect the patient's quality of life, resulting in increased morbidity and mortality risks, but can also place a significant financial burden on the patient and healthcare system as well. 2,5,[11][12][13][14] Hence, a focused investigation on these outcomes following orthognathic surgery is warranted to direct future efforts to minimize these costs and complications.…”

Alternative management of patients with gummy smile due to maxillary growth: Clinical case

“…This individualization depends on several factors, of which we will retain mainly three: the "timing" of the orthodontic treatment, the cephalometric analysis and the desires of the patient [5] . Despite orthognathic surgery being the ideal treatment for some cases, it is important to recognize that there are contraindications and disadvantages of this type of surgery, such as: planning that takes a long time, high costs that prevent it from being a routine treatment, temporary worsening the appearance of the patient; and psychological problems due to delays in achieving the main demand of the patient, which is usually an aesthetic facial appearance, a technique of high surgical skill since any minor error could affect the treatment result, some patients reject the use of orthodontics altogether with the surgical treatment for which orthodontic stability problems could arise, it can be considered an invasive surgery due to the use of general anesthesia depending on the approach technique of the surgeon [4,6,7,8] , some patients cannot undergo surgery when their systemic state is not ideal , or patients with uncontrolled Diabetes Mellitus due to increased probability of tissue necrosis, patients with thalassemia at increased risk of bleeding and infection, bone and joint disease, patients with skeletal immaturity, those with progressive dentofacial disease, vitamin D deficiency, disease Chron's and chronic obstructive pulmonary disorder [9] . Rubenstein and Kostianovsk first described a technique similar to the LipStaT in 1973 called Lip repositioning.…”