Patient satisfaction after orthognathic surgery: a 3 year follow-up of 60 high-angle Class II individuals

Abstract

Summary Background and objectives High-angle Class II malocclusion is considered challenging to treat to a stable result and, although studies report treatment outcome in terms of morphology, patient satisfaction has not been addressed. The objectives of the present study were to examine patients’ motives for treatment and satisfaction with the results. Material and methods A structured questionnaire was distributed 3 years post-operatively to 93 consecutively treated patients with an initial diagnosis of mandibular-plane angle (ML/NSL) ≥34.0 degrees and ANB angle ≥4.0 degrees. Three surgical subsamples were defined: one-piece Le Fort I, bilateral sagittal split osteotomy, or a combination of the two (Bimax). Lateral cephalometric radiographs were used to assess morphological characteristics and post-treatment changes. Results Questionnaire participation was 69.8 per cent. The most frequently reported motives for seeking treatment were to improve oral function (85.0 per cent) and dental appearance (71.7 per cent). Thirty per cent were very satisfied, 53.3 per cent were satisfied, and 16.7 per cent were dissatisfied with the overall treatment result. Dissatisfaction was associated with a persisting post-treatment anterior open bite (AOB), horizontal relapse at B point, and with sensory impairment. Conclusions and implications A higher rate of dissatisfaction was found than what has usually been reported for othognathic surgical patients, and this was associated with a persisting AOB. In addition, mandibular relapse and impaired sensory function were related to dissatisfaction and are associated with mandibular surgery. Prospective high-angle Class II patients should be comprehensively informed about the unpredictability of treatment outcomes in terms of occlusion and facial appearance.

Does orthognathic treatment improve patients’ psychosocial well-being?

“…Yet the mean score is lower at the end of treatment than at one year after surgery, though statistical significance is not reached. The only improvements maintained at the end of the treatment are found in general orthognathic quality of life, oral function and facial aesthetics, supporting recent findings by Torgersbråten et al [28] who reported improvements in oral function, dental and facial appearance three years post-surgery. The results also support the results by Paunonen et al [16], who found improvements in OQLQ in patients treated 4-8 years previously, as we did find changes both in functional and aesthetic issues.…”

In Vivo Accuracy of a New Digital Planning System in Terms of Jaw Relation, Extent of Surgical Movements and the Hierarchy of Stability in Orthognathic Surgery

“…The most common reason for seeking orthognathic surgery is the correction of occlusion or oral function [ 24 , 25 , 26 ], followed by facial and psychosocial improvement [ 27 ]. With new procedures, it is therefore essential to evaluate the postoperative occlusion, which is the orthodontic basis for achieving a good final intercuspation and the associated masticatory function.…”

“… Overview of rotation errors (yaw, roll, and pitch) concerning studies on virtual planning in orthognathic surgery. Measurements of the present study compared to the results of three systematic reviews (Sys Rev) covering the years 2007–2020 [ 4 , 26 , 35 ]. …”

Assessment of the quality of life of orthodontic and surgical patients. Analysis of the factors that motivate the initiation of treatment within the masticatory system

“…Based on our own experience and available sources, we can conclude that there is a risk that patients may find it difficult to accept their new face after surgery and will need a lot of time to get used to it. It may happen that they will not be satisfied with their new appearance and will have difficulties adapting for the rest of their lives [26]. From the perspective of this problem, it seems important to develop and widely implement 3D modeling as one of the elements of patient preparation for surgery.…”