Our Summary

This research paper is about a study that was conducted to understand the current practices of orthognathic surgery (a type of jaw surgery) in Germany. They surveyed 169 surgeons using online questionnaires. The results showed that the way surgeons are trained, the care provided around the time of surgery, and the use of digital tools varied greatly. Less than half of the surgeons used a mix of traditional and digital methods for planning surgeries, with the main barriers to using more digital methods being cost and logistical challenges. There was also a lot of variation in how patients were cared for during surgery, especially when it came to blood management and how long antibiotics were given. However, nearly all the surgeons agreed on the need for antibiotic use to prevent infection. Most surgeons followed the same surgical steps, such as doing orthodontics before surgery, removing the third molar before surgery, and operating on the upper jaw first. After surgery, most patients were moved to standard care and discharged within 3-5 days. The study also found that surgeons with more experience and who performed more surgeries had better patient outcomes, including shorter operation times and faster discharge. The authors conclude that there should be standardized procedures for orthognathic surgery to improve patient safety and recovery, and to ensure consistency in healthcare settings.

FAQs

  1. What are the current practices of orthognathic surgery (OGS) in Germany?
  2. What are some challenges in adopting a more digital workflow in orthognathic surgery practices in Germany?
  3. What correlations were observed between surgeon experience, case volume, and patient outcomes in orthognathic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about oral surgery is to follow all preoperative instructions provided by the surgeon, including fasting before the procedure and avoiding certain medications that may increase the risk of bleeding. It is important to communicate any concerns or questions with the surgeon before the surgery to ensure a smooth and successful recovery.

Suitable For

Patients who are typically recommended oral surgery include those with:

  1. Malocclusion (misalignment of the teeth or jaw)
  2. Facial trauma or injuries
  3. Temporomandibular joint disorders
  4. Impacted wisdom teeth
  5. Cleft lip and palate
  6. Sleep apnea
  7. Tumors or cysts in the jaw or mouth
  8. Severe dental infections
  9. Dental implants or bone grafting needs
  10. Corrective jaw surgery for functional or aesthetic reasons.

Timeline

Before oral surgery:

  1. Patient consults with oral and maxillofacial surgeon for evaluation and treatment planning.
  2. Preoperative assessments and tests are conducted, including imaging studies.
  3. Patient receives preoperative instructions, including fasting guidelines and medication management.
  4. Surgery date is scheduled and anesthesia options are discussed with the patient.

After oral surgery:

  1. Patient undergoes the surgical procedure under anesthesia.
  2. Postoperative care instructions are provided, including pain management and wound care.
  3. Patient may experience swelling, pain, and discomfort in the immediate postoperative period.
  4. Follow-up appointments are scheduled for monitoring healing and removal of sutures.
  5. Patient gradually resumes normal activities and diet as directed by the surgeon.
  6. Patient may require orthodontic treatment post-surgery for optimal results.
  7. Patient is discharged from care with instructions for long-term oral health maintenance and follow-up appointments.

What to Ask Your Doctor

  1. What specific oral surgery procedure do you recommend for my condition?

  2. What are the potential risks and complications associated with the surgery?

  3. What are the expected outcomes and recovery time after the surgery?

  4. Are there any alternative treatment options to consider before undergoing oral surgery?

  5. What type of anesthesia will be used during the surgery and what are the potential side effects?

  6. How experienced are you in performing this specific type of oral surgery?

  7. What is the overall success rate of this surgery in patients with similar conditions?

  8. What type of postoperative care and follow-up appointments will be necessary?

  9. Will I need to make any changes to my diet or lifestyle before or after the surgery?

  10. Are there any specific instructions or precautions I should follow to ensure a successful recovery?

Reference

Authors: Bär AK, Pabst A, Bouffleur F, Thiem DGE, Werkmeister R, Kesting MR, Heiland M, Al-Nawas B, Becker P. Journal: J Craniomaxillofac Surg. 2025 Jul;53(7):927-937. doi: 10.1016/j.jcms.2025.03.004. Epub 2025 Mar 19. PMID: 40113459