Our Summary

This research paper investigates how to transition from in-patient to outpatient jaw surgery (orthognathic surgery). The study looked at what makes a successful transition and what factors could lead to a longer hospital stay. Over a year, 102 patients who had jaw surgery were observed. The study found that patients older than 22, surgeries that ended before 1 pm, shorter surgeries, and surgeries where the patient didn’t vomit afterwards or need morphine were more successful in outpatient care. The researchers concluded that the right patient selection, organizing outpatient facilities properly, and the correct anesthesia protocols are important for outpatient jaw surgery. This study helps set a basis for future practices, but more research is needed to understand what factors might lead to unsuccessful outpatient surgery. The research is relevant to clinics because it shows that in certain cases, jaw surgery can be done on an outpatient basis successfully.

FAQs

  1. What factors were found to contribute to a successful transition from in-patient to outpatient orthognathic surgery?
  2. What does the research suggest is important for successful outpatient jaw surgery?
  3. What further research is needed according to this study on transitioning from in-patient to outpatient jaw surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about orthognathic surgery is to follow all pre-operative and post-operative instructions closely to ensure a successful recovery. This includes attending all follow-up appointments, taking prescribed medications as directed, and maintaining a healthy diet to aid in healing. Additionally, it is important to communicate any concerns or complications to your healthcare provider promptly.

Suitable For

Patients who are typically recommended orthognathic surgery are those who have skeletal and dental abnormalities that affect their bite, facial appearance, and overall oral health. This includes patients with:

  1. Severe malocclusion (misalignment of the teeth)
  2. Facial asymmetry
  3. Difficulty chewing, speaking, or breathing due to jaw misalignment
  4. Temporomandibular joint (TMJ) disorders
  5. Sleep apnea or other breathing problems related to jaw position
  6. Cleft lip and palate deformities
  7. Chronic jaw pain or headaches related to jaw misalignment

Orthognathic surgery is often recommended for patients who have completed their growth and development, typically around age 18 for females and age 21 for males. However, older patients can also benefit from orthognathic surgery if they have functional or aesthetic concerns related to their jaw alignment.

Overall, the decision to undergo orthognathic surgery is based on a comprehensive evaluation by a team of oral and maxillofacial surgeons, orthodontists, and other specialists to determine the best course of treatment for each individual patient.

Timeline

Before orthognathic surgery:

  1. Patient consults with an orthodontist and oral surgeon to discuss treatment options and determine if surgery is necessary.
  2. Pre-operative appointments are scheduled to discuss the procedure, risks, and expectations.
  3. Pre-surgical orthodontic treatment may be required to align the teeth and jaws.
  4. Pre-operative testing and evaluations are conducted to ensure the patient is healthy enough for surgery.

After orthognathic surgery:

  1. The patient is monitored closely in the hospital for the first 24-48 hours post-surgery.
  2. Pain management and swelling control are priorities in the immediate post-operative period.
  3. The patient may be on a liquid or soft food diet for a period of time to allow for proper healing.
  4. Follow-up appointments with the oral surgeon and orthodontist are scheduled to monitor progress and adjust treatment as needed.
  5. Physical therapy may be recommended to help with jaw movement and function.
  6. Full recovery from orthognathic surgery can take several months, with continued orthodontic treatment to fine-tune the bite and alignment of the teeth.

What to Ask Your Doctor

  1. Am I a suitable candidate for outpatient orthognathic surgery?
  2. What are the potential risks and complications associated with orthognathic surgery?
  3. How long is the recovery period for outpatient orthognathic surgery?
  4. What type of anesthesia will be used during the surgery?
  5. Will I need to stay overnight in the hospital following the surgery?
  6. What post-operative care will be required following the surgery?
  7. How soon after the surgery can I resume normal activities?
  8. What are the expected outcomes of the surgery in terms of functional and aesthetic improvements?
  9. How many orthognathic surgeries have you performed and what is your success rate?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: Prevost A, Lauwers F, Varazzani A, Poulet V, Mure M, Lopez R, Cavallier Z. Journal: Clin Oral Investig. 2023 Nov;27(11):6781-6788. doi: 10.1007/s00784-023-05290-x. Epub 2023 Oct 4. PMID: 37792221