Our Summary

This study looked back at past medical records to understand how common and what type of complications occur in patients who have had orthognathic surgery, a procedure that corrects conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, or other problems.

The researchers looked at two types of surgeries: operations that only corrected one jaw (single-jaw procedures) and operations that corrected both jaws (bimaxillary procedures). They studied 190 patients who had a total of 209 of these procedures.

Most of the surgeries (88%) were performed to treat a condition called angle class III malocclusion, a problem with the way teeth align when the jaws are closed. The rest of the surgeries (12%) were to treat class II malocclusion, another type of teeth alignment issue.

Out of all the surgeries, 94 complications happened, which is about 45% of the total. For single-jaw surgeries, 22 complications occurred, about 28% of all those operations. For bimaxillary surgeries, 72 complications happened, or about 55% of all those operations.

When comparing the types of complications between the two groups, they were mostly similar, except for late-stage malocclusion. A slight but significant difference was observed in late-stage malocclusion occurrence between the two groups with more cases seen in the bimaxillary group.

The good news is, most of the complications that happened during and after the surgery were temporary or minor and didn’t require much, if any, treatment.

FAQs

  1. What is the incidence and nature of complications in orthognathic procedures?
  2. Are there more complications in single-jaw procedures or bimaxillary procedures in orthognathic surgery?
  3. What is the difference in malocclusion incidences between the bimaxillary and single-jaw groups in orthognathic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about orthognathic surgery is to follow postoperative care instructions closely to minimize the risk of complications and ensure a successful recovery. This may include proper oral hygiene, eating soft foods, avoiding strenuous activities, and attending follow-up appointments as scheduled. It’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Orthognathic surgery is typically recommended for patients with severe jaw misalignment or malocclusion that cannot be corrected with traditional orthodontic treatment alone. This includes patients with:

  1. Severe underbite (class III malocclusion)
  2. Severe overbite (class II malocclusion)
  3. Facial asymmetry
  4. Difficulty chewing or speaking due to jaw misalignment
  5. Temporomandibular joint (TMJ) disorders
  6. Sleep apnea or other breathing problems related to jaw alignment

It is important for patients considering orthognathic surgery to consult with an orthodontist and oral surgeon to determine if they are a suitable candidate for the procedure.

Timeline

Before orthognathic surgery:

  • Patient undergoes consultation with oral and maxillofacial surgeon to discuss treatment options and goals
  • Patient may undergo orthodontic treatment to align teeth and prepare for surgery
  • Preoperative assessments, including physical exams, imaging studies, and dental molds, are conducted
  • Patient is informed about the risks and benefits of the procedure

After orthognathic surgery:

  • Patient undergoes surgery, which may involve LeFort I osteotomy, sagittal split osteotomy, or vertical ramus osteotomy
  • Patient is monitored in the hospital for a few days post-surgery
  • Patient may experience swelling, pain, and difficulty eating or speaking in the immediate postoperative period
  • Follow-up appointments with the surgeon and orthodontist are scheduled for monitoring progress and making any necessary adjustments
  • Patient may need to continue orthodontic treatment for a period after surgery to finalize the results

Overall, the timeline for orthognathic surgery can vary depending on the specific case and individual patient factors, but typically involves several months of preparation, the surgical procedure itself, and several weeks to months of recovery and follow-up care.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with orthognathic surgery?
  2. How long is the recovery period after orthognathic surgery?
  3. What are the expected outcomes of the surgery in terms of improvements in bite alignment and facial appearance?
  4. Will I need to wear braces before or after the surgery?
  5. What type of anesthesia will be used during the surgery?
  6. How long will the surgery take?
  7. Will I need to stay in the hospital after the surgery, and if so, for how long?
  8. What kind of diet restrictions will I have after the surgery?
  9. How soon can I return to normal activities, such as work or school, after the surgery?
  10. Are there any long-term effects or risks associated with orthognathic surgery that I should be aware of?

Reference

Authors: Peleg O, Mahmoud R, Shuster A, Arbel S, Manor Y, Ianculovici C, Kleinman S. Journal: J Craniomaxillofac Surg. 2021 Oct;49(10):891-897. doi: 10.1016/j.jcms.2021.04.006. Epub 2021 Apr 20. PMID: 33994296