Assessment of Patient Satisfaction and Functional Outcomes in Orthognathic Surgery

ABSTRACT

Background:

Orthognathic surgery is a surgical procedure performed to correct severe jaw misalignments that can affect a patient’s facial aesthetics and functional occlusion. While the primary goal of orthognathic surgery is to improve functional outcomes and facial appearance, it is essential to assess patient satisfaction as a crucial aspect of overall treatment success.

Materials and Methods:

Patient selection: We conducted a prospective study involving 50 patients who underwent orthognathic surgery. All patients had a confirmed diagnosis of severe jaw misalignment, as determined by clinical and radiographic assessments. The surgical procedures performed included maxillary advancement, mandibular setback, or a combination of both, depending on the patient’s specific diagnosis. Preoperative orthodontic treatment was provided to align the teeth and prepare the patient for surgery. Patients were evaluated preoperatively and at postoperative intervals of 3 months, 6 months, and 1 year.

Results:

Patient satisfaction scores and functional outcomes were as follows: aesthetics of facial profile (1-year post-op): mean score = 4.6, chewing function (1-year post-op): mean score = 4.4, speech function (1-year post-op): mean score = 4.3, and overall satisfaction with surgical outcome (1-year post-op): mean score = 4.5. Objective assessments revealed a significant improvement in occlusion and facial aesthetics. The mean reduction in overjet was 4.8 mm, and the mean reduction in overbite was 3.2 mm. Additionally, the mean postoperative ANB angle improved by 3.7°, indicating a better facial balance.

Conclusion:

Orthognathic surgery in our cohort of 50 patients resulted in high levels of patient satisfaction with both functional outcomes and facial aesthetics. Objective measurements also indicated significant improvements in occlusion and facial balance.

INTRODUCTION

Orthognathic surgery, a corrective surgical procedure aimed at addressing severe jaw misalignments and their associated functional and aesthetic concerns, has become an essential component of contemporary oral and maxillofacial surgery.[1] Jaw misalignments, if left untreated, can not only impact facial aesthetics but also lead to functional issues, including chewing and speech difficulties. The primary objective of orthognathic surgery is to restore both facial harmony and proper occlusal function, thereby enhancing patients’ quality of life.

Orthognathic surgery involves repositioning the maxilla (upper jaw), the mandible (lower jaw), or both to achieve optimal alignment.[2]

While the clinical and radiographic outcomes of orthognathic surgery have been extensively studied, relatively fewer investigations have focused on patient-reported outcomes and satisfaction levels.[3] Understanding patient satisfaction is essential as it not only provides valuable feedback for healthcare providers but also contributes to patient-centered care and decision-making. Therefore, this study aims to assess patient satisfaction and functional outcomes following orthognathic surgery in a cohort of 50 patients, shedding light on the overall success of this surgical intervention.

MATERIALS AND METHODS

Study design and patient selection

We included a cohort of 50 patients who underwent orthognathic surgery for the correction of severe jaw misalignments. All patients provided informed consent to participate in the study.

Inclusion criteria

Patients were eligible for inclusion if they met the following criteria:

• Confirmed diagnosis of severe jaw misalignment based on clinical and radiographic assessments.

• No history of previous orthognathic surgery.

• Willingness to participate in postoperative follow-up evaluations.

Surgical procedures

The surgical procedures performed in this study included maxillary advancement, mandibular setback, or a combination of both, depending on the individual patient’s diagnosis. All surgeries were performed by experienced oral and maxillofacial surgeons.

Preoperative orthodontic treatment

Prior to surgery, all patients underwent preoperative orthodontic treatment to align their teeth and prepare for the surgical correction of jaw misalignment. This phase aimed to optimize dental occlusion.

Data collection

Patients were evaluated at multiple time points, including preoperatively and at postoperative intervals of 3 months, 6 months, and 1 year. Patient-reported outcomes were assessed using a standardized questionnaire administered during these follow-up visits.

Patient-reported questionnaire

The questionnaire included Likert scale ratings to assess patient satisfaction in the following domains:

Aesthetics of facial profile (rated on a scale of 1–5, with 1 indicating “very dissatisfied” and 5 indicating “very satisfied”).

Chewing function (rated on the same 1–5 scale).

Speech function (rated on the same 1–5 scale).

Overall satisfaction with the surgical outcome (rated on the same 1–5 scale).

Objective assessments

Objective assessments were conducted during clinical examinations and included cephalometric radiographs to measure changes in skeletal relationships, such as the ANB angle. These assessments provided objective data on functional outcomes and facial aesthetics.

Statistical analysis

Descriptive statistics were used to summarize patient-reported outcomes. Mean values were calculated for each domain, and changes over time were assessed. Objective measurements were analyzed to evaluate functional and aesthetic improvements. Statistical significance was determined using appropriate tests (e.g., t-tests or analysis of variance).

RESULTS

Patient satisfaction scores and objective measurements are presented in the following tables.

Table 1 shows patient satisfaction scores at different postoperative time points. Patients reported a significant improvement in all domains over time. Aesthetics, chewing function, speech function, and overall satisfaction scores increased progressively from the preoperative assessment to the 1-year postoperative evaluation. All changes were statistically significant (P < 0.001).

Table 1.

Patient satisfaction scores

Time point (months)	Aesthetics (mean±SD)	Chewing function (mean±SD)	Speech function (mean±SD)	Overall satisfaction (mean±SD)
Preoperative	2.1±0.6	2.2±0.5	2.3±0.7	2.0±0.6
3 months	3.9±0.4	3.8±0.5	3.7±0.6	3.9±0.4
6 months	4.3±0.3	4.4±0.4	4.2±0.5	4.3±0.4
1 year	4.6±0.2	4.5±0.3	4.4±0.4	4.5±0.3

SD=Standard deviation. All P values were <0.001 for the comparison of postoperative time points to the preoperative values

Table 2 displays objective measurements taken during the study. Overjet and overbite reductions were evident at the 3-month assessment and continued to improve over time. By the 1-year postoperative evaluation, patients had experienced a significant mean reduction in overjet (4.8 mm), overbite (3.2 mm), and a positive change in the ANB angle (3.7°). All these changes were statistically significant (P < 0.001).

Table 2.

Objective measurements

Time point (months)	Overjet reduction (mm)	Overbite reduction (mm)	ANB angle change (°)
Preoperative	–	–	–
3 months	2.1±0.4	1.5±0.3	–
6 months	3.5±0.5	2.2±0.4	–
1 year	4.8±0.6	3.2±0.5	3.7±0.8

SD=Standard deviation. All P values were <0.001 for the comparison of postoperative time points to the preoperative values

These results indicate a substantial improvement in both patient-reported satisfaction and objective functional and aesthetic outcomes following orthognathic surgery. The surgical intervention effectively addressed severe jaw misalignments, leading to enhanced facial aesthetics and improved occlusal function.

DISCUSSION

This study assessed patient satisfaction and functional outcomes following orthognathic surgery in a cohort of 50 patients. Our findings reveal significant improvements in both patient-reported satisfaction scores and objective measurements, highlighting the overall success of orthognathic surgery as a treatment for severe jaw misalignments.

Patient satisfaction

Patient-reported outcomes play a crucial role in evaluating the success of orthognathic surgery. Our study demonstrated a substantial increase in patient satisfaction scores over time. At the 1-year postoperative assessment, patients reported high levels of satisfaction with their facial aesthetics, chewing function, speech function, and overall surgical outcome. These findings are consistent with previous research indicating improved patient satisfaction following orthognathic surgery.[1,2]

Functional and aesthetic improvements

Objective measurements provided valuable insights into the functional and aesthetic improvements achieved through orthognathic surgery. Reductions in overjet and overbite were evident early in the postoperative period and continued to improve over time. These changes indicate enhanced occlusion and facial aesthetics. Additionally, the positive change in the ANB angle reflects improved facial balance. These objective improvements align with the goals of orthognathic surgery, emphasizing its effectiveness in correcting severe jaw misalignments.[3,4]

Clinical significance

Orthognathic surgery not only addresses the functional challenges associated with severe jaw misalignments but also has a profound impact on patients’ self-esteem and overall quality of life. The substantial increases in patient satisfaction scores emphasize the positive psychosocial effects of this surgical intervention. Patients report feeling more confident in their facial appearance and experience improved chewing and speech function, contributing to an enhanced sense of well-being.

CONCLUSION

In conclusion, our study demonstrates that orthognathic surgery effectively improves patient satisfaction and functional outcomes in individuals with severe jaw misalignments. This surgical intervention not only corrects functional issues but also positively impacts facial aesthetics and psychosocial well-being. These findings underscore the importance of a multidisciplinary approach involving oral and maxillofacial surgeons, orthodontists, and patients to achieve successful outcomes in orthognathic surgery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.