Assessment of long term patient satisfaction in orthognathic surgery

Assessment of Long Term Patient Satisfaction in Orthognatic SurgeryOrthognatic surgery is the correction of disorders in tooth bearing parts of maxilla and mandible. Patients in this group cannot be treated ideally with orthodontic methods only. The purpose of the orthognatic surgery is not only to correct dental arrangement but also to achieve ideal facial aesthetic appearence. Lefort 1 osteotomy and sagittal split ramus osteotomy are the most commonly used methods for the correction of dentofacial deformities. Even though there are many good and reliable data in clinics that deal with orthognatic surgery, there is very little information about patient satisfaction in literature. When evaluating the success of the surgery, clinicians usually take postoperative occlusion and cephalometric measurements into consideration. However for the patietns, aesthetic appearence is as important as occlusion.In this study, 80 patients who underwent orthognatic surgery due to developmental malocclusion between the years of 2003-2011 in university of Çukurova, plastic reconstructive and aesthetic surgery clinic were studied. All of these patients were interviewed either personally or by the phone with a questionairre of 14 questions that reflect patient satisfaction such as preoperative and postoperative aesthetic facial apperance, change in self confidence, mastication, hypoestesia due to inferior alveol nerve damage, pain in temporomandibular joint and speaking. Twenty two and a half percent of the patients stated that there was aesthetic improvement, 8,8 percent stated only improvement in mastication and 62,5 percent stated there was improvement in both. A total of 70% of the patients (n=56) pointed out there was significant improvement in their self esteem, and 33,8% said there was numbness in their faces. Preoperatively 17,5% of the patients complained from pain in the temporomandibular joint where as postoperatively this rate was 26,3%. After the surgery significant recovery were determined in mastication and aesthetic improvement. The results of this survey was compared with the literature statistically.In this manner, this study suggests that outcomes of the surgeries can be evaluated not only by occlusion and cephalometric measurements but also with subjective complaints and satisfaction of the patients. To achieve long term success in orthognatic surgery, one should know the relationship between function and aesthetic facial appearence and take both of them into consideration equally.