ABSTRACT
Objective: The aim of the present study is to review data regarding patients' satisfaction after orthognatic surgery in a systematic approach. Methods and Materials: Electronic searching was done in Medline, EMBASE and CENTRAL databases. Inclusion criteria were: 1) assessment of patients' satisfaction or quality of life, 2) onestage orthognathic surgery, 3) follow up period of 8 weeks or more, and English, German, Persian and Arabic articles. Exclusion criteria were: 1) presence of craniofacial syndromes, cleft lip and palate or traumatic injuries, 2) previous facial surgery, 3) psychological problems before surgery. Data were extracted and analyzed in three groups: function, appearance and overall satisfaction. Results: 18 studies met the inclusion criteria. Esthetic and function was improved in majority of patients, however, it was not possible to assess the issue statistically. Overall satisfaction analysis revealed that 88.6% of patients were satisfied, while 2.8% and 8.6% of patients were neutral and dissatisfied, respectively. Conclusion: Most of the patients were satisfied with the surgical outcome. Satisfaction was seemed to be multifactorial and it was not possible to predict satisfaction prior to the surgery.
ABSTRACT
Aims: Expanding mandibular arch for correcting transverse deficiency is a challenging problem in orthodontics. It is believed that mandibular symphyseal distraction osteogenesis (MSDO) is an attractive solution for this problem. The aim of the present study is to review available data regarding stability of MSDO and its effect on temporomandibular joint and teeth and their surrounding tissues, in a systematic approach. Study Design: The study is a systematic review of available evidence. Place and Duration of Study: Department of Orthodontics of Dental school at Shahid Beheshti University of Medical Sciences. From January 2014 to January 2015. Methodology: Electronic searching was done in Medline, Embase and CENTRAL databases. Published clinical studies and case series in English language which had used tooth borne, bone borne or hybrid distractors and had follow up period of 1 year or more were included. Review article, case reports, and letters were not included. Presence of samples with syndromic problems or mandibular cleft and simultaneous other surgical procedures in mandible were reasons for excluding articles. Data were extracted from selected articles. Risk of bias was assessed in articles. Results: A total of 77 articles were found, from which, 10 met the inclusion criteria. 5 articles had assessed stability and none had reported instability. The effect of MSDO on temporomandibular joint was evaluated in all of the included studies, all of them stating that MSDO would not cause permanent changes in temporomandibular joint status. Gingivitis, root injury, mobility, pseudopocket and irresponsiveness to cold stimulus were reported in 6 studies. Risk of bias was assessed to be high in the included studies. Conclusion: Within the limits of this review it is concluded that MSDO would be a stable procedure and it may not cause temporomandibular joint disorder, provided that proper technique is used. Risk of injury to tooth is not so common; however, great care should be taken in order to prevent these injuries. Well-designed randomized clinical trials are highly recommended to clarify these issues.