Orthognathic surgery--postoperative clinical and radiographic follow-up routines at Swedish oral and maxillofacial surgery departments.

Abstract

Orthognathic surgery is a frequent procedure at Swedish Oral and Maxillofacial Surgery Departments.The number of clinical and radiographic postoperative follow-up examinations and the choice of radiographic methods seem to vary.The intention with this study was to find out when postoperative clinical and radiographic follow-up was performed following orthognathic surgery and the type of radiographic examinations that were used. In 2009, all Swedish Oral and Maxillofacial Surgery Departments in the Public Health Service (25 centres) were given a form containing standardized questions on the time for clinical follow-up after orthognathic surgery and the radiographic examinations used. A pilot study on 49 consecutive patients at one of the centres was performed to determine if the postoperative radiographic examinations added additional information, leading to further procedures compared to the clinical observations only. A one-year follow-up was the most frequently used clinical control reported by 15 centres, and a six-month follow-up, the next most frequent. At 14 of the 15 centres, radiographic examinations were included at the one-year follow-up. A five-year clinical and radiographic follow-up was reported by two centres. One or, at the most, two postoperative radiographic follow-up sessions were reported by 68% of the centres. Profile and panoramic imaging were most often used. In the evaluation of the postoperative handling of the 49 consecutive patients in the pilot study, a radiolucency around a fixation screw noted radiographically was the only additional postoperative radiological finding that resulted in a surgical procedure. Postoperative clinical and radiographic follow-up routines following orthognathic surgery vary considerably between the Swedish Oral and Maxillofacial Surgery Departments.There appears to be a need for studies on the value of the information,which repeated postoperative clinical and radiographic follow-up controls add in routine medical attendance.