Preoperative, intraoperative, and postoperative complications in orthognathic surgery: a systematic review

OBJECTIVES: The aim of this study was to determine whether orthognathic surgery is associated with any complications, and what type of complications may occur. MATERIALS AND METHODS: Data were obtained using PubMed (MEDLINE), ISI Web of Knowledge, Ovid, Cochrane Library, Embase Library, and an additional manual search. The titles and abstracts of the electronic search results were screened and evaluated by two observers for eligibility according to the inclusion and exclusion criteria. RESULTS: A total of 1924 articles were identified, and we retained 44 articles for the final analysis. The Prisma diagram flowchart demonstrates our selection scheme. For the purpose of this study, the Cochrane data extraction form was modified. One review author extracted data from the included studies, and the second author checked all of the forms. The hierarchy of evidence classification from the UK NHS Centre for Reviews and Dissemination was used to assess the level of evidence for the retrieved studies. CONCLUSIONS: An evaluation of the obtained studies revealed the existence of a large number of varied complications associated with orthognathic surgery procedures. CLINICAL RELEVANCE: Oral and maxillofacial surgeons, orthodontists, and the surgical team need to prevent such complications during preoperative, intraoperative, and postoperative periods to increase the safety of orthognathic surgery procedures. This review was registered on http://www.crd.york.ac.uk/PROSPERO as CRD42013004711. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00784-015-1452-1) contains supplementary material, which is available to authorized users.