Orthognathic surgery is used to treat dental issues such as misaligned jaws and teeth and skeletal abnormalities related to them. It is often recommended when there are significant dentofacial abnormalities that cannot be corrected by orthodontic therapy alone, particularly in adults when the natural growth pressures have stopped. Dentofacial malformations or abnormalities often affect one or both jaws, although they may also impact other craniofacial structures [1]. Orthognathic surgery's main objective is to address the underlying skeletal abnormality to enhance function [2, 3]. According to many studies [4], individuals with skeletal malocclusions often have a range of functional impairments, such as decreased biting power, limited mandibular excursions, strange chewing patterns, and temporomandibular disorders [4]. In addition, changes in the soft tissue that lies on top of the facial bones may be manifested as a direct consequence of skeletal improvements made during orthognathic surgery. As a result of restoring the harmony between the face's skeletal bones, the patient's facial look will improve after surgery. According to reports, those with excellent dentofacial balance are seen as more handsome, gregarious, and intriguing and often come from a high socioeconomic class [5]. Additionally, enhancing one's facial look may boost self-esteem and improve confidence and social skills. How orthognathic surgery impacts patients' lives is a considerable scientific interest [6].

Dentofacial abnormalities may be fixed using a variety of procedures [7]. However, the ideal method for treating moderate-to-severe abnormalities is believed to be orthodontic therapy coupled with orthognathic surgery [4]. Orthognathic surgery involves correcting the maxilla surgically so that the teeth and bones are correctly positioned and aligned with the base of the skull. In particular, for individuals with dentofacial deformity, orthognathic surgery combined with orthodontic therapy offers satisfactory correction of malocclusion [5].

The surgical repair might include anything from relocating a few teeth to completely realigning the mandible and maxilla, depending on how severe the issue is. This procedure provides a stable relationship between dental arches, functional occlusion, facial and dental symmetry, and healthy orofacial structures [6]. Additionally, according to specific research, dentofacial abnormalities influence patients' psychological and esthetic well-being, which includes all elements of quality of life, in addition to the occlusal and functional aspects of the stomatognathic system [6].

The effects of orthognathic surgery on patients' psychological, social, physical, functional, and esthetic quality of life have been documented in several studies before and after the procedure [6]. The World Health Organization (WHO) defines the quality of life as an individual's view of their place in life about their objectives, aspirations, standards, and concerns, as well as the culture and value systems in which they live [8]. However, an agreement about the optimal instrument to evaluate the results of orthognathic surgery has yet to be established [9] despite the significant growth in research on the connection between quality of life and oral surgery.

Numerous studies have revealed that after orthognathic surgery, quality of life (QoL) and psychological components significantly improved [6, 8]. The psychological effects include more fantastic body and face perception, increased self-assurance, and better social adjustment [9, 10]. Review publications have also indicated that orthognathic surgery for jaw abnormalities increases patients' quality of life (QoL), which has a beneficial effect on their psychological status [10, 11]. A feeling of well-being and subjectively perceived social, psychological, and bodily functioning are all included in the multidimensional notion of quality of life (QoL) [12].

Impacts on overall health status (not only the orofacial region) are evaluated using health assessment tools such as the Short Form Health Survey (SF-36) [13]. In addition, the influence of dental health on quality of life is investigated using global oral health assessment tools, such as the Oral Health Impact Profile short form (OHIP-14). Finally, the Orthognathic Quality of Life Questionnaire (OQLQ), which is often used to examine the effects of orthognathic surgery in the postoperative period [14], is one of the tools that focus on particular scenarios.

Patient satisfaction in the postoperative period is another significant outcome that should be assessed in addition to the effect on the quality of life since it is one of the critical therapeutic objectives. According to Khattak et al. [15], patients' satisfaction after treatment may be predicted by the patients' perceptions before operations and the information supplied by the professionals. Even though the success rate of orthognathic surgery is relatively high, some patients express unhappiness with the outcome of the treatment. The causes of this unhappiness and how it affects patients' quality of life have yet to be entirely understood [16].

This research aimed to assess the health-related QoL and degree of patient satisfaction among Saudi Arabian patients having orthognathic surgery. The null hypothesis was that orthognathic surgery wouldn't change how patients felt about their overall health or their confidence in social situations, facial aesthetics, oral function, and self-awareness.

Materials and Methods

Study design

An online questionnaire using Google forms was constructed and sent to patients who underwent orthognathic surgery.

Setting

Saudi Arabia.

Sample size

250.

Instrument validity and reliability

A pilot study was conducted by sending the survey to 20 participants and the data were inserted in SPSS version 22 to determine the reliability by using Chronbach’s coefficient alpha (value: 0.712). The validity of the questionnaire was tested by sending it to experienced researchers and changes were made according to their feedback and comments.

Statistical analysis

Collected data were analyzed using SPSS version 22, where descriptive as well as inferential statistics were conducted.

Results and Discussion

Table 1. Background information of the patients.

The result demonstrates the response of the patient suffering from dental issues. Table 1 analyzes the background information of the patient. The result shows that the mean age of the patient suffering from a dental abnormality related to the skull is 29.5 years, of which most are females. Male patients are 14.3%, and females are 5.7%, which illustrates that dental abnormalities are primarily present in females requiring orthognathic surgery. The main result evaluated from Table 1 provides information that patients who suffer from dental disease before surgery. The complaints received in an open bite are 29%, underbite complaints are 23% recessed, lower jaw complaints are 39%, and skewed mandible is 9%. The orthognathic surgery of patients expresses excellent results because 91.1% of patients have no complaints after surgery.

Table 2. Questions related to satisfaction of patients from the doctor.

Table 2 illustrates the patient's satisfaction with the doctor before and after orthognathic surgery. The first question is that patients quickly get an appointment with a doctor. The result shows that 35.7% agreed, 28.6% agreed that they get an appointment soon and 7.1% strongly disagreed, and 3.6% disagreed. The next question asked by the patient is whether the doctor can provide the consultation on time, and the result expressed that most patient agrees (42.9%) that they give an appointment time. The further questionnaire is whether the consultation fee is suitable, and the outcome illustrated that the patient mostly agreed (39.3%) and was satisfied with the doctor's price. Table 2 also elaborates that 48.2% of patients agree with the doctor's cooperation, and 69.6% feel comforted with the whole doctor's time. The primary outcome evaluated from the table is that 66.1% of the patients are satisfied with the doctor's performance as he analyzed the medical examination and diagnosed the test before surgery. The important questionnaire asked the patient was that the doctor forced them to choose surgery to solve the jaw problem, and most patients said that they disagreed (37.5%) with this statement. The other question is if doctors explain all medical terms, and do most patients somewhat agree or disagree? Table 2 demonstrates that most patients were satisfied (42.9%) with the statement and said that the doctor explained all the cons and pros of the surgery before submitting the performance.

The results of the patient's satisfaction with surgery are shown in Table 2. According to the findings, 48.2% of respondents agree that the hospital administration asked for your signature and that of your family on the surgical consent form. In addition, under surgical procedures, patients are generally pleased (57.1%) and satisfied (53.6%), respectively, with the operating room, which was both clean and well-equipped and successfully managed the patient's anxiety during anesthesia.

The patient has inquired whether or not they need an additional surgical operation to assist them in the treatment of issues, as well as an examination from the doctor about complications after surgery. According to the response, 51.8% of respondents agree they need further surgical treatment. Conversely, 30.5% of respondents either partially agree or disagree that they require examination for some problem after surgery. Therefore, according to Table 3, most patients (37.5%) are advised to go through with this orthognathic surgical operation.

Table 3. Questions related to satisfaction of patients from the surgery.

Table 4. Questions related to satisfaction with the result after surgery

In Table 4, we see an illustration of how satisfied patients were with the results of their orthodontic surgery. The first assertion was that 42.9% of people agree that surgery is the consequence. The second issue was whether or not orthodontic surgery assists patients with chewing food and speaking after the procedure. The results showed that 35.7% of patients agree that they do not experience any difficulties chewing food and speaking after the procedure. The significant finding about orthognathic surgery is that fifty percent of patients and fifty-three point six percent are content with how surgery improves the cosmetic look of the face and teeth. The patient with dental anomaly was questioned about whether or not they felt the surgery was worth the money spent, and 37.5% of them agreed with the statement. The findings indicate that 58.9% of patients reported a rise in their self-confidence, and 51.8% reported being happy with the procedure. Finally, the patient was questioned whether or not their relatives and friends believed that they have enhanced their look due to surgery. The results indicate that 48.2% of patients are happy with this assertion (views about appearance are improved).

Table 5. Complications after surgery.