title: Patient satisfaction after orthodontic treatment combined with orthognathic surgery: A systematic review.
abstract: OBJECTIVE
  To synthesize available evidence about factors associated with patients' satisfaction after orthodontic treatment combined with orthognathic surgery.
  
  
  METHODS
  Studies that evaluated any factor associated with patients' satisfaction after the conclusion of an orthodontic treatment combined with an orthognathic surgery were identified. Orthognathic surgical procedures should have been undertaken after completion of craniofacial growth. Any satisfaction psychometric tool was considered. No language limitation was set. A detailed individual search strategy for each of the following bibliographic databases was crafted: MEDLINE, PubMed, EBM Reviews, Web of Science, EMBASE, LILACS, and Scopus. The references cited in the identified articles were also cross-checked, and a partial gray-literature search was undertaken using Google Scholar.
  
  
  RESULTS
  Eight articles satisfied the inclusion criteria of this systematic review and accounted for 998 patients. The included studies showed large variation in sample size (range  =  44 to 505 patients), age (range  =  15 to 72 years old), distinct psychological evaluation tools, and time elapsed between the assessment and the completion of surgery and postorthodontic treatment. Most of the studies (five of eight) were classified as having high risk of bias.
  
  
  CONCLUSIONS
  Factors associated with satisfaction were final esthetic outcome, perceived social benefits from the outcome, type of orthognathic surgery, sex, and changes in patient self-concept during treatment. Factors associated with dissatisfaction were treatment length; sensation of functional impairment and/or dysfunction after surgery, and perceived omitted information about surgical risks.
authors: a  Assistant Clinical Professor, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors: Camila
authors: C
authors: Pachêco-Pereira
authors: b  PhD student, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors: Lucas G
authors: LG
authors: Abreu
authors: c  Associate Professor, Department of Anesthesiology and Pain Medicine and Department of Psychiatry & Pediatrics, and Chief of Psychology, Multidisciplinary Pain Centre, University of Alberta, Edmonton, Canada.
authors: Bruce D
authors: BD
authors: Dick
authors: d  Associate Professor, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil, and Adjunct Professor, Department of Dentistry School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors: Graziela
authors: G
authors: De Luca Canto
authors: e  Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors: Saul M
authors: SM
authors: Paiva
authors: f  Professor and Division Head of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
authors: Carlos
authors: C
authors: Flores-Mir
mesh_terms: D004955:Esthetics, Dental; D006801:Humans; D009971:Orthodontics, Corrective; D057909:Orthognathic Surgery; D017060:Patient Satisfaction; D016896:Treatment Outcome
keywords: Combined orthodontics; Orthodontic; Orthognathic; Patient satisfaction; Satisfaction