An updated overview of orthognathic surgery practices in France.

Abstract

Introduction: Orthognathic surgery is a fundamental component of a maxillofacial surgeon's practice. In France, 510 specialists actively practice oral and maxillofacial surgery. In OMFs, despite the existence of evidence-based recommendation that address diagnosis, treatment planning, and operating methods, each surgeon/institution has developed an individual approach towards clinical management. This study comprehensively overviews the current practices of French orthognathic surgeons.

Methods: A questionnaire was electronically sent to 500 oral and maxillofacial surgeons in France, some of whom practiced orthognathic surgery and some of whom did not. The answers were anonymous.

Results: We obtained 52 responses. With consensus on 12 of the practical, economic, and peri-operative questions. We didn't find difference on any topics where the surgeon has his residence or the age of the surgeon. Management and correction of occlusal disorders were the primary indications for osteotomy. Of all responders, 42 % were in private practice. Both virtual and conventional planning methods were used, with no clear preference for either method. During bimaxillary surgery, 76 % of surgeons initially osteotomised and stabilised the maxilla; 69 % used an intermediate splint. ERAS protocols are not used.

Conclusion: This study is an update and it provides new information compared a 2002 report on orthognathic surgery in France. It highlights a consensus on conventional planning but no significant influence from academic centers, age, or experience on surgical practices. New technologies and ERAS protocols are underused despite their benefits for safer surgeries. There is a lack of standardized procedures, leading to varied practices despite a national teaching program. More data and practitioner involvement are needed to develop French and European guidelines.