Optimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide

Area of Science:

• Oral and Maxillofacial Surgery
• Pharmacology
• Evidence-Based Medicine

Background:

• Orthognathic surgery requires careful management of perioperative and postoperative medications.
• Optimizing drug regimens and supplementation can significantly impact patient outcomes.

Purpose of the Study:

• To provide a comprehensive literature review and practical guide for optimizing drug regimens and supplementation in orthognathic surgery.
• To consolidate evidence on various medications and supplements used in the perioperative and postoperative phases.

Main Methods:

• Systematic literature review following PRISMA-ScR guidelines.
• Inclusion of clinical trials, cohort, cross-sectional, prospective, and retrospective studies.
• Exclusion of case reports and reviews.

Main Results:

• Analysis of 78 studies covering antibiotics, analgesics, corticosteroids, antiemetics, hemostatic agents, local anesthetics, herbal medicine, and botulinum toxin.
• Evaluation of medications for pain and edema control, including ropivacaine and bupivacaine for local anesthesia.
• Discussion of mineral and vitamin supplementation, tranexamic acid, and postoperative anesthetic blocks.

Conclusions:

• Optimized drug regimens and supplementation can lead to improved pain management, reduced swelling, enhanced wound healing, and faster recovery.
• While evidence is limited for some interventions like supplements and preemptive antiemetics, they show promise for improved orthognathic surgery outcomes.