Reported outcome measures in orthognathic surgery: a scoping review

This review provides a comprehensive overview of the variety of outcome measures reported following orthognathic surgery. A systematic search of the literature was conducted to identify studies reporting on the outcomes of orthognathic surgery until December 2024 within the Embase, PubMed, MEDLINE, Ovid, Web of Science, Cochrane, and Google Scholar databases. The study cohort consisted of 11,703 patients, with 32% undergoing bimaxillary surgery. One hundred and ninety studies were analysed for outcome measures. Five broad categories of outcome measures were identified: Quality of Life (QoL), facial attractiveness scores, masticatory efficiency, occlusal assessment, and cephalometric-based outcomes. QoL was the most reported measure (63%), with in-house and validated questionnaires used inconsistently. Facial attractiveness assessments varied significantly in methods and scoring systems. Masticatory efficiency was commonly evaluated using bite force transducers or particle degradation after chewing, but no consensus on methodology was found. Cephalometric outcomes were primarily angular and linear measurements, though its use was limited. This review highlighted the lack of standardised outcome measures in orthognathic surgery. QoL was the most common measure, yet inconsistencies in the questionnaires highlight the need for global validation and standardisation. Internationally recognised methodologies for facial attractiveness and masticatory efficiency are also essential to enhance comparability and reliability across studies, facilitating advancements in clinical practice worldwide.