Psychological function in orthognathic surgical patients before and after bilateral sagittal split osteotomy with rigid and wire fixation

A multisite randomized controlled trial was conducted to compare the psycho logical function of patients who undergo surgical correction of a Class II malrelation with bilateral sagittal split osteotomy with either wire or rig id fixation. Subjects were 31 male and 86 female patients referred by ortho dontists, Psychopathological symptoms and psychological distress were measu red with the Symptom Checklist-90 Revised at the following times: before pl acement of orthodontic appliances, 1 to 2 weeks presurgery, and 1 week, 8 w eeks, 6 months, and 2 years postsurgery Patients' satisfaction with their s urgical outcome was measured with a 3-item questionnaire. Results showed no statistically significant differences in psychological function or satisfa ction between patients treated with wire or rigid fixation. Psychological f unction was within normal limits immediately before surgery. Psychological parameters did not determine patient satisfaction, even among patients who met an operational definition of "psychopathological caseness," Psychologic al symptoms and general distress increased modestly immediately after surge ry for both groups and then progressively declined over the succeeding 2 ye ars, eventually reaching levels that were significantly lower than presurgi cal levels. It was concluded that (1) rigid and wire fixation do not differ in their effects on psychological function and satisfaction; (2) patients who seek orthognathic surgery for a Class II malocclusion are psychological ly healthy, ie, comparable to normal populations, immediately before surger y; (3) presurgical psychological function does not determine satisfaction w ith surgical outcome; and (4) psychological function tends to improve durin g the 2 years after surgery.