Multimodal physiotherapeutic management of postoperative complications in orthognathic surgery: A literature review and institutional protocol proposal

TL;DR

This paper proposes a standardized physiotherapy protocol to manage post-surgery complications in orthognathic surgery, aiming to improve recovery and reduce issues like pain and swelling.

Contribution

The paper introduces a novel, evidence-based multimodal physiotherapeutic protocol for postoperative care in orthognathic surgery.

Findings

Multimodal strategies like photobiomodulation and manual therapy improve postoperative outcomes.

Early and structured physiotherapy accelerates edema resolution and neurosensory recovery.

The protocol promotes mandibular mobility and bone healing after orthognathic surgery.

Abstract

Orthognathic surgery (OS) corrects skeletal and dental discrepancies in the maxillofacial region, improving occlusion, masticatory function, respiration, and facial aesthetics. However, the immediate and intermediate postoperative periods are frequently associated with acute pain, facial edema, neurosensory disturbances (e.g., paresthesia of the inferior alveolar and/or infraorbital nerves), and restricted mandibular mobility (trismus), which may prolong recovery and impair quality of life. Physiotherapeutic rehabilitation has emerged as a key component of postoperative care, yet standardized guidance remains limited.
The objective is to present a standardized, evidence-based physiotherapeutic protocol for managing common postoperative complications after OS, aiming to optimize functional recovery and reduce morbidity.

A narrative review of the literature on postoperative physiotherapeutic rehabilitation in OS was conducted, focusing on interventions for pain, edema, neurosensory disturbances, trismus, and bone healing. The protocol was developed within the Postgraduate Program in Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, University of Chile, integrating current evidence and clinical experience.

The protocol proposes multimodal strategies-including photobiomodulation, manual therapy, and therapeutic exercises-to address the most frequent postoperative complications. Evidence supports early, structured, and systematic intervention to improve analgesia, accelerate edema resolution, enhance neurosensory recovery, increase mandibular mobility, and promote bone healing.

Early, structured physiotherapeutic management is fundamental to postoperative care in OS. The proposed protocol offers a replicable, evidence-based framework to facilitate optimal recovery and functional reintegration.

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