Balanced scales showing orthognathic surgery leading to a confident smile.

Orthognathic Surgery: A Before-and-After Look at Class II vs. Class III Outcomes

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Jordan Keane in Health & Wellness October 2026 • 4 min read.

"Explore how satisfaction levels compare between Class II and Class III patients post-surgery and discover the factors influencing their experiences."


Orthognathic surgery, often combined with orthodontic treatment, is a transformative solution for individuals with dentofacial deformities. These deformities can significantly impact a person's self-esteem, oral function, and overall quality of life. By correcting misalignments of the jaw and facial structure, orthognathic surgery aims to improve both aesthetics and function, leading to enhanced psychosocial well-being.

While the benefits of orthognathic surgery are well-documented, understanding the nuances of patient satisfaction across different types of dentofacial deformities is crucial. Specifically, comparing outcomes between Class II and Class III malocclusions can provide valuable insights into the factors that contribute to a successful surgical experience.

This article delves into a recent study that investigates postoperative satisfaction in Class II and Class III orthognathic surgery patients. By examining improvements in facial and dental aesthetics, masticatory and respiratory function, and psychosocial factors, we aim to shed light on the comparative effectiveness of this treatment approach for different patient groups.

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Milestones in Orthognathic Surgery

A 2023 history chapter describes milestones and pioneers in the evolution of orthognathic surgery, noting that surgical approaches have been modified by multiple authors and that many approaches are currently in use. A 2024 chapter traces the field’s evolution through five publications highlighting key events in the development of contemporary techniques. It focuses on techniques for skeletal malocclusions related to developmental or congenital conditions.

What Drives Satisfaction After Orthognathic Surgery?

Balanced scales showing orthognathic surgery leading to a confident smile.

The study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Protocol, involved a retrospective cross-sectional analysis of patients from private clinics specializing in maxillofacial surgery. The sample consisted of individuals who had undergone bimaxillary surgery with a standardized surgical technique, ensuring consistent postoperative follow-up.

The patients were divided into two groups: Class II (n=50) and Class III (n=30) dentofacial deformities. Data was collected using an electronic questionnaire comprising 20 objective questions, adapted from existing models to assess various aspects of patient satisfaction.

  • Aesthetic Improvements: Both groups reported significant enhancements in dental and facial appearance. 84% of Class II and 83% of Class III patients noted major improvements in dental aesthetics, while 84% and 73.3% respectively, experienced positive changes in their facial appearance.
  • Functional Outcomes: The study found no significant differences between the groups regarding functional improvements. Approximately 50% of Class II and 66.6% of Class III patients reported enhanced masticatory function.
  • Psychosocial Impact: A notable 94% of Class II and 100% of Class III patients felt that the treatment had a great or somewhat positive psychological impact on their lives.
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Recent Research and Data Gaps

A November 28, 2025 article on skeletal deformities and orthognathic procedures describes orthognathic surgery as a well-established method for correcting skeletal dentofacial deformities. It notes that the procedure is widely applied. However, the article reports that large-scale data on deformity prevalence and the distribution of surgical approaches remain limited.

Limits in Satisfaction Evidence

A three-year follow-up study of 60 high-angle Class II patients used a questionnaire with fixed alternative answers. Because the study was retrospective, its authors said they could not switch to another method, such as a visual analogue scale or an oral health-related quality of life index. A systematic review likewise found that studies used different questionnaires at different assessment times, and their extracted data were not homogeneous enough for meta-analysis.

Class II and III Quality-of-Life Outcomes

A systematic review and meta-analysis reported large improvements in oral health-related quality of life global scores 4–7 months after surgery for both Class II patients (SMD 2.09, 95% CI 0.68 to 3.49) and Class III patients (SMD 1.96, 95% CI 1.22 to 2.70). These figures describe improvement in each group; the reported snippet does not establish that one class improved more than the other. A separate systematic review concluded that orthognathic surgery significantly benefits patients with dentofacial deformity, while calling for further long-term studies using standardized, validated questionnaires.

The results indicated that regardless of the type of dentofacial deformity, patients experienced significant positive effects from orthognathic surgery. Improvements in aesthetics, function, and psychosocial well-being were consistently reported across both Class II and Class III groups. While specific functional outcomes like speech did not show significant improvement, the overall satisfaction levels remained high.

The Lasting Impact: A Worthwhile Investment in Quality of Life

The study underscores that orthognathic surgery, when appropriately indicated and executed, can yield substantial benefits for patients with dentofacial deformities. The positive effects extend beyond mere physical correction, significantly enhancing patients' self-esteem and social interactions.

Despite the initial discomforts and potential complications, such as temporary loss of sensitivity, the vast majority of patients expressed satisfaction with the overall treatment outcome. An overwhelming 92% of Class II and 93.3% of Class III patients stated they were satisfied or very satisfied with the results.

Ultimately, this research reinforces the value of orthognathic surgery as a life-changing intervention for individuals with dentofacial deformities. By addressing both aesthetic and functional concerns, this treatment approach offers a pathway to improved quality of life and enhanced psychosocial well-being.

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What exactly is orthognathic surgery?

Orthognathic surgery is a surgical procedure, often combined with orthodontic treatment, designed to correct dentofacial deformities. These deformities involve misalignments of the jaw and facial structure, impacting both aesthetics and oral function. The goal is to improve a patient's self-esteem, oral function, and overall quality of life through these corrections.

2

What aspects contribute to patient satisfaction after orthognathic surgery?

Patient satisfaction after orthognathic surgery is assessed by considering improvements in several areas. The key factors include aesthetic improvements (dental and facial appearance), functional outcomes (masticatory and respiratory function), and psychosocial impact (self-esteem and psychological well-being). The study highlighted how these factors contribute to the overall success of the surgery and the patient's perception of their results, regardless of whether they have Class II or Class III dentofacial deformities.

3

What are the key differences between Class II and Class III dentofacial deformities?

Class II dentofacial deformity involves a retruded mandible (the lower jaw is set back). Class III, on the other hand, involves a prognathic mandible (the lower jaw is forward). The study specifically compared these two types to understand how outcomes and patient satisfaction vary based on the specific nature of the deformity. The study focused on how successful the surgeries were for each group and how it affected patient satisfaction levels.

4

How do the outcomes of orthognathic surgery compare between Class II and Class III patients?

Both Class II and Class III patients reported significant positive outcomes from orthognathic surgery. In terms of aesthetic improvements, 84% of Class II patients and 83% of Class III patients noted improvements in dental aesthetics, while 84% and 73.3%, respectively, experienced positive changes in their facial appearance. Functionally, approximately 50% of Class II and 66.6% of Class III patients reported enhanced masticatory function. Notably, a substantial 94% of Class II and 100% of Class III patients felt a great or somewhat positive psychological impact.

5

Why is orthognathic surgery considered a worthwhile investment?

The study's findings underscore that orthognathic surgery is a worthwhile investment because it provides substantial benefits to patients with dentofacial deformities. Beyond the physical corrections, it enhances self-esteem and social interactions. The high satisfaction levels across both Class II and Class III patients, with improvements in aesthetics, function, and psychosocial well-being, highlight its positive impact on overall quality of life. The study helps confirm the value of orthognathic surgery and shows the value for patients, showing positive long-term effects.

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