Comparative Evaluation of Orthognathic Surgery with and without PreSurgical Orthodontics in Skeletal Class III Patients: Clinical, Functional and Patient-Reported Outcomes

Background: Skeletal Class III malocclusion is a dentofacial deformity that may require orthognathic surgery to correct maxillomandibular discrepancies. Presurgical orthodontics is traditionally performed before surgery, whereas the surgeryfirst approach omits this preparatory phase. Objectives: To compare clinical, functional, and patient-reported outcomes of orthognathic surgery with and without presurgical orthodontic treatment in patients with skeletal Class III malocclusion. Study Design & Setting: Comparative study conducted at the Department of Oral and Maxillofacial Surgery Shahida Islam Medical & Dental College (SIMDC) from February 2026 to July 2026. Methodology: A total of 120 patients were divided into two groups of 60 each. Group A underwent conventional orthognathic surgery preceded by presurgical orthodontics, whereas Group B underwent the surgery-first approach. Clinical, functional, and patient-reported outcomes were assessed using clinical examination, cephalometric measurements, maximum interincisal opening, masticatory function assessment, and the Oral Health Impact Profile-14 (OHIP-14). Data were analyzed using IBM SPSS Statistics version 26, with p≤0.05 considered statistically significant. Results: The mean total treatment duration was 22.6 ± 4.1 months in Group A and 16.8 ± 3.7 months in Group B (p<0.001). At six months, mean postoperative overjet was 2.1 ± 0.8 mm and 2.0 ± 0.7 mm, respectively (p=0.463). Maximum interincisal opening was 39.2 ± 4.8 mm in Group A and 40.5 ± 4.6 mm in Group B (p=0.127). Mean OHIP-14 scores were 10.8 ± 4.1 and 9.6 ± 3.8, respectively (p=0.098). Postoperative complications occurred in 23.3% and 26.7% of patients, respectively (p=0.672). Conclusion: The surgery-first approach was associated with shorter total treatment duration, while the measured clinical, functional, and patient-reported outcomes were broadly comparable between groups.