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

Abstract

Background: 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. Objective: To present a standardized, evidence-based physiotherapeutic protocol for managing common postoperative complications after OS, aiming to optimize functional recovery and reduce morbidity. Material and Methods: 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. Results: 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. Conclusions: 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.