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VOLUME 16 , ISSUE 6 ( June, 2015 ) > List of Articles


Orthognathic Surgery in a Patient with Multiple Sclerosis

Saleh A Al-Bazie

Citation Information : Al-Bazie SA. Orthognathic Surgery in a Patient with Multiple Sclerosis. J Contemp Dent Pract 2015; 16 (6):507-511.

DOI: 10.5005/jp-journals-10024-1713

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2015; The Author(s).



The aim of this paper was to report a case of orthognathic surgery successfully done in a patient with multiple sclerosis.


Multiple sclerosis (MS) is a chronic, progressive inflammatory disorder of the central nervous system affecting young adults, characterized by lymphocytic infiltration of the brain and spinal cord leading to demyelination and focal axonal damage. Clinically, MS patients present with reversible neurological dysfunction in the early stages, which progresses to irreversible neurological disability and deficit. Oral manifestations of MS include facial numbness or pain, neuralgias, facial paralysis, dysarthria and dysphagia. While dental treatment is not contraindicated in MS patients, it is, however, limited to preventive and supportive dental care.

Case description

A 23-year-old Saudi male patient with a diagnosis of MS since 2008 reported to the oral and maxillofacial surgery (OMFS) department for correction of dentofacial deformity. The patient was under follow-up with the neurology department and was being treated with interferon beta-1a. Following consent from the neurologist and the patient, a Lefort 1 segmental osteotomy was done under general anesthesia. The patient was stable throughout the surgical procedure and during the postoperative period. The patient was discharged upon complete surgical recovery and no acute exacerbations of MS were reported during the perioperative period.


Based on our observations, orthognathic and maxillofacial surgical procedures can be safely carried out in patients with MS, provided a strict perioperative prophylactic regimen for stress reduction and prevention of acute attacks of MS is adhered to.

Clinical significance

Due to the stressful nature of dental treatment and oral and maxillofacial surgical procedures, acute exacerbations of MS are very much likely. Hence, it is imperative that dental and oral surgical practitioners are aware of the manifestations of MS and are able to manage such patients with suitable treatment modifications.

How to cite this article

Al-Bazie SA. Orthognathic Surgery in a Patient with Multiple Sclerosis. J Contemp Dent Pract 2015;16(6):507-511.

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  1. Multiple sclerosis. The Lancet 2008;372(9648):1502-1517.
  2. Multiple sclerosis: an update for oral health care providers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Sep;108(3):318-327.
  3. Clinical assessment of orofacial manifestations in 500 patients with multiple sclerosis. J Oral Maxillofac Surg 2013 Feb;71(2):290-294.
  4. Oral health status and temporomandibular disorders in multiple sclerosis patients. Coll Antropol 2005 Dec;29(2):441-444.
  5. The Dale E. McFarlin Memorial Lecture: the immunology of the multiple sclerosis lesion. Ann Neurol 1994; 36Suppl:S61-S72.
  6. Natalizumab treatment in multiple sclerosis patients: a multicenter experience in clinical practice in Italy. Int J Immunopathol Pharmacol 2014 Apr-Jun;27(2):147-154.
  7. Botulinum toxin for symptomatic therapy in multiple sclerosis. Curr Neurol Neurosci Rep 2014 Aug;14(8):463.
  8. Oral and maxillofacial manifestations of multiple sclerosis. J Can Dent Assoc 2000 Dec;66(11):600-605.
  9. Numb chin syndrome: an ominous clinical sign. Br Dent J 2010 Apr;208(7):283-285.
  10. Prophylaxis to avert exacerbation/relapse of multiple sclerosis in affected patients undergoing surgery. Surgical observations and recommendations. J Neurosurg Sci 2004 Sep;48(3):135-137.
  11. Multiple sclerosis: the environment and causation. Curr Opin Neurol 2007 Jun;20(3):261-268.
  12. Isolated abducens nerve palsy following mandibular block articaine anesthesia, a first manifestation of multiple sclerosis: a case report. Quintessence Int 2009 Mar;40(3):251-256.
  13. [Sevoflurane anesthesia in a patient with multiple sclerosis]. Masui 1994 Aug;43(8):1229-1232.
  14. [Perioperative anesthetic management of a patient with multiple sclerosis]. Masui 2009 Jun;58(6):772-774.
  15. Desflurane anaesthesia in a patient with multiple sclerosis in total hip replacement. Arch Med Sci 2010 Dec;6(6):984-956.
  16. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011 Feb;69(2):292-302.
  17. Pattern of presentation of multiple sclerosis in Saudi Arabia: analysis based on clinical and paraclinical features. Eur Neurol 1998;39(3):182-186.
  18. Multiple sclerosis and surgery. Anaesthesia 1976 Nov;31(9):1211-1216.
  19. Unusual presentation of multiple sclerosis. Br Dent J 2001 Nov;191(9):477.
  20. Heart transplantation in a patient with multiple sclerosis and mitoxantrone-induced cardiomyopathy. J Heart Lung Transplant 2004 May;23(5):641-643.
  21. Anesthetic management of a patient with multiple sclerosis undergoing cesarean section with low dose epidural bupivacaine. Saudi J Anaesth 2014 Jul;8(3):402-405.
  22. Duration of hospital stay following orthognathic surgery at the Jordan University Hospital. J Maxillofac Oral Surg 2012 Sep;11(3):314-318.
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