Orthognathic surgery in patients with Crohn's disease: a review of the pathophysiology and perioperative management.

The patient with Crohn's disease poses an interesting challenge to the oral and maxillofacial surgeon contemplating orthognathic surgery. Elective surgery should be limited to periods of disease remission. Even in a quiescent state, however, this disease requires careful perioperative management. Special attention must be paid to the patient's diet and maintenance medications. Often these patients have required long-term corticosteroid therapy, which, in addition to increasing surgical and anesthetic risk, has the potential to adversely affect bone healing. This article presents a review of the pathophysiology of Crohn's disease and discusses the perioperative and postoperative concerns associated with this disease.