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Al-Rawee RY, Tawfeeq BA, Tawfek ZS. Orthognathic Surgery Trending: Retrospective Ten Years Cases Analysis in Nineveh Province, Iraq. J Craniofac Surg 2024; 35:e361-e367. [PMID: 38587371 DOI: 10.1097/scs.0000000000010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
AIMS The study aimed at analyzing patient's case sheets in regard to the incidence of skeletal discrepancy present in cases and its relation with the demographic profile of the sample. All these are chronicled for more than 10 years periods. METHODOLOGY This is a retrospective study analysis of the orthognathic case sheets for more than 10 years period. The total numbers of patients are 678. Patient's case sheet was already prepared by the Multi-Disciplinary Team Orthognathic Surgery Clinic in Al-Salam Teaching Hospital, which is the only authorized committee in Nineveh Health Directorate. RESULTS The highest age percentage is between (18 and 27 y/76%). Angle class III cases are the uppermost cases (36%) from the total. A significant P value is clear at the level ≤0.05 and ≤0.01 between surgery type and discrepancy in anterior segmental osteotomies (upper and lower) which is performed in bi-maxillary protrusion cases and Angle class II cases (0.01**). Similarly, anterior segmental osteotomies (upper jaw only) which are indicated in both open bite and Angle Class II cases documented as a statistically significant P value (0.02*). The positive correlation is shown in all variables with the disharmony or facial discrepancies. Esthetic and beauty as causes for treatment recorded more than function in relation to time series. CONCLUSION This study documents that patients with skeletal class III accounted for the largest percentage (64%) in the study group. A high increase in patients number seeking treatment for their discrepancy is obvious with time from 2009 till 2022.
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Affiliation(s)
- Rawaa Y Al-Rawee
- Department of Oral and Maxillofacial Surgery, Al-Salam Teaching Hospital
| | - Bashar A Tawfeeq
- Department of Oral and Maxillofacial Surgery, Al-Noor University College
| | - Zaid S Tawfek
- Department of Orthodontics, Alnoor University College, Mosul, Iraq
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Zheng Z, Hasebe D, Suda D, Saito N, Saito D, Nihara J, Nohno K, Saito I, Kobayashi T. Investigation of orthognathic surgery indicators-combination with index of orthognathic functional treatment needs (IOFTN) and maxillofacial morphometric analysis. Oral Maxillofac Surg 2024:10.1007/s10006-024-01243-0. [PMID: 38528193 DOI: 10.1007/s10006-024-01243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The aim of this retrospective study was to determine orthognathic surgery indicators for Japanese patients with jaw deformities using both Index of Orthognathic Functional Treatment Needs (IOFTN) and maxillofacial morphometric analysis. SUBJECTS AND METHODS The subjects were 89 patients treated with orthognathic surgery and 92 patients treated with orthodontic treatment alone, and were classified as class I, II, or III according to the ANB angle. Based on the results for IOFTN and the results of cephalometric analysis, the indication criteria for orthognathic surgery were examined. RESULTS In IOFTN analysis, none of patients in the orthognathic surgery group were classified as category 1 or 2, while 48% of the patients in the orthodontic treatment group were classified as category 4 or 5. The results of the cephalometric analysis of patients in classified categories 4 and 5 showed that the orthognathic surgery group had significantly greater lateral mandibular deviation in Class I cases, significantly more severe degree of mandibular retrusion in Class II cases, and significantly more severe degree of mandibular prognathism in Class III cases. The results of the logistic regression analysis showed that IOFTN was a common variable as an indication criterion for orthognathic surgery, and several different variables were also selected from the cephalometric measurements in each group. CONCLUSION IOFTN is a highly sensitive and useful indicator as a criterion for orthognathic surgery. However, in the choice of treatment strategy, maxillofacial morphometric analyses and the patient's desired goal are important.
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Affiliation(s)
- Zhuoyang Zheng
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Daichi Hasebe
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Daisuke Suda
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Naoaki Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Daisuke Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Nihara
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kaname Nohno
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Isao Saito
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Stålhand G, Abdiu A, Rasmusson L, Abtahi J. Distribution of orthognathic surgery among the Swedish population: a retrospective register-based study. Acta Odontol Scand 2023:1-8. [PMID: 36794525 DOI: 10.1080/00016357.2022.2164352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE The aim of this study was to provide a nationally representative assessment of orthognathic procedures performed in hospitalised patients in Sweden and study regional differences in prevalence, demographic parameters and hospitalisation time. MATERIAL AND METHODS From the Swedish National Board of Health and Welfare's register, all the patients undergoing orthognathic surgery between 2010 and 2014 were identified. Outcome variables were categorised into: (1) Surgical methods and regional distribution (2) Demographic variations (3) Hospitalisation time. RESULTS The population-prevalence-rate of orthognathic procedures over the 5-year period was 6.3 (SD 0.4) per 100,000 persons, a regional difference in the prevalence was found. Most common were Le Fort I osteotomies (43.4%) and bilateral sagittal split osteotomies (41.6%), 39% of the patients had bimaxillary surgery. The majority of the surgery was performed in the age group 19-29 (68.8%). The mean hospital stay was 2.2 days (SD = 0.9, range 1.7-3.4). A significant regional difference (p ≤ 0.001) was found in hospitalisation time for single-jaw versus bimaxillary surgery. CONCLUSIONS Regional differences in the distribution of orthognathic surgery and demographic variations were found in Sweden in 2010-2014. The underlying causes of variations are still unknown and request further investigation.
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Affiliation(s)
- Gudrun Stålhand
- Maxillofacial Unit in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Avni Abdiu
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Rasmusson
- Maxillofacial Unit in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jahan Abtahi
- Maxillofacial Unit in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Sharifi R, Kordi S, Noravesh F, Aghababaei Y, Ramezani M, Maghbooli Z. Bone mineral density and muscle mass in adults with developmental skeletal discrepancies. BMC Musculoskelet Disord 2022; 23:593. [PMID: 35725431 PMCID: PMC9208105 DOI: 10.1186/s12891-022-05538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background It was aimed to investigate the musculoskeletal status in individuals diagnosed with skeletal discrepancies. Methods This case–control study was performed on 35 patients with developmental skeletal discrepancies listed for orthognathic surgery as a case group and 33 patients who were nominated for wisdom tooth removal as a control group. All participants were aged 18–40 years and the research was carried out in the period between May 2018 and May 2019. Dual X-ray absorptiometry (DEXA) was used to assess bone mass density at three bone sites: total hip, femoral neck, and the spinal lumbar vertebrae (L1-L4). The appendicular muscle mass index (ASMI) was measured based on the four limbs from the DEXA scan. Results Our data showed that 45.7% (16) of the case group were osteopenic or osteoporotic while in the control group only 21.2% (7) were osteopenic in at least one region (total hip, femoral neck, or lumbar) (p-value = 0.03). Regarding muscle mass, there was significantly lower SMI in subjects with skeletal discrepancies (case group) compared with the control group (median (IQR) 5.9 (2.5) vs. 6.8 (2.9) (kg/m2), respectively, p = 0.04). Conclusions There is an essential need for more studies to understand the exact interrelationship between musculoskeletal status and skeletal jaw discrepancies.
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Affiliation(s)
- Reza Sharifi
- Oral and Maxillofacial Surgery Department, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheida Kordi
- Oral and Maxillofacial Surgery Department, Dentistry School, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Noravesh
- Oral and Maxillofacial Surgery Department, Dental Branch, Craniomaxillofacial Research Center, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Majid Ramezani
- Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Zhila Maghbooli
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Effects of sex, age, choice of surgical orthodontic treatment, and skeletal pattern on the psychological assessments of orthodontic patients. Sci Rep 2022; 12:9114. [PMID: 35650249 PMCID: PMC9159988 DOI: 10.1038/s41598-022-12129-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
We aimed to examine the effects of sex, age, choice of surgical orthodontic treatment, and skeletal pattern on psychological assessment scores of orthodontic patients before edgewise treatment. They completed the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI)-II, and the psychological domain of the World Health Organization Quality of Life 26 (Psych-QOL) for assessment of anxiety, depression, and body image, respectively. No significant effects on psychological assessment scores due to sex or age differences were found. Surgical orthodontic treatment patients and patients with skeletal Class III had significantly higher STAI-Trait and/or BDI-II scores and lower Psych-QOL score. Based on the linear mixed-effects model, the choice of surgical orthodontic treatment had a significant effect on the STAI-Trait, BDI-II, and Psych-QOL scores. No significant interaction effect was found between the choice of surgical orthodontic treatment and the skeletal pattern by ANB angle. Patients with skeletal Class I or III who chose surgical orthodontic treatment had higher STAI-Trait and/or BDI-II scores and/or lower body image score, respectively. These results suggest that patients who chose surgical orthodontic treatment, particularly those with skeletal Class I and III, may be more prone to experience anxiety and depression and have body image dissatisfaction.
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OUP accepted manuscript. Eur J Orthod 2022; 44:603-613. [DOI: 10.1093/ejo/cjac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Duarte V, Zaror C, Villanueva J, Werlinger F, Vidal C, Solé P, O Ryan JA, Requena R, Dallaserra M, Rojas R, Burgos M, Ferrer M. Changes in health-related quality of life after orthognathic surgery: a multicenter study. Clin Oral Investig 2021; 26:3467-3476. [PMID: 34854989 PMCID: PMC8637059 DOI: 10.1007/s00784-021-04315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
Objective To evaluate changes in general and oral health-related quality of life (HRQoL) in patients with dentofacial deformity undergoing orthognathic surgery, and whether these changes vary according to type of deformity. Material and methods This is a prospective longitudinal multicenter study of patients with dentofacial deformities (n = 90). The Orthognathic Quality of Life Questionnaire (OQLQ), Oral Health Impact Profile (OHIP-14), and Short-Form Health Survey version2 (SF-36v2) were self-completed by patients before surgery, 3 and 6 months after orthognathic surgery. Change was tested using paired t-test, and compared between Class II and Class III of dentofacial deformity by unpaired t-test. The magnitude of change was examined estimating the standardized response mean (SRM). Results The OQLQ and OHIP-14 showed statistically significant improvements 6 months after surgery, compared with the pre-surgical evaluation, but the SF-36v2 only in the physical component summary. The SRM was large in OQLQ oral function (-1.11) and dentofacial facial aesthetics (-0.76) dimensions, and moderate in most of OHIP-14 dimensions. Differences in mean change between Class II and III were statistically significant for global scores of OQLQ (-10.08 vs -20.30, p = 0.0271) and OHIP-14 (-3.79 vs -10.56, p = 0.0144). Conclusions A significant improvement was observed in oral HRQoL and in the physical component of general health in patients with dentofacial deformities Class II and III after orthognathic surgery. Improvement was greater among Class III than in Class II patients. Clinical relevance These results provide patients, oral health care professionals, and planners with valuable information to make evidence-based decisions and facilitate shared clinical decision-making, taking into account the patients’ perspective.
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Affiliation(s)
- Valentina Duarte
- Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
- Department of Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, San Ignacio 725, Valparaíso, Chile.
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Carlos Zaror
- Department of Paediatric Dentistry and Orthodontic, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Julio Villanueva
- Department of Oral & Maxillofacial Surgery and Cochrane Associated Center, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Hospital Clínico San Borja-Arriarán, Santiago, Chile
| | - Fabiola Werlinger
- Center for Epidemiology and Surveillance of Oral Disease (CEVEO), Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Constanza Vidal
- Department of Oral & Maxillofacial Surgery, Hospital Carlos Van Buren, San Ignacio 725, Valparaíso, Chile
| | - Pedro Solé
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Clínica Universidad de Los Andes, Santiago, Chile
| | - Juan Alberto O Ryan
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Roberto Requena
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
- Department of Oral & Maxillofacial Surgery, Clínica Universidad de Los Andes, Santiago, Chile
| | - Matías Dallaserra
- Department of Oral & Maxillofacial Surgery and Cochrane Associated Center, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - René Rojas
- Department of Oral & Maxillofacial Surgery, Clínica Santa María, Santiago, Chile
| | - Marcela Burgos
- Clinical Psychologist, Private Practice, Santiago, Chile
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Ng JH, Chen YA, Hsieh YJ, Yao CF, Liao YF, Chen YR. One-splint versus two-splint technique in orthognathic surgery for class III asymmetry: comparison of patient-centred outcomes. Clin Oral Investig 2021; 25:6799-6811. [PMID: 33948684 PMCID: PMC8602230 DOI: 10.1007/s00784-021-03967-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/22/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Two-jaw orthognathic surgery (OGS) is done using either the one-splint technique with free-hand positioning of the maxillomandibular complex or the two-splint technique with intermediate splints to position the maxilla. It is uncertain which technique achieves better outcomes. This study compares frontal soft tissue symmetry and subjective patient QoL between one-splint and two-splint techniques in skeletal Class III asymmetry patients undergoing OGS with three-dimensional surgical planning. MATERIALS AND METHODS This retrospective case-control study comprised 34 one-splint and 46 two-splint OGS patients. Frontal photographs and Orthognathic Quality of Life Questionnaire (OQLQ) were done pre- and post-treatment. Frontal soft tissue symmetry was analysed with the anthropometric Facial Symmetry Index. Measurements were compared with t-tests and chi-squared tests with p-value set at 0.05. RESULTS The groups differed in pre-treatment ANB and OQLQ scores. The two-splint group showed significant improvement in all symmetry measures. The one-splint group showed significant improvement in all symmetry measures except midface deviation, upper contour deviation and the Facial Contour Symmetry Index. Both groups showed significant improvement in OQLQ scores. There were no significant differences in post-treatment symmetry measurements and OQLQ scores between groups. CONCLUSIONS Although two-splint technique may better improve contour symmetry, there were no significant differences in frontal soft tissue symmetry and QoL after OGS in skeletal Class III asymmetry with either one-splint or two-splint technique, with both techniques resulting in significant improvement. CLINICAL RELEVANCE One-splint and two-splint surgical techniques produce similar patient-centred outcomes in Class III asymmetry patients.
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Affiliation(s)
- Jing Hao Ng
- Department of Orthodontics, National Dental Centre Singapore, Singapore, Singapore
| | - Ying-An Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yuh-Jia Hsieh
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chuan-Fong Yao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Fang Liao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Ray Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Basso IB, Gonçalves FM, Martins AA, Schroder AGD, Taveira KVM, Stechman-Neto J, Santos RS, Guariza-Filho O, de Araujo CM. Psychosocial changes in patients submitted to orthodontic surgery treatment: a systematic review and meta-analysis. Clin Oral Investig 2021; 26:2237-2251. [PMID: 34817686 DOI: 10.1007/s00784-021-04304-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This systematic review aims to answer the following question: What is the psychological impact of orthognathic surgery on patients with dentofacial deformities undergoing orthodontic-surgical treatment? MATERIAL AND METHODS The search was adapted for each of the following databases: American and Caribbean Center on Health Sciences (LILACS), Cochrane Library, Embase, Psychinfo, PubMed/Medline, Scopus and Web of Science, and gray literature using Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. This study performed estimates of interest, random-effects meta-analyses, and calculated heterogeneity using Higgins inconsistency index (I2). RESULTS A total of 6751 references were found in all searches. After applying the eligibility criteria after full-text reading, 37 studies comprised the final qualitative synthesis. Thirteen studies were included in quantitative synthesis, and it was possible to meta-analyze data from the following questionnaires: GHQ-28, MMPI, RSES, and SCL-90-R. There was an improvement in psychological aspects related to depression, hysteria, self-esteem, anxiety, obsessive-compulsiveness, interpersonal sensitivity, paranoid ideas, and psychoticism (p < 0.05). CONCLUSIONS Correction of dentofacial deformity through orthodontic-surgical treatment is associated with improvements observed in several psychological domains, especially in relation to depressive states. CLINICAL RELEVANCE This result highlights the importance of surgeons and orthodontists in promoting adequate control of patients' expectations and treatment goals taking into account the individual's psychological aspects.
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Affiliation(s)
- Isabela Bittencourt Basso
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica Do Paraná, Curitiba, Paraná, Brazil
| | - Flavio Magno Gonçalves
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Agnes Andrade Martins
- Undergraduate Department of Dentistry, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Karinna Veríssimo Meira Taveira
- Speech-Language Pathologist, Department of Morphology-Center of Biosciences, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Odilon Guariza-Filho
- Department of Orthodontics, Pontifícia Universidade Católica Do Paraná, Curitiba, Paraná, Brazil
| | - Cristiano Miranda de Araujo
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil.
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Sleep, Distressed Appearance, and Quality of Life Relate to Satisfaction with Orthognathic Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111253. [PMID: 34769770 PMCID: PMC8583211 DOI: 10.3390/ijerph182111253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND In this study, we aimed to identify factors correlating with satisfaction with orthognathic surgery in order to improve its outcome. METHODS We recruited 77 participants who had received orthognathic surgery and 32 age- and gender-matched normal-controls. Questionnaires that included devised questions for family support, Big Five Inventory, Derriford Appearance Score, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, 36-Item Short-Form Health Survey, and a visual analogy scale for satisfaction, were completed before and one month and nine months after the surgery. The statistical analysis methods included descriptive statistics, t-test, and Pearson correlation. RESULTS All participants received the preoperative and one-month follow-up, while 28 also completed the nine-month follow-up. Satisfaction was not significantly related to demographic data, but long-term satisfaction was related to an extraverted personality. The preoperative and postoperative results of the Derriford Appearance Scale were related to short-term and long-term satisfaction. Furthermore, both the preoperative and one-month postoperative Pittsburgh Sleep Quality Index findings were significantly related to short-term satisfaction. The postoperative 36-Item Short-Form Health Survey was significantly related to short-term and long-term satisfaction. CONCLUSIONS Not only subjective distress and dysfunction of appearance but also sleep problems and quality of life were correlated to satisfaction with orthognathic surgery. In the future, relevant interventions can be developed to further improve patient's satisfaction and their physical and mental health.
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11
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Onaga Y, Kamio T, Takaki T, Shibahara T. Three-Dimensional Analysis of Soft and Hard Tissue Changes following Orthognathic Surgery. THE BULLETIN OF TOKYO DENTAL COLLEGE 2021; 62:151-161. [PMID: 34393141 DOI: 10.2209/tdcpublication.2020-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Change in soft tissue in relation to that in hard tissue following orthognathic surgery was evaluated. Twenty-five patients were enrolled in the study. The diagnosis in all was jaw deformity (maxillary retrusion and mandibular protrusion) and all underwent a Le Fort I osteotomy and bilateral sagittal splitting ramus osteotomy. Three-dimensional (3D) computer-aided design (CAD) models (polygon models) of the hard and soft tissue of the maxilla and mandible were constructed and superimposed. Reference points were established on the pre- and postoperative hard and soft tissues. Specific elements of each reference point were divided into X, Y, and Z components, respectively, and the distances in each direction and 3D distance (normal distance) measured. The Wilcoxon signed-rank test was used to determine differences in the mean values for the distance moved of each element as the error between pre- and postoperatively. The results revealed statistically significant differences in the Y-direction in the maxilla and the X- and Z-directions in the mandible. A significant difference was also observed in the 3D distances of the maxilla and mandible. Little evidence was found of linearity between the amount of hard and soft tissue movement in the X- and Z-directions in the maxilla. This means that 3D movement in the maxilla was masked more by changes in the morphology of the soft tissue than in the mandible, making it less evident. The results of this study suggest that the 3D analysis method used enables changes in hard and soft tissues to be understood qualitatively, and that it can be used in diagnosis and treatment in orthognathic surgery. It may also be useful in simulation of morphological change in soft tissue.
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Affiliation(s)
- Yoshiko Onaga
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Takashi Kamio
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Takashi Takaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
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Jin C, Lv X, Sun Y, Jiang H. Effect of continuous infusion of dexmedetomidine on blood loss in orthognathic surgery: a retrospective study. Eur J Med Res 2021; 26:78. [PMID: 34284825 PMCID: PMC8290530 DOI: 10.1186/s40001-021-00551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with maxillofacial deformities require orthognathic surgeries to correct occlusion. The surgical procedure may lead to massive bleeding, which is associated with haematoma, respiratory obstruction, and asphyxia. Dexmedetomidine has been used in controlled hypotension and may reduce blood loss in orthognathic surgery. We conducted a retrospective cohort study to evaluate the effect of dexmedetomidine on blood loss in orthognathic surgeries. METHODS The primary outcome examined was blood loss, and secondary outcomes were postoperative haemoglobin level; intraoperative heart rate and blood pressure (T1: at incision; T2: 30 min after incision; T3: 60 min after incision; T4: 120 min after incision); dosage of fentanyl, remifentanil, urapidil, and esmolol; operation time; and incidence of allogeneic blood transfusion. RESULTS A total of 1247 patients were included in this study, and 540 patient pairs were matched via propensity score matching. There were significant decreases in mean blood loss, heart rate at T1-T4, blood pressure at T1, and remifentanil and esmolol dosage in the dexmedetomidine group compared with those in the control group. There was also a significant increase in the postoperative haemoglobin level of the dexmedetomidine group. CONCLUSIONS Continuous infusion of dexmedetomidine can decrease blood loss in orthognathic surgery. TRIAL REGISTRATION ChiCTR1800018794 (retrospectively registered) Name of registry: Chinese Clinical Trial Registry Date of registration: 2018/10/09 URL: www.chictr.org.cn/showproj.aspx?proj=30612.
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Affiliation(s)
- Chenyu Jin
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiang Lv
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yu Sun
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, 639 Zhizaoju Road, Shanghai, China.
| | - Hong Jiang
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, 639 Zhizaoju Road, Shanghai, China.
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Current Trends in Orthognathic Surgery in Poland—A Retrospective Analysis of 124 Cases. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11146439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.
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Long-term follow-up of late maxillary orthopedic advancement with the Liou-Alternate rapid maxillary expansion-constriction technique in patients with skeletal Class III malocclusion. Am J Orthod Dentofacial Orthop 2021; 160:221-230. [PMID: 34183222 DOI: 10.1016/j.ajodo.2020.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate short and long-term results of the application of the alternate rapid maxillary expansion/constriction (Alt-RAMEC) technique in patients with skeletal Class III malocclusion. METHODS Forty-two white patients were consecutively treated with the Alt-RAMEC technique. The average age of the patients was 12.7 ± 1.6 years (range, 9.4-15.9 years) before protraction. The average age at long-term follow-up was 19.4 ± 2.8 years (range, 17.2-26.9 years). A sample of nontreated patients with Class III malocclusion from the archives of orthognatic surgery in our hospital was used as a control group. The initial records were matched for sex, the severity of Class III malocclusion, and age (mean, 12.1 ± 1.4 years; range, 9.7-14.1 years) with the old records available in the archive. The control sample had records presurgery (mean, 19.8 ± 2.2 years; range, 16.6-21.6 years). RESULTS The sagittal advancement of A-point, after the application of the technique, was 5.43 ± 2.71 mm. Some mandibular dentoalveolar adaptation was noted. The position of the maxilla was stable in the long term. In contrast, the control group showed limited growth at the maxillary level during the long-term follow-up period. CONCLUSIONS Our results showed that the Alt-RAMEC technique, performed at the correct time, with a double-hinged expander, followed by Class III spring or elastic traction, 24 h/d, allows for satisfactory maxillary protraction, with stable long-term results. The comparison with a sample of matched nontreated patients with Class III malocclusion allowed to suggest the positive effect of the treatment on the maxillary position vs the natural evolution of the Class III skeletal discrepancy.
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Quality of Life After Class III Repair Orthognathic Surgery: Five-Year Retrospective Study. J Craniofac Surg 2021; 32:2588-2591. [PMID: 34172683 DOI: 10.1097/scs.0000000000007716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the effect of orthognathic surgery on the long-term quality of life of patients with presurgical skeletal Class III and to identify its strongest effect-whether esthetic, social, or functional. MATERIALS AND METHODS In this retrospective cohort study, the subjects were patients after orthognathic surgery for repairing skeletal Class III. Fifty-five patients who had undergone orthognathic surgery from 2013 to 2018 in the oral and maxillofacial surgery department participated in this study. Each participant completed a modified questionnaire used to assess the patient's esthetic, social, and functional abilities after orthognathic surgery. RESULTS The rate of esthetic improvement in orthognathic surgery patients was 88%. More than four-fifths (81.8%) of the patients reported improvement in their personal and social self-esteem and confidence. Finally, 40.7% of the patients reported functional improvement. No significant differences between male and female patients were found. All but one of the patients recommended orthognathic surgery for patients with similar problems. One in six (17.3%) patients was dissatisfied with the nasal appearance after the surgical procedure, while almost a quarter (21.8%) reported worsening of their mouth opening, and 25.4% reported worsening of TMJ (Temporo-Mandibular Joint) symptoms. Analysis of the results revealed no statistically significant pattern connecting preoperative overjet or overbite measures with satisfaction rates. CONCLUSIONS In this study, patient satisfaction with the orthognathic surgical procedure was mostly a result of improvements in facial esthetics, followed by psychological well-being and functional abilities. Most dissatisfaction after the orthognathic surgical procedure was related to nasal appearance, mouth opening, and TMJ complaints.
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Short-term and Long-term Psychological Impact and Quality of Life of Patients Undergoing Orthognathic Surgery. Biomed J 2021; 45:549-556. [PMID: 34118465 PMCID: PMC9421923 DOI: 10.1016/j.bj.2021.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/25/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Orthognathic Surgery (OGS) is a surgery for patients with dento-facial deformity but not all patients are satisfied with its outcome. The purpose of this study is to find out the short-term and long-term psychological impact and quality-of-life of OGS. Methods 77 participants receiving OGS and 32 age and gender-matched controls were enrolled. The data of questionnaires were collected before OGS, one month and 9 months after OGS, including short form of the Derriford-Appearance-Scale (DAS-24), Big-Five-Inventory (BFI), Hospital-Anxiety-and-Depression-Scale (HADS), Pittsburgh-sleep-quality-index (PSQI), and 36-Item Short-Form-Health-Survey (SF-36). Variables were presented as mean ± standard deviation or frequency. Paired t-test, ANOVA and MANOVA were used to evaluate the pre-and post-surgery data. Results Short-term and long-term satisfaction of OGS was high. Before OGS, BFI showed the extraversion had significant difference between the male and female OGS subgroups. Several domains of DAS-24 were significantly different between the OGS and the control groups. Both groups had no significant difference in PSQI, HADS and SF-36, except sleep-efficiency. After OGS, many domains of DAS-24 were significantly improved and the improvement persisted to 9 months later. Sleep-latency, physical-function, role-limitations-due-to-physical-health and social-functioning exacerbated after OGS. Sleep-latency, physical-function, and social-functioning were improved 9 months after OGS, but sleep-efficiency and role-limitations-due-to-physical-health were still significantly worse than controls. Conclusion People received OGS for unfavorable appearance and the surgery could decrease their distress of appearance and impact to their daily living. Through long-term assessment, we should pay attention to sleep problems and role-limitations-due-to-physical-health after OGS.
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Grillo R, Jodas CRP, Leal MDOCD, Teixeira RG. Orthognathic surgery in a precocious edentulous patient. J Taibah Univ Med Sci 2021; 16:461-464. [PMID: 34140875 PMCID: PMC8178686 DOI: 10.1016/j.jtumed.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 10/27/2022] Open
Abstract
This paper aims to discuss orthognathic surgery in a precocious edentulous patient as a viable alternative treatment. The present article is a case report of a total edentulous patient 32 years ago, with a double denture and dentofacial deformity, aggravated due to the early loss of teeth. Orthognathic surgery is a procedure that has been gaining more and more space in the specialty of maxillofacial surgery and traumatology because it is currently more accessible to patients due to the reduction in surgery costs and the greater number of surgeons who perform it, among others. The vast majority of patients who undergo this surgery are young adults. However, age does not impede orthognathic performance, older patients prefer other types of treatment due to its morbidity. Orthognathic surgery is a viable and highly predictable treatment in cases of prosthetic rehabilitation of totally edentulous patients.
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Affiliation(s)
- Ricardo Grillo
- Assistant Professor, Department of Oral & Maxillofacial Surgery - Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Cláudio R P Jodas
- Assistant Professor, Department of Oral & Maxillofacial Surgery - Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Marília de O C D Leal
- Assistant Professor, Department of Oral & Maxillofacial Surgery - Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Rubens G Teixeira
- Head, Department of Oral & Maxillofacial Surgery - Faculdade São Leopoldo Mandic, Campinas, Brazil
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Glen P, Aurora F, Thomas S, Kissun D. Orthognathic surgery in COVID-19 times, is it safe? Br J Oral Maxillofac Surg 2021; 59:490-493. [PMID: 33579540 PMCID: PMC7825947 DOI: 10.1016/j.bjoms.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 12/04/2022]
Abstract
COVID-19 has impacted the provision of orthognathic surgery globally. Uncertainty around its effects and transmission in aerosol generating procedures (AGP’s) has led to disagreement within maxillofacial surgeons into the safety of orthognathic surgery during the pandemic. We present a local case series of orthognathic surgery undertaken during the COVID-19 pandemic. To our knowledge no such similar study has been reported worldwide. Data was collected from the 1st June to 30th November 2020 for all patients undergoing orthognathic surgery by a single consultant. All procedures and inpatient stays were performed ‘off site’ at the local Spire Healthcare Group plc© facility. A strict preoperative two-week self-isolation period and negative COVID-19 testing was mandatory. All procedures were classified as AGP’s and personal protective equipment (PPE) was worn in line with local guidelines. The primary outcome was 30-day COVID-19 infection among patients, with day 0 the date of surgery. Secondary outcome measures included duration of stay, return to theatre and complications. A total of 59 patients were identified. 42/59 had bimaxillary procedures and 17/59 single jaw. 9/17 had maxillary and 8/17 had mandibular procedures. A total of 3/59 had simultaneous genioplasty. Median duration of stay was one night (range 1-3). Immediate and late complications were seen in 3% (2/59) and 3% (2/59) respectively. Only 1% (1/59) returned to theatre. Zero patients tested positive in the 30-day postoperative period. No staff members tested positive for the duration of the study. Adopting strict safety protocols, orthognathic surgery can be safely delivered during the pandemic without detriment to the patient or staff.
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Affiliation(s)
- P Glen
- Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY.
| | - F Aurora
- Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY
| | - S Thomas
- Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY
| | - D Kissun
- Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY
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Patients' narratives of orthognathic treatment for facial asymmetry: a qualitative study. Br J Oral Maxillofac Surg 2020; 59:445-453. [PMID: 33451811 DOI: 10.1016/j.bjoms.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022]
Abstract
To explore patients' experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being identified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery. Interviews were transcribed and thematic narrative analysis undertaken. Participants were largely positive about their orthognathic treatment. The following themes were identified: preoperative (becoming aware, negative impacts of asymmetry, committing to treatment, establishing expectations), pre-surgery orthodontics and inpatient experiences (challenges and coping strategies, preparedness, support, and shared experiences); and postoperative (surgery as 'worth it', positive impacts of treatment, adapting to facial change). Undergoing orthognathic surgery was portrayed as a journey involving recognisable narratives (treatment unfinished, threat of liminality, treatment as resolution, and treatment as transformation). Patients' experiences of facial asymmetry are associated with feeling 'abnormal', and negative impacts, and orthognathic treatment for facial asymmetry is worthwhile. Having the feeling that something is 'wrong' legitimised by clinicians allows patients access to a recognisable treatment narrative (resolution). Orthognathic treatment is also described as transformation from 'normal abnormality' to being 'normal'. Nevertheless, the associated challenges can be frustrating, particularly if resolution is hard to envisage. Further psychological input could help patients cope with these challenges and the complex process of adapting to facial change.
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Saghafi H, Benington P, Ayoub A. Impact of orthognathic surgery on quality of life: a comparison between orthodontics-first and surgery-first approaches. Br J Oral Maxillofac Surg 2020; 58:341-347. [DOI: 10.1016/j.bjoms.2020.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
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Association between gender, estrogen receptors genes and anxiety levels in patients undergoing orthognathic surgery. J Craniomaxillofac Surg 2019; 47:1300-1305. [DOI: 10.1016/j.jcms.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 12/15/2022] Open
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Psychological profiles in patients undergoing orthognathic surgery or rhinoplasty: a preoperative and preliminary comparison. Oral Maxillofac Surg 2019; 23:179-186. [PMID: 31016403 DOI: 10.1007/s10006-019-00758-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to assess, identify, and compare the personality traits and psychosocial status of two groups of patients undergoing orthognathic surgery and rhinoseptoplasty respectively. STUDY DESIGN This prospective study recruited patients referred for orthognathic surgery and for rhinoseptoplasty. The research protocol included the administrations of questionnaires to the patients during their last visit before surgery, including the Minnesota Multiphasic Personality Inventory (MMPI-2), the Myers-Briggs Type Indicator (MBTI), the tree drawing test (or Baum test), and the BC Scale. RESULTS As for MMPI-2, the highest (pathological) percentages were encountered in Hypochondriasis and Psychasthenia scales within the Orthognathic Surgery Group, whereas in the rhinoseptoplasty group, the highest scores were obtained in the Hypochondriasis, Psychasthenia, Psychopathic Deviate, and Schizophrenia scales. CONCLUSIONS It would be important to assess some characteristics of the patients' mental health and emotional state prior to surgery, including depression, anxiety, panic, and aggression. The overview of these factors may give an insight into the psychological and emotional capacity of the patients undergoing orthognathic and rhinoseptoplasty surgery.
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Baker C, Courtney P, Knepil G. Evaluating societal outcomes of orthognathic surgery: an innovative application of the Social Return on Investment methodology to patients after orthognathic treatment. Br J Oral Maxillofac Surg 2019; 57:145-150. [PMID: 30665666 DOI: 10.1016/j.bjoms.2018.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
Outcomes after orthognathic treatment are complex, and include improvements to mental and physical health, and psychosocial adjustments. The Social Return on Investment (SROI), a framework that is recognised by the government, explores the wider social value of interventions, but has not yet, to our knowledge, been used to measure the value of surgical procedures. To test its feasibility in a surgical setting and to begin to understand the wider nature of the changes experienced by patients after orthognathic surgery, we designed a pilot study that focused on the first two stages of the six-stage model. We collected data from 16 participants about their perceptions and experiences of the short, medium, and longer term outcomes of their treatment during two qualitative storyboard workshops. A grounded theory-SROI method was used to explore their experiences through a process of constant comparison by which data were analysed for concepts and organised into distinct themes. This produced a theory of change that clearly expressed the short to medium-term and longer term outcomes of orthognathic treatment, and provided an initial framework for the approach. The theory captured several outcomes and showed that the framework can be used effectively to investigate the wider psychosocial changes after orthognathic treatment. It therefore provides a basis on which to develop potential indicators for the assessment and valuation of these outcomes over time. The application of these findings to the selection of patients, engagement, and postoperative care, is briefly discussed.
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Affiliation(s)
- C Baker
- School of Sport and Exercise, University of Gloucestershire, Oxstalls Campus, Gloucester, Gloucestershire, GL2 9HW, UK.
| | - P Courtney
- Community and Countryside Research Institute, University of Gloucestershire, Francis Close Hall, Cheltenham, GL50 4AZ, UK.
| | - G Knepil
- Gloucestershire NHS Hospitals Foundation Trust, 1 College Lawn, Cheltenham, Gloucestershire, GL53 7AG.
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Ghorbani F, Gheibollahi H, Tavanafar S, Eftekharian HR. Improvement of Esthetic, Functional, and Social Well-Being After Orthognathic Surgical Intervention: A Sampling of Postsurgical Patients Over a 10-Year Period From 2007 to 2017. J Oral Maxillofac Surg 2018; 76:2398-2403. [DOI: 10.1016/j.joms.2018.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/04/2018] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
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Kulczynski FZ, de Oliveira Andriola F, Deon PH, da Silva Melo DA, Pagnoncelli RM. Postural assessment in class III patients before and after orthognathic surgery. Oral Maxillofac Surg 2018; 22:143-150. [PMID: 29442244 DOI: 10.1007/s10006-018-0681-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE This study aimed to assess body posture before and after bimaxillary orthognathic surgery by photogrammetry in skeletal class III patients. METHODS Thirty-one patients with skeletal class III dentofacial deformities (14 men, 17 women) who underwent orthodontic preparation for surgery were included in this non-randomized controlled trial. Of these, 15 who did not undergo orthognathic surgery during the period of this study served as controls. Postural assessment was performed by photogrammetry using SAPO® (Postural Assessment Software) based on anterior-, posterior-, and lateral-view images taken 1 month before and 4 months after bimaxillary orthognathic surgery with internal rigid fixation (or 4 months after the initial assessment, for the control group). The study was approved by PUCRS Research Ethics Committee, and written informed consent was obtained from all individual participants prior to their inclusion in the study. RESULTS There was no significant difference between groups for age, gender, and GAP. In the intervention group, the right leg/hindfoot angle, which initially indicated a valgus deformity, normalized after intervention (P < 0.048). Posterior displacement of the head (P < 0.005) and trunk (P < 0.004) were observed after intervention. CONCLUSIONS These results suggest that correction of class III dentofacial deformities by bimaxillary orthognathic surgery can produce systemic postural adjustments, especially posterior displacement of the head and trunk and knee and ankle valgus.
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Affiliation(s)
- Fernando Zugno Kulczynski
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Fernando de Oliveira Andriola
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
| | | | | | - Rogério Miranda Pagnoncelli
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Chaurasia N, Upadhyaya C, Srivastava S, Dulal S. Assessment of changes in quality of life in patients with Dentofacial deformities after orthognathic surgery—A study in Nepalese population. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2018. [DOI: 10.1016/j.ajoms.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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A longitudinal study of changes in psychosocial well-being during orthognathic treatment. Int J Oral Maxillofac Surg 2017; 46:1380-1386. [DOI: 10.1016/j.ijom.2017.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/28/2017] [Accepted: 05/09/2017] [Indexed: 11/22/2022]
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Choi SH, Cha JY, Lee KJ, Yu HS, Hwang CJ. Changes in psychological health, subjective food intake ability and oral health-related quality of life during orthodontic treatment. J Oral Rehabil 2017; 44:860-869. [DOI: 10.1111/joor.12556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S.-H. Choi
- Department of Orthodontics; The Institute of Craniofacial Deformity; College of Dentistry; Yonsei University; Seoul Korea
| | - J.-Y. Cha
- Department of Orthodontics; The Institute of Craniofacial Deformity; College of Dentistry; Yonsei University; Seoul Korea
| | - K.-J. Lee
- Department of Orthodontics; The Institute of Craniofacial Deformity; College of Dentistry; Yonsei University; Seoul Korea
| | - H.-S. Yu
- Department of Orthodontics; The Institute of Craniofacial Deformity; College of Dentistry; Yonsei University; Seoul Korea
| | - C.-J. Hwang
- Department of Orthodontics; The Institute of Craniofacial Deformity; College of Dentistry; Yonsei University; Seoul Korea
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Pain threshold reflects psychological traits in patients with chronic pain: a cross-sectional study. Biopsychosoc Med 2017; 11:13. [PMID: 28507594 PMCID: PMC5429533 DOI: 10.1186/s13030-017-0098-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 04/21/2017] [Indexed: 12/02/2022] Open
Abstract
Background Chronic pain enhances sensory sensitivity and induces the biased development of psychological traits such as depression and pain catastrophizing, leading to the formation of heterogeneous conditions. Fluctuations in the sensory-related thresholds of non-injured sites (with normal peripheral tissue) in patients with chronic pain are thought to be related to central sensitization. The objectives of this study were to analyze the association between pain tolerance thresholds (PTTs) in non-injured sites and the psychological traits of patients with chronic pain and to evaluate the usefulness of PTT measures in assessments of pathological conditions related to chronic pain. Methods This study included 57 patients with chronic pain. The PTTs were measured in non-injured sites with quantitative sensory testing (QST) with electrical stimulation and then classified with cluster analysis. The Short-Form McGill Pain Questionnaire was used to subjectively assess pain in the injured sites. The Minnesota Multiphasic Personality Inventory (MMPI) was used to assess the patients’ psychological traits. Results Based on the cluster analysis of PTTs, the patients were classified into a High-Sensitivity group and an Others group consisting of the remaining patients. The results of the MMPI profiles showed that the High-Sensitivity group included significantly more patients with the Neurotic Triad pattern and no patients with the Conversion V pattern. The scores of the hypochondriasis and hysteria scales were significantly lower in the High-Sensitivity group than in the Others group. Conclusions This study indicated that patients with chronic pain can be classified according to PTTs in non-injured sites and suggests that patients with High-Sensitivity have characteristic psychological traits. Assessment of PTTs in non-injured sites would be useful for evaluating the psychological condition of patients with chronic pain.
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Cariati P, Martínez R, Martínez-Lara I. Psycho-social impact of orthogathic sugery. J Clin Exp Dent 2016; 8:e540-e545. [PMID: 27957267 PMCID: PMC5149088 DOI: 10.4317/jced.53007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/12/2016] [Indexed: 11/25/2022] Open
Abstract
Background Orthognathic surgery is a branch of maxillofacial surgery. It carries out the treatment of the facial skeleton asymmetries and deformities. The patients who ask for this surgery are often young people who usually refer symptoms related to dental malocclusion, difficulty eating and temporo-mandibular pain. These physical symptoms are often accompanied by psychological symptoms triggered by their physical appearance such as low self-esteem, self-confidence and negativism about their social and emotional future. Material and Methods Patients with skeletal malformation of facial bones, consisting in Class II, III, open bite and asymmetries, underwent to orthognathic surgery in our center agreed to participate voluntarily in this study. They answered a questionnaire regarding several psychosocial variables. Results Orthognathic surgery helps to improve patient’s psychosocial well-being. Conclusions Patients with dentofacial deformitiesexperience physical and psychological, oftentimes underestimated by society. A combination of orthodontic treatment and reconstructive surgery is often a necessity to restore function and psychosocial well-being. Key words:Orthogathic surgery, psychosocial consequences, mood, emotions, sense of power, motivation, satisfaction, social changes, satisfaction.
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Affiliation(s)
- Paolo Cariati
- Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain
| | - Rocío Martínez
- Social Psychology Department. University of Granada. Campus Cartuja s/n. 18001, Granada, Spain
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Impact of orthognathic surgery on oral health-related quality of life in patients with jaw deformities. Int J Oral Maxillofac Surg 2016; 45:1513-1519. [DOI: 10.1016/j.ijom.2016.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/07/2016] [Indexed: 11/19/2022]
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Jung MH. Quality of Life and Self-Esteem of Female Orthognathic Surgery Patients. J Oral Maxillofac Surg 2016; 74:1240.e1-7. [DOI: 10.1016/j.joms.2016.01.046] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/23/2016] [Accepted: 01/23/2016] [Indexed: 11/30/2022]
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