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Outcome of photographic evaluation of facial appearance in orthognathic surgery: how does it correlate with planning of treatment and patient-reported outcome?

Journal article
Authors M. Bengtsson
A. Al-Ateyah
G. Wall
J. P. Becktor
Lars Rasmusson
Published in British Journal of Oral & Maxillofacial Surgery
Volume 57
Issue 4
Pages 345-351
ISSN 0266-4356
Publication year 2019
Published at Institute of Odontology
Pages 345-351
Language en
Links dx.doi.org/10.1016/j.bjoms.2018.12....
Keywords Orthognathic Surgery, Randomized Controlled Trial, Patient Reported, Outcome Measures, Imaging, Three-Dimensional, Photography, cleft-lip, accuracy, attractiveness, palate, impact
Subject categories Surgical research

Abstract

The outcome of treatment in orthognathic surgery is dependent on preoperative surgical planning. The main purpose of the present study was to evaluate from photographs the improvement in facial appearance after orthognathic surgery. In addition, the outcomes of two different planning techniques, 2-dimensional and 3-dimensional, were compared and the correlation between the outcome and health-related quality of life (HRQoL) assessed. The study was a randomised controlled trial with the intervention being either 2-dimensional or 3-dimensional treatment planning. An evaluation panel compared photographs taken before and after operation on patients with severe class III malocclusion. The change in facial appearance was rated, the two planning techniques compared, and the result correlated with previously published findings on cephalometric accuracy and HRQoL in the same group. Completed 12-month follow-up resulted in the inclusion of 57 subjects aged between 18 and 28 years at the time of operation (mean 21 years). We found significant differences between the two evaluations (p = 4.4E-9) but no significant difference in facial improvement between the planning techniques (p = 0.54). However, there was a correlation between cephalometric measurement of accuracy in the anterior maxilla and evaluation of improvement of facial appearance (p = 0.024, r = 0.30), but we found no correlation + between HRQoL and the evaluation of facial appearance (p = 0.31, r = -0.14). We conclude that there was an improvement in facial aesthetics after orthognathic surgery that was independent of the planning technique used. (C) 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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