Search

Introduction: To better understand why patients believe they need orthognathic treatment, a study was undertaken to examine perceived need for treatment by patients and clinicians. This questionnaire-based study was undertaken at The John Radcliffe Hospital, Oxford, United Kingdom. Subjects and methods: Forty patients were recruited from combined orthodontic-surgical clinics. They were asked to rate their perceived need for treatment based on facial appearance, dental appearance, function, and overall need. Twenty orthodontists and 20 maxillofacial surgeons were asked to rate perceived need for treatment based on the same parameters, using study models and clinical photographs. Ratings were marked on visual analog scales. Results: Significant differences were found between patients and clinicians in perceived need for treatment based on facial appearance (orthodontists compared with patients, P = .023; surgeons compared with patients, P = .001). In addition, maxillofacial surgeons rated a significantly greater overall need for treatment than patients ( P = .027), and they rated treatment need based on facial appearance ( P = .005) and function ( P Conclusions: Clinicians rated greater need for orthognathic treatment based on facial appearance than did patients. Surgeons also rated greater overall need for treatment than patients. In addition, surgeons rated treatment need based on facial appearance and function significantly higher than orthodontists, but large variations existed in both clinician groups.

Patients who undergo osteotomy experience a radical change in the skeletal relationship between the mandible and maxilla and as yet little is known about how this affects speech articulation. This study investigated the extent to which articulatory placement for the lingual consonant /s/ changed following surgery. Using the technique of electropalatography and acoustic analysis, patients' productions of fricative sounds were recorded before and after osteotomy. Five patients were investigated, 3 with mandibular prognathism and 2 with maxillary protrusion. Results showed that there were significant changes in articulatory placement after the operation, and that these were correlated with an acoustic measure (CPF). The direction of change could be predicted on the basis of the type of operation undergone, and these changes were maintained 6 months post-operatively. The implications of the findings are discussed.