Facial Discrepancies Research Articles

Orthognathic Surgery Trending: Retrospective Ten Years Cases Analysis in Nineveh Province, Iraq.

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. 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. The highest age percentage is between (18 and 27y/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. 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.

Appearance Satisfaction Among Adolescent Girls in Australia, China, India, and Iran: The Role of Perceived Actual-Ideal Discrepancies in Facial and Bodily Attributes

The current study examined the associations between perceived actual-ideal discrepancies in facial and bodily attributes and adolescent girls’ appearance satisfaction and whether these relationships were moderated by the importance associated with the attributes and/or the country of the participants. A multilingual survey was completed by 900 girls aged 12–18 years old living in Australia, China, India, and Iran. Girls in India and Iran were most satisfied with their appearance followed by girls in China and Australia. Iranian girls had the highest perceived actual-ideal discrepancies in facial and bodily attributes. Chinese and Indian girls perceived their facial attributes to be more important to their overall sense of appearance than their bodily attributes, whereas Australian and Iranian girls valued them equally. Higher perceived actual-ideal facial discrepancies were related to lower appearance satisfaction only for Iranian girls and higher perceived bodily discrepancies were linked to lower appearance satisfaction only for Australian girls. The importance associated with physical attributes and/or the country of participants did not moderate the relationship between perceived discrepancies and appearance satisfaction for facial or bodily attributes. Findings underscore the critical role of cultural nuances in understanding body image among adolescent girls and determinants of appearance satisfaction.

Development of a patient-reported outcomes and experience measure for Orthognathic surgery: validation of the Northwick Park Orthognathic Questionnaire (NOQ)

Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. The expected benefits are functional, cosmetic, and psychological. In a previous publication, this group assessed the determinants of patient satisfaction to formulate the Northwick Park Orthognathic Questionnaire (NOQ). The aim of the present study was to validate this questionnaire. A total of 118 postoperative patients prospectively completed the NOQ, 30 of whom completed the questionnaire a second time. The mean completion rate was 87.6 ± 10%. Response reproducibility was high: 92% of patients gave identical responses (range 81–100%). The intra-class correlation coefficient (ICC) was 0.96 (0.96 ± 0.072). Average test–retest scores for each domain were as follows (range in parenthesis): reasons for treatment 93% (60–100%), preoperative experience 96% (81–100%), preparation for surgery 95% (81–100%), inpatient experience 89% (55–100%), post-discharge experience 83% (55–100%), benefits of treatment 92% (71–100%), overall patient education 91% (62–100%). Internal validity using Cronbach’s alpha was 0.72 (standard deviation 0.23, range 0.5–1). The results confirm the consistency of responses and the reliability of the information collected with the NOQ. The NOQ is a novel questionnaire and a valid metric to quantify a patient’s perception of their experience. Its adoption may aid in making targeted improvements to patient care.

Likert scale vs visual analog scale for assessing facial pleasantness

•Facial pleasantness was assessed with Likert and visual analog scales. •Oral surgeons, orthodontists, and laypeople evaluated sets of photographs. •Results were similar regardless of the scale used. •Most evaluators preferred the Likert scale because of its simplicity. Introduction This study aimed to compare the 2 most commonly used methods for assessing facial pleasantness, the Likert scale and the visual analog scale (VAS). Methods For assessing facial pleasantness, an album was assembled containing the front and profile view facial photographs of 10 patients (5 females, 5 males) who sought orthodontic treatment representing each of the different sagittal and vertical facial discrepancies (straight profile, convex profile, concave profile, long faces, and short faces). The facial pleasantness of the patients was judged by 3 groups of 90 evaluators (47 females and 43 males): 30 orthodontists (mean age, 32.41 years), 30 oral maxillofacial surgeons (mean age, 36.83 years), and 30 laypeople (mean age, 36.83 years). The evaluators judged the facial pleasantness using VAS and a 5-point Likert scale. At the end of the evaluation, the evaluators completed a questionnaire about their preferred scale. Analysis of variance and Tukey and Kruskal-Wallis tests were used to compare the data from VAS and Likert scale, respectively. The Spearman correlation coefficient was used to estimate the correlation between the 2 scales. Fisher transformation and z-statistic were used to estimate the correlation among the evaluator groups. In all tests, a 5% statistical significance level was adopted. Results Both scales presented similar answers; only VAS values for the scores of pleasant and very pleasant according to the Likert scale could not be distinct. Most evaluators preferred the Likert scale as they found it easier to convey their opinion than VAS. Conclusions Although both scales can be used to assess facial pleasantness, the Likert scale seems more appropriate as the evaluators preferred it because of its simplicity. This study aimed to compare the 2 most commonly used methods for assessing facial pleasantness, the Likert scale and the visual analog scale (VAS). For assessing facial pleasantness, an album was assembled containing the front and profile view facial photographs of 10 patients (5 females, 5 males) who sought orthodontic treatment representing each of the different sagittal and vertical facial discrepancies (straight profile, convex profile, concave profile, long faces, and short faces). The facial pleasantness of the patients was judged by 3 groups of 90 evaluators (47 females and 43 males): 30 orthodontists (mean age, 32.41 years), 30 oral maxillofacial surgeons (mean age, 36.83 years), and 30 laypeople (mean age, 36.83 years). The evaluators judged the facial pleasantness using VAS and a 5-point Likert scale. At the end of the evaluation, the evaluators completed a questionnaire about their preferred scale. Analysis of variance and Tukey and Kruskal-Wallis tests were used to compare the data from VAS and Likert scale, respectively. The Spearman correlation coefficient was used to estimate the correlation between the 2 scales. Fisher transformation and z-statistic were used to estimate the correlation among the evaluator groups. In all tests, a 5% statistical significance level was adopted. Both scales presented similar answers; only VAS values for the scores of pleasant and very pleasant according to the Likert scale could not be distinct. Most evaluators preferred the Likert scale as they found it easier to convey their opinion than VAS. Although both scales can be used to assess facial pleasantness, the Likert scale seems more appropriate as the evaluators preferred it because of its simplicity.

Evaluation of the Correlation Between Vertical Facial Discrepancies and Cervical Vertebral Fusion

Evaluation of the Correlation Between Vertical Facial Discrepancies and Cervical Vertebral Fusion

Patient expectations and satisfaction following orthognathic surgery

Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. Treatment usually requires a minimum of 18 months, necessitating that patients are adequately satisfied with the treatment provided. This study aimed to assess the determinants of patient satisfaction following treatment. One hundred and eighteen patients who had undergone orthognathic surgery were included prospectively. All participants completed a questionnaire regarding their reasons for undergoing treatment, treatment logistics, treatment outcomes, and satisfaction throughout their journey. Most patients were ‘very satisfied’ (71.2%) or ‘satisfied’ (19.5%) with the overall treatment. The majority wished to improve their smile (78.0%); post-treatment, 89.0% of patients reported an improved smile. Almost half of the patients (46.6%) stayed in hospital for only one night, and 41.5% took over 4 weeks off work or school post-surgery. People with postoperative breathing difficulties spent more days in hospital (P=0.021), but importantly, the duration of hospital stay did not differ between maxillary advancement, bilateral sagittal split osteotomy, and bimaxillary surgery (P=0.78). In conclusion, patient satisfaction was high following orthognathic treatment. The results highlight areas for improvement, such as information delivery to the patient throughout the treatment journey, and show that the presence of ongoing problems is an important predictor of patient satisfaction.

Diagnostic performance of various cephalometric parameters for the assessment of vertical growth pattern.

ABSTRACTIntroduction: Multiple cephalometric analyses are used to diagnose vertical skeletal facial discrepancy. A multitude of times, these parameters show conflicting results, and a specific diagnosis is hard to reach. Objective: Hence, this study aimed to identify the skeletal analysis that performs best for the identification of vertical skeletal pattern in borderline cases. Methods: The sample consisted of 161 subjects (71 males and 90 females; mean age = 23.6 ± 4.6 years). Y-axis, Sella-Nasion to mandibular plane angle (SN.MP), maxillary plane to mandibular plane angle (MMA), Sella-Nasion to Gonion-Gnathion angle (SN.GoGn), Frankfort to mandibular plane angle (FMA), R-angle and facial height ratio (LAFH.TAFH) were used to evaluate vertical growth pattern on lateral cephalograms. The subjects were divided into three groups (hypodivergent, normodivergent and hyperdivergent groups), as indicated by the diagnostic results of the majority of parameters. Kappa statistics was applied to compare the diagnostic accuracy of various analyses. To further validate the results, sensitivity and positive predictive values (PPV) for each parameter were also calculated. Results: SN.GoGn showed a substantial interclass agreement (k = 0.850). In the hypodivergent group, MMA showed the highest sensitivity (0.934), whereas FMA showed the highest PPV (0.964). In the normodivergent group, FMA showed the highest sensitivity (0.909) and SN.GoGn had the highest PPV (0.903). SN.GoGn showed the highest sensitivity (0.980) and PPV (0.87) in the hyperdivergent group. Conclusions: SN.GoGn and FMA were found to be the most reliable indicators, whereas LAFH.TAFH is the least reliable indicator in assessing facial vertical growth pattern. Hence, the cephalometric analyses may be limited to fewer analyses of higher diagnostic performance.

A Study of Facial Pattern in Patients with Fanconi Anemia

This study is aimed to evaluate craniofacial features in patients with Fanconi anemia (FA) through cephalometric analysis and to classify the facial growth pattern to observe possible facial discrepancies. This is a cross-sectional study which employed a quantitative approach to compare linear and angular measurements of cephalometric analysis in lateral teleradiographic images of a clinical type sample of patients with FA. A retrospective cephalometric study was performed using cephalometric analyses of Ricketts and Steiner; growth patterns according to Ricketts' vertical growth pattern (VERT index) were also analyzed. Fifty patients diagnosed with FA who were undergoing anti-aplasia treatment at the outpatient Hematology service at the Federal University of Paraná, Curitiba, Brazil were included in the study. The patients were evaluated in the School of Dentistry of the Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil. Exclusion criteria included patients who had used or were using growth hormone medication, had undergone bone marrow transplant, or had been previously subjected to dental treatment. Cephalometric points were plotted in order to set up linear and angular cephalometric measurements. Angular and linear measurements from 17 factors proposed by Ricketts' cephalometric analysis were assessed. Dolicofacial appearance was observed in 52% of individuals; braquifacial in 28%, and mesofacial in 20%. Significant maxillary/mandibular discrepancy was observed. It was concluded that upon anteroposterior evaluation of facial bone structures, the FA sample presented smaller median measurements in most variables evaluated; it also presented mandibular micrognathism and mainly dolicofacial vertical growth pattern. These findings, together with other features such as skin pigmentation and microphthalmia, may lead to a possible recognition of a FA condition from a patient's facial features.

Orthodontic management of a case with skeletal Class III malocclusion

Class III malocclusions are considered one of the most complex and difficult orthodontic problems to diagnose and treat. Skeletal and/or dental asymmetries in patients presenting with Class III malocclusions can worsen the prognosis. Recognizing the dentoalveolar and skeletal characteristics of Class III malocclusions and their treatment possibilities is essential for a favorable nonsurgical correction. Therefore, this article presents a nonsurgical extraction approach to Class III malocclusion treatment which can significantly improve the occlusal and facial discrepancies. DOI: http://dx.doi.org/10.3329/bjodfo.v2i1.15999 Ban J Orthod & Dentofac Orthop, October 2011; Vol-2, No.1, 20-25

A cross-sectional study of soft tissue facial morphometry in children of West Bengal

Context:Facial analysis is the first step in the evaluation of patients with orthodontic, cosmetic, or reconstructive procedures of the face, and one of the most important components of orthodontic diagnosis and treatment planning. It is a well-established fact that human faces differ from one another on the basis of race and ethnicity. The study will provide the aesthetic guidelines to assess the facial discrepancy in Bengali children to develop a proper treatment plan.Aims:To find out the mean values for selective linear measurements on the facial soft tissue of Bengali children, to demonstrate gender differences in the measurements.Materials and Methods:A cross-sectional study was done on 250 Bengali children of 6-14 years age, by measuring certain identified facial landmarks using a digital caliper.Statistical Analysis Used:Analytical statistical method with the help of student's t-test was used to determine mean values, standard deviation, and gender differences in the measurements using SPSS version 11.0.Results:In 6-8 years age group, male's average inter-endocanthion distance was significantly higher than that of females (P < 0.05), whereas in 12-14 years age group, the same parameter for females was significantly higher than that of males (P < 0.001). In 9-11 years age group, the average distance of exocanthion to exocanthion was higher for males compared to females, but the difference was not significant at 5% level (P > 0.05), though for 87% of cases, it was significant (P = 0.13). Total facial height for male subject was significantly high compared to that of females (P < 0.001) in 12-14 years age group.Conclusions:The study will provide the aesthetic guidelines to assess the facial discrepancy in Bengali children and provide a proper treatment plan through a simple and economically reasonable soft tissue analysis method.

ORAL FEATURES IN CORNELIA DE LANGE SYNDROME

Cornelia de Lange syndrome (CdLS) is a multisystem malformation syndrome. There is wide clinical variability in this disorder. This disorder is relatively uncommon and characterised by series of malformations which includes skeletal, craniofacial, gastrointestinal and cardiac malformations. The main clinical feature includes growth retardation, limb abnormalities, mental retardation, developmental delay and facial discrepancies. Here we report Cornelia De Lange syndrome in an adult patient with characteristic limb abnormalities and distinctive oral features.

Changes in dentoalveolar and facial heights during early and late growth periods: a longitudinal study.

This longitudinal study examined the dentoalveolar structures during early and late growth periods in 62 subjects (26 male, 36 female) with normal facial patterns and acceptable occlusions. Hand-wrist radiographs were assessed and subjects grouped accordingly as either early stage (group 1) or late stage (group 2). Group 1 comprised 30 subjects with skeletal development maturation stages between PP2= and MP3=, H or S. Group 2 comprised 32 subjects with skeletal development maturation stages between MP3u and Ru. Skeletal and dentoalveolar measurements and ratios were assessed at the beginning and end of the observation periods. Differences in measurements and ratios within each group were examined using paired t-tests. Differences between the 2 groups were evaluated using Student's t-tests. Increases in alveolar heights (except for upper posterior alveolar heights) differed between the groups. Vertical alveolar dimensions increased substantially in group 1 in comparison with group 2. With the exception of upper anterior alveolar heights, all increases in group 2 were statistically significant. As a result of differential growth in alveolar dimensions, lower facial ratio (Co-Go/ANS-Me) and overbite remained constant in both stages. Vertical alveolar growth exhibited regional differentiation according to the pubertal growth periods. Although this growth plays a role in the establishment of normal facial patterns and occlusion, it should also be considered with respect to the treatment and treatment stability of patients showing vertical facial discrepancies.

Orthodontic treatment alternative to a class III subdivision malocclusion

Class III malocclusions are considered one of the most complex and difficult orthodontic problems to diagnose and treat. Skeletal and/or dental asymmetries in patients presenting with Class III malocclusions can worsen the prognosis. Recognizing the dentoalveolar and skeletal characteristics of subdivision malocclusions and their treatment possibilities is essential for a favorable nonsurgical correction. Therefore, this article presents a nonsurgical asymmetric extraction approach to Class III subdivision malocclusion treatment which can significantly improve the occlusal and facial discrepancies.