Improvement In Facial Appearance Research Articles

Patient-Perceived Improvement in Facial Appearance and Quality of life: FACE-Q as a Tool to Study Reduction Mandibuloplasty Outcomes.

This study aimed to assess patient satisfaction regarding facial appearance and quality of life pre- and post-reduction mandibuloplasty. In addition, it sought to investigate the factors influencing patient satisfaction. Conducted as a prospective cohort study spanning from November 2020 to October 2023, participants were required to complete the FACE-Q assessment both before and one year following reduction mandibuloplasty. Normative FACE-Q values from individuals aged over 18 years were employed for comparison. A multivariate linear regression model was used to evaluate the impact of various factors on FACE-Q outcomes. Statistically significant enhancements in patient satisfaction were observed with overall appearance, lower face and jawline, and quality of life post-surgery. When compared to normative data, preoperative scores were significantly lower, yet postoperative scores reach levels comparable to those of the normative population. Moreover, patients generally perceived themselves as looking approximately 0.75 years younger post-surgery. Notably, patients aged 30 and younger experienced more pronounced improvements than those above 30. Reduction mandibuloplasty significantly contributes to the enhancement of facial appearance and quality of life, achieving results representative of the general population. Moreover, it positively influences the perception of apparent facial age. The extent of improvement varies among distinct age groups, emphasizing the recommendation for reduction mandibuloplasty at earlier ages, as older patients tended to exhibit less improvement. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Correlation of Orthognathic Surgical Movements to Perception of Facial Appearance in Patients With Cleft Lip and Palate.

Cephalometric scans were compared before and after surgery to assess the degree of correction. Correlations between skeletal movements and survey outcomes were determined using multivariate regression analysis. This study aims to identify relationships between subjective observer-reported improvements in esthetics and emotional appearance with specific surgical movements. Ten patients at a single tertiary institution (average age: 18.1 ± 0.8), 9 males and 1 female, underwent orthognathic repair and had comprehensive cephalometric records. Standardized anterior posterior and lateral pre and postoperative photographs of patients were included in a survey to clinicians to assess noncognitive domains on a Likert Scale (1-10). CLEFT-Q was administered to gauge patient satisfaction in categories of appearance, speech, and quality of life. Per clinicians, multiple domains increased including facial attractiveness (4.1 ± 0.7 versus 7.3 ± 0.7, P < 0.001), friendliness (4.5 ± 0.4 versus 7.3 ± 0.5, P < 0.001), confidence (4.1 ± 0.4 versus 7.1 ± 0.4, P < 0.001), and recommendation for surgery decreased (8.9 ± 0.1 versus 3.6 ± 0.5, P < 0.001). Speech distress decreased with increased SNA and convexity, whereas Psychological and Social scores decreased with an increased ANB. Functional eating and drinking scores increased with maxillary depth. Orthognathic surgery improves many noncognitive domains in patients with cleft lip and palate as assessed by both patients and clinicians on all aspects of facial attractiveness and perception. These findings demonstrate objective bases of skeletal adjustments for perceived improvements in facial appearance and emotion.

Expectations of Patients Receiving Orthodontic Treatment from Saidu College of Dentistry Swat: A Cross Sectional Study

OBJECTIVE: The aim of this study was to assess the anticipations of orthodontic treatment held by both patients and parents. This would enable the provision of optimal services for expectations that are rational, while also facilitating discussions or guidance for expectations that are impractical. One of the key goals of healthcare systems today is to meet patient expectations. The declaration of a patient’s desires is significant because healthcare providers frequently undervalue their need for treatment. When a clinician is aware of patient demands, they are better equipped to meet the patient’s realistic expectations while explaining the least possibility to fulfil arbitrary expectations, thus results in more rewarding therapeutic interventions. METHODOLOGY: The data collection process involved the utilization of a non-randomized sampling technique, specifically selecting 300 participants as determined through Epi info using a structured form. The study focused on recruiting new patients who exhibited internal motivation, along with anatomical or morphological issues related to their teeth or jaws. A prior history of orthodontic treatment was an exclusion criterion. Participants with craniofacial syndromes or malformations, as well as those dealing with mental or psychological health conditions, were excluded from the research. RESULTS: In total, 300 individuals were examined, with 170 females and 130 males. Improvement in facial appearance was the most popular reason for seeking orthodontic treatment (180 patients out of 300), although other functions like mastication, better oral health and communication were mentioned by 120 patients. 70% (210) had a thought, since they would receive treatment, they would be more accepted by society and thus improve their social standing, while the remaining 30% (90) thought that it would have no difference. CONCLUSION: Essentially, expectations from orthodontic interventions among patients are quite uniform, although males generally display more practical perceptions regarding treatment duration and the initial appointment. However, when it comes to dietary and beverage restrictions during orthodontic treatment, patient expectations differ from those held by their parents. KEYWORDS: Patient expectations, orthodontics, Evaluate.

Treatment with synchronized radiofrequency and facial muscle stimulation: Histologic analysis of human skin for changes in collagen and elastin fibers.

Skin's exposure to intrinsic and extrinsic factors causes age-related changes, leading to a lower amount of dermal collagen and elastin. This study investigated the effects of a novel facial muscle stimulation technology combined with radiofrequency (RF) heating on dermal collagen and elastin content for the treatment of facial wrinkles and skin laxity. The active group subjects (N = 6) received four 20-min facial treatments with simultaneous RF and facial muscle stimulation, once weekly. The control subject (N = 1) was untreated. Skin biopsies obtained at baseline, 1-month and 3-month follow-up were evaluated histologically to determine collagen and elastin fibers content. A group of independent aestheticians evaluated facial skin appearance and wrinkle severity. Patient safety was followed. In the active group, collagen-occupied area reached 11.91 ± 1.80 × 106 μm2 (+25.32%, p < 0.05) and 12.35 ± 1.44 × 105 μm2 (+30.00%, p < 0.05) at 1-month and 3-month follow-up visits. Elastin-occupied area at 1-month and 3-month follow-up was 1.64 ± 0.14 × 105 μm2 (+67.23%, p < 0.05), and 1.99 ± 0.21 × 105 μm2 (+102.80%, p < 0.05). In the control group, there was no significant difference (p > 0.05) in collagen and elastin fibers. Active group wrinkle scores decreased from 5 (moderate, class II) to 3 (mild, class I). All subjects, except the control, improved in appearance posttreatment. No adverse events or side effects occurred. Decreased dermal collagen and elastin levels contributes to a gradual decline in skin elasticity, leading to facial wrinkles and unfirm skin. Study results showed noticeable improvement in facial appearance and increased dermal collagen and elastin content subsequent to simultaneous, noninvasive RF, and facial muscle stimulation treatments.

Remodeling of facial soft tissue induced by simultaneous application of HIFES and synchronized radiofrequency provides nonsurgical lift of facial soft tissues.

The application of radiofrequency (RF) and HIFES on the body provides improvement in skeletal muscle tissue, reduction in fatty tissue, reorganization of connective tissue, and skin texture improvement. However, overall facial appearance relies on both skin and underlying structures, specifically muscles and connective tissue which have to be treated as one unit to achieve proper care while preserving fatty layers that define youth facial appearance. The aim of this study is to find whether the effect of novel RF + HIFES is safe and can induce the lifting of soft tissue and overall improvement in facial appearance. In this study, 21 subjects were enrolled. The therapy was administered in four 20-min treatments on the forehead and cheeks. Photographs were evaluated by a Global Aesthetic Improvement Score (GAIS) and linear measurements of facial tissue lifting at 1- and 3-month follow-ups. Volumetric changes in the cheek area were investigated as well. The patients' satisfaction, safety, and comfort were documented throughout the study. The data indicated improvement in overall facial appearance, and 23% of average lifting was found in brows (p = 3.14 × 10-12 ) and cheeks (p = 6.00 × 10-15 ). The assessment of digital photographs showed an improvement in 100% of patients at 3-month follow-up. The treatments were safe, accompanied by high therapy comfort and subject satisfaction of 98%. The treatment by simultaneous RF and HIFES technology produces significant changes to the overall facial appearance, characterized by the lifting of facial tissues.

A Surgical Management Algorithm for Type 4 Parry-Romberg Syndrome.

Type 4 Parry-Romberg syndrome (PRS) affects multiple facial esthetic units involving many tissue types, requiring both bone and soft tissue restoration and requiring different surgical procedures over a long period of time. To date, the timing and sequence of these operations remains controversial. A retrospective analysis was performed to introduce our surgical management algorithm for type 4 PRS and to evaluate its safety and efficacy according to long-term follow-up results. Six Chinese patients (5 females and 1 male) fulfilled the inclusion criteria. The follow-up period ranged from 23 to 90 months (mean 51.83mo). All patients were satisfied with the improvement in facial appearance after staged bone and soft tissue reconstruction. No major complications were reported except for 1 case of infection after Medpor implantation. For severe PRS, both bone and soft tissue reconstruction is recommended. Enlargement of the bony framework provides a good foundation for subsequent soft tissue restoration. Alloplastic implants in the maxilla can be problematic if the patient has undergone either a zygomatic or maxillary osteotomy. The anterolateral thigh adipofascial flap is a reliable choice for large soft tissue deficits in type 4 PRS. We hope that reporting our surgical management algorithm with long-term follow-up results will improve the personalized treatment of these patients.

Combined Bipolar Radiofrequency and Non-Crosslinked Hyaluronic Acid Mesotherapy Protocol to Improve Skin Appearance and Epidermal Barrier Function: A Pilot Study.

Age-associated changes in epidermal hydration, pigmentation, thickness and cell renewal influence skin appearance and can lead to laxity, dryness and poor skin tone. The aim of this pilot study was to assess the synergistic effects of a new bipolar radiofrequency plus non-crosslinked hyaluronic acid (HA) mesotherapy protocol compared with radiofrequency alone on skin appearance and markers of epidermal function. This prospective, single-center, split-face pilot study recruited women aged 25-65 years with dryness and laxity of the facial skin defined by a trans-epidermal water loss (TEWL) value of ≥26 g/m2/h. Subjects were treated with a bipolar radiofrequency device on both sides of the face. This was immediately followed by needle hyaluronic acid (HA) treatment on one side of the face with 2.5 mL of a non-crosslinked HA. Photographic documentation, analysis of epidermal barrier function parameters, and high frequency (HF) ultrasound analysis were performed prior to treatment and at 28 days. Twenty female subjects with a mean age of 46 (range 29 to 54) years and dry and lax facial skin were included. TEWL was reduced and skin hydration improved to a greater extent with the combined radiofrequency plus mesotherapy protocol compared with radiofrequency alone (-5.8% vs. +3.9% and +23.1% vs. +1.0%, respectively). The combined protocol was also associated with greater improvements in melanin (-7.5% vs. -1.5%) and erythema values (-7.2% vs. +3.0%), respectively. Ultrasound measures of epidermal thickness and epidermal density were greater after the combined protocol compared with radiofrequency alone (12.0% vs. 5.6% and 57.7% vs. 7.1%, respectively). Both treatments were well-tolerated. The combined bipolar radiofrequency and HA mesotherapy protocol provided greater improvements in skin hydration, firmness and tone compared with radiofrequency alone. The combination treatment was also associated with greater epidermal thickness and density and increased keratinocyte differentiation suggesting a synergistic effect of both treatments on epidermal homeostasis and barrier function. Both treatments were well-tolerated and led to improvements in facial appearance.

Improved Super-elastic Ti-Ni Alloy Wire for Nonsurgical Treatment of Skeletal Class III Malocclusion Combined with Anterior Crowding and Anterior Crossbite Case

The article reported the use of improved super-elastic Ti-Ni alloy wire (ISW), which was developed by Tokyo Medical and Dental University, to correct a case of skeletal Class III malocclusion combined with anterior crowding and anterior crossbite. An 18-year-old male with a chief complaint of poor dental alignment and protruded lower incisors showed up in our clinic for treatment. Clinical examination revealed skeletal Class III facial profile. Anterior crowding and anterior crossbite could be also noted. Because the patient refused orthognathic surgery, we tried camouflage orthodontic treatment. First, we used ISW crossbite arch to eliminate the anterior interference in order to observe the change of the mandibular position. After that, we use ISW multiloop edgewise arch wire (MEAW) technique and intermaxillary elastics to achieve midline correction and adequate overjet with the bite raising process. The treatment was finished with the improvement of facial appearance and a stable occlusion.

Dermal Fillers in the Treatment of Acne Scars: A Review.

Acne vulgaris (AV) is the eighth most common disease in the world. This condition can impair the affected patients' social and psychological functioning and lower their quality of life. In general, scar reduction, rather than complete scar removal, is the aim of AV treatment. Dermal abrasion, chemical peeling, laser resurfacing, subcision, punch methods, tissue-improving substances, and dermal fillers are the currently available therapeutic options. In this study, we focused on the rapidly developing field of dermal fillers used alone or in combination with other therapies to reconstruct skin affected by acne scars and to evaluate the improvement of facial appearance after using different types of dermal fillers.

Surgical miniscrew assisted orthodontics; changes in facial appearance and smile of an adult female: A case study

Proclined upper incisors are the reasons for lip incompetence, excessive incisor display and very unesthetic smile characters for a good number of patients seeking orthodontic treatment. Majority of these cases are treated following extraction of premolars and intrusion and retraction of incisors, which became much more feasible through usage of temporary anchorage devices like miniscrew implants. Before titanium orthodontic miniscrew were available in the market, surgical screws for fixation of bone-plates were started to be used for orthodontic anchorage. This article presents a case to show how surgical miniscrews can be utilized to intrude and retract severely proclined upper incisors to bring upon noticeable improvement in facial appearance and smile.

Helium plasma dermal resurfacing: VISIA CR assessment of facial spots, pores, and wrinkles-Preliminary findings.

ObjectivesEffects of low energy, single‐pass helium plasma dermal resurfacing (PDR) treatment on brown spots, enlarged pores, and wrinkles—preliminary findings.MethodsTwenty two subjects (64.6 ± 6.6 years) with Fitzpatrick Wrinkle and Elastosis Scale score (FWS) of ≤2 and seeking improvement of facial appearance were included in this subanalysis. All subjects received a single, one‐pass, full face, and low power helium PDR treatment. Standard digital images were collected using the VISIA‐CR (Canfield Scientific Inc.) at baseline and 3 months after treatment with images assessed for improvement in FWS and for improvements in brown spots, enlarged pores, and wrinkles by proprietary automated image processing algorithms.ResultsNearly all subjects demonstrated ≥1‐point improvement in FWS and also reported improvement per modified Global Aesthetic Improvement Scale query. The numbers of brown spots and enlarged pores decreased by 45.1% and 28.3%, respectively. Stratification of brown spots data by presence or absence of post‐inflammatory hyperpigmentation revealed paradoxically conflicting data. The improvement detected in wrinkle area and mean wrinkle thickness was less pronounced with overall reductions of 13.4% and 4.8%, respectively. 37 Non‐serious adverse events (AEs) in 22 subjects were reported with most resolving within 14 days or less, and no serious AEs were observed.ConclusionsWhile longer‐term follow‐up is needed, these early study results show that one single‐pass, low energy helium PDR treatment improves facial skin appearance both qualitatively and quantitatively. Studies evaluating higher energy levels and multiple treatment passes are ongoing.

Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation.

Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone.

Comparison of results and quality of life in patients with thyroid eye disease after different methods of orbital decompression

Purpose. To evaluate the changes in the quality of life of patients with thyroid eye disease after different methods of orbital decompression.&#x0D; Materials and methods. The study included 24 patients (37 orbits) with thyroid eye disease, aged 41.6 20.6 (from 20 to 79 years), 18 women and 6 men. The patients were divided into two groups. The first group included 12 patients (19 orbits) who underwent orbital fat decompression. The second group included 12 patients (18 orbits) who underwent endoscopic endonasal bony orbital decompression. The Graves ophthalmopathy quality of life questionnaire (GO-QOL) was completed before surgery, and 3 and 6 months after it. Outcome analysis included also the assessment of visual acuity, proptosis, eyelid retraction, and palpebral fissure height.&#x0D; Results. The GO-QOL visual function scores in both groups did not change significantly in 3 and in 6 months after orbital decompression (p 0.05): in the first group, before and after 6 months, scores were 69.27 20.02 and 68.96 18.44, in the second group 53.13 29.13 and 57.81 23.56, respectively. An improvement in the GO-QOL visual function estimation was observed in those patients whose visual acuity improved after surgery. The GO-QOL facial appearance scores significantly improved 3 months after surgery, and continued to increase up to 6 months: in the first group, facial appearance scores improved from 23.96 23.01 to 48.42 25.56 (p = 0.004), in the second group from 47.92 21.04 to 66.15 23.15 (p = 0.037).&#x0D; Conclusions. Orbital decompression significantly improves the quality of life of patients with thyroid eye disease, this is primarily associated with an improvement in facial appearance.

Decoding the facial asymmetry

Introduction: When degree of facial asymmetry is noticeable, it negatively affects facial and smile esthetics. It may due to discrepancies in size and position between cranial base and maxilla/ mandible. Asymmetry due to occlusal interference may result in functional shift of the mandible which usually poses a challenge. So diagnosis and functional examination are keys to an esthetic and stable outcome. Objectives: This case report addresses the facial asymmetry in an adult patient who sought for improvement infacial appearance and occlusion. Case Description: A 26-year old male patient reported with chief complaint of noticeable facial asymmetry and irregularly positioned teeth. Clinical examination revealed mild facial asymmetry. Intraorally patient showed crowding, non-coincident dental midlines, anterior cross bite, missing 23 and root stump 46. Starting point in diagnosis and treatment of this case was establishing centric relation through guiding the mandible into centric relation rather than centric occlusion. During functional examination we observed discrepancyin CR-CO which was confirmed using PA-Ceph in centric rest position. Treatment was planned as deprogramming splint followed by fixed mechanotherapy. Post muscle deprogramming we were able to achieve “true” anatomic relationship of the mandible to the maxilla. Conclusion: Thus, the present case report aims at addressing important aspect of functional examination to be considered by the orthodontist while reaching an accurate diagnosis and treatment plan in such patient’s with challenging asymmetry. Keywords: Centric relation, Asymmetry, Deprogramming.

Apnea and Speech Therapy: Pharyngeal Stimulation Proposal

Introduction: Obstructive sleep apnea syndrome (OSAS) currently represents one of the biggest health problems for the individual, causing changes in breathing during sleep. It is accompanied by Snoring, described by a malfunctioning vibration of the oropharynx generating noise emissions. Among the causes of this pathology, there are alterations in the soft structures of the Stomatognathic System. Objective: To describe the specific myofunctional therapy work for the Pharynx Walls in a female patient, a 22-year-old patient, diagnosed with Apnea and to show its efficiency. Method: The object of study was a patient of the FMU clinic, 22 years old, diagnosed with severe Apnea by Polysomnography exam and with oromyofunctional alteration. Patient performed 30 continuous days of pharynx wall exercises. Results: After 30 days the patient showed a significant improvement in facial appearance, in the coloration of periorbital hyperpigmentation of the eyes, Mallampati II classification, greater balance of the muscles during chewing and absence of pain when swallowing. Conclusion: In this case, pharynx wall exercises are effective for improving muscle condition and should be included in the therapeutic plan for working with Apnea; however, they were not sufficient to resolve the change, due to the severe degree of the pathology.

Long lasting facial rejuvenation by repeated placement of calcium hydroxylapatite in elderly women.

Calcium hydroxylapatite (CaHA) is a biostimulatory filler with long lasting efficacy after a single injection. Data con the effect of repeated injections, however, are sparse. This is a single-center observational study. Forty Caucasian females of Fitzpatrick skin type I to III, aged between 50 and 95 years (mean age 63 ± 13.4 years), and seeking nonsurgical improvement of facial aging were included. Patients with previous face lifts, threads or other surgical treatments were excluded. Only women ≥50 years of age were included. Midface and lower face were treated, that is, cheeks, tear troughs, jawline, and Marionette lines. The usual time for a repetition of filler injection was 12 to 14 months. Mean follow-up was 36 ± 10.8 months after first injection of Radiesse. Outcome was measured using the Global Aesthetic Improvement Scale (GAIS). Mean patient's GAIS was 2.7 ± 0.7, while physicians GAIS was 2.6 ± 0.6 suggesting a remarkable improvement 12 months after the first procedure. Mean patient's GAIS at 3 and 5 years after first procedure was 2.4 ± 0.8, while physicians GAIS was 2.5 ± 0.7. Repeated injection of CaHA leads to a significant and long-lasting improvement of facial appearance.

Is there a difference in judgement of facial appearance depending on ethnic background? Photographic evaluation of facial appearance in orthognathic surgery.

Is there a variation in facial ideals depending on ethnic background that affects judgements of outcome in orthognathic surgery? How does the evaluation correlate with patient-reported outcome measures? Two evaluation panels, Singaporean and Swedish, judged photographs of patients undergoing orthognathic surgery taken before and after operation. Improvement in facial aesthetics was calculated between the two ratings. The result was compared between the panels and correlated with health-related quality of life (QoL) measures. Thirty male and 27 female patients aged between 18 and 28 years (mean 21) were included, and 52 subjects were eligible for comparison of health-related QoL. The photographic evaluation showed that both panels judged there to be significant improvement in facial aesthetics after treatment (p<0.001). The Singaporean panel rated the overall facial appearance higher than the Swedish panel when evaluating photographs both before (p=0.025) and after (p=0.032) operation. Improvement of the overall facial appearance showed no significant difference between the panels (p>0.30). No correlation between health-related QoL and improvement of facial appearance was found by either panel. Subjective evaluation of facial aesthetics in orthognathic surgery is unaffected by the observer's ethnic origin. Independently of their ethnicity, the evaluation juries found that facial aesthetics improved after orthognathic surgery. Improvement reported by the juries corresponded to that reported by patients.

Measuring patient-reported outcomes in orthognathic surgery: Linguistic and psychometric validation of the Mandarin Chinese version of FACE-Q instrument

BackgroundOrthognathic surgery is useful for correction of dental malocclusion and improvement of facial appearance. The FACE-Q is a patient-reported outcome instrument for evaluation of surgical and psychosocial effect. The purposes of this study were to conduct a linguistic validation of all FACE-Q scales to Mandarin Chinese, to test the orthognathic surgery-related scales for reliability and validity, and to evaluate the effect of orthognathic surgery. MethodsAll FACE-Q scales and checklists were translated from English to Mandarin Chinese according to international recommendations: forward translations, backward translation, and cognitive interviews. Psychometric testing of orthognathic surgery-related scales of translated version was administered to patients with facial deformities and history of orthognathic surgery (n = 53; 17 scales) or no history of orthognathic surgery (n = 44; 11 scales), and control subjects (n = 57; 11 scales). ResultsAll FACE-Q scales and checklists were linguistically validated into Mandarin Chinese. The contents were confirmed valid among Mandarin Chinese-speaking population. The FACE-Q scales had excellent internal consistency (Cronbach's alpha >0.70) and discriminated (p < 0.05) well between patients before and after orthognathic surgeries and normal subjects. ConclusionsThis study discovered significant benefit of orthognathic surgery on improving facial appearance and psychosocial function, as compared with the non-surgical patients and normal controls.

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

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.

The changes of self-esteem, sensitivity to criticism, and social appearance anxiety in orthognathic surgery patients: A controlled study.

To evaluate the changes of psychologic parameters, such as self-esteem, sensitivity to criticism, and social appearance anxiety, in skeletal Class III patients undergoing orthognathic surgery and to compare the psychologic status of skeletal Class III patients with control subjects. The first group consisted of 60 patients with a mean age of 22.07±1.30years who did not need orthognathic surgery. The second group comprised 45 patients with skeletal Class III malocclusion (mean age 21.40±2.02years) who were evaluated in terms of psychologic changes from before to after surgery. A third group consisted of 50 Class III patients (mean age 20.09±2.59years) who were evaluated before surgery and a different 50 Class III patients (mean age 22.15±2.03years) who were investigated after surgery. The Rosenberg Self-Esteem Scale and the Social Appearance Anxiety Scale were used to evaluate psychologic parameters both before and after surgery. Analysis was carried out with the use of independent- and dependent-sample t tests, 1-way analysis of variance, and post hoc Tukey test. Self-esteem of the patients with skeletal Class III malocclusion increased, and sensitivity to criticism and social appearance anxiety decreased significantly after the surgery (P<0.001). In the patients with Class III malocclusion, self-esteem was significantly lower and social appearance anxiety significantly higher before orthognathic surgery than in the control group, and at the postoperative evaluation Class III patients had significantly higher self-esteem than the control group (P<0.001). Through the improvement in facial appearance after surgery, patients' self-esteem increases and their sensitivity to criticism and social appearance anxiety decrease.