Authors : Sreevatsan Raghavan, Koshi Philip, Puneet Batra
DOI : 10.18231/j.jco.2017.013
Volume : 1
Issue : 3
Year : 2017
Page No : 12-20
Background and Objective: To evaluate the motivation and satisfaction of combined orthodontic-orthognathic treatment and to assess the outcome of the same objectively(cephalometrics)of post-treatment soft-tissue profile and subjectively through profile photographic aesthetic evaluation by laypersons and clinicians. Correlation with satisfaction of the patients and the degree of post-treatment soft-tissue correction
Materials and Methods: The sample comprised of 30 patients (Kerala origin) who had completed combined orthodontic-orthognathic treatment. Motivation and satisfaction with treatment results were evaluated using a pre-validated questionnaire. Post-treatment cephalograms were assessed using the Burstone and Legan’s Soft tissue analysis along with comparison to regional norms of the Kerala population. Standardized pre and post- treatment profile photograph aesthetics were assessed by six laypersons and six clinicians using a 7- point scale.
Results:The most common reasons for seeking orthognathic treatment were dissatisfaction with facial appearance (76.7 percent)- majority (14/23) being women and problems in biting and chewing (23.6 percent). All patients were satisfied with treatment results. Some degree of numbness in the lips and/or jaw beyond 1 month post-operatively was experienced by 66 percent. The most satisfied patients were the ones who were dissatisfied initially with their facial appearance. Complete cephalometric normalization of the parameters was not achieved with orthognathic surgery, showing significant differences when compared to the aesthetic norms. There were significant differences in the aesthetic scores between laypersons and clinicians. Interpretations and Conclusion:Although satisfied with the results, majority of the patients found the surgical experience as the most unpleasant part of the whole treatment process. The professionals should make efforts to understand the patient’s motivations for and expectations of treatment. Maxillary prognathism and vertical height ratio were the only cephalometric parameters that significantly influenced clinicians’ assessment of profile aesthetics. Patient satisfaction was not related to cephalometric change observed.
Keywords: Motivation; Satisfaction; Orthodontics; Orthognathic Surgery; Aesthetics; Psychological; Kerala Population; Cephalometrics