Influences on Stability following Orthognathic Surgery

对正颌手术后稳定性的影响

• 批准号: 6611543
• 负责人: WILLIAM R PROFFIT
• 金额: $ 39.05万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1979
• 资助国家: 美国
• 起止时间: 1979-01-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6611543
• 关键词: age difference; anxiety; biodegradable product; cephalometry; clinical research; computed axial tomography; human subject; human therapy evaluation; information systems; jaw; jaw movement; longitudinal human study; mandible /maxilla; mandibular condyle; mathematical model; oral facial restoration; oral pharyngeal surgery; orthodontics; outcomes research; perception; quality of life; questionnaires; satisfaction; stress

DESCRIPTION (provided by applicant): Systematic prospective observational studies, of which this project is an excellent example, have led to significant progress in the applications of orthognathic surgery to treatment of dentofacial deformity. Options now exist for patients who might not have been recommended for treatment previously, and the appropriate treatment methods have been clarified. In the continuation of this project, we plan to evaluate remodeling of the mandibular condyles as a factor in post surgical stability that has not been adequately evaluated previously. A new cone-beam CT instrument specialized for maxillofacial imaging now makes it feasible to follow these changes and relate them to treatment outcomes. This may be of particular interest in patients with facial asymmetry. Further information about stability and influences on it is needed to assess more completely the orthognathic surgery procedures that have been assessed so far only in a preliminary way (for example, maxillary / two-jaw surgery for Class III problems, correction of facial asymmetry) and to update the existing data base to document the effect of changes in technique (such as the replacement of metal with resorbable devices for rigid internal fixation). To document the benefits of treatment for dentofacial problems, it is important to evaluate not only the morphologic and functional changes but also what patients perceive and experience, both short- and long term. We will evaluate influences on patient satisfaction and health-related quality of life, with emphasis on how perceptions of a surgical experience are affected by anxiety and psychologic distress. Data for this relationship in the systemically healthy population who are candidates for orthognathic surgery will be more widely generalizable than data from chronically ill subjects, and can lead to improved patient preparation for surgery and patient management after surgery.

描述（由申请人提供）：系统的前瞻性观察研究（本项目就是一个很好的例子）在正颌手术治疗牙面畸形的应用中取得了重大进展。对于以前可能没有被推荐接受治疗的患者来说，现在有了选择，并且适当的治疗方法也已经明确。 在该项目的继续过程中，我们计划评估下颌髁突重塑作为术后稳定性的一个因素，这一因素之前尚未得到充分评估。现在，一种专门用于颌面成像的新型锥形束 CT 仪器可以跟踪这些变化并将其与治疗结果联系起来。这可能对面部不对称的患者特别感兴趣。需要更多有关稳定性及其影响的信息，以更全面地评估迄今为止仅以初步方式评估的正颌手术程序（例如，针对 III 类问题的上颌/两颌手术、面部不对称的矫正），并更新现有数据库以记录技术变化的效果（例如用可吸收装置替代金属进行刚性内固定）。为了记录牙面部问题治疗的益处，重要的是不仅要评估形态和功能的变化，还要评估患者短期和长期的感知和体验。我们将评估对患者满意度和健康相关生活质量的影响，重点关注焦虑和心理困扰如何影响手术经历的感知。在适合正颌手术的全身健康人群中，这种关系的数据将比来自慢性病受试者的数据具有更广泛的普遍性，并且可以改善患者的手术准备和术后患者管理。