Influences on Stability following Orthognathic Surgery

描述（由申请人提供）：系统的前瞻性观察性研究，其中该项目是一个很好的例子，导致了正颌外科手术治疗牙面畸形的应用取得了重大进展。对于以前可能不建议治疗的患者，现在有了选择，并且已经澄清了适当的治疗方法。 在这个项目的延续中，我们计划评估下颌骨髁突的重塑作为手术后稳定性的一个因素，这在以前没有得到充分的评估。一种专门用于颌面部成像的新型锥形束CT仪器现在使得跟踪这些变化并将其与治疗结果联系起来成为可能。这可能是特别感兴趣的患者面部不对称。需要更多关于稳定性及其影响因素的信息，以更全面地评估迄今为止仅以初步方式评估的正颌外科手术（例如，针对III类问题的上颌/双颌手术，矫正面部不对称），并更新现有数据库，以记录技术变化的影响（例如用可吸收器械代替金属进行刚性内固定）。为了记录牙面问题治疗的益处，重要的是不仅要评估形态和功能变化，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，重点是焦虑和心理困扰如何影响手术体验。与慢性病受试者的数据相比，系统健康人群中正颌手术候选人的这种关系的数据将更广泛地推广，并且可以改善患者的手术准备和术后患者管理。

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.