Influences on Stability following Orthognathic Surgery

描述(申请人提供)：系统的前瞻性观察研究，这个项目是一个很好的例子，导致正颌外科在治疗牙面部畸形方面的应用取得了重大进展。对于以前可能没有被推荐治疗的患者，现在有了选择，并且已经明确了适当的治疗方法。 在这个项目的继续中，我们计划评估下颌骨髁状突的重塑作为手术后稳定性的一个因素，这在以前还没有得到充分的评估。一种专门用于颌面部成像的新锥束CT仪器现在使跟踪这些变化并将其与治疗结果联系起来成为可能。这可能对面部不对称的患者特别感兴趣。需要更多关于稳定性及其影响的信息，以更全面地评估迄今仅以初步方式评估的正颌外科手术(例如，上颌/双颌手术治疗III类问题，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，用可吸收装置取代金属进行坚固内固定)。为了证明牙颌面问题治疗的益处，重要的是不仅要评估形态和功能的变化，而且要评估患者的感知和体验，无论是短期还是长期。我们将评估对患者满意度和与健康相关的生活质量的影响，重点是焦虑和心理痛苦如何影响手术体验的感知。这种关系的数据在系统健康的人群中是正颌外科手术的候选对象，将比来自慢性疾病受试者的数据更具普遍性，并可能导致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.