Uppada Uday Kiran, Tauro David P, Senthilnathan K P
Department of Oral and Maxillofacial Surgery, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
Department of Dentistry, All India Institute of Medical Sciences, Nagpur, India.
Natl J Maxillofac Surg. 2025 Jan-Apr;16(1):44-50. doi: 10.4103/njms.njms_34_24. Epub 2025 Apr 28.
To understand the viewpoint of the patients who already underwent corrective jaw surgery in order to ascertain whether the clinicians are justified pertaining to their diagnosis and treatment planning of patients with dentofacial deformities.
In order to conduct this study, a predetermined questionnaire was designed to comprehend the thought process of patients who were already subjected to corrective jaw surgery in various surgical centers belonging to various states of south India. One hundred and thirty-six patients were enrolled in the survey. Demographic information, educational qualification, primary reason for undergoing corrective jaw surgery, whether they were convinced with the surgical treatment plan offered to them by the clinician following thorough evaluation, whether they were willing to proceed with a staged surgical treatment plan if offered, and whether they prefer a simple chair-side facial analysis which is time-consuming yet effective or advanced and sophisticated technology that can predict the surgical outcome were evaluated.
It was observed that among the patients who underwent corrective jaw surgery, nearly 62% had both esthetic and functional concerns, while 27% had esthetic concerns and only 11% had functional concerns. The patients with esthetic concerns primarily had apprehensions pertaining to their lips and chin region followed by the jaws, while the functional concerns were primarily with regard to difficulty in chewing. It was observed that 77% of the patients with dentofacial deformity were willing for a staged surgical treatment plan for an optimal clinical outcome. Only 58% of patients felt that the investigations performed on them were sufficient to provide a proper treatment plan and an optimal clinical outcome, while 36% were unaware. It was noticed that 68% of the patients preferred a simple chair-side facial analysis over an advanced and sophisticated technology that can predict the clinical outcome.
On the basis of the inferences obtained from this study, it is wise to recommend that all the esthetic units of the face need to be taken into account while assessing the esthetics of a human face and not merely the relationships of the jaws. It can now be concluded based on the results obtained from this study that when one accomplishes a corrective jaw surgery purely constructed on the norms of the cephalometric analysis and data obtained from three-dimensional (3D) software solutions, it can inevitably fail to address few imperfections of the face. Therefore, for the diagnosis and planning treatment of dentofacial deformity patients, cephalometric analysis and 3D software solutions can only be used as an adjunctive diagnostic tools and clinical judgment needs to be given greater emphasis.
了解已接受正颌手术患者的观点，以确定临床医生对牙颌面畸形患者的诊断和治疗计划是否合理。
为开展本研究，设计了一份预定问卷，以了解在印度南部不同邦的各个手术中心已接受正颌手术患者的思维过程。136名患者参与了调查。评估了人口统计学信息、教育程度、接受正颌手术的主要原因、在经过全面评估后他们是否信服临床医生提供给他们的手术治疗方案、如果提供分阶段手术治疗方案他们是否愿意接受，以及他们更喜欢耗时但有效的简单椅旁面部分析还是能预测手术结果的先进复杂技术。
观察到，在接受正颌手术的患者中，近62%既有美观方面的担忧，也有功能方面的担忧，而27%只有美观方面的担忧，只有11%只有功能方面的担忧。有美观方面担忧的患者主要担心嘴唇和下巴区域，其次是颌骨，而功能方面的担忧主要是咀嚼困难。观察到77%的牙颌面畸形患者愿意接受分阶段手术治疗方案以获得最佳临床效果。只有58%的患者认为对他们进行的检查足以提供合适的治疗方案和最佳临床效果，而36%的患者并不清楚。注意到68%的患者更喜欢简单的椅旁面部分析，而不是能预测临床结果的先进复杂技术。
基于本研究得出的推论，明智的做法是建议在评估人脸美观时，要考虑面部的所有美学单位，而不仅仅是颌骨的关系。根据本研究获得的结果现在可以得出结论，当纯粹基于头影测量分析的标准和从三维（3D）软件解决方案获得的数据完成正颌手术时，不可避免地无法解决面部的一些瑕疵。因此，对于牙颌面畸形患者的诊断和治疗计划，头影测量分析和3D软件解决方案只能用作辅助诊断工具，需要更加强调临床判断。
