Commissioning of Orthognathic Treatment in England

Hunt, NP

doi:10.1308/204268515x14163115404610

Cited by 5 publications

(2 citation statements)

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“…There is a need for further research into the orthognathic clinical setting to ensure distribution of the correct NHS resources are available nationwide. The call for further research, to reduce the disparity of orthognathic care across England, has been previously echoed by Hunt (2015).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of orthognathic multidisciplinary team clinics in England. Part 1: A questionnaire survey

et al. 2023

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Background: Orthognathic clinics across England are currently run in a multidisciplinary team (MDT) format. It is, however, likely that there is a large variation in the style of these clinics and care pathways for orthognathic patients across the country. This is a cross-sectional, online questionnaire with a primary aim to obtain information on the way orthognathic care is currently delivered throughout England. The secondary objectives were to determine the compliance to the minimum dataset for record collection. The questionnaire, disseminated to orthodontic consultants, detailed 27 items split into waiting lists for new patients, mechanics of the clinic, support for patients and record collection. Results: A total of 36 participants responded (one was excluded) to give a total of 35 questionnaire responses. Descriptive statistics were used to analyse the data. Of the participants, 34% followed up their patients as per the commissioning guidelines at 1, 2 and 5 years after treatment. Of the participants, 20% said patients’ mental health would be screened before adding them to a waiting list, with 26% of participants stating screening was not undertaken for all patients. Of the participants, 11% had available access to psychological support during the MDT meeting and 20% recorded the minimum dataset at the follow-up intervals. Conclusion: There are inconsistencies in the orthognathic MDT design across England. Acceptance criteria, support services available and records collected for patients showed substantial variation, highlighting the limited guidance offered by the commissioning guidelines and the potential need to revise the minimum dataset.

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Section: Introductionmentioning

confidence: 99%

Characteristics of orthognathic multidisciplinary team clinics in England. Part 1: A questionnaire survey

et al. 2023

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“…It is usually indicated in the case of occlusal malfunction, improper aesthetic facial appearance, and temporomandibular joint dysfunction [2]. According to recent figures from England and Wales, more than 2600 orthognathic surgical procedures are performed annually [3]; a similar rate was reported from the United States (US) as well [4]. As patients with severe dentofacial deformities are more likely to suffer from poor psychological status related to their facial appearance, orthognathic surgery was reported to have a positive impact on patients’ psychology and well-being [5].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Osteoimmunological Changes Following Orthognathic Surgery

Soliman¹,

Dehis²,

Ahmed³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: There is a scarcity in the published literature which evaluates the postoperative inflammatory response and patients’ immunity following orthognathic surgery. AIM: The present prospective study aimed to evaluate the changes in two immunological callipers to measure the traumatic effect of orthognathic surgery METHODS: In the present prospective cohort study, we included women (age range 16-30 years) with severe dentofacial deformities who were scheduled for bimaxillary osteotomy. Blood samples were collected for measurement of transforming growth factor beta one (TGF-β1) and osteoprotegrin (OPG) levels. The statistical analysis was carried with SPSS software. RESULTS: In the present study, nine patients with severe dentofacial deformity were operated successfully under general anaesthesia. All patients reported decreased energy and fatigue in the early days after surgery and had difficulties with nutrition due to pain, oedema and paresthesia; however, no massive weight loss was reported. The levels of OPG started to increase immediately postoperatively (mean = 0.46 ± 0.08; p = 0.001). A significant increase in the concentration of OPG begun postoperatively and continued to rise significantly until the six weeks to reach 2.24 ± 0.30 ng/mL (p < 0.001). Similarly, the concentration of TGF-β1 increased at three days postoperatively and continued to rise until the six weeks to reach 1.28 ± 0.19 ng/mL (p <0 .001). CONCLUSION: In conclusion, orthognathic surgery is associated with a significant rise in the pro-inflammatory cytokines until the six weeks postoperatively. These observed results may indicate a significant alteration in the immunity of the patients to undergoing orthognathic surgery.

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Retrospective study of eligibility for orthognathic surgery using the Index of Orthognathic Functional Treatment Need (IOFTN)

Fowler

King

Lee

et al. 2018

British Journal of Oral and Maxillofacial Surgery

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Commissioning of Orthognathic Treatment in England

Abstract: The saga of the way in which commissioners of services have managed those patients requiring combined orthodontic treatment and orthognathic surgery can be described as disappointing but in reality it is shambolic.

Cited by 5 publications

References 1 publication

Characteristics of orthognathic multidisciplinary team clinics in England. Part 1: A questionnaire survey

Characteristics of orthognathic multidisciplinary team clinics in England. Part 1: A questionnaire survey

Assessment of Osteoimmunological Changes Following Orthognathic Surgery

Retrospective study of eligibility for orthognathic surgery using the Index of Orthognathic Functional Treatment Need (IOFTN)

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