Outcome of Orthognathic Surgery in Chinese Patients

Abstract

Objective: To evaluate the outcome of orthognathic surgery by objective cephalometric measurement of posttreatment soft-tissue profile and by subjective evaluation of profile esthetics by laypersons and clinicians. Materials and Methods: The sample consisted of 30 Chinese patients who had completed combined orthodontic and orthognathic surgical treatment. The posttreatment cephalograms of these patients were analyzed with respect to profile convexity, facial height, and lip contours and these were compared to the previously established esthetic norms. Line drawings of the soft-tissue profile were displayed to a panel comprising six laypersons and six clinicians who scored the esthetics of each profile using a 7-point scale.Results: Complete normalization of cephalometric soft-tissue variables was not achieved with orthognathic surgery in most patients, with four of the six soft-tissue cephalometric measurements showing significant differences compared to the esthetic norms. There were good correlations in the esthetic scores between laypersons and clinicians, even though clinicians tend to rate the profiles more favorably. Facial convexity and facial height did not significantly influence the subjective scores of both the laypersons and clinicians. Lower lip protrusion was the only cephalometric variable that significantly influenced clinicians' assessment of profile esthetics (P Ͻ .01). Conclusions: Profile convexity and lower facial height proportion had little influence on both lay and professional perception of profile esthetics. Lower lip position is the only cephalometric variable that significantly influenced clinicians' assessment of profile esthetics.

Association of facial sagittal and vertical characteristics with facial aesthetics in the Northern Finland Birth Cohort 1966

“…However, this is not in agreement with our findings. The present results are in accordance with the study of Chew et al (36) which was based on cephalograms and showed that lower facial height did not significantly influence profile aesthetics as evaluated by clinicians and laypersons. According to a facial silhouette study, lower facial height has an influence on frontal facial attractiveness perception of laypersons (17).…”

The Perception of Smile Attractiveness

“…In addition, based on our results, the correction of a deviation is not always going to perfect a smile, according to the evaluations of laypeople. Some studies show that laypeople accept a wider range of deviation compared to dentists, 7,8 and because of this a dentist must be careful about imposing his or her own beauty norms upon patients.…”

“…[7][8][9] Currently, a consensus on the levels of acceptability of different variations from esthetic norms does not ex- ist, and there is not even an accepted hierarchy of the influence of different esthetic norms. Knowledge in this area will aid the choice of treatments and increase the chances of clinical success.…”

Motivation for orthognathic treatment and anticipated satisfaction levels—a two-centre cross-national audit

“…This accentuates the importance of understanding the patient's reasons for seeking treatment and their expectations, as these factors help clinicians determine whether the benefits of treatment outweigh the risks for each individual. The need to elicit and discuss patient's wishes is instrumental for post-treatment success (Oland et al, 2011); this is particularly important with regards to aesthetics, as patients may perceive themselves differently from how their clinicians see them (Chew et al, 2007). It is well established that post-treatment success is linked to pre-treatment motivation and expectations and that unrealistic wishes may contribute to post-treatment dissatisfaction (Nurminen et al, 1999;Espeland et al, 2008;Oland et al, 2011).…”