Abstract
This prospective questionnaire-based study was designed to determine the incidence
of patients attending orthognathic combined clinics who have previously had orthodontic
treatment, and to assess the impact, if any, this has had on their proposed surgical
treatment. Contemporaneous and historical data from consecutive patients at different
stages of treatment who were attending clinics at two London hospitals during a three-month
period were included. In total 22/56 patients (39%) had previously had orthodontic
treatment, and of those, it had had an undesirable effect on the current management
of 10 (45%). The effects included a reduced range of dental movements available to
orthodontists (8/23, 35%), undesirable extractions (5/23, 22%), and a prolonging of
preoperative orthodontics (5/23, 22%). The median age at which previous orthodontic
treatment had been started was 13.5 (range 11–26). Nearly a third of patients reported
that they had not been advised by their referring practitioner that a combined orthodontic
and surgical approach might be required. The study suggests that preliminary assessment
should be improved. Patients should be informed about and prevented from undergoing
orthodontic treatment that may limit future surgical management, otherwise they may
have to face repeated and prolonged orthodontic treatment, unexpected operations,
and potential limitations to the outcome of surgical treatment. This could be achieved
through the training and education of all practitioners and the development of referral
guidelines.
Keywords
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Article info
Publication history
Published online: December 07, 2011
Accepted:
November 9,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
