Factors Influencing the Accuracy of Cephalometric Prediction of Soft Tissue Profile Changes Following Orthognathic Surgery

Abstract

The cephalometric prediction of orthognathic treatment outcome is an important part of the surgical planning and the process of informed consent. The orthodontic and surgical changes must be described accurately prior to treatment in order to assess the treatment's feasibility, to optimize case management and to increase patient's understanding and acceptance of the recommended treatment. The aim of the present article was to investigate on the factors that could influence the accuracy of cephalometric prediction in planning orthognathic surgery. Review of the literature revealed that, besides factors directly related to the prediction method and its use, there exist a considerable number of factors which could affect significantly the accuracy of soft tissue response. These factors could be biological ones such as relapse, centre of mandibular rotation and individual variation in response to treatment and others such as gender, race, pre-operative soft tissue thickness and data bases for mean ratios of soft to hard tissue movement changes. Some of the factors affecting the accuracy of prediction of soft tissue response following orthognathic surgery are inevitable and there are others, difficult to control and predict. However, patients should be informed that predictions are only a guide, may not represent the actual result of the surgical outcome, and as such they should be implemented.

Thank Orthodontic Intrusion Using Temporary Anchorage Devices Compared to Other Orthodontic Intrusion Methods: A Systematic Review

“…It has been reported in the literature that racial variations in soft tissue-to-hard tissue movement ratios exist in tissue response. 25 As a result, the generalization of our conclusion might not be applicable to different ethnicities.…”

Accuracy of three-dimensional virtual simulation of the soft tissues of the face in OrtogOnBlender for correction of class II dentofacial deformities: an uncontrolled experimental case-series study

“…Thus, a larger sample size would be desirable for a prospective follow-up study, preferably one comparing the results of other software programs using different mesh deformation models to the model used in the present study. Literature has shown a variety of factors affecting the accuracy of predictions of soft tissue outcomes: gender, race, soft tissue thickness, mean ratios of soft tissue to hard tissue movements, biological factors, relapse, method-related factors (reproducibility in landmark identification and computer digitization), magnitude of skeletal repositioning, number of oral surgeons involved, pre-surgical orthodontics, condylar displacement, and mandibular center of rotation [ 53 ].…”

“…One can speak of “hypotheses” instead of “diagnoses,” thus changing the expectations of patients and health professionals alike and facilitating a conceptual change [ 61 ]. We are now facing this hypothesis challenge with the COVID-19 pandemic, where physician investigators and public health services worldwide are trying to find a successful approach to fight the novel coronavirus [ 53 ]. To date, there are no specific vaccines or medicines for COVID-19.…”

Informed Consent in Orthognathic Surgery

“…Written consent is generally obtained at the time of the operation. Until this point, consent could therefore be said to be implied because the patient has voluntarily attended and accepted treatment, but has not given consent in writing 1234567. In literature, different opinions have been presented about the need of written consent.…”

“…Adequately informing a patient confirms this relationship and fulfills the legal obligation of the physician to inform the patient to the best of his knowledge. [1][2][3][4][5][6][7][8] The surgeon is authorized to act only in the presence of an explicit manifestation of the patient's agreement, as no person can be forced to undergo medical/surgical therapy against his will, except when a specific law provides otherwise. 7 Informed consent is the process of providing patients with the realistic and necessary information in a manner which they can understand and recall, to allow them voluntarily to make an informed choice on the treatment.…”