A Cross-Sectional Study of Factors Influencing Pre-Operative Anxiety in Orthognathic Patients.

Orthognathic treatment is an important treatment modality to manage severe dentofacial discrepancies. Patients awaiting orthognathic surgery often experience increased anxiety, which may adversely affect post-operative recovery and treatment satisfaction. This study investigated the effects of a number of factors on pre-operative anxiety in orthognathic patients. Seventy patients prospectively recruited from three orthognathic centres in the UK completed a pre-operative questionnaire that included validated scales for measuring anxiety, social support, resilience, and coping styles. Sociodemographic data and satisfaction with the information provided by the clinical team were also elicited from the questionnaire. Univariable analysis showed that social support from a significant other (p = 0.026), resilience (p < 0.001), and satisfaction with the information provided by the clinical team (p = 0.002) were significantly associated with reduced anxiety, whilst avoidance coping (p < 0.001) and coping through seeking social support (p = 0.006) were significantly related to increased anxiety. With the exception of coping by seeking social support, these relationships retained significance in a multivariable regression analysis. Neither gender nor ethnicity moderated the effects of social support on pre-operative anxiety. These findings suggest potential avenues for clinicians to address with future interventions to reduce pre-operative anxiety. Further qualitative research may provide greater clarity on the relationship between these variables and anxiety.

Odontogenic keratocyst: An incidental finding during an orthodontic examination.

For all orthodontic patients, a detailed clinical examination is essential to obtain the correct diagnosis before the formulation of an orthodontic treatment plan. Additional information may be required from radiographs in order to supplement this clinical examination. While orthodontists principally prescribe dental panoramic tomographs for orthodontic patients to confirm the presence, position and morphology of unerupted teeth, the absence or presence of disease within the supporting structures may be overlooked. This case report presents one such instance where the pre-orthodontic radiographic examination of a young male patient revealed the presence of an asymptomatic odontogenic keratocyst in the right posterior body of the mandible.This case report discusses how this incidental finding was diagnosed, managed and how its surgical treatment subsequently affected the orthodontic management of the patient. Furthermore, this case highlights the importance of undertaking a thorough and systematic approach when analysing any prescribed radiographs, in order to reduce the risk of overlooking any evidence of underlying disease.

Orthodontic cost awareness amongst orthodontic trainees in a university teaching hospital.

INTRODUCTION: After successful completion of orthodontic membership examinations, post-graduate specialty trainees are deemed proficient to work independently in primary care, where some understanding of the costs of providing treatment may be required. Financial management forms part of Module 33 of the Specialty Advisory Committee (SAC) curriculum for orthodontic training. OBJECTIVES: Establish knowledge levels of the cost of orthodontic items by King's College Hospital (KCH) Orthodontic trainees. METHODS: A pictorial questionnaire was distributed to all KCH orthodontic trainees (n = 16) asking them to estimate the cost of 42 pictured items. Actual costs were calculated as a mean from supplier catalogues. Perceived costs were analysed and calculated as a range, mean and percentage difference in relation to actual costs. RESULTS: When comparing perceived mean costs with actual means, no individual correctly valued at least half of the items within a 50% difference. With all respondents results combined to create an overall mean per item, just under a third (12 items) were valued within a 25% difference, just over half (22 items) within 50% difference, and just over a third (15 items) were greater than 100% difference. CONCLUSION: The responses highlighted a large discrepancy in knowledge, highlighting a requirement for basic fiscal education.

Reproducibility of soft tissue landmarks on three-dimensional facial scans.

This study evaluated the reproducibility of 24 soft tissue landmarks on six three-dimensional (3D) facial scans. The scans were taken on a DSP400 facial scanner and were viewed using a customized software program. Intraoperator data were obtained by one researcher placing the 24 landmarks on all six scans a total of 30 times. Thirty different orthodontists of varying experience were then asked to place all 24 landmarks on each of the six facial scans in order to establish interoperator reproducibility. The standard deviations (SDs) from the mean were calculated from the data for each individual landmark in the x-, y-, and z-axes. For the intraoperator data, 12 of the 24 landmarks were found to be reproducible to within a 1 mm SD for each plane of space. The interoperator data showed lower reproducibility with just two landmarks showing less than a 1 mm SD in all three planes of space. Familiarity with 3D facial scans and associated software programs is important in improving reproducibility. In addition, the landmarks investigated in this study included those not often used. It is suggested that landmarks showing poor reproducibility for both inter- and intraoperator data should be avoided, if at all possible, or at least used with caution.