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Dentofacial deformity

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It is estimated that nearly 30% of the general population present with malocclusions that are in great need of orthodontic treatment.[1] However, the term dentofacial deformity describes an array of dental and maxillo-mandibular abnormalities, often presenting with a malocclusion, which is not amenable to orthodontic treatment alone and definitive treatment needs surgical alignment of upper/lower jaws or both (orthognathic surgery). Individuals with dentofacial deformities often present with lower quality of life and compromised functions with respect to breathing, swallowing, chewing, speech articulation, and lip closure/posture.[2][3][4] It is estimated that about 5% of general population present with dentofacial deformities that are not amenable to orthodontic treatment only and required sugical correction (orthognathic surgery) as well [5][6][7][8] and patients with Class III malocclusion appear to form the mojority of these patients.[9][10][11]


Facial skeletal deformity can be in the form of maxillary prognathism/retrognathism (pushed out or deficient upper jaw), mandibular prognathism/retrognathism (pushed out or deficient lower jaw/receding chin), open bite (upper and lower front teeth do not meet), transverse discrepancies and asymmetry of the Jaws (very narrow/wide upper or lower jaws, shifting upper/lower jaws to right/left side), and long/short faces.[12][13][14]

Surgical correction of dentofacial deformities started around 1849 in the USA by S. R. Hullihan, a general surgeon, and was limited to the correction of the mandible (prognathism). Later on, around the turn of the twentieth century, early orthognathic surgery was born, when in St. Louis Edward Angle (orthodontist) and Vilray Blair (surgeon) started to work together and Blair stressed the importance of collaboration between surgeon and orthodontist. However, modern orthognathic surgery started to develop in central Europe by surgeons such as R. Trauner (Graz), Martin Wassmund (Berlin), Heinz Köle (Graz) and Hugo Obwegeser (Zurich).[15]

Detecting patients with dentofacial deformity by clinicians using an index is a new development in orthodontics and orthognathic surgery; Dr Anthony Ireland and his colleagues developed a new index called the index of orthognathic functional treatment need (IOFTN) that detects patients with the greatest need for orthognathic surgery as a part of their comprehensive treatment.[16] IOFTN has been validated internationally and when used on retrospective samples of patients who had orthognathic surgery, detected over 93% of patients with the greatest need for orthognathic surgery (IOFTN score≥4).[17]

References

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  1. ^ Borzabadi-Farahani, A (2011). "An Insight Into Four Orthodontic Treatment Need Indices". Prog Orthod. 12 (2): 132–142. doi:10.1016/j.pio.2011.06.001. PMID 22074838.
  2. ^ Bourdiol P, Soulier-Peigue D, Lachaze P, Nicolas E, Woda A, Hennequin M (2017). "Only severe malocclusion correlates with mastication deficiency". Arch Oral Biol. 75 (March): 14–20. doi:10.1016/j.archoralbio.2016.12.002. PMID 27978477.
  3. ^ Al-Asfour A, Waheedi M, Koshy S (2018). "Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction". Int J Oral Maxillofac Surg. 6 (47): 726–731. doi:10.1016/j.ijom.2017.12.010. PMID 29373200. S2CID 13781651.
  4. ^ Kim H, Sakamoto T, Yamaguchi H, Sueishi K (2017). "Evaluation of Chewing Movement in Skeletal Class III Patients with Orthognathic Treatment". Bull Tokyo Dent Coll. 4 (58): 213–221. doi:10.2209/tdcpublication.2016-2300. PMID 29269715.
  5. ^ Posnick, Jeffrey C. (September 2013). Orthognatic Surgery: Principles and Practice. Amsterdam: Elsevier. pp. 61–68. doi:10.1016/B978-1-4557-2698-1.00003-4. ISBN 978-145572698-1.
  6. ^ Harrington C, Gallagher JR, Borzabadi-Farahani A (2015). "A retrospective analysis of dentofacial deformities and orthognathic surgeries using the index of orthognathic functional treatment needs (IOFTN)". Int J Pediatr Otorhinolaryngol. 79 (7): 1063–6. doi:10.1016/j.ijporl.2015.04.027. PMID 25957779.
  7. ^ Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016). "Functional needs of subjects with dentofacial deformities: A study using the index of orthognathic functional treatment need (IOFTN)". J Plast Reconstr Aesthet Surg. 69 (6): 796–801. doi:10.1016/j.bjps.2016.03.008. PMID 27068664.
  8. ^ Eslamian L, Borzabadi-Farahani A, Badiee MR, Le BT (2019). "An Objective Assessment of Orthognathic Surgery Patients". J Craniofac Surg. 30 (8): 2479–248. doi:10.1097/SCS.0000000000005916. PMID 31689730. S2CID 207894272.
  9. ^ Proffit WR, Jackson TH, Turvey TA (2013). "Changes in the pattern of patients receiving surgical-orthodontic treatment". Am J Orthod Dentofacial Orthop. 143 (6): 793–8. doi:10.1016/j.ajodo.2013.01.014. PMID 23726329.
  10. ^ Ireland AJ, Atack NE, Cunningham SJ, House K, Cobourne MT, Hunt NP, Sherriff M, Sandy JR (2019). "National British Orthodontic Society (BOS) Orthognathic Audit 2017-2018". J Orthod. 46 (4): 287–296. doi:10.1177/1465312519879934. hdl:1983/eb2594aa-f924-4641-8eca-28d3660a225b. PMID 31595815.
  11. ^ Borzabadi Farahani A, Olkun HK, Eslamian L, Eslamipour F (2024). "A retrospective investigation of orthognathic patients and functional needs". Australasian Orthodontic Journal. 40: 111–120. doi:10.2478/aoj-2024-0013.
  12. ^ Fonseca, Raymond J. (April 2017). Oral and Maxillofacial Surgery. Amsterdam: Elsevier. ISBN 9780323414999.
  13. ^ Eslamipour F, Borzabadi-Farahani A, Le BT, Shahmoradi M (2017). "A retrospective analysis of dentofacial deformities and orthognathic surgeries". Ann Maxillofac Surg. 7 (1): 73–77. doi:10.4103/ams.ams_104_16. PMC 5502519. PMID 28713739.
  14. ^ Olkun HK, Borzabadi-Farahani A, Uçkan S (2019). "Orthognathic Surgery Treatment Need in a Turkish Adult Population: A Retrospective Study". Int J Environ Res Public Health. 16 (11): 1881. doi:10.3390/ijerph16111881. PMC 6603578. PMID 31141986.
  15. ^ Steinhäuser EW (1996). "Historical development of orthognathic surgery". J Craniomaxillofac Surg. 24 (4): 195–204. doi:10.1016/S1010-5182(96)80002-3. PMID 8880445.
  16. ^ Ireland AJ, Cunningham SJ, Petrie A, Cobourne MT, Acharya P, Sandy JR, Hunt NP (2014). "An index of orthognathic functional treatment need (IOFTN)". J Orthod. 41 (2): 77–83. doi:10.1179/1465313314Y.0000000100. PMC 4063315. PMID 24951095.
  17. ^ Borzabadi-Farahani, A (2023). "Systematic Review and Meta-Analysis of the Index of Orthognathic Functional Treatment Need for Detecting Subjects with Great Need for Orthognathic Surgery". Cleft Palate Craniofac J. doi:10.1177/10556656231216833. PMID 38037271.
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