Systematic prospective observational studies, of which this project is an excellent example, have led to significant progress in the applications of orthognathic surgery to treatment of dentofacial deformity. Options now exist for patients who might not have been recommended for treatment previously, and the appropriate treatment methods have been clarified. ? ? In the continuation of this project, we plan to evaluate remodeling of the mandibular condyles as a factor in post surgical stability that has not been adequately evaluated previously. A new cone-beam CT instrument specialized for maxillofacial imaging now makes it feasible to follow these changes and relate them to treatment outcomes. This may be of particular interest in patients with facial asymmetry. Further information about stability and influences on it is needed to assess more completely the orthognathic surgery procedures that have been assessed so far only in a preliminary way (for example, maxillary / two-jaw surgery for Class III problems, correction of facial asymmetry) and to update the existing data base to document the effect of changes in technique (such as the replacement of metal with resorbable devices for rigid internal fixation). To document the benefits of treatment for dentofacial problems, it is important to evaluate not only the morphologic and functional changes but also what patients perceive and experience, both short- and long term. We will evaluate influences on patient satisfaction and health-related quality of life, with emphasis on how perceptions of a surgical experience are affected by anxiety and psychologic distress. Data for this relationship in the systemically healthy population who are candidates for orthognathic surgery will be more widely generalizable than data from chronically ill subjects, and can lead to improved patient preparation for surgery and patient management after surgery. ? ?

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Research Project (R01)
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Study Section
Special Emphasis Panel (ZDE1-GH (04))
Program Officer
Fischer, Dena
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University of North Carolina Chapel Hill
Schools of Dentistry
Chapel Hill
United States
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Brookes, Carolyn Dicus; Berry, John; Rich, Josiah et al. (2015) Multimodal protocol reduces postoperative nausea and vomiting in patients undergoing Le Fort I osteotomy. J Oral Maxillofac Surg 73:324-32
Brookes, Carolyn Dicus; Turvey, Timothy A; Phillips, Ceib et al. (2015) Postdischarge Nausea and Vomiting Remains Frequent After Le Fort I Osteotomy Despite Implementation of a Multimodal Antiemetic Protocol Effective in Reducing Postoperative Nausea and Vomiting. J Oral Maxillofac Surg 73:1259-66
Phillips, C; Brookes, C D; Rich, J et al. (2015) Postoperative nausea and vomiting following orthognathic surgery. Int J Oral Maxillofac Surg 44:745-51
Brookes, Carolyn Dicus; Golden, Brent A; Lawrence, Scott D et al. (2015) Unilateral mydriasis after maxillary osteotomy: a case series and review of the literature. J Oral Maxillofac Surg 73:1159-68
Magraw, Caitlin B L; Garaas, Rachel; Shaw, Alan et al. (2015) Changes in scleral exposure following modified Le Fort III osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol 120:119-24.e1
Nguyen, Tung; Cevidanes, Lucia; Paniagua, Beatriz et al. (2014) Use of shape correspondence analysis to quantify skeletal changes associated with bone-anchored Class III correction. Angle Orthod 84:329-36
Perin, J; Preisser, J S; Phillips, C et al. (2014) Regression analysis of correlated ordinal data using orthogonalized residuals. Biometrics 70:902-9
Blakey, G H; Rossouw, E; Turvey, T A et al. (2014) Are bioresorbable polylactate devices comparable to titanium devices for stabilizing Le Fort I advancement? Int J Oral Maxillofac Surg 43:437-44
Rich, J; Golden, B A; Phillips, C (2014) Systematic review of preoperative mandibular canal position as it relates to postoperative neurosensory disturbance following the sagittal split ramus osteotomy. Int J Oral Maxillofac Surg 43:1076-81
Scheffler, Nicole R; Proffit, William R; Phillips, Ceib (2014) Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint. Am J Orthod Dentofacial Orthop 146:594-602

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