Social anxiety in orthognathic patients.

There is evidence that patients seeking orthognathic treatment may be motivated by social anxiety disorder (SAD). The aim of this study was to investigate SAD in orthognathic patients using the Brief Fear of Negative Evaluation Scale (BFNES) and to compare these findings with those of the general population. This was a cross-sectional, questionnaire study conducted in two parts. Firstly, a national survey was conducted to yield data for the BFNES from a large, random sample of the UK general population. Secondly, orthognathic patients completed the BFNES. The BFNES scores are reported in two formats: the original 12-item scale (O-BFNES) and a shorter eight-item version (S-BFNES). With regards to the national survey, 1196 individuals participated. The mean O-BFNES score was 29.72 (standard deviation (SD) 9.39) and S-BFNES score was 15.59 (SD 7.67). With regards to the orthognathic sample, 61 patients participated. The mean O-BFNES score was 39.56 (SD 10.35) and the mean S-BFNES score was 24.21 (SD 8.41). Orthognathic patients had significantly higher scores than the general UK population (P<0.001), and multiple linear regression revealed that age, gender, and patient status were all independent predictors of BFNES scores. From the results of this study, orthognathic patients experience significantly higher levels of social anxiety than the general population.

Clinicians' knowledge and practice of data protection legislation and information management.

AIMS: The aim of this study was to review current legislation and guidance on information governance and to audit clinicians' management of confidential patient information and knowledge of published guidelines in a teaching hospital. MATERIALS AND METHODS: A questionnaire was developed based on published Department of Health, General Dental Council and National Health Service guidance. This was then piloted and distributed to clinicians to complete. RESULTS: A review of the current guidance revealed many confusing and unclear areas. However, clinicians' knowledge of information governance was generally good, with an overall correct response rate of 73%. CONCLUSIONS: All clinicians have an ethical and legal obligation to protect confidential patient data and to be aware of their responsibilities. Local guidelines need to be clarified to help clinicians to manage patient data effectively.

Distraction in a case of otopalatodigital syndrome type II.

INTRODUCTION: Otopalatodigital syndrome type II is a rare X-linked recessive disorder with generalized skeletal dysplasia and hearing anomalies. Its features include conductive hearing loss, unusual facies, cleft palate, micrognathia, and overlapping flexed fingers and toes. It is a more lethal variant of otopalatodigital syndrome type I. There are many consistently reported craniofacial and dental findings; however, no case has been published in dental literature. CASE REPORT: We report a case of otopalatodigital syndrome type II with micrognathia, cleft of the soft palate, and partial anodontia, and discuss the combined orthodontic and surgical management. CONCLUSION: We also discuss the differential diagnosis and consider more recent theories on possible aetiology as well as clinical management strategies for such cases.

Long term results of mandibular distraction.

Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction) where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

Ectodermal dysplasia--an unusual dental presentation.

Ectodermal dysplasia (ED) is a rare group of disorders affecting the hair, teeth, nails and sweat glands to a variable degree. There is a wide range of clinical presentation of ED. Missing teeth or abnormal tooth form may be the first indicator of the presence of the disorder. There is typically hypodontia with microdontia. We present an unusual case of ED with severe hypodontia and macrodontia affecting all first permanent molar teeth. We also consider the classification and presentation of this disorder.

The relation between nasorespiratory function and dentofacial morphology: a review.

It is commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specifically, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, the outcome is development of the "adenoid facies" (dentofacial morphology). Such patients characteristically manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch, and a greater than normal mandibular plane angle. These dentofacial traits have repeatedly been attributed to restricted nasorespiratory function. It is generally believed that environmental factors can exert subtle or dramatic effects upon dentofacial morphology, depending upon their magnitude, duration, and time of occurrence. The purpose of this article is to present a critical review of the literature concerning the effect of one such environmental factor, nasal airway function, upon dentofacial morphogenesis. This review will critically examine the most frequently cited papers reporting a relationship between nasorespiratory function and dentofacial morphology. In summary, this critical review fails to support a consistent relationship between obstructed nasorespiratory function and the adenoid facies or long-face syndrome. Additional objective evaluations of this relation are encouraged.

Neuromuscular adaptation to surgical superior repositioning of the maxilla.

This study was designed to evaluate neuromuscular adaption to orthognathic surgery. Fifteen adults were evaluated before and three months after surgical superior repositioning of the maxilla via computerized morphometric, kinesiometric, and electromyographic instrumentation. The findings of this study suggest that immediate and complete adaptation mediated by the central nervous system is followed gradually by delayed and partial compensatory adaptation within the muscles, tendons, and bones of the stomatognathic system.