DDS
Denise Philip Møller-Hansen
Department of Oral and Maxillofacial Surgery, Odense University Hospital
| Project management | ||
| Project status | Open | |
| Data collection dates | ||
| Start | 01.10.2024 | |
| End | 01.08.2026 | |
Insight to Excellence: The power of Feedback in Orthognathic Surgery
Short summary
An accurate outcome in orthognathic surgery is critical, as even small deviations can affect both function and appearance. The primary aim of this study is to evaluate the effect of quantitative outcome measurements of surgical accuracy on the surgeons' perception of a successful outcome. Data on the deviation between planned and actual outcome will be gathered using OrthognathicAnalyzer. 6 surgeons will complete a questionnaire regarding 20 of their patients each with following analyses.
Rationale
Orthognathic surgery is a complex procedure aimed at correcting dentofacial deformities to improve functional outcomes, aesthetics, and patient quality of life1-3. An accurate surgical outcome is critical for achieving these goals, as even small deviations can affect both function and appearance lifelong and orthognathic surgical patients are usually in their early twenties when undergoing orthognathic surgery. Clinically the effectiveness of orthognathic surgery is usually assessed through subjective assessments of the surgical process, imaging evaluations of the postoperative 3D scan, and patient contentment4. However, in research, quantitative measurements, comparing the obtained surgical jaw reposition in the postoperative 3D scan with the planned surgical repositioning of the jaws, has become an increasingly important tool for evaluating the accuracy of the surgical results5,6. These measurements allow for objective evaluation of how closely the actual surgical outcome aligns with the preoperative plan. The drawbacks of the existing feedback from radiological and patient-reported sources stem from the fact that patients undergo surgery only a single time, which means they lack a reference point to compare the outcomes against or to assess how much improvement could have been achieved with a more precise outcome. In essence, the present postoperative evaluation merely determines if the procedure was sufficiently successful to eliminate the need for re-operation. The incorporation of quantitative feedback adds a valuable dimension of understanding that could uncover inconsistencies that may not be apparent through subjective evaluations alone. It is vital to comprehend how surgeons interpret this objective data and whether it corresponds with their personal feelings regarding the success of the surgery. This protocol seeks to evaluate whether offering surgeons' quantitative accuracy metrics influences their perception of surgical success and if they concur with this evaluation. The primary aim of this study is to evaluate the effect of providing quantitative outcome measurements of surgical accuracy on the surgeons' perception of a successful outcome. Specifically, this study will assess whether surgeons agree with the feedback provided by these measurements and whether their perception of surgical success changes after receiving this objective data. A secondary aim is to explore how surgeons' agreement or disagreement with the quantitative feedback influences their future surgical decision-making and techniques. Additionally, the study seeks to identify specific areas where discrepancies between subjective and objective assessments are most likely to arise.
Description of the cohort
This will be a retrospective, observational study conducted within the Department of Oral and Maxillofacial Surgery, Odense University Hospital. The study will involve all maxillofacial surgeons who have performed orthognathic surgery, and data will be collected from 20 patients operated from each collection will occur after a wash-out period of 6 months following surgery. Patient data will be recruited based on the following inclusion criteria: Patients above 18 years of age who underwent orthognathic surgery where the surgery was executed in accordance with the surgical plan. Exclusion criteria were deviation from the surgical plan large enough to warrant a secondary surgery to correct.
Data and biological material
Data on the deviation between planned and actual outcomes will be gathered using OrthognathicAnalyzer. Surgeons will complete a questionnaire in REDCap while gradually being introduced to the different data relevant to the sections of the study. The data relevant to the study includes data from the patient journals (the pre-operative surgical plan, the post-operative scan and the description of the surgical procedure).