title: Psychological function in orthognathic surgical patients before and after bilateral sagittal split osteotomy with rigid and wire fixation.
abstract: A multisite randomized controlled trial was conducted to compare the psychological function of patients who undergo surgical correction of a Class II malrelation with bilateral sagittal split osteotomy with either wire or rigid fixation. Subjects were 31 male and 86 female patients referred by orthodontists. Psychopathological symptoms and psychological distress were measured with the Symptom Checklist-90 Revised at the following times: before placement of orthodontic appliances, 1 to 2 weeks presurgery, and 1 week, 8 weeks, 6 months, and 2 years postsurgery. Patients' satisfaction with their surgical outcome was measured with a 3-item questionnaire. Results showed no statistically significant differences in psychological function or satisfaction between patients treated with wire or rigid fixation. Psychological function was within normal limits immediately before surgery. Psychological parameters did not determine patient satisfaction, even among patients who met an operational definition of "psychopathological caseness." Psychological symptoms and general distress increased modestly immediately after surgery for both groups and then progressively declined over the succeeding 2 years, eventually reaching levels that were significantly lower than presurgical levels. It was concluded that (1) rigid and wire fixation do not differ in their effects on psychological function and satisfaction; (2) patients who seek orthognathic surgery for a Class II malocclusion are psychologically healthy, ie, comparable to normal populations, immediately before surgery; (3) presurgical psychological function does not determine satisfaction with surgical outcome; and (4) psychological function tends to improve during the 2 years after surgery.
authors.affiliation: Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 78234-7910, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Hatch
authors.forename: J D
authors.initials: JD
authors.lastname: Rugh
authors.forename: R A
authors.initials: RA
authors.lastname: Bays
authors.forename: J E
authors.initials: JE
authors.lastname: Van Sickels
authors.forename: S D
authors.initials: SD
authors.lastname: Keeling
authors.forename: G M
authors.initials: GM
authors.lastname: Clark
mesh_terms: D000328:Adult; D001864:Bone Wires; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods / Q000523:psychology*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011599:Psychopathology; D012985:Software Design; D018709:Statistics, Nonparametric; D013997:Time Factors