Effects of a computerized treatment simulation on patient expectations for orthognathic surgery

One hundred forty-six patients, ranging in age from 15 to 50 and presenting with a moderate to severe dentofacial disharmony requiring orthodontics and orthognathic surgery, were randomly assigned to 2 preparation strategy groups: standard presurgical consultation with or without a computerized treatment simulation presentation. The demographic profiles of the 2 groups were similar. Viewing a treatment simulation did not have a significant effect on the anticipation of social/interpersonal or general health problems in the first month after surgery. These 2 areas of concern were significantly related to psychological well-being. Psychologically distressed patients, whether or not they saw a simulation, expected significantly more problems in social/interpersonal relations and in general health during the first month after surgery. A treatment simulation presentation did affect patients' overall expectations of problems in the first month after surgery and their concerns about symptom recovery. However, the impact of the presentation was related to the patient's psychological well-being. In the standard presurgical consultation group, the average anticipated level of overall problems and discomfort during recovery was significantly higher for patients who reported elevated psychological distress than for those who did not. In the treatment simulation group, the average level of concern was similar for those patients who reported distress and those who did not. Preparation strategy was not significantly related to the long-term expectation of improvement after treatment. Long-term expectation of treatment improvement was related to psychological distress and gender. Men tended to report similar expectations regardless of psychological well-being, while women who were distressed anticipated significantly more improvement overall, in self-image, and in general health after treatment than women who were not distressed.