Readiness for orthognathic surgery: a survey of practitioner opinion

The purpose of this study was to determine if a general consensus exists among orthodontists regarding the features of an adequate presurgical setup. A questionnaire was developed to assess the importance of 12 criteria for surgical readiness. Each criterion was rated on a 5-point scale (1 = Unimportant, 5 = Critical). This questionnaire was sent to 104 randomly selected, board-certified orthodontists in the United States and Puerto Rico. Usable questionnaires were returned by 57 respondents (55% response rate). The highest and most consistent ratings were given for Arch Compatibility in the transverse dimension (mean = 4.66, SD = 0.55), Crossbite (mean = 4.57, SD = 0.63), and Torque of the Anterior Teeth (mean = 4.38, SD = 0.73). Further analysis showed a correlation between surgical experience of the orthodontist and a higher rating of importance for Torque of the Mandibular Teeth (Spearman r = 0.38), Torque of the Maxillary Teeth (Spearman r = 0.37), and Torque of the Anterior Teeth (Spearman r = 0.28). These results suggest that as orthodontists gain surgical experience, they attribute more importance to correcting the torque of the teeth. Also, the relatively large differences in opinion regarding presurgery orthodontic setup support a need for further research and/or educational effort regarding what criteria are important before surgery.