Presurgical profile preferences of patients and clinicians

The purpose of this study was to compare the presurgical preferences for profile change of patients seeking orthognathic surgery with the preferences of "significant others" and clinicians. In this study, five features of lateral profile images of 11 patients scheduled for orthognathic surgery limited to the mandible (ie, set-back or advancement) were animated for continuous change with the use of customized morphing software and video imaging. Each patient profile was evaluated by the patient, a significant other, three orthodontists, and three oral surgeons. As the feature animated between two extremes, the zone of acceptability was established by depressing the computer mouse when the changing feature became acceptable and releasing the button when the image was no longer acceptable. In a separate task, the participants were asked to indicate the most pleasing position. An analysis of variance was used to find a significant difference (P <.017) in the zone of acceptability for all five profile features among all groups of evaluators. From smallest to largest, the order of the mean zone of acceptability was: orthognathic patient < oral surgeon < significant other < orthodontist. No consistent differences were found, however, for either the midpoint of acceptability or most pleasing distortion among the patients, significant others, and professional groups. In conclusion, it was demonstrated that (1) patients having orthognathic surgery were able to use this new video imaging method to communicate to clinicians what they find acceptable; and (2) although all groups had similar preferences, orthognathic patients had the lowest tolerance for deviation from the preferred image.