Perceptions of orthognathic surgery patient's change in profile. A five-year follow-up.

OBJECTIVES To compare pairs of silhouettes generated from presurgical and 5-year postsurgical cephalometric radiographs to evaluate whether orthodontists, oral surgeons, and lay persons perceive changes in profile resulting from orthodontics and mandibular advancement surgical treatment. MATERIALS AND METHODS A survey-based method of data collection was used to evaluate 15 pairs of silhouettes. These silhouettes included 1 control pair and 14 surgically treated pairs representing mandibular advancements ranging from 0.11 mm to 10.13 mm. Collected data were analyzed to determine whether changes can be perceived and whether these changes were esthetically pleasing. RESULTS The control silhouette pair was identified by 104 of 127 evaluators. For the 14 surgical treated silhouette pairs, the vast majority of evaluators (N = 127; 53 orthodontists, 32 oral surgeons, and 42 lay persons) were able to identify changes in profile and individual features. At least one group of evaluators was able to perceive significant (P < .05) improvement in the visual analog scale (VAS) score for all these silhouette pairs, except for the pair with 10.13 mm of mandibular advancement. This silhouette pair, which represented the largest mandibular advancement, was perceived to have a significant (P < .05) worsening in the VAS score by the lay person group. There were significant differences among the groups of evaluators. Esthetic improvement in profile was perceived for 13 of 14 surgically treated silhouette pairs. CONCLUSION In some cases, orthodontists, oral surgeons, and lay persons perceived changes in profile differently.