Suitability for Surgery First Orthognathic Treatment V1
Research type
Research Study
Full title
Clinician Consensus on Patient Suitability for a 'Surgery First' approach to Orthognathic Treatment
IRAS ID
335960
Contact name
Beth Bradley
Contact email
Sponsor organisation
University of Leeds - Head of Research Regulatory Compliance
Duration of Study in the UK
1 years, 4 months, 27 days
Research summary
Dento-facial deformity describes an abnormal relationship between teeth and jaws, which can significantly impact individual psychosocial wellbeing. Orthognathic (jaw) treatment is the primary method for treating dento-facial deformity. Traditionally this involves an initial 18-24 months of orthodontic (brace) treatment, followed by jaw surgery then another 6-9 months of orthodontic treatment. This can negatively impact on appearance and chewing function in the pre-surgery phase.
The ‘Surgery First’ approach(SFA) to jaw surgery has gained popularity over the last decade. In this approach, jaw surgery is undertaken first before any orthodontic treatment, which is then started immediately after surgery. The proposed benefit is that the same outcome is achieved but with reduced treatment time and improved patient experience.
The current evidence base has a high risk of bias, variability in outcomes and outcome measures and the studies are predominantly from Southeast Asia where there is different health service population and dento-facial deformity to UK. Therefore, better quality evidence is needed for UK patients. To inform the inclusion criteria for a subsequent clinical trial, it is necessary to establish which potential orthognathic patients are suitable for ‘Surgery First’ approach.
The Study Design is a cross-sectional study utilising a case-based questionnaire and a consensus group workshop. The planned sample of 20 study participants (Clinicians) will review NHS patients’ routine orthodontic records, which are presented as case studies, to answer the research question and aim to reach a consensus on which features of dento-facial deformity and malocclusion influence an patients suitability for SFA orthognathic treatment.
The study flow is:
1)Case-study preparation (using NHS patients routine orthodontic records)
- Case-study recruitment and consent of NHS Patients.
- Duplication of records to allow case study preparation
- No further involvement of NHS patients
2)Participant recruitment - NHS Consultants
3) Workshop 1 - Case based questionnaire face-to-face workshop
4) Workshop 2 - Facilitated consensus group workshop’REC name
London - Stanmore Research Ethics Committee
REC reference
25/PR/0432
Date of REC Opinion
12 May 2025
REC opinion
Further Information Favourable Opinion