Orthognathic treatment is an important treatment modality to manage severe dentofacial discrepancies. Patients awaiting orthognathic surgery often experience increased anxiety, which may adversely affect post-operative recovery and treatment satisfaction. This study investigated the effects of a number of factors on pre-operative anxiety in orthognathic patients. Seventy patients prospectively recruited from three orthognathic centres in the UK completed a pre-operative questionnaire that included validated scales for measuring anxiety, social support, resilience, and coping styles. Sociodemographic data and satisfaction with the information provided by the clinical team were also elicited from the questionnaire. Univariable analysis showed that social support from a significant other (p = 0.026), resilience (p < 0.001), and satisfaction with the information provided by the clinical team (p = 0.002) were significantly associated with reduced anxiety, whilst avoidance coping (p < 0.001) and coping through seeking social support (p = 0.006) were significantly related to increased anxiety. With the exception of coping by seeking social support, these relationships retained significance in a multivariable regression analysis. Neither gender nor ethnicity moderated the effects of social support on pre-operative anxiety. These findings suggest potential avenues for clinicians to address with future interventions to reduce pre-operative anxiety. Further qualitative research may provide greater clarity on the relationship between these variables and anxiety.

YouTube™ has become a widely used resource of information about health-related topics nowadays. This cross-sectional study has aimed to analyze the content and quality of YouTube™ videos on orthognathic surgery.
In our study, six orthognathic surgery-related keywords (Le Fort I osteotomy, sagittal split osteotomy, jaw surgery, jaw correction surgery, orthodontic surgery, and orthognathic surgery) were used to search on YouTube™. Only the videos in English, which had visually and audibly acceptable quality and were mainly about orthognathic surgery, were chosen from the videos. A total of 360 videos were selected, the top 60 videos for each search term, and sorted according to view count. Of these videos, the first 60 videos were analyzed. Video source (independent or educational), duration, number of views, likes, and dislikes were recorded for each video. Moreover, two impartial observers evaluated the visibility, popularity, quality, usefulness, and reliability of the videos.
41 of 60 videos were of independent sources while 19 of them were of educational origin. Information content of the videos was found to be insufficient. No significant difference was determined between independent and educational videos in terms of popularity, visibility, usefulness and quality analysis of the videos (p > 0.05), but a significant difference was found in terms of reliability values (p < 0.05).
It can be said that YouTube™ videos were not a reliable and accurate enough source of information when evaluated in terms of orthognathic surgery-related content and quality. Therefore, the information content provided by specialists and health institutions, in particular, should be increased in number, thereby making access to better quality information on orthognathic surgery easy for patients.

The purpose of this prospective study was to evaluate whether the surgical protocol involving marginal incision and Le Fort I osteotomy affects the periodontal outcome. Twenty-nine patients requiring surgical correction of maxillary dysgnathia were selected for this study. Periodontal conditions of maxillary anterior teeth were assessed prior to the surgery (T0), one month (T1), and 6 months (T2) after the surgical procedure. Interdental papillae loss, periodontal parameters and aesthetic outcomes in the anterior zone were assessed. Statistical analysis was performed with Friedman´s test and within ANOVA (p ≤ 0.05) followed by post-hoc tests. Papilla height decreased from T0 to T1 (p = 0.003), followed by an increase from T1 to T2 (p = 0.040). PPD (T0 = 1.72 ± 0.46; T2 = 2.13 ± 0.43) and CAL (T0 = 1.24 ± 0.55; T2 = 1.99 ± 0.70) increased after 6 months. There were statistically significant differences in aesthetic score among T0, T1 and T2. Periodontal changes after orthognathic surgery were within acceptable biological levels. Although a change in papillae height was reported after the surgery, initial values were recovered after 6 months. Surgical incision design might improve the outcome of Le-Fort I osteotomy. Anterior aesthetic zone may benefit from a marginal incision design, as it respects vascularization principle and may ensure a wound healing without complications.

OBJECTIVE: To retrospectively compare the high-angled sagittal split osteotomy (HOO) and the bilateral sagittal split osteotomy (BSSO) for the correction of skeletal dysgnathias regarding intra- and postoperative complications.
METHODS: The electronic medical records of all patients treated with an orthognathic surgery at the Department for Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Germany, between the years 2009 and 2019 were retrospectively reviewed.
RESULTS: Two hundred ninety-one patients were included. The overall complication rates were 19.78% (BSSO) compared to 12.5% (HOO) (p = 0.14). Significant differences were found regarding the operation time (HOO < BSSO, p = 0.02), material failure (HOO > BSSO, p = 0.04), and early recurrence requiring revision surgery (HOO < BSSO, p = 0.002). The use of a ramus plate significantly reduced the risk of plate failure (2.8% < 13.6%, p = 0.05). More bad splits (p = 0.08) and early sensory disorders (p = 0.07) occurred in the BSSO group.
CONCLUSIONS: The HOO presents a possible alternative to the BSSO since newly developed osteosynthesis material significantly reduces the risk of material failure. The BSSO is accompanied by higher risks of developing complications like a bad split and sensory disorders but, however, remains the standard for large anterior-posterior transpositions of the mandible.

The objective of this study was to analyze the distribution and morphology of the valves in the human retromandibular vein. The retromandibular, internal thoracic, azygos, femoral, and brachial veins were harvested from 46 cadavers donated to the Department of Anatomy at Tokyo Dental College for dissection. The frequency of the valves in each vein, the length of the cusps, and the thickness of the vein itself were measured. Valves were present at high frequency (92.1%) in the veins of the limbs and had cusps at least twice as long as the internal diameter of the vein. Veins in the trunk contained a lower frequency of valves, with cusps that tended to be shorter (1.60±0.77) than those of the venous valves in the limbs (2.12±0.60). The valves of the retromandibular vein tended to resemble venous valves in the trunk in terms of both frequency and morphology. The main function of venous valves in the limbs is to prevent retrograde flow. Conversely, valves in the veins of the trunk and retromandibular vein play a role in retaining blood in the veins, and their relationship to other veins means that they can cause major hemorrhage.