Abstract
The diagnosis of maxillofacial deformities may consist of two aspects: one is primary diagnosis which may be defined as the clinical diagnosis of facial morphology and occlusion based on clinical inspection, the other is secondary diagnosis based on cephalometric analysis, model analysis and so on. Since the chief objective of orthognathic surgery is improvement of facial disharmong and malocclusion, the clinical diagnosis has much to do with the treatment planning and its result. However, clinical diagnosis of the facial morphology greatly depends on the clinician's subjectivity, and it is considered that a great variety of the terminology would be used in the clinical diagnosis.
The purpose of this study was to survey the terminology for clinical diagnosis used by OMF surgeons and orthodontists. The facial pictures (frontal and lateral views) and intraoral pictures in centric occlusion (frontal and lateral views) of four patients with maxillofacial deformity were sent to orthodontists and oral andmaxillofacial (OMF) surgeons who belonged to a dental school or a medical school in Japan. They were simply asked to make a clinical diagnosis for each patient. Seventy-nine OMF surgeons and 16 orthodontists replied. The returned diagnoses were subjected to statistical analysis and the results were as follows:
1) The diagnostic terminology was categorized into six groups:(1) the generic term, (2) prognathism of maxilla or mandible, (3) symmetry, (4) facial height, (5) occlusion, and (6) others.
2) There was a great variety of Japanese terminology applied to the same symptom. It is desired that the diagnostic terminology be standardized and unified.
3) From the diagnoses of facial morphology, convexity of the lower third of the face in the profile view was commonly recognized, but middle-third anteroposterior deficiency, facial asymmetry in the frontal view or difference in facial height were generally not recognized except for a remarkable case.
