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Objective: To investigate: (1) orthodontists' training experience in the psychological assessment of orthognathic patients and their wish for training/further training; (2) the availability of psychological support, referral patterns and outcomes after referral; (3) and adverse incidents prompting orthodontists to refer patients for psychological assessment., Design: Prospective cross-sectional study., Methods: A 25-item questionnaire was designed to investigate the above mentioned aims. After a pilot study, the questionnaire was distributed to all members of the Consultant Orthodontist Group, British Orthodontic Society., Results: Based on a 29.1% response rate (n = 102), 76.5% of respondents had undertaken training in identifying orthognathic patients who may benefit from psychological assessment. However, 90.2% favoured further training. All respondents believed that some orthognathic patients would benefit from referral; however, 31.3% of units referred no patients at all, mostly due to limited/no access (66.7%). Most referrals (68.9%) were to psychiatrists/psychologists with dentofacial deformity expertise, with 28.9% of units having such services onsite (14 different units). Psychological referrals had potentially useful outcomes, with 36.4% of respondents sometimes changing treatment plans following referral. Clinical incidents were experienced by 35.1% of respondents, prompting referral of patients for psychological assessment; such incidents included patient suicides (n = 4)., Conclusion: Most respondents had trained in psychological assessment of orthognathic patients; however there was a large demand for further training. Clinicians value the psychological services available; however, limited availability may affect referrals for some respondents. Adverse incidents are of real concern and highlight the need to ensure that training and resources are provided to support orthognathic patients and teams.

Objective: To identify the craniofacial features of Japanese girls with Class II division 1 malocclusions., Method: One hundred and ninety lateral cephalometric radiographs were analysed, and the subjects whose age ranged from 7 years 6 months to 15 years 10 months were divided into three groups by their dentition: middle mixed dentition, late mixed dentition, and early permanent dentition. The mean values of 5 linear and 16 angular cephalometric parameters were compared with established Japanese Class I control values., Results: Japanese girls with Class II division 1 malocclusion had a significantly small S-N-B angle (p < 0.001), short mandibular ramus (p < 0.05-0.001), and a large mandibular plane angle (p < 0.05-0.001)., Conclusion: Japanese girls with Class II division 1 malocclusion had a high-angle facial pattern associated with the short mandibular ramus.

The aetiology of asymmetric growth in the mandible is not well understood. Previous studies have indicated that the functional lateral shift of the mandible in the period of prepubertal growth may translate to a true skeletal asymmetry, exclusively in skeletal Class III malocclusion. This asymmetry develops more characteristic features during the pubertal and post-pubertal growth periods. Early correction of a functional lateral shift of the mandible is recommended. The purpose of this study was to examine the relationship between the morphology of the temporomandibular joints and asymmetry in skeletal Class III malocclusion in adult female patients. Cephalometric and laminographic findings in 36 asymmetric skeletal Class III patients with a lateral shift of mandible (group 3) were compared to those of 25 symmetric skeletal Class I patients (group 1) and the same number of symmetric skeletal Class III malocclusions (group 2). All the patients had received no orthodontic treatment. The results showed that the TMJ of the side to which the mandible shifted showed a significantly narrower and shorter shape of the condyle head, smaller superior condylar space, and steeper eminence than those of the unshifted side.

Over the last 10-15 years, the terms quality of life (QOL) and health-related quality of life (HRQL) have been seen increasingly in medical literature. Much of the orthodontic treatment that is undertaken is justified on the basis of improving health-related quality of life. With this in mind, studying HRQL in orthodontic patients has the potential to provide information about treatment needs and outcomes, and may also facilitate improved care. Clinicians should therefore be aware of some of the ways in which health-related quality of life may be assessed. The first part of this review article looks at the general concepts of health-related quality of life, whilst the second section focuses on dentistry and orthodontics.