A regional audit of orthodontic timelines and surgical complications of orthognathic surgery
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Oral presentations / British Journal of Oral and Maxillofacial Surgery 51 (2013) e79–e106 e87 more common in older patients. The results of this study provide reassurance when planning, consenting and operat- ing on the increasingly older orthognathic patient. http://dx.doi.org/10.1016/j.bjoms.2013.05.031 20 Division of ankyloglossia: an update Beverly Buahin ∗ , James Gallagher, Gary Cousin Northampton General Hospital, United Kingdom Introduction/aims: We have continued to collect out- come data on breastfeeding scores in neonates and young infants using the Northampton Breastfeeding/Division of Ankyloglossia data collection tool. This data is also collected with colleagues at other centres using the same proforma. Our aim is to present the latest data that continues to show a statistically significant improvement in breastfeed- ing scores in those patients who have undergone division of ankyloglossia in the various centres. Materials/methods: We continue to use the same data collection tool but recently we have encountered cases referred for division of a “posterior tongue tie”. Having reviewed this entity, it is not widely reported in the medical literature. It is however, more widely reported in the breast feeding and midwifery literature. Results/statistics: We continue to show a statistically sig- nificant improvement in breastfeeding scores in those cases treated. With reference to “posterior tongue tie”, we have dis- cussed this with our paediatric and breastfeeding specialist colleagues in Northampton and have developed a pragmatic approach to managing this entity, outlined in this update. Conclusions/clinical relevance: Ongoing statistically significant improvement in breastfeeding seen with division of anterior tongue tie but as “posterior tongue tie” difficult to diagnose and treat with poorer outcome, we advise against carrying out division of “posterior tongue ties”. As our data collection tool supports NICE recommendations in the divi- sion of ankylossia, we are planning to submit this as the basis for a national tongue tie registry this year. http://dx.doi.org/10.1016/j.bjoms.2013.05.032 21 A regional audit of orthodontic timelines and surgical complications of orthognathic surgery Niamh Galligan ∗ , Kruti Desai John Radcliffe Hospital, Oxford, United Kingdom Introduction/aims: This was a re-audit based on a sim- ilar study carried out retrospectively from July 2006 to July 2009. The aim of this audit was to re-evaluate both the length of orthodontic treatment (pre- and post-surgery) and the inci- dence of operative complications in orthognathic patients. Material/methods: A retrospective study based on three units; Stoke Mandeville (unit 1), Royal Berkshire (unit 2) and the John Radcliffe (unit 3). Patients were audited from July 2009 to July 2010. Our aim was to determine, mean length of orthodontic treatment pre- and post-surgery; length of time between appointments; time lapsed from completion of orthodontic treatment to surgery and surgical complications. Results: Data obtained for the three units from patient records was collected in two parts; orthodontic treatment and surgical complications. Results show a definite variation in length of orthodontic treatment among all three units with- out an obvious difference in length of time between review appointments. Post-surgery orthodontics lasted approxi- mately the same length of time in all three units regardless of the type of surgery undertaken. The most common post- operative surgical complications noted were open bites and non-coincident centrelines. When compared with the pre- vious audit there was a noted reduction in the following post-operative complications; need for IMF, crossbite and numbness. Conclusion/clinical relevance: There is a clear variation in length of orthodontic treatment prior to surgery despite the similar timing of appointments. It suggests a need for national guidelines on ideal length of orthodontic treatment pre- surgery. Common complications were post-operative open bites and non coincident centres lines however, all had accept- able occlusions. When comparing both audits there has been a regional improvement in the incidence of complications. http://dx.doi.org/10.1016/j.bjoms.2013.05.033 22 Who audits audits in oral and maxillofacial surgery! William Reuther ∗ , V. Shekar, B. Southorn, R. Anand Queen Alexandra Hospital, Portsmouth, United Kingdom Objective: Clinical audit is a key pillar of clinical gov- ernance aiming to improve quality of care. Satisfactory completion of audit is a mandatory requirement for com- pliance with the Care Quality Commission and a vital part of revalidation for medical and dental professionals. Audit cost our Primary Care Trust £276,000 for the last financial year and £36.3 million in Scotland in 2000. Research suggests that audit is not fully utilised for the benefit of patients or health professionals due to high turnover of junior staff and incomplete audit cycles. There is no published evidence in the Oral and Maxillofacial literature relating to effectiveness of clinical audit in secondary care. The authors studied the effectiveness of clinical audit in the department of Oral and Maxillo-Facial Surgery since its inception of registration process with the clinical audit department. Methods: Analysis of all audits registered to oral and max- illofacial units was undertaken utilising a standard proforma since its inception of registration process with clinical audit
Transcript of A regional audit of orthodontic timelines and surgical complications of orthognathic surgery
Oral presentations / British Journal of Oral and Maxillofacial Surgery 51 (2013) e79–e106 e87
more common in older patients. The results of this studyprovide reassurance when planning, consenting and operat-ing on the increasingly older orthognathic patient.
http://dx.doi.org/10.1016/j.bjoms.2013.05.031
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Division of ankyloglossia: an update
Beverly Buahin ∗, James Gallagher, Gary Cousin
Northampton General Hospital, United Kingdom
Introduction/aims: We have continued to collect out-come data on breastfeeding scores in neonates and younginfants using the Northampton Breastfeeding/Division ofAnkyloglossia data collection tool. This data is also collectedwith colleagues at other centres using the same proforma.
Our aim is to present the latest data that continues toshow a statistically significant improvement in breastfeed-ing scores in those patients who have undergone division ofankyloglossia in the various centres.
Materials/methods: We continue to use the same datacollection tool but recently we have encountered casesreferred for division of a “posterior tongue tie”. Havingreviewed this entity, it is not widely reported in the medicalliterature. It is however, more widely reported in the breastfeeding and midwifery literature.
Results/statistics: We continue to show a statistically sig-nificant improvement in breastfeeding scores in those casestreated. With reference to “posterior tongue tie”, we have dis-cussed this with our paediatric and breastfeeding specialistcolleagues in Northampton and have developed a pragmaticapproach to managing this entity, outlined in this update.
Conclusions/clinical relevance: Ongoing statisticallysignificant improvement in breastfeeding seen with divisionof anterior tongue tie but as “posterior tongue tie” difficult todiagnose and treat with poorer outcome, we advise againstcarrying out division of “posterior tongue ties”. As our datacollection tool supports NICE recommendations in the divi-sion of ankylossia, we are planning to submit this as the basisfor a national tongue tie registry this year.
http://dx.doi.org/10.1016/j.bjoms.2013.05.032
21
A regional audit of orthodontic timelines and surgicalcomplications of orthognathic surgery
Niamh Galligan ∗, Kruti Desai
John Radcliffe Hospital, Oxford, United Kingdom
Introduction/aims: This was a re-audit based on a sim-ilar study carried out retrospectively from July 2006 to July2009. The aim of this audit was to re-evaluate both the lengthof orthodontic treatment (pre- and post-surgery) and the inci-dence of operative complications in orthognathic patients.
Material/methods: A retrospective study based on threeunits; Stoke Mandeville (unit 1), Royal Berkshire (unit 2) andthe John Radcliffe (unit 3). Patients were audited from July2009 to July 2010. Our aim was to determine, mean lengthof orthodontic treatment pre- and post-surgery; length oftime between appointments; time lapsed from completion oforthodontic treatment to surgery and surgical complications.
Results: Data obtained for the three units from patientrecords was collected in two parts; orthodontic treatment andsurgical complications. Results show a definite variation inlength of orthodontic treatment among all three units with-out an obvious difference in length of time between reviewappointments. Post-surgery orthodontics lasted approxi-mately the same length of time in all three units regardlessof the type of surgery undertaken. The most common post-operative surgical complications noted were open bites andnon-coincident centrelines. When compared with the pre-vious audit there was a noted reduction in the followingpost-operative complications; need for IMF, crossbite andnumbness.
Conclusion/clinical relevance: There is a clear variationin length of orthodontic treatment prior to surgery despite thesimilar timing of appointments. It suggests a need for nationalguidelines on ideal length of orthodontic treatment pre-surgery. Common complications were post-operative openbites and non coincident centres lines however, all had accept-able occlusions. When comparing both audits there has beena regional improvement in the incidence of complications.
http://dx.doi.org/10.1016/j.bjoms.2013.05.033
22
Who audits audits in oral and maxillofacial surgery!
William Reuther ∗, V. Shekar, B. Southorn, R. Anand
Queen Alexandra Hospital, Portsmouth, United Kingdom
Objective: Clinical audit is a key pillar of clinical gov-ernance aiming to improve quality of care. Satisfactorycompletion of audit is a mandatory requirement for com-pliance with the Care Quality Commission and a vital part ofrevalidation for medical and dental professionals. Audit costour Primary Care Trust £276,000 for the last financial yearand £36.3 million in Scotland in 2000.
Research suggests that audit is not fully utilised for thebenefit of patients or health professionals due to high turnoverof junior staff and incomplete audit cycles. There is nopublished evidence in the Oral and Maxillofacial literaturerelating to effectiveness of clinical audit in secondary care.The authors studied the effectiveness of clinical audit inthe department of Oral and Maxillo-Facial Surgery sinceits inception of registration process with the clinical auditdepartment.
Methods: Analysis of all audits registered to oral and max-illofacial units was undertaken utilising a standard proformasince its inception of registration process with clinical audit
