Samuel Kent, Roderick Morrison


Rural and urban differences in presentation of patients with cancer have been demonstrated at our centre, but have not yet been demonstrated in orthognathic surgery patients. We hypothesised that patients from areas further from our hospital face higher costs to attend, and may not present with minor problems as often as patients who live close to the hospital.

Methods and materials

Six year single centre retrospective review of all patients presenting for orthognathic surgery. Severity of malocclusion and facial disharmony was determined by combining measured intraoperative movements, whilst rurality was measured as distance from home address to hospital at the time of surgery.


216 patients presented for surgery. Patients with smaller intraoperative movements (<7mm combined movement) lived significantly closer to the hospital as the crow flies (mean difference 15.13 miles, CI 0.20 to 30.48, p=0.05) and in terms of travel time (mean difference 65 minutes CI 9.8 to 121.7, p=0.02) than those with larger movements.


Our results suggest that patients living further from our centre may be less likely to present for surgery with small malocclusions and facial disharmonies than those who live closer to the hospital. We discuss why socioeconomic class is unlikely to confound our results, and potential ways of minimising the effect observed.


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