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Alsenaidi A, Al Hashmi A, Al Nabhani M, Bakathir A, Jose S, Qutieshat A. Health-related quality of life and satisfaction following orthognathic surgery: a prospective cohort study. Oral Maxillofac Surg 2024:10.1007/s10006-024-01250-1. [PMID: 38602585 DOI: 10.1007/s10006-024-01250-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE This study investigates the motivations for orthognathic surgery and assesses the quality of life (QoL) and satisfaction among patients treated at a hospital over 12 months. METHODS We employed an Arabic version of the Orthognathic Quality of Life Questionnaire (OQLQ), used pre-surgery and at 2 weeks, 3 months, and 6 months post-surgery. This included demographic data, the OQLQ, and visual analogue scales (VAS). The OQLQ, originally by Cunningham et al., was translated and adapted by Al-Asfour et al. Additional validated questions were added to both pre- and post-operative surveys. RESULTS Of 136 participants (51 males, 85 females, average age 25.1), most underwent surgery for facial aesthetics (85.2%) and bite correction (57.3%). Treatments included various osteotomies. OQLQ scores significantly dropped from 63.3% pre-surgery to 23% at 6 months, showing QoL improvement. 97.8% reported better psychological status post-surgery (p = 0.0001), with 94.1% satisfaction at 6 months (p = 0.0001). CONCLUSION The orthognathic surgery yielded positive outcomes in functional and psychological aspects, leading to high satisfaction and improved QoL in patients with dentofacial deformity.
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Affiliation(s)
- Amur Alsenaidi
- Adult Restorative Dentistry, Oman Dental College, Muscat, Oman
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Madhan S, Nascimento GG, Ingerslev J, Cornelis M, Pinholt EM, Cattaneo PM, Svensson P. Health-related quality of life, jaw function and sleep-disordered breathing among patients with dentofacial deformity. J Oral Rehabil 2024; 51:684-694. [PMID: 38239176 DOI: 10.1111/joor.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/15/2023] [Accepted: 10/30/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment. METHODS A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM). RESULTS Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ. CONCLUSION Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.
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Affiliation(s)
- Sivaranjani Madhan
- Sections for Orthodontics and Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Visiting Researcher, Department of Oral Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, Duke-NUS Medical School, Singapore, Singapore
| | - Janne Ingerslev
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Marie Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Else Marie Pinholt
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Paolo M Cattaneo
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Faculty of Odontology, Malmø University, Sweden
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Zheng Z, Hasebe D, Suda D, Saito N, Saito D, Nihara J, Nohno K, Saito I, Kobayashi T. Investigation of orthognathic surgery indicators-combination with index of orthognathic functional treatment needs (IOFTN) and maxillofacial morphometric analysis. Oral Maxillofac Surg 2024:10.1007/s10006-024-01243-0. [PMID: 38528193 DOI: 10.1007/s10006-024-01243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The aim of this retrospective study was to determine orthognathic surgery indicators for Japanese patients with jaw deformities using both Index of Orthognathic Functional Treatment Needs (IOFTN) and maxillofacial morphometric analysis. SUBJECTS AND METHODS The subjects were 89 patients treated with orthognathic surgery and 92 patients treated with orthodontic treatment alone, and were classified as class I, II, or III according to the ANB angle. Based on the results for IOFTN and the results of cephalometric analysis, the indication criteria for orthognathic surgery were examined. RESULTS In IOFTN analysis, none of patients in the orthognathic surgery group were classified as category 1 or 2, while 48% of the patients in the orthodontic treatment group were classified as category 4 or 5. The results of the cephalometric analysis of patients in classified categories 4 and 5 showed that the orthognathic surgery group had significantly greater lateral mandibular deviation in Class I cases, significantly more severe degree of mandibular retrusion in Class II cases, and significantly more severe degree of mandibular prognathism in Class III cases. The results of the logistic regression analysis showed that IOFTN was a common variable as an indication criterion for orthognathic surgery, and several different variables were also selected from the cephalometric measurements in each group. CONCLUSION IOFTN is a highly sensitive and useful indicator as a criterion for orthognathic surgery. However, in the choice of treatment strategy, maxillofacial morphometric analyses and the patient's desired goal are important.
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Affiliation(s)
- Zhuoyang Zheng
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Daichi Hasebe
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Daisuke Suda
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Naoaki Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Daisuke Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Nihara
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kaname Nohno
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Isao Saito
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Schaefer G, Jacobs C, Sagheb K, Al-Nawas B, Rahimi-Nedjat RK. Changes in the quality of life in patients undergoing orthognathic therapy - A systematic review. J Craniomaxillofac Surg 2024; 52:71-76. [PMID: 38129187 DOI: 10.1016/j.jcms.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/09/2023] [Accepted: 10/15/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to investigate the impact of orthognathic therapy on patients' quality of life. Therefore, a systematic review was conducted including all prospective studies that compared pretherapeutic and posttherapeutic Oral Health Impact Profile (OHIP) or Overall Quality of Life (OQOL) questionnaire scores. Studies in patients with congenital deformities, clefts, or posttraumatic or cancer-associated deformities were excluded. Overall, 23 prospective studies were included; 8 used OHIP, 9 used OQOL and 6 used both questionnaires. A total of 1039 patients were identified (60.29% women, 39.71% men), with a mean age of 45.17 years. All analyzed studies showed in both OHIP and OQLQ an improvement of the quality of life in patients after orthognathic therapy. While improved scores could be observed in all investigated criteria, the studies demonstrated that social and aesthetic aspects showed the most prominent impact. Comparison of different Angle Classes showed, furthermore, that Class III patients had an even greater advantage over those with a Class II deformity. The review confirms that the quality of life in patients with orthognathic therapy improves significantly in all observed aspects. With regard to Angle Classes, Class III patients showed an even greater improvement than Class II patients.
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Affiliation(s)
- G Schaefer
- Department of Oral and Maxillofacial Surgery - Facial Plastic Surgery, Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.
| | - C Jacobs
- Policlinic for Orthodontics, University Medical Center Jena, Germany
| | - K Sagheb
- Department of Oral and Maxillofacial Surgery - Facial Plastic Surgery, Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - B Al-Nawas
- Department of Oral and Maxillofacial Surgery - Facial Plastic Surgery, Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - R K Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery - Facial Plastic Surgery, Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
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Rai A, Jain A, Arora A, Vanza B. Correction of Facial Asymmetry due to Different Complex Mandibular Pathologies by Aesthetic Surgical Procedures: A Case Series and Assessment of Quality of Life Following Corrective Surgeries. J Maxillofac Oral Surg 2023; 22:1148-1152. [PMID: 38105842 PMCID: PMC10719167 DOI: 10.1007/s12663-022-01783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background A numerous diseases may result in facial asymmetry, one of them is the presence of any condylar pathology. Patients with such condylar pathology resulting in facial asymmetry have a functional, aesthetic and psychological impact on them. The present study aims to identify the effect of corrective surgeries of such cosmetic deformities on the quality of life of the patients. Case Reports Patients diagnosed with condylar pathologies resulting in facial asymmetry subjected to the corrective surgeries. The quality of life assessment was done preoperatively and 3 months postoperatively, by assessing the oral health using the Japanese version of the Oral Health impact profile (OHIP). A total of 12 patients were operated and assessed with an age ranges of 18-42 years. Seven out of 12 patients were diagnosed with condylar hyperplasia, and five patients were having benign tumor of the mandibular condyle. The mean preoperative OHIP score was 68.25 ± 7.19, which significantly improved to 24.58 ± 4.88 postoperatively. Conclusion Corrective surgeries of facial deformity dramatically improves the quality of life of the patients.
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Affiliation(s)
- Anshul Rai
- Department of Dentistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Anuj Jain
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
- Department of Oral and Maxillofacial Surgery, Dr. HSRSM Dental College and Hospital, Hingoli, Maharashtra India
| | - Aakash Arora
- Department of Oral and Maxillofacial Surgery, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh India
| | - Bhavuk Vanza
- Department of Oral and Maxillofacial Surgery, Government Dental College, Indore, Madhya Pradesh India
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Onoda N, Mikami T, Saito N, Kobayashi T. Evaluation of oral health-related quality of life in patients with temporomandibular disorders. Cranio 2023; 41:486-493. [PMID: 33554774 DOI: 10.1080/08869634.2021.1883378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate oral health-related quality of life (OHRQoL) in patients with temporomandibular disorders (TMDs). METHODS Subjects included 56 patients diagnosed with TMD. Control subjects consisted of 30 individuals without temporomandibular joint symptoms. OHRQoL was evaluated using the Japanese version of the Oral Health Impact Profile (OHIP-J54) before and 4 months after treatment. RESULTS Total score and all subscale scores of the OHIP-J54 in patients before treatment were significantly higher than those of the control subjects and were significantly improved after treatment, except for social disability. Gender and NRS pain scores had statistically significant effects on OHRQoL, which was low in females and patients with severe pain. CONCLUSION OHIP-J54 appeared to be useful for understanding psychological and social problems as a screening tool and for assessing the extent of changes in the well-being of patients with TMD.
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Affiliation(s)
- Norio Onoda
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Toshihiko Mikami
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Naoaki Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Impact of malocclusion treatments on Oral Health-Related Quality of Life: an overview of systematic reviews. Clin Oral Investig 2023; 27:907-932. [PMID: 36602588 DOI: 10.1007/s00784-022-04837-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To perform an overview of systematic reviews (SR) assessing the impact of malocclusion treatments (Orthodontic Treatment - OT and/or Orthodontic Surgical Treatment - OST) on Oral Health-Related Quality of Life (OHRQoL). MATERIALS AND METHODS A search strategy was conducted in electronic databases until June 7th, 2021, followed by a manual search in grey literature and registration databases. Two independent authors applied the eligibility criteria, extracted the data, assessed the risk of bias (AMSTAR-2), and performed the certainty of evidence (GRADE) evaluation. Meta-analysis was planned to be carried out in RevMan 5.3 (with 95% confidence intervals (CI) considering p < 0.05), in case of homogeneous studies considering OHRQoL instrument and time of follow-up. RESULTS A total of 126 articles were accessed on the database, 18 registers, 33 records on grey literature and 3 articles by means of citation searching. After duplicates removal and eligibility criteria analyses, 15 SR were included. From that, 13 showed improvement in OHRQoL after OT and/or OST. The methodological quality ranges from high (n = 2), to critically low (n = 9). Meta-analysis was conducted. Improvement on OHRQoL after a 6-month OST using the OQLQ-22 (p < 0.00001; 19.65; CI: 12.60-26.70) and OHIP-14 instruments (p < 0.00001; 10.70; CI: 9.89-11.51); and after a 6-month OT using the CPQ 11-14 instrument (p = 0.010; 3.57; CI: 0.86-6.28) with very low certainty of the evidence for all outcomes was observed. CONCLUSIONS Although most SR selected in this overview are characterized by a critically low quality, as well as very low certainty of the evidence, OT and/or OST seem to have a positive impact in improving the OHRQoL. CLINICAL RELEVANCE The overview of existing systematic reviews compiled that OT and/or OST seem to have a positive impact on improving the OHRQoL. This information will facilitate clinical decision-making considering the clinical and psychological parameters.
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Bhandari SK, Issar Y, Rana RPS, Datana S. Evaluating the quality of life among patients undergoing orthognathic surgery using a customized questionnaire: A prospective study. APOS TRENDS IN ORTHODONTICS 2023. [DOI: 10.25259/apos_230_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Objectives:
A questionnaire, specific to the clinical condition treated is important. The aim of this study was to evaluate the Quality of life (QOL) amongst patients undergoing orthognathic surgery using a customized questionnaire encompassing, patients’ perception of facial form and also patient perception of overall quality of care provided during the entire treatment.
Materials and Methods:
This prospective, qualitative, observational study was carried out on 21 patients, who underwent Ortho-surgical management between Jan 2019 and Mar 2020. The Orthognathic QOL questionnaire was customized, Phase I, immediately prior; and Phase II, 6 months after surgery. Appropriate analysis was done to compare Phase I and Phase II, with the level of significance set to P < 0.05.
Results:
“Aesthetics” was the most frequent reported reason for seeking treatment. The mean pre-/post-treatment difference for oral function was statistically significant. Majority (87%) of patients reported surgical outcomes met their expectations. Results, post-surgery; good hospital care (33.3%), supportive doctors (28.57%) and regular follow up (9.52%).
Conclusion:
“Patients’ perspective” of treatment, is often neglected, the immense importance of which has been duly reflected in our study. We recommend the use of our questionnaire in a similar, broad based multicentric study with a larger patient base, will aid in improving overall outcome of ortho-surgical interventions.
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Affiliation(s)
- Sujit Kumar Bhandari
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India,
| | - Yuvraj Issar
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India,
| | - Ravinder Pal Singh Rana
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India,
| | - Sanjeev Datana
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India,
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Machado NC, Gerber JT, Santos KMD, Bergamaschi IP, Meger MN, Costa DJD, Küchler EC, Scariot R. Association of the estrogen receptor gene with oral health-related quality of life in patients with dentofacial deformities. Braz Oral Res 2022; 36:e089. [PMID: 35830136 DOI: 10.1590/1807-3107bor-2022.vol36.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 11/03/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the associations between oral health-related quality of life (OHRQoL) and patient-associated factors and polymorphisms in the estrogen receptor 1 (ESR1) and 2 (ESR2) genes in patients with dentofacial deformities (DFD). This cross-sectional study included 234 adult individuals. Data such as age, sex, and the type of facial profile (I, II, or III), were collected, and the short-form oral health impact profile 14 (OHIP-14) questionnaire was used to assess their OHRQoL. DNA was collected from oral mucosa cells, and the polymorphisms in ESR1 (rs2234693 and rs9340799) and ESR2 (rs1256049 and rs4986938) were evaluated using real-time polymerase chain reaction. The data were subjected to statistical analysis at a significance level of 5%. Individuals over 28 years of age exhibited worse OHRQoL (p = 0.003) than individuals aged less than or equal to 28 years. Women had worse OHRQoL than men (p < 0.001). Profile II individuals had worse OHRQoL in the social disability domain than profile III individuals (p = 0.030). Genetic analysis showed that rs9340799 was associated with OHRQoL in the functional limitation domain, and GG individuals exhibited worse OHRQoL than individuals carrying the AA/AG genotypes (p < 0.030). In the social handicap domain, individuals with GG genotype in rs9340799 exhibited worse OHRQoL than AG individuals (p < 0.043). Collectively, our results reveal that factors including age, sex, and type of facial profile, are associated with OHRQoL in patients with DFD. In addition, individuals with the GG genotype in rs9340799 (ESR1) may experience a negative impact on OHRQoL in the functional limitation and social handicap domains.
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Affiliation(s)
- Nilza Cristina Machado
- Universidade Positivo - UP, School of Health Sciences, Dental School, Curitiba, PR, Brazil
| | - Jennifer Tsi Gerber
- Universidade Positivo - UP, School of Health Sciences, Dental School, Curitiba, PR, Brazil
| | | | | | | | - Delson João da Costa
- Universidade Federal do Paraná - UFPR, Dental School, Department of Stomatology, Curitiba, PR, Brazil
| | - Erika Calvano Küchler
- Universidade de São Paulo - USP, Ribeirão Preto Dental School, Department of Pediatric Dentistry, Ribeirão Preto, SP, Brazil
| | - Rafaela Scariot
- Universidade Federal do Paraná - UFPR, Dental School, Department of Stomatology, Curitiba, PR, Brazil
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Alanko OME, Svedström-Oristo AL, Suominen A, Soukka T, Peltomäki T, Tuomisto MT. Does orthognathic treatment improve patients' psychosocial well-being? Acta Odontol Scand 2022; 80:177-181. [PMID: 34550844 DOI: 10.1080/00016357.2021.1977384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To analyse changes in patients' psychosocial well-being from before treatment until post-surgical orthodontic treatment (including retention) is completed. MATERIALS AND METHODS Data was collected six times: before treatment (T0), 6-8 weeks after the placement of orthodontic appliances (T2), 3-4 weeks before surgery (T3), six weeks after surgery (T4), one year after surgery (T5) and after completing orthodontic treatment (T6; 20-57 months after surgery). At T0, 60 patients participated while at T6, data was available for 15 patients. All patients completed the Orthognathic Quality of Life Questionnaire (OQLQ), Rosenberg Self-Esteem Questionnaire (RSES), Acceptance and Action Questionnaire II (AAQ-II) and the Symptom Checklist 90 (SCL-90). All pairwise comparisons between variables were conducted with the Wilcoxon signed-rank test. RESULTS OQLQ function, RSES, AAQ-II and SCL GSI worsened from T0 to T2. At T5, improvements compared to T0 were found in all aspects of OQLQ and SCL GSI. When comparing results at T6 to T0, improvements where only found in OQLQ sum, OQLQ facial aesthetics and OQLQ function. CONCLUSIONS Although well-being of orthognathic patients seems to improve during treatment, many improvements cannot be verified anymore at the completion of the retention period. Most stable changes are found in the oral function component and in the facial aesthetics component of the OQLQ.
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Affiliation(s)
- Outi Marja Elina Alanko
- Pediatric Dentistry and Orthodontics, University of Turku, Turku, Finland
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Anna-Liisa Svedström-Oristo
- Pediatric Dentistry and Orthodontics, University of Turku, Turku, Finland
- Department of Oral Diseases, Turku University Hospital, Turku, Finland
| | - Auli Suominen
- Community Dentistry, University of Turku, Turku, Finland
| | - Tero Soukka
- Department of Oral Diseases, Turku University Hospital, Turku, Finland
| | - Timo Peltomäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Martti T. Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
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Oral Health-Related Quality of Life Changes in Patients with Dentofacial Deformities Class II and III after Orthognathic Surgery: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041940. [PMID: 35206128 PMCID: PMC8872566 DOI: 10.3390/ijerph19041940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 01/27/2023]
Abstract
Our aim was to assess the impact of combined orthodontic–surgical treatment on patients’ oral health-related quality of life (OHRQoL) according to type of dentofacial deformities, by synthesizing the available evidence. Methods: Search was conducted in the PubMed, Embase/MEDLINE, Scopus, and Cochrane databases. The eligibility criteria were studies that measured OHRQoL before–after orthognathic surgery, with results disaggregated by Class II and III. Two researchers independently performed the selection process, data extraction, and methodological quality assessment. Meta-analysis of the standard mean differences (SMD) was performed using random effect models. Results: The search identified 1047 references. Thirteen studies met the inclusion criteria, and four were included in the meta-analysis. The SMD of OHRQL global score showed large improvement 4–7 months after surgery in Class II and III patients (2.09, 95% CI 0.68 to 3.49 and 1.96, 95% CI 1.22 to 2.70, respectively). The sensitivity analyses, excluding studies with weak methodological quality, showed that Class III patients’ improvement in functional limitation was significantly higher than in Class II patients (SMD 0.57, 95% CI 0.12–1.02). Conclusions: There is not enough evidence to support differences between Class II and III patients in the OHRQoL impact after orthognathic surgery, but findings suggest lower improvement of some domains in Class II patients.
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Elzohry AM, Alghamdi O, Helmy M, Ibrahime O. Postoperative myoclonic movement following mandibular cyst enucleation under general anesthesia: A case report. Saudi J Anaesth 2022; 16:472-474. [PMID: 36337409 PMCID: PMC9630691 DOI: 10.4103/sja.sja_888_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022] Open
Abstract
Postoperative myoclonic movement (PMM) is an uncommon side effect after general anesthesia (GA), and the exact cause of this neurologic complication is still unknown. Many factors such as anesthesia, psychological stresses, and surgical stress could trigger PMM. We are here reporting a case of PMM in the post-anesthetic care unit (PACU) following general anesthesia in an apparently healthy patient.
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Do the stages of orthodontic-surgical treatment affect patients' quality of life and self-esteem? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:434-439. [PMID: 34628100 DOI: 10.1016/j.jormas.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022]
Abstract
The orthodontic-surgical treatment comprises different stages from diagnosis to final soft tissue accommodation, but there are no data regarding the patient's perception during these phases. This study aimed to investigate the impact of these stages on quality of life and self-esteem of patients with dentofacial deformity. Patients were divided into 4 groups according to the treatment stage: initial orthodontic pre-treatment (1), one week before surgery (2), three months after surgery (3), and after the removal of the orthodontic appliance (4) (n = 20 / group). They filled the following questionnaires: Oral Health Impact Profile (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ) and Rosenberg Self-Esteem Scale (RSES). Data were evaluated by Kruskal-Wallis test. Differences among groups were noticed in all evaluated scales (p = 0.001 for all). No statistically significant differences between patients in groups 1 and 2 (OHIP, OQLQ, and RSES, p >0.05 for all), while patients at group 4 presented different scores in all questionnaires compared to 1, 2, and 3 (p < 0.05 for all), irrespective of the type of dentofacial deformity (p > 0.05). The results indicate that dental decompensation stage did not negatively affect patient's confidence and well-being. Despite the improvement noticed few months after the orthognathic surgery, the main impact on patient's quality of life and self-esteem was evidenced after the removal of the orthodontic appliance. We highlight the important role of counselling patients to discuss all the treatment stages to clarify patients' subjective expectations before any intervention is carried out.
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Surgical-Orthodontic Diagnosis and Treatment Planning in an Asymmetric Skeletal Class III Patient—A Case Report. Symmetry (Basel) 2021. [DOI: 10.3390/sym13071150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The skeletal Class III pattern is characterized by a sagittal intermaxillary mesial discrepancy. This discrepancy may have an unfavorable impact on function and aesthetics, which can be aggravated by the presence of facial asymmetries. This case report describes the diagnosis and treatment planning of a 19-year-old male patient with a skeletal Class III, maxillary hypoplasia, anterior crossbite, and mandibular asymmetry. When the patient reached skeletal maturity at the end of puberty, the definitive diagnosis was skeletal Class III with hyperdivergent profile and mandibular asymmetry, and a surgical-orthodontic treatment was proposed. At the end of the treatment, bimaxillary surgical correction allowed a skeletal Class I with mandibular symmetry, improving the function of the stomatognathic system and facial aesthetics.
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Psychological symptoms and salivary inflammatory biomarkers in patients with dentofacial deformities: a case-control study. Sci Rep 2021; 11:11083. [PMID: 34040126 PMCID: PMC8155030 DOI: 10.1038/s41598-021-90721-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/17/2021] [Indexed: 12/02/2022] Open
Abstract
Individuals with dentofacial deformities often display a low quality of life (QoL) through biological mechanisms that remain unraveled. In this case–control study, the salivary levels of cytokines, glutamate, and kynurenine metabolites were assessed in patients undergoing orthognathic surgery (OS), while correlating these parameters with QoL and psychological symptoms. Thirty-six patients were enrolled in control (under orthodontic treatment) and test (undergoing OS) groups, matched by age and sex. The QoL was assessed through the World Health Organization Quality of Life BREF (WHOQOL-BREF) and the Orthognathic Quality of Life Questionnaire (OQLQ). The psychological symptoms were evaluated by the Satisfaction with Life Scale, the Rosenberg Self-Esteem Scale (RSES), and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The salivary levels of IL-1β, IL-6, IL-10, glutamate, and kynurenine metabolites were evaluated. The OQLQ demonstrated increased QoL scores in the test group, regarding social aspects, facial esthetics, and function domains, without significant differences in respect to the other surveys. These patients displayed higher IL-1β and glutamate levels; conversely, the kynurenine metabolites were unaltered. The glutamate levels positively correlated with the OQLQ function scores. The data brings novel evidence about the psychobiological features of patients with dentofacial deformities, showing salivary variations of inflammatory biomarkers in these individuals.
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Impact of orthognathic surgery on quality of life and comparison of patients' postoperative experience after single- and double-jaw surgery: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:633-640. [PMID: 34511359 DOI: 10.1016/j.oooo.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the impact of orthognathic surgery on quality of life (QoL) and to compare single- and double-jaw surgeries in terms of ratio and patient perceptions of the postoperative period. STUDY DESIGN A prospective, longitudinal observational study was conducted. The short form Oral Health Impact Profile (OHIP-14) and the Orthognathic Quality of Life Questionnaire (OQLQ) were applied preoperatively and 6 months postoperatively to evaluate oral health-related QoL (OHRQoL). Additionally, patient perceptions of the immediate postoperative period were assessed at the first and fourth week after surgery. RESULTS One hundred consecutive patients were recruited and assigned to the single-jaw group (n = 24) or the double-jaw group (n = 76) according to the characteristics of each facial or occlusal deformity. The questionnaires showed lower scores for both groups after surgery, indicating significant benefits to OHRQoL. The whole sample OHIP-14 mean total scores decreased from 10.5 to 2.8 (P < .001, d = 1.35), whereas OQLQ showed a decrease from 48.4 to 11.6 (P < .001, d = 1.75). CONCLUSIONS Orthognathic surgery can improve OHRQoL, and long-term benefits outweigh the risks and discomfort associated with the treatment.
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Vongkamolchoon S, Sinha SP, Liao YF, Chen YR, Huang CS. The impact of a surgery-first approach on oral health-related quality of life. Int J Oral Maxillofac Surg 2021; 50:1336-1341. [PMID: 33642150 DOI: 10.1016/j.ijom.2021.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/17/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
Orthognathic surgery using a surgery-first approach (SFA) has been shown to result in better quality of life (QoL) throughout the treatment duration; however, the effects of gender, age and type of dentofacial deformity on SFA-related QoL remain unknown. In total, 228 consecutive patients underwent SFA for correction of dentofacial deformities (skeletal class III, bimaxillary protrusion and facial asymmetry). We assessed their QoL before surgery and at 1, 6 and 12 months after surgery using the Orthognathic Quality of Life Questionnaire (OQLQ). The results indicated a significant decrease in the total OQLQ, facial aesthetics and social aspect domain scores 1, 6 and 12 months after surgery. Among all domains, the greatest improvement was noted in the facial aesthetics domain. The oral function scores declined significantly immediately after surgery, but improved significantly 6 and 12 months after surgery; however, the awareness scores remained relatively stable. At each time point, women and the bimaxillary protrusion group exhibited a significantly higher total and specific domain scores. Patients aged 18-22 years exhibited lower total and four specific domain scores than older patients. Thus, QoL improves in all aspects, except awareness domain, by 12 months after SFA, but gender, age, and type of dentofacial deformity affect this improvement.
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Affiliation(s)
- S Vongkamolchoon
- Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - S P Sinha
- Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Y-F Liao
- Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Y-R Chen
- Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - C S Huang
- Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Belusic Gobic M, Kralj M, Harmicar D, Cerovic R, Mady Maricic B, Spalj S. Dentofacial deformity and orthognatic surgery: Influence on self-esteem and aspects of quality of life. J Craniomaxillofac Surg 2021; 49:277-281. [PMID: 33579617 DOI: 10.1016/j.jcms.2021.01.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/27/2020] [Accepted: 01/31/2021] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess the extent to which psychosocial and functional aspects are affected in orthognathic surgery patients. The Oral Health Impact Profile (OHIP-CRO14), Orthognathic Quality of Life Questionnaire and Self-Esteem (SE) Scale were used. The sample included 110 Caucasian subjects (73% females) aged 19-54 years. Fifty-five patients with dentofacial deformities were treated by combined orthodontic-orthognathic surgical treatment, and 55 others, matched by sex and age, were untreated controls without dentofacial deformities. In comparison with the untreated subjects, patients before surgery had a poorer quality of life, with the largest effect size in oral function (OF) and OHIP (average differences 8.0 and 14.7, respectively; p < 0.001; r = 0.65 and 0.63), while the lowest effect sizes were in awareness of facial aesthetics (AW) and SE. The treatment induced statistically significant changes in all psychosocial and functional aspects, mainly with a large effect size (p < 0.001; r = 0.48-0.78). The major effect size was a decrease in facial aesthetic concerns (FE; 7.6 ± 6.2; p < 0.001; r = 0.78), followed by a decrease in impairment of OF and OHIP (8.0 ± 7.1 and 16.6 ± 14.6; p < 0.001; r = 0.75). The lowest effect size was in the decrease in AW and increase in SE. After surgery, all aspects were similar to those in the untreated subjects. In conclusion, facial deformity raises many issues, primarily related to aesthetic concerns and functional impairment; however, orthognathic surgery manages to improve quality of life to be similar to that of the population without deformities.
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Affiliation(s)
- Margita Belusic Gobic
- University of Rijeka, Faculty of Medicine, Department of Maxillofacial Surgery, Tome Strizica 3, 51000, Rijeka, Croatia
| | - Martin Kralj
- University of Rijeka, Faculty of Medicine, Department of Maxillofacial Surgery, Tome Strizica 3, 51000, Rijeka, Croatia
| | - David Harmicar
- University of Rijeka, Faculty of Medicine, Department of Maxillofacial Surgery, Tome Strizica 3, 51000, Rijeka, Croatia
| | - Robert Cerovic
- University of Rijeka, Faculty of Medicine, Department of Maxillofacial Surgery, Tome Strizica 3, 51000, Rijeka, Croatia
| | - Barbara Mady Maricic
- University of Rijeka, Faculty of Dental Medicine, Department of Orthodontics, Kresimirova 40, Rijeka, Croatia
| | - Stjepan Spalj
- University of Rijeka, Faculty of Dental Medicine, Department of Orthodontics, Kresimirova 40, Rijeka, Croatia; J. J. Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Department of Dental Medicine 1, Crkvena 21, Osijek, Croatia.
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Vignesh U, Mehrotra D, Bhave SM, Singh PK. Quality of life after distraction osteogenesis in TMJ ankylosis patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:295-303. [PMID: 33187947 DOI: 10.1016/j.oooo.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/29/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our study was to evaluate the success of distraction osteogenesis in temporomandibular joint (TMJ) ankylosis patients with facial deformities at our maxillofacial unit; assess the psychosocial and well-being outcomes of distraction osteogenesis and its impact on oral health; and discriminate the differences in quality of life (QoL) with application of external or internal devices, unilateral or bilateral, linear or multivector, and maxillomandibular or mandibular distraction. STUDY DESIGN QoL and the Oral Health Impact Profile (OHIP) were prospectively studied in 42 consecutive patients with facial deformities, planned for maxillofacial distraction osteogenesis, using 2 validated questionnaires, the Orthognathic Quality of Life Questionnaire and OHIP-14. Patients who had undergone any previous surgeries were excluded. RESULTS Among these patients, 16 were female, 26 male; mean age was 14.98 ± 4.88 years, and all had prearthroplastic distraction. The shortening in the mandible was in the proportion 29:01:12 in the body, ramus, and ramus-body, respectively. Mean QoL scores before and after distraction were 68.52 ± 9.50 and 26.62 ± 3.51; and mean OHIP scores before and after distraction were 33.88 ± 6.26 and 15.36 ± 2.54, a highly significant difference (P < .001) suggesting improvement. Significant improvement was identified on all QoL and OHIP questions after distraction (P < .01). The postdistraction overall mean QoL score among patients with extraoral or intraoral distractor did not have a significant difference (P = .32), but facial appearance in the bilateral distraction group; jaw function and overall well-being in the multivector distraction group; and facial appearance, jaw function, and overall well-being in maxillomandibular distraction group had significant improvements (P < .05). CONCLUSIONS Distraction osteogenesis considerably improves oral health and health-related QoL in patients with TMJ ankylosis with facial deformities. The use of an external or internal distractor did not make any difference in the QoL; however, bilateral distraction, multivector distraction, and maxillomandibular distraction resulted in better QoL outcomes.
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Affiliation(s)
- Uthirapathy Vignesh
- Senior Resident, Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Divya Mehrotra
- Professor, Department of Oral & Maxillofacial Surgery, King George Medical University, Lucknow, India.
| | - Sujay Milind Bhave
- Junior Resident, Department of Oral & Maxillofacial Surgery, King George Medical University, Lucknow, India
| | - Praveen K Singh
- Junior Resident, Department of Oral & Maxillofacial Surgery, King George Medical University, Lucknow, India
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Bengtsson M, Loh JSP, Wall G, Becktor JP, Rasmusson L. Is there a difference in judgement of facial appearance depending on ethnic background? Photographic evaluation of facial appearance in orthognathic surgery. Br J Oral Maxillofac Surg 2020; 58:812-818. [PMID: 32409131 DOI: 10.1016/j.bjoms.2020.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Abstract
Is there a variation in facial ideals depending on ethnic background that affects judgements of outcome in orthognathic surgery? How does the evaluation correlate with patient-reported outcome measures? Two evaluation panels, Singaporean and Swedish, judged photographs of patients undergoing orthognathic surgery taken before and after operation. Improvement in facial aesthetics was calculated between the two ratings. The result was compared between the panels and correlated with health-related quality of life (QoL) measures. Thirty male and 27 female patients aged between 18 and 28 years (mean 21) were included, and 52 subjects were eligible for comparison of health-related QoL. The photographic evaluation showed that both panels judged there to be significant improvement in facial aesthetics after treatment (p<0.001). The Singaporean panel rated the overall facial appearance higher than the Swedish panel when evaluating photographs both before (p=0.025) and after (p=0.032) operation. Improvement of the overall facial appearance showed no significant difference between the panels (p>0.30). No correlation between health-related QoL and improvement of facial appearance was found by either panel. Subjective evaluation of facial aesthetics in orthognathic surgery is unaffected by the observer's ethnic origin. Independently of their ethnicity, the evaluation juries found that facial aesthetics improved after orthognathic surgery. Improvement reported by the juries corresponded to that reported by patients.
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Affiliation(s)
- M Bengtsson
- Department of Oral & Maxillofacial Surgery, the University Hospital of Skåne, 22185 Lund.
| | - J S P Loh
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore.
| | - G Wall
- Department of Oral & Maxillofacial Surgery, the University Hospital of Skåne, 22185 Lund
| | - J P Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 20506 Malmö.
| | - L Rasmusson
- Department of Oral & Maxillofacial Surgery, the Sahlgrenska Academy, Gothenburg University, Box 450, 405 30 Göteborg.
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Saghafi H, Benington P, Ayoub A. Impact of orthognathic surgery on quality of life: a comparison between orthodontics-first and surgery-first approaches. Br J Oral Maxillofac Surg 2020; 58:341-347. [DOI: 10.1016/j.bjoms.2020.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
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Liu BCL, Lee IC, Lo LJ, Ko EWC. Investigate the oral health impact and quality of life on patients with malocclusion of different treatment needs. Biomed J 2019; 42:422-429. [PMID: 31948607 PMCID: PMC6962747 DOI: 10.1016/j.bj.2019.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 05/01/2019] [Accepted: 05/28/2019] [Indexed: 11/17/2022] Open
Abstract
Background This study compared oral health impacts and QoL among patients with different malocclusion types and a normal population by using self-report questionnaires. Methods In this cross-sectional study, 214 healthy adults were divided into 3 groups: (1) Normal, control group; (2) ORTHO, patients who received orthodontic treatment; and (3) OGS group, patients who received orthognathic surgery (OGS). The timing of measurement were at the initial stage of the orthodontic therapy and before surgery. Two questionnaires and one additional item were used: the 36-item Short Form Health Survey (SF-36) for QoL, the 14-item Oral Health Impact Profile (OHIP-14) for oral health-related QoL (OHRQOL) and one additional item for aesthetic evaluation. Descriptive and inferential statistical analyses were used to compare the 3 groups. The effects of 3 malocclusion types, gender, age, and facial asymmetry in the OGS group were also evaluated. Results The ORTHO and OGS groups had higher negative impacts than did the Normal group in the OHIP-14, but not much difference in the SF-36. The item of aesthetics related to oral health impact was the lowest in the OGS group. The patients in the ORTHO group with a Class II malocclusion were most dissatisfied in the SF-36 and OHIP-14. In the OGS group, the women dissatisfied in the OHIP-14 and the aesthetic. The older patients had higher negative impacts in the OHIP-14 than the younger patients. The patients with facial asymmetry did not suffer higher negative impacts than did the patients with a symmetrical face in the SF-36 and OHIP-14. Conclusions The majority of the patients who required orthodontics or OGS reported a higher negative impact in the OHIP-14 compared with the normal controls, but not in the SF-36. Class II malocclusion suffered from highest psychological stress and aesthetic sensitivity than the other two subgroups in the ORTHO group.
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Affiliation(s)
- Becky Chiang-Lin Liu
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - I-Chen Lee
- Department of Industrial and Business Management, College of Management, Chang Gung University, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Lun-Jou Lo
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ellen Wen-Ching Ko
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Dentistry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Hosseinzadeh Nik T, Gholamrezaei E, Keshvad MA. Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach. J Dent Res Dent Clin Dent Prospects 2019; 13:311-320. [PMID: 32190216 PMCID: PMC7072083 DOI: 10.15171/joddd.2019.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The surgery-first approach (SFA), which proceeds without presurgical orthodontic treatment, is assumed to shorten the treatment course because the direction of post-surgical orthodontic tooth movement conforms to the normal muscular forces.
Moreover, the regional acceleratory phenomenon (RAP), evoked by surgery, helps in tooth alignment and compensation in a
faster way. Although SFA has definite advantages, especially in class III individuals, there is a lack of data about its indications
in patients with facial asymmetry. In this article, we reviewed recently published articles on the treatment of asymmetric
patients using the SFA. Different aspects, including the three-dimensional assessment of stability in different planes, approaches for fabrication of a surgical splint, predictability of the results, skills needed for bimaxillary surgery, indications as
the treatment of choice for condylar hyperplasia, and combination with distraction osteogenesis in candidates with severe
asymmetries were found to be the main topics discussed for patients presenting with facial asymmetry
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Affiliation(s)
- Tahereh Hosseinzadeh Nik
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Gholamrezaei
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Keshvad
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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de Araujo CM, Schroder AGD, de Araujo BMDM, Cavalcante-Leão BL, Stechman-Neto J, Zeigelboim BS, Santos RS, Guariza-Filho O. Impact of orthodontic-surgical treatment on quality of life: a meta-analysis. Eur J Orthod 2019; 42:281-289. [DOI: 10.1093/ejo/cjz093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Summary
Background
Orthognathic surgery involves a change in the patient’s functional and aesthetic aspects.
Objective
The objective was to answer the following focused question: what is the impact on quality of life (QoL; aesthetic, function, social, and psychological aspects) in patients undergoing orthodontic-surgical treatment?
Search methods
Appropriate word combinations and truncations were selected and tailored specifically for each electronic database: PubMed/Medline, Scopus, Web of Science, PsycInfo, and Latin American and Caribbean Health Sciences Literature and gray literature.
Selection criteria
Studies that met the following criteria was included: patients with dentofacial deformity (P); surgical correction through orthodontic-surgical treatment (E/I); before orthodontic-surgical treatment or patients with no dentofacial deformity (C); QoL (O); cross-sectional, cohort, case-control and randomized or non-randomized clinical trial (S).
Data collection and analysis
In phase 1, two reviewers independently reviewed the titles and abstracts of all references. All articles that did not meet the inclusion criteria were excluded. In phase 2, the same reviewers completely read the selected articles independently.
Results
A total of 2879 articles were retrieved during the final database search. Fifty-two articles were selected for full reading, of which 16 were excluded, resulting in 36 included articles. The meta-analysis was performed using 13 of the selected studies. When comparing the period before any treatment with the post-operative period of 4–8 weeks, there was an association only for facial aesthetics (mean difference = 3.00; 95 per cent confidence interval = 1.10–4.89; inconsistency index = 63 per cent). The comparison between the period before any treatment with the 6 month post-operative period showed an improved QoL in all of the domains evaluated and, when comparing data after the orthodontic-surgical preparation (before surgery) and after 5–12 months of surgery, there was also statistical significance with an increased QoL for all of the domains evaluated.
Conclusions
In conclusion, based on the results of this systematic review and meta-analysis, the evidence suggests an improvement in the QoL of patients undergoing orthodontic-surgical treatment regarding aesthetic, functional, social, and psychological aspects.
Registration
CRD42017069495
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Affiliation(s)
- Cristiano Miranda de Araujo
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | | | | | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | - Odilon Guariza-Filho
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba
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Oral health-related quality of life following orthognathic surgery for class III correction its relationship with cephalometric changes. Int J Oral Maxillofac Surg 2019; 48:1434-1439. [DOI: 10.1016/j.ijom.2019.03.899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/27/2019] [Accepted: 03/19/2019] [Indexed: 11/19/2022]
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Yi J, Lu W, Xiao J, Li X, Li Y, Zhao Z. Effect of conventional combined orthodontic-surgical treatment on oral health-related quality of life: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2019; 156:29-43.e5. [DOI: 10.1016/j.ajodo.2019.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/17/2022]
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Impacts of Orthognathic Surgery on Patient Satisfaction, Overall Quality of Life, and Oral Health-Related Quality of Life: A Systematic Literature Review. Int J Dent 2019; 2019:2864216. [PMID: 31316563 PMCID: PMC6604419 DOI: 10.1155/2019/2864216] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/26/2019] [Indexed: 11/17/2022] Open
Abstract
Several treatments have been suggested to correct dentofacial abnormalities, including orthognathic surgery. The aim of the present systematic review was to assess the impact of orthognathic surgery on patient satisfaction, overall quality of life, quality of life related to oral health—and to orthognathic surgery in particular—among adult patients. Two investigators independently reviewed the available literature in the databases PubMed/MEDLINE, LILACS, SciELO, EMBASE, Trip, and Google Scholar (gray literature) based on the keywords “orthognathic surgery” and “quality of life.” An analysis of bias was performed based on the MINORS (methodological index for nonrandomized studies). A total of 245 relevant studies were retrieved from the databases, and 6 additional studies were located after a manual search of the references. Following selection based on titles, abstracts, and full-text analysis, 30 studies were included in the present systematic review. To evaluate quality of life before and after orthognathic surgery, 12 studies applied the surgery-related Orthognathic Quality of Life Questionnaire (OQLQ), 12 used the Oral Health Impact Profile (OHIP-14), and 4 used the Short Form Health Survey (SF-36). Orthognathic surgery results in improvements in quality of life both physically and psychosocially after surgery and is associated with high rates of patient satisfaction.
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Ni J, Song S, Zhou N. Impact of surgical orthodontic treatment on quality of life in Chinese young adults with class III malocclusion: a longitudinal study. BMC Oral Health 2019; 19:109. [PMID: 31196054 PMCID: PMC6567538 DOI: 10.1186/s12903-019-0782-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/08/2019] [Indexed: 11/12/2022] Open
Abstract
Background The quality of life in Class III malocclusion patients are worse than those without the disorder and previous studies have shown that surgical orthodontic treatment has a different effect on these patients compared with mild or moderate malocclusion. This study aimed to investigate the changes in quality of life in patients with Class III malocclusion during surgical orthodontic treatment in Chinese young adults. Methods The 14-item Short Form Oral Health Impact Profile (OHIP-14), and the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) were used to assess the effect of surgical orthodontic treatment on the quality of life in 21 patients with Class III malocclusion at pre-treatment (T0), pre-surgical orthodontic treatment (6 to 8 months, T1) and post-surgical orthodontic treatment (6 to 8 months after surgery, T2), and 24 healthy individuals were included as controls. The comparisons in numerical variables between patients and controls were performed using Mann-Whitney U test. The scores of the two questionnaires between T0, T1, T2 and controls (Tc) were compared using generalized estimating equation. Results According to OHIP-14 questionnaire, the mean scores in T0 and T1 were higher than those in T2 and Tc (P < 0.001), and a significant decrease was observed after post-surgical orthodontic treatment (P < 0.001), which achieved a level similar to the control group (P > 0.05). As to OQLQ questionnaire, the mean scores of all domains showed a significant increase between T0 and T1 except for awareness of dentofacial aesthetics (P > 0.05) and social aspects of dentofacial deformity (P > 0.05), followed by a significant decrease between T1 and T2. Conclusion Surgical orthodontic treatment may improve quality of life in patients with Class III malocclusion, but pre-surgical orthodontic treatment may have an adverse effect on quality of life.
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Affiliation(s)
- Jiaan Ni
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China
| | - Shaohua Song
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China
| | - Nuo Zhou
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China. .,Department of Oral and Maxillofacial Surgery, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China.
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Olkun HK, Borzabadi-Farahani A, Uçkan S. Orthognathic Surgery Treatment Need in a Turkish Adult Population: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111881. [PMID: 31141986 PMCID: PMC6603578 DOI: 10.3390/ijerph16111881] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/18/2019] [Accepted: 05/24/2019] [Indexed: 01/01/2023]
Abstract
Objectives: Limited information exists on orthognathic procedures and respective dentofacial deformities in Turkey. This retrospective study assessed the orthognathic surgery procedures in two universities, using the Index of Orthognathic Functional Treatment Need (IOFTN), and compared the IOFTN grades according to gender as well as sagittal and vertical skeletal relationships. Material and Methods: Records of 200 consecutive patients (120 females, 80 males, mean age = 23.4 (SD: 5.4) years) who received orthognathic treatment (2014–2018) were analyzed. Sagittal (ANB angle) and vertical skeletal type (GoGnSN angle), osteotomies, and IOFTN scores were recorded. Results: Class III, II, and I malocclusions formed 69%, 17.5%, and 13.5% of the samples, respectively. Class III skeletal relationships (69%) and high-angle cases (64%) were the most prevalent (p < 0.05). IOFTN scores were unevenly distributed among genders (p < 0.05) and the prevalent scores were 5.3 (40.5%), 4.3 (15.5%), 5.4 (13%), and 5.2 (7.5%), with 94% scoring 4 or 5 (great and very great functional need). Bimaxillary osteotomies were the most prevalent (55%), followed by LeFort I (32%), and 26% had genioplasty. Conclusion: IOFTN is a reliable tool to identify patients in need of orthognathic surgery. Class III malocclusions and Class III sagittal skeletal relationships were more common in this sample. Comparatively, a higher number of patients had genioplasty as a part of their treatment.
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Affiliation(s)
- Hatice Kübra Olkun
- Department of Orthodontics, School of Dentistry, İstanbul Okan University, İstanbul 34959, Turkey.
| | - Ali Borzabadi-Farahani
- Orthodontics, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00183 Rome, Italy.
- Finchley Orthodontics, North Finchley, London N12 9EN, UK.
| | - Sina Uçkan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, İstanbul Medipol University, İstanbul 34214, Turkey.
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Sharma VK, Rattan V, Rai S, Malhi P. Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study. Int J Oral Maxillofac Surg 2019; 48:1448-1455. [PMID: 31109747 DOI: 10.1016/j.ijom.2019.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/11/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient's quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P < 0.01), recreation and mood (P < 0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.
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Affiliation(s)
- V K Sharma
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - V Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Malhi
- Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh
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Gabardo M, Zielak J, Tórtora G, Gerber J, Meger M, Rebellato N, Küchler E, Scariot R. Impact of orthognathic surgery on quality of life: Predisposing clinical and genetic factors. J Craniomaxillofac Surg 2019; 47:1285-1291. [PMID: 31331851 DOI: 10.1016/j.jcms.2019.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/02/2019] [Accepted: 05/04/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Dentofacial deformities have an impact on quality of life (QOL). Many factors can influence this perception, including genetic aspects. ANKK1 and DRD2 genes are associated with dopaminergic system and could modulate behavioral dysfunction. PURPOSE The impact of orthognathic surgery and associated factors on QOL of adults was evaluated. MATERIAL AND METHODS The abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF) was applied to patients from two surgery services one week before (T0) and six months after surgery (T1). The independent variables were age, sex, race, facial pattern, presence of jaw asymmetry and vertical deformities, and polymorphisms associated with ANKK1 and DRD2 genes. Descriptive and bivariate analyses were performed. RESULTS There was improvement in the perception of QOL from T0 to T1 in the general score, in the physical and psychological domains, and in the quality of life and general health perception (QOLGHP) (p < 0.001). In this interval, individuals aged ≥30 years reported positive impacts on all outcomes (p < 0.05), whereas in women this improvement did not occur only for the physical domain (p = 0.136). There was an association between the polymorphisms associated with the ANKK1 gene (rs1800497) and the perception of QOL in the social relationship's domain (p = 0.021) and QOLGHP (p = 0.042). The other clinical conditions were not associated with outcomes (p > 0.05). CONCLUSION Perception of QOL of patients improved following orthognathic surgery in physical, psychological, and QOLGHP domains. Aged ≥30 years, being women and polymorphisms associated with the ANKK1 gene were related to positive impacts.
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Affiliation(s)
- Marilisa Gabardo
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
| | - João Zielak
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil.
| | - Gabriela Tórtora
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Jennifer Gerber
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Michelle Meger
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Nelson Rebellato
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, Avenida Prefeito Lothário Meissner 632, Curitiba, Paraná 80210-170, Brazil
| | - Erika Küchler
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
| | - Rafaela Scariot
- School of Health Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza 5300, Curitiba, Paraná, 81280-330, Brazil
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Bengtsson M, Al-Ateyah A, Wall G, Becktor J, Rasmusson L. Outcome of photographic evaluation of facial appearance in orthognathic surgery: how does it correlate with planning of treatment and patient-reported outcome? Br J Oral Maxillofac Surg 2019; 57:345-351. [DOI: 10.1016/j.bjoms.2018.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
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Bengtsson M, Wall G, Becktor J, Rasmusson L. A comparison of cost-effectiveness of computer-assisted 2-and 3-dimensional planning techniques in orthognathic surgery. Br J Oral Maxillofac Surg 2019; 57:352-358. [DOI: 10.1016/j.bjoms.2019.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
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Sun H, Shang HT, He LS, Ding MC, Su ZP, Shi YL. Assessing the Quality of Life in Patients With Dentofacial Deformities Before and After Orthognathic Surgery. J Oral Maxillofac Surg 2018; 76:2192-2201. [DOI: 10.1016/j.joms.2018.03.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 11/26/2022]
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Schilbred Eriksen E, Gulati S, Moen K, Wisth PJ, Løes S. Apnea-Hypopnea Index in Healthy Class III Patients Treated With Intraoral Vertical Ramus Osteotomy: A Prospective Cohort Study. J Oral Maxillofac Surg 2018; 77:582-590. [PMID: 30118665 DOI: 10.1016/j.joms.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The study purpose was to assess whether mandibular setback surgery by intraoral vertical ramus osteotomy (IVRO) induces obstructive apnea and hypopnea in healthy Class III patients without a history of respiratory dysfunction. We hypothesized that the apnea-hypopnea index (AHI) would not exceed 5 events per hour after surgery. PATIENTS AND METHODS A prospective cohort study was conducted. The sample was composed of healthy Class III patients without a history of obstructive sleep apnea treated with isolated mandibular setback surgery by the IVRO procedure at a university hospital. In-home respiratory sleep recordings (Nox T3; Nox Medical, Reykjavik, Iceland) and self-administered questionnaires were obtained before and at least 3 months after surgery. The AHI was the primary outcome variable. Other study variables were as follows: peripheral capillary oxygen saturation, oxygen desaturation index, snore index, body mass index, Epworth Sleepiness Scale, and Oral Impact on Daily Performance index. Descriptive and bivariate statistics were computed, and the significance level was set at .05. RESULTS The sample was composed of 8 patients. The mean age at surgery was 23.2 years (range, 18.2 to 33.4 years). The mean amount of surgical setback was 4.3 mm (range, 2.5 to 7.4 mm). The mean body mass index was 24.2 kg/m2 (standard error [SE], 1.3 kg/m2) and 23.9 kg/m2 (SE, 1.4 kg/m2) at the presurgical and postsurgical sleep recordings, respectively. The mean AHI was 1.3 events per hour (SE, 0.3; range, 0.1 to 2.5) before surgery and 1.8 events per hour (SE, 0.4; range, 0.3 to 3.3) after surgery. No statistically significant changes in AHI (P = .412), peripheral capillary oxygen saturation (P = .443), oxygen desaturation index (P = .194), snore index (P = .363), or Epworth Sleepiness Scale (P = .812) were observed. The patients' self-reported oral health-related quality of life was statistically significantly improved after surgery (P = .034). CONCLUSIONS Mandibular setback surgery with the IVRO procedure in the range of 2.5 to 7.4 mm did not induce obstructive sleep apnea, measured as an AHI above 5 events per hour, in the 8 healthy, young adult Class III patients presented in this study. More studies including larger patient samples are needed.
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Affiliation(s)
- Elisabeth Schilbred Eriksen
- Specialist in Orthodontics and PhD Student, Section for Orthodontics and Facial Orthopedics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
| | - Shashi Gulati
- Consultant Ear, Nose, and Throat Surgeon, Department of Otolaryngology, and Centre for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ketil Moen
- Oral and Maxillofacial Surgeon, Section for Oral Surgery and Oral Medicine, Department of Clinical Dentistry, University of Bergen, Bergen, Norway; and Private Practitioner, Langesund, Norway
| | - Per Johan Wisth
- Specialist in Orthodontics and Professor Emeritus, Section for Orthodontics and Facial Orthopedics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Sigbjørn Løes
- Head of Department, Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway; and Associate Professor, Section for Oral Surgery and Oral Medicine, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Bengtsson M, Wall G, Larsson P, Becktor JP, Rasmusson L. Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2- or 3-dimensional planning: A randomized double-blind active-controlled clinical trial. Am J Orthod Dentofacial Orthop 2018; 153:786-796. [PMID: 29853236 DOI: 10.1016/j.ajodo.2017.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Thorough treatment planning is essential for a good clinical outcome in orthognathic treatment. The planning is often digital. Both 2-dimensional (2D) and 3-dimensional (3D) software options are available. The aim of this randomized 2-arm parallel double-blinded active-controlled clinical trial was to compare the outcomes of computer-based 2D and 3D planning techniques according to patient-reported health related quality of life. The hypothesis was that a 3D technique would give a better treatment outcome compared with a 2D technique. METHODS Orthognathic treatment for 62 subjects, aged 18 to 28 years, with severe Class III malocclusion was planned with both 2D and 3D techniques. After treatment planning but before surgery, the patients were randomly allocated via blind collection of 1 enveloped card for each subject in a 1:1 ratio to the test (3D) or the control (2D) group. Thus, the intervention was according to which planning technique was used. The primary outcome was patient-reported outcome measures. The secondary outcome was relationship between patient-reported outcome measures and cephalometric accuracy. Questionnaires on the patient's health-related quality of life (HRQoL) were distributed preoperatively and 12 months after surgical treatment. The questionnaires were coded, meaning blinding throughout the analysis. Differences between groups were tested with the Fisher permutation test. The HRQoL was also compared with measurements of cephalometric accuracy for the 2 groups. RESULTS Three subjects were lost to clinical follow-up, leaving 57 included. Of these, 55 subjects completed the questionnaires, 28 in the 2D and 27 in the 3D groups. No statistically significant difference regarding HRQoL was found between the studied planning techniques: the Oral Health Impact Profile total showed -3.69 (95% confidence interval, -19.68 to 12.30). Consistent results on HRQoL and cephalometric accuracy showed a difference between pretreatment and posttreatment that increased in both groups but to a higher level in the 3D group. A difference between pretreatment and posttreatment HRQoL was shown for both groups, indicating increased quality of life after treatment. This supports recent findings comparing 3D and 2D planning techniques. No serious harm was observed during the study. CONCLUSIONS Improvements of HRQoL were shown after treatment independent of which planning technique, 2D or 3D, was used. No statistically significant difference was found between the planning techniques. REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement. FUNDING This project was supported by personal grants to Martin Bengtsson from the Scandinavian Association of Oral and Maxillofacial Surgeons (25000 SEK), the Southern Region of the Swedish Dental Association (50000 SEK), and the Swedish Association of Oral and Maxillofacial Surgeons (25000 SEK). The sponsors had no influence on the study design, analysis of the data, or the writing of the article.
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Affiliation(s)
- Martin Bengtsson
- Department of Oral and Maxillofacial Surgery, University Hospital of Skåne, Lund, Sweden.
| | - Gert Wall
- Department of Oral and Maxillofacial Surgery, University Hospital of Skåne, Lund, Sweden
| | - Pernilla Larsson
- Center of Oral Rehabilitation, Östergötland County Council, Linköping, Sweden; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Jonas P Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction. Int J Oral Maxillofac Surg 2018; 47:726-731. [DOI: 10.1016/j.ijom.2017.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/17/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022]
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Evaluation of the Changes in the Quality of Life in Patients Undergoing Orthognathic Surgery: A Multicenter Study. J Craniofac Surg 2018; 28:e739-e743. [PMID: 28922243 DOI: 10.1097/scs.0000000000003887] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Orthognathic surgery can affect patients' quality of life. The aim of the present study was to assess changes in quality of life during combined orthodontics-surgery treatment and effect of orthodontist-surgeon teamwork on final patient's satisfaction. Twenty-six orthognathic patients who were referred to oral and maxillofacial department of 3 hospitals in Tehran were included in the study. Orthognathic quality of life questionnaire (OQLQ) was given to patients 1 week before, 4 weeks and 4 months after surgery. Two self-designed forms were used for evaluating mood and comfort of patients 1 week before surgery and 4 days after surgery. Self-designed forms were given to the orthodontists and the maxillofacial surgeons to assess quality of teamwork and difficulty of the procedure. Twenty-four patients (15 females and 9 males) with the mean age of 22.62 ± 3.57 completed the study. Quality of life increased from 1 week before surgery to 4 months after surgery (P < 0.013) and the difference was statistically significant between OQLQ score at 1 week before surgery and that of 4 months postoperative. Esthetic and social domain showed significant changes during the studied period. Orthognathic quality of life questionnaire at 4 months postoperative was correlated with surgery difficulty and duration. It can be concluded that orthognathic surgery can improve quality of life, especially in esthetic and social aspects.
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Schilbred Eriksen E, Moen K, Wisth PJ, Løes S, Klock KS. Patient satisfaction and oral health-related quality of life 10-15 years after orthodontic-surgical treatment of mandibular prognathism. Int J Oral Maxillofac Surg 2018; 47:1015-1021. [PMID: 29426739 DOI: 10.1016/j.ijom.2018.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/06/2017] [Accepted: 01/10/2018] [Indexed: 11/19/2022]
Abstract
This study investigated 36 patients at 10-15 years after they had undergone mandibular setback surgery by intraoral vertical ramus osteotomy (IVRO) and subsequent intermaxillary fixation for 6 weeks. The patients completed a 37-item structured questionnaire to evaluate patient satisfaction and possible long-term effects of the treatment. Visual analogue scales were used to measure self-perceived changes in seven items concerning oral function and appearance. Oral health-related quality of life was assessed using the Oral Impacts on Daily Performance (OIDP) index. The main reasons for seeking treatment were to improve chewing function and appearance. The treatment had resulted in significant improvements regarding chewing function, appearance, bullying, and self-confidence in social settings (all P<0.05). All patients were either very satisfied (61%) or reasonably satisfied (39%) with the treatment result. The mean OIDP frequency score was 8.49 on a scale from 8 to 40. Seventy-four percent of the patients reported no oral impacts on quality of life. In conclusion, 10-15 years after combined orthodontic and IVRO surgical treatment of mandibular prognathism, the patients were satisfied, and oral health-related quality of life was reported to be good.
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Affiliation(s)
- E Schilbred Eriksen
- Section for Orthodontics and Facial Orthopedics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
| | - K Moen
- Section for Oral and Maxillofacial Surgery, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - P J Wisth
- Section for Orthodontics and Facial Orthopedics, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - S Løes
- Section for Oral and Maxillofacial Surgery, Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Department of Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - K S Klock
- Section for Community Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Pietilä R, Tolvanen M, Peltomäki T, Svedström-Oristo AL. Symptoms in the masticatory system and related quality of life in prospective orthognathic patients. Acta Odontol Scand 2017; 75:402-406. [PMID: 28502207 DOI: 10.1080/00016357.2017.1324637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relation between orthognathic patients' self-reported symptoms in the head and neck region and their quality of life (QoL). MATERIAL AND METHODS Participants included were consecutive patients (n = 50) referred to the assessment of orthognathic treatment need and voluntary first-year university students (n = 29). All participants filled in the Orthognathic Quality of Life Questionnaire (OQLQ) and a structured diary created by the authors. The median values of Orthognathic Quality of Life (OQOL) sum and subscores, satisfaction with oral function and number of awakenings were compared between patients and controls. Further, correlations between the OQOL sum and subscores, satisfaction with oral function and number of awakenings were analyzed. RESULTS Patients reported significantly more symptoms (p = .013) and woke up significantly more often than the controls (p = .032). Their OQOL sum scores were significantly higher (indicating a lower OQOL) (p = .001), and they were significantly less satisfied with their oral function than the controls (p < .001). Among the awakened and not-rested patients, the most commonly reported symptoms were pain in the head and/or neck region and fatigue and/or stiffness in the jaws. CONCLUSIONS Experiences of pain and discomfort have a significant impact on patients' OQOL and well-being.
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Affiliation(s)
- Riikka Pietilä
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Timo Peltomäki
- Oral and Maxillofacial Unit of Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Anna-Liisa Svedström-Oristo
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
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Kim YK. Complications associated with orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2017; 43:3-15. [PMID: 28280704 PMCID: PMC5342970 DOI: 10.5125/jkaoms.2017.43.1.3] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications.
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Affiliation(s)
- Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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