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Saeed K, Hartsfield JK, Lam R, Naoum S, Goonewardene MS. Effect of Orthognathic Surgery On Pulp Blood Flow and Pulp Sensibility: A Prospective Control Trial. J Endod 2024:S0099-2399(24)00160-2. [PMID: 38513792 DOI: 10.1016/j.joen.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Orthognathic surgery has the potential to compromise the vitality of the teeth. This paper aims to assess changes in pulp blood flow (PBF) and pulp sensibility (PS) of the anterior dentition following orthognathic surgery and to assess the influence of the proximity of the surgical osteotomy on the PBF and/or PS. METHODS Twenty-six patients undergoing orthognathic surgery (Le Fort I or bilateral sagittal split osteotomy [BSSO]) were compared to sixteen control patients treated by fixed appliances only using Laser Doppler flowmeter (LDF) and thermal testing (CO2 snow). Surgery patients were tested at T1 (presurgery), T2 (4-5 weeks postsurgery), T3 (3 months postsurgery), and T4 (6 months postsurgery). Control patients were tested at T1 (pretreatment), T2 (6 months posttreatment), T3 (12 months posttreatment), and T4 (18 months posttreatment). Differences between the maxilla and mandible were assessed. RESULTS No differences in PBF or PS were recorded in the control group. In the surgery group, both jaws followed the same pattern after surgery, an initial decrease at T2 followed by a gradual recovery to pretreatment PBF levels with no significant difference between T1 versus T4 in both jaws. No difference in PBF was observed between the maxilla and mandible at any testing time interval. CONCLUSIONS AND CLINICAL IMPLICATIONS PBF and PS of the anterior dentition was severely affected immediately postsurgery, followed by a gradual increase to full recovery. This pattern of recovery was exhibited in both jaws. A negative sensibility response or discoloration should not be seen as an indication of irreversible ischemic pulp changes. Monitoring for at least 6 months or using LDF as a confirmatory test is required before any irreversible endodontic treatment is to be considered.
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Affiliation(s)
- Kamel Saeed
- Department of Orthodontics, Dental School, The University of Western Australia Nedlands, Australia
| | - James K Hartsfield
- Department of Orthodontics, Dental School, The University of Western Australia Nedlands, Australia; Department of Orthodontics and Oral Health Research, College of Dentistry, University of Kentucky, Kentucky
| | - Raymond Lam
- Department of Orthodontics, Dental School, The University of Western Australia Nedlands, Australia
| | - Steven Naoum
- Department of Orthodontics, Dental School, The University of Western Australia Nedlands, Australia
| | - Mithran S Goonewardene
- Department of Orthodontics, Dental School, The University of Western Australia Nedlands, Australia.
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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 2023. [DOI: 10.25259/apos_230_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Brodzikowska A, Górski B, Szerszeń M, Sanz M. Efficacy of Guided Tissue Regeneration Using Frozen Radiation-Sterilized Allogenic Bone Graft as Bone Replacement Graft Compared with Deproteinized Bovine Bone Mineral in the Treatment of Periodontal Intra-Bony Defects: Randomized Controlled Trial. J Clin Med 2023; 12:jcm12041396. [PMID: 36835930 PMCID: PMC9964170 DOI: 10.3390/jcm12041396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
(1) Background: The aim of this study was to compare the clinical and radiographic outcomes of guided tissue regeneration (GTR) using two biomaterials as bone replacement grafts in the treatment of periodontal intra-bony defects. (2) Methods: Using a split-mouth design, 30 periodontal intra-bony defects were treated with either frozen radiation-sterilized allogenic bone grafts (FRSABG tests) or deproteinized bovine bone mineral (DBBM, controls) combined with a bioabsorbable collagen membrane in 15 patients. Clinical attachment level gains (CAL-G), probing pocket depth reductions (PPD-R), and radiographic changes in linear defect fill (LDF) were evaluated 12 months postoperatively. (3) Results: The CAL, PPD, and LDF values improved significantly in both groups 12 months after the surgery. However, in the test group, the PPD-R and LDF values were significantly higher compared to the controls (PPD-R 4.66 mm versus 3.57 mm, p = 0.0429; LDF 5.22 mm versus 4.33, p = 0.0478, respectively). Regression analysis showed that baseline CAL was a significant predictor for PPD-R (p = 0.0434), while the baseline radiographic angle was a predictor for CAL-G (p = 0.0026) and LDF (p = 0.064). (4) Conclusions: Both replacement grafts when used for GTR with a bioabsorbable collagen membrane yielded successful clinical benefits in teeth with deep intra-bony defects 12 months postoperatively. The use of FRSABG significantly enhanced PPD reduction and LDF.
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Affiliation(s)
- Aniela Brodzikowska
- Department of Conservative Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-501019990
| | - Bartłomiej Górski
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Marcin Szerszeń
- Department of Prosthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Mariano Sanz
- ETEP Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, University Complutense of Madrid, 28040 Madrid, Spain
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Keefe SH, Keefe MG, Hui B, Pogrel MA. Patient motivation and satisfaction from orthognathic surgery-a case series. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:e15-e24. [PMID: 36058835 DOI: 10.1016/j.oooo.2022.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study attempted to understand the specific motivations of patients who undergo orthognathic surgery and determine their satisfaction with the surgery. The study also assessed the prevalence of complications and how they may impact patient satisfaction. STUDY DESIGN Patients who underwent orthognathic surgery at the University of California between 2016 and 2019 and had completed postoperative orthodontic treatment for ≥9 months were interviewed. They responded to an open-ended telephone interview regarding their motivations, satisfaction, and complications. RESULTS The patients showed a high level of satisfaction with the surgery, but there were persistent complications that affected satisfaction. The predominant complication was paresthesia over the distribution of the inferior alveolar nerve. The majority of patients who reported prior headaches and temporomandibular joint problems described improvement in those areas. Comparing the patients' motivations before and after surgery showed that before surgery, patients reported functional concerns, whereas postoperatively they were much more likely to recall aesthetic reasons for the surgery. CONCLUSION This study showed that although patients are generally satisfied after orthognathic surgery, patients need to be realistically informed of their expectations and adequately informed of possible complications.
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Affiliation(s)
- S H Keefe
- University of North Carolina, Chapel Hill, NC, USA
| | - M G Keefe
- University of California, San Francisco, CA, USA
| | - B Hui
- University of California, San Francisco, CA, USA
| | - M A Pogrel
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, CA, USA.
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Franks SL, Bakshi A, Khambay BS. The validity of using profile predictions for class III patients planned for bimaxillary orthognathic surgery. Br J Oral Maxillofac Surg 2022; 60:507-512. [PMID: 35346522 DOI: 10.1016/j.bjoms.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
This study assessed whether preoperative class III patients could recreate their facial difference based on a profile photograph. Twenty class III pre-surgery bimaxillary orthognathic patients used CASSOS (SoftEnable Technology Ltd.) to manipulate a distorted soft tissue image of them until they felt it resembled their current soft tissue profile. Patients were able to move their upper lip and lower chin backward and forwards, as well as the lower chin up and down. Differences in the mean absolute distance between the patient-perceived position of the upper lip (Labrale superious) and chin (Pogonion) and the actual position of their upper lip and chin were measured on two occasions. Intra-patient reproducibility was found to be excellent (ICC 0.93 to 0.98). All differences were statistically significantly greater than 3mm, and would be clinically significant. Patients were better at re-creating their AP chin position rather than their AP upper lip and vertical chin positions. Approximately half of patients undergoing surgical correction of their class III skeletal pattern were unable to correctly identify their pre-surgical facial profile. Given the lack of awareness of their profile, this questions the validity of using profile planning for informed consent.
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Affiliation(s)
- Sarah L Franks
- Institute of Clinical Sciences, College of Medical and Dental Sciences, The School of Dentistry, University of Birmingham, United Kingdom
| | - Anant Bakshi
- Institute of Clinical Sciences, College of Medical and Dental Sciences, The School of Dentistry, University of Birmingham, United Kingdom
| | - Balvinder S Khambay
- Institute of Clinical Sciences, College of Medical and Dental Sciences, The School of Dentistry, University of Birmingham, United Kingdom; Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, United Kingdom.
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Basso IB, Gonçalves FM, Martins AA, Schroder AGD, Taveira KVM, Stechman-Neto J, Santos RS, Guariza-Filho O, de Araujo CM. Psychosocial changes in patients submitted to orthodontic surgery treatment: a systematic review and meta-analysis. Clin Oral Investig 2021; 26:2237-2251. [PMID: 34817686 DOI: 10.1007/s00784-021-04304-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This systematic review aims to answer the following question: What is the psychological impact of orthognathic surgery on patients with dentofacial deformities undergoing orthodontic-surgical treatment? MATERIAL AND METHODS The search was adapted for each of the following databases: American and Caribbean Center on Health Sciences (LILACS), Cochrane Library, Embase, Psychinfo, PubMed/Medline, Scopus and Web of Science, and gray literature using Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. This study performed estimates of interest, random-effects meta-analyses, and calculated heterogeneity using Higgins inconsistency index (I2). RESULTS A total of 6751 references were found in all searches. After applying the eligibility criteria after full-text reading, 37 studies comprised the final qualitative synthesis. Thirteen studies were included in quantitative synthesis, and it was possible to meta-analyze data from the following questionnaires: GHQ-28, MMPI, RSES, and SCL-90-R. There was an improvement in psychological aspects related to depression, hysteria, self-esteem, anxiety, obsessive-compulsiveness, interpersonal sensitivity, paranoid ideas, and psychoticism (p < 0.05). CONCLUSIONS Correction of dentofacial deformity through orthodontic-surgical treatment is associated with improvements observed in several psychological domains, especially in relation to depressive states. CLINICAL RELEVANCE This result highlights the importance of surgeons and orthodontists in promoting adequate control of patients' expectations and treatment goals taking into account the individual's psychological aspects.
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Affiliation(s)
- Isabela Bittencourt Basso
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica Do Paraná, Curitiba, Paraná, Brazil
| | - Flavio Magno Gonçalves
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Agnes Andrade Martins
- Undergraduate Department of Dentistry, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Karinna Veríssimo Meira Taveira
- Speech-Language Pathologist, Department of Morphology-Center of Biosciences, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil
| | - Odilon Guariza-Filho
- Department of Orthodontics, Pontifícia Universidade Católica Do Paraná, Curitiba, Paraná, Brazil
| | - Cristiano Miranda de Araujo
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Street Sydnei Antonio Rangel Santos, 238 - Santo Inacio, Curitiba, Brazil.
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Stefanini M, Tavelli L, Barootchi S, Sangiorgi M, Zucchelli G. Patient-reported outcome measures following soft-tissue grafting at implant sites: A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:157-173. [PMID: 34642984 DOI: 10.1111/clr.13767] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/08/2021] [Accepted: 04/24/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To review the available literature on patient-reported outcome measures (PROMs) following soft tissue augmentation at implant sites. MATERIALS AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies that involved soft tissue augmentation around dental implants and reported PROMs, including post-operative morbidity, painkillers intake, quality of life, aesthetics and satisfactions. RESULTS Nineteen articles were included in the qualitative analysis. Autogenous grafts (free gingival graft and connective tissue graft), acellular dermal matrix and xenogeneic collagen matrix were utilized, either with a bilaminar- or an apically positioned flap approach. PROMs reported in the literature included perceived hardship of the procedure and pain during the surgery, post-operative morbidity, painkillers intake, number of days with discomfort, satisfaction, aesthetic evaluation, quality of life and willingness to undergo the treatment again. Most of the included studies showed similar PROMs between autogenous grafts and substitutes, in terms of post-operative morbidity, painkillers intake, quality of life, aesthetic assessment and satisfaction. Nevertheless, a trend towards lower post-operative discomfort was observed for graft substitutes. High scores for patient satisfaction and aesthetic evaluation were observed in all the interventions compared to non-grafted sites. CONCLUSIONS PROMs represent a crucial endpoint of clinical studies evaluating the outcomes of soft tissue grafts at implant sites. Most of the studies did not find significant differences in terms of patient morbidity and painkillers between autogenous grafts and substitutes. Soft tissue grafting can enhance patient satisfaction and aesthetic evaluation compared to non-grafted sites.
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Affiliation(s)
- Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Matteo Sangiorgi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Zucchelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Grillo R. Orthognathic Surgery: A Bibliometric Analysis of the Top 100 Cited Articles. J Oral Maxillofac Surg 2021; 79:2339-2349. [PMID: 34245705 DOI: 10.1016/j.joms.2021.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE An increasing number of articles on orthognathic surgery are published every year. This paper aims to provide a list of the top 100 cited articles on orthognathic surgery to help any professional level with interest in this topic and to map the trends of orthognathic surgery publications over time. METHODS A bibliographic search (retrospective study) following STROBE guidelines was performed on Google Scholar (GS) and Dimensions with the term "orthognathic surgery" in the title, abstract, and keywords. The number of citations, citations per year, authors, and publication year were evaluated. A ranking was created in GS citations order with the top 100 cited articles and variables discussed individually. A graphical illustration of keywords was created using VOSviewer. These steps are fundamental in creating this list and relating it to all published articles on the topic. RESULTS A helpful list of the top 100 articles was developed to help professionals in entirely different manners. Virtual planning and complications in orthognathic surgery were the most cited topics, with a 95% confidence interval (P < .05). Some curiosities are discussed, such as increasing interest in surgery first and the relation between airway/obstructive sleep apnea and orthognathic surgery. CONCLUSIONS Bibliometric and altmetric analysis for free using Google Scholar and Dimensions is laborious but possible. Bibliometrics is a powerful tool to become actualized at any health professional level, from students to academics; and could save considerable effort and time for parties interested in the topic. Appropriate keywords are a crucial step to wider article dissemination.
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Affiliation(s)
- Ricardo Grillo
- Assistant Professor, Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil.
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Ploumen RLM, Duininck JM, Jonkman REG, Nolte JW, Becking AG. The Orthognathic Quality of Life Questionnaire: Translation and Validation into Dutch. J Craniofac Surg 2021; 32:1448-51. [PMID: 33252530 DOI: 10.1097/SCS.0000000000007281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this study is to translate and validate the Orthognathic Quality of Life Questionnaire (OQLQ) in the Dutch language (OQLQ-NL). METHODS The translation of the OQLQ into the Dutch language was performed following the guidelines for the Process of Cross-Cultural Adaption of Self-Report Measures. Sixty-two patients who received orthognathic surgery in the past 10 years were included for participation. Internal reliabilities of the OQLQ-NL were evaluated for multiple item scales with the use of the Cronbach alpha coefficient. For the establishment of the test-retest reliability, the OQLQ-NL was repeated with a 2-week interval and the intraclass correlation coefficient was calculated. Spearman correlation was used to test the correlation with the OHIP-49NL and the FACE-Q, to be able to evaluate the construct validity of the OQLQ-NL. RESULTS Thirty-five patients filled in the OQLQ-NL, OHIP49NL, and FACE-Q upon arrival and 22 patients returned the OQLQ-NL after 2 weeks (response rate of 56.6% and 62.9%, respectively). The OQLQ-NL showed excellent results in internal reliability and test-retest reliability. The vast majority of the correlations between the domains of the questionnaires were as expected. Data from this study and previous studies confirm the construct validity of the OQLQ-NL. CONCLUSION The OQLQ-NL appears to be a valid and reliable instrument to measure quality of life for patients receiving orthognathic surgery in the Netherlands.
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Abstract
BACKGROUND AND OBJECTIVES High-angle Class II malocclusion is considered challenging to treat to a stable result and, although studies report treatment outcome in terms of morphology, patient satisfaction has not been addressed. The objectives of the present study were to examine patients' motives for treatment and satisfaction with the results. MATERIAL AND METHODS A structured questionnaire was distributed 3 years post-operatively to 93 consecutively treated patients with an initial diagnosis of mandibular-plane angle (ML/NSL) ≥34.0 degrees and ANB angle ≥4.0 degrees. Three surgical subsamples were defined: one-piece Le Fort I, bilateral sagittal split osteotomy, or a combination of the two (Bimax). Lateral cephalometric radiographs were used to assess morphological characteristics and post-treatment changes. RESULTS Questionnaire participation was 69.8 per cent. The most frequently reported motives for seeking treatment were to improve oral function (85.0 per cent) and dental appearance (71.7 per cent). Thirty per cent were very satisfied, 53.3 per cent were satisfied, and 16.7 per cent were dissatisfied with the overall treatment result. Dissatisfaction was associated with a persisting post-treatment anterior open bite (AOB), horizontal relapse at B point, and with sensory impairment. CONCLUSIONS AND IMPLICATIONS A higher rate of dissatisfaction was found than what has usually been reported for othognathic surgical patients, and this was associated with a persisting AOB. In addition, mandibular relapse and impaired sensory function were related to dissatisfaction and are associated with mandibular surgery. Prospective high-angle Class II patients should be comprehensively informed about the unpredictability of treatment outcomes in terms of occlusion and facial appearance.
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Affiliation(s)
- Nina Torgersbråten
- Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Arild Stenvik
- Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Lisen Espeland
- Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Lancaster L, Salaita RD, Swamy C, Shanker S, Kennedy KS, Beck FM, Johnston WM, Firestone AR. Effects of orthognathic surgery on quality of life compared with nonsurgical controls in an American population. Am J Orthod Dentofacial Orthop 2020; 158:555-63. [DOI: 10.1016/j.ajodo.2019.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 01/07/2023]
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12
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Omara M, Stamm T, Bekes K. Four-dimensional oral health-related quality of life impact in children: A systematic review. J Oral Rehabil 2020; 48:293-304. [PMID: 32757443 PMCID: PMC7984176 DOI: 10.1111/joor.13066] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 06/08/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Abstract
Oral health‐related quality of life (OHRQoL) is an important dental patient‐reported outcome which is commonly based on 4 dimensions, namely Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact. The Oral Health Impact Profile (OHIP) is the most used OHRQoL instrument designed for adults; nevertheless, it is used off‐label for children as well. Our aim was to describe the OHRQoL impact on children measured by OHIP and map the information to the 4‐dimensions framework of OHRQoL. A systematic literature review following the PRISMA statement was conducted to include studies assessing OHRQoL of children ≤ 18 years using OHIP. The OHIP seven‐domain information was converted to the OHRQoL 4‐dimension scores accompanied by their means and 95% confidence interval. Risk of bias was assessed using a six‐item modified version of quality assessment tool for prevalence studies. We identified 647 articles, after abstracts screening, 111 articles were reviewed in full text. Twelve articles were included, and their information was mapped to the 4‐dimensional OHRQoL. Most included studies had low risk of bias. OHRQoL highest impact was observed for Oral Function, Orofacial Pain, and Orofacial Appearance for children with: Decayed‐Missing‐Filled‐Surface (DMFS) of ≥10, anterior tooth extraction without replacement and untreated fractured anterior teeth, respectively. Across all oral health conditions, Psychosocial Impact was less affected than the other three dimensions. OHIP has been applied to a considerable number of children and adolescents within the literature. One instrument and a standardised set of 4‐OHRQoL dimensions across the entire lifespan seem to be a promising measurement approach in dental and oral medicine.
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Affiliation(s)
- Maisa Omara
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Katrin Bekes
- Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Austria
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Abstract
OBJECTIVE It has been reported that temporomandibular joint (TMJ) function after orthognathic surgery differs from normal patients. Dysfunction of the joints occurs often even in the general public, with an incidence in the range of 20%-25%. Population-based studies among adults report that approximately 10%-15% have symptoms of pain and 5% of them had a perceived need for treatment. To date, no studies have reported on the evaluation of TMJ function after orthognathic surgery through the use of four-dimensional jaw tracking. DESIGN AND SETTING This study evaluated TMJ function using such a device and information from a TMJ questionnaire. Sixteen orthognathic surgery patients and 17 controls were included in this study. Four-dimensional jaw tracking information was obtained using the SiCAT JMT device. Clinical signs and jaw function were evaluated. RESULTS Within the limitations of the study, the following results were seen using the SICAT JMT+ jaw tracking device: (1) no significant differences were found in any of the millimetric measurements between the surgery patients and controls; (2) no significant difference was found in subjective reported symptoms of pain, clicking, crepitation, locking, stiffness, headaches and migraines between the groups; and (3)there was a significant difference in the popping of the joints for surgery and non-surgery groups. CONCLUSION Jaw tracking did not detect significant differences in jaw function, but some clinical symptoms were present.
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Affiliation(s)
- Katarina Aslanidou
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Rongbing Xie
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Terpsithea Christou
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Ejvis Lamani
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
| | - Chung H Kau
- Department of Orthodontics, University of Alabama Birmingham, Birmingham, AL, USA
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Dalaie K, Behnaz M, Khodabakhshi Z, Hosseinpour S. Impact of malocclusion severity on oral health-related quality of life in an Iranian young adult population. Eur J Dent 2019; 12:129-135. [PMID: 29657538 PMCID: PMC5883465 DOI: 10.4103/ejd.ejd_61_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: This study aimed to assess the relationship between malocclusion severity and oral health-related quality of life (QoL) of 18 to 25-year-old Iranians who sought orthodontic treatment. Materials and Methods: A total of 126 patients between 18 and 25 years attending some private orthodontic clinics answered the oral health impact profile-14 (OHIP-14) and a demographic questionnaire. Two calibrated orthodontists recorded the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) determining the severity of malocclusion (Kappa = 0.8). The IOTN-Aesthetic Component (IOTN-AC) was reported by patients for assessing the perception of their esthetic severity of malocclusion. Logistic regression analysis was used. Level of significance was set at α = 0.05. Results: The mean score of OHIP-14 was 20.87 ± 8.6. The frequency of patients with no/slight, borderline, and definite need for orthodontic treatment was determined as 13.4%, 23.8%, and 62.7%, respectively, by IOTN-DHC. There were significant correlations between borderline or definite need treatment and OHIP-14 overall score (P < 0.05). Patients with borderline and definite need for orthodontic treatment had 5 and 21 times lower QoL, respectively, than those with a slight need for orthodontic treatment. Based on IOTN-AC, 50.8% of the patients mentioned slight or no need based on IOTN-AC. No significant association was noted between IOTN-AC and OHIP-14 overall scores. Conclusions: The results showed negative impact of malocclusion severity on the QoL. This study highlighted the importance of individual assessment of orthodontic patients.
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Affiliation(s)
- Kazem Dalaie
- Dental Research Center, Research Institute of Dental Research, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Behnaz
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sepanta Hosseinpour
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Huang X, Cen X, Sun W, Xia K, Yu L, Liu J, Zhao Z. The impact of surgery-first approach on the oral health-related quality of life: a systematic review and meta-analysis. BMC Oral Health 2019; 19:136. [PMID: 31286944 PMCID: PMC6615189 DOI: 10.1186/s12903-019-0842-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/01/2019] [Indexed: 02/05/2023] Open
Abstract
Background The oral health-related quality of life (OHRQoL) is affected by dentofacial deformity. Patients with dentofacial deformity are normally treated with orthognathic surgery, including conventional three-stage method (CTM) and surgery first approach (SFA). The aim of this systematic review and meta-analysis was to compare the impact of SFA with CTM on the OHRQoL of patients with severe dentofacial deformity. Methods Five English databases, three Chinese databases, and six grey literature databases were searched (January 2000 to July 2018). Randomized controlled trials, controlled clinical trials, and cohort studies assessing the OHRQoL of patients who underwent SFA or CTM were included. After selecting studies, extracting data, and assessing risk-of-bias according to the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa Scale, meta-analysis was performed to elucidate the effects of SFA on the changes of OHRQoL of patients with dentofacial deformity at each stage and made a comparison with CTM. Results There were 4 studies with 122 participants were selected for the final analysis. Three among these studies were included in meta-analysis, 2 of which were included in each forest plot. All the included studies were graded as moderate value of evidence according to GRADE quality analysis. Over the period of 2-year follow-up after bonding, the OHRQoL of the patients in SFA group showed an improving trend and was better than those in CTM group generally. After debonding, the summary scores of the 14-item Oral Health Impact Profile (OHIP-14) (− 2.92, P = 0.12) and Orthognathic Quality of Life Questionnaire (OQLQ) (− 5.59, P = 0.01) were smaller in SFA group than CTM group. Conclusions Clinical evidence indicates that SFA can contribute to the better OHRQoL in patients with dentofacial deformity immediately and persistently.
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Affiliation(s)
- Xinqi Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xiao Cen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Temporomandibular joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Wentian Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Kai Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Liyuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China. .,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China. .,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China.
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16
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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17
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Agırnaslıgıl MO, Gul Amuk N, Kılıc E, Kutuk N, Demırbas AE, Alkan A. The changes of self-esteem, sensitivity to criticism, and social appearance anxiety in orthognathic surgery patients: A controlled study. Am J Orthod Dentofacial Orthop 2019; 155:482-489.e2. [DOI: 10.1016/j.ajodo.2018.05.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 12/16/2022]
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18
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Tachiki C, Nishii Y, Takaki T, Sueishi K. Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study. Bull Tokyo Dent Coll 2019; 59:1-14. [PMID: 29563357 DOI: 10.2209/tdcpublication.2016-0042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (p<0.01), and between at pre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (p<0.05, p<0.01). A significant correlation was observed between a negative change in overjet and worsening OQLQ scores at the pre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre-surgical orthodontic treatment.
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Affiliation(s)
- Chie Tachiki
- Department of Orthodontics, Tokyo Dental College
| | | | - Takashi Takaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
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19
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Selvaraj AK, Benington PCM, Murphy L, Ayoub AF. Psychology input to an orthognathic clinic: Patients' perception of service quality. Surgeon 2019; 17:340-345. [PMID: 30661952 DOI: 10.1016/j.surge.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/24/2018] [Accepted: 11/20/2018] [Indexed: 11/17/2022]
Abstract
AIMS The aim of this study was to assess patient satisfaction with a clinical psychology service, integrated within an inter-disciplinary orthognathic planning clinic. METHOD A self-report, custom-designed questionnaire was sent to patients who had completed orthognathic treatment within the last three years. Of the 60 patients approached, 49 responded. RESULTS The great majority of patients agreed that there was a need for a psychological assessment and that its purpose was adequately explained. Most patients were happy with the information given during their appointment and found the experience helpful. A number of patients felt that additional appointments would have been helpful shortly before, and after, surgery. CONCLUSIONS The group of orthognathic patients studied found the pre-treatment psychology assessment, provided for them through the combined clinic, to be very acceptable and beneficial. Some suggested that further appointments, throughout the treatment journey, as well as supportive literature, might also have been helpful.
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20
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Zaoui K, Kuehle R, Baumann I, Schuessler DL, Ristow O, Plath M, Freudlsperger C. Impact of Le-Fort I osteotomy on anatomical and functional aspects of the nasal airway and on quality of life. Eur Arch Otorhinolaryngol 2019; 276:1065-73. [PMID: 30643961 DOI: 10.1007/s00405-018-05277-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Orthognathic surgery is a well-established procedure for skeletal deformities. Beneficial influences to the posterior airway space (PAS) have been described, but little is known about the subjective aesthetical and functional nasal aspects after orthognathic surgery. The aim of this study was to evaluate nasal airflow by anterior rhinomanometry and volumetric changes in the nasal airway space after mono- or bimaxillary surgery using cone-beam computed tomography (CBCT) and a new segmentation software. Furthermore, changes of patient's quality of life (QoL) should be assessed. METHODS Ten patients (9 skeletal class malformation III, 1 skeletal class malformation I) were included. CBCT images, rhinological inspections and anterior rhinomanometries were performed before (T0) and after surgery (T1). All patients completed the FROI-17, the ROE and the SF-36 questionnaires. RESULTS A significant postoperative gain for nasal airway volume compared with the baseline was shown (p < 0.014). No statistically significant differences between pre- and postoperative flow rates were found (p = 0.114). Pre- and postoperative cohorts did not differ in responses of disease-specific (ROE and FROI-17) and generic QoL questionnaires (SF-36). CONCLUSION Maxillary relocation surgery leads to a significant increase in nasal airway space. Subjectively, orthognathic patients did not experience any functional but psychosocial aspects after bimaxillary surgery.
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21
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Sánchez-Burgos R, Martínez-Gimeno C, Arribas-García I, Gómez-Oliveira G, Álvarez-Florez M, García-Hernández A, Martínez-Martínez R. Transcultural adaptation and validation of the Spanish language version of the questionnaire OQLQ for the assessment of quality of life in orthognathic patients. J Clin Exp Dent 2018; 10:e1184-e1191. [PMID: 30697377 PMCID: PMC6343974 DOI: 10.4317/jced.55366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 11/05/2022] Open
Abstract
Background Orthognathic surgery is the cornerstone of the treatment of dentofacial deformities, which have a great psychological and social impact on the life of the patient. Patient satisfaction and the impact on quality of life have recently become clinical parameters of growing importance. The aim of this study was to undertake a transcultural adaptation, translation to Spanish and validation of this version of the questionnaire OQLQ, used to measure quality of life in the context of Spanish culture. Material and Methods Validation of the OQLQ questionnaire to the Spanish language was carried out through the methodology of translation and back translation, conceptual equivalence and piloting. The Spanish version was applied through a cross-sectional study to a total of 50 patients undergoing orthognathic surgery. Results The adapted and validated version showed adequate metric properties of reliability, change sensitivity and validity. In this study, a positive impact of orthognathic surgery on the specific quality of life was evident in 96% of patients, with an average improvement of 58% with respect to the initial score. Conclusions Dentofacial deformities have a marked negative impact on the lives of patients, with orthognathic surgery being a therapeutic tool of great value in improving the quality of life in social, functional and aesthetic terms. The pilot test of this Spanish language version of the OQLQ proved valid for the assessment of quality of life in Spanish-speaking orthognathic patients or those with a Spanish culture. Key words:Orthognathic surgery, quality of life, validation studies, dentofacial deformities, patient satisfaction, treatment outcome.
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Górski B, Jalowski S, Górska R, Zaremba M. Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: subtraction radiography outcomes, prognostic variables, and patient morbidity. Clin Oral Investig 2019; 23:3005-20. [PMID: 30374832 DOI: 10.1007/s00784-018-2712-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
Abstract
Objectives The main objectives of this study were (1) to evaluate bone/graft density alterations by digital subtraction radiography; (2) to determine factors associated with favorable clinical and radiographic outcomes, and (3) to report on patient morbidity after guided tissue regeneration (GTR) in aggressive periodontitis (AgP) patients. Materials and methods Adapting a split-mouth design, 30 comparative intrabony defects in 15 patients were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). The time period of observation was 12 months. Results There were significant improvements in clinical and radiographic parameters within each group, without intergroup differences. However, higher PPD reduction for three-wall defects was noted in MPM sites (5.22 versus 3.62 mm; p = 0.033). Moreover, a significant gain in bone/graft density of 4.9% from 6 to 12 months post-operatively was observed in test sites. Multivariate analysis demonstrated that morphology of intrabony defects was a predictor of CAL gain (p = 0.06), while independent prognostic variables effecting changes in bone/graft density were radiographic defect depth (p = 0.025) and radiographic angle (p = 0.033). The majority of patients reported some discomfort, pain, and edema with mild intensity without any significant differences between treatment modalities. Conclusions This study demonstrated enhanced bone/graft density gain after GTR with MPM, which may indicate greater area of new bone formation. Independent variables effecting treatment outcomes were intrabony defect morphology, radiographic defect depth, and radiographic angle. Clinical relevance This study supports the regenerative treatment of intrabony defects in AgP patients and identifies some variables with prognostic value.
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Pithon MM, Rocha MFN, da Silva Coqueiro R, de Andrade ACDV. Impact of Orthognathic Correction of Class II Malocclusion on the Perception of Social Characteristics. Turk J Orthod 2018; 30:69-72. [PMID: 30112495 DOI: 10.5152/turkjorthod.2017.16024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/16/2017] [Indexed: 11/22/2022]
Abstract
Objective To evaluate the influence on the perception of social characteristics after orthognathic treatment for the correction of Class II malocclusion. Methods A cross-sectional study was conducted with the participation of 240 observers who evaluated images of individuals before and after orthognathic surgery for the correction of malocclusion. Based on the images, two different questionnaires were applied containing 44 questions each for evaluating social competence, intellectual ability, psychological adjustment, and attractiveness. The mean scores for evaluations of the images were compared using the Mann-Whitney U test at 5% level of significance (α=0.05). Results Orthognathic treatment significantly (p<0.05) improved the evaluation of individuals in the requisites of the score attributed to the image (p=0.008), extroversion (p=0.026), happiness (p=0.006), self-confidence (p=0.046), and attractiveness (p=0.015). Conclusion Orthognathic treatment for the correction of Class II malocclusions has a positive effect on the perception of social characteristics of individuals. The individuals subjected to orthognathic surgery were evaluated as being more attractive, intelligent, socially competent, and psychologically adjusted.
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Foletti JM, Antonarakis GS, Vanden Eynden X, Courvoisier DS, Scolozzi P. Is Preoperative Maintenance of the Curve of Spee Associated With an Increase of Facial Height in Class II Short Face Orthognathic Patients? A Never Answered Dogmatic Question. J Oral Maxillofac Surg 2018; 76:2638-2645. [PMID: 29957237 DOI: 10.1016/j.joms.2018.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the association of maintaining the curve of Spee (COS) before surgery with post-treatment facial height in patients with Class II short face syndrome undergoing combined orthodontic and orthognathic treatment. MATERIALS AND METHODS In this retrospective cohort study, the clinical and radiologic data of all patients with Class II short face syndrome who underwent combined orthodontic and orthognathic treatment were reviewed. The primary outcome variables were 1) preoperative COS and 2) post-treatment facial height. Depth of the COS and skeletal and soft tissue relations were measured on digital lateral cephalometric radiographs. Descriptive and bivariate statistics were performed. RESULTS The sample was composed of 20 patients. Statistical analysis showed a significant increase of soft tissue facial height after treatment (P < .02). Preoperative depth of the COS was significantly associated with changes in sagittal skeletal relations (angle formed by the sella, nasion, and B point [SNB], correlation [cor] = -0.54, P < .02; angle formed by the A point, nasion, and B point [ANB], cor = 0.43, P < .06). These changes and changes in overjet were associated with the post-treatment increase of lower facial height (SNB, cor = 0.70, P < .001; ANB, cor = -0.69, P < .001; overjet, cor = -0.55, P < .049). The ratios of upper to lower soft tissue facial height and upper to lower lip height were improved to near normal values (1.0 and 0.5, respectively) for most patients. CONCLUSION In patients with Class II short face orthognathism, the present study found that maintaining the COS before surgery was associated with 1) an increase of soft tissue facial height and 2) an improvement of the ratio of upper to lower facial height and the ratio of upper to lower lip height to near normal values. Moreover, the depth of the COS was correlated with the post-treatment increase of facial height through changes in skeletal relations and was related to the degree of severity of the mandibular deficiency.
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Affiliation(s)
- Jean-Marc Foletti
- Fellow, Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Gregory S Antonarakis
- Orthodontist, Division of Orthodontics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Xavier Vanden Eynden
- Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Biostatistician, Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
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Affiliation(s)
- Angel Insua
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
- Department of Oral Surgery and Stomatology, ZMK Bern, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Marita Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Kavvadia S, Sidiropoulou-Chatzigianni S, Pappa G, Markovitsi E, Kaklamanos EG. Soft Tissue Characteristics and Gender Dimorphism in Class III Malocclusion: a Cephalometric Study in Adult Greeks. Balkan Journal of Dental Medicine 2017. [DOI: 10.1515/bjdm-2017-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background/Aim: Class III malocclusion case are considered complex problems associated with unacceptable esthetics. The purpose of the present study was to assess the characteristics of the soft tissue profile and investigate the possible gender differences in adult Greeks with Class III malocclusion. Material and Methods: The material of the study comprised of 57 pretreatment lateral cephalograms of adult patients with Class III malocclusion aged 18 to 39 years. Eleven variables were assessed. The variables were measured and the mean, minimum and maximum and standard deviations were calculated. Parametric and non-parametric tests were used to compare males and females patients. Results: The total sample was characterized by concave skeletal profile. Male patients exhibited greater nose prominence and superior sulcus depth, longer distance from subnasale to the harmony line, more concave profile, thicker upper lip and larger upper lip strain. Conclusions: Many significant differences were noted in soft tissue characteristics between males and females with skeletal Class III malocclusion, suggesting possible gender dimorphism.
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Affiliation(s)
- Smaragda Kavvadia
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences Aristotle University of Thessaloniki, Thessalonki , Greece
| | - Sossani Sidiropoulou-Chatzigianni
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences Aristotle University of Thessaloniki, Thessalonki , Greece
| | | | - Eleni Markovitsi
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences Aristotle University of Thessaloniki, Thessalonki , Greece
| | - Eleftherios G. Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid, University of Medicine and Health Sciences, Dubai , United Arab Emirates
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Feu D, de Oliveira BH, Palomares NB, Celeste RK, Miguel JAM. Oral health-related quality of life changes in patients with severe Class III malocclusion treated with the 2-jaw surgery-first approach. Am J Orthod Dentofacial Orthop 2017; 151:1048-1057. [PMID: 28554450 DOI: 10.1016/j.ajodo.2016.10.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In this nonrandomized prospective study, we compared the effects of the surgery-first approach with conventional 2-jaw orthognathic surgery on skeletal Class III patients' oral health-related quality of life (OHRQoL), quality of the orthodontic outcome, and average treatment duration. METHODS The sample consisted of 16 patients with severe skeletal Class III malocclusion, who needed 2-jaw orthognathic surgery: 8 were treated with the surgery-first approach, and 8 were treated with the traditional orthodontic-surgical approach. OHRQoL was assessed by using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Oral Health Impact Profile-short version (OHIP-14). Malocclusion severity and esthetic self-perception were assessed with the Index of Orthodontic Treatment Need. Dental health status was determined using the Decayed, Missing and Filled Teeth Index. Tests were repeated at 7 times: baseline, 1 month after appliance placement, and 3 months, 6 months, 1 year, and 2 years after the beginning of the treatment; and for both groups, there was an also evaluation stage after the orthognathic surgery. RESULTS After 2 years, the surgery-first group showed a significant decrease in malocclusion severity (P <0.001) and had significant reductions in OQLQ (P <0.001) and OHIP-14 scores (P <0.001). These changes began after the orthognathic surgery and were progressive throughout the evaluation periods. In the traditional orthodontic-surgical approach group, after 2 years of monitoring, all patients were still in the preoperative orthodontic preparation phase, and their malocclusion severity increased significantly, thereby resulting in a not statistically significant worsening of their OHRQoL (OHIP-14, P = 0.89; OQLQ, P = 0.11). CONCLUSIONS OHRQoL improved significantly in a linear trend of progressive improvements in all severe Class III patients who had the surgery-first approach after the surgical procedure through 2 years of follow-up, as their malocclusion and esthetic self-perception also improved.
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Affiliation(s)
- Daniela Feu
- Department of Orthodontics, Vila Velha University, Vila Velha, Espirito Santo, Brazil.
| | - Branca Heloísa de Oliveira
- Department of Preventive and Community Dentistry, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nathalia Barbosa Palomares
- Department of Preventive and Community Dentistry, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - José Augusto Mendes Miguel
- Department of Preventive and Community Dentistry, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
OBJECTIVE The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. MATERIAL AND METHODS The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. RESULTS Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p < .001, linear regression). CONCLUSIONS Tooth extractions (excluding 3rd molars) included in pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.
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Affiliation(s)
- Jaakko Paunonen
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Mika Helminen
- Science Center, Pirkanmaa Hospital District and Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Timo Peltomäki
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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Mohanty P, Acharya SS, Sahoo N, Sah S, Sahu SK. The Comparison of Patient Satisfaction after “Surgery First” and Conventional Orthognathic Surgery: An Original Research. APOS 2017. [DOI: 10.4103/apos.apos_18_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims and Objectives
We evaluated the factors which affect patient satisfaction and their expectations toward “surgery first” and conventional orthognathic surgery.
Materials and Methods
Questionnaires consisting of 17 questions were given to the subjects postoperatively who had undergone Le fort 1 maxillary superior impaction for skeletal gummy smile correction with conventional orthognathic surgery and “surgery first” approach. Eleven-point rating scale based on a (visual analog scale; 0 = poor; 10 = excellent) were used to answer six questions. Ten closed-form questions were also included as well as one open question for “further remarks.”
Results
Nineteen patients (12 females, 07 males; mean age, 23.4 ± 4.9 [standard deviation] years) gave their consent to participate in the study. The intention to undergo surgery only for esthetics was noted in 42.11% of patients; only improvement of chewing function in 21.05% and both in 36.84%.
Conclusion
The most common factor for patient satisfaction after “surgery first” and conventional orthognathic surgery was facial esthetics, but masticatory function and even psychological aspects should be considered equally when planning surgery. The patient satisfaction was more in “surgery first” than conventional orthognathic surgery. The timing of treatment and immediate results are important factors toward patient satisfaction.
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Affiliation(s)
- Pritam Mohanty
- Department of Orthodontics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Swati Saraswata Acharya
- Department of Orthodontics, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
| | - Nivedita Sahoo
- Department of Orthodontics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Sushila Sah
- Department of Orthodontics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Sanjeeb Kumar Sahu
- Department of Orthodontics, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
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Crerand CE, Sarwer DB, Kazak AE, Clarke A, DPsych, Rumsey N. Body Image and Quality of Life in Adolescents With Craniofacial Conditions. Cleft Palate Craniofac J 2017; 54:2-12. [PMID: 26751907 PMCID: PMC5603909 DOI: 10.1597/15-167] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate body image in adolescents with and without craniofacial conditions and to examine relationships between body image and quality of life. DESIGN Case-control design. SETTING A pediatric hospital's craniofacial center and primary care practices. PARTICIPANTS Seventy adolescents with visible craniofacial conditions and a demographically matched sample of 42 adolescents without craniofacial conditions. MAIN OUTCOME MEASURE Adolescents completed measures of quality of life and body image including satisfaction with weight, facial and overall appearance, investment in appearance (importance of appearance to self-worth), and body image disturbance (appearance-related distress and impairment in functioning). RESULTS Adolescents with craniofacial conditions reported lower appearance investment (P < .001) and were more likely to report concerns about facial features (P < .02) compared with nonaffected youth. Females in both groups reported greater investment in appearance, greater body image disturbance, and lower weight satisfaction compared with males (P < .01). Within both groups, greater body image disturbance was associated with lower quality of life (P < .01). The two groups did not differ significantly on measures of quality of life, body image disturbance, or satisfaction with appearance. CONCLUSIONS Body image and quality of life in adolescents with craniofacial conditions are similar to nonaffected youth. Relationships between body image and quality of life emphasize that appearance perceptions are important to adolescents' well-being regardless of whether they have a facial disfigurement. Investment in one's appearance may explain variations in body image satisfaction and serve as an intervention target, particularly for females.
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Affiliation(s)
- Canice E. Crerand
- Assistant Professor of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine and Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, OH
| | - David B. Sarwer
- Professor of Psychology, Departments of Psychiatry and Surgery, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Anne E. Kazak
- Professor of Pediatrics and Psychology, Sidney Kimmel Medical College of Thomas Jefferson University and Nemours Children’s Health System; Wilmington, DE
| | | | - DPsych
- Visiting Professor, Center for Appearance Research, University of the West of England; Bristol, United Kingdom
| | - Nichola Rumsey
- Professor and Co-Director, Center for Appearance Research, Department of Psychology, University of the West of England, Bristol, United Kingdom
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Palomares NB, Celeste RK, Miguel JAM. Impact of orthosurgical treatment phases on oral health-related quality of life. Am J Orthod Dentofacial Orthop 2016; 149:171-81. [PMID: 26827973 DOI: 10.1016/j.ajodo.2015.07.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 01/22/2023]
Abstract
INTRODUCTION In this cross-sectional study, we investigated the impact of the orthosurgical treatment phases on the oral health-related and condition-specific quality of life (QoL) of patients with dentofacial deformities. METHODS Two hundred fifty-four orthognathic patients were allocated into 4 groups according to treatment phase: initial (not yet treated), presurgical orthodontics, postsurgical orthodontics, and retention. Data were collected using the Oral Health Impact Profile to evaluate the oral health-related QoL, the Orthognathic QoL Questionnaire to analyze the condition-specific QoL, and the Index of Orthodontic Treatment Need to assess malocclusion severity and esthetic impairment. Specific malocclusion characteristics were also documented. RESULTS A negative binomial regression analysis showed that the initial group had a more negative oral health-related QoL than did the postsurgical, presurgical, and retention groups (relative risks, 1, 0.79, 0.74 and 0.25, respectively). The initial group had a more negative condition-specific QoL than did the presurgical, postsurgical, and retention groups (relative risks, 1, 0.77, 0.38 and 0.15, respectively) regardless of age, income, or education; women reported greater negative impacts than men. Certain occlusal traits were related to higher Orthognathic QoL Questionnaire scores (P <0.01). CONCLUSIONS Patients who completed their orthosurgical treatment had a significantly better oral health-related QoL and a more positive esthetic self-perception than did those undergoing treatment and those who were untreated. Crowding, crossbite, open bite, concave profile, edge-to-edge overjet, or Class III malocclusion negatively affected oral health-related QoL.
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Affiliation(s)
- Nathália Barbosa Palomares
- Postgraduate student, Clinic of Orthodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Roger Keller Celeste
- Associate professor, Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - José Augusto M Miguel
- Associate professor, Clinic of Orthodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Jung MH. Quality of Life and Self-Esteem of Female Orthognathic Surgery Patients. J Oral Maxillofac Surg 2016; 74:1240.e1-7. [DOI: 10.1016/j.joms.2016.01.046] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/23/2016] [Accepted: 01/23/2016] [Indexed: 11/30/2022]
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Inglehart MR. Perceived Esthetic Outcomes, Psychological Benefits, and Quality of Care Affect Patient or Parent Satisfaction after Orthodontic Treatment. J Evid Based Dent Pract 2016; 16:115-7. [DOI: 10.1016/j.jebdp.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pachêco-Pereira C, Abreu LG, Dick BD, De Luca Canto G, Paiva SM, Flores-Mir C. Patient satisfaction after orthodontic treatment combined with orthognathic surgery: A systematic review. Angle Orthod 2016; 86:495-508. [PMID: 26313228 PMCID: PMC8601732 DOI: 10.2319/040615-227.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/01/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To synthesize available evidence about factors associated with patients' satisfaction after orthodontic treatment combined with orthognathic surgery. MATERIALS AND METHODS Studies that evaluated any factor associated with patients' satisfaction after the conclusion of an orthodontic treatment combined with an orthognathic surgery were identified. Orthognathic surgical procedures should have been undertaken after completion of craniofacial growth. Any satisfaction psychometric tool was considered. No language limitation was set. A detailed individual search strategy for each of the following bibliographic databases was crafted: MEDLINE, PubMed, EBM Reviews, Web of Science, EMBASE, LILACS, and Scopus. The references cited in the identified articles were also cross-checked, and a partial gray-literature search was undertaken using Google Scholar. RESULTS Eight articles satisfied the inclusion criteria of this systematic review and accounted for 998 patients. The included studies showed large variation in sample size (range = 44 to 505 patients), age (range = 15 to 72 years old), distinct psychological evaluation tools, and time elapsed between the assessment and the completion of surgery and postorthodontic treatment. Most of the studies (five of eight) were classified as having high risk of bias. CONCLUSION Factors associated with satisfaction were final esthetic outcome, perceived social benefits from the outcome, type of orthognathic surgery, sex, and changes in patient self-concept during treatment. Factors associated with dissatisfaction were treatment length; sensation of functional impairment and/or dysfunction after surgery, and perceived omitted information about surgical risks.
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Affiliation(s)
- Camila Pachêco-Pereira
- Assistant Clinical Professor, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Lucas G. Abreu
- PhD student, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bruce D. Dick
- Associate Professor, Department of Anesthesiology and Pain Medicine and Department of Psychiatry & Pediatrics, and Chief of Psychology, Multidisciplinary Pain Centre, University of Alberta, Edmonton, Canada
| | - Graziela De Luca Canto
- Associate Professor, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil, and Adjunct Professor, Department of Dentistry School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Saul M. Paiva
- Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Flores-Mir
- Professor and Division Head of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Baherimoghaddam T, Tabrizi R, Naseri N, Pouzesh A, Oshagh M, Torkan S. Assessment of the changes in quality of life of patients with class II and III deformities during and after orthodontic–surgical treatment. Int J Oral Maxillofac Surg 2016; 45:476-85. [DOI: 10.1016/j.ijom.2015.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 08/06/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022]
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Song YL, Yap AUJ. Orthognathic treatment of dentofacial disharmonies: its impact on temporomandibular disorders, quality of life, and psychosocial wellness. Cranio 2016; 35:52-57. [DOI: 10.1080/08869634.2016.1147676] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Asada K, Motoyoshi M, Tamura T, Nakajima A, Mayahara K, Shimizu N. Satisfaction with orthognathic surgery of skeletal Class III patients. Am J Orthod Dentofacial Orthop 2016; 148:827-37. [PMID: 26522044 DOI: 10.1016/j.ajodo.2015.05.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Class III relationships can be corrected with single-jaw or bimaxillary surgery. The purpose of this research was to assess patient satisfaction after bimaxillary surgery, compared with setback surgery alone, for Class III corrections. Identifying patients' relative levels of satisfaction will provide guidance for the selection of surgical options. METHODS The cephalometric outcomes for 25 patients who underwent 2-jaw surgery were compared with the outcomes in 40 patients who had mandibular setback. Soft and hard tissue changes were evaluated using initial and postsurgical lateral cephalograms. The patients were asked to complete self-administered questionnaires after orthognathic treatment. Correlations between cephalometric improvement and patient satisfaction were evaluated. RESULTS The patients in the 2-jaw group reported significantly higher satisfaction in the appearance of the mouth (P <0.05), smile (P <0.05), and treatment outcome (P <0.001). These item scores and the changes in ANB, ANS-M, and nasolabial angle showed strong correlations in the 2-jaw group and moderate correlations in the 1-jaw group. CONCLUSIONS ANS-M and nasolabial angle should be considered in the conventional diagnosis of skeletal Class III orthognathic surgery to obtain adequate correction of facial esthetics and patient satisfaction. Esthetic needs contribute to surgical decisions when treating patients with skeletal Class III malocclusions and dentofacial deformities such as maxillary deficiency and long facial height that causes a turned-up upper lip.
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Affiliation(s)
- Kaoru Asada
- Resident, Department of Orthodontics, School of Dentistry, Nihon University, Tokyo, Japan
| | - Mitsuru Motoyoshi
- Associate professor, Department of Orthodontics and Division of Clinical Research, Dental Research Center, School of Dentistry, Nihon University, Tokyo, Japan.
| | - Takahiko Tamura
- Clinical associate professor, Department of Orthodontics and Division of Clinical Research, Dental Research Center, School of Dentistry, Nihon University, Tokyo, Japan
| | - Akira Nakajima
- Assistant professor, Department of Orthodontics and Division of Clinical Research, Dental Research Center, School of Dentistry, Nihon University, Tokyo, Japan
| | - Kotoe Mayahara
- Assistant professor, Department of Orthodontics and Division of Clinical Research, Dental Research Center, School of Dentistry, Nihon University, Tokyo, Japan
| | - Noriyoshi Shimizu
- Professor and chair, Department of Orthodontics and Division of Clinical Research, Dental Research Center, School of Dentistry, Nihon University, Tokyo, Japan
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Liddle MJ, Baker SR, Smith KG, Thompson AR. Psychosocial Outcomes in Orthognathic Surgery: A Review of the Literature. Cleft Palate Craniofac J 2015; 52:458-70. [DOI: 10.1597/14-021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To identify and critically appraise the literature on the psychosocial outcomes of orthognathic surgery, reflect on the clinical and theoretical implications, and suggest avenues for future research. Design A search of the literature was completed using the databases Web of Science, MEDLINE, and PsycINFO to identify English-language articles published since January 2001 that have reported a measure of psychosocial functioning posttreatment. Results A total of 38 articles were eligible for inclusion in the review. The studies reported improvements in areas such as satisfaction with facial appearance, self-confidence, self-esteem, anxiety, and social functioning. Small percentages of patients were left dissatisfied or had difficulty adjusting to appearance change despite the absence of treatment complications. Gains in psychosocial functioning were maintained over several years, and satisfaction increased over time. Conclusions There are consistent positive outcomes reported as a result of orthognathic surgery, but conclusions are limited by methodological issues in study design such as small sample sizes, limited use of control groups, and measures that fail to tap into relevant areas of psychosocial functioning. In addition, further exploration is required of processes such as adjustment to facial change and the role of psychological support during treatment.
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Affiliation(s)
- Morna J. Liddle
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Sarah R. Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Keith G. Smith
- Oral and Maxillofacial Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Andrew R. Thompson
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
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Soh CL, Narayanan V. The impact of surgical correction on the quality of life in patients with dentofacial deformity—A prospective study. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2015. [DOI: 10.1016/j.ajoms.2014.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kilinc A, Ertas U. An Assessment of the Quality of Life of Patients With Class III Deformities Treated With Orthognathic Surgery. J Oral Maxillofac Surg 2015; 73:1394.e1-5. [PMID: 25976691 DOI: 10.1016/j.joms.2015.02.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/13/2015] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate quality of life (QoL) from a broad perspective by a comparison of Turkish patients undergoing orthognathic surgery to correct Angle Class III skeletal deformity with a control group composed of participants without dentofacial deformity using general health, generic oral health, and condition-specific QoL approaches. MATERIALS AND METHODS Thirty patients who underwent orthognathic surgery to correct Class III relations (monomaxillary and bimaxillary groups) and 30 participants with Class I skeletal structure and good dentofacial harmony (control group) were evaluated. Condition-specific QoL through a 22-item Orthognathic Quality of Life Questionnaire (OQLQ), generic oral health-related QoL through a 14-item Short-Form Oral Health Impact Profile (OHIP-14), and generic health-related QoL through a 36-item Short-Form Health Survey (SF-36) were assessed. RESULTS When the groups were compared, OQLQ scores showed a significant difference in the oral function domain only in the bimaxillary group (P < .05), and OHIP-14 scores showed significant differences in half the OHIP-14 subscale scores in the monomaxillary and bimaxillary groups (P < .05). The SF-36 scores showed significant differences only for the vitality domain in the monomaxillary group and the vitality and mental health domains in the bimaxillary group (P < .05). CONCLUSIONS For condition-specific and health-related QoL, the QoL of orthognathic surgical patients appeared to be similar to that of participants without dentofacial deformities. Oral health-related QoL of orthognathic surgical patients seemed moderately similar to that of participants without dentofacial deformities. The combined use of these methods is helpful for evaluating QoL from a larger perspective.
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Affiliation(s)
- Adnan Kilinc
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey.
| | - Umit Ertas
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
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Abstract
The decision on whether starting an orthosurgical treatment depends on the negative
esthetic, functional and social impact the dentofacial deformity has on the quality
of life of each patient. The objective of this article is to demonstrate the
importance of assessing the quality of life of these individuals by means of applying
specific questionnaires before treatment onset in order to increase the success rate
of orthosurgical treatment. These questionnaires assess not only the esthetic factor,
but also the functional conditions that may be affected as well as the psychological
issues related to self-esteem and sociability, all of which must be assessed in order
to enable the development of an individual treatment plan that meets patient's
expectations. Thus, a more predictable level of satisfaction can be achieved at
treatment completion, not only from a normative standpoint stated by professionals,
but also from a subjective standpoint stated by patients. Although not enough
comparable data is available in the literature for us to assess the extent of
improvements produced by orthosurgical treatment, a few recent reports conducted by
different universities around the world reveal a good response from the majority of
patients after surgery, demonstrating great satisfaction with regard to esthetic,
functional and psychosocial factors. Therefore, it is reasonable to conclude that the
current objective of orthodontic treatment associated with orthognathic surgery
consists not only in treating the esthetic functional components of dentofacial
deformities, but also in considering patients' psychological factor.
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Reddy MS, Aichelmann-Reidy ME, Avila-Ortiz G, Klokkevold PR, Murphy KG, Rosen PS, Schallhorn RG, Sculean A, Wang HL. Periodontal Regeneration – Furcation Defects: A Consensus Report From the AAP Regeneration Workshop. J Periodontol 2015; 86:S131-3. [DOI: 10.1902/jop.2015.140379] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Inglehart MR. Enhancing Periodontal Health Through Regenerative Approaches: A Commentary on the Need for Patient-Reported Outcomes. J Periodontol 2015; 86:S4-7. [DOI: 10.1902/jop.2015.140574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Travess HC, Newton JT, Sandy JR, Williams AC. The development of a patient-centered measure of the process and outcome of combined orthodontic and orthognathic treatment. J Orthod 2014; 31:220-34; discussion 201-2. [PMID: 15489366 DOI: 10.1179/146531204225022434] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of this study was to develop a patient-based measure of the process and outcome of combined orthodontic and orthognathic care in the National Health Service in the UK. DESIGN Identification of relevant dimensions through qualitative methods, design of form, determination of psychometric properties of the scale, specific readability, reliability and validity. SETTING NHS hospitals in the South West Region. SUBJECTS The sample comprised patients who had received combined orthodontic and orthognathic treatment between 01 January 1998 and 31 December 2000. Twenty-six participants (a 25% response rate) took part in four focus group meetings. Thirty subjects (65% response rate) took part in a pilot study to test the properties of the questionnaire. MAIN OUTCOME MEASURES Six broad themes emerged from the focus groups. These formed the basis of the sections in the questionnaire. RESULTS The questionnaire developed had a Flesch reading ease score of 72.9 or US grade level 4 equivalent to aged 9-10 years. Test-retest reliability gave kappa values for most questions that exceeded 0.4. Criterion validity of the measure was established by comparing responses to the questionnaire over two periods with a telephone interview on a sample of 30 patients. Criterion related validity was poor for nine of the 16 items. By contrast the construct validity of the questionnaire was satisfactory. CONCLUSION A patient-based measure of the process and outcome of combined orthodontic and orthognathic treatment has been developed. This has sufficient validity and reliability for use in inter-center audit projects.
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Verdonck A, Bertrand J, Carels C, Swinnen S, Schoenaers J. Orthodontic and orthognathic management of a patient with Apert syndrome: a case report. J Orthod 2014; 37:121-7. [DOI: 10.1179/14653121042984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Shelton AT, Houghton NY, Morris DO, Latchford GL, Bekker HL, Munyombwe T. The development and validation of a psychological questionnaire for patients undergoing orthognathic treatment. Orthod Craniofac Res 2014; 18:51-64. [DOI: 10.1111/ocr.12061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. T. Shelton
- Department of Orthodontics; Montagu Hospital; Mexborough UK
- Department of Orthodontics; Leeds Dental Institute; Leeds UK
| | - N. Y. Houghton
- Department of Orthodontics; St Lukes Hospital; Bradford UK
| | - D. O. Morris
- Department of Orthodontics; Leeds Dental Institute; Leeds UK
| | | | - H. L. Bekker
- Department of Behavioural Sciences; University of Leeds; Leeds UK
| | - T. Munyombwe
- Department of Biostatistics; University of Leeds; Leeds UK
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Anderson LE, Inglehart MR, El-Kholy K, Eber R, Wang HL. Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft. IMPLANT DENT 2014; 23:416-25. [PMID: 25033346 DOI: 10.1097/ID.0000000000000122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This randomized controlled clinical pilot trial compared the efficacy of 2 soft tissue grafting methods for correcting esthetic discrepancies associated with definitively restored implant crowns. METHODS Thirteen patients presenting with implants displaying recession, thin biotype, concavity defects, or a combination thereof associated with single crowned dental implants randomly received subepithelial connective tissue grafts (SCTG) in the control group (N = 7) or acellular dermal matrix (ADM) allografts in the test group (N = 6), both under coronally positioned flaps. Data regarding soft tissue, hard tissue, esthetics, and quality of life (QoL) parameters were collected over 6 months. RESULTS Both groups gained tissue thickness (SCTG: 63% and ADM: 105%), reduced concavity measures (SCTG: 82% and ADM: 96%), and improved recessions (SCTG: 40% and ADM: 28%) from baseline to 6 months. Clinicians determined improvement in esthetics for both groups (P = 0.001), unlike patients who did not change their esthetic ratings. No statistical differences were noted for QoL assessment; however, ADM subjects had more eventful wound healing (P = 0.021). CONCLUSIONS Within the limitations of this study, both SCTG and ADM result in increased mucosal thickness, reduction in concavity dimensions, and have a potential for recession reduction on definitively restored dental implants.
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