Quality of Life (QoL) changes after orthognathic surgery: Do they correlate with the quantum of hard and soft tissue change? Original Research
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Abstract
Aim: To investigate the relationship between post orthognathic surgery changes in soft and hard tissue cephalometric variables in Class II and Class III patients and quality of life (QoL) measured using a condition-specific QoL questionnaire and to determine cephalometric predictors of the overall OQLQ after surgery.
Methods: The sample included 50 orthodontic patients, 28 Class II and 22 Class III skeletal relationships whose treatment included orthognathic surgery. Correlations between cephalometric changes and Orthognathic Quality of Life Questionnaire (OQLQ) were tested by Pearson’s correlation. Multiple linear regression was used to determine cephalometric predictors of the overall OQLQ after surgery.
Results: In Class II patients, OQLQ before surgery and changes in SNA were significant predictors for OQLQ after surgery. For Class III patients, OQLQ after surgery was significantly correlated with the change in mandibular plane angle and lower face height (r = 0.6 and r = 0.5 respectively). The decrease in facial angle was negatively correlated with OQLQ (r = -0.4). Mandibular plane angle, mandibular length, and OQLQ before surgery were significant predictors for OQLQ after surgery.
Conclusion: QoL improved for Class II and III after orthognathic surgery. Changes in certain cephalometric measurements seem to predict quality of life after orthognathic surgery.
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References
Group W. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Quality of life Research. 1993;2:153-59.
Hunt OT, Johnston CD, Hepper PG, Burden DJ. The psychosocial impact of orthognathic surgery: a systematic review. Am J Orthod Dentofacial Orthop. 2001;120(5):490-96.
Ryan FS, Barnard M, Cunningham SJ. Impact of dentofacial deformity and motivation for treatment: a qualitative study. Am J Orthod Dentofacial Orthop. 2012;141(6):734-42.
Khadka A, Liu Y, Li J, et al. Changes in quality of life after orthognathic surgery: a comparison based on the involvement of the occlusion. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;112(6):719-25.
Lee S, McGrath C, Samman N. Quality of life in patients with dentofacial deformity: a comparison of measurement approaches. Int J Oral Maxillofac Surgery. 2007;36(6):488-492.
Rusanen J, Lahti S, Tolvanen M, Pirttiniemi P. Quality of life in patients with severe malocclusion before treatment. Eur J Orthod. 2010;32(1):43-48.
Miguel JAM, Palomares NB, Feu D. Life-quality of orthognathic surgery patients: the search for an integral diagnosis. Dental Press J Orthod. 2014;19:123-37.
Vaid NR, Adel SM. Contemporary Orthodontic Workflows: A Panacea for Efficiency? Elsevier; 2023:1-3.
Vaid N, Doshi V, Vandekar M. What's “Trend” ing in Orthodontic literature? APOS Trends in Orthodontics. 2016;6(1):1-1.
AlSeraidi M, Hansa I, Dhaval F, Ferguson DJ, Vaid NR. The effect of vestibular, lingual, and aligner appliances on the quality of life of adult patients during the initial stages of orthodontic treatment. Prog Orthod. 2021;22:1-6.
Cunningham SJ, Garratt AM, Hunt NP. Development of a condition-specific quality of life measure for patients with dentofacial deformity: I. Reliability of the instrument. Community Dent Oral Epidemiol. Jun 2000;28(3):195-201.
Ware JE, Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. Jun 1992;30(6):473-83.
Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. Mar 1994;11(1):3-11.
Cunningham SJ, Garratt AM, Hunt NP. Development of a condition-specific quality of life measure for patients with dentofacial deformity: II. Validity and responsiveness testing. Community Dent Oral Epidemiol. 2002:81-90. vol. 2.
Abdullah WA. Changes in quality of life after orthognathic surgery in Saudi patients. Saudi Dent J. Jul 2015;27(3):161-4.
Al-Asfour A, Waheedi M, Koshy S. Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction. Int J Oral Maxillofac Surg. Jun 2018;47(6):726-31.
Al-Ahmad HT, Al-Sa'di WS, Al-Omari IK, Al-Bitar ZB. Condition-specific quality of life in Jordanian patients with dentofacial deformities: a comparison of generic and disease-specific measures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jan 2009;107(1):49-55.
Duarte V, Zaror C, Villanueva J, et al. Changes in health-related quality of life after orthognathic surgery: a multicenter study. Clin Oral Investig. Apr 2022;26(4):3467-76.
Duarte V, Zaror C, Villanueva J, et al. Oral health-related quality of life changes in patients with dentofacial deformities class II and III after orthognathic surgery: a systematic review and meta-analysis. Int J Environ Res and Public Health. 2022;19(4):1940.
Belusic Gobic M, Kralj M, Harmicar D, Cerovic R, Mady Maricic B, Spalj S. Dentofacial deformity and orthognatic surgery: Influence on self-esteem and aspects of quality of life. J Craniomaxillofac Surg. Apr 2021;49(4):277-81.
Meger MN, Fatturi AL, Gerber JT, et al. Impact of orthognathic surgery on quality of life of patients with dentofacial deformity: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. Apr 2021;59(3):265-71.
Lancaster L, Salaita RD, Swamy C, et al. Effects of orthognathic surgery on quality of life compared with nonsurgical controls in an American population. Am J Orthod Dentofacial Orthop. Oct 2020;158(4):555-63.
de Araujo CM, Schroder AGD, de Araujo BMM, et al. Impact of orthodontic-surgical treatment on quality of life: a meta-analysis. Eur J Orthod. Jun 23 2020;42(3):281-89.
Yi J, Lu W, Xiao J, Li X, Li Y, Zhao Z. Effect of conventional combined orthodontic-surgical treatment on oral health-related quality of life: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. Jul 2019;156(1):29-43.e5.
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(1):1-7.
Zamboni R, de Moura FRR, Brew MC, et al. Impacts of Orthognathic Surgery on Patient Satisfaction, Overall Quality of Life, and Oral Health-Related Quality of Life: A Systematic Literature Review. Int J Dent. 2019;2019:2864216.
Sun H, Shang HT, He LS, Ding MC, Su ZP, Shi YL. Assessing the Quality of Life in Patients With Dentofacial Deformities Before and After Orthognathic Surgery. J Oral Maxillofac Surg. Oct 2018;76(10):2192-01.
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(4):476-85.
Soh C, Narayanan V. Quality of life assessment in patients with dentofacial deformity undergoing orthognathic surgery—a systematic review. Int J Oral Maxillofac Surg. 2013;42(8):974-980.
Muftuoglu O, Guler AY, Karasu HA. The impact of orthognathic surgery on quality of life for class III dentofacial deformities. Br J Oral Maxillofac Surg. May 2023;61(4):274-277.
Locker D, Slade G. Association between clinical and subjective indicators of oral health status in an older adult population. Gerodontology. 1994: (2)11: 108-14.
Allen PF. Assessment of oral health related quality of life. Health and quality of life outcomes. 2003;1(1):1-8.
Ahmed A, Fida M, Sukhia RH. Cephalometric predictors for optimal soft tissue profile outcome in adult Asian class I subjects treated via extraction and non-extraction. A retrospective study. Int Orthod. 2021;19(4):641-51.
Kolokitha O-E, Topouzelis N. Cephalometric methods of prediction in orthognathic surgery. J Maxillofac and Oral Surg. 2011;10:236-45.
Rustemeyer J, Martin A, Gregersen J. Changes in quality of life and their relation to cephalometric changes in orthognathic surgery patients. Angle Orthod. Mar 2012;82(2):235-41.
Chadda D, Majumdar SK, Shome A, Das RK. Evaluation of Cephalometric Changes and Its Relation to Changes in Patients' Quality of Life After Mandibular Setback Surgery. J Maxillofac Oral Surg. Dec 2022;21(4):1279-85.
Baherimoghaddam T, Oshagh M, Naseri N, Nasrbadi NI, Torkan S. Changes in cephalometric variables after orthognathic surgery and their relationship to patients' quality of life and satisfaction. J Oral Maxillofac Res. Oct-Dec 2014;5(4):e6.
Geramy A, Mazaheri Nazarifar A, Saffar Shahroudi A, Sheikhzadeh S. Oral health-related quality of life following orthognathic surgery for class III correction its relationship with cephalometric changes. Int J Oral Maxillofac Surg. Nov 2019;48(11):1434-39.
Stagles C, Popat H, Rogers S. Factors influencing patient-reported quality of life in pretreatment orthognathic surgery patients. The Angle Orthodontist. 2015;86(2):331-36.
Kämäräinen M, Alanko O, Svedström-Oristo AL, Peltomäki T. Association between quality of life and severity of profile deviation in prospective orthognathic patients. Eur J Orthod. Jun 23 2020;42(3):290-94.
Agou SH. Validation of the Arabic version of the Orthognathic Quality of Life Questionnaire. medRxiv. 2024:2024.01.02.23300573.
Kinzinger G, Frye L, Diedrich P. Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery--a cephalometric study to evaluate various therapeutic effects. J Orofac Orthop. Jan 2009;70(1):63-91.
Nanjannawar L, Agrawal J, Agrawal M. Pattern of Malocclusion and Treatment Need in Orthodontic Patients: An Institution-based Study. World J Dent. 2012;(2):136-40.
Krivan JF. Category 2: Skeletal Class II malocclusion with retrognathic mandible and hyperdivergent pattern. Am J Orthod Dentofacial Orthop. Jun 2005;127(6):739-48.
Rustemeyer J, Martin A. Soft tissue response in orthognathic surgery patients treated by bimaxillary osteotomy: cephalometry compared with 2-D photogrammetry. Oral Maxillofac Surg. Mar 2013;17(1):33-41.
Türker N, Varol A, Ogel K, Basa S. Perceptions of preoperative expectations and postoperative outcomes from orthognathic surgery: part I: Turkish female patients. Int J Oral Maxillofac Surg. Aug 2008;37(8):710-5.
Brunault P, Battini J, Potard C, et al. Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less. Int J Oral Maxillofac Surg. Jan 2016;45(1):26-34.