Quality of life changes in different types of skeletal malocclusion treated by orthognathic surgery (a longitudinal study)
Date
2015
DOI
Authors
Shahin, Suliman Yousif
Version
OA Version
Citation
Abstract
Background: Today more emphasis is being placed on patient-based outcomes of treatment, such as Oral Health-Related Quality of Life (OHRQoL). Orthognathics is a complex and lengthy modality of treatment. Patients who are born with dentofacial deformities require extensive treatment planning. It is crucial to have a good understanding of OHRQoL outcomes to effectively develop treatment plans and communicate with patients. Orthognathic patients can present with different facial types . Exploring facial types in relation to OHRQoL might explain a skeletal-structural component of the deformities. The purpose of our study was to evaluate OHRQoL changes that occur by the various facial types using four validated instruments.
Materials and Methods: A prospective study was approved by the Institutional Review Board of Boston University Goldman School of Dental Medicine (BUGSDM). At baseline 150 subjects were evaluated for OHRQoL at the Oral and Maxillofacial Surgery Department at BUGSDM before orthodontic treatment (T1). Thirty-nine of those subjects were further evaluated after orthodontic preparation (T2) and immediately after orthognathic surgery (T3). OHRQoL was measured using: 1) Oral Health Impact Profile-14 (OHIP-14) to measure generic OHRQoL; 2) Orthognathic Quality of Life Questionnaire (OQLQ) to evaluate condition-specific OHRQoL; 3) the 12-item oral quality of life instrument (12- item OQOL) to measure generic OHRQoL, and 4) the Epworth sleepiness scale (ESS) to measure daytime sleepiness. Cephalometric X-ray measurements were used to categorize facial types. Two-sample T-test and one-way ANOVA test were used to compare OHRQoL across groups crossectionally. A linear mixed-effects model was used to evaluate longitudinal changes in OHRQoL.
Results: The changes in OHIP-14, OQOL and 12-item OQOL were statistically significant from Tl to T2 and from T2 to T3 (p[less than] 0.05). Mean scores for the three items increased from Tl to T2 and from T2 to T3. This increase indicates gradual deterioration in OHRQoL. OHIP-14, OQOL and 12-item OQOL baseline scores were also statistically different between different skeletal classification groups (p[less than] 0.05), with Class II being the worst.
Conclusion: OHRQoL gradually deteriorates through combined orthodontic and orthognathic treatment up to the immediate post-operative phase. This report is based on initial results of an ongoing study. More subjects will be examined post-surgically and will be followed to study the long-term changes.
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Thesis (DScD) --Boston University, Henry M. Goldman School of Dental Medicine, 2015 (Department of Orthodontics and Dentofacial Orthopedics).
Includes bibliography: leaves 88-93.
Thesis (DScD) --Boston University, Henry M. Goldman School of Dental Medicine, 2015 (Department of Orthodontics and Dentofacial Orthopedics).
Includes bibliography: leaves 88-93.
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This work is protected by copyright. Downloading is restricted to the BU community. If you are the author of this work and would like to make it publicly available, please contact open-help@bu.edu.