Changes in quality of life and their relation to cephalometric changes in orthognathic surgery patients

Abstract

Objective: To evaluate correlations between presurgical and postsurgical changes in quality of life (QoL) and cephalometric hard and soft tissue changes in patients undergoing orthognathic surgery. Materials and Methods: The study sample consisted of 30 patients (mean age 24.3 6 4.5 years) with Class III malocclusion undergoing orthognathic surgery for mandibular setback with a median follow-up of 8.3 6 1.2 months. Presurgical and postsurgical cephalograms were traced and Oral Health Impact Profile (OHIP) questionnaires were completed. Each questionnaire consisted of 14 items designed to evaluate functional, physical, psychological, and social impacts. Results: Significant correlations between significant presurgical-to-postsurgical changes in individual items and OHIP parameters were found between labiomental angle (LA) and question 5 (''feeling self-conscious''; correlation coefficient [r] 5 0.530), between LA and question 6 (''feeling tense''; r 5 0.598), between nasion-pogonion and question 5 (r 5 0.523), and between facial convexity and question 5 (r 5 20.540). Hence, reduction of both LA and nasion-pogonion led to a significant decrease in the impact scores of items covering psychological discomfort, while reduced facial convexity led to increased impact scores. Conclusions: Although the associations were moderate, changes in QoL following cephalometric modifications should be considered as a major concern when planning orthognathic surgery. Postsurgical changes to a more convex profile after mandibular setback should be emphasized before surgery to help patients become accustomed to their new appearance more easily without negatively affecting QoL. (Angle Orthod. 2012;82:235-241.)

Quality of life after orthognathic surgery: a case report

“…This study showed that orthognathic surgery was able to promote a positive impact on oral health-related QoL 18,19,22,26,27 in a patient studied within a short period, when pre-and postoperative results were compared after 3 months of surgery. Similar results were observed in the short term in a study that aimed to investigate changes in QoL and in the patient's perception of aesthetic improvements after orthognathic surgery.…”

Avaliação da qualidade de vida em adultos com deformidade dentofacial de Classe III

“…Avaliação psicométrica x morfológica A ausência de associação entre a complexidade da maloclusão e o impacto que ela exerce sobre a QV é outro achado relevante do presente estudo (Tabela 5.5). A literatura não é consensual a respeito deste assunto, uma vez que certos estudos mostram uma associação moderada (Rustemeyer et al, 2012), fraca e ausente (Nicodemo et al, 2008a). Certamente, a falta de padronização metodológica tem contribuído para a variabilidade dos resultados e dificultado a comparação direta e confiável (Khan;Fida, 2008).…”

“…Quanto ao aspecto temporal, os questionários têm sido aplicados transversalmente Nadanovsky, 2005;Marques et al, 2006;O´Brien et al, 2007;Esperão et al, 2010;Feu et al, 2010a;Rusanen et al, 2010;Palomares et al, 2012) ou longitudinalmente (Bertolini et al, 2000;Motegi et al, 2003;Rispoli et al, 2004;Nicodemo et al, 2008;Choi et al, 2010;Khadka et al, 2011;Murphy et al, 2011;Rustemeyer et al, 2012). Os questionários requerem padronização, sendo que a validade (mensurar realmente o que se propõe) e a confiabilidade (reprodutibilidade da mensuração) são características indispensáveis para se evitar erros metodológicos e falsear conclusões (Sardenberg et al, 2011).…”

Satisfaction with Life in Patients with Skeletal Class III Malocclusion After Orthognathic Surgery

“…The majority of patients with skeletal class III malocclusion after orthognathic surgeries are satisfied with the outcome of the therapy [5,7]. As far as the examined population is concerned, all patients evaluated the appearance of their face after the surgery as being very good or good.…”

“…Prolonging the lower part of the face, protrusion of the mandible give one's face an aggressive appearance, which is particularly negatively perceived in case of women. It has been proven that a smaller labiomental angle and the nasion-pogonion angle is associated with lowered feeling of psychical discomfort caused by a negative assessment of the facial appearance in patients, who underwent mandibular setback surgery [5]. Among people with maxillofacial defects, mainly with skeletal class III malocclusion, negative emotions associated with the lack of acceptance for one's own appearance may lead not only to lowered satisfaction with life but also to worsened quality of life.…”