Impact of orthognathic surgery on quality of life in patients with different dentofacial deformities: longitudinal study of the Oral Health Impact Profile (OHIP-14) with at least 1 year of follow-up

Abstract

Objective The objective of this study was to assess the impact of orthognathic surgery for dental facial deformities on oral health-related quality of life (OHRQoL) in the immediate postoperative period up to at least 1 year after surgery. Study design This prospective study evaluated data from 85 patients. OHRQoL was assessed using the Dutch version of the Oral Health Impact Profile questionnaire (OHIP-14NL) preoperatively (T0), each day for 7 days postoperatively (T1–T7) and 4 weeks (T8), 6 months (T9), and at least 1 year (T10) after surgery. The total OHIP score was calculated for each patient, with higher OHIP scores indicating a worse impact on oral health. Patients also completed an extra questionnaire about self-care, discomfort, and experienced pain (rated on a 10-point scale) in the postoperative period (T1–T10). Results The mean OHIP score increased sharply at T1 compared to T0 but decreased significantly in the first postoperative week. The mean OHIP score at T8 was still higher than before surgery. However, at T9 and T10, the mean OHIP score was significantly lower than at T0 (P < .05). No significant difference in OHIP score was found between gender, age, type of surgery, and indication for surgery. Pain significantly decreased from T6 to T0. The OHIP and pain scores significantly positively correlated at every time point except T9. Conclusion The findings indicate that OHRQoL is reduced from baseline in the immediate postoperative period but improves over time. By 1 year, OHRQoL improves significantly after orthognathic surgery in patients with dentofacial deformities.

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

“…The final sample size of patients with dentofacial deformities ranged from 14 to 85 subjects, and the mean of age ranged from 21.3 to 31 years. Seven studies used the Oral Health Impact Profile (OHIP-14) [ 13 , 15 , 25 , 34 , 35 , 36 , 37 ] to measure OHRQoL, one used the modified Japanese version of OHIP-49 (OHIPJ54) [ 32 ], two used the Orthognathic Quality of Life Questionnaire (OQLQ) [ 23 , 38 ], and three studies used both OHIP-14 and OQLQ [ 24 , 33 , 39 ]. Pre-surgical OHRQoL assessment was carried out during the orthodontic treatment and the last follow-up, around 6 months after surgery in most studies.…”

“…The reasons why certain studies could not be included in the meta-analysis were: pre-surgery assessment carried out prior to orthodontic appliance installation [ 13 , 34 ], or after setting orthodontic appliances but at an undetermined time or far from surgery [ 33 , 38 ]; no assessment at 4–7 months after surgery [ 39 ]; mean, SD or number of participants by class not reported [ 32 , 35 , 36 ]; and results provided only at item level [ 37 ].…”

“…Figure 2 shows that five studies were rated as having a moderate methodological quality [ 24 , 25 , 32 , 33 , 38 ], and eight were qualified as being of weak quality, according to the global rating [ 13 , 15 , 23 , 34 , 35 , 36 , 37 , 39 ]. “Data collection methods” was the best evaluated domain, with all studies showing strong quality because they had used a validated OHRQoL instrument.…”

“…Two studies reported no difference between Class II and III patients [ 23 , 35 ], while another study [ 32 ] reported significant differences in the global score and all OHIP-14 domains except functional limitation. No statistically significative change in Class II patients was observed in some studies for functional limitation [ 25 , 32 , 36 ] and physical disability domains [ 36 ], and Sun et al [ 24 ] reported no significant improvement in any domain.…”

Effect of Orthognathic Surgery on the Quality of Life

“…The OQLQ score also reduced significantly following surgery, demonstrating improvements in the social elements of dentofacial deformity, oral function, facial aesthetics, and knowledge of dentofacial aesthetic domains. A recent study that examined the immediate postoperative period until at least one year using the Oral Health Impact Profile-14 questionnaire (OHIP-14NL) questionnaire (40) discovered that oral health related QoL declines from baseline in the early postoperative period but improves over time. One year after undergoing orthognathic surgery, the oral health-related QoL of patients with dentofacial abnormalities considerably improves.…”