Changes in Oral Health-related Quality of Life before and after Orthognathic Surgery and Predictors of Outcome Original Research

Main Article Content

Shoroog Hassan Agou, BDS, MScCH (HPTE), MEd(c), PhD

Abstract

Aim: There is good evidence that orthognathic surgery improves quality of life (QoL), but it is uncertain whether QoL outcomes differ for patients with different dentofacial deformities. The aim of this study was to (i) assess changes in QoL before and after orthognathic surgery; (ii) compare QoL between deformity classes; and (iii) establish predictors of QoL


Methods: This was a prospective, longitudinal, observations study of adult patients seeking orthognathic treatment. Patients were classified into class II or class III dentofacial deformities. The paired t-test was used to compare Orthognathic Quality of Life Questionnaire (OQLQ) scores before and after surgery, and multivariable linear regression was used to identify predictors of post-operative OQLQ score. 


Results: Of the 50 participants, 36 (72%) were female, and the average age was 29.9 ± 4.2 years. Overall and domain OQLQ scores were significantly lower after surgery (p < 0.0001). The mean change in QoL score was significantly greater for class II patients (p = 0.003). Age and baseline OQLQ score were significantly associated with post-operative OQLQ score.


Conclusions: This study confirms that orthognathic surgery has a very positive impact on QoL. The finding that age and baseline QoL predict subsequent QoL outcomes paves the way for targeted interventions in specific patients.

Article Details

How to Cite
Agou, S. H. (2024). Changes in Oral Health-related Quality of Life before and after Orthognathic Surgery and Predictors of Outcome: Original Research. International Journal of Orthodontic Rehabilitation, 15(3), 1–11. https://doi.org/10.56501/intjorthodrehabil.v15i3.1038
Section
Articles

References

Khechoyan, D.Y., 2013, August. Orthognathic surgery: general considerations. Semin Plastic Surg (Vol. 27, No. 03, pp. 133-136). Thieme Medical Publishers.

Rizzatto SM, de Menezes LM, da Cunha Filho JJ, Allgayer S. Conventional surgical-orthodontic approach with double-jaw surgery for a patient with a skeletal Class III malocclusion: Stability of results 10 years posttreatment. Am J Orthod Dentofacial Orthop. 2018 Jul 1;154(1):128-39.

Sabri R. The role of orthodontics, orthognathic surgery and adjunct surgical procedures in the esthetic rehabilitation of the face and smile: potential and limitations. Semin Orthod 2023 Sep 1 (Vol. 29, No. 3, pp. 300-307). WB Saunders.

Agou S, Locker D, Streiner DL, Tompson B. Impact of self-esteem on the oral-health-related quality of life of children with malocclusion. Am. J. Orthod. Dentofacial Orthop. 2008;134(4):484-9.

Myrberg N, Thilander B. Orthodontic need of treatment of Swedish schoolchildren from objective and subjective aspects. Scand. J. Dent. Res. 1973;81(2):81-4.

O'Brien K, Kay L, Fox D, Mandall N. Assessing oral health outcomes for orthodontics--measuring health status and quality of life. Community Dent. Health. 1998;15(1):22-6.

Phillips C. Patient-centered outcomes in surgical andorthodontic treatment. Semin Orthod 1999 Dec 1 (Vol. 5, No. 4, pp. 223-230). WB Saunders.

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. 2000 Jun;28(3):195-201.

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 Apr;30(2):81-90.

Kanatas AN, Rogers SN. A systematic review of patient self-completed questionnaires suitable for oral and maxillofacial surgery. Br J Oral Maxillofac Surg. 2010 Dec 1;48(8):579-90.

Meger MN, Fatturi AL, Gerber JT, Weiss SG, Rocha JS, Scariot R, 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. 2021;59(3):265-71.

Li X, Zheng W, Zhang X, Zhang Y. Meta-analysis of outcomes related to the quality of life after orthodontic-surgical treatment. Adv Clin Exp Med. 2023;32(10):1099-111.

Zamboni R, de Moura FR, Brew MC, Rivaldo EG, Braz MA, Grossmann E, Bavaresco CS. 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(1):2864216.

Abdullah WA. Changes in quality of life after orthognathic surgery in Saudi patients. Saudi Dent J. 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. 2018;47(6):726-31.

Elmouden L, Ousehal L. Assessment of the Quality of Life in Moroccan Patients Undergoing Orthognathic Surgery. Turk J Orthod. 2018;31(3):79-85.

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. 2009;107(1):49-55.

Al-Bitar ZB, Al-Omari IK, Al-Ahmad HT, El Maaytah MA, Cunningham SJ. A comparison of health-related quality of life between Jordanian and British orthognathic patients. Eur J Orthod. 2009;31(5):485-9.

Al-Ahmad HT, Al-Bitar ZB. The effect of temporomandibular disorders on condition-specific quality of life in patients with dentofacial deformities. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(3):293-301.

Hanafy M, Abou-Elfetouh A, Mounir RM. Quality of life after different approaches of orthognathic surgery: a randomized controlled study. Minerva Stomatol. 2019;68(3):112-7.

Agou SH. Validation of the Arabic version of the Orthognathic Quality of Life Questionnaire. medRxiv. 2024:2024-01.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-7.

Duarte V, Zaror C, Villanueva J, Werlinger F, Vidal C, Sole P, et al. Changes in health-related quality of life after orthognathic surgery: a multicenter study. Clin. Oral Investig. 2022;26(4):3467-76.

Eslamipour F, Najimi A, Tadayonfard A, Azamian Z. Impact of Orthognathic Surgery on Quality of Life in Patients with Dentofacial Deformities. Int J Dent. 2017;2017:4103905.

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 2018;76(10):2192-201.

Gerzanic L, Jagsch R, Watzke IM. Psychologic implications of orthognathic surgery in patients with skeletal Class II or Class ill malocclusion. Int J Adult Orthod Orthognath Surg. 2002;17(2):75-81.

Takatsuji H, Kobayashi T, Kojima T, Hasebe D, Izumi N, Saito I, et al. Effects of orthognathic surgery on psychological status of patients with jaw deformities. Int J Oral Maxillofac Surg 2015;44(9):1125-30.

Rivera SM, Hatch JP, Rugh JD. Psychosocial factors associated with orthodontic and orthognathic surgical treatment. Semin Orthod 2000 Dec 1 (Vol. 6, No. 4, pp. 259-269). WB Saunders.

Moon W, Kim J. Psychological considerations in orthognathic surgery and orthodontics. Semin Orthod 2016 Mar 1 (Vol. 22, No. 1, pp. 12-17). WB Saunders.

Stagles C, Popat H, Rogers S. Factors influencing patient-reported quality of life in pretreatment orthognathic surgery patients. Angle Orthod. 2016;86(2):331-6.

Gabardo M, Zielak J, Tortora G, Gerber J, Meger M, Rebellato N, et al. Impact of orthognathic surgery on quality of life: Predisposing clinical and genetic factors. J Craniomaxillofac Surg. 2019;47(8):1285-91.

Brunault P, Battini J, Potard C, Jonas C, Zagala-Bouquillon B, Chabut A, 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 2016;45(1):26-34.

Kurabe K, Kojima T, Kato Y, Saito I, Kobayashi T. Impact of orthognathic surgery on oral health-related quality of life in patients with jaw deformities. Int J Oral Maxillofac Surg 2016;45(12):1513-9.

Allison PJ, Locker D, Feine JS. Quality of life: a dynamic construct. Soc. Sci. Med. 1997;45(2):221-30.