Page 149 - Demo

Impact of orthognathic surgery on quality of life in patients with different dentofacial deformities1478IntroductionMany studies have found lower oral health-related quality of life (OHRQoL) in patients with dentofacial deformities.1-7Patients with dentofacial deformities are characterized by various irregularities of the face and dental bone structures, such as hyperplasia, hypoplasia, and asymmetries of the maxilla, mandible, or chin. An abnormal position of the jaws can manifest in the dentition as a class II or III malocclusion and cause aesthetic and functional problems, including difficulty chewing, sleeping, breathing, speaking, or overall oral health problems.8 Some patients experience psychological and emotional problems.9Orthognathic surgery is a common treatment for dentofacial deformities. The procedure involves repositioning the maxilla, mandible, or both, sometimes in combination with correction of the chin. The functional and aesthetic goals are to achieve a class I dental occlusion and facial balance and proportion. Traditionally, orthognathic surgery involves preoperative and postoperative orthodontics to achieve dentofacial correction by aligning the dental arches. The main surgical techniques are Le Fort I osteotomy, bilateral sagittal split osteotomy (BSSO), and bimaxillary osteotomy (BIMAX), which are sometimes combined with an osseous genioplasty. Patients seek orthognathic surgery for various reasons. Their primary motivations are aesthetic concerns and improved QoL.10, 11 Some studies have found that oral function, including bite, pain, smile, and speech, is a primary motivation.12-14 A recent systematic review15 showed physiological and psychological improvement in QoL following orthognathic surgery. A study with a 5-year follow-up found significant improvement and stabilization after 2-5 years in regards to the general health-related QoL, OHRQoL, and psychosocial function after BSSO.16The Oral Health Impact Profile (OHIP-14) is a standardized questionnaire that measures the OHRQoL. The questionnaire is a short version of the OHIP-49 that includes 14 questions representing 7 domains.17, 18 The Dutch version of the questionnaire, OHIP-14NL, was reported in 2011 to be a reliable and valid