Page 161 - Demo

Impact of orthognathic surgery on quality of life in patients with different dentofacial deformities1598The pain score significantly decreased after day 5 and was very low after 4 weeks. In the first week, a high percentage of patients said that they had taken painkillers. This could influence the perceived pain, so the actual pain score may have been higher. There was a significant positive correlation between pain scores and OHIP scores for every time point except 6 months, but no association was found between pain and age, gender, blood loss, time of surgery, indication for surgery, or type of surgery.A major limitation of this study is that only 22 of the 85 patients completed all the questionnaires. A paper version of the questionnaires was used only in the first 6 months of this study. After that, the questionnaire was sent by email; patients may have perceived the questionnaires received by email as less important, despite the reminders that were sent. Consequently, the number of patients was too low for all 11 time points (T0-T10). Therefore, we applied the Friedman test for only the first 7 days after surgery and separately tested the later time points using the Wilcoxon signed rank test. In this study, some patients mentioned numbness of the lower lip in the comments to the questionnaire, though numbness of the lower lip after surgery was not specifically requested. There may have been more patients who suffered from this complication. Damage of the inferior alveolar nerve is a common postoperative complication.37-39 There is broad variation in the incidence of inferior alveolar nerve injury,40,41 which could influence patient satisfaction.42 However, some studies that report a high incidence of lip paraesthesia in patients following orthognathic surgery have shown no effect on patient satisfaction.9, 43, 44 Most patients, especially in the younger age group, seem to adapt to this complication.42Another limitation of this study was that the first questionnaire was completed before surgery, but this was not the baseline for orthodontic treatment. Patients already had orthodontic braces for a few months, which can influence the OHRQoL when they filled out the first questionnaire. Huang et al. compared surgery-first and orthodontic-first treatments. The orthodonticfirst group experienced deterioration before surgery and suggested that preorthodontics could worsen the facial deformity.48 Therefore, our last evaluation was 1-3 years after surgery. Not every patient had finished the orthodontic