Quality of Life Changes in Taiwanese Dentofacial Deformity Patients Undergoing Orthognathic Surgery

Abstract

Abstract Objectives The evaluation of orthognathic surgery (OgS) is shifting towards a coherent approach for patient care that balances objective clinician-defined measures with patient-centred outcome assessments, including health-related quality of life (QoL). This aim of this study adds to the pool of literature in East Asian subjects by studying the longitudinal QoL changes in Taiwanese patients with dentofacial deformities (DFD) undergoing OgS, using two standardized questionnaires at three different treatment stages. Materials and Methods This prospective cohort study comprised 113 consecutive Taiwanese OgS patients who underwent surgical-orthodontic treatment between 2015 and 2018. The subjects completed SF-36 and OHIP-14 standardized questionnaires with one additional aesthetics question at one month before OGS (T1), 3 months (T2) and at debond (T3). All responses were screened, and 90 valid questionnaires included for analysis. Additional subgroup comparisons were made between Class II and Class III patients, symmetric and asymmetric patients, surgery-first approach and orthodontics-first approach, presence or absence of genioplasty, genders, and younger and older patients. Results The cohort was comprised largely of skeletal Class III patients (84.4%) and showed significant improvements in OHIP-14 and Aesthetic score from T1 to T3. Pre-surgical orthodontic decompensation leads to a decrease in QoL. Patients who have undergone genioplasty have better generic health QoL than those without genioplasty at T3. Male DFD patients have better generic oral health and aesthetics QoL than female DFD patients. Age does not appear to affect generic health, generic oral health and aesthetics QoL at any time during OgS treatment. Conclusion OgS has positive effects on generic health, generic oral health and aesthetics QoL in DFD patients. The effect of asymmetry on QoL in OgS patients remains an area that requires further research in order to clarify conflicting results in the literature. Future studies should explore the long-term stability of QoL effects. Clinical Relevance: Prospective evaluation with contemporaneous questionnaire surveys at appropriate time points could better reflect the fluctuations of QoL and treatment variables throughout the surgical-orthodontic treatment.