Department of Orthodontics, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Germany.
J Craniomaxillofac Surg. 2017 Dec;45(12):1971-1979. doi: 10.1016/j.jcms.2017.08.016. Epub 2017 Aug 31.
The aim of the study was to collect information about the oral health-related quality of life (OHRQoL) after combined orthodontic and maxillofacial surgical treatment as well as its influence on health-related quality of life (HRQoL).
The study includes data from a total of 130 subjects, 65 of whom (21 male, 44 female, mean age at baseline: 24 years, mean age at the time of surgery: 26 years) were compared with control subjects matched on the basis of gender and age. The set of questionnaires used consisted of a questionnaire advanced by the authors including 35 general and treatment-specific questions, and the German version of the validated "Orthognathic Quality of Life Questionnaire" (OQLQ) to analyze the specific OHRQoL, and the SF-36 to measure HRQoL.
The main reason for treatment was most often a combination of esthetic and functional complaints. In most cases, the treatment results met the expectations of subjects well or very well, particularly in the areas of aesthetics and masticatory function. Postoperative numbness or paresthesia were present in 59% of patients, especially in the chin and lower lip areas. In all, 20% of subjects considered the temporary restriction of mouth opening as very bothersome. A decrease in HRQoL was noted as compared with the control group in the subscales of "role physical" (p < 0.001), "general health" (p = 0.023), and "role emotional" (p = 0.007). No differences were found in the "physical functioning," "bodily pain," "vitality," "social functioning," and "mental health" subscales. The specific OHRQoL resulted in statistically significant limitations in the patient group for all areas examined. The "oral function" (p < 0.001), "dentofacial aesthetics" (p = 0.005), "social aspects" (p = 0.002), and "awareness of dentofacial aesthetics" (p = 0.004) values were significantly decreased.
Overall, patients expressed a high level of satisfaction and approval with regard to the combined orthodontic and maxillofacial surgical treatment. However, even after combined orthodontic and maxillofacial surgical treatment of malocclusion patients, it is possible to detect smaller limitations with regard to the specific OHRQoL, which may have a negative impact on HRQoL. Based on the results, a participatory decision-making process focusing on the individual therapy-related expectations, desires, and psychological factors of the patient concerning the improvements effected by the treatment appears to be advisable.
本研究旨在收集正畸联合正颌手术治疗后口腔健康相关生活质量（OHRQoL）的信息，并探讨其对健康相关生活质量（HRQoL）的影响。
本研究共纳入 130 例患者，其中 65 例（21 例男性，44 例女性，基线时平均年龄为 24 岁，手术时平均年龄为 26 岁）与性别和年龄匹配的对照组患者进行比较。使用的问卷集包括作者提出的包含 35 个一般问题和治疗特异性问题的问卷，以及经验证的德国版“正颌治疗生活质量问卷”（OQLQ），以分析特定的 OHRQoL，以及 SF-36 来衡量 HRQoL。
治疗的主要原因通常是美观和功能投诉的组合。大多数情况下，患者对治疗结果的满意度较高，尤其是在美观和咀嚼功能方面。术后麻木或感觉异常的发生率为 59%，尤其是在下巴和下唇区域。总的来说，20%的患者认为暂时限制张口非常麻烦。与对照组相比，患者组在“生理职能”（p<0.001）、“总体健康”（p=0.023）和“情感职能”（p=0.007）亚量表中的 HRQoL 下降。在“生理机能”、“躯体疼痛”、“活力”、“社会功能”和“心理健康”亚量表中未发现差异。特定的 OHRQoL 导致患者组在所有检查领域均存在统计学显著限制。“口腔功能”（p<0.001）、“牙颌面美观”（p=0.005）、“社会方面”（p=0.002）和“对牙颌面美观的认识”（p=0.004）值显著降低。
总体而言，患者对正畸联合正颌手术治疗表示高度满意和认可。然而，即使在对错颌畸形患者进行正畸联合正颌手术后，仍有可能发现特定 OHRQoL 的较小限制，这可能对 HRQoL 产生负面影响。基于这些结果，似乎有必要进行以患者为中心的决策过程，重点关注患者的个体治疗相关期望、愿望和心理因素。
