Tachiki Chie, Nishii Yasushi, Takaki Takashi, Sueishi Kenji
Department of Orthodontics, Tokyo Dental College.
Department of Oral and Maxillofacial Surgery, Tokyo Dental College.
Bull Tokyo Dent Coll. 2018;59(1):1-14. doi: 10.2209/tdcpublication.2016-0042.
Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (p<0.01), and between at pre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (p<0.05, p<0.01). A significant correlation was observed between a negative change in overjet and worsening OQLQ scores at the pre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre-surgical orthodontic treatment.
据报道,外科正畸治疗可改善口腔健康相关生活质量(OHRQL)。此类治疗包括三个阶段:术前正畸治疗;正颌外科手术;以及术后正畸治疗。大多数研究都集中在手术前后OHRQL的变化上。然而,在术前正畸治疗阶段评估OHRQL也很有必要,因为与治疗前相比,它可能会受到牙齿代偿的负面影响。这项前瞻性研究的目的是通过评估骨骼III类病例治疗各阶段特定状况生活质量的变化,来调查外科正畸治疗对生活质量的影响。20名需要接受外科正畸治疗的骨骼III类患者纳入了该研究。每位患者都完成了为牙颌面畸形患者编制的正颌生活质量问卷(OQLQ)。其项目分为4个领域:“牙颌面畸形的社会方面”;“面部美观”;“口腔功能”;以及“牙颌面美观意识”。该问卷在治疗前、术前正畸治疗和术后正畸治疗阶段完成。结果显示,在面部美观和口腔功能领域,治疗前与术前正畸治疗之间的得分显著恶化(p<0.01),在除牙颌面美观意识外的所有领域,术前正畸治疗与术后正畸治疗之间的得分也显著恶化(p<0.05,p<0.01)。在术前正畸治疗阶段,覆盖减小的负向变化与OQLQ得分恶化之间观察到显著相关性。在术后正畸治疗阶段,上下唇差异改善、软组织颏前点突出和ANB角改善与OQLQ得分改善之间也观察到显著相关性。这些结果表明,形态学变化不仅在手术后,而且在术前正畸治疗期间都会影响接受外科正畸治疗患者的OHRQL。