State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.
Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China.
BMC Oral Health. 2019 Jul 8;19(1):136. doi: 10.1186/s12903-019-0842-1.
The oral health-related quality of life (OHRQoL) is affected by dentofacial deformity. Patients with dentofacial deformity are normally treated with orthognathic surgery, including conventional three-stage method (CTM) and surgery first approach (SFA). The aim of this systematic review and meta-analysis was to compare the impact of SFA with CTM on the OHRQoL of patients with severe dentofacial deformity.
Five English databases, three Chinese databases, and six grey literature databases were searched (January 2000 to July 2018). Randomized controlled trials, controlled clinical trials, and cohort studies assessing the OHRQoL of patients who underwent SFA or CTM were included. After selecting studies, extracting data, and assessing risk-of-bias according to the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa Scale, meta-analysis was performed to elucidate the effects of SFA on the changes of OHRQoL of patients with dentofacial deformity at each stage and made a comparison with CTM.
There were 4 studies with 122 participants were selected for the final analysis. Three among these studies were included in meta-analysis, 2 of which were included in each forest plot. All the included studies were graded as moderate value of evidence according to GRADE quality analysis. Over the period of 2-year follow-up after bonding, the OHRQoL of the patients in SFA group showed an improving trend and was better than those in CTM group generally. After debonding, the summary scores of the 14-item Oral Health Impact Profile (OHIP-14) (- 2.92, P = 0.12) and Orthognathic Quality of Life Questionnaire (OQLQ) (- 5.59, P = 0.01) were smaller in SFA group than CTM group.
Clinical evidence indicates that SFA can contribute to the better OHRQoL in patients with dentofacial deformity immediately and persistently.
口腔健康相关生活质量（OHRQoL）受到牙颌面畸形的影响。牙颌面畸形患者通常接受正颌手术治疗，包括传统的三阶段方法（CTM）和手术优先方法（SFA）。本系统评价和荟萃分析的目的是比较 SFA 与 CTM 对严重牙颌面畸形患者 OHRQoL 的影响。
检索了 5 个英文数据库、3 个中文数据库和 6 个灰色文献数据库（2000 年 1 月至 2018 年 7 月）。纳入评估 SFA 或 CTM 治疗的患者 OHRQoL 的随机对照试验、对照临床试验和队列研究。选择研究后，根据 Cochrane 系统评价干预手册和纽卡斯尔-渥太华量表提取数据并评估偏倚风险，然后进行荟萃分析，以阐明 SFA 对牙颌面畸形患者 OHRQoL 各阶段变化的影响，并与 CTM 进行比较。
最终分析纳入了 4 项研究共 122 名参与者。其中 3 项研究纳入荟萃分析，其中 2 项研究分别纳入每个森林图。根据 GRADE 质量分析，所有纳入的研究均为中度证据值。在粘结后 2 年的随访期间，SFA 组患者的 OHRQoL 呈改善趋势，通常优于 CTM 组。去粘结后，SFA 组的 14 项口腔健康影响简表（OHIP-14）（-2.92，P=0.12）和正颌质量生活问卷（OQLQ）（-5.59，P=0.01）总分均小于 CTM 组。
临床证据表明，SFA 可以使牙颌面畸形患者的 OHRQoL 立即和持续得到改善。
Zotero 插件
