Department of Oral and Maxillofacial Surgery, Prosthesis and Traumatology, School of Dentistry, University of Sao Paulo, Sao-Paulo, SP, Brazil.
Department of Oral, Craniomaxillofacial and Plastic Surgery, Sana Hospital Offenbach, Frankfurt, Germany.
J Stomatol Oral Maxillofac Surg. 2022 Sep;123(4):434-439. doi: 10.1016/j.jormas.2021.10.002. Epub 2021 Oct 8.
The orthodontic-surgical treatment comprises different stages from diagnosis to final soft tissue accommodation, but there are no data regarding the patient's perception during these phases. This study aimed to investigate the impact of these stages on quality of life and self-esteem of patients with dentofacial deformity. Patients were divided into 4 groups according to the treatment stage: initial orthodontic pre-treatment (1), one week before surgery (2), three months after surgery (3), and after the removal of the orthodontic appliance (4) (n = 20 / group). They filled the following questionnaires: Oral Health Impact Profile (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ) and Rosenberg Self-Esteem Scale (RSES). Data were evaluated by Kruskal-Wallis test. Differences among groups were noticed in all evaluated scales (p = 0.001 for all). No statistically significant differences between patients in groups 1 and 2 (OHIP, OQLQ, and RSES, p >0.05 for all), while patients at group 4 presented different scores in all questionnaires compared to 1, 2, and 3 (p < 0.05 for all), irrespective of the type of dentofacial deformity (p > 0.05). The results indicate that dental decompensation stage did not negatively affect patient's confidence and well-being. Despite the improvement noticed few months after the orthognathic surgery, the main impact on patient's quality of life and self-esteem was evidenced after the removal of the orthodontic appliance. We highlight the important role of counselling patients to discuss all the treatment stages to clarify patients' subjective expectations before any intervention is carried out.
正畸-正颌联合治疗包括从诊断到最终软组织适应的不同阶段，但目前尚无关于患者在这些阶段的感知的相关数据。本研究旨在探讨这些阶段对牙颌面畸形患者生活质量和自尊的影响。根据治疗阶段，患者分为 4 组：初始正畸预处理（1）、手术前一周（2）、手术后三个月（3）和正畸矫治器去除后（4）（每组 20 例）。他们填写了以下问卷：口腔健康影响量表（OHIP-14）、正颌治疗生活质量问卷（OQLQ）和罗森伯格自尊量表（RSES）。数据采用 Kruskal-Wallis 检验进行评估。所有评估量表均显示组间存在差异（所有 p 值均为 0.001）。第 1 组和第 2 组之间的患者在所有问卷上均无统计学差异（OHIP、OQLQ 和 RSES，所有 p 值均>0.05），而第 4 组的患者在所有问卷上的评分均与第 1、2 和 3 组不同（所有 p 值均<0.05），无论牙颌面畸形的类型如何（所有 p 值均>0.05）。结果表明，牙代偿阶段并未对患者的信心和幸福感产生负面影响。尽管在正颌手术后几个月内注意到了改善，但在去除正畸矫治器后，对患者生活质量和自尊的主要影响更为显著。我们强调了对患者进行咨询的重要性，讨论所有治疗阶段，以在进行任何干预之前澄清患者的主观期望。
