Sections for Orthodontics and Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark.
Visiting Researcher, Department of Oral Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark.
J Oral Rehabil. 2024 Apr;51(4):684-694. doi: 10.1111/joor.13619. Epub 2024 Jan 19.
Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment.
A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM).
Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ.
Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.
患有牙颌面畸形（DFD）需要正颌治疗的患者，其美观、颌骨功能和心理健康状况较差，这可能会影响其生活质量。本研究旨在探讨不同阶段正颌手术治疗对牙颌面畸形患者健康相关的一般状况、口腔和正颌状况、颌骨功能和睡眠呼吸紊乱的影响。
共招募了 120 例连续的牙颌面畸形患者，分为正畸治疗前（第 1 组）、术前（第 2 组）、术后 4 个月（第 3 组）、术后 24 个月（第 4 组），并另外选择 30 例无牙颌面畸形的对照组（第 0 组）。采用一般健康状况简表（SF-36）、口腔健康影响程度量表（OHIP-14）、正颌治疗生活质量问卷（OQLQ）、STOP-Bang 量表和颌骨功能受限量表（JFLS）评估结果。此外，还记录了疼痛的存在或不存在。采用方差分析、Kruskal-Wallis 检验、Tukey 事后检验和结构方程模型（SEM）对数据进行检验。
结果显示，对照组和治疗组的 SF-36（p = .814）和 STOP-Bang（p = .143）总分无差异。相比之下，OHIP-14、OQLQ 和 JFLS 总分在各组间有差异（p = .001）。与对照组相比，第 1 组（p = .001）、第 2 组（p = .001）和第 3 组（p = .041）的分数更高，表明牙颌面畸形患者口腔健康状况较差。重要的是，第 4 组的口腔健康相关生活质量较好，OHIP-14（p = .936）和 JFLS（p = .572）评分与对照组无差异。第 4 组的 OQLQ 评分明显低于第 1 组（p = .001），但高于对照组（p = .013）。SEM 结果显示，疼痛与 JFLS 和 OQLQ、OHIP-14 与 OQLQ、OHIP-14 与 SF-36 呈显著负相关，STOP-Bang 与 SF-36 呈显著正相关。JFLS 与 OHIP-14、OHIP-14 与 OQLQ 呈正相关。
正颌手术后 24 个月，口腔健康相关的生活质量和颌骨功能似乎有所改善。疼痛和颌骨功能受限与生活质量呈负相关。
