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成年患者正颌治疗后满意度水平的评估:一项系统评价

Evaluation of Satisfaction Levels Following Orthognathic Treatment in Adult Patients: A Systematic Review.

作者信息

Almasri Abdulmalek M H, Hajeer Mohammad Y, Sultan Kinda, Aljabban Ossama, Zakaria Ahmad Salim, Alhaffar Jacqueline B

机构信息

Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR.

Department of Endodontics and Restorative Dentistry, Faculty of Dentistry, University of Damascus, Damascus, SYR.

出版信息

Cureus. 2024 Nov 17;16(11):e73846. doi: 10.7759/cureus.73846. eCollection 2024 Nov.

Abstract

Dentofacial deformities can significantly impact an individual's quality of life, affecting facial aesthetics, self-esteem, and overall well-being. The combined orthognathic surgery-orthodontic treatment is the preferred approach for correcting moderate-to-severe deformities. However, patient satisfaction following orthognathic surgery remains a crucial outcome measure, influenced by various factors, including the type of malocclusion, surgical procedure, and demographic characteristics. This systematic review aimed to synthesize the available evidence regarding patient satisfaction following orthognathic surgery, exploring the effects of the type of malocclusion, surgical procedure, age, and gender on satisfaction rates, addressing a gap left by previous outdated reviews. A comprehensive literature search was conducted across multiple databases, including PubMed®, Scopus®, Web of Science™, and Embase®. Eligibility criteria were defined using the PICOS (population, intervention, comparison, outcomes, and study design) framework. Cochrane's ROBINS-I (Risk of Bias In Non-randomized Studies-of Interventions) tool was employed for non-randomized intervention studies within clinical controlled trials to assess the risk of bias. In parallel, a revised version of the Newcastle-Ottawa scale determined the methodological quality of cohort and cross-sectional studies. Sixteen studies were analyzed, revealing satisfaction levels ranging from 83% to 100%. Findings indicate that class III malocclusion patients report higher satisfaction than class II patients and satisfaction varies based on surgical type, with bimaxillary procedures generally yielding better outcomes. While most studies found no significant correlation between satisfaction and demographic factors such as age and gender, some suggested younger patients may express higher satisfaction and that female patients might report lower satisfaction levels. The review highlights the importance of effective patient communication and expectation management in achieving optimal satisfaction outcomes in orthognathic surgery. Limitations such as memory bias and methodological diversity across studies restrict the ability to perform meta-analyses, underscoring the need for further research in this area.

摘要

牙颌面畸形会对个人生活质量产生重大影响,影响面部美观、自尊和整体幸福感。正颌外科手术与正畸治疗相结合是矫正中重度畸形的首选方法。然而,正颌外科手术后患者的满意度仍然是一项关键的疗效指标,受到多种因素的影响,包括错牙合类型、手术方式和人口统计学特征。本系统评价旨在综合有关正颌外科手术后患者满意度的现有证据,探讨错牙合类型、手术方式、年龄和性别对满意度的影响,填补以往过时评价留下的空白。我们在多个数据库中进行了全面的文献检索,包括PubMed®、Scopus®、Web of Science™和Embase®。使用PICOS(人群、干预措施、对照、结局和研究设计)框架定义纳入标准。Cochrane的ROBINS-I(非随机干预研究的偏倚风险)工具用于评估临床对照试验中非随机干预研究的偏倚风险。同时,纽卡斯尔-渥太华量表的修订版用于确定队列研究和横断面研究的方法学质量。分析了16项研究,满意度水平在83%至100%之间。研究结果表明,III类错牙合患者的满意度高于II类患者,满意度因手术类型而异,双颌手术通常能产生更好的效果。虽然大多数研究发现满意度与年龄和性别等人口统计学因素之间没有显著相关性,但一些研究表明年轻患者可能表达更高的满意度,而女性患者的满意度可能较低。该评价强调了有效的患者沟通和期望管理在正颌外科手术中实现最佳满意度结果的重要性。诸如记忆偏差和研究间方法学多样性等局限性限制了进行荟萃分析的能力,凸显了该领域进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7843/11569791/1b8b0e8ee334/cureus-0016-00000073846-i01.jpg

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