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Using patient self-report data to evaluate orofacial surgical outcomes.
Kathryn A Atchison1, Vivek Shetty, Thomas R Belin
1UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA. kathya@dent.ucla.edu
Community Dentistry and Oral Epidemiology
|March 7, 2006
Summary
Patients treated for mandible fractures reported fewer issues early after maxillomandibular fixation (MMF) compared to rigid internal fixation (RIF). However, oral health quality of life improved significantly over six months for both treatment groups.
Area of Science:
- Oral and Maxillofacial Surgery
- Health Services Research
- Quality of Life Research
Background:
- Mandible fractures are common injuries requiring surgical intervention.
- Assessing patient-reported outcomes is crucial for evaluating surgical success in orofacial surgery.
- Previous studies have focused on objective measures, with less emphasis on subjective patient experiences.
Purpose of the Study:
- To analyze the association between subjective patient evaluations and objective clinical outcomes following orofacial surgery for mandible fractures.
- To compare patient-reported outcomes between two common surgical fixation methods: maxillomandibular fixation (MMF) and rigid internal fixation (RIF).
Main Methods:
- A prospective study of 336 patients treated for mandible fractures between 1996 and 2001.
- Patient-reported outcomes were assessed using the General Oral Health Assessment Index (GOHAI), Mental Health Inventory (MHI-5), and self-reported health status at hospital discharge, 10 days, 1 month, and 6 months post-discharge.
- Longitudinal growth curve analysis was used to compare GOHAI scores between MMF and RIF groups over time.
Main Results:
- General Oral Health Assessment Index (GOHAI) scores improved substantially by 6 months post-discharge for all patients.
- The maxillomandibular fixation (MMF) group had a significantly higher average intercept for GOHAI scores initially compared to the rigid internal fixation (RIF) group.
- The RIF group demonstrated a significantly greater increase in GOHAI scores over time, leading to comparable scores between groups at 6 months.
Conclusions:
- Patients undergoing MMF reported fewer oral health problems in the early post-operative period compared to those treated with RIF.
- While initial subjective reports differed, both MMF and RIF treatments led to significant improvements in oral health-related quality of life by six months.
- Patient-reported outcomes provide valuable insights into the recovery process following mandible fracture surgery.