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Orthognathic Surgery and Oral Health-Related Quality of Life in Skeletal Class III Non-Syndromic Patients with Cleft
Bernardo Olsson1,2, Marina Fanderuff1, Katheleen Miranda Dos Santos1,2
1Department of Stomatology, Department of Oral and Maxillofacial Surgery, Federal University of Paraná, Curitiba, Brazil.
Abstract:
ObjectiveTo compare oral health-related quality of life (OHRQoL) of individuals with cleft lip and palate (CLP) and skeletal Class III malocclusion before and 6 months after orthognathic surgery.Study designLongitudinal observational study.SettingTertiary care.ParticipantsFifty-two individuals with CLP and skeletal Class III malocclusion.InterventionsOrthognathic surgery.Main outcomesChanges in OHIP-14 (oral health impact profile-14) score.ResultsAmong individuals included, 30 (58%) were female, 28 (54%) were ≤ 21 years old, 36 (69%) were "White," 30 (58%) presented with facial asymmetry, and 38 (73%) had unilateral CLP. Analyses using the Wilcoxon test and the Mann-Whitney U test indicated improvement in OHRQoL. The total OHIP-14 score improved significantly (p = 0.002), along with the domains of "psychological discomfort" (p = 0.015), "psychological disability" (p = 0.002), "social disability" (p = 0.001), and "participant restriction" (p < 0.001). The term "participant restriction" has been used to supersede the original domain terminology "handicap". Exploratory within-subgroup analyses indicated reductions in OHIP-14 scores among females (p = 0.007), individuals older than 21 years (p = 0.008), self-reported "White" participants (p = 0.008), those with facial asymmetry (p = 0.013), and both unilateral (p = 0.034) and bilateral CLP (p = 0.024) phenotypes. However, these within-group changes are exploratory and do not establish significant differences in treatment effect between subgroups.ConclusionOrthognathic surgery improved the OHRQoL in individuals with non-syndromic CLP and skeletal Class III malocclusion. Improvements were observed in the total OHIP-14 score and in psychological, social, and participation restriction domains related to OHRQoL.
