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Zheng Y, Liao N, Mo S, Huang X, Zhou N. Effect of surgery-first approach on quality of life and mental health of orthognathic patients: A systematic review and meta-analysis. Heliyon 2024; 10:e23285. [PMID: 38163099 PMCID: PMC10757011 DOI: 10.1016/j.heliyon.2023.e23285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/27/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives This study intends to explore the effects of the surgery-first approach (SFA) on quality of life and mental health of patients who undergo orthognathic surgery compared to the conventional three-stage approach (CTA). Data The analysis included eight studies with a total of 307 patients, of which one was randomized controlled trial (RCT), one was clinical controlled trial (CCT), and six were non-randomized studies of interventions (NRSIs). Sources Electronic databases such as Medline, Embase, Scopus, and Web of Science were searched for eligible trials up to April 2023. Study selection RCTs, CCTs, and NRSIs, which compared the quality of life or mental health of orthognathic patients treated with SFA and CTA, were included in this study. The meta-analysis showed that the standardized mean differences (SMD) of Oral Health Impact Profiles-14 (OHIP-14) scores and the Orthognathic Quality of Life Questionnaire (OQLQ) between SFA and CTA were -1.58 (P = 0.05) and -2.99 (P < 0.00001) at the termination of the first-stage treatment, which altered to -0.94 (P = 0.54) and 0.09 (P = 0.65) after total treatment. Two studies applied the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Beck Depression Inventory (BDI-II) to examine mental health, resulting in a trend similar to the former scales. Conclusion In contrast to the conventional procedure, orthognathic treatment with SFA can instantly enhance the quality of life at the end of the first-stage treatment but has similar effects after the overall treatment. Moreover, SFA has a positive impact on psychological conditions. Clinical significance This study first systematically reviewed the effect of SFA on patients' mental well-being. According to our findings, it is better to select SFA if possible. Otherwise, the patient's psychological condition should be monitored appropriately throughout decompensation for better well-being both physically and mentally.
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Affiliation(s)
- Yi Zheng
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No.10 Shuangyong Road Nanning, Guangxi 530021, People's Republic of China
| | - Ni Liao
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No.10 Shuangyong Road Nanning, Guangxi 530021, People's Republic of China
| | - Shuixue Mo
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No.10 Shuangyong Road Nanning, Guangxi 530021, People's Republic of China
| | - Xuanping Huang
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No.10 Shuangyong Road Nanning, Guangxi 530021, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning 530021, Guangxi, People's Republic of China
| | - Nuo Zhou
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, No.10 Shuangyong Road Nanning, Guangxi 530021, People's Republic of China
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning 530021, Guangxi, People's Republic of China
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Brouns VEHW, de Waal ALML, Bronkhorst EM, Kuijpers-Jagtman AM, Ongkosuwito EM. Oral health-related quality of life before, during, and after orthodontic-orthognathic treatment: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:2223-2235. [PMID: 35194682 DOI: 10.1007/s00784-021-04288-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 11/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The effect of combined orthodontic-orthognathic treatment was estimated, specifically the impact of pre-surgical orthodontic treatment, on oral health-related quality of life (OHRQoL). MATERIALS AND METHODS The research question was formulated using the PICO method. The search was carried out in MEDLINE via PubMed, CINAHL, psychINFO, Embase, and Cochrane (until February 3, 2020). Inclusion criteria were patients aged ≥ 17 years who underwent combined orthodontic-surgical treatment, quality of life assessment, and study design of randomized controlled trial, controlled clinical trial, prospective cohort study, observational study, intervention study, or cross-sectional study. The ROBINS-1 tool was used to assess the risk of bias within studies. A random effects meta-analysis was conducted when appropriate. The quality of evidence was assessed using the GRADE approach. RESULTS Six studies were analyzed. The OHIP-14 and/or OQLQ-22 questionnaires were used to measure the OHRQoL. All six studies had a serious risk of bias. Two studies (87 participants) were included in a meta-analysis showing improvement of OHRQoL when comparing before and after treatment were compared (mean 14.85 scale points, 95% confidence interval 10.36;19.35). CONCLUSIONS Studies indicate a decrease in OHRQoL during the pre-surgical orthodontic treatment phase but improvement after orthodontic-orthognathic treatment. Data substantiating these results are limited, and the quality of evidence is low. Further research is needed to assess the impact of pre-surgical orthodontic treatment on the OHRQoL in an orthognathic trajectory. CLINICAL RELEVANCE Patients should be well informed about the effect facial/esthetic changes may have on their OHRQoL during sequential phases of orthodontic-orthognathic treatment.
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Affiliation(s)
- Victorine E H W Brouns
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | | | - Ewald M Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland.,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Edwin M Ongkosuwito
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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3
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Fındık Y, Büyükçavuş MH, Koçer G, Yazıcı T, Baykul T. Comparison of psychosocial and aesthetic features of class III malocclusion after orthognathic surgery: Conventional approach versus surgery-first approach. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e153-e158. [PMID: 34628099 DOI: 10.1016/j.jormas.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/01/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022]
Abstract
The aim of this study is to investigate and compare the changes in psychosocial status, self-esteem, and quality of life in patients treated with conventional and SF approaches. 14 patients (mean age 23.04±3.36; 9 male and 5 female) who met the inclusion criteria were included in the SF group; 18 patients with class III malocclusion (mean age 29.27±3.78; 9 male and 9 female) were included in the COS group. In the research protocol, the first questionnaires were carried out 2 weeks before surgery (T0); second survey approximately 4 weeks after surgery (T1); and the third one was done to patients after the treatment was completed (debonding) (T2). In our study, Orthognathic Quality of Life Questionnaire (OQLQ), Pyschosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14), Beck Depression Inventory second edition (BDI-II) and Rosenberg Self-Esteem Scale (RSES), surveys were conducted. No statistically significant difference was observed in all of the PIDAQ parameters and most of the OQLQ parameters within the COS and SF groups (P>0.05). When the BDI-II results were examined, different trends in scores were observed between the two groups, and this difference was found to be statistically significant (P<0.05). In the SF approach, progressive improvement was detected in the patients in terms of psychosocial and quality of life in the early period of treatment. The greater improvement in psychological and social characteristics in the SF approach compared to conventional orthognathic surgery may also be associated with a shorter treatment time.
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Affiliation(s)
- Yavuz Fındık
- Süleyman Demirel University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Isparta, Turkey.
| | | | | | - Tayfun Yazıcı
- Süleyman Demirel University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Isparta, Turkey
| | - Timuçin Baykul
- Süleyman Demirel University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Isparta, Turkey
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Yao K, Zhu G, Chen M, Zhang B, Wu Y, Li P. Effect of surgery-first orthognathic approach on oral health-related quality of life. Angle Orthod 2021; 90:723-733. [PMID: 33378482 DOI: 10.2319/112619-749.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/01/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To systematically evaluate the effect of the surgery-first approach (SFA) on oral health-related quality of life (OHRQoL) in patients with dentofacial deformities. MATERIALS AND METHODS An electronic database search and hand search of selected journals and references were carried out. Studies investigating the OHRQoL of patients receiving SFA with or without a control group were included. The risk of bias was assessed by the Cochrane risk of bias tool in randomized clinical trials (RCTs) and the Newcastle-Ottawa Scale in non-RCTs. RESULTS A total of seven articles met the eligible criteria and were included, of which six were cohort studies and one was an RCT, and six assessed the OHRQoL of the SFA with conventional orthodontic-surgical treatment (COST) as a control and one without. A total of 214 patients were examined, with sample sizes in studies ranging from 9 to 50. A total of 3 articles successfully measured the OHRQoL both before and after treatment in both the SFA and conventional orthodontic-surgical treatment groups. A total of six cohort studies were classified as low to moderate risk of bias, and the RCT was classified as high. CONCLUSIONS The SFA could improve the OHRQoL of patients with dentofacial deformities similar to conventional orthodontic-surgical treatment at the end of complete treatment. In addition, it increases OHRQoL immediately at the beginning of treatment without a deterioration.
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Elnagar MH, Handelman CS, Lippincott JS, Kim MR, BeGole E. Alveolar cortical plate changes associated with incisor retraction and its influence on the limits of orthodontic tooth movement. Orthod Craniofac Res 2021; 24:536-542. [PMID: 33475228 DOI: 10.1111/ocr.12469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/29/2020] [Accepted: 01/08/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The extent to which the modelling behaviour of the anterior alveolus limits tooth movement remains unclear. Will the labial and lingual cortical plates model as incisors retract, or will they remain unchanged, therefore limiting the extent of possible tooth movement? SETTING AND SAMPLE POPULATION Pre- and post-treatment lateral cephalometric radiographs of 29 bimaxillary protrusive patients of South Korean descent were examined. Treatment consisted of two premolar extractions in one or both arches with en masse retraction of the incisors using miniscrew anchorage. MATERIALS AND METHODS Pre- and post-treatment measurements of both tooth and cortical plate position were made at various increments along the length of the root and then compared using paired t tests. RESULTS Despite the use of miniscrew anchorage, the incisors were retracted by controlled tipping. The labial cortical plates in both arches modelled to follow tooth movement. Following retraction of the incisors in the maxilla, the incisor root approached the lingual cortical plate, which remained unchanged. In the mandible, the lingual cortical plate position was unchanged except at the level closest to the cementoenamel junction. CONCLUSIONS The maxillary and mandibular lingual cortical plates did not model to follow the incisor movement while the labial cortical plates did. These findings suggest that lingual cortical plates may act as limitations to planned orthodontic tooth movement.
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Affiliation(s)
- Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Orthodontics, Tanta University, Tanta, Egypt
| | - Chester S Handelman
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Myung-Rip Kim
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA.,Private Practice, Seoul, South Korea.,Catholic University of Korea, Seoul, South Korea
| | - Ellen BeGole
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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6
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Barone S, Morice A, Picard A, Giudice A. Surgery-first orthognathic approach vs conventional orthognathic approach: A systematic review of systematic reviews. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:162-172. [PMID: 32898673 DOI: 10.1016/j.jormas.2020.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/13/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023]
Abstract
Surgery-first approach (SFA) has been introduced as an alternative for conventional orthognathic approach (COA) in the treatment of patients with dentoskeletal deformities. This review aimed to evaluate skeletal stability, treatment time, surgical complications, and quality of life in SFA and COA. Six databases were accessed up to May 2020 to obtain all systematic reviews (SRs). After title and abstract reading, data extraction was performed from eligible SRs. The methodological quality was calculated for the included SRs using the last version of A Measurement Tool to Assess Systematic Review (AMSTAR-2). Ten SRs were included in this review. A good stability of the jaws was assessed both with SFA and COA by most of low- or critically low-quality SRs. Less treatment time was reported for SFA than COA with a moderate quality level. Slightly higher complications rate was recorded with SFA than COA by SRs with low or moderate quality. A better quality of life with SFA than COA was reported by moderate- or low-quality SRs. SFA may represent a reasonable alternative to COA. However, for the heterogeneity of the included SRs, well-designed studies with a long term follow-up are needed to clarify the findings of this analysis.
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Affiliation(s)
- Selene Barone
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Anne Morice
- Descartes-Sorbonne Paris University, Paris, France; APHP, Department of Maxillofacial and Plastic Surgery, Necker-Enfants Malades Hospital, Paris, France
| | - Arnaud Picard
- Descartes-Sorbonne Paris University, Paris, France; APHP, Department of Maxillofacial and Plastic Surgery, Necker-Enfants Malades Hospital, Paris, France
| | - Amerigo Giudice
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy; Department of Oral and Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy.
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7
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Daws S. Assent for Orthognathic Surgery: Features, Challenges, and Benefits. Cleft Palate Craniofac J 2020; 58:391-395. [PMID: 32815374 DOI: 10.1177/1055665620951062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The ideal age to undergo orthognathic surgery approximates the age of majority, and as a result a considerable portion of the patient population undergoing orthognathic surgery are legal minors. When a patient cannot legally provide consent, assent is often sought. Assent for surgical orthodontics is complicated by particular changes in cognitive variables during adolescence, the multiphased and multi-provider treatment course, and the intervention's elective nature. Ultimately, inclusion of a high-quality assent process can help identify patients most likely to benefit from orthognathic surgery and increase patient satisfaction.
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Affiliation(s)
- Steven Daws
- Resident, Department of Oral & Maxillofacial Surgery, 21927Ascension Macomb-Oakland Hospital, Warren, MI, USA
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8
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Saghafi H, Benington P, Ayoub A. Impact of orthognathic surgery on quality of life: a comparison between orthodontics-first and surgery-first approaches. Br J Oral Maxillofac Surg 2020; 58:341-347. [DOI: 10.1016/j.bjoms.2020.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
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9
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de Araujo CM, Schroder AGD, de Araujo BMDM, Cavalcante-Leão BL, Stechman-Neto J, Zeigelboim BS, Santos RS, Guariza-Filho O. Impact of orthodontic-surgical treatment on quality of life: a meta-analysis. Eur J Orthod 2019; 42:281-289. [DOI: 10.1093/ejo/cjz093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Summary
Background
Orthognathic surgery involves a change in the patient’s functional and aesthetic aspects.
Objective
The objective was to answer the following focused question: what is the impact on quality of life (QoL; aesthetic, function, social, and psychological aspects) in patients undergoing orthodontic-surgical treatment?
Search methods
Appropriate word combinations and truncations were selected and tailored specifically for each electronic database: PubMed/Medline, Scopus, Web of Science, PsycInfo, and Latin American and Caribbean Health Sciences Literature and gray literature.
Selection criteria
Studies that met the following criteria was included: patients with dentofacial deformity (P); surgical correction through orthodontic-surgical treatment (E/I); before orthodontic-surgical treatment or patients with no dentofacial deformity (C); QoL (O); cross-sectional, cohort, case-control and randomized or non-randomized clinical trial (S).
Data collection and analysis
In phase 1, two reviewers independently reviewed the titles and abstracts of all references. All articles that did not meet the inclusion criteria were excluded. In phase 2, the same reviewers completely read the selected articles independently.
Results
A total of 2879 articles were retrieved during the final database search. Fifty-two articles were selected for full reading, of which 16 were excluded, resulting in 36 included articles. The meta-analysis was performed using 13 of the selected studies. When comparing the period before any treatment with the post-operative period of 4–8 weeks, there was an association only for facial aesthetics (mean difference = 3.00; 95 per cent confidence interval = 1.10–4.89; inconsistency index = 63 per cent). The comparison between the period before any treatment with the 6 month post-operative period showed an improved QoL in all of the domains evaluated and, when comparing data after the orthodontic-surgical preparation (before surgery) and after 5–12 months of surgery, there was also statistical significance with an increased QoL for all of the domains evaluated.
Conclusions
In conclusion, based on the results of this systematic review and meta-analysis, the evidence suggests an improvement in the QoL of patients undergoing orthodontic-surgical treatment regarding aesthetic, functional, social, and psychological aspects.
Registration
CRD42017069495
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Affiliation(s)
- Cristiano Miranda de Araujo
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | | | | | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | - Odilon Guariza-Filho
- Postgraduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba
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10
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Yi J, Lu W, Xiao J, Li X, Li Y, Zhao Z. Effect of conventional combined orthodontic-surgical treatment on oral health-related quality of life: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2019; 156:29-43.e5. [DOI: 10.1016/j.ajodo.2019.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/17/2022]
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Gandedkar NH, Dávila MMC, Chng CK, Liou EJW, Darendeliler A. Surgery-first orthognathic approach: A “scoping review” for mapping outcomes and plausible recommendations to develop core outcome sets. APOS TRENDS IN ORTHODONTICS 2019. [DOI: 10.25259/apos-77-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims and Objectives
The aim of this scoping review was to identify the type of outcomes measured in surgery- first orthognathic approach (SFOA). The objectives were to classify the outcomes into predetermined domains and explore the degree of representation of each domain. Furthermore, to identify which domains are over- or under-represented and determine whether the findings of this scoping review could be employed to provide a template for core outcome sets (COS). Five outcomes were identified, and all the research pertinent to SFOA were assigned to these outcomes.
Materials and Methods
Electronic databases and additional records were searched from January 2009 to March 2019 to source the data, and 525 records were identified.
Results
The initial database and additional search resulted in 525 records, of which 54 potentially relevant articles were retrieved in full. 35 studies met the selection criteria following screening and were included in the scoping review with the results of the search depicted in the preferred reporting items for systematic reviews and meta-analyses. Domains such as morphological features or changes in maxillofacial skeleton and occlusion (n = 25, 71.42%) and psychosocial well-being including quality of life outcome (n = 8, 22.85%) were well represented while functional status (n = 1, 2.85%), health resource utilization (n = 0), and adverse effects (n = 1, 2.85 %) were under-represented.
Conclusions
Limited research on SFOA precludes development of COS. However, future SFOA clinical trials should consider underrepresented outcome domains to address the SFOA treatment modality comprehensively.
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Affiliation(s)
- Narayan H. Gandedkar
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, New South Wales 2006, Sydney, Australia,
| | - María Mélita Chacón Dávila
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, New South Wales 2006, Sydney, Australia,
| | - Chai Kiat Chng
- Cleft and Craniofacial Centre and Dental Service, KK Women’s and Children’s Hospital, Singapore,
| | - Eric J. W. Liou
- Department of Craniofacial Orthodontics, Craniofacial Research Center, Chang Gung Memorial Hospital and Graduate Institute of Craniofacial Medicine, Chang Gung University, Taipei, Taiwan
| | - Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, New South Wales 2006, Sydney, Australia,
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12
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Ni J, Song S, Zhou N. Impact of surgical orthodontic treatment on quality of life in Chinese young adults with class III malocclusion: a longitudinal study. BMC Oral Health 2019; 19:109. [PMID: 31196054 PMCID: PMC6567538 DOI: 10.1186/s12903-019-0782-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/08/2019] [Indexed: 11/12/2022] Open
Abstract
Background The quality of life in Class III malocclusion patients are worse than those without the disorder and previous studies have shown that surgical orthodontic treatment has a different effect on these patients compared with mild or moderate malocclusion. This study aimed to investigate the changes in quality of life in patients with Class III malocclusion during surgical orthodontic treatment in Chinese young adults. Methods The 14-item Short Form Oral Health Impact Profile (OHIP-14), and the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) were used to assess the effect of surgical orthodontic treatment on the quality of life in 21 patients with Class III malocclusion at pre-treatment (T0), pre-surgical orthodontic treatment (6 to 8 months, T1) and post-surgical orthodontic treatment (6 to 8 months after surgery, T2), and 24 healthy individuals were included as controls. The comparisons in numerical variables between patients and controls were performed using Mann-Whitney U test. The scores of the two questionnaires between T0, T1, T2 and controls (Tc) were compared using generalized estimating equation. Results According to OHIP-14 questionnaire, the mean scores in T0 and T1 were higher than those in T2 and Tc (P < 0.001), and a significant decrease was observed after post-surgical orthodontic treatment (P < 0.001), which achieved a level similar to the control group (P > 0.05). As to OQLQ questionnaire, the mean scores of all domains showed a significant increase between T0 and T1 except for awareness of dentofacial aesthetics (P > 0.05) and social aspects of dentofacial deformity (P > 0.05), followed by a significant decrease between T1 and T2. Conclusion Surgical orthodontic treatment may improve quality of life in patients with Class III malocclusion, but pre-surgical orthodontic treatment may have an adverse effect on quality of life.
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Affiliation(s)
- Jiaan Ni
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China
| | - Shaohua Song
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China
| | - Nuo Zhou
- Orthognathic Centre, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China. .,Department of Oral and Maxillofacial Surgery, College of Stomatology, GuangXi Medical University, Nanning, 530021, People's Republic of China.
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13
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Kwon TG, Han MD. Current status of surgery first approach (part II): precautions and complications. Maxillofac Plast Reconstr Surg 2019; 41:23. [PMID: 31218215 PMCID: PMC6546776 DOI: 10.1186/s40902-019-0206-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
The choice of surgical technique in orthognathic surgery is based primarily on the surgical treatment objectives (STO), which is a fundamental component of the orthognathic treatment process. In the conventional orthodontics-first approach, presurgical planning can be performed twice, during the preorthodontic (initial STO) and presurgical phases (final STO). Recently, a surgery-first orthognathic approach (SFA) without presurgical orthodontic treatment has been introduced and combined initial and final STO at the same time. In contrast to the conventional surgical-orthodontic treatment protocol that includes preoperative orthodontics for dental decompensations to maximize stable postoperative occlusion, the SFA potentially shortens the treatment period and minimizes esthetic concerns during the decompensation period because skeletal problems are corrected from the beginning. The indications for the SFA have been proposed in the literature, but no consensus exists. Moreover, because dental occlusion of the pre-orthodontic arches cannot be used as a guide for establishing the surgical treatment plan, there are fundamental limitations in accurate prediction of postsurgical results in the SFA. Recently, the concepts of postsurgical orthodontic treatment are continuously changing and evolving to overcome this inherent limitation of the SFA. The elimination of presurgical orthodontics can change the paradigm of orthognathic surgery but still requires cautious case selection and thorough discussion and collaboration between orthodontists and surgeons regarding the goals and postoperative management of the orthognathic procedure.
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Affiliation(s)
- Tae-Geon Kwon
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu, 41940 Republic of Korea
| | - Michael D Han
- 2Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago , Chicago, IL 60612-7211 USA
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Jang HJ, Kim MH. [Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial]. J Korean Acad Nurs 2018. [PMID: 29535282 DOI: 10.4040/jkan.2018.48.1.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. METHODS The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. RESULTS The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p<.001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p<.001), discomfort score (F=9.38, p<.001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. CONCLUSION The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.
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Affiliation(s)
- Hyo Jin Jang
- Department of Nursing, Pusan National University, Yangsan, Korea.,(Bio)Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Myung Hee Kim
- Department of Nursing, Pusan National University, Yangsan, Korea.
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