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Abstract
Anatomy and standards of beauty are different between Asians and Westerners. Unlike Westerners, Asians have a wide and prominent jaw shape but prefer a slim and soft face shape. To achieve this goal, maxillary setback and/or posterior impaction surgeries are popular among upper jaw surgery, and various adjuvant surgeries are performed simultaneously on the mandible to obtain the so-called oval shape or V-line face. In addition, according to the development of virtual surgery software and orthodontic treatment techniques, the surgery-first approach is now accepted as a reliable option for orthognathic surgery if it is indicated.
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Affiliation(s)
- Yoon-Ji Kim
- Department of Orthodontics, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
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Bergamaschi IP, Cavalcante RC, Fanderuff M, Gerber JT, Petinati MFP, Sebastiani AM, da Costa DJ, Scariot R. Orthognathic surgery in class II patients: a longitudinal study on quality of life, TMD, and psychological aspects. Clin Oral Investig 2021; 25:3801-3808. [PMID: 33415380 DOI: 10.1007/s00784-020-03709-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate, longitudinally, the impacts of orthognathic surgery in patients with skeletal class II malocclusion on oral health-related quality of life (OHRQoL), temporomandibular disorders (TMD) and psychological symptoms. MATERIALS AND METHODS Forty-three patients with skeletal class II malocclusion who were submitted to orthognathic surgery were evaluated during their preoperative and postoperative periods. They answered the short version of the Oral Health Impact Profile (OHIP-14) and were also diagnosed according to Axes I and II of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The evolution of OHRQoL and TMD before and after surgery was verified, and the relationships among these variables were found through statistical analysis using Wilcoxon, McNemar, chi-square, and Mann-Whitney tests, with a 5% significance level. RESULTS The median of the overall OHIP-14 score and five domains decreased after orthognathic surgery (p < 0.05), the functional limitation domain increased (p = 0.014), and the physical disability domain did not show an association (p = 0.133). There were improvements in articular pain (p = 0.016), chronic pain (p = 0.019), and nonspecific physical symptoms excluding pain (p = 0.013). In addition, an association was found between poorer OHRQoL (overall scale and domains) and the Axis II variables of the RDC/TMD (p < 0.05). CONCLUSION Orthognathic surgery improved perceived OHRQoL, articular pain, and chronic pain. The conditions of Axis II of the RDC/TMD interfered with OHRQoL postoperatively. CLINICAL RELEVANCE Although orthognathic surgery improves QoL and some TMD conditions in skeletal class II patients, poorer postoperative outcomes are observed when psychological conditions are present.
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Affiliation(s)
- Isabela Polesi Bergamaschi
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Rafael Correia Cavalcante
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Marina Fanderuff
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Jennifer Tsi Gerber
- School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
| | - Maria Fernanda Pivetta Petinati
- School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
| | - Aline Monise Sebastiani
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil. .,School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil.
| | - Delson João da Costa
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil
| | - Rafaela Scariot
- Department of Stomatology, School of Dentistry of Universidade Federal do Paraná, 632 Prefeito Lothário Meissner Avenue, Curitiba, Paraná, 80210-170, Brazil.,School of Health Sciences, Universidade Positivo, 5300 Prof. Pedro Viriato Parigot de Souza Street, Curitiba, Paraná, 81280-330, Brazil
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Mehraban SH, Jamali S, Azizi A, Nasrabadi N. Evaluating the Effectiveness of Orthognathic Surgery on the Pre-existing Temporomandibular Disorders in Patients with Malocclusion: A Systematic Review and Meta-analysis. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Affiliation(s)
| | | | - Amir Azizi
- Alborz University of Medical Sciences, Iran
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Comparison of the Outcomes of Three Different Nutritional Supports in Patients with Oral and Maxillofacial Malignant Tumors following Surgery. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5627141. [PMID: 30515234 PMCID: PMC6236920 DOI: 10.1155/2018/5627141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/11/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022]
Abstract
Objective. This study aimed to compare the physical and mental states and the clinical effects of parenteral nutrition combined with enteral nutrition (PN+EN), total enteral nutrition (TEN), and total parenteral nutrition (TPN) after surgery in patients with maxillofacial malignant tumors. Methods. A total of 112 patients were divided into three groups, with 58, 33, and 21 patients in the PN+EN, TPN, and TEN groups, respectively. The psychological survey contained the Faces Pain Scale-Revised (FRS-R), visual analog scale (VAS), numerical rating scale (NRS), Hamilton anxiety rating scale (HAMA), and short-form 36 health survey questionnaire (SF-36). Spirit symptoms, length of hospital stay, nutritional assessments, and related biochemical indices were recorded and compared. Results. The traditional Chinese medicine (TCM) symptoms of anxiety and dysphoria were least frequently identified in the TPN group. The levels of lymphocytes, hemoglobin (HB), albumin (ALB), and prealbumin (PA) were significantly higher in the PE+EN group, whereas white blood cell count, neutrophil count, HB, PA, and ALB were significantly lower in the TPN group. Better psychological scores were observed in the TPN group. The PE+EN group had a shorter length of stay and higher SGA categories. Potassium, sodium, and chlorine levels were significantly lower in the TEN group (all P < 0.05). Conclusions. As an auxiliary method, TCM symptoms can help to identify spirit disequilibrium earlier and are associated with blood indices. Without the consideration of cost and long length of hospital stay, patients in the TPN group had the best mental status, with PN+EN therapy being an alternative.
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Ribeiro-Neto CA, Ferreira G, Monnazzi GCB, Gabrielli MFR, Monnazzi MS. Dentofacial deformities and the quality of life of patients with these conditions: a comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:457-462. [PMID: 30291005 DOI: 10.1016/j.oooo.2018.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 06/09/2018] [Accepted: 08/22/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of the present study was to evaluate the quality of life of patients with dentofacial deformities and of patients subjected to orthognathic surgery to compare their results with those of patients who have no dentofacial deformity by applying the Orthognathic Quality of Life Questionnaire (OQLQ). STUDY DESIGN Three groups of patients were interviewed, and the OQLQ instrument was applied to them by one examiner. RESULTS Results showed statistical differences between groups and suggested that patients with no deformity and those subjected to orthognathic surgery have better quality of life compared with those with facial deformity. CONCLUSIONS Orthognathic surgery with the consequent dentofacial correction seems to have a positive effect on quality of life.
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Affiliation(s)
- Carlos Alberto Ribeiro-Neto
- Oral and Maxillofacial Surgery Department, Dental School, Campus (Araraquara), Sao Paulo State University (Unesp), Sao Paulo, Brazil
| | - Gabriely Ferreira
- Oral and Maxillofacial Surgery Department, Dental School, Campus (Araraquara), Sao Paulo State University (Unesp), Sao Paulo, Brazil
| | - Gislaine Calselin Batista Monnazzi
- Psychologist, Campus (Ribeirão Preto), Moura Lacerda Institution, Preto, Sao Paulo, Brazil; Titular Professor, Oral and Maxillofacial Surgery Department, Dental School, Campus (Araraquara), Sao Paulo State University (Unesp), Sao Paulo, Brazil
| | - Mario Francisco Real Gabrielli
- Titular Professor, Oral and Maxillofacial Surgery Department, Dental School, Campus (Araraquara), Sao Paulo State University (Unesp), Sao Paulo, Brazil
| | - Marcelo Silva Monnazzi
- Volunteer Professor, Oral and Maxillofacial Surgery Department, Dental School, Campus (Araraquara), Sao Paulo State University (Unesp), Sao Paulo, Brazil.
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Does orthognathic surgery improve myofacial pain in individuals with skeletal class III? One-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:322-330. [PMID: 29778439 DOI: 10.1016/j.oooo.2018.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 03/20/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of the study was to evaluate the effect of orthognathic surgery on temporomandibular disorder (TMD) in patients with skeletal class III malocclusion. STUDY DESIGN Forty-seven patients undergoing surgery were evaluated by a trained examiner using Axis I of the Research Diagnostic Criteria/TMD index, consecutively, at 3 different periods: 1 week before operation (T0), 6 months after operation (T1), and 1 year after operation (T2). Bivariate analyses were performed to compare the evaluation periods (P < .05). RESULTS The prevalence of TMD in the sampled patients from T0 to T1 decreased from 30 (63.8%) to 22 (46.8%) (P = .021). Even in T2, the prevalence of TMD remained lower than that in T0, at 21 (44.7%) diagnosed patients (P = .049). The reported frequencies of myofascial pain and headache were lower in T1 and T2 than in T0 (P < .001). Decrease in the frequency of joint pain and joint sounds was observed only from T0 to T1 (P = .039 and P = .021, respectively). The mean maximum of mouth opening decreased from T0 to T1 (P < .001) and increased again at T2 (P < .001). CONCLUSIONS Orthognathic surgery promoted reduction in the frequencies of myofascial pain and headache reported by patients with skeletal class III malocclusion.
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Do patients with malocclusion have a higher prevalence of temporomandibular disorders than controls both before and after orthognathic surgery? A systematic review and meta-analysis. J Craniomaxillofac Surg 2017; 45:1716-1723. [PMID: 28843406 DOI: 10.1016/j.jcms.2017.07.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 06/27/2017] [Accepted: 07/24/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to identify, through meta-analysis, whether patients who require orthognathic surgery have a higher prevalence of temporomandibular disorders (TMDs) than controls, both before treatment and after. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on PRISMA guidelines, to address the study purposes. A search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was performed to locate all pertinent articles published from inception to June 2016. Inclusion criteria were controlled clinical studies, either prospective or retrospective, and case-control studies comparing preoperative and postoperative signs and symptoms of TMDs in patients who undergo orthognathic surgery to those of a healthy volunteer population with no dentofacial deformities. The predictor variables were patients with dentofacial deformities who underwent orthognathic surgery and patients with no dentofacial deformities and with good maxillomandibular relations and normal occlusion. The outcomes variables were the weighted, prevalence rate (proportion) in signs and symptoms of TMDs in patients with dentofacial deformities and risk ratio (RR) of signs and symptoms of TMDs before and after orthognathic surgery, compared to the control group. RESULTS A total of 542 patients enrolled in 6 studies were included in this analysis. The overall pooled weighted rate or prevalence of TMDs for orthognathic surgery patients preoperatively was 32.5% (95% CI = 26.7%-38.9%). There was a significant difference between the 2 groups with respect to TMDs before surgery, but no significant difference in TMDs after surgery. The RR for patients who had dentofacial deformities before orthognathic surgery compared with a control group was 1.634 (95% CI = 1.216-2.194; P = 0.001). The RR for patients after orthognathic surgery compared with a control group was 1.262 (0.718; 95% CI = 0.805-1.979; P = 0.311). CONCLUSION The results of this study show that patients who are going to have a correction of their malocclusion by orthodontics and orthognathic surgery have a significant incidence of TMDs when compared to a control population, but that after treatment, the incidence of TMDs does not differ from a control population. The reasons for these findings are not clear.
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Svedström-Oristo AL, Ekholm H, Tolvanen M, Peltomäki T. Self-reported temporomandibular disorder symptoms and severity of malocclusion in prospective orthognathic-surgical patients. Acta Odontol Scand 2016; 74:466-70. [PMID: 27339119 DOI: 10.1080/00016357.2016.1199815] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objective of this study is to analyze the association between self-reported symptoms of temporomandibular joint disorder (TMD) and the severity of malocclusion in prospective orthognathic-surgical patients. MATERIAL AND METHODS The subjects consisted of 50 consecutive patients (13 males and 37 females) referred to two university clinics for assessment of orthodontic-surgical treatment need. Data considering self-reported TMD symptoms were gathered using a semi-structured diary. At the first appointment, all patients rated the importance of treatment (on a scale of 1-10) and assessed self-perceived dental appearance using a VAS scale. The scale was anchored with photographs 1 and 10 from the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Study models were assessed by an experienced orthodontic specialist using the Peer Assessment Rating (PAR) index and the Index of Complexity, Outcome and Need (ICON). Association between the PAR and ICON scores and the number of reported symptoms was analyzed statistically. RESULTS Seventy-one percent of patients reported experiencing TMD symptoms. The most prevalent symptoms were pain in the head and/or neck region and fatigue in the TMJ region. The number of symptoms was highest in the morning. Ninety percent of males and 86% of females rated the importance of treatment as high; males experiencing TMD symptoms tended to rate surgery as more important compared with males with no symptoms (p = 0.056). CONCLUSIONS In this sample, the results cannot unambiguously confirm an association between self-reported symptoms of TMD and objectively defined severity of malocclusion.
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Song YL, Yap AUJ. Orthognathic treatment of dentofacial disharmonies: its impact on temporomandibular disorders, quality of life, and psychosocial wellness. Cranio 2016; 35:52-57. [DOI: 10.1080/08869634.2016.1147676] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sebastiani AM, Baratto-Filho F, Bonotto D, Kluppel LE, Rebellato NLB, da Costa DJ, Scariot R. Influence of orthognathic surgery for symptoms of temporomandibular dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:119-25. [PMID: 26482191 DOI: 10.1016/j.oooo.2015.08.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/20/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the influence of orthognathic surgery on the clinical signs and symptoms of temporomandibular disorders (TMDs). STUDY DESIGN In a cohort study, 54 patients undergoing orthognathic surgery were evaluated with regard to the signs and symptoms of TMDs through subjective and objective assessments. These evaluations were performed 1 week preoperatively (T1), 1 month postoperatively (T2), and 6 months postoperatively (T3). The evaluations included patient variables and surgery. Univariate analyzes were performed to verify the association of the variables (P < .05). RESULTS The incidence of TMD 6 months after orthognathic surgery was significantly lower (P < .001). TMD intensity decreases significantly in the postoperative period. Females had a higher prevalence of TMD (P = .003) and muscular disorders preoperatively (P = .001). There was a decrease in clicks between T1 and T3 (P = .013). Mouth opening without pain worsened from T1 to T2 (P < .001) and improved from T1 to T3 (P = .015) and T2 to T3 (P < .001). The results were similar for mouth opening with pain (P < .001). In patients undergoing jaw fixation with bicortical screws, mouth opening without pain was significantly less in T3 patients than in patients undergoing fixation with plate and monocortical screws (P = .048). CONCLUSIONS Orthognathic surgery reduces the clinical signs and symptoms of TMD.
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Affiliation(s)
- Aline Monise Sebastiani
- Student of graduate program in dentistry at Federal Univesity of Parana, Curitiba, PR, Brazil.
| | - Flares Baratto-Filho
- Professor of the graduate program in dentistry, Positivo University, Curitiba/PR, Brazil
| | - Daniel Bonotto
- Professor of Temporomandibular Dysfunction and Orofacial Pain of the Federal University of Parana, Curitiba/PR, Brazil
| | - Leandro Eduardo Kluppel
- Professor of Oral and Maxillofacial Surgery residency of the Federal University of Parana, Curitiba/PR, Brazil
| | | | - Delson João da Costa
- Professor of Oral and Maxillofacial Surgery residency of the Federal University of Parana, Curitiba/PR, Brazil
| | - Rafaela Scariot
- Professor of the graduate program in dentistry, Positivo University, Curitiba/PR, Brazil
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