Health-related quality of life, jaw function and sleep-disordered breathing among patients with dentofacial deformity

BACKGROUND AND OBJECTIVES

Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment.

METHODS

A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM).

RESULTS

Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ.

CONCLUSION

Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.

Crystal-structure determination and Hirshfeld surface analysis of two new thio-phene derivatives: (E)-N-{2-[2-(benzo[b]thio-phen-2-yl)ethen-yl]-5-fluoro-phen-yl}benzene-sulfonamide and (E)-N-{2-[2-(benzo[b]thio-phen-2-yl)ethen-yl]-5-fluoro-phen-yl}-N-(but-2-yn-1-yl)benzene-sulfonamide

In the title compounds, C22H16FNO2S2 (I) and C26H20FNO2S2 (II), the benzo-thio-phene rings are essentially planar with maximum deviations of 0.009 (1) and 0.001 (1) Å for the carbon and sulfur atom in compounds I and II, respectively. In I, the thio-phene ring system is almost orthogonal to the phenyl ring attached to the sulfonyl group, with a dihedral angle of 77.7 (1)°. In compound I, the mol-ecular structure is stabilized by weak C-H⋯O intra-molecular inter-actions formed by the sulfone oxygen atoms, which generate two S(5) ring motifs. In the crystal of I, N-H⋯O hydrogen bonds link the mol-ecules into R 2 2(8) rings, which are connected into a C(10) chain via C-H⋯F hydrogen bonds. Inter-molecular C-H⋯π inter-actions are also observed. In compound II, the mol-ecules are linked via C-H⋯O and C-H⋯F hydrogen bonding, generating infinite C(11) and C(13) chains running parallel to [010].

The synthesis, crystal structure and Hirshfeld surface analysis of the thio-phene derivatives 5-(phenyl-sulfon-yl)-5,6-di-hydro-benzo[4,5]thieno[3,2-j]phenanthridine and (E)-N-{2-[2-(benzo[b]thiophen-2-yl)ethenyl]phen-yl}-N-(prop-2-yn-1-yl)benzene-sulfonamide

In both of the title compounds, C₂₆H₁₉NO₂S₂, (I), and C₂₅H₁₉NO₂S₂, (II), the benzo-thio-phene rings are essentially planar with maximum deviations of 0.026 (1) and -0.016 (1) Å for the carbon and sulfur atoms in compounds (I) and (II), respectively. In (I), the thio-phene ring system is almost orthogonal to the phenyl ring attached to the sulfonyl group, subtending a dihedral angle of 88.1 (1)°, and the di-hydro-pyridine ring adopts a screw-boat conformation. In both compounds, the mol-ecular structure is consolidated by weak C-H⋯O intra-molecular inter-actions formed by the sulfone oxygen atoms, which generate S(5) ring motifs. In the crystal of II, mol-ecules are linked via C-H⋯O hydrogen bonds, generating C(7) chains running along the [100] direction. No significant inter-molecular inter-actions are observed in I.

Associations between Temporomandibular Disorders, Pain, Jaw and Masticatory Function in Dentofacial Deformity Patients: a Cross-sectional Study

BACKGROUND

Patients with dentofacial deformity often present with impaired masticatory function, orofacial pain, and temporomandibular disorders (TMD). This study investigates the relationship between TMD, pain, jaw, and masticatory function at different stages of orthognathic surgical (OS) treatment.

METHOD

A total of 120 OS patients were prospectively recruited and grouped as pre-orthodontic (group 1), pre-surgery (group 2), 4-month post-surgery (group 3), 24-month post-surgery (group 4), in addition to 30 controls (group 0). Outcomes were assessed using: Jaw Function Limitation Scale (JFLS), McGill pain questionnaire, DC/TMD instrument, voluntary maximum bite force (MVBF), and masticatory efficiency (ME) using two-colored chewing gum. Data were analyzed using structural equation modeling.

RESULTS

The prevalence of non-painful TMD did not differ between groups (P = 0.827). However, the prevalence of painful TMD differed between groups (P = 0.001). Amongst the painful TMDs, the highest prevalence was observed for masseter myalgia in group 2 (P = 0.031), and importantly group 4 did not differ from group 0 (P = 0.948). The MPQ score was significantly higher in group 1 (P = 0.001) compared to group 0, and the JFLS score was significantly higher in group 1, 2 and 3 compared to group 0. Notably MPQ (P = 0.756) and JFLS (P = 0.572) scores in group 4 were not different from group 0. However, MVBF (P = 0.996) and ME (P = 0.991) did not differ between groups 1 and 4. Association of self-reported pain and jaw function with masticatory function was observed in OS patients.

CONCLUSION

OS was not associated with a negative impact on TMD. Jaw function and pain levels were similar to controls at the 24-month follow-up. Masticatory function was further affected by the surgery and seems to require a longer recovery time. Moreover, it was confirmed that pain and TMD were associated with limitations in jaw function and impacts on masticatory function.

Crystal structures of two new carbazole derivatives: ethyl 9-(benzenesulfonyl)-2-(4-fluoro-2-nitrophenyl)-6-methoxy-9H-carbazole-3-carboxylate and 12-(benzenesulfonyl)-12H-quinolino[4,3-b]carbazole

The title compounds, C28H21FN2O7S (I) and C25H16N2O2S (II), are carbazole derivatives with a benzenesulfonyl group attached to the carbazole moiety at the N atom on both molecules. A fluoro-substituted nitrophenyl ring system in I and a fused isoquinoline ring in II are attached to the respective carbazole moieties. In both compounds, the carbazole ring systems are essentially planar, with maximum deviations of 0.028 (2) and 0.026 (2) Å for carbon atoms in compounds I and II, respectively. The carbazole ring system is almost orthogonal to the benzene ring attached to sulfonyl group, with dihedral angles of 79.7 (2) in I and 88.2 (2)° in II, respectively. The mean planes of the carbazole ring systems make dihedral angles of 66.1 (2) and 1.3 (2)°, respectively, with the nitrophenyl ring in I and the planar isoquinoline moiety [maximum deviation of 0.009 (3) Å for a carbon atom in II, indicating that the ring system in II is essentially planar]. The benzenesulfonyl ring is almost normal to the isoquinoline ring, with a dihedral angle of 87.9 (2)° in II and the nitrophenyl ring forms a dihedral angle of 17.8 (2)° in I. In both compounds, intramolecular C—H...O hydrogen bonds generate S(6) ring motifs with the sulfone group O atoms. In crystals of compound I, the molecules are linked by C—H...O intermolecular weak hydrogen bonds, which generate C(7) and C(10) chains running parallel to [010] and [100], respectively.

Pharyngeal airway changes five years after bimaxillary surgery - A retrospective study

The aim of this study was to retrospectively evaluate pharyngeal airway (PA) changes after bimaxillary surgery (BMS). Preoperative, immediate- and 5-year postoperative cone-beam computed tomography images of subjects who underwent BMS were assessed. The primary outcome variable was the PA volume. The secondary outcome variables were the retropalatal and oropharyngeal volumes, cross-sectional area, minimal hydraulic diameter, soft tissue, skeletal movements and sleep-disordered breathing (SDB). A total of 50 patients were included, 33 female and 17 male, with a mean age of 26.5 years. A significant increase in the PA volume was seen immediately after surgery (40%), and this increase was still present at 5-year follow-up (34%) (P < 0.001). A linear mixed model regression analysis revealed that a mandibular advancement of ≥5 mm (P = 0.025) and every 1-mm upward movement of epiglottis (P = 0.016) was associated with a volume increase of the oropharyngeal compartment. Moreover, ≥5-mm upward movement of hyoid bone (P = 0.034) and every 1-mm increase in minimal hydraulic diameter (P < 0.001) correlated with an increase of the PA volume. A total of 30 subjects reported improvement in the SDB at 5-year follow-up. This study demonstrated that BMS led to an increase in PA dimensions in non-OSA patients, and these changes were still present at 5-year follow-up. BMS seemed to induce clinical improvement in SDB.

Novel three-dimensional methods to analyze the morphology of the nasal cavity and pharyngeal airway

OBJECTIVES

To assess the intraexaminer and interexaminer reliabilities of novel semiautomatic methods to segment the nasal cavity (NC) and pharyngeal airway (PA) and to determine the minimal cross-sectional area (CS) and hydraulic diameter (HD) of the PA.

MATERIALS AND METHODS

To test reproducibility, two examiners analyzed the NC and PA independently in 10 retrospectively selected cone beam computed tomography (CBCT) images using semiautomatic segmentation. The PA centerline was determined to assess the minimal CS and HD. The intraclass correlation coefficient (ICC) was used to calculate intraexaminer and interexaminer reliabilities. Measurement errors were assessed by Dahlberg's formula and paired t-tests. The level of agreement was assessed using the Bland-Altman method.

RESULTS

Intraexaminer and interexaminer reliabilities were excellent (minimal ICC, 0.960). The error of the method was good except for interexaminer values for the oropharynx (P = .016). The minimal CS and HD measurements were reliable (minimal ICC, 0.993; narrow limits of agreement).

CONCLUSIONS

The novel methods for analysis of the NC and PA are reliable. The minimal CS and HD demonstrated excellent reliabilities, which are critical to detect the most constricted part of the PA. Separation of the oropharynx from the voids close to the retroglossal area is not trivial and should be considered with caution.