Quality of life assessment in patients with dentofacial deformity undergoing orthognathic surgery—A systematic review

Abstract

The aim of this systematic review was to evaluate the benefits of orthognathic surgery to quality of life, the different motivations and perceptions of patients towards orthognathic surgery, and the various methods that have been used to analyze these changes, in patients who undergo orthognathic surgery for dentofacial deformities. A review of the literature was carried out, and articles published from 2001 to June of 2012 that satisfied the inclusion criteria were included in the review. A total of 21 articles were included. The results indicate that orthognathic patients experience an improvement in quality of life after surgery. Each individual patient has different motivations and expectations from the treatment. Also the use of validated instruments helped in quantifying results. Further research should be aimed at higher levels of evidence in study design, quantifying the changes for different types of dentofacial deformities and surgeries, and have a longer follow-up duration.

Introduction

Patients with dentofacial deformities are at a disadvantage in society due to low self-esteem and decreased levels of confidence, as well as associated physiological problems. Indeed such deformities interfere not only with oral health and function, but also adversely affect mental well-being, thus affecting the entire spectrum that constitutes quality of life.

Orthognathic surgery is recognized as the mainstay of treatment for dentofacial deformities. While most published articles have placed an emphasis on the techniques for performing such surgeries, it is also necessary to give importance to the effects of such surgical interventions on the psyche of the patient. Over the years, research has shown that most patients desire correction of dentofacial deformities to improve the aesthetics of the facial and dental components. There are also certain studies that have reported the primary motivation to be bite function rather than appearance.

As such interventions affect the patient’s appearance directly over an almost immediate period of time, it is also of paramount importance to quantify the psychological impact of the surgery. The earliest reports of patient satisfaction indicated good responses to orthognathic surgery, and this has since been substantiated by other authors. However the lack of comparable quantifiable data to denote the extent of improvement has been one of the shortcomings in the past literature. This has mainly been due to the lack of consensus among the various scales and tools used to measure such a change.

The onus is now not only on treating the aesthetic component of dentofacial deformity, but also on restoring the patient’s psychosocial component as well. It is easy to assume that the two go hand in hand, but the motivations, perceptions, and expectations of the individual play a significant role in determining not only the surgical success, but also the psychosocial success; all of these contribute to the overall quality of life of the individual.

Thus the aim of this systematic review was to evaluate the motivations and perceptions of patients and the benefits of orthognathic surgery to quality of life, as well as the various methods and tools that have been used to analyze quality of life and psychosocial changes in patients who undergo orthognathic surgery for dentofacial deformities.

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Jan 24, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Quality of life assessment in patients with dentofacial deformity undergoing orthognathic surgery—A systematic review
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