Effects of Orthognathic Surgery on Quality of Life Compared to Non-Surgical Controls

Objectives: (1) To determine the psychosocial effects of a facial skeletal mal-relationship with its subsequent correction in a group of patients treated using surgical orthodontics compared to a matched population of non-treated controls. (2) To assess correlation between severity of malocclusion and patient’s quality of life(QOL).
Methods: Subjects are patients presenting with facial skeletal mal-relationships whose proposed treatment plan includes orthognathic surgery or who have previously received surgical correction. This study utilizes valid and reliable questionnaires: OQLQ, COHIP-19, BDI, SWLS, and STAIY, administered at three different stages of treatment (Stage 1=initial consultation, Stage 2= prior to oral surgery, and Stage 3 = at completion of treatment). A matched group of controls are surveyed with the same questionnaires. Treatment subjects’ severity of malocclusion was assessed by recording ANB angle(º), overjet (mm) and amount of openbite(mm).
Results: Sample size of 245 subjects recruited. Current study is a continuation of a cross-sectional study with a smaller sample size. Previous data revealed only a significant difference in the Oral Function domain of the OQLQ for surgery patients compared to controls and those results have been confirmed thus far. Spearmen correlation coefficient revealed a positive correlation between severity of openbite with the Oral Function domain of the OQLQ, ρ=0.23668 (P=0.0074) and significant negative correlations between ANB, ρ=-0.21159 (P<=.0169), and overjet, ρ=-0.18376 (P=0.0386), within the same domain. Another significant inverse relationship was found between severity of openbite and the Functional Well Being domain of the COHIP, ρ=-0.71347 (P=0.0469). Lastly a positive correlation was found between severity of overjet and the Functional Domain of the CDI, ρ=0.26671 (P=0.043).
Conclusions: Patients selecting to have orthognathic surgery can expect an improvement in oral function. A relationship does exist between severity of malocclusion and QOL measures. Specifically, oral function QOL decreased as openbite increased, and as severity of Class III increased (skeletal and dental). Symptoms of depression increased in children with increased overjet.