Health-related Quality of Life in Patients Five Years after Orthognathic Surgery

Objectives: This multi-site prospective, randomized clinical trial compared long-term generic and oral health-related quality of life after bilateral sagittal split osteotomy (BSSO) to correct Class II malocclusion in 93 patients receiving either wire or rigid fixation. Methods: Quality of life was measured using the Sickness Impact Profile (SIP), a generic measure of health-related quality of life, and the Oral Health Status Questionnaire (OHSQ), a specific measure of oral health and function designed for use with orthognathic surgery patients. Patients were evaluated approximately 2 weeks before surgery, 2 years and 5 years following surgery. Data were analyzed using the Wilcoxon signed-rank test with Bonferroni correction. Results: Scores on the SIP Psychosocial Dimension and all of its components (Social Interaction, Communication, Alertness Behavior, Emotional Behavior) showed significant improvement from pre-surgery to 5 years post-surgery (p<0.05). Sleep and Rest, Recreation and Pastimes, and the Overall Dimension score also showed significant improvement (p<0.05). Change between 2 and 5 years post-surgery was not significant, demonstrating the improvement was stable between 2 and 5 years. The Physical Dimension score and its component did not improve. All components scores of the OHSQ (General Oral Health, Work and Social Activities, Esthetics, Pain and Sensitivity, Oral Function) showed significant improvement at 5 years relative to pre-surgery(p<0.05). With the exception of General Oral Health, these improvements too remained stable between 2 and 5 years. Conclusion: Measures of both general health-related quality of life and oral health-related quality of life show significant improvement following BSSO. These improvements remain stable between 2 and 5 years. Supported by NIDCR grant DE09630.