Comparison of the quality of life changes of patients receiving sagittal split ramus osteotomy or intraoral vertical subsigmoid osteotomy for mandibular prognathism.

Abstract

To investigate and compare the effect of two orthognathic procedures for mandibular setback, namely, sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO), on oral health, mental- and physical health-related quality of life across time. Patients with mandibular prognathism and planned for orthognathic surgery were recruited in this study. Patients were randomized into two groups (IVRO and SSRO groups). Quality of life (QoL) was assessed with the 14-item Short-Form Oral Health Impact Profile (OHIP-14) and the 36-item Short-Form Health Survey (SF-36) preoperatively (T0), postoperative 2weeks (T1), 6weeks (T2), 3months (T3), 6months (T4), 12months (T5), and 24months (T6). A comparison of OHIP-14 and SF-36 scores between two groups was conducted. Ninety-eight patients (49 SSRO group, 49 IVRO group) participated in this study. There was no significant difference in OHIP-14 scores between SSRO and IVRO throughout the treatment process. SSRO group had significant reduction of OHIP-14 score (i.e., improving oral health-related QoL) since postoperative 2weeks, whereas IVRO group had significant reduction since postoperative 6weeks. Starting from postoperative 3months, the oral health-related QoL of both groups was already significantly better than the baseline level and continued to steadily improve afterwards. For SF-36, both groups had increased physical health summary score starting from postoperative 2weeks, indicating an early and gradual recovery of physical health-related QoL. The mental health summary score of the SSRO group began to increase from postoperative 2weeks, but that of the IVRO group only began to increase from postoperative 6weeks. Patient age at the time of surgery was positively correlated with OHIP scores in the postoperative period. The study concludes that both SSRO and IVRO contributed to the improvement of QoL in the long term, but oral health- and mental health-related QoL of SSRO groups showed earlier improvement. Undergoing orthognathic surgery at early ages is advised, as older age of patients appeared to have worse QoL. Clinical trial registration number: HKUCTR-1985. Date of Registration: 14 Apr 2015.