Effect of conventional combined orthodontic-surgical treatment on oral health-related quality of life: A systematic review and meta-analysis.

Abstract

Although conventional combined orthodontic-surgical treatment is frequently applied in orthodontic clinic practice, its actual effect on oral health-related quality of life (OHRQoL) remains inconclusive. We aimed to appraise trials investigating the effect of conventional combined orthodontic-surgical treatment on OHRQoL in patients with dentofacial deformities. Electronic searches of 6 databases and manual searches were conducted up to January 2019. Randomized controlled trials, controlled clinical trials, and prospective cohort studies that investigated the impact of combined orthodontic-surgical treatment on OHRQoL using validated instruments were included. The risk of bias within individual studies was assessed with the use of the Cochrane tool or the Newcastle-Ottawa Scale according to study designs. Meta-analysis was conducted, and OHRQoL at different time points during conventional combined orthodontic-surgical treatment were statistically pooled and compared. Of the 893 records initially identified, 24 studies were included in this review. Relative to pretreatment, the condition-specific OHRQoL was significantly improved 6months after surgery, particularly in the perceptions to social aspects (mean difference [MD] 4.88, 95% confidence interval [CI] 2.45 to 7.32), facial appearance (MD 5.48, 95% CI 4.18 to 6.79), and oral function (MD 4.49, 95% CI 3.27 to 5.72). In terms of changes during combined orthodontic-surgical treatment, the condition-specific OHRQoL worsened in the presurgical orthodontic treatment (MD -7.25, 95% CI -13.29 to -1.22) and improved postsurgically compared with pretreatment (MD 16.59, 95% CI 10.41 to 22.77). Similar patterns were observed in the general OHRQoL changes. For patients undergoing combined orthodontic-surgical treatment, the OHRQoL seems to decrease temporarily in presurgical orthodontic treatment compared with pretreatment and to increase to a level better than it was before treatment during postsurgical orthodontic treatment. Based on the present review, combined orthodontic-surgical treatment could be an effective choice to improve OHRQoL for patients affected with severe dentofacial deformities.