Abstract
The aim of this study was to compare the impact that the orthodontics-first approach
and the surgery-first approach have on quality of life, anxiety, and depression in
patients treated for dentofacial deformities. Data were collected on 32 patients (aged
17–47 years) who were all treated at a single multidisciplinary orthognathic clinic.
They completed a 22-item Orthognathic Quality of Life Questionnaire (OQLQ), a seven-item
Generalised Anxiety Disorder (GAD-7) questionnaire, and a nine-item Patient Health
Questionnaire (PHQ-9), at one week preoperatively (T1), and at six weeks (T2) and
six months (T3) postoperatively. Quality of life was significantly better in the surgery-first
group preoperatively (p = 0.010, ES = 0.96). The mean score and the individual domain scores of the OQLQ showed significant
improvements at six weeks and six months postoperatively. The facial aesthetic domain
showed the largest improvement (orthodontics-first group: ES = 2.5; surgery-first group: ES = 2.2). Patients in the orthodontics-first group had a poorer quality of life and greater
deterioration in social life immediately before surgery. Postoperatively, the scores
for anxiety and depression did not reduce significantly in either group. Our results
do not support the assumption that all psychological aspects of a patient’s life improve
after orthognathic surgery. The surgery-first approach eliminates the deterioration
in social activities that is associated with preoperative orthodontic decompensation.
Keywords
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Article info
Publication history
Published online: January 25, 2020
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© 2020 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
