Orthognathic Surgery and Oral Health-Related Quality of Life in Skeletal Class III Non-Syndromic Patients with Cleft Lip and Palate

Abstract

Objective To compare oral health-related quality of life (OHRQoL) of individuals with cleft lip and palate (CLP) and skeletal Class III malocclusion before and 6 months after orthognathic surgery. Study design Longitudinal observational study. Setting Tertiary care. Participants Fifty-two individuals with CLP and skeletal Class III malocclusion. Interventions Orthognathic surgery. Main outcomes Changes in OHIP-14 (oral health impact profile-14) score. Results Among individuals included, 30 (58%) were female, 28 (54%) were ≤ 21 years old, 36 (69%) were “White,” 30 (58%) presented with facial asymmetry, and 38 (73%) had unilateral CLP. Analyses using the Wilcoxon test and the Mann–Whitney U test indicated improvement in OHRQoL. The total OHIP-14 score improved significantly ( p = 0.002), along with the domains of “psychological discomfort” ( p = 0.015), “psychological disability” ( p = 0.002), “social disability” ( p = 0.001), and “participant restriction” ( p < 0.001). The term “participant restriction” has been used to supersede the original domain terminology “handicap”. Exploratory within-subgroup analyses indicated reductions in OHIP-14 scores among females ( p = 0.007), individuals older than 21 years ( p = 0.008), self-reported “White” participants ( p = 0.008), those with facial asymmetry ( p = 0.013), and both unilateral ( p = 0.034) and bilateral CLP ( p = 0.024) phenotypes. However, these within-group changes are exploratory and do not establish significant differences in treatment effect between subgroups. Conclusion Orthognathic surgery improved the OHRQoL in individuals with non-syndromic CLP and skeletal Class III malocclusion. Improvements were observed in the total OHIP-14 score and in psychological, social, and participation restriction domains related to OHRQoL.