The influence of morphological and functional disorders on the quality of life of patients with skeletal anomalies of occlusion

Abstract

The criterion for the need for combined treatment of maxillofacial deformities, in addition to formal objective indications, should be based on patients’ subjective perception of their existing facial anomalies and deformities. One of the criteria, that allows a doctor to assess a patient’s subjective need for treatment, is to determine the degree of influence of morphological disorders caused by skeletal abnormalities on his quality of life. Providing the patient with reliable information about influence of morphological factors on the patient’s aesthetic self-identification and his general psycho-emotional status allows him to be warned against unrealistic expectations of the treatment. The purpose of the study is to comprehensively assess the impact of morphological and functional disorders on the quality of life of patients with skeletal abnormalities of occlusion.
Materials and methods.
To determine the quality of life using the Orthognathic Quality of Life Questionnaire (OQLQ), 70 patients with II and III skeletal classes, as well as 58 students and employees without skeletal anomalies of the jaws, were surveyed before orthognathic surgery.
Results.
Indicators of facial aesthetics, function and social aspects of the quality of life of patients with skeletal classes II and III of dentofacial anomalies significantly prevailed over the indicators of the control group (p≤0.05). However, there was no statistically significant difference in the aspect of deformity awareness according to the OQLQ questionnaire between these groups. The social aspect of life and individual perception of facial aesthetic parameters according to the OQLQ questionnaire are subject to a greater negative influence of morphological disorders of skeletal occlusion abnormalities in female patients. Thus, in the social aspect of life, the average difference in indicators between the control group (5.3±5.4) and patients with skeletal classes II (10.9±9.6) and III (10.2±7.1) was 5. 6 and 4.9, respectively (p≤0.05). In individual perception of facial aesthetic parameters, the average difference when comparing the control group (3.5±3.4) and patients with skeletal classes II (11.6±6.6) and III (12.0±5.0) was 8.1 and 8.5, respectively (p≤0.05). At the same time, despite the absence of any anomalies and deformations of the jaws, 43.1% of respondents in the control group also expressed dissatisfaction associated with the aesthetic perception of their face.
Conclusion.
Anomalies in the development of the jaws contribute to a deterioration in patients’ perception of the aesthetic parameters of their own face, dysfunction of the jaws, which can contribute to difficulties in interacting with society and self-doubt. In other words, the difficulties of social adaptation of patients are partly associated with a negative perception of the aesthetics of their face. At the same time, the psychological aspect of awareness of the fact of deformation of the jaw bones as such, according to the OQLQ questionnaire, does not correlate with the severity and type of jaw anomaly. Subjective perception of quality of life probably depends to a greater extent on the psychological status of the patient rather than on specific morphological or functional disorders.