An Oral Health-Related Quality of Life Comparison Between Adults With Unilateral Cleft Lip and Palate and Class III Malocclusion

Abstract

Objective: To compare oral health-related quality of life (OHRQoL) before treatment of adults with unilateral cleft lip and palate (UCLP) and surgical Class III malocclusion, and to consider if clefts needing different orthodontic treatment protocols could influence people’s self-perception. Design: Cross sectional. Setting: Cleft Lip and Palate Center and Clinic of Orthognathic Surgery from a School of Dentistry. Participants: A sample of adults with repaired nonsyndromic UCLP (n = 52) which was age- and sex-matched with a noncleft Class III malocclusion sample seeking orthognathic surgery (n = 51). In turn, the cleft group was subdivided according to treatment planning into nonsurgical orthodontic and surgical orthodontic approaches. Main Outcome Measure: The whole sample was assessed using the short-form oral health impact profile (OHIP-14), with higher scores indicating a poorer OHRQoL. Statistical comparisons were performed with Mann-Whitney U and Kruskal-Wallis tests, and effect size. Bonferroni adjustment was used for post hoc tests ( P < .017). Results: The OHIP-14 scores of the UCLP and Class III groups were significantly different ( P = .001, η2 = 0.108), and higher in Class III. The largest commitment was in the physical disability, physical pain, and psychological disability domains. In addition, no differences were found when the UCLP treatment planning was considered. Conclusion: Surgical Class III malocclusion have a poorer OHRQoL when compared to patients with UCLP, irrespective of whether they are treated surgically or orthodontically. Therefore, the greater commitment of OHRQoL appears to be influenced by the etiology of Class III, and not by treatment plan.

Quality of Life and Temporomandibular Disorders in Patients With Skeletal Class III Malocclusion With Cleft Lip and Palate

“…A difference was found in the total score and the domains of physical pain, physical disability, and psychological disability. One previous study (Barros et al, 2019) is consistent with our study in terms of the OHIP-14 total score and domain scores. Although the studies were conducted in different states, Brazil's public health system's legislation is the same across the entire country.…”

“…This difference may have occurred because the patients included in the study conducted by Marcusson et al (2001b) did not have dentofacial deformities, and dentofacial deformities and chronic pain have been shown to be associated (Silva et al, 2018). Some aspects of the methods used in this study should be mentioned in comparison to previous studies (Nichols et al, 2018;Barros et al, 2019). In our study, the CLP and non-CLP groups were fairly homogeneous-there was a larger sample size in the CLP group compared to previous studies; and the QOL, OHRQOL, TMDs, and psychological aspects of the patients referred to referral centers for orthognathic surgery in the same city were assessed.…”

“…In Brazil, every individual has the right to receive multidisciplinary health care for free, including dental care, orthodontic care, and speech therapy. Patients with CLP have easier access to this level of care (Barros et al, 2019).…”

“…Skeletal Class III deformities are also common in patients without CLP, affecting esthetics, speech, chewing, psychological health, and consequently affecting the quality of life (QOL) (Locker et al, 2005; Mani et al, 2010; Cadogan and Bennun, 2011; Frejman et al, 2013; Palomares et al, 2016). Orthodontic treatment with or without orthognathic surgery is the treatment of choice for patients with skeletal Class III deformities (Palomares et al, 2016; Barros et al, 2019). A previous study showed that orthognathic surgery may improve QOL by enhancing self-esteem, facial appearance, and social relationships (Silva et al, 2013).…”

A Comparative Study of Oral Health-Related Quality of Life among Cleft Lip and Palate Patients and Their Families during Orthodontic Treatment

“…To date, most studies in this field found that surgical patients had a significantly greater reduction in OHRQoL score than patients with severe malocclusions or cleft patients [ 17 ]. Barros et al compared Class III malocclusion with unilateral CLP and suggested that OHRQoL appears to be more affected by the etiology of Class III than by surgical or orthodontic treatment [ 18 ]. Despite this, the impact of orthodontic treatment on CLP patients without considering surgical approaches remains ambiguous.…”