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研究生:翁偉忠
研究生(外文):Sarut Vongkamolchoon
論文名稱:正顎手術後生活品質之長期評估
論文名稱(外文):Longitudinal Changes in Quality of Life After Orthognathic Surgery
指導教授:黃烱興
指導教授(外文):C. S. Huang
學位類別:碩士
校院名稱:長庚大學
系所名稱:顱顏口腔醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2018
畢業學年度:107
語文別:英文
論文頁數:152
中文關鍵詞:no
外文關鍵詞:Quality of lifeOrthognathic surgeryOrthognathic quality of life questionnaire
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Purpose: To determine the effects of orthognathic surgery in related to the quality of life (QoL) and make a comparison of each facial type, gender, age groups

Material & Methods: This prospective cohort study was performed involving 271 subjects: skeletal Class III malocclusion, bimaxillary protrusion, facial asymmetry. The QoL was assessed using the orthognathic quality of life questionnaire (OQLQ), which were used in 4-time points: before operation (Pre-op), after operation (Post-op) 1, 6, 12 months. Then Generalized Estimate Equation (GEE) was chosen for statistical analysis. The age and gender effect on QoL was also compared for each group throughout the observation period.

Results and Conclusion: There was a significant change in OQLQ score along the course of treatment. Esthetic and social domain were found significant improvement one month after surgery and score get better through one year of follow-up. A transient decrease in the QoL of the oral function domain was found one month after surgery then gradually desirable. Awareness domain found no change after treatment. For gender, age, and facial type difference was found as male patients were better in QoL than female. Class III patients were better than asymmetric, and bimaxillary protrusion patients respectively. Patients in the university age were better in QoL than older patients significantly in most OQLQ domains.
TABLE OF CONTENTS
Recommendation Letter from the Thesis Advisor
Thesis/Dissertation Oral Defense Committee Certification
Preface or Acknowledgements .... iii
Abstract...iv
Table of contents...v
LIST OF TABLES.........ix
LIST OF FIGURES.......x
CHAPTER 1 INTRODUCTION......1
CHAPTER 2 SYSTEMATIC REVIEW......3
2.1 Introduction.........3
2.2 Methods....6
2.2.1 PICO...6
2.2.2 Criteria for considering studies for systematic review...7
2.3 Results......8
2.4 Review summary..........10
2.4.1 Surgery first orthognathic approach versus Conventional
orthognathic surgery.....10
2.4.2 Deformities related to the quality of life...11
2.4.3 Demographic data related to the quality of life....12
2.4.4 Correlation...12
2.4.5 Other questionnaires........13
2.5 Discussion.........14
2.5.1 OQLQ for orthognathic patient..15
2.5.2 Compare of top three quality of life questionnaire.......16
2.5.3 Which OQLQ domains improve the most?.......16
2.5.4 Timing effect........18
2.6 Conclusions.......20
CHAPTER 3 PURPOSE AND HYPOTHESES...21
CHAPTER 4 METHODS.....22
4.1 Participants........22
4.1.1 Grouping of the participant by facial type.........22
4.1.1.1 Skeletal class III malocclusion group..23
4.1.1.2 Bimaxillary protrusion group...23
4.1.1.3 Facial asymmetry group...23
4.1.2 Grouping of the participant by demographic data........24
4.1.2.1 by age......24
4.1.2.2 by gender....24
4.2 Data collection and instrument...25
4.3 Questionnaire....25
4.4 Patient preparation before orthognathic surgery.......27
4.5 Surgical technique overview....27
4.6 Orthodontic treatment after orthognathic surgery.....28
4.7 Data Visualization........28
4.8 Statistical Analysis.......28
CHAPTER 5 RESULTS.......29
5.1 Subjects..29
5.2 Comparison of Total score.......29
5.2.1 Progressive change during each interval...29
5.2.2 Gender.......29
5.2.3 Age....30
5.2.4 Facial type....30
5.3 Comparison of Facial esthetic domain...30
5.3.1 Progressive change during each interval...30
5.3.2 Gender.......30
5.3.3 Age....31
5.3.4 Facial type....31
5.4 Comparison of Oral function domain....31
5.4.1 Progressive change during each interval...31
5.4.2 Gender.......31
5.4.3 Age....32
5.4.4 Facial type....32
5.5 Comparison of Awareness domain.....32
5.5.1 Progressive change during each interval...32
5.5.2 Gender.......32
5.5.3 Age....33
5.5.4 Facial type....33
5.6 Comparison of Social domain.....33
5.6.1 Progressive change during each interval...33
5.6.2 Gender.......33
5.6.3 Age.......34
5.6.4 Facial type............34
5.7 Test of model effects on OQLQ domains..................34
CHAPTER 6 DISCUSSION...........36
6.1 Progressive change of the quality of life in each domain...........36
6.2 Gender Effect...............39
6.3 Age effect...................39
6.4 Dentofacial type effect..................40
6.5 Dissatisfied patient.......42
6.6 Limitations.............43
CHAPTER 7 CONCLUSIONS.............44
REFERENCES..............45
APPENDIX A.......................51
The traditional Chinese version of OQLQ used in this study..........51
Guidance for Assessing the Quality of Before-After (Pre-Post) Studies....52
Table 1 through 16........58
Figure 1 through 13......81
APPENDIX B..94
Manuscript 1......94
Manuscript 2....119



LIST OF TABLES
Table 1 Demographic Characteristics of the studies included …………..58
Table 2 OQLQ score change between the baseline score to the last follow
up in each study ………………………………………..………………..62
Table 3 Quality assessment tool for before-after (pre-post) studies, scores
of included studies .………………………...……………………………63
Table 3.1 Criteria for quality assessment for the included studies.………64
Table 4 Demographic characteristics of patients ………………………..65
Table 5 Mean, standard deviation, and p-value in each timing, variables,
and domains …………………………………………………………….66
Table 6 Mean difference of OQLQ score compare timing to all patient…67
Table 7 Mean difference of OQLQ score compare timing and gender ...68
Table 8 Mean difference of OQLQ score compare timing and age group.69
Table 9 Mean difference of OQLQ score compare the timing and facial
types …………………………………………………………………...71
Table 10 Mean difference of OQLQ in gender at all time ………………73
Table 11 Mean difference of OQLQ score in age group at all time ……74
Table 12 Mean difference of OQLQ score in facial types at all time ….75
Table 13 Mean difference of OQLQ score compare age group at each time
point ……………………………………………………………………..76
Table 14 Mean difference of OQLQ score compare facial types at each
time point ………………………………………………………………..77
Table 15 p-value of the test model effect ………………………………78
Table 16 p-value of the effect of timing ………………………………..79



LIST OF FIGURES
Figure 1 The Orthognathic Quality of Life Questionnaire (OQLQ) form.81
Figure 2 Prisma flow 2009 diagram for the eligible article included in the
systematic review ……………………………………………………..82
Figure 3 Comparison of data collection timeframe of the study included83
Figure 4 Demographic data and characteristic of participants ………….84
Figure 5 Time trend in total OQLQ score ………………………………85
Figure 6 Time trend score in the Facial esthetic domain ……………….86
Figure 7 Time trend score in the Oral function domain …………………87
Figure 8 Time trend score in the Awareness domain ……………………88
Figure 9 Time trend score in the Social domain ………………………89
Figure 10 Percentage in answer values in the Facial esthetic domain ...…90
Figure 11 Percentage in answer values in the Oral function domain ……91
Figure 12 Percentage in answer values in the Awareness domain ………92
Figure 13 Percentage in answer values in the Social domain ……………93
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