Changes Of Facial Profile And Quality Of Life After The Combination Of Ortho-orthognathic Surgery In The Skeleton Class Ⅲ Patients

Objective :1.To evaluate the treatment outcomes and compare the changes of hard and soft tissues before and after the orthodontic-orthognathic treatment in the skeleton class III patients.2.To illuminate the improvement of quality of life after the orthodontic-orthognathic treatment in the skeleton class III patients3.to prove the relationship between postsurgical cephalometric changes and quality of lifeMaterial and methods:21 cases of skeleton class III were collected from the Guangxi Medical University Dental Hospital.The study period was from march2014 to April 2017.All of the patients were taken the cephalometric radiographic at pre –treatment(T0)and post treatment(T2)and compared and analyzed the changes of the hard and soft tissues.Let them fill the OHIP-14 and OQLQ survey form at the pre treatment(T0),pre-surgery(T1)and post-treatment(T2).All of the volunteer 40(Tc)were filled the two same survey forms and compared and analyzed T0-T1,T1-T2,T2-Tc,AND T0-T2 by using the SPSS 20 statistical software.Moreover The cephalometric value that were used were SNA,SNB,ANB,Go-Pg,ANS-Me,ANSMe/NMe,<U1-L1,UL-EP,LL-EP,Z ANGLE,<N-Sn-Pg,wits(mm).correlate the relationship between postsurgical cephalometric changes and quality of life(OQLQ and OHIP 14)by using the SPSS 20Result:1.after combination of orthodontic-orthognathic treatment,<SNA,<SNB were statistically significant(P<0.05).<ANB and Wits improved near to the normal(P <0.01).Go-Pg length shorter than before(P <0.01),but Go-Co were no significantly changes.Lower vertical third ANS-Me(P <0.01)and ANS-Me / N-Me reduced(P<0.05)near to the normal value.<U1-SN 角,<U1-NA and U1-NAlength were reduced,L1-MP were increased(P<0.05)N-Sn-Pg,Z angle,UL-EP,LL-EP significantly reduced(P <0.01).2.In OHIP-14:psychological illness、psychological disorder and communication improved in comparing of T2 with T0 and T1(P <0.01),T1 greater than T0,T1 greater than T2(P<0.05).These three factors were statistically significant.But T2 and Tc were no statistically significant.In OQLQ,all of four factors were statistically significant in comparing T2-T0 and T1-T0(P <0.01),however T2-Tc were no statistically significant 。 Moreover in class III malocclusion patients,decrease convexity angle,in lower lip protrusion and relationship of upper and lower were the most positive impact on quality of life.A significant corelation was detected post operatively in the soft tissue parameters;Z angle,LL-EP.(P<0.05).In the hard tissue parameters ANB and angle U1-L1(P<0.05).In class III malocclusion patients,decrease convexity angle,in lower lip protrusion and relationship of upper and lower were the most positive impact on quality of life.Conclusion 1.By combination treatment of orthodontic and orthognathic surgery,the facial profile are significantly improved in adult skeleton class III patient as well as the quality of life of the patients were significantly improved.