Asociación entre la condición oral y sistémica con la calidad de vida en salud bucal de adultos mayores institucionalizados en Recoleta. Estudio piloto

Objetivo: Evaluar la asociación entre la condición oral y sistémica con la calidad de vida relacionada a salud bucal de adultos mayores institucionalizados en un hogar en Recoleta, Santiago. Material y método: En el presente estudio piloto de corte transversal, se realizó un examen intraoral y se aplicó la encuesta OHIP-7Sp a adultos mayores internados en la residencia Mi Hogar. Además, se revisaron las fichas médicas de los participantes para el registro de sus enfermedades y fármacos. Los datos fueron analizados a través del test t, test de Mann-Whitney y regresión logística considerando un valor p < a 0.05 como estadísticamente significativo. Resultados: 20 adultos mayores cumplieron los criterios de inclusión, 11 hombres y 9 mujeres, con un rango de edad entre 65 y 88 años. Se encontró asociación clínica entre la condición oral (p=0.06), salud general (p=0.2) y calidad de vida asociada a salud bucal en los adultos mayores. Conclusión: La condición oral, salud general y calidad de vida asociada a salud bucal de los adultos mayores se consideró deficiente. Se requieren estudios posteriores con una mayor muestra para lograr establecer una significancia estadística de las variables y así, proponer intervenciones para mejorar las condiciones de salud de los adultos mayores institucionalizados.

Aim: To evaluate the association between the oral and systemic condition and the oral health-related quality of life of institutionalized older people in a retirement home in Recoleta, Santiago. Material and method: In the present pilot, non-experimental, cross-sectional and descriptive study, an oral examination was performed, alongside with the OHIP-7Sp survey to the individuals that meets the inclusion criteria. In addition, the medical history of the participants was reviewed to record the diseases under treatment and the drugs in use. Results: 20 individuals met the inclusion criteria, 11 men and 9 women with ages ranging between 65 and 88 years. There was a clinical association between oral condition, general health and oral health-related quality of life related to oral health in the oelder people of thefrom the residence retirement home of in Recoleta. A statistical significance was not established. Conclusion: The oral condition, general health and quality of life related to oral health was were deficient. Subsequent studies with a larger sample are required to establish a statistically significant relationship of between the variables in order to propose different solutions.

Changes in health-related quality of life after orthognathic surgery: a multicenter study.

OBJECTIVE: To evaluate changes in general and oral health-related quality of life (HRQoL) in patients with dentofacial deformity undergoing orthognathic surgery, and whether these changes vary according to type of deformity. MATERIAL AND METHODS: This is a prospective longitudinal multicenter study of patients with dentofacial deformities (n = 90). The Orthognathic Quality of Life Questionnaire (OQLQ), Oral Health Impact Profile (OHIP-14), and Short-Form Health Survey version2 (SF-36v2) were self-completed by patients before surgery, 3 and 6 months after orthognathic surgery. Change was tested using paired t-test, and compared between Class II and Class III of dentofacial deformity by unpaired t-test. The magnitude of change was examined estimating the standardized response mean (SRM). RESULTS: The OQLQ and OHIP-14 showed statistically significant improvements 6 months after surgery, compared with the pre-surgical evaluation, but the SF-36v2 only in the physical component summary. The SRM was large in OQLQ oral function (-1.11) and dentofacial facial aesthetics (-0.76) dimensions, and moderate in most of OHIP-14 dimensions. Differences in mean change between Class II and III were statistically significant for global scores of OQLQ (-10.08 vs -20.30, p = 0.0271) and OHIP-14 (-3.79 vs -10.56, p = 0.0144). CONCLUSIONS: A significant improvement was observed in oral HRQoL and in the physical component of general health in patients with dentofacial deformities Class II and III after orthognathic surgery. Improvement was greater among Class III than in Class II patients. CLINICAL RELEVANCE: These results provide patients, oral health care professionals, and planners with valuable information to make evidence-based decisions and facilitate shared clinical decision-making, taking into account the patients' perspective.

Estabilidad del tratamiento ortodóncico-quirúrgico de avance mandibular mediante osteotomía sagital bilateral de rama mandibular en pacientes clase II. Revisión narrativa / Stability of the orthodontic-surgical treatment of mandibular advancement through bilateral sagittal split osteotomy in class II patients. Narrative review

RESUMEN: Introducción: La anomalía esqueletal clase II posee un 16 a 22,5% de prevalencia mundial. Cuando estos pacientes se someten al avance mandibular mediante osteotomía sagital de rama mandibular pueden presentar un grado de inestabilidad postoperatoria evidenciándose como recidiva de éste. Objetivo: Describir la estabilidad del avance mandibular mediante osteotomía sagital bilateral de rama mandibular en pacientes clase II esqueletal. Material y método: Se realizó una búsqueda electrónica en las bases de datos PubMed, EBSCO, The Cochrane Library, Tripdatabase y Scopus mediante las palabras clave "mandibular stability", "skeletal stability", "mandibular advancement", "sagittal split osteotomy", "sagittal split ramus osteotomy", "class II", "class III" y "distraction osteogenesis", relacionadas entre sí con los términos booleanos AND, OR y NOT. También se incluyeron los términos MeSH "mandibular advancement" y "Sagittal Split Ramus Osteotomy". Paralelamente se realizó una búsqueda manual en las revistas AJODO, BJOMS, JOMS y EJO. Resultados y discusión: Se seleccionaron 29 artículos: 24 estudios observacionales analíticos, 2 revisiones sistemáticas y 3 ensayos clínicos aleatorizados. El avance mandibular mediante osteotomía sagital de rama mandibular es estable. No obstante, se debe tener en cuenta la existencia de múltiples factores pre e intraquirúrgicos que podrían generar recidiva del tratamiento.

ABSTRACT: Introduction: The class II skeletal anomaly has a 16-22,5% prevalence worldwide. When class II patients undergo mandibular advancement through Bilateral Sagittal Split Osteotomy (BSSO), they can present a postoperative instability, evidenced as a relapse. Objective: To describe the stability of mandibular advancement through BSSO in skeletal class II patients. Materials and method: An electronic search was performed in the databases PubMed, EBSCO, The Cochrane Library, Tripdatabase and Scopus using the keywords "mandibular stability", "skeletal stability", "mandibular advancement", "sagittal split osteotomy", "sagittal split ramus osteotomy", "class II", "class III" and "distraction osteogenesis", related to each other with the Boolean terms AND, OR and NOT. Also "mandibular advancement" and "Sagittal Split Ramus Osteotomy" MeSH terms were included. In parallel, a manual search in the journals AJODO, BJOMS, JOMS and EJO was performed. Results and discussion: 29 articles were selected: 24 analytic observational studies, 2 systematic reviews and 3 randomized clinical trials. Mandibular advancement through BSSO is stable. However, multiple pre and intraoperative factors that could cause a treatment relapse must be taken into account.

Cross-cultural adaptation and validation of the Spanish version of the Orthognathic Quality of Life Questionnaire for patients with dentofacial deformities.

OBJECTIVE: The aim of this study was to develop a Spanish version of the Orthognathic Quality of Life Questionnaire (OQLQ) that is conceptually equivalent to the original questionnaire, as well as acceptable, reliable, valid, and responsive for use in Chilean patients with dentofacial deformities. MATERIAL AND METHODS: The recommended standard methodology, with direct and back-translation, was used. A prospective longitudinal multicenter study of adult patients diagnosed with dentofacial deformity was carried out, self-administrating OQLQ, OHIP-14 (Oral Health Impact Profile), and SF-36 (Short Form 36 Health Survey) during the presurgery visit in order to examine construct validity. To evaluate reproducibility, questionnaires were re-administered 4 weeks later to subjects with a stable dental condition. Responsiveness was assessed among subjects followed up until 3 months after surgery. RESULTS: Of the 230 patients under presurgical orthodontic treatment included in the study, 216 completed the questionnaire, 142 formed the reliability sub-sample, and 30 were evaluated 3 months after surgery. Cronbach's alpha ranged from 0.78 to 0.94 and test-retest intraclass correlation coefficients ranged from 0.84 to 0.91 (p = 0.001) by dimension. The correlation matrix between OQLQ dimensions and SF-36 and OHIP-14 confirmed most of the associations previously hypothesized as moderate (rs > 0.4). Confirmatory factor analysis supported the same structure as the original instrument, considering four dimensions. Responsiveness was demonstrated by the large improvement observed in the global score 3 months after surgery: mean change ±SD = -15.1 ± 18.05 and standard response mean = -0.84 (p < 0.001). CONCLUSIONS: The Spanish version of OQLQ has demonstrated good levels of reliability, validity, and responsiveness - similar to those of the original questionnaire.

Periodontally Accelerated Osteogenic Orthodontics (PAOO) technique in cleft patients: A complement to orthognathic surgery in dentoalveolar expansion. A case series report.

The aim of this study was to describe a surgical technique that can be used to solve dentofacial deformities in cleft palate patients with maxillary hypoplasia in order to increase maxillary alveolar bone width, without modifying the skeletal base, and therefore, keeping the velopharyngeal function unaltered. Four patients with a history of cleft palate not associated with syndrome and treated under conventional surgical protocol during their childhood, underwent PAOO surgery incorporating L-PRF, followed by an accelerated orthodontic treatment with checkups every two weeks. All patients reached the desired occlusion without modifying their skeletal bases and velopharyngeal function. Orthodontic treatments were finished between 10 and 14 months after surgery without complications. There were no observed complications in the velopharyngeal postsurgical function and an increase in the arch width was achieved in all cases, along with a reduced orthodontic treatment time. The clinical results obtained confirm that PAOO technique is a safe and reliable complement to orthognathic surgery in the surgical treatment of cleft patients. By increasing the perimeter of the maxillary dentoalveolar ridge, the segmentation of the maxilla could be avoided, increasing the post operatory stability of these patients.