{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:46:14Z","timestamp":1792248374708,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T00:00:00Z","timestamp":1624665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,30]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\/objectives<\/jats:title>\n                  <jats:p>To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P &amp;lt; 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (\u03b2 = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (\u03b2 = \u22120.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (\u03b2 = 0.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>The short follow-up period of 6 months after orthognathic surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions\/implications<\/jats:title>\n                  <jats:p>This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjab039","type":"journal-article","created":{"date-parts":[[2021,5,23]],"date-time":"2021-05-23T19:06:35Z","timestamp":1621796795000},"page":"170-177","source":"Crossref","is-referenced-by-count":12,"title":["The impact of orthognathic surgery on quality of life in individuals with oral clefts"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3792-4536","authenticated-orcid":false,"given":"Mariana Chaves Petri","family":"Feitosa","sequence":"first","affiliation":[{"name":"Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of S\u00e3o Paulo, Bauru, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Garib","sequence":"additional","affiliation":[{"name":"Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of S\u00e3o Paulo, Bauru, SP, Brazil"},{"name":"Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo, Bauru, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"de C\u00e1ssia Moura Carvalho Lauris","sequence":"additional","affiliation":[{"name":"Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of S\u00e3o Paulo, Bauru, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula Queiroz","family":"Herkrath","sequence":"additional","affiliation":[{"name":"School of Dentistry, Federal University of Amazonas, Manaus, Amazonas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Vianna","family":"Vettore","sequence":"additional","affiliation":[{"name":"Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,26]]},"reference":[{"key":"2022033005311582400_CIT0001","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1590\/S1678-77572012000100003","article-title":"Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies\/USP (HRAC\/USP)\u2013Part 1: overall aspects","volume":"20","author":"Freitas","year":"2012","journal-title":"Journal of Applied Oral Science: Revista FOB,"},{"key":"2022033005311582400_CIT0002","first-page":"189","article-title":"Oral health-related quality of life in non-syndromic cleft lip and\/or palate patients: a systematic review","volume":"30","author":"Antonarakis","year":"2013","journal-title":"Community Dental Health,"},{"key":"2022033005311582400_CIT0003","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1597\/02-119.3.1","article-title":"The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 3: dental arch relationships","volume":"42","author":"M\u00f8lsted","year":"2005","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0004","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1093\/ejo\/cjr073","article-title":"Appreciation of cleft lip and palate treatment outcome by professionals and laypeople","volume":"34","author":"Papamanou","year":"2012","journal-title":"European Journal of Orthodontics,"},{"key":"2022033005311582400_CIT0005","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.ijom.2007.07.008","article-title":"Satisfaction with treatment outcome in bilateral cleft lip and palate patients","volume":"36","author":"Oosterkamp","year":"2007","journal-title":"International Journal of Oral and Maxillofacial Surgery,"},{"key":"2022033005311582400_CIT0006","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1597\/13-104","article-title":"Measurement of health-related and oral health-related quality of life among individuals with nonsyndromic orofacial clefts: a systematic review and meta-analysis","volume":"52","author":"Queiroz Herkrath","year":"2015","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0007","first-page":"E48","article-title":"Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery","volume":"13","author":"Nicodemo","year":"2008","journal-title":"Medicina Oral, Patologia Oral Y Cirugia Bucal,"},{"key":"2022033005311582400_CIT0008","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1590\/S0080-623420160000200006","article-title":"Quality of life of individuals with cleft lip and palate pre- and post-surgical correction of dentofacial deformity","volume":"50","author":"Beluci","year":"2016","journal-title":"Revista da Escola de Enfermagem da U S P,"},{"key":"2022033005311582400_CIT0009","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1097\/SCS.0000000000005425","article-title":"Difference in degrees of satisfaction with orthognathic surgery and orthodontic treatment between skeletal Class III and cleft patients","volume":"30","author":"Yim","year":"2019","journal-title":"The Journal of Craniofacial Surgery,"},{"key":"2022033005311582400_CIT0010","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1600-0528.2004.00190.x","article-title":"The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks","volume":"33","author":"Newton","year":"2005","journal-title":"Community Dentistry and Oral Epidemiology,"},{"key":"2022033005311582400_CIT0011","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/jama.1995.03520250075037","article-title":"Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes","volume":"273","author":"Wilson","year":"1995","journal-title":"JAMA,"},{"key":"2022033005311582400_CIT0012","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1597\/09-122","article-title":"A new yardstick for rating dental arch relationship in patients with complete bilateral cleft lip and palate","volume":"48","author":"Ozawa","year":"2011","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0013","volume-title":"Manual of the General Health Questionnaire Windsor","author":"Goldberg","year":"1978"},{"issue":"1","key":"2022033005311582400_CIT0014","first-page":"17","article-title":"Joao Carlos Ten\u00f3rio Adapta\u00e7\u00e3o e valida\u00e7\u00e3o de uma escala de bem-estar psicol\u00f3gico para uso em estudos ocupacionais","volume":"1","author":"De oliveira Borges","year":"2002","journal-title":"Interamerican Journal of Psychological Assessment"},{"key":"2022033005311582400_CIT0015","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/oxfordjournals.aje.a112674","article-title":"Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents","volume":"109","author":"Berkman","year":"1979","journal-title":"American Journal of Epidemiology,"},{"issue":"4","key":"2022033005311582400_CIT0016","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1590\/S0102-311X2001000400022","article-title":"Social network and social support measures from the Pr\u00f3-Sa\u00fade Study: pre-tests and pilot study","volume":"17","author":"Chor","year":"2001","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"2022033005311582400_CIT0017","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/0277-9536(91)90150-B","article-title":"The MOS social support survey","volume":"32","author":"Sherbourne","year":"1991","journal-title":"Social Science & Medicine (1982),"},{"issue":"2","key":"2022033005311582400_CIT0018","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1590\/S0102-311X2003000200029","article-title":"Social support: scale test-retest reliability in the Pro-Health Study","volume":"19","author":"Griep","year":"2003","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"2022033005311582400_CIT0019","first-page":"125","volume-title":"Oral Health Surveys: Basic Methods","author":"World Health Organization","year":"2013","edition":"5"},{"key":"2022033005311582400_CIT0020","first-page":"134","volume-title":"DAI--The Dental Aesthetic Index","author":"Cons","year":"1986"},{"key":"2022033005311582400_CIT0021","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j.1600-0528.2005.00225.x","article-title":"Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form","volume":"33","author":"Oliveira","year":"2005","journal-title":"Community Dentistry and Oral Epidemiology,"},{"key":"2022033005311582400_CIT0022","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1600-0528.2009.00495.x","article-title":"Applying Andersen\u2019s behavioural model to oral health: what are the contextual factors shaping perceived oral health outcomes?","volume":"37","author":"Baker","year":"2009","journal-title":"Community Dentistry and Oral Epidemiology,"},{"key":"2022033005311582400_CIT0023","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.ajodo.2017.06.018","article-title":"Long-term changes in oral health-related quality of life of standard, cleft, and surgery patients after orthodontic treatment: a longitudinal study","volume":"153","author":"Nichols","year":"2018","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics,"},{"key":"2022033005311582400_CIT0024","first-page":"503","article-title":"Relationship between the severity of malocclusion and oral health related quality of life: a systematic review and meta-analysis","volume":"15","author":"Sun","year":"2017","journal-title":"Oral Health & Preventive Dentistry,"},{"key":"2022033005311582400_CIT0025","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1597\/09-181.1","article-title":"The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 2. Dental arch relationships","volume":"48","author":"Hathaway","year":"2011","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0026","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1597\/04-117r.1","article-title":"Assessment of dental arch relationships in Japanese patients with unilateral cleft lip and palate","volume":"43","author":"Susami","year":"2006","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0027","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1597\/07-210.1","article-title":"Dentoalveolar relationships of Malay children with unilateral cleft lip and palate","volume":"46","author":"Zreaqat","year":"2009","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0028","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1597\/1545-1569(2003)040<0054:EOOSOS>2.0.CO;2","article-title":"Effects of orthognathic surgery on speech and breathing of subjects with cleft lip and palate: acoustic and aerodynamic assessment","volume":"40","author":"Trindade","year":"2003","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"issue":"2","key":"2022033005311582400_CIT0029","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/00001665-199803000-00017","article-title":"Speech changes after maxillary advancement in 40 cleft lip and palate patients","volume":"9","author":"Maegawa","year":"1998","journal-title":"The Journal of Craniofacial Surgery"},{"key":"2022033005311582400_CIT0030","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1177\/1055665619852562","article-title":"Predictors of velopharyngeal dysfunction in individuals with cleft palate following surgical maxillary advancement: clinical and tomographic assessments","volume":"56","author":"de Medeiros-Santana","year":"2019","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0031","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1597\/10-126","article-title":"General health-related quality of life and oral health impact among Australians with cleft compared with population norms; age and gender differences","volume":"49","author":"Foo","year":"2012","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"key":"2022033005311582400_CIT0032","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1597\/08-281","article-title":"Quality of life varies with gender and age among adults treated for unilateral cleft lip and palate","volume":"47","author":"Mani","year":"2010","journal-title":"The Cleft Palate-Craniofacial Journal,"},{"issue":"9","key":"2022033005311582400_CIT0033","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1177\/1055665618763377","article-title":"Determinants of health-related and oral health-related quality of life in adults with orofacial clefts: a cross-sectional study","volume":"55","author":"Correa de Queiroz Herkrath","year":"2018","journal-title":"The Cleft Palate-Craniofacial Journal"},{"key":"2022033005311582400_CIT0034","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1177\/0022034515592880","article-title":"Oral health inequalities: relationships between environmental and individual factors","volume":"94","author":"Gupta","year":"2015","journal-title":"Journal of Dental Research,"},{"key":"2022033005311582400_CIT0035","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/cdoe.12080","article-title":"Determinants of children\u2019s oral-health-related quality of life over time","volume":"42","author":"Gururatana","year":"2014","journal-title":"Community Dentistry and Oral Epidemiology,"}],"container-title":["European Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/44\/2\/170\/43024181\/cjab039.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/44\/2\/170\/43024181\/cjab039.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T05:31:42Z","timestamp":1648618302000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejo\/article\/44\/2\/170\/6309938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,26]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6,26]]},"published-print":{"date-parts":[[2022,3,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ejo\/cjab039","relation":{},"ISSN":["0141-5387","1460-2210"],"issn-type":[{"value":"0141-5387","type":"print"},{"value":"1460-2210","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,4,1]]},"published":{"date-parts":[[2021,6,26]]}}}