Verbesserung der Lebensqualität von Patienten nach bimaxillärer Umstellungsosteotomie durch Genioplastik

Verbesserung der Lebensqualität von Patienten nach bimaxillärer Umstellungsosteotomie durch Genioplastik

Reduction genioplasty enhances quality of life in patients with prognathism and maxillary hypoplasia undergoing bimaxillary osteotomy

Antje Lehmann

Doctoral thesis

Date of Examination: 2017-12-04

Date of issue: 2017-11-21

Advisor: Rustemeyer, Jan Prof. Dr. Dr.

Referee: Rustemeyer, Jan Prof. Dr. Dr.

Referee: Felmerer, Gunther PD Dr.

Referee: Laskawi, Rainer Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0023-3F6E-2

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Abstract

English

The structure of the chin determines facial attractiveness and is directly linked to quality of life (QoL). In patients with prognathism and maxillary hypoplasia, bimaxillary osteotomy (BIMAX) with mandibular setback does not always lead to a more slender chin or improved aesthetics. The aim of the present study was to evaluate whether QoL differed between females undergoing BIMAX alone (group I; n = 30) and those undergoing BIMAX combined with reduction genioplasty (group II; n = 30). Presurgical and postsurgical evaluations included cephalography, photogrammetry, and the Oral Health Impact Profile with one additional domain (aesthetics). Setback of the hard tissue pogonion was significantly greater (P = 0.006) in group II (7.1 mm) than in group I (2.7 mm). Only in group II were soft tissue pogonion changes highly significant (P < 0.001), amounting to a mean of 5 mm. In both groups, the QoL domains ‘social disability’, ‘psychological discomfort’, and ‘dissatisfied with aesthetics’ changed significantly towards lower impact scores. Changes in the latter two domains were significantly greater in group II patients than in group I patients (P = 0.021; P < 0.001) and were correlated with changes in the soft tissue pogonion in the horizontal (P = 0.024; P = 0.022) and the domain 'dissatisfied with aesthetics' in the vertical directions (P = 0.042). Genioplasty addresses both psychological and aesthetic concerns, and therefore significantly enhances postsurgical QoL.

Keywords: genioplasty