Comparison of the Short-Term Quality of Life Changes of Patients Undergoing Orthognathic Surgery With Clear Aligners and Fixed Appliances: A Retrospective Study

Abstract

AIM: To assess and compare the short-term impact of clear aligners and fixed appliances on oral, psychological and physical health of patients undergoing orthognathic surgery.

METHODS: A total of 60 patients who underwent orthognathic surgery between 2021 and 2024 were invited to fill out questionnaires. These patients who were diagnosed with skeletal malocclusion and required a combined surgical and orthodontic treatment approach were divided into clear aligners (CA) and fixed appliances (FA) groups. Oral, psychological and physical health were used to evaluate the quality of life (QoL) multidimensionally by 36-item Short-Form Health Survey (SF-36) and 14-item Short-Form Oral Health Impact Profile (OHIP-14) at two time points: preoperative (T0) and 2 weeks postoperative (T1). Comparative analyses of OHIP-14 and SF-36 scores were conducted between the two cohorts.

RESULTS: The OHIP-14 total scores exhibited a notable increase from T0 to T1 in both the CA and FA groups, whereas the physical health summary (PCS) and mental health summary (MCS) scores decreased from T0 to T1. Significant differences in the OHIP-14 total scores, PCS and MCS (p < 0.0001) were observed between the two groups at T1, demonstrating better postoperative QoL in the CA group. Significant negative correlations between age and PCS were observed in both groups (r < –0.5, p < 0.0001) at T1. Age demonstrated significant correlation with MCS in the FA group (r < –0.5, p < 0.0001) at T1. A longer duration of presurgical orthodontics treatment was associated with higher OHIP-14 scores in the FA group (r > 0.3, p < 0.05) and lower MCS scores in both FA and CA groups (r < –0.3, p < 0.05).

CONCLUSIONS: Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after orthognathic surgery had better oral, mental, and physical QoL.