The supplemental tables were not included in “Effect of surgery-first orthognathic approach on oral health-related quality of life: A systematic review,” by Ke Yao, Guanyin Zhu, Miao Chen, Bo Zhang, Yongzhi Wu, and Peilin Li. Angle Orthod. 2020;90:723–733. They are provided here:
Supplementary Table 1.
Search Strategies of Each Database
| Electronic Database |
Search Strategy |
Hits |
| PubMed | (Orthodontics[MeSH Terms] OR orthodont*) AND (Orthognathic Surgery[MeSH Terms] OR orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND (Quality of Life[MeSH Terms] OR quality of life OR oral health-related quality of life OR OHRQoL) | 404 |
| Cochrane Central Register of Controlled Trials (CENTRAL) via The Cochrane Library | ([mh Orthodontics] OR orthodont*) AND ([mh “Orthognathic Surgery”] OR [mh “Orthognathic Surgical Procedures”] OR orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND ([mh “Quality of Life”] OR quality of life OR oral health-related quality of life OR OHRQoL) | 26 |
| Cochrane Database of Systematic Reviews (CDSR) via The Cochrane Library | ([mh Orthodontics] OR orthodont*) AND ([mh “Orthognathic Surgery”] OR [mh “Orthognathic Surgical Procedures”] OR orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND ([mh “Quality of Life”] OR quality of life OR oral health-related quality of life OR OHRQoL) | 67 |
| EMBASE via Ovid | (exp orthodontics/ OR orthodont*) AND (exp orthognathic surgery/ OR orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND (exp “quality of life"/ OR quality of life OR oral health-related quality of life OR OHRQoL) | 220 |
| Web of Science | TS=(orthodont*) AND TS=(orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND TS=(quality of life OR life quality OR oral health-related quality of life OR HRQOL OR OHRQoL) | 259 |
| SCOPUS | TITLE-ABS-KEY(orthodont*) AND TITLE-ABS-KEY(orthognathic OR surgery OR surgical OR osteotomy OR (Le Fort) OR (sagittal split ramus) OR (intraoral vertical ramus)) AND TITLE-ABS-KEY((quality of life) OR (life quality) OR (oral health-related quality of life) OR HRQOL OR OHRQoL) | 228 |
| China National Knowledge Infrastructure (CNKI) | SU=‘orthodont*' AND SU=(‘orthognathic'+‘surgery'+‘osteotomy') AND SU=(‘quality of life' +‘HRQOL'+‘OHRQoL') | 11 |
| Chinese Biomedical Literature Database (CBM) | (“Orthodontics”[MeSH Terms] OR “orthodont*”) AND (“Orthognathic Surgery”[MeSH Terms] OR “Orthognathic Surgical Procedures”[MeSH Terms] OR “orthognathic” OR “surgery” OR “osteotomy”) AND (“Quality of Life”[MeSH Terms] OR “quality of life” OR “HRQOL” OR “OHRQoL”) | 141 |
| ProQuest Dissertation & Theses Database | (mainsubject(orthodontics) OR orthodont*) AND (orthognathic OR surgery OR surgical OR osteotomy OR “Le Fort” OR “sagittal split ramus” OR “intraoral vertical ramus”) AND (“quality of life” OR “life quality” OR “oral health-related quality of life” OR HRQOL OR OHRQoL) | 442 |
| System for Information on Grey Literature in Europe (SIGLE) | (orthodont*) AND (orthognathic OR surgery OR surgical OR osteotomy OR Le Fort OR sagittal split ramus OR intraoral vertical ramus) AND (quality of life OR life quality OR oral health-related quality of life OR HRQOL OR OHRQoL) | 2 |
| ClinicalTrials.gov | 21 |
Supplementary Table 2.
Summary of Excluded Studies
| Author and Year |
Title |
Reason |
|
| 1 | Peter 2017 | Oral health-related quality of life in surgery-first vs traditional orthognathic approach | Comment |
| 2 | Gambaro 2016 | Surgery-first or orthognathic surgery approach: Psychosocial and physical changes | Conference abstract with no full text available |
| 3 | Alanko 2017 | A longitudinal study of changes in psychosocial well-being during orthognathic treatment | Only conventional three-stage patients |
| 4 | Asada 2015 | Satisfaction with orthognathic surgery of skeletal Class III patients | Only conventional three-stage patients |
| 5 | Baherimoghaddam 2016 | Assessment of the changes in quality of life of patients with class II and III deformities during and after orthodontic-surgical treatment | Only conventional three-stage patients |
| 6 | Eslamipour 2017 | Impact of orthognathic surgery on quality of life in patients with dentofacial deformities | Only conventional three-stage patients |
| 7 | Kavin 2012 | Changes in quality of life and impact on patients' perception of esthetics after orthognathic surgery | Only conventional three-stage patients |
| 8 | Kurabe 2016 | Impact of orthognathic surgery on oral health-related quality of life in patients with jaw deformities | Only conventional three-stage patients |
| 9 | Murphy 2011 | The clinical relevance of orthognathic surgery on quality of life | Only conventional three-stage patients |
| 10 | Razvadi 2017 | Evaluation of the changes in the quality of life in patients undergoing orthognathic surgery: a multicenter study | Only conventional three-stage patients |
| 11 | Rustemeyer 2012 | Quality of life in orthognathic surgery patients: post-surgical improvements in aesthetics and self-confidence | Only conventional three-stage patients |
| 12 | Silva 2013 | Evaluation of life quality of patients submitted to orthognathic surgery | Only conventional three-stage patients |
| 13 | Silva 2016 | Quality of life in patients undergoing orthognathic surgery—a two-centered Swedish study | Only conventional three-stage patients |
| 14 | Le Gall 2015 | First-line surgery: indications, advantages and drawbacks | Review |
| 15 | Antoun 2015 | Oral health-related quality of life changes in standard, cleft, and surgery patients after orthodontic treatment | Specific method not mentioned |
| 16 | Azuma 2008 | Beneficial effects of orthodontic treatment on quality of life in patients with malocclusion | Specific method not mentioned |
| 17 | Choi 2010 | Change in quality of life after combined orthodontic-surgical treatment of dentofacial deformities | Specific method not mentioned |
| 18 | Nichols 2018 | Long-term changes in oral health-related quality of life of standard, cleft, and surgery patients after orthodontic treatment: a longitudinal study | Specific method not mentioned |
| 19 | Schmidt 2013 | Survey of oral health-related quality of life among skeletal malocclusion patients following orthodontic treatment and orthognathic surgery | Specific method not mentioned |
| 20 | Silvola 2014 | Dental esthetics and quality of life in adults with severe malocclusion before and after treatment | Specific method not mentioned |
| 21 | Silvola 2016 | Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion? | Specific method not mentioned |
| 22 | Tamme 2017 | Correlation of general and oral health-related quality of life in malocclusion patients treated with a combined orthodontic and maxillofacial surgical approach | Specific method not mentioned |
| 23 | Bock 2009 | Assessment of quality of life in patients undergoing orthognathic surgery | Without treatment |
| 24 | Jung 2016 | Quality of life and self-esteem of female orthognathic surgery patients | Without treatment |
Supplementary Table 3.
GRADE Evidence Profile for the Effects of a Surgery-First Approach on Patients With Dentofacial Deformities
| Certainty Assessment |
Summary of Findings |
||||||
| Outcome No. of Participants (Studies) | Risk of Bias | Inconsistency | Indirectness | Imprecision | Other Considerations | Overall Certainty of Evidence | Impact |
| Final OHRQoL 126 (3) | Seriousa | Not serious | Not serious | Not serious | None | ⊕○○○ VERY LOW | The total OHRQoL scores and the scores of every domains did not show any difference between patients treated with SFA and COST. |
| Presurgical deterioration of OHRQoL 214 (7) | Seriousa | Not serious | Not serious | Not serious | Very strong association | ⊕⊕⊕○ MODERATE | OHRQoL of patients in the SFA group improved immediately after orthognathic surgery, while patients treated by COST suffered a significant presurgical deterioration of OHRQoL. |
| Treatment duration 125 (4) | Not seriousb | Not serious | Seriousc | Not serious | Strong association | ⊕⊕○○ LOW | Two studies showed an average treatment duration of 16.6 months and 25.3 months in the SFA and COST groups, respectively. One study showed that the SFA treatment lasted for 15.7 ± 3.31 months. In another study, 5 of 8 patients completed treatment after 2 years, while all patients in the COST group were still in the preoperative orthodontic phase. |
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
Nonrandomized cohort studies were conducted without blinding, and outcomes were assessed by self-reported questionnaires.
Treatment time is an objective outcome hardly affected by the nonrandomized cohort study design.
One study had ceased before all patients completed treatment. One study was conducted without the COST group.
