DETERMINATION OF THE QUALITY OF LIFE OF PATIENTS WITH CONGENITAL CLEFT OF THE UPPER LIP AND PALATE BEFORE AND AFTER THEIR ORTHOPEDIC REHABILITATION
Authors: Oliinyk M. Y. 
Published: December 2020

Abstract. Congenital malformations remain one of the most pressing medical and social problems, and their frequency is an important characteristic of the population health status. Unfortunately, the tendency to their decrease is not observed in recent years, on average from 450 to 500 newborns per year. In this regard, it is important to study different aspects of the life quality of patients of different ages and with different types of congenital malformations of the upper lip and palate.

The positive dynamics of changes in the life quality can be evidenced by the survey data of these patients, which must be conducted after each stage of their rehabilitation with the use of special validated questionnaires.

Objective. The aim of the study was to assess the life quality of patients with congenital malformations of the upper lip and palate before and after the final stage of orthopedic treatment with different types of aesthetic designs of dentures.

Material and methods. An investigation of the life quality related to the oral health was proposed using data of 37 patients aged 17 to 36 years, including 26 men and 11 women with congenital malformations of the upper lip and palate, using the OHIP-14 (Oral health impact profile) questionnaire. Non-removable structures are made for 27 patients, combined (non-removable + removable) - for 10 patients. The questionnaire was conducted before treatment and one month after their orthopaedic its completion.

The analysis was conducted on individual questions, which were grouped into separate blocks: questions related to problems with eating, questions related to communication problems, questions related to problems in everyday life.

Research results. There was a significant improvement in the life quality of patients with congenital malformations of the upper lip and palate after completion of their orthopaedic rehabilitation as separate blocks of questions (Block I 12,703 ± 0,915 before, against 1,784 ± 0,165 after orthopaedic treatment; Block II 13,378 ± 0,672 before, against 1,405 ± 0,175 after orthopaedic treatment; Block III 9,919 ± 0,736 before, against 0,676 ± 0,155 after orthopaedic treatment), confirmed by statistical processing of the material (p <0,001) as well as the total number of points in the questionnaires (95,142 ± 1,405 before, against 10,214 ± 1,209 after orthopaedic treatment; p <0,001).

It should be considered that the life quality of patients with congenital malformations of the upper lip and palate, as well as other dental patients is a non-permanent category. It usually changes with age, as well as a result of treatment and prevention measures, so it must always be assessed in the dynamics. As a rule, successful treatment improves the life quality.

Inadequate aesthetic condition of the oral cavity, which is formed after a comprehensive treatment, along with the functions of chewing and speech, most significantly affects the life quality.

Thus, a study of the life quality associated with oral health of patients in this category suggests that adequate orthopaedic rehabilitation can significantly improve their life quality. In addition, the presence of either a fixed or a combined prosthesis, including in the area of the split (mouthpiece) aesthetically raises the upper lip and allows you to perform additional plastic surgery on it if necessary.

Conclusion. The life quality of patients with congenital malformations of the upper lip and palate associated with oral health is usually a temporary category and tends to change depending on the type of split, time and method of rehabilitation, especially orthopedic treatment. Adequate and high-quality prosthetics of defects and deformations of the teeth rows can significantly improve both the subjective assessment of the life quality and the objective improvement of the functional state of the dental-jaw system, as evidenced by these objective research methods.