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基因多态性与接受正颌手术的Ⅲ类骨面型患者的口腔健康相关生活质量有关。

Genetic polymorphisms are involved in oral health-related quality of life in skeletal class III patients submitted to orthognathic surgery.

作者信息

Meger Michelle Nascimento, Gerber Jennifer Tsi, Azeredo Willian Martins, Sebastiani Aline Monise, Deliberador Tatiana Miranda, Küchler Erika Calvano, Klüppel Leandro Eduardo, Scariot Rafaela

机构信息

School of Health Sciences, Positivo University, 5300 Professor Pedro Viriato Parigot de Souza Street, Curitiba, PR, 81280-330, Brazil.

Department of Stomatology, School of Dentistry, Federal University of Parana, 632 Prefeito Lothario Meissner Avenue, Curitiba, PR, 80210-170, Brazil.

出版信息

Clin Oral Investig. 2023 Apr;27(4):1409-1421. doi: 10.1007/s00784-023-04925-3. Epub 2023 Feb 24.

Abstract

OBJECTIVE

This study aimed to evaluate whether sex and genetic polymorphisms impact the oral health-related quality of life (OHRQoL) preoperatively and the difference between preoperative and postoperative OHRQoL in skeletal Class III patients submitted to orthognathic surgery.

MATERIALS AND METHODS

This longitudinal study consisted of ninety-nine patients with skeletal Class III malocclusion who required orthognathic surgery. The Oral Health Impact Profile-14 (OHIP-14) is a questionnaire used to assess the OHRQoL with a 5-point Likert-type scale, covering seven domains related to physical and psychosocial factors. The questionnaire was applied in the preoperative and postoperative periods, and the difference scores were calculated to assess the OHRQoL after orthognathic surgery. The DNA was extracted from oral mucosa cells to evaluate genetic polymorphisms in ANKK1, DRD2, ESR1, and ESR2 through real-time PCR.

RESULTS

There was an improvement in all OHRQoL domains following orthognathic surgery (p < 0.05). In the preoperative evaluation, women presented worse OHRQoL (p < 0.05) than men. There was no statistical difference between sex and the OHRQoL after surgery (p > 0.05). When evaluating the polymorphisms and preoperative OHIP-14 scores, CT genotype patients for rs1800497 (ANKK1) had a worse perception of the physical pain domain than CC genotype (p = 0.026), and CC genotype patients for rs1256049 (ESR2) had a worse perception of the functional limitation domain than CT genotype (p = 0.002). In the analysis between polymorphisms and postoperative and preoperative difference scores, CT genotype patients for rs1256049 (ESR2) had a greater improvement in the perception of the physical pain domain than the CC genotype (p = 0.031). In rs6275 and rs6276 (DRD2), patients with the CC genotype worsened the perception of the functional limitation domain than the TT genotype (p = 0.045), and AA genotype patients worsened the perception of the functional limitation domain than GG genotype (p = 0.048) after surgery, respectively. In addition, patients with the CT genotype for rs1800497 (ANKK1) had a greater improvement of OHRQoL perception in the total scale than the TT genotype (p = 0.018), and CT genotype patients had a greater improvement in the perception of function limitation domain than TT genotype (p = 0.017).

CONCLUSION

Women have a worse perception of OHRQoL in the preoperative period of orthognathic surgery. Furthermore, polymorphisms in the ANKK1, DRD2, and ESR2 genes could be involved with OHRQoL in the preoperative period and following orthognathic surgery.

CLINICAL RELEVANCE

The knowledge of the genetic background concerning OHRQoL in skeletal class III patients would aid in clinical practice to screen for associated genetic factors and prevent OHRQoL deterioration, especially after orthognathic surgery, considering that patients' genetic profiles would soon be available.

摘要

目的

本研究旨在评估性别和基因多态性对正颌手术患者术前口腔健康相关生活质量(OHRQoL)的影响,以及正颌手术患者术前和术后OHRQoL的差异。

材料与方法

这项纵向研究纳入了99例需要正颌手术的Ⅲ类骨性错颌患者。口腔健康影响程度量表-14(OHIP-14)是一份用于评估OHRQoL的问卷,采用5级李克特量表,涵盖与身体和心理社会因素相关的七个领域。该问卷在术前和术后进行发放,并计算差异分数以评估正颌手术后的OHRQoL。从口腔黏膜细胞中提取DNA,通过实时PCR评估ANKK1、DRD2、ESR1和ESR2基因的多态性。

结果

正颌手术后所有OHRQoL领域均有改善(p<0.05)。在术前评估中,女性的OHRQoL比男性差(p<0.05)。性别与术后OHRQoL之间无统计学差异(p>0.05)。在评估基因多态性与术前OHIP-14评分时,rs1800497(ANKK1)的CT基因型患者在身体疼痛领域的感知比CC基因型患者差(p=0.026),rs1256049(ESR2)的CC基因型患者在功能受限领域的感知比CT基因型患者差(p=0.002)。在分析基因多态性与术后和术前差异分数之间的关系时,rs1256049(ESR2)的CT基因型患者在身体疼痛领域的感知改善程度比CC基因型患者大(p=0.031)。在rs6275和rs6276(DRD2)中,CC基因型患者在术后功能受限领域的感知比TT基因型患者恶化(p=0.045),AA基因型患者在术后功能受限领域的感知比GG基因型患者恶化(p=0.048)。此外,rs1800497(ANKK1)的CT基因型患者在总量表上的OHRQoL感知改善程度比TT基因型患者大(p=0.018),CT基因型患者在功能受限领域的感知改善程度比TT基因型患者大(p=0.017)。

结论

女性在正颌手术术前对OHRQoL的感知较差。此外,ANKK1、DRD2和ESR2基因的多态性可能与正颌手术术前及术后的OHRQoL有关。

临床意义

了解Ⅲ类骨性错颌患者OHRQoL的遗传背景,将有助于临床实践中筛查相关遗传因素,预防OHRQoL恶化,特别是在正颌手术后,因为患者的基因图谱很快就可以获取。

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