Assessment of health-related quality of life for patients with severe skeletal disharmony: a review of the issues.

Health-related quality of life (HRQOL) assessments made by patients provide a view of dentofacial disharmony and surgical outcome that can inform clinicians in important ways. In this paper, HRQOL as it pertains to patients with dentofacial disharmony and orthognathic surgery is discussed from three perspectives. First, arguments regarding the necessity of studying HRQOL in orthognathic patients are presented. Second, a variety of ways of defining HRQOL are reviewed, and implications for applications to orthognathic surgery are discussed. Finally, various measurement techniques are presented for assessing HRQOL in orthognathic patients. Use of dental HRQOL measures, as well as multi-item, multimeasure techniques, are discussed. For more reliable and comprehensive HRQOL measurement in patients with dentofacial disharmony, multi-item, multimeasurement techniques should be employed. While such techniques place greater demands on patients who are completing paper-and-pencil measures, the resultant low measurement error and comprehensive HRQOL assessment outweighs the risk of subject fatigue.