Calidad de vida en pacientes con maloclusiones sagitales clase III sometidos a cirugía ortognática. Una revisión sistemática

Abstract

Introduction. Class III sagittal malocclusions are frequent and cause aesthetic, functional, and psychosocial repercussions that deteriorate quality of life. In adults, orthognathic surgery is the treatment of choice because it corrects skeletal discrepancies and harmonizes the facial profile; however, published results on satisfaction and well-being are variable, which justifies a rigorous synthesis. Objective. To determine the impact of orthognathic surgery on the quality of life of adults with Class III malocclusion through a systematic review of literature published between 2020 and 2024. Methods. Articles were searched in PubMed, Scopus, Web of Science, and ScienceDirect. Observational studies in English or Spanish, full-text, with non-syndromic adults operated for Class III were included. Predefined selection criteria were applied, methodological quality was assessed with the Spanish-validated STROBE checklist, and study design, sample characteristics, quality-of-life instruments (OQLQ, OHIP-14, FACE-Q, PIDAQ), follow-up times, and main outcomes were extracted. Results. Of 96 records identified, 15 met the criteria. Clearly significant improvements were observed from the third postoperative month, consolidating at 6–12 months. The most benefited domains were facial aesthetics, self-esteem, oral function, and social interaction, while awareness of deformity showed less recovery. Forty percent of the studies had high methodological quality, and 60% medium quality. The heterogeneity of instruments and follow-ups hindered direct comparisons. Conclusion. Evidence from 2020–2024 indicates that orthognathic surgery for Class III consistently improves perceived quality of life, with the greatest effect in aesthetic, psychosocial, and functional dimensions, and benefits consolidating from 6–12 months onward.