Oral health-related quality of life and severe hypodontia

The aims of the study were to assess oral health-related quality of life (ohqol) impact among patients with severe hypodontia and to determine the association between ohqol and the number of missing teeth. Twenty-five patients with severe hypodontia (four or more missing permanent teeth) self-completed the child perception questionnaire (CPQ) to assess oral symptoms (OS), functional limitation (FL), emotional well-being (EWB) and social well-being (SWB). Correlation between CPQ scores (overall and at domain level) and the number of missing teeth was assessed. All participants reported ohqol impact, 100% reported experiencing OS, 88% FL, 55% EWB and 100% SWB impacts. The correlation between the number of missing permanent teeth and the CPQ scores was moderate: overall CPQ score (r = 0.54), OS (r = 0.41), FL (0.52), EWB (0.52), SWB (0.49), P < 0.05. Having accounted for retained primary teeth (where a retained primary tooth was considered to have compensated for a missing permanent tooth), the correlation between the number of missing teeth and CPQ scores was strong: overall CPQ score (r = 0.94), OS (r = 0.78), FL (0.88), EWB (0.92), SWB (0.70), P < 0.001. Subjects with severe hypodontia report considerable ohqol impact. The number of missing permanent teeth was moderately correlated with ohqol. However, when retained primary teeth were taken into account, the number of missing teeth was highly correlated with ohqol. This study has implications in understanding the impact of hypodontia on quality of life and highlights the importance of retaining primary teeth in children and adolescents with severe hypodontia.     

The use of the Oral Health Impact Profile to measure the impact of mild,moderate and severe hypodontia on oral health‐related quality of life in young adults

There is limited understanding of the subjective impact of congenital absence of teeth in patients with hypodontia. This study aimed to investigate the impact of mild, moderate and severe hypodontia on oral health‐related quality of life (OHRQoL) and its relationship to age, gender and extent of hypodontia prior to treatment. 82 patients (43 females and 39 males, age range from 16 to 34 years) with a confirmed diagnosis of non‐syndromic hypodontia were recruited for this study prior to treatment. Demographic details were recorded and a clinical examination documented the number and location of missing teeth. Participants were also asked to complete an oral health‐related quality of life measure, the OHIP‐49. The impact was of hypodontia was significant, with appearance concerns being the most prevalent impacts on oral health‐related quality of life. Gender was a significant predictor of the overall OHIP‐49 score, with females having higher level of impacts. The number and location of missing permanent teeth was not a good predictor of quality of life. However, location of missing teeth was a predictor of the psychological discomfort subscale score. There was a positive correlation between age and the functional limitation and physical disability subscale scores. This study shows that the impact of hypodontia on oral health‐related quality of life is substantial.     

Impact of resin bonded bridgework on quality of life of patients with hypodontia

ObjectivesTo determine the impact of hypodontia on the quality of life of adolescent and young adult patients, and, to assess the impact of restoring tooth spaces with resin bonded bridgework on quality of life of patients with hypodontia.MethodsIn a prospective study, 82 patients with a confirmed diagnosis of hypodontia participated. The primary outcome was oral health related quality of life (OHRQoL) and this was measured using the OHIP-49 prior to treatment. The pre-treatment sample was then divided into two groups: the test group (n = 40 patients) who had completed orthodontic treatment and had tooth spaces restored with resin bonded bridgework, and, a control group (n = 42 patients) who were still in the process of orthodontic treatment. All patients completed a follow-up OHIP-49, and between and within group comparisons made.ResultsThe pre-treatment sample included 43 females and 39 males, age ranged from 16 to 34 years (median age 19). Forty-three patients had more than 4 congenitally missing teeth and thirty-nine had ≤4 congenitally missing teeth. There were no differences between the groups prior to treatment. For the test group, there was a significant improvement in median OHIP summary scores (p < 0.001) after treatment. OHIP scores deteriorated to a significant degree for control subjects (p = 0.002). The effect sizes for the pre–post treatment change in both groups were moderate to large.ConclusionsHypodontia has a significant impact on oral health related quality of life. Provision of resin bonded bridges has a positive impact on oral health related quality of life of patients with hypodontia.     

Case report of a rare syndrome associating amelogenesis imperfecta and nephrocalcinosis in a consanguineous family

A rare syndrome associating amelogenesis imperfecta (AI) with nephrocalcinosis has been reported. The purpose of this study is to characterise the phenotype of a consanguineous family presenting amelogenesis imperfecta, delayed permanent teeth eruption and nephrocalcinosis. Six family members were examined. Ground sections of the case index deciduous teeth and biopsies of enlarged dental follicles were analysed. The patients's parents were first cousins. The case index had yellow discoloration and altered teeth shapes, retention of deciduous teeth, and delayed eruption. Panoramic radiographs revealed multiple enlarged pericoronal follicles in unerupted teeth and generalised intrapulpal calcifications. Renal ultrasound showed the presence of nephrocalcinosis. No other family members presented enamel defects or nephrocalcinosis. Histologically, the enamel appeared hypoplastic, and dental follicles indicated pericoronal hamartoma. The consanguineous marriage suggests an autosomal recessive mode of inheritance. Further studies are necessary to clarify the genetic defect behind this syndrome that associates AI, nephrocalcinosis and impaired tooth eruption.     

Evaluation of oral and systemic manifestations in an amelogenesis imperfecta population

Objectives: The aim of this investigation was to describe the dental and craniofacial characteristics of patients with amelogenesis imperfecta (AI). Methods: The study group included 43 patients(33 female and 10 male) with a mean age of 11.4±2.6 years. A panoramic and a cephalometric radiograph were obtained from each of these patients. Clinically AI cases were divided into four main groups according to Witkop. All patients were evaluated for chronological, bone and dental age. The patients who had severe retarded bone age were evaluated for plasma growth hormone(GH) concentrations. Results: Dental and bone ages were retarded with respect to chronological age in five patients. Dental maturity and tooth eruption were not age- appropriate in some of our patients. In type III AI patients a delay in skelatal age was observed. Severe late eruption was seen in 3 patients, severe delay in dental maturity was noted in patients with type IV AI. Dental age was clinically lower in GH-deficient subjects, and skeletal age was consistently more retarded than dental age when compared to chronological age. Anterior open bite was present in both primary and permanent dentitions of 50% of the patients with type I AI, 30.8% of the patients with type II AI, and 60% of type III AI. Conclusion: It is concluded that the primary structure for the classification of AI be based on the mode of inheritance, with the clinical and radiographic appearances (and any other features such as systemic findings) being the secondary discriminators.     

Hypocalcified type of amelogenesis imperfecta in a large family: clinical,radiographic, and histological findings,associated dento-facial anomalies,and resulting treatment load

Objective. The purpose of this study was to report on the clinical, radiographic, and histological dental findings and the resulting treatment load in a five-generation family with amelogenesis imperfecta (AI). Material and methods. Thirteen affected and 15 unaffected individuals were examined clinically and radiographically. In addition, four exfoliated deciduous teeth were examined by scanning electron microscopy and microradiography. Results. The mode of inheritance of AI was autosomal-dominant. At eruption, most of the tooth enamel was yellow, lacking translucency, and prone to gradual loss in subjects with AI. Post-eruptive breakdown of enamel was extensive in accordance with the histological observations of hypomineralized and porous enamel. Extensive enamel loss and discoloration were observed in older affected individuals. The treatment need had been extensive: 76.2% of the total number of teeth present in affected individuals had been treated with partial or full coverage compared to 1.7% of the teeth in unaffected relatives. Unaffected individuals had more endodontically treated teeth than AI-affected relatives. Adjunctive findings, e.g. tooth agenesis, tooth impaction, pulp stones, enlarged follicular space, and taurodontism, were rare in both groups. Conclusions. Affected family members had the hypocalcified type of AI, which is characterized by severe hypomineralization, extensive post-eruptive loss, and discoloration of the enamel. Adjunctive findings were rare. Individuals with the hypocalcified type of AI have an extensive restorative treatment load compared to unaffected relatives.     

An evaluation of self-esteem and quality of life in orthodontic patients: Effects of crowding and protrusion

Objective:To evaluate the effect of dental crowding and lip protrusion on self-esteem and quality of life (QOL) in female orthodontic patients with Class I malocclusion.Materials and Methods:The study sample consisted of 201 patients (mean age 22.6 ± 3.0 years) who sought orthodontic treatment. All the patients were evaluated before treatment in terms of their degree of dental crowding and lip protrusion. Rosenberg''s Self-Esteem Scale and the Orthognathic Quality of Life Questionnaire (OQLQ) were used to determine self-esteem and QOL and to evaluate whether these values were related to malocclusion severity.Results:The results indicated that severe crowding and severe protrusion can result in lower self-esteem and poorer QOL (P < .05) than mild crowding and protrusion in Class I malocclusion. In the oral function component of the OQLQ, the severity of protrusion did not have significant effect.Conclusions:In Class I malocclusion, patients with mild crowding or protrusion had significantly better self-esteem and QOL scores than severe crowding or protrusion patients.     

Dentofacial deformity and orthognatic surgery: Influence on self-esteem and aspects of quality of life

This study aimed to assess the extent to which psychosocial and functional aspects are affected in orthognathic surgery patients. The Oral Health Impact Profile (OHIP-CRO14), Orthognathic Quality of Life Questionnaire and Self-Esteem (SE) Scale were used. The sample included 110 Caucasian subjects (73% females) aged 19–54 years. Fifty-five patients with dentofacial deformities were treated by combined orthodontic-orthognathic surgical treatment, and 55 others, matched by sex and age, were untreated controls without dentofacial deformities. In comparison with the untreated subjects, patients before surgery had a poorer quality of life, with the largest effect size in oral function (OF) and OHIP (average differences 8.0 and 14.7, respectively; p < 0.001; r = 0.65 and 0.63), while the lowest effect sizes were in awareness of facial aesthetics (AW) and SE. The treatment induced statistically significant changes in all psychosocial and functional aspects, mainly with a large effect size (p < 0.001; r = 0.48–0.78). The major effect size was a decrease in facial aesthetic concerns (FE; 7.6 ± 6.2; p < 0.001; r = 0.78), followed by a decrease in impairment of OF and OHIP (8.0 ± 7.1 and 16.6 ± 14.6; p < 0.001; r = 0.75). The lowest effect size was in the decrease in AW and increase in SE. After surgery, all aspects were similar to those in the untreated subjects. In conclusion, facial deformity raises many issues, primarily related to aesthetic concerns and functional impairment; however, orthognathic surgery manages to improve quality of life to be similar to that of the population without deformities.     

成人固定正畸治疗前后的口腔健康相关生活质量

目的 探讨错(牙合)畸形及正畸治疗对患者口腔健康相关生活质量(OH-QoL)的影响趋势和程度,分析可能影响患者生活质量的因素.方法 用口腔健康研究量表(OHIP-14中文版)测量不同类型错(牙合)畸形人群治疗前后的口腔健康生活质量.运用统计分析方法比较162例成人患者正畸治疗开始后1个月(T1)、3个月(T2)、6个月(T3)、12个月(T4)、治疗结束拆除矫正器(T5)、治疗结束后6个月(T6)的口腔健康生活质量变化,分析患者OH-QoL的变化趋势和可能的影响因素.结果 量表各领域中Angle Ⅰ类错殆组及Angle Ⅱ类错(牙合)组在心理不适(领域3)得分最高,而Angle Ⅲ类错(牙合)组在功能限制(领域1)得分最高,患者正畸治疗开始后1个月(T1)OHIP-14平均总得分最高(P＜0.05);同时T0与T1 、T1与T2、T2与T3、T4与T5、T5与T6比较差异均有统计学意义(P＜0.05).正畸治疗后(T6)得分低于治疗前(T0)(P＜0.05),即患者治疗后总体OH-QoL比治疗前提高.各条目中,正畸治疗前(T0)“其他人面前觉得不自在”最常给错(牙合)畸形患者带来负面影响,T1“出现过明显疼痛”、“吃什么东西都不舒服”、“在其他人面前觉得不自在”、“感到紧张不安”、“对自己的饮食不满意”给固定正畸患者带来负面影响最大,与正畸治疗前(T0)比较差异均有统计学意义(P＜0.05).结论 口腔健康状况对本研究患者OH-QoL的影响主要体现在心理不适领域,而对于AngleⅢ类错(牙合)畸形患者的负面影响主要体现在功能障碍方面;错(牙合)畸形的固定正畸矫治过程会对患者产生一定的消极影响,治疗后能改善患者口腔健康,提高患者的口腔健康相关生活质量.     

Impact of orthognathic surgery on quality of life of patients with dentofacial deformity: a systematic review and meta-analysis

The aim of this study was to evaluate the impact of orthognathic surgery on the quality of life (QoL) of patients with dentofacial deformity. This systematic review was performed through the survey of observational studies that had evaluated the impact of orthognathic surgery on the QoL of patients with dentofacial deformity. The article databases included PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias was analysed according to the Newcastle-Ottawa Scale for quality assessment. The meta-analysis was performed considering the exposure before and after orthognathic surgery using the Oral Health Impact Profile (OHIP-14) versus the Orthognathic Quality of Life Questionnaire (OQLQ). A total of 2,263 articles were identified. Twelve studies remained in the qualitative synthesis and seven studies were included in the meta-analysis. The impact of QoL both preoperatively and postoperatively with the OHIP-14 questionnaire was 7.63 (95% confidence interval (CI) = 1.62 to 13.65; p = 0.01) and the OQLQ questionnaire was 20.53 (95% CI = 14.27 to 26.79; p < 0.0001). Overall impact of QoL was 16.01 (95% CI = 10.50 to 21.52; p < 0.0001), which showed that orthognathic surgery has an influence on the QoL. Orthognathic surgery generates positive impact on the QoL of patients with dentofacial deformity.     

正畸治疗对患者生活质量的影响

目的：研究正畸治疗对患者日常行为的影响,评价患者在治疗过程中生活质量的变化。方法：随机抽取正畸治疗复诊患者400名进行间卷调查,年龄12～38岁,其中男133名,女267名,采用“口腔健康状况对日常行为影响量表”对患者进行测评。结果：①在各项日常行为中,正畸治疗对患者的进食、口腔卫生及社会交往影响较大,疗程越长对患者工作学习的影响越大,并有统计学意义（P〈0．05）。②对正畸治疗影响的主观感受程度,不同疗程及不同年龄组患者之间有显著性差异（P〈0．05）。结论：正畸治疗影响患者的生活质量,并在矫治初期、长疗程及成年患者中表现更为明显。     

Changes in quality of life after orthognathic surgery in Saudi patients

Aim

This study was conducted to measure the impact of orthognathic surgery on quality of life in Saudi patients.

Materials and methods

Patients with a discrepancy of 5 mm or more who underwent orthognathic surgery either single jaw or bimaxillary at the Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, between September 2007 and June 2013 were included in the study. They were asked to complete the Arabic version of the 22-item Orthognathic Quality of Life Questionnaire (OQLQ) preoperatively and postoperatively. Responses at these two timepoints were compared using paired t-tests, with the significance level set to P < 0.05.

Results

Seventeen patients participated in the study. Total OQLQ scores and those in the instrument’s four domains (oral function, facial aesthetics, awareness of dentofacial aesthetics, and social aspects) indicated that quality of life was significantly improved by orthognathic surgery (all P < 0.001).The social aspect domain was shown to be more important for patients than were facial aesthetics and oral function.

Conclusion

The present study revealed highly significant improvement in Saudi patients’ quality of life following orthognathic surgery. This improvement was evident in all four OQLQ domains.     

Impact of wearing fixed orthodontic appliances on quality of life among adolescents: Case-control study

Objective:To investigate the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among adolescents.Materials and Methods:A case-control study (1∶2) was carried out with a population-based randomized sample of 327 adolescents aged 11 to 14 years enrolled at public and private schools in the City of Brumadinho, southeast of Brazil. The case group (n  =  109) was made up of adolescents with a high negative impact on OHRQoL, and the control group (n  =  218) was made up of adolescents with a low negative impact. The outcome variable was the impact on OHRQoL measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ_11–14) – Impact Short Form (ISF:16). The main independent variable was wearing fixed orthodontic appliances. Malocclusion and the type of school were identified as possible confounding variables. Bivariate and multiple conditional logistic regressions were employed in the statistical analysis.Results:A multiple conditional logistic regression model demonstrated that adolescents wearing fixed orthodontic appliances had a 4.88-fold greater chance of presenting high negative impact on OHRQoL (95% CI: 2.93–8.13; P < .001) than those who did not wear fixed orthodontic appliances. A bivariate conditional logistic regression demonstrated that malocclusion was significantly associated with OHRQoL (P  =  .017), whereas no statistically significant association was found between the type of school and OHRQoL (P  =  .108).Conclusions:Adolescents who wore fixed orthodontic appliances had a greater chance of reporting a negative impact on OHRQoL than those who did not wear such appliances.     

Comparison of two survey instruments measuring quality of life in pediatric dentofacial patients

Objectives(1) To assess the effectiveness of the Orthognathic Quality of Life Questionnaire (OQLQ) and the Child Oral Health Impact Profile (COHIP) to detect differences in Oral Health-Related Quality of Life (OHRQoL) between pediatric patients with dentofacial deformities and controls. (2) To assess for correlations between scores from the OQLQ and COHIP domains with the type and severity of the skeletal mal-relationship. (3) To assess if the COHIP and OQLQ were identifying unique or overlapping OHRQoL concerns.Materials and MethodsSubjects were under age 18, presented with a dentofacial deformity, and completed both surveys. Matched controls completed the same. Severity for conditions was recorded via overjet, overbite, and ANB values and subjects were classified as skeletal Class I, II, or III.ResultsEnrollment yielded 30 subjects and 31 controls. For the OQLQ, significant differences between subjects and controls were found for the Facial Esthetics domain, Oral Function domain, and total score. For the COHIP, significant differences were found for the Social/Emotional Well-Being and Self-Image domains plus total score. There were no significant correlations between the severity of the condition as measured by overjet and reported OHRQoL for any domains.ConclusionsThe OQLQ and COHIP are effective at detecting significant OHRQoL differences between pediatric patients with dentofacial deformities and controls. Although there is some overlap in the results, the instruments appear to identify different OHRQoL concerns.     

Dental management and consideration of patients with severe deforming,type III osteogenesis imperfecta in clinic: A case report

Osteogenesis imperfecta (OI) is an autosomal dominant disorder not only influencing the musculoskeletal system but also dentition. This case is a 6 year 2 month old female suffering from severe deforming, type III OI, which is deathful due to frequent bone fractures and hyperthermia. We could observe very short stature, severe scoliosis, hunchback, and bowing of legs from appearance. She visited our clinic due to pain from multiple dental caries and complicated medical status. In the oral cavity, dentinogenesis imperfecta and constriction of maxilla were also presented. With multiple visits, pain was relieved and occlusion was re-established successfully.     

固定矫治对错(牙合)患者口腔健康相关生活质量的影响

目的 探讨固定矫治对错胎患者口腔健康相关生活质量的影响,以期为临床提供参考.方法 使用口腔健康影响程度量表,选择2006年9月-2007年9月于中山大学光华口腔医学院正畸科行固定矫治的错(牙合)畸形患者进行生活质量调查,调查时间为矫治前和矫治1、4、12、24周,根据人口统计学资料(性别、年龄、学历)及正畸临床资料(安氏错(牙合)分类、骨面型分类、牙列拥挤程度、拔牙与否)分组,分析患者生活质量随矫治而发生的变化.结果 共发放问卷1250份,回收问卷1110份,问卷回收率为88.8%;其中有效问卷1110份,即完整回收222例患者5个时间点的问卷.矫治开始后4周内固定矫治对患者的负面影响明显,集中于生理疼痛[55/222(27.8%)]、心理不适[40/222(18.0%)].矫治前和矫治1、4、12、24周量表总分分别为3、10、7、5、4分,矫治前与矫治24周时、矫治4周与12周时量表总分的差异无统计学意义(P>0.05),其他任何两个时间点量表总分的差异均有统计学意义(P<0.001).不同性别和临床情况组间量表总分差异无统计学意义(P>0.05),不同年龄(成年组各时间点分别为9、13、8、4、3分,青少年组各时间点分别为6、9、5、3、4分)和学历组(高学历组各时间点分别为9、12、8、3、3分,低学历组各时间点分别为6、9、5、3、4分)量表总分差异均有统计学意义(P<0.001).结论 固定矫治可影响患者口腔健康相关生活质量.矫治1周时患者生活质量最差,而后逐步回升,至矫治24周时患者生活质量基本与矫治前无差别.     

146例口腔癌患者术后生存质量评价

目的探讨口腔癌患者术后生存质量的变化及其影响因素。方法通过对术后6个月的146例患者华盛顿大学生存质量问卷调查而分析生存质量的变化及影响因素。结果术后患者总体生活质量下降，术后T3、T4组、N0、N1组、颌骨连续性破坏组及根治性颈淋巴结清扫术组分别低于T1、T2组、N3、N4组、颌骨连续组及功能性淋巴结清扫术组。结论术后6个月时口腔癌患者生存质量下降，肿瘤大小、颈淋巴结转移、手术后颌骨的连续性、颈淋巴结清扫术式影响术后生存质量。