儿童正畸治疗对父母生活质量的影响

目的：观察儿童正畸患者治疗前后其父母生活质量的变化;分析Family Impact Scale（FIS）问卷对正畸治疗的应答性。方法：从正畸临床病人中随机挑选122例儿童患者,其父母分别在正畸前后填写汉语化的FIS问卷,治疗前后的模型采用ICON指数（Index of Complexity,Outcome and Need）进行评价。结果：治疗结束后家长的FIS值比治疗前显著降低,治疗前后FIS差值与家长的自我评价一致,但与ICON治疗前后差值没有显著关系。结论：正畸治疗后患者家长的生活质量显著提高,FIS问卷能够用于对患者家长生活质量的评估。     

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目的 评估正颌手术治疗骨性安氏Ⅲ类错牙合时软硬组织变化及其与治疗前后生活质量变化的相关性。方法 选择2009—2011年在锦州市口腔医院正畸科接受正畸-正颌联合治疗的骨性安氏Ⅲ类错牙合患者28 例,进行术前术后头影测量,以及翻译后的口腔健康影响程度量表（oral health impact profile,OHIP）问卷调查,每份问卷包括14项,分别对功能、身体、心理及社会影响进行评估。结果 手术前后鼻唇角与颏唇角的变化与OH-5、OH-6显著相关,减小颏唇角、增大鼻唇角可减小心理不适这项分数。面型突度与OH-5呈负相关,减小面型突度将导致影响分数增加。结论 正颌手术计划的制定,应将手术前后软硬组织及口腔健康生活质量的变化作为重要考虑因素。提前了解术后面型突度变化,能够帮助患者更快适应并提高生活质量。     

成人正畸治疗后满意度评估及相关心理因素分析

目的 评估成人正畸治疗后满意度,分析相关影响因素。方法 分别用口腔状况对日常生活影响（dental impact on daily living,DIDL）问卷,和艾森克人格问卷(EPQ)来评估正畸后满意度和患者的心理特点。结果 27.0%的受试者完全满意,不满意的为11.5%。外倾性得分与总体满意度正相关。神经质得分与总体满意度、舒适度满意度、整体性能满意度呈负相关。结论 年龄、性别、矫正时间、拔牙与否对正畸治疗后满意度无影响。人格与满意度有相关性,互相之间相互影响。神经质得分高的正畸治疗患者常常对矫治结果满意度低。外倾性得分高者满意度高。     

治疗性义齿对无牙颌患者义齿空间的影响及临床效果评估

目的探究治疗性义齿对无牙颌患者义齿空间变化的影响,并对其临床疗效进行系统性评估。方法对20例接受治疗性义齿治疗的患者进行治疗前后满意度问卷调查,填写口腔健康影响程度量表(oral health impact profile,OHIP?14),收集义齿空间、义齿组织面、咬合印迹、哥特式弓描记图像、黏膜状态、偏侧咬合状态、咬合力、固位稳定、患者咀嚼能力、义齿满意度及OHIP?14评分等数据进行统计分析。结果本研究中受试者通过治疗性义齿的治疗,义齿空间得到改善,义齿的组织面的组织调理剂逐渐分布均匀,咬合印迹逐渐对称、均匀,哥特式弓描记图像显示关节、神经和肌肉逐渐稳定,口腔黏膜转变为健康状态,偏侧咬合情况有所改善,咬合力、固位稳定性和主、客观咀嚼能力也较治疗前有显著提高,在治疗前后的患者满意度及OHIP?14评分均有明显改善,差异有统计学意义(P<0.05)。客观咀嚼能力与义齿的固位稳定性、主观咀嚼能力和义齿满意度呈正相关;而与OHIP?14评分呈负相关。结论治疗性义齿有助于恢复理想的无牙颌义齿的空间,并且能改善患者的口腔健康状况,提高义齿的固位与稳定和咀嚼能力,从而提高患者的满意度,有临床应用的价值与推广的潜力。     

正畸治疗能否达到儿童患者期望值的调查

目的：调查儿童患者正畸治疗后与口腔健康相关的生活质量的变化,并观察这种变化能否满足病人的希望。方法：随机挑选正畸临床212例儿童患者,分别在正畸治疗前后填写汉语化的儿童感知问卷（Child Perception Questionnaire,CPQ1）,并在治疗前填写一份关于治疗结果期望的问卷。结果：男孩与女孩在治疗前的CPQ分数和期望得到的效果没有统计学差异,治疗结束后病人的CPQ分数比治疗前显著降低,与病人期望的CPQ分数没有显著差异。结论：正畸治疗后与口腔健康相关的生活质量可显著提高,能满足病人的需要。     

成人牙周炎患者正畸治疗前后TNF-α含量的变化

目的:探讨成人牙周炎患者正畸治疗前后龈沟液中肿瘤坏死因子-α(TNF-α)含量变化和临床意义。方法:对38例成人牙周炎患者正畸治疗前后龈沟液TNF-α的动态监测,探讨TNF-α在临床治疗中的意义。结果:TNF-α在成人牙周炎患者龈沟液中含量显著高于无牙周炎患者,正畸治疗后TNF-α浓度显著减少(P<0.05);成人牙周炎患者正畸治疗后下前牙牙槽骨降低,后牙牙槽骨无明显改变。结论:TNF-α参与成人牙周炎患者正畸治疗中牙槽骨的改建,TNF-α是重要的炎性因子。     

江苏地区成人和青少年唇腭裂患者口腔健康状况及生活质量的调查比较研究

目的调查成人和青少年唇腭裂患者口腔健康、功能及生活质量状况,比较两组年龄段人群在此的差异,为提高唇腭裂患者生活质量而制定相关政策时提供依据。方法选取20例成人唇腭裂患者(19~28岁,G1)和20例唇腭裂青少年患者(10~18岁,G2)纳入实验组;对照组为20例健康成年人(19~28岁,G3)和20例健康青少年(10~18岁,G4)。运用口腔健康相关生活质量调查表(Oral health-related quality of life,OHRQOL)对研究对象进行问卷调查。采用SPSS 19.0软件包对四组数据进行独立样本t检验,比较不同年龄段唇腭裂患者的口腔健康状况和生活质量。结果 1.成人唇腭裂组在口腔健康影响量表(Oral health impact profile 14,OHIP14)和美学评价方面得分显著高于成人对照组(P=0.002);在口耳鼻功能、咬合功能和治疗满意度方面得分与成人对照组差异无显著性;2.成人唇腭裂组在OHIP14(P=0.024)和美学评价(P=0.008)方面得分显著高于青少年唇腭裂患者;在口耳鼻功能、咬合功能和治疗满意度方面得分与青少年唇腭裂患者无显著性差异(P>0.05)。结论成人唇腭裂患者生活质量和口腔健康状况偏低。     

OHIP-14量表在评价全口义齿修复效果中的应用研究

目的：应用口腔健康影响程度量表中文版(Oral Health Impact Profile,OHIP-14)测量老年无牙颌患者初次全口义齿修复前后的口腔健康相关生活质量的变化,对比老年患者全口义齿修复后的主观感受,分析OHIP-14量表在评价全口义齿修复效果中的作用。方法：对1050名老年无牙颌患者进行全口义齿修复并与修复前由患者本人填写OHIP-14量表,修复后1个月复诊填写OHIP-14量表及满意度调查表。采用SPSS17.0软件包对量表数据进行相关统计分析。结果：(1)全口义齿修复1月后OHIP量表总得分及七个方面得分均明显降低,差异统计学意义(P<0.01)。(2)全口义齿修复前后OHIP-14得分差值与满意度得分呈负相关关系(Spearman秩相关,rs=0.351, P<0.05)。结论：OHIP-14量表可以客观评价全口义齿修复效果及患者对全口义齿的满意度,可以作为临床修复效果的评估提供参考。     

身体意象在青少年正畸治疗中的作用

目的 探讨青少年正畸患者的心理因素、身体意象和整体自尊在正畸治疗过程中的作用以及对正畸疗效和满意度的影响。方法 研究共纳入528名患者,历时18~24个月的正畸治疗前后采用正畸治疗需要指数的美学成分量表（IOTN-AC）、罗森伯格自尊量表（SES)、负面身体自我量表-整体分量表（NPS-G）等分析量表研究身体意象在青少年正畸治疗中的作用。结果 患者牙齿的美学评价在矫正后得到显著提高,患者IOTN-AC自我评价与医生评价的差异、牙齿美学的心理影响问卷-牙齿自信心、美学关注、心理影响及社会功能均得到明显改善;牙齿美学成分的改善（T2时IOTN-AC的医生评价）与患者的疗效评价存在显著正相关,与患者基线时的消极情绪呈显著负相关。结论 消极身体意象-牙齿不满意-认知成分和情感成分、整体的消极身体意象以及消极情绪能够显著预测治疗后患者对疗效的满意度;正畸治疗不仅能提高青少年患者自我美学评价,对青少年患者的心理健康也有积极影响。     

成人正畸治疗对生活质量的影响

目的：研究正畸治疗对成人患者日常生活质量的影响。方法：随机抽取正畸治疗复诊患者400名进行问卷调查,年龄18～45岁,其中男90名,女310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：正畸治疗对日常生活中进食、清洁、微笑的影响较大,疗程越长对患者工作学习的影响越大（P〈0.05）;正畸治疗对不同性别、不同年龄成人患者影响不同,女性患者认为对口腔卫生的护理更费时间,而男性则认为对社会交往的影响更明显（P〈0.05）;年轻患者（小于25岁）认为佩戴矫治器对日常生活中微笑的影响更显著（P〈0.05）。结论：正畸治疗影响成人患者的生活质量,在矫治初期、长疗程中表现更为明显;而不同性别,不同年龄的成人患者对正畸治疗影响日常生活各个方面的感受各不相同。     

The sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening

OBJECTIVES: To assess the sensitivity and responsiveness of an oral health related quality of life measure to tooth whitening. METHODS: Following screening at a clinic, 87 subjects were given an array of tooth whitening products to use at home and reviewed 8 weeks later. Subjects self-completed the 49-item Oral Health Impact Profile (OHIP) at baseline and follow-up, and rated their satisfaction with the whiteness of their teeth compared to baseline on a global transition scale. RESULTS: In terms of sensitivity, observed changes were apparent in overall OHIP scores (P<0.05) and across several domains, notably functional limitation (P<0.01). However, the magnitude of change (effect size) was generally small except for the functional domain. There was an observed gradient in observed change in OHIP scores and in the magnitude of such changes (effect sizes) in relation to global rating of satisfaction with the outcome, supporting the responsiveness of the measure. CONCLUSION: The OHIP scale is sensitive and responsive to the effects of tooth whitening. Greatest sensitivity and responsiveness was in relation to functional limitations. These findings have implications for the use of oral health related quality of life measures as an outcome measure of interventions aimed at improving dental aesthetics through tooth whitening.     

Associations between orthodontic treatment need and oral health‐related quality of life among young adults: does it depend on how you assess them?

Liu Z, McGrath C, Hägg U. Associations between orthodontic treatment need and oral health‐related quality of life among young adults: does it depend on how you assess them? Community Dent Oral Epidemiol 2011; 39: 137–144. © 2011 John Wiley & Sons A/S Abstract – Objective: To determine the association between orthodontic treatment need (OTN) and oral health‐related quality of life (OHRQoL). Methods: A cross‐sectional study involving 273 young adults seeking orthodontic care. OHRQoL was assessed by the short‐form Oral Health Impact Profile (OHIP‐14) and United Kingdom oral health‐related quality of life measure (OHQoL‐UK). Study casts were assessed for OTN by: Dental Aesthetic Index (DAI), Index of Orthodontic Treatment Need (IOTN)‐Aesthetic Component (IOTN‐AC) and Dental Health Component (IOTN‐DHC) and Index of Complexity, Outcome and Need (ICON). Variations in OHIP‐14 and OHQoL‐UK were determined with respect to OTN, and the magnitude of differences was calculated (effect size: ES). Results: There were significant but weak correlations between occlusal indices scores and OHIP‐14 scores (P < 0.05, r < 0.3) and between occlusal indices scores and OHQoL‐UK scores (P < 0.05, r < 0.4). The magnitude of the statistical difference in OHQoL‐UK scores was moderate to large with respect to OTN (ES: 0.36–0.87) and largest when DHC (ES = 0.87) and ICON (ES = 0.74) were used. The magnitude of the statistical difference in OHIP‐14 scores was relatively lower (ES: 0.21–0.69), but also greatest when DHC and ICON were used to determine OTN (ES 0.69 and 0.50, respectively). Conclusion: Orthodontic treatment need was associated with OHRQoL. The magnitude of the statistical difference between those with and without an orthodontic treatment need was larger when OHRQoL was assessed using OHQoL‐UK compared to OHIP‐14. DHC and ICON were more useful indices in identifying greater differences in OHRQoL with respect to orthodontic treatment need.     

深圳市成人牙科畏惧症患者的口腔健康相关生活质量研究

目的：研究牙科畏惧症（DF）患者的口腔健康相关生活质量。方法：选择在深圳市第五人民医院口腔科门诊就诊的358名18～75岁初诊患者,应用口腔焦虑量表（CDAS）和口腔健康影响程度量表（OHIP-14中文版）、人口统计学一般项目表进行调查。结果：DF患者的OHIP-14的分值中位数为21.25,明显高于一般就诊患者（中位数11.20）。且在生理性疼痛、心理不适和心理障碍等领域影响最大。CDAS与OHIP-14分值间的相关系数为0.255。结论：在牙科畏惧症患者中,牙科畏惧程度与口腔健康影响程度之间存在相关性,焦虑程度越高的患者口腔健康相关生活质量越差。对牙科畏惧症患者进行有效的心理干预可以提高其相关生活质量。     

Implant retained or conventional dentures, which give more patients satisfaction?

DESIGN: This was a randomised controlled trial (RCT) set in a dental hospital. INTERVENTION: The implant group (IG) had two implants placed in the interforaminal region of the lower jaw followed (after healing) by a denture fixed to the implants by a ball attachment mechanism. In the conventional dentures group (CG), dentures were constructed using conventional replacement denture techniques. Patients in the IG had conventional upper dentures made in the same fashion. OUTCOME MEASURE: The performance of the dentures was evaluated using an oral health impact profile (OHIP) and a denture satisfaction scale before treatment and 3 months post-treatment. RESULTS: Analysis was conducted on an intention-to-treat basis. Substantial improvements in oral-health-related quality of life and denture satisfaction were reported by both groups. There were, however, no significant differences post-treatment between the groups. Patients randomised to the IG who declined implants had significantly lower pretreatment OHIP scores and there were significantly greater pre-/ post-treatment change-scores for individuals who had implants compared with the change-scores of people who declined. CONCLUSIONS: There were no significant post-treatment differences between the groups, but a treatment effect may be masked by the intention-to-treat analysis. The pre-/ post-treatment OHIP change-scores were significantly greater for people receiving implants than for those who refused.     

Occlusal characteristics and quality of life before and after treatment of severe malocclusion

The aim of this study was to evaluate the relationship between occlusal characteristics and oral health-related quality of life in adults who underwent orthodontic or orthodontic-surgical treatment. The study group consisted of 51 adult patients (35 women, 16 men) with severe malocclusion and considerable functional disorders. Thirty-six of the patients underwent combined orthodontic-surgical treatment, while 15 underwent orthodontic treatment. Data were collected before and after treatment. Mean follow-up period was 5.0 years (range 2.2-6.7 years). Occlusal characteristics were measured from dental casts by using Peer Assessment Rating (PAR) index. A self-completed Oral Health Impact Profile (OHIP-14) was used to measure oral impacts. The changes in PAR and OHIP-14 were measured, and correlation between PAR and OHIP tested before and after treatment and in the changes during the follow-up. Statistical significance was evaluated with the paired samples t-test and Mann-Whitney U-test, and the correlation between PAR and OHIP scores assessed using Pearson's and Spearman's correlation coefficient. The occlusion was significantly improved in all subjects, mean PAR reduction being 78.1 per cent. The prevalences of oral impacts at threshold `fairly often' or `very often' before and after treatment were 70.6 per cent and 9.8 per cent, respectively (P < 0.001). The PAR and OHIP scores correlated after treatment but not before treatment or in the changes. The treatment of severe malocclusion reduced the reported oral impacts to the level of general population and significantly improved oral health-related quality of life.     

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.     

An assessment of sensitivity to change of the Oral Health Impact Profile in a clinical trial

Patient-based assessment of oral health outcomes is of growing interest. Measurement of change following clinical intervention is a key property of a health status measure. To date, most of the research on oral health status measurement has focused on construct and discriminant validity of health status measures. OBJECTIVES: The objective of this study was to assess sensitivity to change of an oral-specific health status measure, the Oral Health Impact Profile (OHIP). METHODS: Study subjects were in three groups, namely, edentulous/edentate subjects who requested and received complete implant stabilised oral prostheses (IG, n=26), edentulous/edentate subjects who requested implants but received conventional dentures (CDG1, n=22), and edentulous subjects who had new conventional complete dentures (CDG2, n=35). Data were collected pre- and post-operatively using the OHIP and a validated denture satisfaction questionnaire. RESULTS: All subjects reported similar low levels of denture satisfaction pre-operatively. Denture problems had a more significant impact on oral health-related quality of life (OHRQL) for implant seekers (IG and CDG1 subjects) than subjects seeking conventional dentures (CDG2). Following treatment, significant improvement in satisfaction with oral prostheses and OHRQL was reported by IG and CDG2 subjects; the level of improvement was more moderate for CDG1 subjects. OHIP change scores were correlated with denture satisfaction change scores. CONCLUSIONS: It was concluded that sensitivity to change of the OHIP was good. This property was not improved by using statement weights.