Influence of malocclusion on OHRQoL in adolescents in initial orthodontic treatment phase.

OBJECTIVES: Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances. METHODS: 85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN). RESULTS: The initial type of malocclusion affected the children's OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains "Oral symptoms" and "Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015). CONCLUSIONS: At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values. CLINICAL RELEVANCE: The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child's satisfaction and overall quality of life.

Comparison of oral health-related quality of life among endodontic patients with irreversible pulpitis and pulp necrosis using the oral health-related endodontic patient's quality of life scale.

This prospective cohort study aimed to clarify differences in the longitudinal effects on oral health-related quality of life (OHRQoL) among patients undergoing endodontic treatment for irreversible pulpitis and for pulp necrosis, using a newly developed oral health-related endodontic patient's quality of life (OHQE) scale. This study included 131 patients diagnosed with irreversible pulpitis and pulp necrosis. Comprehensive data regarding the patient's background, medical history, and dental history were collected. The OHQE was administered three times to each patient: before and after endodontic treatment, as well as 2 weeks after endodontic treatment as a follow-up. Statistical analysis was performed using a linear mixed model for repeated measurements of changes in the OHQE score over time in cases of irreversible pulpitis and pulp necrosis. The patients consisted of 48 (36.6%) males and 83 (63.4%) females with a mean age of 36.2 (standard deviation, 12.6) years. Of these, 62 (47.3%) had irreversible pulpitis, and 69 (52.7%) had pulp necrosis. Intragroup comparisons showed an improvement in the OHQE scores over time in both groups (p < 0.001). Group comparisons revealed no significant differences at any time point. No interactions or changes over time were observed between the two groups. No difference in the improvement of quality of life after endodontic treatment was seen in the two disease groups, and both groups improved over time. However, patients' expectations of receiving endodontic treatment remained unchanged after treatment. Therefore, dental providers should consider explaining the value of endodontic treatment to patients and address the measures that contribute to patient satisfaction.

Mandibular third molar coronectomy in older adults and its effects on oral health-related quality of life.

OBJECTIVE: The purpose of this study was to investigate the effect of coronectomy on postoperative quality of life in older adults. BACKGROUND: Coronectomy is an alternative to complete surgical removal of a mandibular third molar that lies close to the inferior alveolar nerve. MATERIALS AND METHODS: This prospective study included patients >60 years old who had an indication for coronectomy of a mandibular third molar. Patients were asked to complete the Dutch version of the Oral Health Impact Profile-14 (OHIP-14) daily during the first postoperative week. Postoperative pain, swelling, limited mouth opening, chewing ability and infection were also recorded. Furthermore, the effect of the impaction pattern, state of eruption, presence of preoperative pathology, patient health status according to the American Society of Anaesthesiologists score, gender, smoking on the postoperative OHIP-14 and pain scores were investigated. RESULTS: Thirty patients (16 males, 14 females) with a mean age of 71.2 (SD 8.3, range 60-91) years were included in the study. OHIP-14 and pain scores were highest on the first postoperative day and gradually declined during the first postoperative week. Patients who underwent coronectomy of a fully impacted mandibular third molar had significantly higher OHIP-14 scores on the first postoperative day than those who underwent coronectomy on a (partially) erupted mandibular third molar. We did not observe any postoperative complications up to 1 year after the surgery. CONCLUSION: Mandibular third molar coronectomy seems to present a valid treatment option in older adults.

Cross-cultural adaptation and validation of the Chinese version of the Malocclusion Impact Scale for Early Childhood (MIS-EC/C).

BACKGROUND: The Malocclusion Impact Scale for Early Childhood (MIS-EC) is a newly developed questionnaire used to measure the parental perceptions of the impact of malocclusion on oral health-related quality of life (OHRQoL) of preschool children aged 3-5 years. This study describes the cross-cultural adaptation and validation of the MIS-EC questionnaire into Chinese version (MIS-EC/C). METHODS: The MIS-EC/C was developed in accordance with international standards. The scale was then evaluated in a cross-sectional study comprising 210 preschool children aged 3-5 years. The reliability of the MIS-EC/C was tested using internal consistency and test-retest reliability analyses. Cross-cultural validity, discriminant validity and convergent validity were tested. RESULTS: The Cronbach's α value and intraclass correlation coefficient (ICC) value for the MIS-EC/C were 0.943 and 0.873, respectively. Confirmatory factor analysis indicated that the fitting indicators of the two-factor model all reached the standard. The MIS-EC/C can differentiate preschool children with malocclusion from those without malocclusion. In addition, there is a good relationship between the MIS-EC/C and the general oral health question. CONCLUSION: The MIS-EC/C is a reliable and effective assessment tool for assessing the effect of malocclusion on the OHRQoL of preschool children in China.

Oral health-related quality of life and oral hygiene status among special need school students in amhara region, Ethiopia.

BACKGROUND: Oral conditions remain a substantial population health challenge worldwide. Poor oral health affects the quality of life as a result of pain or discomfort, tooth loss, impaired oral functioning, disfigurement, missing school time, loss of work hours, and sometimes even death. This study assessed the magnitude of Oral Health-Related Quality of Life (OHRQoL) and oral hygiene status and associated factors among special needs school students in the Amhara region. METHODS: An institution-based cross-sectional study was conducted from November 2020 to April 2021 in the Amhara Region, Ethiopia. A total of 443 randomly selected special needs students were included. A structured pretested interview-administered questionnaire was used for data collection. Bivariable and multivariable ordinal logistic regression models were fitted to identify the factors associated with oral hygiene status. The statistical significance of differences in mean OHIP-14 scores was assessed using the Kruskal-Wallis equality-of-populations rank and Wilcoxon rank-sum tests. Variables with a p-value less than 0.05 were considered statistically significant. RESULTS: Almost half 46.6% (95% CI: 42.1%, 51.4%) of the study participant had poor oral hygiene status. The median OHIP-14 score was 16 with an interquartile range from 14 to 20. The highest score was for functional limitation (mean: 1.45 (SD ± 0.70)) and the lowest score was for psychological disability (mean: 1.08 (SD ± 0.45)). Mother education, frequency of taking sugared foods, and the types of disabilities were significant predictors of the poor oral hygiene status of special needs students in the Amhara region. The students living in Dessie had higher OHIP-14 scores compared to those living in other places (Gondar, Bahir Dar, and Debre Markos). The students who never brush their teeth had lower OHIP-14 scores than those who brush sometime and once a day. Whereas, students affiliated with the orthodox religion had lower OHIP-14 scores compared to those affiliated with all other religions (Catholic, Muslim, and Protestant). CONCLUSION: A substantial amount of students with a disability had poor oral hygiene. The OHIP-14 scores indicated poor oral health-related quality of life. The study found that maternal education, frequency of taking sugared foods, and the types of disabilities were statistically significant factors associated with oral hygiene status.

Dimensional structure of the OHIP-14 and associations with self-report oral health-related variables in home-dwelling Norwegians aged 70.

OBJECTIVES: The primary objective of the present study was to investigate the dimensional structure of the OHIP-14 in a sample of elderly Norwegians. A secondary objective was to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables to assess the dimensions' criterion validity. MATERIALS AND METHODS: A survey questionnaire including the OHIP-14 and additional self-report oral health-related measures was completed by 325 home-dwelling Norwegians aged 70+. Exploratory factor analysis was used to investigate the dimensional structure of the OHIP-14 in this sample. Bivariate correlations were used to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables. RESULTS: Three dimensions named psychosocial impacts, oral function impacts and general function impacts were revealed. Convergent and discriminant validity of these dimensions were largely supported, and internal consistency reliability for each dimension was good. Statistically significant associations were found between the exposed dimensions and additional self-report oral health-related variables, supporting the dimensions' criterion validity. CONCLUSIONS: A three-dimensional structure of the OHIP-14 was exposed and validated in the present study sample. Since different aspects of oral health-related quality of life (OHRQoL) may be perceived and weighted differently in various populations, suggestions for future research include more profound investigations of the construct validity of the OHIP-14 and similar instruments assessing OHRQoL. Such research should include an exploration of various dimensions and the weights given to them through qualitative research in the target population(s).

Effect of smile esthetics on the quality of life in a Han Chinese population.

OBJECTIVE: This study aimed to explore the influence of smile esthetics on the quality of life in a Han Chinese population. METHODS: A total of 110 Han Chinese volunteers (52 males and 58 females, mean age 26.7 years) were recruited, and frontal images of their smiles were collected. A photoediting program was used to evaluate the following components of smile esthetics: the buccal corridor ratios, the angle between the interpupillary and commissural lines, the number of visible teeth, and width-to-length ratios of the maxillary central incisors. Oral health-related quality of life (OHRQoL) in these volunteers was evaluated using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile-14 (OHIP-14). Statistical analyses were performed by using Pearson's correlations and multiple linear regression (α = 0.05). RESULTS: Compared to males, females scored higher on psychological impact (p = 0.017). Moreover, the number of visible teeth had a significant effect on social impact, psychological impact and esthetic concern (all p < 0.05). However, the buccal corridor ratios, the angle between the interpupillary and commissural lines, and the width-to-length ratios of the maxillary central incisor did not correlate with the OHRQoL (all p > 0.05). CONCLUSIONS: The number of visible teeth significantly influenced the quality of life in a Han Chinese population. Smile esthetics had a significantly greater psychological impact on females than males. CLINICAL SIGNIFICANCE: This study highlights the effects of smile esthetics on the quality of life in a Han Chinese population. Female patients may raise more esthetic concerns in clinical practice.

The relationship between children's oral health behaviours and oral health-related quality of life: a cross-sectional study.

BACKGROUND: Understanding oral health behaviour s and their impact on Oral Health-Related Quality of Life (OHRQoL) may serve as an instrument to articulate the conventional oral health policy framework, thereby ameliorating the overall health of young individuals in the long term. OBJECTIVE: The aim of this study was to investigate the relationship between children's oral health behaviour s and Oral Health-Related Quality of Life in the capital governorate, Kuwait. METHODS: A cross-sectional study involving 607 children aged 12-14 years, randomly selected from schools in Kuwait Capital Region. A validated Oral Health Behaviour s and OHRQoL Child Perception Questionnaires (CPQ12-14) was used to collect the data. Chi-square, t-tests, and ANOVA were used to examine the association between oral behaviour s and children's OHRQoL. RESULTS: About 52.2% of participants were males and the overall response rate was 93.8%. The mean ± SD for total OHRQoL impact was 3.1 ± 0.58, while the total mean for individual domains- for oral symptoms, functional limitations, emotional well-being and social well-being were 2.89 ± 0.63, 2.89 ± 0.72, 3.1 ± 0.91 and 3.4 ± 0.61, respectively. There was no significant difference in total OHRQoL impact score by frequency of last dental visit, flossing, use of mouth rinse or chewing gum (p > 0.05) but for the overall OHRQoL, frequency of soft drink intake was the only significant predictor associated with 0.2-unit decrease (B = -0.207, 95% CI, p = 0.002) in total OHRQoL scores. CONCLUSIONS: High frequency of soft drink consumption was related to poorer OHRQoL. Behaviour changing interventions based on OHRQoL inferences coupled with clinical intervention are needed.

Linking the demographic, socio-economic and oral health status to oral health-related quality of life of the sudanese older adults: a cross sectional study.

BACKGROUND: Oral Health-Related Quality of Life (OHRQoL) is an important measure of patients' needs and progress. Identifying the links between clinical and non-clinical factors with OHRQoL in a specific population will facilitate the development of effective preventive strategies. The aim of the study was to assess the OHRQoL of Sudanese older adults, and to identify the possible relations between clinical and non-clinical predictors with OHRQoL using Wilson and Cleary model. METHODS: This cross-sectional study was conducted among older adults attending the out-patient clinics in Khartoum State's Health Care Centers, Sudan. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Two modifications of Wilson and Cleary's conceptual model were tested using structural equations modeling including: oral health status, symptom status, perceived difficulty of chewing, oral health perceptions, and OHRQoL. RESULTS: 249 older adults participated in the study. Their mean age was 68.24 (± 6.7) years. The mean GOHAI score was 53.96 (± 6.31) and trouble biting/chewing was the most commonly reported negative impact. Wilson and Cleary models showed that pain, Perceived Difficulty Chewing (PDC), and Perceived Oral Health had a direct effect on OHRQoL. In model 1, age and gender had direct effects on oral health status, while education had direct effects on OHRQoL. In model 2, poor oral health status is associated indirectly with poor OHRQoL. CONCLUSIONS: The OHRQoL of the studied Sudanese older adults was relatively good. The study partially confirmed Wilson and Cleary model as Oral Health Status was related directly to PDC and indirectly to OHRQoL through functional status.

Oral health knowledge is associated with oral health-related quality of life: a survey of first-year undergraduate students enrolled in an American university.

BACKGROUND: Oral health knowledge forms part of oral health literacy that enables individuals to inform appropriate oral health decisions and actions. Oral health-related quality of life (OHRQoL) characterizes self-perception of well-being influenced by oral health. This study aimed to examine the relationship between oral health knowledge and OHRQoL. METHODS: A random sample of 19-to-24-year-old first-year undergraduate students (n = 372) in Minnesota, United States of America was used. Each student was assessed with an online survey using the Comprehensive Measure of Oral Health Knowledge (CMOHK) and the OHRQoL items of the World Health Organization (WHO) Oral Health Questionnaire for Adults. Relationships between OHRQoL parameters and CMOHK together with other covariates were assessed using ordinal regression models. Associations between OHRQoL parameters were examined with the Kendall's tau-b method. RESULTS: Dry mouth (45%) was the most reported OHRQoL issue. The respondents showing good oral health knowledge were less likely to experience speech or pronunciation difficulty (ß=-1.12, p = 0.0006), interrupted sleep (ß=-1.43, p = 0.0040), taking days off (ß=-1.71, p = 0.0054), difficulty doing usual activities (ß=-2.37, p = 0.0002), or reduced participation in social activities due to dental or oral issues (ß=-1.65, p = 0.0078). CONCLUSIONS: This study suggested a protective effect of better oral health knowledge on specific OHRQoL issues. In addition to provision of affordable dental services, university-wide oral health education can be implemented to improve OHRQoL in undergraduate students.

Can malocclusion among children impact their oral health-related quality of life? parents' perspective.

Background and Aim: Malocclusion can negatively impact the quality of life of children. Therefore, this study assesses the impact of proxy-reported malocclusion and oral health-related quality of life among children in Riyadh, Saudi Arabia, from the parents or guardians' perspectives. Materials and Methods: A self-administered electronic questionnaire was used to assess the correlation between proxy-reported malocclusion conditions during the early mixed dentition stage (children age 6-12 years) and oral health-related quality of life using the OHIP-14 measure. All collected data were analyzed using SPSS. Results: Among the 353 participants in the study, anterior open-bite was the most common proxy-reported malocclusion with a prevalence of 19%, followed by unilateral posterior cross bite (13.3%). Furthermore, 31% reported that their children sometimes experienced negative impacts on quality of life from malocclusions. The results also show that OHIP-14 scores were significantly associated with all proxy-reported malocclusion (p < 0.05). The highest OHIP-14 score was found to be significantly associated with the presence of deep-bite from parents' or guardians' perspective. Conclusion: The presence of some proxy-assessed malocclusion was associated with negative impacts on children's oral health-related quality of life. This is very important to consider when assessing the need for orthodontic intervention, especially at this stage as this age is critical in building a child's confidence and self-esteem.

A NARRATIVE REVIEW ON THE OVERLOOKED ASPECTS OF dPROs IN CONNECTION WITH DENTAL MATERIALS.

OBJECTIVE: Dentists use a large number of dental materials to treat patients, mainly for pain relief, improved oral function, and orofacial appearance purposes. These materials supposably have been clinically tested and registered before launching onto the market. In terms of clinical testing, despite various objective and subjective assessments that could be done, the dentist-centred outcomes and regulatory body requirements might not fully reflect the perspective of the patient. Thus, dental-patient reported outcomes (dPROs) might be useful in providing valuable self-perceived feedback to stakeholders across a long period of time about the materials... performances. METHODS AND RESULTS: This narrative review evaluated various assessment dPROs tools and their applications to contemporary dental materials, trying to link up basic materials science and biomechanics with the patients... reported outcomes. CONCLUSIONS: dPROs can eventually form a basis of value-based dentistry for dental materials that would be of importance in terms of research, regulatory and safety.

OPERATIONALIZING ORAL HEALTH OUTCOME MEASURES TO IMPROVE THE ORAL HEALTH OF PERSONS WITH INTELLECTUAL DISABILITIES.

Individuals with intellectual disability (ID) face significant challenges in preventing oral diseases. They also lack access to high-quality oral health care in professional settings. To understand the effects of oral conditions on their lives and health, it is necessary to assess their oral health outcome measures. For those with mild ID, who possess adequate linguistic and cognitive abilities, accessibility features should be incorporated in the dental patient reported outcome (dPRO) measures. But many other individuals often lack the linguistic and cognitive ability to self-report through dPRO measures. While self-reported measures are preferable, requiring dPROs in this population would result in a high amount of missing data and the inability to assess interventions for improving their dental health. Thus, there is a need to use proxy-reported outcome (ProxRO) measures, observer reported outcome (ObsRO) measures, and clinician reported outcome (ClinRO) measures among those with ID. This is also a common approach taken by other specialties that work closely with those with ID, where the measures for activities of daily living and adaptive behavior measures use reporting by caregivers. ProxRO measures in dentistry that were created for infants and young children provide a structure for appropriate adaptations and the creation of relevant outcome measures. Including input from the intensely multidisciplinary teams that provide supports for those with ID is key to creating high-quality measures and oral health interventions for those with ID.

Cross-cultural adaptations of the oral health impact profile - An assessment of global availability of 4-dimensional oral health impact characterization.

OBJECTIVE: The 4-dimensional (4D) structure of oral health-related quality of life (OHRQoL), comprising of the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, is clinically plausible and psychometrically solid. The original Oral Health Impact Profile (OHIP) instrument and its short-form versions have been proven to lend themselves well to the assessment of these 4 OHRQoL dimensions. However, whether this 4-dimensional approach to oral health impact characterization can be performed on a global scale, that is, for most of the world's population, is not known. The purpose of this study was perform a systematic review to identify all cross-cultural adaptations of OHIP versions with 49, 20/19, 14, and 5 items. The global availability of 4D oral health impact characterization was investigated. METHODS: We performed searches of electronic databases- Scopus, Pubmed, Web of Science, along with hand searching in June 2022 to identify all cross-cultural language adaptations of the different OHIP versions available in the literature. Whether the 4D oral health impact assessment can be considered a global approach was judged based on the criteria whether 4D psychometric information was available for at least 75% of the most widely spoken languages with an OHIP version. RESULTS: We identified 82 studies with a total of 90 individual OHIP language versions for 45 languages. Among the top 20 languages with most first-language (native) speakers, 16 (80%) had OHIP versions. Among the top 20 languages with the most first- and second-language speakers, also 16 (80%) had OHIP versions. Of these 16 OHIP versions, across both language categories, 13 versions (81%) allowed for 4D oral health impact characterization. CONCLUSION: Four-dimensional oral health impact assessment using the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can be considered a globally available approach given that OHIP versions with 4D information are readily available for most widely spoken languages. Thus, psychometrically sound, practical, and internationally comparable oral health impact characterization can be easily performed to study population oral health and determine oral disease impact and treatment efficacy for dental patients.

Validation and minimally important difference of the Child-OIDP in a socioeconomically diverse sample of Indian adolescents.

INTRODUCTION: While different measures have been validated and used to assess the oral health related quality of life (OHRQoL) of children and adolescents, no previous study has tested the psychometric performance of OHRQoL amongst the most marginalized adolescents, living in extremely deprived neighbourhoods like urban slums and resettlement areas in modern cities. Our study assessed the internal consistency reliability, construct validity and Minimally Important Difference (MID) of the Child-OIDP in a sample of adolescents aged 12-15 years reporting oral health problems that lived in three different types (including two extremely vulnerable) of neighbourhoods (urban slums, resettlement colonies, and middle and upper middle-class neighbourhoods) in the National Capital Territory of Delhi. METHODS: We conducted data analysis on a cross-sectional study, comprising of 840 adolescents. The Child-OIDP was used as a measure of OHRQoL. Internal consistency reliability was tested using the standardized Cronbach's Alpha Coefficient. The Child-OIDP was also tested for content and construct validity (the latter through the median test), while a distribution-based approach was used to identify the MID. RESULTS: The Indian Child-OIDP showed good internal consistency, as the Cronbach's alpha coefficient was 0.77. Inter-item correlation coefficients among the items ranged from 0.13 to 0.50, with the mean inter-item correlation being 0.30. The corrected item-total correlations ranged from 0.30 (social contact) to 0.54 (speaking). For construct validity, the Child-OIDP extent was significantly associated with three subjective oral and general health variables in the expected direction. The calculated effect sizes for these differences indicated that they were moderate (0.50-0.79). We also calculated the standard error of measurement (SEM) of Child-OIDP extent as 0.75. CONCLUSION: This study demonstrated that the Indian Child-OIDP is a reliable and valid measure for the assessment of the oral health related quality of life among Indian adolescents especially from marginalised and socioeconomically vulnerable groups. This is an essential step towards assessing oral health and evaluating oral health promotion interventions in those populations and settings.

Oral health-related quality of life following peri-implantitis surgery: A prospective study.

AIM: The aim of this prospective study was to describe long-term patient-reported outcomes following surgical treatment of peri-implantitis. METHODS: Oral health-related quality of life (OHRQoL) of 43 patients diagnosed with peri-implantitis was recorded using the short form of the Oral Health Impact Profile (OHIP-14), where low scores indicate low impact. A Norwegian version of the OHIP-14 form was filled out 1 week before and 6-, 18- and 36 months after the peri-implant surgery. The mean and median OHIP-14 scores were calculated for its seven domains (i.e., Functional limitation, Physical pain, Psychological discomfort, Physical disability, Psychological disability, Social disability, and Handicap) across four different time points. The dataset was analyzed to find correlations between independent variables and the OHIP-scores. RESULTS: The OHIP-14 scores were at a low level from baseline to 36 months post-surgery. The mean scores at specific time points were at baseline 7.2 (SD 7.3), 6 months post-surgery 6.0 (SD 6.9), 18 months post-surgery 6.8 (SD 9.7), and 3 years post-surgery 7.0 (SD 9.4). None of these changes were statistically significant. Specific domains of OHRQoL did not significantly differ across different time points (pre- and post-surgery) in males (except for domain "Handicap") or females (except for domain "Functional limitation"). CONCLUSIONS: The reported OHIP-14 measures were initially low and stayed low up to 3 years after peri-implant surgery. This may indicate that neither the disease nor the treatment deteriorated or improved the OHRQoL.

Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial.

OBJECTIVE: To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs). METHODS: Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05). RESULTS: There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups. Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery. CONCLUSIONS: Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.

Psycho-social perspectives of nonsurgical versus surgical endodontic interventions in persistent endodontic disease.

INTRODUCTION: Patients' experiences related to dental treatment could influence care-seeking behaviour and engender personal bias. Although endodontic retreatment and apical surgery are procedures often performed to manage previously treated teeth with persistent disease, there is lack of information regarding psycho-social perspectives of patients who undergo these treatments. Our aim was to compare experiences of patients who received these two treatment modalities using a qualitative approach. METHODS: A purposive sample of patients was taken from our previous study utilizing the Oral Health Impact Profile to compare oral health-related quality of life of 150 patients who received retreatment and apical surgery. Patients who reported impact and no impact were invited to participate in focus group discussions (FGDs). Eighteen patients from the retreatment group and 15 patients from the surgical group participated in six FGDs. Thematic analysis was conducted to identify key themes. RESULTS: Four themes emerged: (1) psycho-social disability associated with dental procedures, (2) physical disability associated with dental problems, (3) reliance on dentist's advice for treatment and (4) self-management to preserve treated teeth. Patients undergoing endodontic retreatment reported significant time loss from work and were less informed of alternative treatment options. However, they were pleased with the aesthetics of their teeth, especially if new crowns were made. Patients undergoing surgery experienced anxiety related to loss of control during surgery and apprehension on visualizing the wound post-surgery. They reported more impact on their diet, social interaction and sleep quality and some felt self-conscious due to post-treatment gingival recession. Patients in both groups placed great trust in professional advice and expressed a clear desire to maintain their natural dentition. There was low awareness regarding long-term care and future sequelae of their treated tooth. CONCLUSIONS: Patients reported different psycho-social and physical impacts following endodontic retreatment and apical surgery. Patients undergoing endodontic retreatment were more satisfied with aesthetic outcomes but experienced greater impact related to complexities and length of time taken for treatment. Patients undergoing surgery were better informed of treatment options but experienced greater physical and psycho-social disability during the recovery phase. Clinicians could consider incorporating findings from this study into the patient-dentist discussion.

Impact of diseases of the hard tissues of teeth on oral health-related quality of life of schoolchildren in area with a high concentration of fluoride in drinking water.

OBJECTIVE: To assess the impact of caries, Molar Incisor Hypomineralization (MIH), and fluorosis on the Oral Health-Related Quality of Life (OHRQoL) of schoolchildren aged 8-10 years living in area with different fluoride levels in the drinking water. SUBJECT AND METHODS: The prevalence of caries and fluorosis were assessed among 663 Mexican schoolchildren using the International Caries Detection and Assessment System (ICDAS II) and the Thylstrup and Fejerskov Index (TFI), respectively. MIH was recorded using the European Academy of Pediatric Dentistry (EAPD) criteria and OHRQoL using the Child Perceptions Questionnaire (CPQ8-10). Poisson regression models were used in data analysis. RESULTS: Schoolchildren presenting two of the three conditions (cavitated lesions and TFI≥4, cavitated lesions and MIH or TFI≥4 and MIH) experienced worse quality of life than children who did not [RR=4.18; (95% CI 3.83, 4.56)]. Children with all three conditions had worse quality of life than children who did not [RR=5.64; (95% CI 5.13, 6.20)]. CONCLUSIONS: Fluorosis, MIH, and caries have a negative impact on the OHRQoL of schoolchildren living in area with a high concentration of fluoride in their drinking water.

Oral health-related quality of life and satisfaction in edentulous patients rehabilitated with implant-supported full dentures all-on-four concept: a systematic review.

OBJECTIVE: Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome. MATERIAL AND METHODS: A search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria (PRISMA). The PICO question was used to address the following specific question: "What is the level of oral health-related quality of life and satisfaction in edentulous patients and with atrophic jaws who received dental implants for full-arch implant-supported restorations following the all-on-four in the mandible or maxilla?" RESULTS: Eleven studies including 693 patients aged 55 to 71 years were selected. The shortest follow-up period was 3 months and the longest, 7 years. Regarding the OHRQoL assessment method and patient satisfaction, the oral health impact profile (OHIP) and the visual analog scale (VAS) were the most used. CONCLUSION: OHRQoL and satisfaction in patients whose rehabilitation was based on the all-on-four concept were high. However, the current evidence is still limited by the quality of the available studies, making long-term randomized studies necessary to establish the real effectiveness of this surgical-prosthetic approach. CLINICAL RELEVANCE: Carefully analyze the aspects related to satisfaction and oral health-related quality of life of rehabilitated patients with implant-supported total prostheses made according to the all-on-four concept, aiming to achieve success through procedures with greater predictability and less complexity, as these are directly associated with recovery oral health of edentulous individuals with less morbidity and minimized costs.