Integration of oral health-related quality of life instruments.

OBJECTIVES: To integrate items from two widely used oral health-related quality of life (OHRQoL) questionnaires, the General Oral Health Assessment Index (GOHAI) and the Oral Impacts on Daily Performances (OIDP), as well as culturally-specific items of the Oral Health Impact Profile (OHIP) into a four-dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. METHODS: Subjects came from an ancillary study of the Dimensions of Oral Health-Related Quality of Life Project (N=267 patients, mean age±SD: 54.0±17.2years, 58% women.) Patients filled in the original 49 items of OHIP and 22 additional OHRQoL items in a cross-sectional study. These additional items consisted of 7 culturally specific OHIP items and 15 GOHAI or OIDP items with unique content not covered in OHIP-49. Before data collection, three experts hypothesized to which of the four OHRQoL dimensions these items belong. Hypotheses were tested in correlation analyses between the 22 items and the four dimension scores that were derived from OHIP-49. RESULTS: Five of the 22 items did not provide sufficient information to which dimension they belong. In 16 of the remaining 17 items, the pattern of correlation coefficients fitted experts' a priori hypotheses. Acceptance of 16 of the 17 hypotheses was interpreted as evidence that additional (not in OHIP-49 contained) OHRQoL items can be assigned to Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. CONCLUSION: Items of three OHRQoL instruments can be integrated into a dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. CLINICAL SIGNIFICANCE: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can serve as a simple and clinically appealing set of oral health-related quality of life (OHRQoL) dimensions and therefore provide an opportunity for simpler, but psychometrically improved OHRQoL measurement in the future.

A 7-day recall period for a clinical application of the oral health impact profile questionnaire.

OBJECTIVES: Aims were to investigate and compare the validity and reliability of Oral Health Impact Profile (OHIP) scores referencing 7-day and 1-month recall periods in international prosthodontic patients. MATERIAL AND METHODS: A sample of 267 patients (mean age = 54.0 years, SD = 17.2 years, 58 % women) with stable oral health-related quality of life was recruited from prosthodontic treatment centers in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden. These patients completed the OHIP on two occasions using a new 7-day recall period and the traditional 1-month recall period. OHIP score validity and reliability were investigated with structural equation models (SEMs) that included OHIP(past 7 days) and OHIP(1 month) latent factors and single indicator measures of global oral health status. The SEMs assessed measurement invariance and the relative validities of the two OHIP latent factors (representing the two recall periods). RESULTS: The SEMs provided cogent evidence for recall period measurement invariance for the two OHIP forms and equal validities (r = .48) with external measures of global oral health status. CONCLUSION: When assessed in international prosthodontic patients, OHIP scores using the new 7-day recall period were as reliable and valid as the scores using the 1-month recall period. CLINICAL RELEVANCE: Conceptual advantages make a 7-day recall period a preferred frame of reference in clinical applications of the OHIP questionnaire.

[Retrospective study of direct composite restorations according to the USPHS criteria]. / Direkt kompozit restaurációk retrospektív vizsgálata USPHS kritériumrendszer alapján.

The purpose of this retrospective study was to evaluate and describe the occurrence of different deficiencies of composite restorations in molar and premolar teeth. Further aim was to investigate possible correlations between occurring malformations and the localization or size of the restorations. 240 class II composite restorations (in 85 patients) were involved in the study. Control examinations were carried out five years after restorations, according to the United States Public Health Services' criteria. Namely, anatomic form, marginal integrity, marginal stain, color stability, surface smoothness, and the presence of secondary caries or fractures of the restorations. The associations between variables were calculated by bivariate analyses using either Pearson chi-square or Fisher tests. P < 0.05 was considered significant. In 0.8% of the fillings, secondary caries and in 0.4% of the cases, fracture was found as a failure. The frequency of adjacent deficiencies were found as follows: color instability, 12.5%; marginal stain, 20.8%; anatomic deformity, 15.0%; failure of marginal integrity, 8.8%; and surface roughness, 2.5%. Color instability was significantly more frequent in premolar teeth, than in molars (P = 0.031). Color instability (P = 0.015), marginal stain (P < 0.001) and anatomic form malformation (P = 0.002) occurred more frequently in MOD restorations than in MO/OD fillings. Our results suggest that class II restorations are correct both functionally and esthetically in 98.8% of the cases, even after a 5-year-period.

Impaired oral health-related quality of life in Hungary.

OBJECTIVES: To describe the prevalence of impaired oral health-related quality of life (OHRQoL) in the adult Hungarian population and to determine population-based norms for three Hungarian versions of the Oral Health Impact Profile (OHIP-H). MATERIAL AND METHODS: In a survey of 1059 randomly selected subjects, OHIP responses, age, gender, and denture status [natural dentition or fixed partial dentures (FPDs), removable partial dentures (RPDs), or complete dentures (CDs)] were collected. Study outcomes were item prevalence and OHIP summary score frequency ('norms'). RESULTS: The prevalence of OHIP items ranged from 2% to 43%, with a mean item prevalence of 14%. The distribution of summary scores was characterized by decile norms. Median scores for OHIP-H49, the 49-item questionnaire, were 6 OHIP units for subjects with FPDs, 10 OHIP units for subjects with RPDs, and 6 OHIP units for subjects with CDs. The median scores were 0, 0, and 1 OHIP units for the 14-item OHIP-H, and 0, 0, and 0 OHIP units for the five-item OHIP-H. CONCLUSIONS: Our sample demonstrates substantial OHRQoL impact in the Hungarian general population. The derived norms provide a framework for interpretation of data in future studies using the Hungarian OHIP versions, as well as data on how oral conditions and cultural factors affect perceived oral health when compared with international findings.

[Impact of prosthetic care on oral health related quality of life]. / Protetikai terápiás lehetoségek eletminoségre gyakorolt hatása.

Patients' perception of oral health can be characterized by Oral Health Related Quality of Life (OHRQoL). Therefore, it should be able to be used to measure their perceived benefits of prosthodontic treatment. Oral Health Impact Profile (OHIP) is one of the technically most sophisticated and most widely used instruments measuring OHRQoL. The aim of this study was to measure the impact of prosthodontic treatment on Oral Health Related Quality of Life. The Hungarian version of OHIP (OHIP-H 53) was applied for a sample of 63 prosthodontic patients at baseline, and at 1 as well as at 6 and 12 months following treatment. OHRQoL impairment is characterized by OHIP-H 53 scores. A linear regression model was used to estimate the rate of improvement of OHRQoL in different prosthodontic treatment groups (FPD, RPD and CD) at baseline and at follow-ups. OHRQoL improved rapidly within 1 month after treatment (76% of patients) and it underwent further but moderate improvement within the following 6 to 12 months after treatment in subjects with fixed, removable and complete dentures (90%) as indicated by the reduced OHIP-H scores. The largest improvement was observed in patients treated with fixed prosthodontics. Patients receiving removable or complete dentures had poorer OHRQoL than respondents treated with fixed prosthodontics. It can be concluded that OHRQoL can be improved by prosthodontic treatment, especially by using fixed prosthodontics. Besides considering clinical factors in prosthodontics, subjective conditions should also be involved in treatment planning in order to achieve a higher rate of acceptance of prosthetic care by the patient.

[Quality of life and prosthodontics]. / Eletminoség és fogpótlástan.

Orofacial pain, functional limitations, psychosocial impacts, and concern about appearance are all dimensions of oral health-related quality of life. Consequently, OHRQoL is especially important for prosthodontics. OHRQoL is assessed by multiple-item questionnaires that ask about numerous symptoms, problems and social impacts. 49 items into seven dimensions were developed in the OHIP which was then verified among several different cultural circumstances. Evaluating baseline (To) immediately after treatment (T1) and after a longer observation time (T2), a decrease of symptoms and problems could be followed in prosthodontic care. Fastest improvement in patient satisfaction was observed in case of fixed partial denture wearers. The profile of pre- and post-treatment problems differed extensively among removable partial and complete denture wearers, and only minor problems were found after a longer time of adaptation. OHIP instrument seems to be a reliable indicator of change in oral health-related quality of life, for cultural circumstances deviated largely from each others.