Malocclusion traits and oral health-related quality of life in children with osteogenesis imperfecta: A cross-sectional study

Comparison of fixed braces and clear braces for malocclusion treatment

BACKGROUND

To study and compare the effects of clear aligners without brackets and traditional fixed aligners in orthodontic treatment.

METHODS

The samples were collected from January 2022 to April 2023. The control group (n = 26) received orthodontic treatment using traditional fixed appliances. The research group (n = 20) received orthodontic treatment using the clear aligners without brackets. Compare the therapeutic effects and related evaluation indicators between two groups.

RESULTS

The total effective ratio was compared between the 2 groups, and the study group was greater(P < 0.05). After treatment, the detected values of the periodontal condition indicators (plaque index, debris index, and gingival bleeding index), serum inflammatory factors (CRP, IL-6 and TNF-α) of the two groups, were less than before, also were all less than the control group. (P < 0.05). After therapy, in comparison of the control group, the value of mastication efficiency, comfort and psychological evaluation, sleep indicators and the points of the four dimensions of life quality in the study group was greater, and the detection results were obviously greater than before(P < 0.05).

CONCLUSION

In the orthodontic therapy of sufferers with malocclusion, compared with the traditional fixed appliance, the clear aligners without brackets can enhance the treatment effects, improve the periodontal condition and masticatory function, and reduce the inflammatory responses, so that patients can feel more comfortable, thereby improving their psychology, sleep and quality of life. In the future, with the continual advancement of technology and people's pursuit of beauty, the application of clear aligners without brackets in orthodontic treatment will become more and more extensive. The continuous introduction of new materials and new technologies will further improve the effects and comfort of the clear aligners without brackets, reduce treatment time and discomfort, and also reduce patients' resistance to aligners, bringing patients a better treatment experience.

A standard set of outcome measures for the comprehensive assessment of oral health and occlusion in individuals with osteogenesis imperfecta

BACKGROUND

Osteogenesis imperfecta (OI) is a group of inherited connective tissue disorders of varying severity characterized by bone fragility. The primary objective of this international multidisciplinary collaboration initiative was to reach a consensus for a standardized set of clinician and patient-reported outcome measures, as well as associated measuring instruments for dental care of individuals with OI, based on the aspects considered important by both experts and patients. This project is a subsequent to the Key4OI project initiated by the Care4BrittleBones foundation which aims to develop a standard set of outcome measures covering a large domain of factors affecting quality of life for people with OI. An international team of experts comprising orthodontists, pediatric dentists, oral and maxillofacial surgeons, and prosthetic dentists used a modified Delphi consensus process to select clinician-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs) to evaluate oral health in individuals with OI. Important domains were identified through a literature review and by professional expertise (both CROMs and PROMs). In three focus groups of individuals with OI, important and relevant issues regarding dental health were identified. The input from the focus groups was used as the basis for the final set of outcome measures: the selected issues were attributed to relevant CROMs and, when appropriate, matched with validated questionnaires to establish the final PROMs which represented best the specific oral health-related concerns of individuals with OI.

RESULTS

Consensus was reached on selected CROMs and PROMs for a standard set of outcome measures and measuring instruments of oral health in individuals with OI.

CONCLUSIONS

Our project resulted in consensus statements for standardization oral health PROMs and CROMs in individuals with OI. This outcome set can improve the standard of care by incorporating recommendations of professionals involved in dental care of individuals with OI. Further, it can facilitate research and international research co-operation. In addition, the significant contribution of the focus groups highlights the relevance of dental and oral health-related problems of individuals with OI.

Orofacial Features, Oral Health-Related Quality of Life, and Exposure to Bullying in Osteogenesis Imperfecta: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Osteogenesis imperfecta (OI) is a rare genetic disease that is responsible for bone fragility, but also for dental malocclusions and dentinogenesis imperfecta (DI). The aim of this study was to assess whether the severity of dental malocclusion influenced the oral health-related quality of life (OHRQoL) and exposure to bullying in a paediatric OI population compared with a control group.

METHODS

Dental and occlusal characteristics were noted during oral and radiographic examination. The severity of malocclusion was assessed using the PAR index. P-CPQ, COHIP(34), and BCS-A questionnaires were used to evaluate, respectively, externally and self-perceived OHRQoL and bullying.

RESULTS

We included 39 patients with a mean age of 11.3 (±4.8 SD) in the OI group, and 45 patients with a mean age of 12.3 (±3.2 SD) in the control group. There were no significant differences between the two groups in terms of occlusal vertical and transverse dimensions. Patients with severe OI, presenting with bone fractures, bones deformities, and short stature, had significantly more anterior (p < 0.05) and posterior openbites (p < 0.05) and more DI (p < 0.05) compared to patients who had moderate or mild OI. Self-perceived OHRQoL was negatively impacted by the disease (p = 0.01), particularly in the domains of oral health (p < 0.05) and self-image (p < 0.001), but not by its severity. Exposure to bullying did not differ significantly between the two groups, although more patients with OI reported being teased (21.4% face to face and 7.1% online vs. 14.6% and 2.4% in the control group).

CONCLUSION

Interventions for dental malocclusion and oral health in OI patients would help to improve their quality of life and self-image.

Genetic Evaluation for Monogenic Disorders of Low Bone Mass and Increased Bone Fragility: What Clinicians Need to Know

PURPOSE OF REVIEW

The purpose of this review is to outline the principles of clinical genetic testing and to provide practical guidance to clinicians in navigating genetic testing for patients with suspected monogenic forms of osteoporosis.

RECENT FINDINGS

Heritability assessments and genome-wide association studies have clearly shown the significant contributions of genetic variations to the pathogenesis of osteoporosis. Currently, over 50 monogenic disorders that present primarily with low bone mass and increased risk of fractures have been described. The widespread availability of clinical genetic testing offers a valuable opportunity to correctly diagnose individuals with monogenic forms of osteoporosis, thus instituting appropriate surveillance and treatment. Clinical genetic testing may identify the appropriate diagnosis in a subset of patients with low bone mass, multiple or unusual fractures, and severe or early-onset osteoporosis, and thus clinicians should be aware of how to incorporate such testing into their clinical practices.

Dental abnormalities in rare genetic bone diseases: Literature review

Currently, over 500 rare genetic bone disorders are identified. These diseases are often accompanied by dental abnormalities, which are sometimes the first clue for an early diagnosis. However, not many dentists are sufficiently familiar with phenotypic abnormalities and treatment approaches when they encounter patients with rare diseases. Such patients often need dental treatment but have difficulties in finding a dentist who can treat them appropriately. Herein we focus on major dental phenotypes and summarize their potential causes and mechanisms, if known. We discuss representative diseases, dental treatments, and their effect on the oral health of patients and on oral health-related quality of life. This review can serve as a starting point for dentists to contribute to early diagnosis and further investigate the best treatment options for patients with rare disorders, with the goal of optimizing treatment outcomes.

The impact of osteogenesis imperfecta severity on oral health-related quality of life in Spain: a cross-sectional study

BACKGROUND

Osteogenesis imperfecta (OI) affects dental and craniofacial development; therefore, it can influence oral health-related quality of life (OHRQoL). The objective of this study was to explore the influence of the severity of OI on OHRQoL in adults older than eighteen years residing in Spain.

METHOD

Adults with OI were recruited from the Spanish Association of Crystal Bone (AHUCE) foundation. OHRQoL was evaluated using the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14sp), oral hygiene habits, and a dental care survey. Clinical and radiological dental examinations were performed to evaluate the patients' oral conditions.

RESULTS

A total of 65 adults (n = 46 females) aged between nineteen and sixty-two years who were diagnosed with OI and classified as type I, III, and IV (n = 20, 14, and 31, respectively) participated in this research. The total OHIP-14sp scores were significantly greater (worse) for type III (23 [SD = 10]) and type IV (21.4 [SD = 12]) than for type I (13.8 [SD = 6]) (P < 0.05). The negative impact of OHRQoL was due to the association of type III OI with all domains except for the handicap domain, while type IV OI was associated with the physical disability, social disability, and handicap domains (P < 0.05 for all).

CONCLUSION

The severity of OI negatively impacted OHRQoL in adults. This association was statistically significant.

The impact of craniofacial and dental osteogenesis imperfecta manifestations on oral health-related quality of life of children and adolescents

OBJECTIVE

Craniofacial and oral manifestations of Osteogenesis Imperfecta (OI) can affect the functioning of the stomatognathic system and impact the patient's quality of life. The objective of the study was to evaluate the relationship between craniofacial and oral manifestations and the Oral Health-related Quality of Life (OHRQoL) of OI children and adolescents.

MATERIAL AND METHODS

A total of 30 OI patients aged eight to fourteen years old followed up at the Oral Care Center for Inherited Diseases were enrolled in the research. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ) for eight to ten-year-olds (CPQ8-10) and 11 to 14-year-olds (CPQ11-14). The relationship between the OHRQoL index and its assessment domains, OI types, and the presence of dentinogenesis imperfecta (DI), class III malocclusion, and dental agenesis were evaluated.

RESULTS

The median CPQ score of patients was 5, and there was no significant difference in OHRQoL between children and adolescents, nor associated with the disease severity or the presence of DI. The oral manifestations evaluated did not directly impact the patients' OHRQoL.

CONCLUSIONS

The study demonstrated that the perception of OHRQoL is similar for both adolescents and children. The oral symptom was the most relevant domain for the index among patients aged eight to fourteen years while the emotional well-being was the most impacted.

CLINICAL RELEVANCE

this study makes contributions by indicating that addressing dental care for children and adolescents with OI is important in clinical management and better OHRQoL for this population.

Reliability and validity of the Child Perception Questionnaire 8 ~ 10 (CPQ8~10) in China: an instrument for measuring oral health-related quality of life among 8-10-year-old children

OBJECTIVES

Children aged 8-10 are in a critical stage of growth and development, facing complex and specific oral health problems. In China, there is no specific assessment questionnaire for this age group. The Child Perception Questionnare 8 ~ 10 (CPQ8~10) has been widely used in many countries, with good reliability and validity. This study aimed to translate the CPQ8~10 into Chinese and assess its reliability and validity, and ascertain its applicability for 8-10-year-old children in China.

MATERIALS AND METHODS

Brislin's translation model was used in developing the Chinese version of CPQ8~10. Internal consistency, retest reliability, criterion validity, and confirmatory factor analysis were performed to evaluate the reliability and validity of the Chinese version of the CPQ8~10 among 494 8 ~ 10-year-old children in China.

RESULTS

A Chinese version of the CPQ8~10, aligned with Chinese culture and social features, was developed. The criterion validity was 0.719 (P < 0.001). The item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) for the Chinese version of the CPQ8~10 were 0.80 ~ 1.00 and 0.968, respectively. Factor analysis revealed a logical relationship among the items in the Chinese version of the CPQ8~10. The Cronbach's α coefficient, retest reliability, and Guttman split-half reliability coefficient for the Chinese version of the CPQ8~10 were 0.819, 0.830, and 0.849, respectively.

CONCLUSIONS

The Chinese version of the CPQ8~10 exhibited a structure consistent with the original questionnaire, displaying good reliability and validity. This study facilitates the application of CPQ8~10 in China.

CLINICAL RELEVANCE

The Chinese version of the CPQ8~10 is a brief and suitable tool to evaluate oral health-related quality of life of 8 ~ 10-year-old children.

The patient clinical journey and socioeconomic impact of osteogenesis imperfecta: a systematic scoping review

BACKGROUND

Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder primarily characterised by skeletal deformity and fragility, and an array of secondary features. The purpose of this review was to capture and quantify the published evidence relating specifically to the clinical, humanistic, and economic impact of OI on individuals, their families, and wider society.

METHODS

A systematic scoping review of 11 databases (MEDLINE, MEDLINE in-progress, EMBASE, CENTRAL, PsycINFO, NHS EED, CEA Registry, PEDE, ScHARRHUd, Orphanet and Google Scholar), supplemented by hand searches of grey literature, was conducted to identify OI literature published 1st January 1995-18th December 2021. Searches were restricted to English language but without geographical limitations. The quality of included records was assessed using the AGREE II checklist and an adapted version of the JBI cross-sectional study checklist.

RESULTS

Of the identified 7,850 records, 271 records of 245 unique studies met the inclusion criteria; overall, 168 included records examined clinical aspects of OI, 67 provided humanistic data, 6 reported on the economic impact of OI, and 30 provided data on mixed outcomes. Bone conditions, anthropometric measurements, oral conditions, diagnostic techniques, use of pharmacotherapy, and physical functioning of adults and children with OI were well described. However, few records included current care practice, diagnosis and monitoring, interactions with the healthcare system, or transition of care across life stages. Limited data on wider health concerns beyond bone health, how these concerns may impact health-related quality of life, in particular that of adult men and other family members, were identified. Few records described fatigue in children or adults. Markedly few records provided data on the socioeconomic impact of OI on patients and their caregivers, and associated costs to healthcare systems, and wider society. Most included records had qualitative limitations.

CONCLUSION

Despite the rarity of OI, the volume of recently published literature highlights the breadth of interest in the OI field from the research community. However, significant data gaps describing the experience of OI for individuals, their families, and wider society warrant further research to capture and quantify the full impact of OI.

Evaluation of the Severity of Malocclusion in Children with Osteogenesis Imperfecta

Occlusion is the way in which the dental arches are related to each other and depends on craniofacial growth and development. It is affected in patients with Osteogenesis Imperfecta (OI) who present altered craniofacial development. The malocclusion present in 49 patients diagnosed with different types of OI aged between 4 and 18 was studied. The control group of healthy people was matched for age, sex, and molar class. To study the mixed and permanent dentition, the American Board of Orthodontics (ABO) discrepancy Index was applied. The primary dentition was evaluated with a Temporary Dentition Occlusion Analysis proposed for this study. The OI group obtained higher scores in the Discrepancy Index than the control group, indicating a high difficulty of treatment. The most significant differences were found in types III and IV of the disease. Regarding the variables studied, the greatest differences were found in the presence of lateral open bite in patients with OI, and in the variable "others" (agenesis and ectopic eruption). The analysis of primary dentition did not show significant differences between the OI and control groups. Patients with OI have more severe malocclusions than their healthy peers. Malocclusion is related to the severity of the disease and may progress with age.

Dental Implants in People with Osteogenesis Imperfecta: A Systematic Review

The aim of this systematic review was to answer the question of whether patients with osteogenesis imperfecta can be prosthetically rehabilitated with dental implants. A protocol was prospectively registered in PROSPERO (CRD42021286368). The inclusion criteria were the presence of osteogenesis imperfecta and the use of implants for prosthetic restorations. Cases in which the inclusion criteria were not met were excluded. PubMed, Web of Science, and Scopus were last searched on 22 August 2021. Quality assessment was performed using the Methodological Quality and Synthesis of Case Series and Case Reports tool. The primary outcome was implant survival. Supporting data were analyzed descriptively. Twelve studies were included. Twenty-three patients received a total number of 116 implants, with 5.0 (±3.8) implants placed per patient. The implant survival rate was 94.0% with a mean follow-up of 59.1 months (±36.1). A limitation of this review was the relatively short follow-up time in some of the included studies; therefore, the survival rate may be overestimated. Nevertheless, the available data showed the loss of only seven implants, with two implants lost due to implant fractures not attributable to the patient. With the limitations of this review and based on the available data, dental implants have a high survival rate in patients with osteogenesis imperfecta. Therefore, dental implants may be a viable treatment option for replacing missing teeth. This research was not funded by external resources.

Alterations of a serum marker of collagen X in growing children with osteogenesis imperfecta

Abnormalities in the structure and/or processing of type I collagen cause osteogenesis imperfecta and result in bone fragility, abnormal bone growth and short stature. Type I collagen is expressed in the growth plate but the mechanisms by which abnormalities in collagen I contribute to growth plate dysfunction and growth retardation are unknown. The non-collagenous domain (NC1) of type X collagen (CXM) is released from the hypertrophic zone of active growth plates and is a marker for new endochondral bone formation. Serum CXM levels are strongly correlated with the rate of growth in healthy children. We hypothesized that CXM levels in children with OI would be abnormal when compared to normally growing children. Using participants from the Brittle Bone Disease Consortium Natural History Study we analyzed the distribution of CXM over the ages of 8 months to 40 years in 187 subjects with OI (89 type I and 98 types III/IV) as well as analyzed the relationship between growth velocity and CXM levels in a subset of 100 children <16 years old with OI (44 type I and 56 types III/IV). CXM levels in both control and OI children demonstrated a similar pattern of variation by age with higher levels in early life and puberty followed by a post-pubertal drop. However, there was greater variability within the OI cohort and the relationship with growth velocity was weaker. The ratio of CXM level to growth velocity was elevated in children with type III/IV OI compared to controls. These results suggest that the relationship between hypertrophic zone function and the end point of skeletal growth is disrupted in OI.