Dental esthetic self-perception in young adults with and without previous orthodontic treatment

Agreement and association between normative and subjective orthodontic treatment need using the Index of Orthodontic Treatment Need

AIMS:

To determine the association and level of agreement between young adults’ perception of orthodontic treatment need (subjective need) and the orthodontists’ assessment of treatment need (normative objective need).

METHODOLOGY:

For this study, 670 students [280 males and 390 females; mean age (standard deviation) of 15.32 (1.81) years] were selected from public and private schools from different demographic areas of Jeddah city, Saudi Arabia, and divided into two age groups (12–15 years) and (16–19 years). All the participants were examined, and the Index of Orthodontic Treatment Need (IOTN) components [dental health component (DHC) and aesthetic component (AC)] were recorded.

RESULTS:

Kappa statistics showed a statistically significant but fair agreement between clinician AC (CAC) and student AC (SAC) assessments in both age groups (k = 0.343 and 0.334, respectively; P < 0.001), whereas Spearman's correlation coefficient showed a statistically significant but moderate association (r = 0.487 and 0.517, respectively; P < 0.001). The degrees of agreement were 76.4% and 76.7% at the no-need and mild-need levels of treatment, respectively. There was a statistically significant but weak association between the subjective and normative needs (SAC and IOTN-DHC) in both age groups (r = 0.336 and 0.360, respectively; P < 0.001). However, the degrees of agreement were 58.9% and 61.5% at the no-need and mild-need levels of treatment, respectively.

CONCLUSION:

Significant but weak positive association was found between the normative and subjective orthodontic treatment needs, indicating a lack of understanding of the nature of malocclusion and its consequences. Thus, promoting further knowledge and awareness of malocclusion are indicated.

Perception of midline deviations in smile esthetics by laypersons

Objective:

To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment.

Methods:

An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student’s t-test and Mann-Whitney test were applied, adopting a 5% level of significance.

Results:

Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm.

Conclusions:

Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

Translation and validation of the Turkish version of the Psychosocial Impact of Dental Aesthetics Questionnaire

Objective

The aim of this study was to translate the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) into Turkish, validate the questionnaire, and provide a cross-cultural adaptation.

Methods

The translation process included the following steps, which were performed by a translation committee: (1) translation into Turkish, (2) back translation into English, (3) pretesting, and (4) cross-cultural adaptation. The Turkish version of the PIDAQ was produced subsequent to the translation process. Validity and reliability were measured using the Perception of Occlusion Scale and the aesthetic component of the Index of Orthodontic Treatment Need. The questionnaire was administered to 260 individuals (age range, 18–30 years; mean age, 20.50 ± 1.9 years). Structural validity was assessed via factor analysis, and internal consistency was measured using Cronbach's alpha coefficient.

Results

Factor analysis revealed a four-factor structure, with factor loadings for included items ranging from 0.380 to 0.868. Few questions were shuffled among domains various factor loadings. Cronbach's alphas for the Turkish version of the PIDAQ ranged from 0.534 to 0.904. Mean scores for the PIDAQ subscale and total scores differed significantly according to Index of Orthodontic Treatment Need and Perception of Occlusion Scale scores.

Conclusions

This study provided a Turkish version of the PIDAQ, which could be a useful tool in the evaluation of the psychosocial impact of malocclusion in young Turkish adults.

Comparing esthetic smile perceptions among laypersons with and without orthodontic treatment experience and dentists

Objective

The purpose of this study was to examine whether orthodontic treatment experience affects the individual's perception of smile esthetics and to evaluate differences among orthodontically treated laypersons, non-treated laypersons, and dentists by using computerized image alterations.

Methods

A photograph of a woman's smile was digitally altered using a software image editing program. The alterations involved gingival margin height, crown width and length, incisal plane canting, and dental midline of the maxillary anterior teeth. Three groups of raters (orthodontically treated laypersons, non-treated laypersons, and dentists) evaluated the original and altered images using a visual analog scale.

Results

The threshold for detecting changes in maxillary central incisor gingival margin height among laypersons was 1.5 mm; the threshold of dentists, who were more perceptive, was 1.0 mm. For maxillary lateral incisor crown width and height, the threshold of all three groups was 3.0 mm. Canting of the incisal plane was perceived when the canting was 3.0 mm among non-treated laypersons, 2.0 mm among treated laypersons, and 1.0 mm among dentists. Non-treated laypersons could not perceive dental midline shifts; however, treated laypersons and dentists perceived them when the shift was ≥ 3.0 mm.

Conclusions

Laypersons with and without orthodontic treatment experience and dentists have different perceptions of smile esthetics. Orthodontically treated laypersons were more critical than non-treated laypersons regarding incisal plane canting and dental midline shifts. Based on these findings, it is suggested that orthodontic treatment experience improved the esthetic perceptions of laypersons.

Cross-cultural adaptation and validation of the Italian Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)

PURPOSE

To validate and cross-culturally adapt the Italian version of the Psychological Impact of Dental Aesthetics Questionnaire (PIDAQ) among Italian young adults.

METHODS

After translation, back translation, and cross-cultural adaptation of the English PIDAQ, a first version of the Italian questionnaire was pretested. The final Italian PIDAQ was administered to 598 subjects aged 18-30 years, along with two other instruments: the aesthetic component of the index of orthodontic treatment need (IOTN-AC) and the perception of occlusion scale (POS), which identified the self-reporting grade of malocclusion. Structural validity was assessed by means of factorial analysis, internal consistency was measured with Cronbach's alpha coefficient (α), convergent validity was assessed by means of Spearman correlation, and test-retest reliability was calculated with intra-class correlation coefficient (ICC) and standard measurement error. Criterion validity was evaluated by multivariate and univariate analysis of variance with Bonferroni post hoc tests.

RESULTS

The α of the Italian PIDAQ domains ranged between 0.79 and 0.92. The ICC was between 0.81 and 0.90. The mean scores of each PIDAQ domain showed a statistically significant difference when analysed according to the IOTN-AC and POS scores.

CONCLUSION

The satisfactory psychometric properties make PIDAQ a usable tool for future studies on oral health-related quality of life among Italian young adults.

Normative and self-perceived orthodontic treatment need of a Peruvian university population

BACKGROUND

Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults.

METHODS

281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05.

RESULTS

An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4-5 was 29.9% whereas the percentage of students with AC grades 8-10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons.

CONCLUSION

Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need.