Impact of treament with orthodontic aligners on the oral health-related quality of life

BACKGROUND

There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people.

AIM

To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables.

METHOD

Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined.

RESULTS

Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031).

CONCLUSION

Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.

Socio-economic and gender dynamics influence on the parental decision-making process for children's orthodontic care - A study in Madinah, Saudi Arabia

OBJECTIVES

To investigate the socio-economic and personal factors that impact parental decisions regarding orthodontic treatment for their children in Madinah, Saudi Arabia.

MATERIALS AND METHODS

A digital self-administered questionnaire was employed to collect data from 414 parents, focusing on their motivations and barriers that influence their decision-making process regarding orthodontic treatment.

RESULTS

Income level was the most significant factor in orthodontic decisions. Parents with higher incomes were twice as likely to choose orthodontic treatment for esthetic reasons compared to parents with middle incomes. The main incentive for seeking treatment was getting advice from dental professionals, with 60% of participants rating it as the most important factor. 34.5% of respondents identified cost as the main barrier, with middle-income parents being 151% more inclined to perceive it as a significant barrier compared to high-income parents. Gender dynamics revealed that mothers exhibited 48.9% greater concern regarding treatment costs compared to fathers, whereas fathers placed 2.105 times more importance on the orthodontist's reputation than mothers.

CONCLUSION

Income levels, along with other socio-economic factors and gender dynamics, have a significant influence on parental decisions regarding orthodontic care. Personalized consultations that address these variations are crucial for improving communication between patients and practitioners and increasing the accessibility of treatment.

Psychological impact and perceptions of orthodontic treatment of adult patients with different motivations

INTRODUCTION

Motivations, perceptions, and psychosocial states of adult patients with orthodontic disorders in China have not been widely studied. The study assessed the psychosocial states and perceptions of adult patients undergoing orthodontic treatments with different motivations.

METHODS

Two hundred forty-three adult patients (mean age, 30.2 ± 7.4 years; women, 79.0%) undergoing orthodontic treatment were recruited from a tertiary stomatology hospital. The patients answered a patient-centered questionnaire regarding motivations and perceptions of orthodontic treatment and the Psychosocial Impact of Dental Aesthetics Questionnaire. Data were analyzed using the chi-square test on the basis of multiple responses. Multiple linear regression analyses were performed to determine the association between motivation factors and the Psychosocial Impact of Dental Aesthetics Questionnaire subscale scores (P <0.05).

RESULTS

Patients with various motivations were as follows: occlusal function reason (70.4%), dental esthetic reason (54.7%), facial esthetic reason (24.3%), and following others' suggestions (18.5%). Patients with esthetic or occlusal motivations exhibited significantly greater need and interest for orthodontic treatment (P <0.001). Multiple linear regression analyses revealed that the scores of social impact, psychological impact, and esthetic concern subscales were significantly associated with both dental and facial esthetic motivations (P <0.001).

CONCLUSIONS

The primary motivations of Chinese patients were observed to be improved esthetics and occlusal function. Patients with esthetic or occlusal motivations exhibited significantly greater need and interest in treatment. Patients with facial or dental esthetic motivations experienced greater impacts of psychosocial states. Therefore, the patient motivations and impacts of esthetic-related psychosocial states on them should be considered during treatment.

A simple method for quick evaluation of the anterior tooth ratio: an observational study

Background

An ideal relationship of anterior teeth is closely related to postoperative function, stability, and aesthetics. Therefore, it is necessary to estimate the proportion of anterior teeth when communicating with patients about possible treatment plans and outcomes. This study aimed to establish a simple method for assessing the proportion of anterior teeth and to identify the standard ratio value to provide references for clinical work.

Methods

Five hundred fourteen patients were divided into derivation, standard, and validation datasets. We first deduced our novel simplified anterior tooth ratio (SATR) by finding the key teeth with the derivation datasets, then established standard values by measuring the standard models, and finally validated the diagnostic performance of SATR. Independent sample t-test was used to select key teeth. Pearson’s correlation analysis and linear regression analysis was used to test and verify the correlation between SATR and the anterior Bolton ratio. Chi-square test and diagnostic test were used to verify the diagnostic results using SATR. P values of < 0.05 were considered statistically significant.

Results

Patients with an abnormal anterior Bolton ratio were more likely to have variations in the maxillary and mandibular lateral incisors. Therefore, the ratio of maxillary and mandibular lateral incisors was chosen as a simple way to assess the anterior tooth ratio and was defined as SATR (simplified anterior tooth ratio). A positive correlation was observed between SATR and anterior Bolton ratio (r = 0.702, p < 0.001), with the linear regression equation as follows: y = 0.503 + 0.328x, x = SATR, y = anterior Bolton ratio. The standard value of SATR was established (85.69% ± 3.57%) and proven reliable in clinical practice.

Conclusions

The ratio of maxillary and mandibular lateral incisors can be used to estimate the anterior tooth ratio, which showed high reliability and efficiency.

Subjective and Objective Evaluation of the Symmetry of Maxillary Incisors among Residents of Southwest Poland

Dental aesthetics is an essential factor affecting people’s psychosocial wellbeing. One of the most critical components of an aesthetic smile is symmetry within the dentition. Dentists and orthodontists, unlike laypersons, are critical in assessing dental aesthetics. This study aimed to evaluate the accuracy of patients’ assessment of the symmetry of their maxillary incisors and some factors that influence it. The study was conducted on 83 participants aged from 11 to 39 years. First, the participants filled out a questionnaire to obtain patients’ opinions of the symmetry of their upper incisors. This stage was followed by an intraoral examination, during which we used a digital caliper to measure the width of four maxillary incisors. The data were entered into STATISTICA v. 13.3. The following conclusions were drawn from the study. First, the respondents were generally able to determine the asymmetry of the incisors. Second, among the maxillary incisors, the participants defined the symmetry of maxillary central incisors more accurately than the maxillary lateral incisors. The cut-off value for incisor asymmetry noticeable to a layperson is 0.2 mm for maxillary medial incisors and 0.55 for maxillary lateral incisors. Third, we found no dependence of the accuracy of the assessment of incisor asymmetry on the age of the subjects; however, in our study group, the age range (spread) was not significant, so further studies are recommended. Finally, results concerning the relationship with gender showed that males assess the level of symmetry of their maxillary incisors more accurately than females.

Parental perception of malocclusion, its severity and aesthetic concerns in children with mixed dentition: A cross-sectional study

OBJECTIVE

This study aimed to associate the parents' perception of the need for treatment and the children's aesthetic concern, considering the influence of malocclusion severity levels.

METHODS

A population-based cross-sectional study was conducted with 770 children aged 8 to 10 years in the mixed dentition stage. A closed question sent to parents assessed the subjective orthodontic treatment need (outcome). Orthodontic Aesthetic Subjective Impact Score (OASIS) evaluated children's aesthetic concerns, and the Dental Aesthetic Index (DAI) diagnosed the anterior characteristics and malocclusion severity levels. Individual analyses were performed relating the outcome as independent variables. The variables with P<0.20 in the individual analyses were tested in multiple logistic regression models, and those with P<0.10 remained in the model. The adjusted odds ratio was estimated with a 95% confidence interval.

RESULTS

Parents of children with higher aesthetic concerns are 1.82 times more likely to believe that their child needs orthodontic treatment (P<0.05). Parents of children with very severe malocclusion are 1.91 times more likely to perceive their child's need for orthodontic treatment (P<0.05).

CONCLUSION

Parents of children with greater aesthetic concerns are more likely to perceive the need for orthodontic treatment, and very severe malocclusion also influences parents' perception of the need for orthodontic treatment.

Pain and Avoidance during and after Endodontic Therapy: The Role of Pain Anticipation and Self-Efficacy

Background: Pain anticipation has been identified as a predictor of pain and avoidance with respect to endodontic therapy. Self-efficacy is also key to the development and maintenance of health behaviors and achieve patient adherence to treatment. However, the role of self-efficacy has not been studied yet in endodontic treatment. Methods: This study was conducted on 101 patients who needed root canal therapy. They had to fill a questionnaire before treatment registered pain anticipation and self-efficacy; during and after treatment were registered pain intensity and avoidance. Results: Pain anticipation explained pain during (Beta = 0.51, t = 5.82, p ≤ 0.001, [0.34, 0.69]) and after treatment (Beta = 0.38, t = 4.35, p ≤ 0.001, [0.21, 0.55]). Self-efficacy did not have an influence in pain values. Pain anticipation explained avoidance during (Beta = 0.51, t = 3.60, p ≤ 0.001, [0.23, 0.80]) and after treatment (Beta = 0.62, t = 4.29, p ≤ 0.001, [0.33, 0.91]). Self-efficacy had a significant role in avoidance during treatment (Beta = 0.12, t = 2.19, p ≤ 0.03, [0.01, 0.23]) with a strong moderation relationship between pain anticipation and avoidance when self-efficacy was medium (Beta = 0.44, t = 3.24, p = 0.002, [0.17, 0.72]) or high (Beta = 0.84, t = 3.5, p ≤ 0.001, [0.37, 1.33]). Self-efficacy was not significant respect to avoidance after treatment. Conclusions: Self-efficacy is an important variable in endodontic therapy due to their moderating effect between pain anticipation and avoidance behavior during the procedure. It is necessary to improve the results of root canal therapy and reduce patient’s avoidance in order to take into account this variable.

Self-Esteem and Oral Health-Related Quality of Life within a Cleft Lip and/or Palate Population: A Prospective Cohort Study

(1) Objective: To investigate the oral health-related quality of life (OHRQoL) and self-esteem (SE) of a population with cleft lip and/or palate (CLP) and to compare it with a non-affected control cohort. (2) Materials and methods: This study comprised 91 CLP patients and a control group of 790 individuals, seeking orthodontic treatment. OHRQoL and SE were assessed by the Child’s Perception Questionnaire (CPQ) and the Dutch adaptation of the Harter’s Self-Perception Profile for Adolescents. Treatment need and self-perception of oral aesthetic were assessed using the Index of Orthodontic Treatment Need (IOTN) and the Oral Aesthetic Subjective Impact Scale (OASIS). Patients’ expectations and motivation for treatment were also scored. Linear models were used for statistical comparisons between groups. (3) Results: The cleft group scored higher in all domains of the CPQ, OASIS, IOTN and regarding SE for the domains of scholastic competence, athletic competence, physical appearance and behavioral conduct. The cleft group was not only more motivated and expected less discomfort during treatment but also had higher expectations for the treatment outcome. (4) Conclusions: The OHRQoL of CLP patients is strongly correlated with the presence of an oral cleft, while SE remains a personal resource not influenced by the malocclusion or medical condition.

How do general dental practitioners perceive and deal with orthodontic bonded retainers?

INTRODUCTION

Long-term follow-up and management of orthodontic bonded retainers require a strong collaboration between orthodontists and general dental practitioners (GDPs). This study aimed to evaluate if Eastern French GDPs were aware of bonded retainers' complications and side effects and if they were willing to take part in their long-term follow-up.

METHODS

Two-hundred and eighteen randomly selected GDPs were invited to answer an online questionnaire. The initial sections covered their experience and management with bonded retainers. In the final sections, GDPs were asked their opinion on the responsibility for long-term follow-up of patients wearing fixed retainers and on the mutual communication between orthodontists and GDPs. Statistical analysis involved descriptive statistics and Fisher exact tests.

RESULTS

Response rate was 32.6% (n = 71). The vast majority of GDPs were familiar with loose retainers, but only 45.2% were willing to repair them. Respondents offering orthodontic services on a regular basis were more likely to insert retainers and repair loose or broken retainers (P < 0.001). Approximately 18.6% of GDPs were aware of third-order side effects encountered with unintentionally active retainers bonded to all 6 anterior teeth. For 88.8% of GDPs, permanent retention was justified, whereas 90% of the dentists refused to be responsible for long-term supervision of fixed retainers. In addition, 67.1% were interested in further training on orthodontic retention, and 92.9% would appreciate clinical guidelines.

CONCLUSIONS

Knowledge about the harmful side effects of bonded retainers was evaluated as insufficient among surveyed GDPs. Long-term follow-up of patients wearing bonded retainers raises issues that should be addressed globally by enhancing mutual communication, practitioners' education, and patients' involvement.

The effect of social media on patient acceptance of temporary anchorage devices

OBJECTIVES

To investigate the relationship between the use of social networking sites (SNSs) on patient perceptions, acceptance, and expectations of treatment using temporary anchorage devices (TADs) and to compare differences between patients from the United Kingdom and Brazil.

MATERIALS AND METHODS

Cross-sectional questionnaires were administered to 39 participants at orthodontic practices in the United Kingdom and Brazil about patients' use of SNSs, exposure to TADs on SNSs, and thoughts on extractions, jaw surgery, or TADs as treatment options.

RESULTS

UK patients prefer for clinicians to have SNS profiles (P = .022). Most UK and Brazilian patients want to see their clinician's work online (76.7%) and use SNSs to get information about treatment options (76.6%). There was a statistically significant difference in Brazilian patients' acceptance of TADs as a treatment option compared with UK patients, particularly if it meant avoiding extractions (P = .002), avoiding jaw surgery (P = .004), or reducing treatment time (P = .010). Knowledge of TADs was greater in Brazilian patients (P < .001).

CONCLUSIONS

Patients use SNSs to obtain information about treatments and prefer clinicians to have social media accounts. Patients exposed to TADs on SNSs are more likely to accept them as an orthodontic treatment option. UK patients have less knowledge of TADs and are therefore less sure to consider TADs as an option. Brazilian patients are more confident in considering the use of TADs. Clinicians should consider increasing their social media presence to accommodate patients' expectations and acceptance of TADs.