Psychometric properties of the Albanian version of the Orofacial Esthetic Scale: OES-ALB

Assessing Orofacial Esthetics in Prosthodontic Care: A Systematic Review and Meta-Analysis of Psychometric Properties

Objective

To validate and ascertain the reliability of the Orofacial Esthetic Scale specifically within the context of prosthodontic patients, aiming to establish it as a credible and standardized tool for evaluating orofacial esthetics in this specialized cohort.

Methods

The systematic analysis adhered to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search using four databases PubMed /Medline, Web of Science, Scopus, Science Direct along with manual and grey literature (ProQuest and Google scholar) till 30 October 2023 was performed. The risk of biasness was assessed using Joanna Briggs Institute (JBI) critical appraisal checklist followed by validity analysis. For meta-analysis, psychometric values (Cronbach alpha and Intra class correlation coefficient) were used through MedCalc software.

Results

The overall ICC value was 0.95 (95% CI: 0.94 to 0.96) and the overall Cronbach alpha value was 0.94 (95% CI: 0.92 to 0.96). There was evidence of high heterogeneity and no publication bias among the studies included.

Conclusion

This study underscores the pivotal role of orofacial esthetics in prosthodontic care, introducing the Orofacial Esthetic Scale as a validated tool to quantitatively assess subjective perceptions. This will highlight its potential for tailored treatment planning and improved patient outcomes.

Development and psychometric properties of the Turkish version of the Orofacial Esthetic Scale

OBJECTIVE

This study aimed to develop the Turkish version of the Orofacial Esthetic Scale (OES-Tr) and to evaluate its psychometric properties.

MATERIALS AND METHODS

The OES-Tr questionnaire was obtained from the English version of OES by translation and back-translation. The current version's psychometric properties were evaluated in a cohort of 221 participants (81 dental students, 70 dentists with 1-10 years of clinical experience, and 70 dentists with 11-20 years of clinical experience). To assess the test-retest reliability, the OES was administered twice to all participants, with a time interval of 2-4 weeks. The reliability and validity of the questionnaire were assessed. Also, in validity studies, OES total scores were correlated with Oral Health Impact Profile-Turkish Version (OHIP-Tr) total scores.

RESULTS

The Cronbach's alpha value obtained from seven items was 0.866 in the examination performed on all individuals. Reliability results show that all questionnaire items are consistent within the test. Bartlett's test of sphericity was statistically significant (p < 0.05) and Kaiser-Meyer-Olkin test was 0.794. The results of the exploratory factor analysis indicated the creation of a single-factor structure. The examinations conducted on all participants revealed a statistically significant weak negative correlation between OES and OHIP scores (r = -0.144).

CONCLUSIONS

OES-Tr can be utilized as a reliable tool to evaluate an individual's perception of their orofacial appearance. With its excellent psychometric properties, it serves as a valuable instrument for assessing self-perceived orofacial esthetics.

CLINICAL SIGNIFICANCE

OES-Tr is a valuable instrument for assessing the appearance of the orofacial region, with good psychometric properties.

Development and psychometric properties of the Serbian version of the Orofacial Esthetic Scale

OBJECTIVE

The aim of the study was to develop the Serbian language version of the Orofacial Esthetic Scale questionnaire (OES SERB) and to evaluate its psychometric properties.

METHODS

The study included 226 subjects - 110 dental students and 116 patients (the validation sample). The students answered all the questions individually with the help of supervisors, whereas the prosthodontic patients were interviewed by the same trained dentist. The reliability and validity of the questionnaire were assessed.

RESULTS

Internal consistency of the OES-SERB was considered satisfactory (Cronbach's alpha 0.92, inter-item correlation coefficient ranged between 0.735 and 0.898). The construct validity of the OES was proved using exploratory factor analysis, which confirmed the one- dimensional model of the OES-SERB that assumed 66.549% of the variance. The Bartlett's test of sphericity was 1380.134 (df = 28, p < 0.001) and the Kaiser-Meyer-Olkin (KMO) test was 0.900. The total score was statistically significantly different between students and patients (p < 0.001), which confirmed the discriminant validity.

CONCLUSION

The Serbian version of the OES, adapted to the cultural setting of the Republic of Serbia, has exhibited excellent psychometric properties and has been confirmed as a one-dimensional tool for self-assessment of the appearance of the orofacial region.

CLINICAL SIGNIFICANCE

The Serbian version of the OES has good psychometric properties and is a valuable instrument for self-assessment of the appearance of the orofacial region.

Development and validation of the Italian version of the Orofacial Esthetic Scale (OES-I)

OBJECTIVE

To develop an Italian version of the Orofacial Esthetic Scale (OES-I), validated in a prosthodontic and non-prosthodontic patients' cohort, for clinicians and researchers to use in their practice.

MATERIALS AND METHODS

The OES-I was obtained with a process of translation and back translation from the English version of the questionnaire (OES-E). The psychometric properties of the obtained version were then observed in a group of 70 prosthodontic and 70 non-prosthodontic patients. Validity (discriminative and convergent) and reliability (internal and external) were measured. Also, CFA (confirmatory factor analysis) was run, and several models were obtained.

RESULTS

The OES-I scores were much higher for patients who were not scheduled for an esthetic prosthodontic treatment (p < 0.05); similarly, the same analysis conducted by a clinicians provided similar results (Pearson's coefficient = 0.93, p < 0.05). Reliability results show that the different items of the questionnaire are consistent within the test (Cronbach alpha = 0.93) and that the obtained results are stable within a reasonable time period (test-retest reliability = 0.98). The Final CFA model showed that OES score can properly characterize orofacial esthetic.

CONCLUSIONS

The OES-I is a reliable means both for clinicians and researchers to assess patients' self-perceived esthetic.

CLINICAL RELEVANCE

The OES-I can be used effectively for measuring the self-perceived esthetic appearance in all areas of dental practice and research.

Comparison of two rating scales with the orofacial esthetic scale and practical recommendations for its application

Purpose

We compared measurement properties of 5-point and 11-point response formats for the orofacial esthetic scale (OES) items to determine whether collapsing the format would degrade OES score precision.

Methods

Data were collected from a consecutive sample of adult dental patients from HealthPartners dental clinics in Minnesota (N = 2,078). We fitted an Item Response Theory (IRT) model to the 11-point response format and the six derived 5-point response formats. We compared all response formats using test (or scale) information, correlation between the IRT scores, Cronbach’s alpha estimates for each scaling format, correlations based on the observed scores for the seven OES items and the eighth global item, and the relationship of observed and IRT scores to an external criterion using orofacial appearance (OA) indicators from the Oral Health Impact Profile (OHIP).

Results

The correlations among scores based on the different response formats were uniformly high for observed (0.97–0.99) and IRT scores (0.96–0.99); as were correlations of both observed and IRT scores and the OHIP measure of OA (0.66–0.68). Cronbach’s alpha based on any of the 5-point formats (α = 0.95) was nearly the same as that based on the 11-point format (α = 0.96). The weighted total information area for five of six derived 5-point response formats was 98% of that for the 11-point response format.

Conclusions

Our results support the use of scores based on a 5-point response format for the OES items. The measurement properties of scores based on a 5-point response format are comparable to those of scores based on the 11-point response format.

Adaptation to New Dentures and 5 Years of Clinical Use: A Comparison between Complete Denture and Mini-implant Mandibular Overdenture Patients based on Oral Health-Related Quality of Life (OHRQoL) and Orofacial Esthetics

Objective of work

It is unclear how long patients need to adapt to new dentures. This study assessed adaptation and five years of clinical use, comparing complete denture wearers (CDs) and mini-implant mandibular overdenture wearers opposing a maxillary CD (MDI-OD), based on oral health reported quality of life (OHRQoL) and orofacial esthetics (OES).

Material and Methods

A total of 36 subjects in the CD group (25 females) and 30 subjects in the MDI group (20 females) completed the 5-year study. All patients received new CDs, but in the MDI-OD group, four mini-implants were inserted interforaminally in the mandible before denture manufacture. Participants filled in the OHIP-EDENT and OES questionnaires one day after dentures’ delivery, on the 3^rd, 8^th, 15^th, 30^th day, and at the 1-, 3- and 5-year follow-up examinations. Statistical analysis comprised descriptive methods, X² test, independent t-test, Friedman, and Mann-Whitney test.

Results and Conclusions

Both groups' adaptation to new dentures was completed within a month. The MDI-OD group had significantly better OHRQoL in all follow-ups except for the 3^rd and 8^th day, probably due to soreness and pain, the reason why the MDI-OD group had limitation in functioning in the first days after new dentures’ delivery. Already after the third year and at the fifth year, OHRQoL worsened (p<0.01) in both groups. However it was significantly more pronounced in the conventional CD wearers (p<0.01) than in the MDI-OD group. Orofacial esthetics was highly scored in both groups. The scores dropped down only after three years, equally in both groups.

Keywords

OHRQoL, OES, prospective study, complete dentures, mini-implants, adaptation

MeSH Terms

Complete Dentures; Dental Implants; Quality of Life; Dental Esthetics

Assessment of Orofacial Esthetics among Different Specialists in Dental Medicine: A pilot study

Objectives

Little is known whether specialists in different dental fields assess orofacial esthetics differently due to various focus of their interest. The aim was to find out if there is a difference in judgement of orofacial esthetics among specialists in three different fields of Dental Medicine, i.e. specialists in Prosthodontics (S-Prosthod), Periodontology (S-Perio), and Orthodontics (S-Ortho).

Material and methods

A total of 69 specialists (23 participants in each group) assessed the same 60 photographs of the lower third of the face of young healthy people with Angle Class I and natural teeth while smiling. Moreover, the assessed anterior teeth on the photographs of similes had to be without any restorations. The assessments were made using 7 out of 8 Items of Orofacial Esthetic Scale (OES). A face profile assessment was not performed. A Likert 1-5 scale was used for assessments (1-the worst score; 5-the best score). Mean values of summary scores as well as of each OES item were calculated for each specialist for further statistical analysis. One-sample Kolmogorov-Smirnov test, descriptive statistics, one-way ANOVA, and Sheffe post-hoc tests were performed.

Results

The specialists in Periodontology gave significantly lowest scores to all 7 items related to orofacial esthetics, while the specialists in Prosthodontics gave the highest scores (p<0.05).

Conclusion

Assessments of orofacial esthetics differ significantly among specialists in Prosthodontics, Periodontology and Orthodontics. Further study is needed to clarify the factors which influence the judgement, and to find out if specific education in certain specialties can modify the assessment.

Self-perception of orofacial appearance: Brazil-Finland cross-national study

OBJECTIVE

(i) To study the measurement invariance of Orofacial Esthetic Scale (OES) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), (ii) to compare the perception of orofacial appearance (OA) and (iii) to study the frequency of individuals who have sought or received aesthetic dental treatment between Brazil and Finland.

METHODS

This was a cross-sectional observational study with snowball non-probability sample selection. Students and staff from universities in Finland and Brazil were invited to participate. Data were collected online using a demographic questionnaire, OES and PIDAQ. The samples consisted of 3636 Finns (75.0% female; age: 32.0 years) and 1468 Brazilians (72.6% female; age: 33.2 years). The frequency of receiving aesthetic dental treatment was estimated. If configurational invariance was observed, cross-national measurement invariance was verified by multigroup analysis. When measurement invariance was attested, factor scores were compared using Welch's t-test.

RESULTS

OES showed configurational and measurement invariance and no significant difference between the countries. Despite similarity in satisfaction with OA, 71.9% of Brazilians had received aesthetic dental treatment, while 59.4% of Finns had never sought such treatments. PIDAQ did not present configurational invariance between the countries.

CONCLUSION

Although there is no difference in satisfaction with OA, seeking and receiving aesthetic dental treatment is significantly greater for Brazilians. Psychosocial impact of OA is perceived differently in the studied countries.

Including the patient's oral health perspective in evidence-based decision-making

BACKGROUND

How to approach the assessment of patient-perceived oral health is of fundamental importance for the evaluation of clinical and public health interventions because the patient's assessment should be used as an adjunct to objective dental findings in order to decide which interventions work.

AIM

This review article aims to provide an overview of the principles, current status, and future outlook for how a patient's oral health perception can and should be assessed.

REVIEW FINDINGS

The hierarchical position of dental patient-reported outcomes, oral health-related quality of life (OHRQoL), and dental patient-reported outcome measures within the hierarchical concepts of quality of life and its component, health-related quality of life, is presented. The Mapping Oral Disease Impact with a Common Metric project is outlined as an international effort to describe current approaches to standardize the measurement of oral impact using the four OHRQoL dimensions of oral function, orofacial pain, orofacial appearance, and psychosocial impact.

CONCLUSION

Ultimately, these four dimensions of OHRQoL provide a practical and psychometrically solid way to collect and analyze OHRQoL data for all oral diseases in all settings, and eventually for all treatments through the use of a standardized, universal measurement tool. This universal impact metric capturing the patient's oral health perspective is the key to moving evidence-based dentistry and value-based oral health care forward.

Development of a one-item version of the Orofacial Esthetic Scale

OBJECTIVES

Orofacial appearance is increasingly recognized as an important dental patient-reported outcome making instrument development and refinement efforts to measure the outcome better necessary. The aim of this study was to derive a one-item version of the Orofacial Esthetic Scale (OES).

MATERIALS AND METHODS

OES data were collected from a consecutive sample of a total of 2113 adult English- or Spanish-speaking dental patients from HealthPartners dental clinic in Minnesota. Participants with missing data were excluded and analysis were performed using data from 2012 participants. Orofacial appearance was assessed with the English and the Spanish language version of the OES. Linear regression analysis was performed, with the OES item 8 ("Overall, how do you feel about the appearance of your face, your mouth, and your teeth?") as the predictor variable and the OES summary score as the criterion variable, to calculate the adjusted coefficients of determination (R²).

RESULTS

The value of adjusted R² was 0.83, indicating that the OES item 8 score explained about 83% of the variance of the OES summary score. The difference in R² scores between the two language groups was negligible.

CONCLUSION

The OES item 8 can be used for the one-item OES (OES-1). It is a psychometrically sound instrument for measuring orofacial appearance.

CLINICAL RELEVANCE

Due to its easy application and sufficient psychometric properties, the OES-1 can be used effectively as an alternative to longer OES instruments in all areas of dental practice and research.

Orofacial Esthetic Scale and Psychosocial Impact of Dental Aesthetics Questionnaire: development and psychometric properties of the Finnish version

OBJECTIVE

To develop the Finnish version of the Orofacial Esthetic Scale (OES-Fi) and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ-Fi) and estimate the psychometric properties of these instruments applied to adult Finns.

METHODS

The English versions of the instruments were translated into Finnish and back-translated. Thereafter, OES-Fi and PIDAQ-Fi were established in a pilot study. The factorial validity was estimated using Confirmatory Factor Analysis (CFI, TLI, SRMR) in independent samples (Test and Validation samples). The measurement invariance of the factorial models was tested using multigroup analysis (ΔCFI). Convergent validity [Average Variance Extracted (AVE)] and reliability [Composite Reliability (CR) and α] were estimated.

RESULTS

A total of 3636 individuals [mean age = 32.0 (SD = 11.6) years, 75% women] participated in the study. After refinements, the factorial model of the instruments showed an adequate fit to the data (CFI ≥0.94, TLI ≥0.90, SRMR ≤0.07) and showed measurement invariance in two independent samples (|ΔCFI| <0.01). Convergent validity (AVE = 0.54-0.82) and reliability (α = 0.86-0.94) were adequate.

CONCLUSION

The data obtained using OES-Fi and PIDAQ-Fi were valid and reliable. Thus, these instruments could be useful for evaluating individual satisfaction with orofacial appearance and the psychosocial impact of dental aesthetics in a clinical or research setting.

Assessment of differential item functioning across English and Spanish versions of the Orofacial Esthetic Scale

OBJECTIVES

To investigate differential item functioning across the Spanish and English versions of the Orofacial Esthetic Scale (OES).

METHODS

OES data were collected from a consecutive sample of a total of 622 adult dental patients (311 English- and 311 Spanish-speaking adults) from HealthPartners dental clinics in Minnesota. We inspected boundary characteristic curves (BCCs) based on item response theory (IRT) in English speakers and Spanish speakers to examine differential item functioning (DIF). Using the Samejima's graded response model, we used the item response theory log-likelihood ratio (IRTLR) approach to test whether DIF was statistically significant.

RESULTS

Inspection of the BCCs did not reveal substantial differences in item difficulty and discrimination between English speakers and Spanish speakers. When IRTLR tests were performed for the seven OES items, no item was flagged with significant DIF after P-values were adjusted for multiple comparisons.

CONCLUSIONS

Pooling of Orofacial Esthetic Scale (OES) data from English and Spanish-speaking dental patients for analysis and interpretation is supported by the absence of differential item functioning (DIF) across the two language groups.

Perception of orofacial appearance among laypersons with diverse social and demographic status

BACKGROUND

The perception of dentofacial esthetics differs considerably between patients and dentists. Patient's expectations regarding his/her esthetics are important and should be assessed ahead of any planning of esthetic treatment. The aim of this study was to explore the differences in perception of orofacial appearance by laypersons with different social and demographic status.

MATERIALS AND METHODS

Self-administered questionnaires were distributed to 400 subjects. The questionnaire comprised three parts; the first part addressed the demographic variables. The second part queried about dental prosthesis, orthognathic or plastic surgery, and/or ongoing or previous orthodontic treatment. The third part included the Arabic version of the-8-item Orofacial Esthetic Scale (OES-Ar) whose responses were scored in the 5-point Likert scale. These scores were compared by different grouping factors (age, gender, marital status, and education) using non-parametric Mann-Whitney U and Kruskal Willis tests with 95% confidence interval (α > 0.05).

RESULTS

A total of 268 questionnaires were eligible for analysis, representing 67% response rate. The satisfaction with facial profile appearance was the highest (4.0±1.1) followed by facial appearance (3.9±1.1), while the color of teeth was the least satisfying item (3.1±1.3). No significant differences were found between age groups for the mean summary score as well as for each item independently. No significant difference was found between both sexes except for the last item "overall impression". Married subjects rated one item (alignment of teeth) better than their counterparts. Positive perception of orofacial appearance increased significantly with the increase of education level, the perception of the oral health status, and the perception of the general health status.

CONCLUSION

Good oral health and/or high education level are significant determinants of more positive perception of orofacial esthetic appearance. Patients with these characteristics might be more concerned about their orofacial appearance, and this should be taken into consideration before planning any esthetic restorative dental treatment.

Methodological considerations when measuring oral health-related quality of life

BACKGROUND

Dental patient-reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence-based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results.

METHODS

In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed.

RESULTS

Oral disease-generic and dimension-generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5-item version being the one with the lowest burden for the patient. Responses are given on a 5-point ordinal rating scale, the recommended response scale for dPROMs. A 7-day recall period allows for assessment of short-term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument.

CONCLUSION

OHIP-5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions.

Measuring Patient’s Orofacial Estheticsin in Prosthodontics: A Scoping Review of a Current Instrument

Objective:

Although prosthodontic treatment is aimed at improving oral function, esthetics has become the most common motivation for treatment. To ensure successful outcomes, valid and reliable instruments for comprehensively evaluating the esthetic aspects of prosthodontic treatment from both clinician perspective and patient self-assessment are needed. The literature on measurement tools used in prosthodontics to evaluate orofacial esthetic aspects was also studied.

Methods:

A scoping review was conducted to map existing instruments such as a questionnaire, index, or scale designed to evaluate orofacial esthetics by clinician and patient for prosthodontic treatment.

Results:

Of the 27 studies evaluated, the Orofacial Esthetic Scale (OES) was used mostly for evaluating a patient’s esthetic perception. The ‘Dental Esthetic Screening Index’ (DESI) was found as the most currently developed instrument with objective quantification for the clinical situation having good reliability and validity. The Prosthetic Esthetic Index (PEI) also has sufficient psychometric properties as an objective assessment tool for clinicians. But the PEI and the DESI are still rarely used in research and practice. Teeth color and position were determined to be the most important factors in recognizing esthetic impairment. Following tooth analysis (appearance, color, alignment, space, proportion, and wear), gingival appearance, smile analysis, facial analysis, and unaesthetic restoration or prosthesis were the most important esthetic factors identified.

Conclusion:

Esthetics is subjective and is influenced by many factors. Instruments for subjective and objective evaluation are needed to determine the esthetic perceptions of clinicians and patients. OES, PEI and DESI were found to be relevant instruments for this.

Development and psychometric properties of the Portuguese version of the Orofacial Esthetic Scale: OES-Pt

Background

The Orofacial Esthetic Scale (OES) is an instrument to assess an individual’s perception of their Orofacial Appearance (OA). However, its translation and evaluation of psychometric properties is necessary for its use in Brazilian individuals.

Objectives

To develop the Portuguese version of OES (OES-Pt), estimate its psychometric properties (validity, measurement invariance and reliability) when applied to Brazilian individuals aged 18–40 years, and estimate the relationship between sociodemographic characteristics and OA.

Methods

This was a cross‐sectional study using a convenience sample. The sample consisted of 1,072 Brazilian individuals (70.1% female, 25.1% dental patients; mean ± SD age: 25.7 ± 5.7 years). After cross-cultural adaptation of OES-Pt, factorial validity was evaluated by confirmatory factor analysis. Convergent validity (average variance extracted (AVE)) and reliability (Cronbach’s alpha coefficient (α) and Composite Reliability (CR)) were also estimated. Concurrent validity was assessed (Pearson’s correlational analysis (r) between OES-Pt total score and item eight of the OES which refers to global assessment of OA). Measurement invariance of the factorial model (multigroup analysis using ΔCFI) was evaluated for independent samples (sample randomly split into two: “Test Sample” and “Validation Sample” and according to sex: male and female, age range: 18–30 and 31–40 years, and whether the individual is undergoing dental treatment or not). A Structural Equation Model estimated the relationship between sociodemographic characteristics and OA.

Results

OES-Pt presented adequate fit to the sample. Convergent validity (AVE ≥ 0.56) and reliability (α and CR ≥ 0.89) were adequate. Concurrent validity was adequate (r = 0.88; p-value < 0.001). OES-Pt presented strict invariance for independent samples. Age, sex, and socioeconomic status (SES) were related to OA, indicated by standardized beta coefficients (standardized β) of 0.036 (standard error: 0.007), 0.001 (0.094) and 0.196 (0.061), respectively on OA. These three relationships were either weak or not statistically significant.

Conclusions

When measuring OA in Brazilian individuals, the OES-Pt was valid, reliable and invariant for independent samples. Age, sex and SES were weak or not statistically significantly related to OA.

Measuring patients' orofacial appearance: Validity and reliability of the English-language Orofacial Esthetic Scale

BACKGROUND

This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients.

METHODS

In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items' correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument's internal consistency by means of computing Cronbach α and average interitem correlation.

RESULTS

All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale's internal consistency was excellent.

CONCLUSION

This study found that the OES-E has sufficient psychometric properties to characterize dental patient's global assessment of orofacial appearance.

PRACTICAL IMPLICATIONS

The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients.

The effects of at-home whitening on patients' oral health, psychology, and aesthetic perception

BACKGROUND

The aesthetic self-perception and psychosocial impact of whitening is poorly explored in the literature; it is even less clear whether the effect of whitening may influence the psychology or social relations of patients. Therefore, the aim of this trial is to evaluate the impact of an at-home whitening procedure on patients' quality of life. Also, this study's secondary objective is the adaptation and validation of the Spanish version of the OES questionnaire (OES-SP).

METHODS

Fifty eight patients underwent whitening with 10% carbamide peroxide (CP) gel for 1 h daily for 3 weeks. For these participants, the OHIP-Esthetics, PIDAQ, and OES surveys were applied before, one week after, and one month after the whitening procedure. Oral health-related quality of life was measured using the OHIP-Esthetics survey and the psychosocial impact using the PIDAQ survey. The orofacial aesthetics was measured by OES and validated for the Spanish Chilean context. The treatment efficacy (ΔE and ΔSGU) and data from the OHIP-Esthetics PIDAQ and OES surveys were compared using the Wilcoxon Signed-Rank test.

RESULTS

The whitening procedure was effective (ΔE = 5.9 ± 1.8). The OHIP-Esthetics results were significant when comparing the initial baseline survey prior to the treatment and one week after whitening (p < 0.001) and when comparing the baseline and one-month results (p < 0.001). The overall score on the PIDAQ, after one week post-whitening, was separated into factors and all factors were statistically significant (p < 0.03); the factors for the one-month results were also all statistically significant (p < 0.001), except the social impact factor. The OES questionnaire had statistically significantly increased scores both one week and one month post-treatment (p < 0.0001). The reliability, validity, and responsiveness of the OES-SP were satisfactory.

CONCLUSION

The at-home whitening procedure with carbamide peroxide 10% had a positive effect on patients' oral health-related quality of life, psychology, and aesthetic perception after one month post-whitening. The Chilean Spanish version of the OES showed satisfactory psychometric characteristics to evaluate dental whitening.

TRIAL REGISTRATION

NCT02605239 . Date that the study was retrospectively registered: 11-11-2015.

Mini Dental Implant-Retained Removable Partial Dentures: Treatment Effect Size and 6-Months Follow-up

Objective

The aim was to compare esthetic outcomes, masticatory performance and a comfort of removable partial denture (RPD) wearing after receiving: clasp-retained RPD (C-RPD) or mini dental implant-retained RPD (MDI-RPD) in the mandible.

Materials and Methods

A sample of 88 patients (Kennedy Class I) with all posterior teeth missing and a linear support for a RPD participated. A total of 52 patients (36 females, 16 males; 56 to 84 years old) participated in the C-RPD group and 36 patients (26 females, 10 males; 43 to 81 years old) in the MDI-RPD group. All MDIs were placed adjacent to the last remaining mandibular anterior tooth or one tooth length posteriorly. The new RPDs had Co-Cr frameworks with lingual plate major connectors; the MDI-RPDs were retained by O-ball matrices and the C-RPDs with clasps. Patients answered questions at pre-treatment and post-treatment stages and after 6-months follow-up: how satisfied they had been with esthetic appearance, how confident they were while chewing hard food, how satisfied they were with food comminution and they also evaluated a comfort of RPD wearing. The 0-10 visual-analogue scale was used. Statistics included descriptive methods, t-tests and the standardized effect-size calculation.

Results

The MDI-RPD wearers were more satisfied with their post-treatment esthetics, food comminution, a comfort with RPDs and had better confidence while chewing than the C-RPD wearers. The MDI-RPD wearers reported larger positive effect of the treatment. The results were consistent throughout the first 6-months period.

Conclusion

The MDI-RPD patients showed superior outcomes than the C-RPD patients after the treatment and over the 6-month period.

Development, validity and reliability of the Orofacial Esthetic Scale - Spanish version

PURPOSE

To develop a Spanish version of the Orofacial Esthetic Scale (OES-Sp) and to determine its psychometric properties in dental patients.

METHODS

We performed a validation study for OES development and validation into Spanish. In the development phase, eight individuals participated in the translation process (cross-cultural adaptation) following the PROMIS methodology. In the validation phase, 331 dental patients (age mean±sd: 42.9±12.3years, 59 % female) from the HealthPartners dental clinics in Minnesota, USA responded to a survey of Spanish speaking patients (n=540, response rate: 61 %). We first explored dimensionality by means of exploratory factor analysis and scree plot, and then we computed reliability measures with the Cronbach's alpha statistic. Finally, we assessed convergent validity by computing Pearson/Spearman rank correlations between OES-Sp and Oral Health Impact Profile (OHIP)-based orofacial appearance measures. All statistical procedures were performed using Stata v.13 for Windows (StataCorp).

RESULTS

Exploratory factor analysis provided evidence that a single factor represents the Spanish OES version. Score reliability was high with Cronbach's alpha statistic of 0.95 (lower limit of the 95 % CI: 0.94). Score validity was sufficient indicated by Pearson and Spearman rank correlations between -0.53 and -0.69 (all 95 % confidence intervals: less than ± 0.10).

CONCLUSIONS

OES is a valuable instrument to measure the orofacial appearance construct for Spanish-speaking populations. OES was concluded to be unidimensional with excellent score reliability and sufficient convergent score validity when compared with other Orofacial Appearance measures. Our results suggest that OES could be used in Spanish-speaking patients, an important and growing population around the globe.

Psychometric Properties of the Croatian Language Version of the Dental Environment Stress Questionnaire on Dental Medicine Students

OBJECTIVE

To develop the Croatian version of the 41-item Dental Environment Stress questionnaire (DES) for stress assessment of dental students in both, preclinical and clinical years of study and to test its psychometric properties in Croatian dental student population.

MATERIALS AND METHODS

The English version of the 41-Item DES questionnaire was first translated into the Croatian language. Subsequently, it was set on the google drive and filled out by a total of 202 students from the School of Dental Medicine, University of Zagreb and 30 additional students from other Faculties. Students also assessed their overall level of stress on the Likert scale (1=no stress, 5=highest level of stress). Internal consistency was tested on 202 dental students; test-retest reliability on 30 dental students who filled out the same questionnaire twice; convergent validity on 202 dental students; and divergent validity on 202 dental students and 30 students from faculties not belonging to the biomedicine group.

RESULTS

Internal consistency showed high Cronbach alpha coefficient (0.9) and test-retest reliability showed no significant difference (P>0.05) within the period of 14 days when stress level had not changed (vacation). Convergent validity was confirmed by the significant association between the DES summary scores and the self- perceived level of stress (Spearman's rho=0.881; P<0.001). Divergent validity was confirmed by significantly lower DES summary scores in students not belonging to the Biomedicine group (t=7.5, P<0.001).

CONCLUSION

Excellent psychometric properties of the Croatian version of the DES questionnaire enable its utilization for assessment of stress level in Croatian dental students.