Clinical Features, Treatment Interventions, and Oral Health-Related Quality of Life in Patients with COVID-19-Associated Mucormycosis: A Descriptive-Analytical Study

Background:Thalassemia major (TM) is a severe life-threatening hemoglobinopathy. It causes a typical chipmunk face due to increased hematopoiesis. Severe malocclusion often accompanies facial deformity, which may affect Oral Health-related Quality of Life (OHRQoL). The aim of this study was to assess the relationship between orthodontic treatment needs and OHRQoL in TM patients.Materials and Methods:One hundred and five adult patients with TM participated in this cross-sectional study. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure OHRQoL and the patient's need for orthodontic treatment was evaluated using the Index of Orthodontic Treatment Need (IOTN). The comparison of OHIP-14 scores between groups regarding orthodontic treatment need was carried out using t-test (SPSS software); P < 0.05 was considered statistically significant.Results:The mean age of participants was 24.92 (±9.33) years, with 52% female versus 48% male. Orthodontic treatment need was 27.6%. The mean score of OHIP-14 was 12.95 (±7.02). A statistically significant relationship was found between OHIP-14 score and age, gender, and orthodontic treatment need (P < 0.05). All domains of OHIP-14 were significantly related to orthodontic treatment need (P < 0.05), except for “physical disability” (P = 0.282).Conclusion:OHRQoL was lower in TM patients with orthodontic treatment needs. Planning to treat malocclusion seems necessary to improve the quality of life in these patients.

Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc. Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders. This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score. Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36.

Oral and general health-related quality of life in oral squamous cell carcinoma patients- comparative analysis of different treatment regims

Background Coronectomy of a mandibular impacted third molar is a surgical treatment to minimize the risk for inferior alveolar nerve damage. We aimed to determine whether this procedure affected the oral health-related quality of life (OHRQoL) within the first postoperative week.Material and Methods This prospective study included 50 patients that underwent a coronectomy for an impacted mandibular third molar. The patients completed the Oral Health Impact Profile-14 (OHIP-14) questionnaire and questions about pain and analgesic intake on every day during the first postoperative week.Results Mean OHIP-14 scores were highest during the first three postoperative days; the highest mean score (26.40, SD: 8.67) was observed on the first postoperative day. Mean OHIP scores gradually declined during the first postoperative week, and the mean OHIP-14 score was 9.82 (SD: 9.15) on the seventh day. Physical pain was the highest contributor to the overall OHIP-14 score. Pain gradually declined with time; the lowest mean pain score (3.38, SD: 2.2) was observed on the seventh day. OHIP-14 and pain scores were not significantly different between sexes or between different grades of impaction. OHIP-14 scores were positively correlated with pain scores.Conclusions A mandibular third molar coronectomy had a strong effect on patient OHRQoL, particularly during the first three postoperative days. Key words:Third molars, coronectomy, pain, OHRQoL.

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. 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). 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. 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. Conceptual advantages make a 7-day recall period a preferred frame of reference in clinical applications of the OHIP questionnaire.

To investigate the prevalence and severity of oral health-related quality of life in patients treated with removable partial dentures at a publicly-funded dental hospital. The association between patients' demographic profiles, denture-related, variables and oral health-related quality of life was also investigated. A questionnaire was designed to investigate the use and satisfaction of removable partial dentures, and oral health-related quality of life of removable partial denture wearers using the Oral Health Impact Profile-14. The questionnaire was administered to 740 randomly-selected patients who received removable partial dentures during 2005-2008. The response rate was 31.35%. Non-parametric tests and a logistic regression model were used to analyze the association between denture-related variables and oral health-related quality of life. A question on symptoms unrelated to dentures was also analyzed. The Oral Health Impact Profile-14 prevalence calculated was 43.1%. The removable partial denture experience and frequency of use was inversely associated with Oral Health Impact Profile-14 scores. Metal-based removable partial dentures were associated with lower Oral Health Impact Profile prevalence and severity scores. No significant association was found between demographic profile, circumstance for provision of removable partial dentures and Oral Health Impact Profile-14 score. The participants of this study indicated that perceived denture performance, removable partial dentures material, experience, and frequency of use are associated with oral health-related quality of life.

Background:Since oral ulcer is a common clinical manifestation, oral health-related quality of life (OHRQoL) is affected by the presence of oral ulcer poorly in patients with Behcet’s disease (BD).Objectives:The aim of the study was to examine associated factors for poor OHRQoL status to improve treatment outcomes in patients with BD.Methods:In this retrospective study, 339 BD patients (F/M: 179/160, mean age: 36,13±9,81 years) included. Data were collected by a structured questionnaire regarding treatment expectation, Oral Health Impact Profile-14 (OHIP-14) questionnaire for OHRQoL, oral ulcer activity, and disease severity score. Treatment expectation was coded by a 5-point Likert type scale (1: symptoms were completely cured vs 5: symptoms were worsened). OHIP-14 score was between “0 point (the best score)” and “56 points (the worst score)”. The disease severity score was calculated according to the organ involvement. Then, patients were categorised as mucocutaneous involvement (n=181) and severe organ involvement (n=158). After preliminary analysis, a Moderated Mediation analysis was carried out.Results:Oral ulcer activity was seen in 63,4% of the group (n=215). OHIP-14 score (22,05±16,47) was correlated with Treatment expectations (2,35±0,98) (r: 0,36 p=0.000) in the group. Poor scores of OHIP-14 and Treatment expectations were found in patients with active oral ulcers (mucocutaneous involvement: 27,56±14,55; 2,68±0,87, vs severe organ involvement: 28,51±17,25; 2,43±0,99) compared to those of inactive patients (mucocutaneous involvement: 13,38±12,23; 1,81±0,73 vs severe organ involvement: 8,79±10,19; 1,85±1,02) (p=0.000 for all). Patients with active oral ulcers were younger (35,09±9,52) than the others (39,57±10,06) in the mucocutaneous involvement group (p=0.0011) whereas a similar relation was not seen in the severe organ involvement (p=0.233).In the moderated mediation analysis, it was found that OHIP-14 score was increased by the presence of oral ulcer in the direct path (p=0.0000) and the negative Expectation of the treatment as a first mediator (p = 0.0001) in the indirect path. Oral ulcer activity was associated with younger patients (p=0.0039). This effect was seen especially in patients with mucocutaneous involvement that had a moderator effect (p=0.0040). In addition, age was found to be a second mediator for the poor OHIP-14 score (p = 0.0053). Mediators and the moderator were found to effective for OHIP-14 score a bootstrap analysis with 5000 replications.Conclusion:OHRQoL was affected by oral ulcer activity and poor treatment expectations. Age was also found to be another critical factor for OHRQoL.Disclosure of Interests:None declared

Impact of maxillofacial prosthetic rehabilitation on oral health-related quality of life for patients with oral cancer: A prospective case series.

PurposeThe purpose of this study was to evaluate the effect of oral rehabilitation (maxillofacial prosthetic intervention and oral hygiene instruction) on oral health-related Quality of Life (OHRQoL) and oral hygiene condition in patients with maxillofacial defects and to explore the correlation between them in these patients. MethodsTwenty-five patients with maxillofacial defects who had been treated since April 2016 to March 2018 were included in this study. The scores of the Oral Health Impact Profile (OHIP) and O’Leary’s Plaque Control Record (PCR) were also identified as the scores of OHRQoL and oral hygiene condition, respectively. Statistical analyses were performed to compare between the scores of “pre” and “post” prosthetic treatment and to evaluate patient-related factors influencing these variables (age, the number of residual teeth and occlusal supports, and occlusal units (OUs)). The effect of combined chemo-radiotherapy (CRT) on each score was also assessed statistically. Furthermore, the correlation of OHIP and PCR scores was explored statistically. ResultsBoth oral rehabilitations could significantly improve OHIP and PCR scores. Significant correlations of the change of OHIP scores with age and OUs were detected. CRT had no significant effect on OHIP and PCR scores. No correlations between OHIP and PCR were observed. ConclusionsAlthough oral rehabilitation such as maxillofacial prosthetic treatment and oral hygiene instruction would be highly effective for improvement of OHRQoL and oral hygiene condition in patients with maxillofacial defects, there was no correlation between them.

To assess the association between length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. Thirty head and neck cancer participants reported their oral health-related quality of life using the oral health impact profile-14 instrument and their global self-rating of general and oral health. All patients had received chemotherapy and radiotherapy. The length of dental arch was assessed in three tooth relational categories: canine-to-canine, shortened (premolars to premolars), and long (molars to molars) dental arches. Inclusion of participants for any of the three categories required verification of opposing teeth relationship with Shim Stock paper. Out of 30 head and neck cancer patients, eight (27%) had a canine-to-canine dental arch, 14 (46%) had a shortened dental arch, and eight (27%) had a long dental arch. The median oral health impact profile-14 scores for participants respectively with the canine-to-canine dental arch was six (IQR = 9.25), seven (IQR = 8) for participants with shortened dental arch, and 11 (IQR = 12.5) for participants with long dental arch. There were no significant differences in oral health impact profile-14 scores between the three-tooth relational groups (Kruskal-Wallis H = 0.769, df = 2, P-value = .681). Similarly, there were no significant differences between three-tooth relational groups on the self rating of general (Chi-squared = 1.714, df = 2, P-value = .424) and oral health (Chi-squared = 1.393, df = 2, P-value = .498). Within the limitations of this study, no association was found between the length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. Other factors such as dry mouth, oral mucositis, loss of taste, and trismus should be considered as contributory factors to reduced oral health-related quality of life in head and neck cancer patients post-radiotherapy, particularly in relation to eating difficulties.

Objective: This cross-sectional study aimed to evaluate the association of oral health-related quality of life with prosthetic rehabilitation status and dental prosthesis condition in residents of Brazilian long-term care facilities. Methods: The oral health-related quality of life of older adults (n = 194; mean [standard deviation] age = 78.93 [9.10]) was assessed by the Geriatric Oral Health Assessment Index and the Oral Health Impact Profile questionnaires. Prosthetic rehabilitation status was recorded according to the absence of teeth and use of dental prostheses. Dental prosthesis condition was considered good or poor based on stability, retention, occlusion, vertical dimension, and defects. Poisson regression models were plotted to analyze the data (α = 0.05). Results:Lower Geriatric Oral Health Assessment Index scores were associated with edentulism with denture use only on one jaw (B = -0.05) and poor dental prosthesis stability (B = -0.04). Similarly, edentulous participants with denture only on one jaw (B = 0.59) and those wearing dental prostheses with poor stability (B = 0.36) are more likely to achieve higher Oral Health Impact Profile scores. Also, lower Oral Health Impact Profile scores were associated with denture defects (B = -0.34). Conclusion:In summary, the oral health-related quality of life of older adults living in longterm care facilities is negatively impacted by edentulism with denture only on one jaw and use of dental prostheses with poor stability. Therefore, long-term care facilities should provide oral health training to caregivers, include dental professionals in the staff, and articulate demands with oral health teams in the primary care system.

Objective: To estimate the prevalence of temporomandibular disorders in adolescent orthodontic patients with different dental malocclusions and to assess the relationship between oral health-related quality of life. Methods: This study was carried out on 648 randomly selected individuals 14–19 years of age. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), Fonseca Questionnaire, and Oral Health Impact Profile-14 (OHIP-14) forms were used. Results: The GCPS, TMD Pain, Fonseca, OHIP-14, PHQ-9, GAD-7, OBC, and PHQ-15 mean scores of female participants were statistically significantly higher than males (p < 0.05).There was a significant difference among the malocclusion groups in terms of their mean scores in GCPS, Fonseca, and OHIP-14 (p < 0.05).The age values and JFLS, TMD Pain, Fonseca, OHIP-14, PHQ-9, GAD-7, and PHQ-15 were statistically significant correlations in the positive direction. Conclusion: The DC/TMD form allows both a physical assessment of Axis I and II that examines psychosocial status and pain-related disorders and a more comprehensive assessment. The mean OHIP-14 and Fonseca questionnaire scores of Class III groups were found to be significantly higher.

Objective: It is crucial to understand how individuals perceive the impact of oral disorders and the treatment associated with or received for those disorders on their quality of life. A relatively new but quickly spreading concept of oral health-related quality of life (OHRQoL) that notably affects three fields, clinical dental practice, dental research, and dental education makes it feasible to figure out the relationship between oral health and its impact on the quality of life of an individual. OHRQoL can be measured in various ways; the most well-liked method uses a multiple-item questionnaire. There haven't been any prior attempts to compare the effects of various invasive and non-invasive dental therapies on OHRQoL, even though few studies have been conducted to evaluate the OHRQoL among patients undergoing independent dental procedures. Such a comparison would aid in our understanding of not only how various dental conditions affect OHRQoL, but also whether or not a patient’s OHRQoL has improved as a result of various therapies for these diseases.Method: A longitudinal study was conducted on patients receiving invasive and non-invasive dental treatment at Teerthanker Mahaveer Dental College and Research Centre, Moradabad. A two-part questionnaire, the first part of which consists of questions related to the demographic details of the patient and the second part consisting of a set of 14 questions of the oral health impact profile (OHIP)-14 for assessing the OHRQoL, was used in the study. Patients' baseline OHRQoL was assessed before the commencement of any treatment by the interview method and follow-up OHRQoL was assessed three days, seven days, one month, and six months post-treatment telephonically. The OHIP-14 contains 14 items on the frequency of adverse impacts caused by oral conditions and the patients were asked to rate each item on a 5-point Likert scale as 0=never; 1=hardly ever; 2=occasionally; 3=fairly often; 4=very often.Results: The results obtained after compiling and analyzing the data from a total sample of 400 indicate that the mean difference in the OHIP score at different time intervals between the groups who undertook invasive and non-invasive treatment was significant as the p-value was less than 0.05. In addition, it was observed that the mean difference at baseline was statistically significant in the invasive and non-invasive groups as the p-value is less than 0.05. At the domain level, the mean score at each domain was higher in the invasive group as compared to the non-invasive treatment group after three days and seven days of treatment. The mean difference between the group treated with invasive treatment on day three and the group treated with non-invasive treatment on day seven was statistically significant as the p-value is less than 0.05. The mean score was high in the invasive group as compared to the non-invasive group after one month and six months of treatment.Conclusion: The present study was conducted to assess dental treatment’s impact on oral health-related quality of life in patients attending Teerthanker Mahaveer Dental College and Research Centre, Moradabad. Results from this study indicated that both types of treatments either invasive or non-invasive have significantly influenced the OHRQoL. Post-treatment OHRQoL improved at different intervals after receiving either treatment.

Background and objective: To date, there have only been a few studies on oral health-related quality of life (OHRQoL) of people with Ehlers–Danlos syndromes (EDS) and oral conditions. The aim of this study was, therefore, to analyze the OHRQoL of people with EDS from their own point of view as well as obtain information about their age at the time of the diagnosis, the period of time until diagnosis, and the presence of oral conditions (if any) and their association with oral health quality. Methods: The study was designed as an anonymous questionnaire-based cross-sectional study. We conducted a descriptive analysis of the Oral Health Impact Profile-14 (OHIP-14) scores, age of the participants, age at diagnosis, and the time-period between the first signs of the disease and the diagnosis of EDS. To verify the differences in OHIP-14 scores between patients with and without oral conditions, a Mann–Whitney U test was performed. A multivariate quantile (median) regression analysis was performed to evaluate the effect of different general characteristics (gender, age, and the presence of oral conditions) on the OHIP 14 scores. Furthermore, using a Mann–Whitney U test, the influence of different oral conditions was verified by testing the differences between patients without any oral conditions and patients with a specific diagnosis. Results: A total of 79 evaluable questionnaires from 66 female (83.5%) and 13 male (16.5%) participants were analyzed. On average, after the first condition, it takes 18.36 years before EDS are correctly diagnosed. Oral conditions were described by 69.6% of the participants. The median (interquartile range) OHIP-14 score was eight (ten) points for patients without oral conditions and 19 (15) for patients with oral conditions. The multivariable quantile regression shows a statistical notable association between OHIP-14 score and oral conditions (p < 0.001). OHIP-14 scores for dysgnathia, periodontitis, TMD (Temporomandibular dysfunction), a high-arched palate, malocclusion, and the anomaly of tooth formation were statistical notably different between the participants with and the participants without oral conditions. Conclusions: Long diagnostic pathways seem to be a typical problem in patients with EDS. Oral conditions associated with the underlying disease occurred regularly and showed a negative correlation with OHRQoL.

Long-term changes in oral health-related quality of life over a period of 5 years in patients treated with narrow diameter implants: A prospective clinical study