Oral Health Impact Profile Summary Scores Research Articles

Effect of treatment with implant-supported fixed partial dentures on oral health-related quality of life in patients with unilateral shortened dental arch

Background/purposeImplant-supported fixed partial dentures (IFPDs) are a treatment option for partially edentulous dentition with missing posterior-most molars despite the concept of a shortened dental arch (SDA). This study aimed to evaluate the effect of IFPD treatment on oral health-related quality of life (OHRQoL) in patients with unilateral SDA missing two adjacent molars and to compare the effects of single- and two-unit IFPDs. Materials and methodsForty patients with unilateral SDA missing two adjacent molars (Kennedy Class II) participated in this study; 11 patients received one implant placement in the first molar and were treated with a single-unit IFPD (single-unit group), and 29 received two implant placements and were treated with a two-unit IFPD (two-unit group). The Oral Health Impact Profile (OHIP) questionnaire for OHRQoL assessment and the gummy jelly test for objective masticatory performance were administered before and after IFPD treatment. The Wilcoxon signed-rank test for all patients and Mann–Whitney U test were performed for pre- and post-treatment comparisons and between-group comparisons, respectively. ResultsThe OHIP summary score and gummy jelly glucose concentration in all patients showed significant improvements after treatment (all P < 0.05). No significant differences were observed between the single- and two-unit groups for any of the items. Using the minimal important difference in the OHIP summary score, 63.6 % and 58.6 % of patients in the single- and two-unit groups, respectively, showed improvement by 6 points or more. ConclusionIFPD treatment for patients with SDA missing two adjacent molars may provide clinically meaningful improvements in OHRQoL.

Association between the treatment choice of implant-supported fixed partial dentures and oral health-related quality of life in patients with a shortened dental arch: A preliminary observational study

Background/purposeIn cases of missing posterior teeth, treatment modalities based on the shortened dental arch (SDA) concept may be a viable alternative. However, the association between oral health-related quality of life (OHRQoL) and patients’ treatment decisions remains unclear. This study aimed to investigate the association between OHRQoL and the decision to be treated with implant-supported fixed partial dentures (IFPDs) or take a wait-and-see approach in patients with an SDA missing a single second molar and to clarify the impact of IFPD treatment on the OHRQoL. Materials and methodsThe Oral Health Impact Profile (OHIP) questionnaire was administered twice (pre- and post-treatment) and once to 41 patients with a unilateral SDA missing a single second molar who chose IFPD treatment (IFPD group, n = 22) and the wait-and-see approach (no treatment group, n = 19), respectively. Logistic regression analysis was performed with IFPD treatment choice as the objective variable and the four OHIP dimension scores, age, and sex as covariates. The pre- and post-treatment values of the OHIP summary and four-dimension scores were compared using a paired t-test. ResultsThe IFPD treatment choice was significantly associated with sex (male), higher Oral Function dimension scores, and lower Psychosocial Impact dimension scores (all P < 0.05). The OHIP summary and four-dimension scores were significantly lower following IFPD treatment (all P < 0.05). ConclusionIFPD treatment for a single missing second molar may be clinically beneficial for improving the OHRQoL of patients with an SDA who experience a decline in masticatory function.

Impact of loading protocol of a mandibular single implant-supported complete denture on oral health-related quality of life over a period of 5 years: A randomized controlled trial

ObjectivesThe aim of the present study was to assess the long-term course of OHRQoL and the impact of the loading protocol in patients receiving a single mandibular implant supporting a complete denture over a period of five years. MethodsIn this multicenter RCT, a total of 158 edentulous patients were initially included and were randomly allocated immediately after placement of a mandibular midline implant to either immediate loading (IL) or to conventional loading (CL) with submerged healing. The assessment of OHRQoL was performed with the 49-item Oral Health Impact Profile (OHIP) at baseline and 1, 4, 12, 24, and 60 months after loading. At 5-year follow-up, 100 patients (mean age: 69.2 years; 45.0% female) with completed OHIP were available for analyses. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement. ResultsThe OHRQoL improved substantially after loading, indicated by a decrease of mean OHIP summary scores from 51.0 points at baseline, by 14.2 (95%-CI: 9.4 – 19.1; p<0.001) points to 37.2 points at 1-month follow-up, and by continuous improvement to 20.4 OHIP points at final follow-up. Considering constant treatment effects, the loading protocol had no significant effect on OHIP scores (-3.7, 95%-CI: -9.4 – 2.2; p = 0.204). Time effect was statistically significant with -0.21 (95%-CI: -0.28 – -0.15; p<0.001) points per month. ConclusionBoth the immediate and conventional loading of a single mandibular midline implant supporting a complete denture offer long-lasting high levels of OHRQoL, with no significant or clinically relevant long-term differences. Clinical significanceThe study firstly presents long-term data for OHRQoL by investigating the loading protocol of single mandibular implant-supported complete dentures. Since immediate loading has been associated with a reduced implant survival rate for this concept, information on patient benefits is essential for evidence-based decision making.

IMPACT OF LOADING PROTOCOL OF 2-IMPLANT BAR-RETAINED MANDIBULAR OVERDENTURES ON ORAL HEALTH-RELATED QUALITY OF LIFE: A RANDOMIZED CONTROLLED TRIAL.

Aim was to assess whether immediate loading (IL) is more effective than delayed loading (DL) for 2-implant bar-retained mandibular overdentures in terms of oral health-related quality of life (OHRQoL) improvement over a period of 24-month. In this randomized controlled trial, 32 edentulous patients (mean age: 65.7 ± 10.6 years, 50.0% female) were included. Potential participants had to be unsatisfied with the retention of their current mandibular complete denture and demanded implant treatment for inclusion in the study. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP) at baseline before treatment and 1, 3, 6, 12, and 24 months after implant loading and insertion of implant-retained bars for overdenture support. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement. Patients' OHRQoL impairment at baseline was substantial indicated by mean OHIP summary score of 45.1 points. OHIP summary scores decreased substantially from baseline to 1-month follow-up to a mean of 33.5 points (P = .020). OHRQoL further improved during study period indicated by OHIP summary score of 25.7 points at 24-month follow-up. Raw treatment effects (IL vs. DL) ranged from -1.2 OHIP points for 12-month follow-up to 5.8 OHIP points for 24-month follow-up. Assuming constant treatment and time effects, treatment effect was small and not statistically significant (-0.7 OHIP points; P= .918). A 2-implant bar-retained mandibular overdentures substantially improves OHRQoL over a period of at least 24 months. There seems to be no significant effect of implant loading protocol.

Measuring oral health: The Physical Oral Health Index

ObjectivesOral health is an important component of a person's general health. Studies focusing on this issue need valid and reliable tools to assess oral health. Aim was to develop a comprehensive measure for physical oral health and to establish its measurement properties. MethodsThe construct physical oral health was defined based on a systematic literature review and a modified Delphi technique in an expert panel (n = 31). The preliminary tool was applied in a multicenter study (n = 609) to gain empirical data on acceptance, item characteristics, reliability, and responsiveness. Validity was assessed as correlation of sores with patients’ and experts’ global oral health ratings and Oral Health Impact Profile (OHIP) summary score. Based on findings of field testing, the tool was modified to derive the final version of the Physical Oral Health Index (PhOX). Finally, measurement properties of the PhOX were determined. ResultsThe PhOX consists of 14 items covering all relevant oral health structures and conditions. For repeated measures, reliability of the summary score was high (ICC = 0.87). The summary score was correlated in the expected direction to patients’ (r = 0.43) and examiners’ (r = 0.55) global oral health ratings and to OHIP summary scores (r = -0.41). Among patients receiving dental treatments between two assessments, PhOX summary scores increased from baseline to follow-up statistically significantly (p = 0.002). ConclusionsThe newly developed PhOX is a methodologically sound and easy to apply tool for the comprehensive assessment of physical oral health.

IMPACT OF SHORTENED DENTAL ARCH ON ORAL HEALTH-RELATED QUALITY OF LIFE

BackgroundA shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars. ObjectivePurpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement. MethodsPatients at least 35 years of age with all molars missing in 1 jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars (n = 79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis (n = 71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed. ResultsAfter an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the 2 treatments (0.4 OHIP points; 95%-CI: 7.1 - 6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well (P = .872). Similar findings were observed in all 4 OHRQoL dimensions. ConclusionsIn patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients’ preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default.

Cost-effectiveness analysis of prosthetic treatment with thermoplastic resin removable partial dentures.

The aim of this study was to compare the cost-effectiveness of thermoplastic resin removable partial dentures (TR-RPDs) with metal clasp-retained removable partial dentures (MC-RPDs), from the patients' perspective. Patient-reported outcome measures (Oral health-related quality of life [OHRQoL], patient satisfaction, oral appearance) were assessed among 24 partially dentate subjects who completed a randomized crossover trial comparing TR-RPDs and MC-RPDs. The prosthetic treatment fee for patients was used as the direct cost. The cost of achieving a clinically minimum important difference (MID) in Oral Health Impact Profile (OHIP) summary score, and the incremental cost-effectiveness ratio (ICE R) for each outcome measure were determined. OHRQoL, patient satisfaction, and oral appearance was rated higher with TR-RPDs compared to MC-RPDs. The median cost of achieving a MID in OHRQoL with TR-RPDs ($698) was 6.5 times higher than that with MC-RPDs ($107). The ICER was $67 for the OHIP summary score, $195 for the satisfaction score, and $1,169 for the oral appearance rating. Although TR-RPDs provide better OHRQoL, patient satisfaction, and oral appearance than MC-RPDs, the cost-effectiveness of TR-RPDs was inferior to MC-RPDs from the patients' perspective.

Methodological considerations when measuring oral health-related quality of life.

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. 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. 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. 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.

Pre-treatment impairment of oral health-related quality of life is associated with variations in minimal clinically important differences among patients with removable partial denture treatment.

The minimal clinically important differences (MID) of the Oral Health-related Quality of Life (OHRQoL) are the benchmark to meaningfully interpret treatment outcomes. However, there is no available information regarding the factors impact the MID variations after removable partial denture (RPD) treatment. The purpose of this study was to determine the influence of the pre-treatment OHRQoL impairment on the MID in the oral health impact profile (OHIP) after RPD treatment. In this prospective study, OHIP and Self-reported Oral Health (SROH) questionnaires were administered to patients before and 3months after RPD treatment. The MID in each OHIP version (OHIP-49, OHIP-20, OHIP-14 and OHIP-5) was the mean score of patients who showed a minimum SROH improvement. Multiple linear regression analysis was conducted to determine the influence of the pre-treatment OHIP summary score on the MID score. Among 248 participants who completed both evaluations, 85 (34%) patients had minimum SROH improvements after RPD treatment. Multiple regression analysis indicated that each 10-point increase in the pre-treatment summary OHIP score was associated with an increase in the MID score of three points for OHIP-49 and four points for OHIP-20, OHIP-14 and OHIP-5 (P<.05), after controlling for age, sex and the number of missing teeth. Therefore, the MID increased as the pre-treatment OHRQoL was impaired. The MID was accounted for by approximately one-third of the pre-treatment summary score, independent of the OHIP version, in the interpretation of the effects of RPD treatment on patients' OHRQoL.

Impact of implant superstructure type on oral health-related quality of life in edentulous patients.

The effect of the type of implant superstructure on oral health-related quality of life (OHRQoL) among edentulous patients remains controversial. The purpose of this study is to investigate the association between the type of implant superstructure and OHRQoL. Seventy-two completely edentulous patients who received implant fixed complete dentures (IFCDs) or implant overdentures (IODs) were administered the Oral Health Impact Profile (OHIP) questionnaire during the post-treatment maintenance period. The OHIP summary score, as well as the four dimension scores, were calculated to evaluate OHRQoL. The mean OHIP summary score for the IFCD group tended to be lower than that for the IOD group, but this difference was not statistically significant (19.9 ± 21.9, 22.8 ± 18.2, respectively; P = .57). However, a significant group difference was found in the four dimension scores (P < .01), with the OHIP item scores representing masticatory function being significantly lower in the IFCD group than in the IOD group (P < .05). Our results suggested that patients with an IOD exhibited comparable OHRQoL to those with an IFCD, with the exception of perceived masticatory function.

Predicting Patient-Reported Outcomes of Dental Implant Treatment.

To investigate whether pretreatment patient-related factors are associated with the outcomes of dental implant treatment through multidimensional evaluations of oral health-related quality of life and health-related quality of life using the Oral Health Impact Profile (OHIP) and the 36-Item Short Form Health Survey (SF-36) developed from the Medical Outcomes Study, respectively. Oral health-related quality of life was evaluated using the Japanese version of the OHIP, and health-related quality of life was evaluated using scores for the mental component summary (MCS) and physical component summary (PCS) dimensions of the SF-36. Data were collected before treatment (baseline) and 1 month after delivery of the prostheses (follow-up). Stepwise multivariate regression analysis was used to explore the associations of posttreatment OHIP and SF-36 scores and changes in these scores after treatment (dependent variables) with age, sex, educational background, number of missing teeth, Eichner's classification, pretreatment state, site of the embedded implant, number of implants, types of definitive prostheses, and baseline OHIP and SF-36 scores (independent variables). Data from 150 consecutive patients (mean age: 58.1 ± 11.5 years) who underwent dental implant treatment between April 2008 and April 2016 were analyzed. The mean OHIP summary score, OHIP dimension scores (oral function, orofacial pain, orofacial appearance, and psychosocial impact), and MCS score showed significant improvements after treatment (P < .05). The baseline OHIP and SF-36 scores were consistently and significantly associated with the treatment outcome (ie, dependent) variables (P < .05). Moreover, the site of the embedded implant was identified as a significant predictor of the posttreatment status and changes in the OHIP summary score, oral function and orofacial appearance dimension scores (OHIP), and MCS score. These results suggest that patient perceptions of health and oral health conditions may help in the prediction of the outcomes of dental implant treatment.

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

ObjectivesThe aim of this study was to assess long-term changes in oral health-related quality of life (OHRQoL) over a period of 5 years in patients treated with narrow diameter implants (NDI) in the mandible for support of an overdenture. MethodsIn this prospective clinical study, a consecutive sample of 20 edentulous patients who had worn sufficient complete dentures for at least 12 weeks was provided with four immediately loaded one-piece titanium NDIs in the mandible. The German 49-item version of the Oral Health Impact Profile (OHIP) was applied to assess OHRQoL at baseline and all follow-ups (4 and 8 weeks, 3, 6, and 12 months, and 3 and 5 years after treatment was finished). ResultsBefore treatment, OHRQoL was substantially impaired indicated by high OHIP summary score (39.9 points). Four weeks after treatment, a substantial treatment-induced drop of OHRQoL impairment was observed (21.8 OHIP points), and at all follow-ups, OHIP scores were lower than at baseline (15.9–26.5 OHIP points; ANOVA: p<.001). Based on mixed-effect linear regression analyses, the treatment-induced effect on OHRQoL improvement over the entire study period was statistically significant for the OHIP summary scores as well as for all four OHIP domains: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact (all: p<.001). ConclusionsThis study suggests that four immediately loaded NDIs for the support of conventional complete dentures in edentulous patients with substantially impaired OHRQoL may lead to a long-lasting treatment-induced improvement in OHRQoL. Clinical significanceThe provision of four NDI in the edentulous mandible is a promising treatment option for patients with substantial OHRQoL impairment and a positive attitude towards implant treatment. Furthermore, patients can be informed that improvements in OHRQoL are expected to last for at least 5 years.

Location of implant-retained fixed dentures affects oral health-related quality of life.

The effects of the locations of dental implants on treatment outcomes, as evaluated by oral health-related quality of life (OHRQoL) assessment, remain controversial. To investigate the association between the locations of dental implants and changes in OHRQoL. Sixty-eight subjects received implant treatment in the anterior or posterior region and completed the Oral Health Impact Profile (OHIP) questionnaire before and after treatment. Change in OHIP summary scores and the 4 dimension scores were calculated to evaluate the effects of implant treatment on OHRQoL. The mean Oro-facial Appearance score for the anterior group was significantly higher than that for the posterior group (10.4 ± 5.1 and 7.2 ± 3.8, respectively; P ＝ .005; Effect size = 0.63) at baseline. All questionnaire scores were significantly improved following implant treatment in both groups, and no significant group differences were observed at follow-up. Regression analysis revealed a significant association between the locations of most anterior implants and changes in the Oro-facial Appearance score (adjusted R2 = 0.073; P = .015). Our results suggest that the locations of dental implants influence OHRQoL impairments and improvements after treatment. This information might be useful in clinical decision-making.

Shortened dental arch and prosthetic effect on oral health‐related quality of life: a systematic review and meta‐analysis

This systematic review aimed to compare oral health-related quality of life (OHRQoL) between two tooth replacement strategies - the shortened dental arch (SDA) concept and conventional treatment with removable partial dental prosthesis (RPDP) or implant-supported fixed partial dental prosthesis (IFPDP) - for distal extension of edentulous space in the posterior area. We retrieved eligible randomised controlled trials (RCTs) and non-RCTs published between 1980 and November 2016 retrieved from MEDLINE and the Cochrane Central Register of Controlled Trials. The primary outcome was OHRQoL evaluated using validated questionnaires. Two reviewers independently screened and selected the articles, evaluated the risk of bias and determined the standardised weighted mean difference (SWMD) in OHRQoL scores between the two strategies using a random effects model. Two RCTs and one non-RCT involving 516 participants were included in this review. All studies employed the oral health impact profile (OHIP) for evaluation of OHRQoL. There was no statistically significant difference in OHIP summary scores between SDA and RPDP at 6 (SWMD = 0·24) or 12 (SWMD = 0·40) months post-treatment. Only one non-RCT had reported higher OHRQoL with IFPDP than with SDA; however, because of the small sample size, there was no significant difference in OHIP summary scores between the two strategies at 6 (SWMD = -0·59) or 12 (SWMD = -0·67) months post-treatment. In terms of OHRQoL in partially dentate patients, the SDA concept appears to be as feasible as RPDP restoration. Further clinical trials are required to clarify the effect of IFPDP restoration on OHRQoL.

The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer.

To analyze the influence of dental treatment on oral health-related quality of life (OHRQoL) in head and neck cancer patients. This study included the data of 116 patients who underwent radiotherapy (RT) because of head and neck cancer. For each patient, the variables age, sex, tumor site, irradiation technique, dose on the spared parotid gland, concomitant chemotherapy, and denture status were documented. OHRQoL was determined using the OHIP-G14 questionnaire. Patients were divided into subgroups according to denture status: none or fixed partial dentures (none/FPD), removable partial dentures (RPD), and full dentures (CD). OHIP summary scores were determined and tested for clinical relevant differences with respect to the different variables. The association between OHRQol and the variables was assessed using linear regression. No clinically relevant influence on OHRQoL was found for gender, irradiation technique, and chemotherapy. Patients with tumors located in the oral cavity had a significantly higher OHIP score than patients with other tumor sites (p<0.001). None/FPD and RPD patients had higher values than those found in a normal population, but did not differ significantly from each other (p=0.387). In contrast to tumor site, teeth and type of denture seem to have a limited effect on OHRQoL in head and neck cancer patients. Prosthetic treatment in head and neck cancer patients do not lead to the same improvement in OHRQoL as found in the normal population. This might be taken into account especially if extensive dental treatment is intended.

Four-implant overdenture fully supported by a CAD-CAM titanium bar: A single-cohort prospective 1-year preliminary study

Statement of problemIn patients with an altered skeletal maxillomandibular relationship and bone resorption, the rehabilitation of edentulous jaws by combining 4 implants, 2 straight medially and 2 tilted distally, may be preferred to avoid a bone augmentation procedure. PurposeThe purpose of this single cohort 1-year prospective study was to evaluate the clinical performance of a 4-implant overdenture fully supported by a computer-aided designed and computer-aided manufactured (CAD-CAM) titanium bar. Material and methodsThis single cohort prospective study included edentulous participants rehabilitated with a 4-implant overdenture in 1 of the 2 jaws. The outcomes were implant and prosthetic survival and success rates, any biologic and technical complications, periimplant marginal bone loss, changes in the oral health impact profile (OHIP), bleeding on probing, and the plaque index. ResultsEighteen participants received 72 implants. One year after implant placement, no implants or prosthesis had failed, and no biologic or technical complications had been observed. At the 1-year follow-up, the mean marginal bone loss was 0.29 ±0.16 mm. The OHIP summary scores demonstrated a significant improvement in oral health-related quality of life. At the 1-year follow-up, positive bleeding was found in 2 participants (11.1%) around 3 implants (4.1%). Three participants (16.6%), accounting for 5 implants (6.9%), showed a slight amount of plaque. ConclusionsA 4-implant overdenture supported by a CAD-CAM titanium bar may be a reliable option for the treatment of the edentulous mandible and maxilla over a 1-year period. Oral health-related quality of life significantly improved in all treated participants.

Factors Affecting Oral Health-Related Quality of Life Among Elderly Croatian Patients.

Oral health-related quality of life (OHRQoL) as a multidimensional concept is affected by many factors. Therefore, the aim of this study was to determine which demographic and subjective factors are significantly affecting the OHRQoL among the elderly people wearing complete removable dental prostheses (CRDP). This questionnaire-based study included 301 participants, residents of elderly care homes (in Zagreb and Slavonski Brod, Croatia) wearing maxillary and/or mandibular CRDP. The questionnaire used in this study consisted of two sections; the first section included questions giving general information and in the second section the Croatian version of Oral Health Impact Profile (OHIP)-49 questionnaire with 49 items representing seven OHIP domains was used. Participants were aged between 60-99 years, with average age of 74 ± 12.1 years. OHIP summary score was 26.5. The highest average OHIP mean values in the domain of functional limitation amounted to 6.7, physical pain 5.1, and physical disability 5.9. The participants' age, education, profession, residence place size, type of CRDP, and the time of denture wearing period all statistically significantly affected OHRQoL (p < 0.05). General and sociodemographic factors had a significant influence on the participant's subjective perception of oral health and OHRQoL. Younger participants, participants from rural places, those with lower levels of education, and shorter period of denture wearing demonstrated a higher impact on OHRQoL.

Impact of resin bonded bridgework on quality of life of patients with hypodontia

ObjectivesTo determine the impact of hypodontia on the quality of life of adolescent and young adult patients, and, to assess the impact of restoring tooth spaces with resin bonded bridgework on quality of life of patients with hypodontia. MethodsIn a prospective study, 82 patients with a confirmed diagnosis of hypodontia participated. The primary outcome was oral health related quality of life (OHRQoL) and this was measured using the OHIP-49 prior to treatment. The pre-treatment sample was then divided into two groups: the test group (n=40 patients) who had completed orthodontic treatment and had tooth spaces restored with resin bonded bridgework, and, a control group (n=42 patients) who were still in the process of orthodontic treatment. All patients completed a follow-up OHIP-49, and between and within group comparisons made. ResultsThe pre-treatment sample included 43 females and 39 males, age ranged from 16 to 34 years (median age 19). Forty-three patients had more than 4 congenitally missing teeth and thirty-nine had ≤4 congenitally missing teeth. There were no differences between the groups prior to treatment. For the test group, there was a significant improvement in median OHIP summary scores (p<0.001) after treatment. OHIP scores deteriorated to a significant degree for control subjects (p=0.002). The effect sizes for the pre–post treatment change in both groups were moderate to large. ConclusionsHypodontia has a significant impact on oral health related quality of life. Provision of resin bonded bridges has a positive impact on oral health related quality of life of patients with hypodontia.

Impact of response shift on the assessment of treatment effects using the Oral Health Impact Profile

The assessment of changes in oral health-related quality of life (OHRQoL) is challenging because individuals' concepts and internal standards of OHRQoL may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile (OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQoL before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQoL after treatment, patients were also asked to rate their pre-treatment OHRQoL without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size (Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively.

Association of cephalometric changes after 5 years of complete dentures wearing and oral health-related quality-of-life

Objective. The aim was to investigate cephalometric changes after 5 years of wearing complete dentures (CDs) and to asses a possible relationship between changes in cephalometric parameters and patients' oral health-related quality-of-life (OHRQoL). Materials and methods. New complete maxillary and mandibular dentures were fabricated for 30 participants. Two lateral radiographs were obtained from each participant with their CDs in the position of maximal intercuspidation (centric relation): the first radiograph was obtained at the CDs delivery and the second one after 5 years of CDs wearing. A questionnaire (OHIP 14) was given to all participants at the 5-year appointment. Results. Significant differences in most linear and angular cephalometric measurements were found after 5 years of CDs wearing, due to the reduction of the height of the lower third of the face and the forward shifting of the mandible. A significant correlation between the OHIP summary scores and five cephalometric variables was found (ANS-Xi/Xi-Pm angle, FH/N-Pog angle, SN/Go-Gn angle, Go-Gn/ANS-PNS angle and occlusal plane/FH), indicating that more severe cephalometric changes were related with the increase of OHIP scores. Conclusion. Changes of cephalometric angles due to lowering of the face and forward shifting of the mandible were related to the decreased OHRQoL (increased OHIP scores).