Oral-health-related quality of life in headgear and functional appliances therapy
Kadkhoda S, Nedjat S, Shirazi M. Comparison of oral-health-related quality of life during treatment with headgear and functional appliances. Int J Paediatr Dent 2011;21:369-73
Since successful orthodontic treatment depends on patient compliance, an appreciation for the psychosocial aspects involved in treatment is essential. Functional appliances and headgear are 2 compliance-dependent approaches to correcting a Class II malocclusion. In this study, the authors examined the psychosocial impact of these treatments on the daily life of patients, compared with a nonmalocclusion group. A total of 187 Iranian children, aged 11 to 14, were divided into 3 groups: functional appliance (n = 67), headgear (n = 67), and nonmalocclusion (control) (n = 53). The subjects were recruited from government and private orthodontic practices. All participants completed the oral health quality of life (OHQoL) child perception questionnaire (CPQ, short form), which encompasses 4 domains: oral symptoms, functional limitations, emotional well-being, and social well-being. The results indicate that the 2 treatment groups did not differ, but they had a poorer quality of life compared with the nonmalocclusion group. No differences were found among the 3 groups in the “oral symptoms” subscale of the CPQ. No OHQoL differences were found between sexes. Several studies have demonstrated obvious differences between malocclusion and nonmalocclusion groups, with the malocclusion groups experiencing lower OHQoL. This was the first study comparing the OHQoL of 2 groups of patients with Class II malocclusion under treatment with 2 approaches. Further studies on this topic would enhance our understanding of the psychosocial impact of orthodontic therapy on our patients.
Reviewed by Christine Hibberd
Malocclusion and sex as risk factors for maxillary incisor trauma
Borzabadi-Farahani A, Borzabadi-Farahani A. The association between orthodontic treatment need and maxillary incisor trauma, a retrospective clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011 Aug 29 [Epub ahead of print]
Incisor trauma can cause physical, psychological, and functional problems in children. In this study, the authors investigated whether sex, the complexity of the malocclusion, and the need for orthodontic treatment were risk factors for incisor trauma. A cross-sectional study involving stratified clusters from 6 schools was conducted. The severity of malocclusion with the index of complexity, outcome, and need (ICON), and the type and degree of incisor trauma (if present), were determined by 1 examiner in 249 boys and 253 girls. No radiographic investigation was performed. The prevalence of incisor trauma was 9% (trauma to dentin, 1.4%; trauma to pulpal tissue, 0.8%; trauma to enamel, 6.2%). Logistic regression suggested that boys had a 2.16-times higher risk of trauma than did girls. Subjects needing orthodontic treatment (ICON score, >43) were found to have a higher risk of trauma. The findings of this study support previous reports indicating an association between malocclusion and the need for orthodontic treatment and the risk of incisor trauma. Study limitations included the lack of radiography when diagnosing incisor trauma. The authors did not specifically consider factors that have been known to increase the risk of incisor trauma such as overjet, adequacy of lip coverage, and children’s high-risk daily activities. Nevertheless, these findings are pertinent to the benefits of orthodontic treatment in reducing overjet, a recognized risk factor for maxillary incisor trauma.
Reviewed by Sean E. V. Chung