Correlation of the need for orthodontic treatment between the self-perception of chilean adolescents aged 14 to 18 years and the dentist's diagnosis / Correlación de la necesidad de tratamiento ortodóncico entre la autopercepción de adolescentes chilenos de 14 a 18 años con la observación del odontólogo

Background: To correlate the need for orthodontic treatment between the self-perception of Chilean adolescents from 14 to 18 years old with the observation of a dentist using the same assessment scale, as well as to determine if covariates such as gender, age and type of school influence the self-perception of the adolescent and the examiner. Material and Methods: Cross-sectional descriptive study of adolescents aged 14 to 18 years from public, subsidized and private schools in Temuco, Chile. The probability sample is stratified by course, from first to fourth year, a total of 414 students participated, according to the eligibility criteria. The photographic score of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used. The statistical analysis of the data was performed with the SPSS Statistics program v.23. Results: 94.9% of the adolescents perceived themselves as having good aesthetics. The examiner considered that 77% presented this condition, p<0.00. Males perceived themselves better than females. At age 15, 1.7% of students considered themselves to have poor aesthetics, p<0.01. From the examiner's perspective, aesthetics are related to type of school, p<0.00. Conclusion: Adolescents perceive themselves better aesthetically than do the evaluators. The school type factor, according to the IOTN-AC examiner, shows a higher proportion of students with no need for orthodontic treatment in private schools, and a threshold need in municipal and subsidized institutions.

Correlacionar la necesidad de tratamiento ortodóncico, entre la autopercepción de adolescentes con el diagnóstico de un evaluador odontólogo, utilizando la misma escala de valoración, así también determinar si las variables como el género, la edad y la dependencia educacional influyen en la autopercepción del adolescente y la observación del examinador. Material y Métodos: Estudio descriptivo de corte transversal, en adolescentes de 14 a 18 años de escuelas públicas, subvencionadas y privadas de Temuco-Chile. Muestreo probabilístico estratificado por cursos, de primero a cuarto medio con una muestra de 414 estudiantes, según los criterios de elegibilidad. Se utilizó el score fotográfico del componente estético (AC) del Índice de Necesidad de Tratamiento de Ortodoncia (INTO). El análisis estadístico de los datos fue realizado con el programa SPSS Statistics v.23. Resultados: El 94,9% de los adolescentes se autoperciben con una buena estética, el examinador considera que un 77% presenta esta condición, p<0,00. Los varones se perciben mejor que las damas. Los adolescentes de 15 años un 1,7% considera tener mala estética, p<0,01. Desde la perspectiva del examinador la estética se relaciona con la dependencia educacional, <0,01. Conclusión: Los adolescentes se autoperciben mejor estéticamente que lo diagnosticado por evaluadores odontólogos. El factor dependencia educacional según INTO-AC examinador, muestra mayor proporción de estudiantes sin necesidad de tratamiento ortodóncico en los establecimientos privados, y necesidad límite en los públicos y subvencionados.

Perceptions of pain levels and chewing impairment among adolescents undergoing orthodontic treatment with fixed appliances

Aim: the aim of this cohort study was to evaluate the perceptions of adolescents regarding pain levels and chewing impairment throughout the first 12 months of orthodontic treatment with fixed appliances. methods: a total of 120 adolescents aged 11 and 12 years undergoing orthodontic treatment at the faculty of dentistry of the Federal University of Minas Gerais participated in this study. malocclusion was evaluated by means of the dental aesthetic index. pain level and degree of chewing impairment were evaluated by means of two questions selected from the short form of the child perceptions questionnaire (CPQ11-14). each question had five response options with the following scoring system: never (0), once or twice (1), sometimes (2), often (3) and every day/almost every day (4). both questions were answered by the adolescents at four different times: before fixed appliances' placement (T1), one month after banding and fixed appliances' bonding (T2), four months after banding and fixed appliances' bonding (T3), and 12 months after banding and fixed appliances' bonding (T4). results: the mean age of adolescents was 11.39 (±0.68). significant differences were observed for pain levels (p=0.038) and chewing impairment (p=0.020) over the study period. pain levels at T1 were significantly lower than at T2 (p=0.038) and T4 (p=0.020). chewing impairment at T1 was significant lower than at T2 (p<0.001), T3 (p=0.014) and T4 (p=0.005). conclusion: adolescents undergoing orthodontic treatment with fixed appliances present an increase in pain levels and in chewing impairment.

Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting.Methods:Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID).Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score.Conclusion:Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances.

Objetivo: avaliar as percepções de pais e cuidadores com relação à qualidade de vida de adolescentes durante os primeiros 12 meses de tratamento ortodôntico com aparelhos fixos, e examinar as propriedades técnicas da versão brasileira do questionário Parental-Caregiver Perceptions Questionnaire(P-CPQ) no cenário ortodôntico.Métodos:dados de uma amostra de 96 pais e cuidadores de adolescentes em tratamento ortodôntico com aparelhos fixos foram coletados através do questionário P-CPQ. As avaliações foram realizadas antes da bandagem e colagem de braquetes (T1) e 12 meses após a colocação do aparelho fixo (T2). A análise estatística incluiu o teste Wilcoxon signed rankpara o escore total do P-CPQ e a correção de Bonferroni para as subescalas do questionário. As propriedades técnicas do P-CPQ foram examinadas por meio do cálculo da responsividade e da mínima diferença clinicamente importante (MDCI).Resultados:dos 96 participantes, 76 eram mães de pacientes, 16 eram pais e 4 possuíam outra relação familiar. A idade média dos adolescentes foi de 11,49 ± 0,50 anos. A maioria das famílias tinha uma renda mensal igual ou menor a três salários mínimos brasileiros. Houve uma melhora significativa nas subescalas de bem-estar emocional e bem-estar social, que contribuíram para uma melhora do escore total de qualidade de vida (p< 0,001). As reduções dos escores do P-CPQ foram associadas com alterações clinicamente moderadas para o escore total e para as subescalas de bem-estar emocional e bem-estar social. A MDCI para o escore total do P-CPQ foi de 6,16.Conclusões: pais e cuidadores relataram uma melhora significativa na qualidade de vida de adolescentes em tratamento ortodôntico com aparelhos fixos.

The influence of patient's motivation on reported pain during orthodontic treatment

INTRODUCTION: Patients usually experience pain during orthodontic treatment. This fact can affect cooperation and the development of treatment. Reporting pain during treatment seems to be influenced by emotional aspects such as the patient's motivation. OBJECTIVE: To assess the relationship between patient's motivation and the intensity of reported pain during two stages of treatment. METHODS: Twenty males (11-37 years old) answered a questionnaire divided into five categories regarding their motivation towards treatment. The subjects were studied for 14 days (7 days with bonded brackets and 7 days with the initial arch inserted) and the intensity of pain was evaluated on a daily basis. All the issues, including the intensity of pain, were measured through the visual analog scale (VAS). RESULTS: The VAS-associated questionnaire proved to have good temporal reliability and reasonable internal consistency, being that the "perceived severity" domain had the greatest, although not significant (p = 0.196) correlation with pain intensity. Only the question asking the patients if they thought that their teeth were too uneven showed a positive correlation with pain intensity (p = 0.048). CONCLUSION: The results seem to indicate that the five categories related to treatment motivation cannot be used to predict discomfort during treatment. In addition, patients who think their teeth are too uneven may experience more severe pain due to greater force application after insertion of the initial arch.

INTRODUÇÃO: experiências de dor são relatadas rotineiramente pelos pacientes durante o tratamento ortodôntico, o que pode prejudicar a cooperação e o desenvolvimento do tratamento. Os relatos de dor parecem ser influenciados por fatores emocionais, como a motivação para o tratamento. OBJETIVO: avaliar a correlação existente entre a motivação para o tratamento ortodôntico e a intensidade de dor relatada pelos pacientes durante duas fases iniciais do tratamento. MÉTODOS: vinte indivíduos homens, com 11 a 37 anos de idade, foram avaliados por meio de um questionário dividido em cinco domínios relacionados à motivação para tratamento ortodôntico. Os indivíduos foram acompanhados durante 14 dias, sendo 7 dias apenas com os braquetes colados e 7 dias com o arco inicial inserido, sendo a intensidade de dor avaliada diariamente. Todas as questões, assim como intensidade da dor, foram mensuradas por meio da Escala Visual Análoga (EVA). RESULTADOS: o questionário associado à EVA apresentou boa confiabilidade temporal e consistência interna razoável, sendo que o domínio "Severidade percebida" apresentou a maior correlação com a intensidade de dor, apesar de não significativa (p = 0,196). Na análise das questões, apenas a que avaliou se os pacientes julgavam seus dentes muito tortos apresentou correlação positiva com a intensidade de dor (p = 0,048). CONCLUSÃO: os resultados indicam que os cinco domínios relacionados à motivação para o tratamento ortodôntico não podem ser utilizados para predizer o desconforto durante o tratamento, porém o fato de o indivíduo julgar seus dentes tortos pode indicar experiências de dor mais intensas devido à maior aplicação de força após a inserção do arco inicial.

Assessment of motivation, expectations and satisfaction of adult patients submitted to orthodontic treatment

OBJECTIVE: The purpose of this study was to analyze the psychological aspects of adult patients who sought and underwent orthodontic treatment, evaluating their expectations and discomfort during treatment, as well as their satisfaction after completion of dental movement. RESULTS AND CONCLUSIONS: Data obtained from previous published papers, and also from questionnaires answered by 54 patients, showed that adult patients stood out for their attention to details and high interest in the esthetic improvements provided by treatment, and also for a greater perception of their initial malocclusion. On the other hand, the same data showed that adult patients, once informed about the limitations of their treatment and having confidence on the orthodontist, presented a high level of satisfaction with treatment results, revealing themselves as good patients for indication and execution of orthodontic procedures.

OBJETIVO: o propósito desse trabalho foi analisar as características psicológicas dos pacientes adultos que procuraram e se submeteram a tratamentos ortodônticos, avaliando suas expectativas, desconforto durante o tratamento e satisfação final após a conclusão das movimentações dentárias propostas. RESULTADOS E CONCLUSÕES: os dados obtidos por meio de uma revisão bibliográfica e de questionários realizados com 54 pacientes demonstraram que os pacientes adultos se destacaram por serem mais detalhistas e exigentes em relação às melhoras estéticas proporcionadas pelo tratamento, e por apresentarem uma maior percepção de sua má oclusão antes do início do tratamento. Por outro lado, esses mesmos dados demonstraram que os pacientes adultos, uma vez bem esclarecidos sobre as limitações peculiares ao seu tratamento e sentindo-se bem amparados e orientados pelos profissionais responsáveis, apresentaram um alto índice de satisfação frente aos resultados finais do tratamento, sendo ótimos pacientes para a indicação e execução de procedimentos ortodônticos.

Expectations of orthodontic treatment in adults: the conduct in orthodontist/patient relationship

INTRODUCTION: The high demand for orthodontic treatment, evidenced over the last few decades, has been justified mainly by the greater importance given to facial esthetics, influencing individual's self esteem. However, the professional frequently does not meet all the patient's expectations, for not establishing good communication and not knowing about the critical points during orthodontic treatment. OBJECTIVE: The aim of this study was to elucidate patients' desires and doubts regarding orthodontic treatment, by means of a survey applied to 60 adult patients. RESULTS: The analysis of results revealed that most individuals (38.3 %) noticed treatment success after its conclusion. Occlusion deviation was pointed out by 66.7 % as the main reason for seeking treatment, and esthetics ranked as second (with 48.3 %). Treatment time was considered within the prediction by 46.7% of the interviewees and the results were judged as very good by 43.3 %. The social relations of most participants were not affected by treatment (73.3 %). Also, 58.3 % of the interviewees reported pain as the main complaint and 53.3 % found it difficult to use dental floss. Most participants saw the orthodontist as a professional who was concerned about their health (76.7 %), and believed that he/she was more able to treat them (96.6 %) when compared with the general practitioner. CONCLUSION: The orthodontist/ patient relationship enables an understanding of the expectations regarding orthodontic treatment, resulting in greater motivation and cooperation, leading to a successful outcome.

INTRODUÇÃO: a elevada procura por tratamentos ortodônticos, evidenciada nas últimas décadas, justifica-se principalmente pela maior importância à estética facial, influenciando a autoestima do indivíduo. Entretanto, muitas vezes o profissional não atinge todas as expectativas esperadas pelo paciente, por não estabelecer uma correta comunicação e conhecer os pontos críticos durante o tratamento ortodôntico. OBJETIVO: esse estudo objetivou elucidar os anseios e dúvidas de pacientes em relação ao tratamento ortodôntico por meio da aplicação de questionário a 60 pacientes adultos. RESULTADOS: a análise dos resultados revelou que a maioria dos indivíduos (38,3%) percebeu êxito após a finalização da terapêutica. O desvio da oclusão foi apontado por 66,7% como principal motivo de procura pelo tratamento, e, em segundo lugar, 48,3% pela estética. O tempo de tratamento foi considerado dentro do previsto por 46,7% dos entrevistados e os resultados foram julgados como muito bons para 43,3%. As relações sociais da maioria dos participantes não foram afetadas pelo tratamento (73,3%), sendo que 58,3% dos entrevistados relataram a dor como queixa principal, e 53,3% encontraram dificuldades no uso do fio dental. A maioria dos participantes vê o ortodontista como um profissional preocupado com sua saúde (76,7%), e acredita que é mais apto em relação ao clínico-geral para tratá-los (96,6%). CONCLUSÃO: o vínculo entre profissional e paciente possibilita compreender as expectativas em relação ao tratamento ortodôntico, resultando em maior motivação, cooperação e sucesso do tratamento.

Serial extraction: 20 years of follow-up

This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment.

Evaluation of self-perceived dental aesthetics and orthodontictreatment need among young adults / Avaliação da autopercepção da estética dental e da necessidade detratamento ortodôntico entre pacientes adultos jovens

Objectives: The aim of the study was to assess the self-perception of dental aesthetics and orthodontic treatment need in a group of young adults. Materials and methods: Perception of dental aesthetics and orthodontic treatment need was assessed among 189 first year university undergraduates using the Oral Aesthetic Subjective Impact Scale (OASIS), a visual analogue scale (VAS), and the Aesthetic component (AC) scale of the Index of Orthodontic treatment Need (IOTN). Data analysis was done using SPSS version 11.0. Descriptive statistics and Chi-square tests were used. One way analysis of variance (ANOVA) was used to identify differences in the mean VAS and OASIS scores according to perceived orthodontic treatment need on the AC scale of IOTN. The relationship between the various scales was examined using correlation tests. Statistical significance was set as p < 0.05. Results: The mean OASIS and VAS scores were 13.61 ± 5.98 and 75.64 ± 18.40 respectively. According to the AC scale of IOTN, 86.8% of participants rated themselves as having no need for treatment, 7.4% borderline need and 5.8% great need for orthodontic treatment. Comparison of mean OASIS and VAS scores according to the AC category showed a trend towards higher mean OASIS scores and lower VAS scores with greater treatment need. ANOVA showed there were significant differences between the AC groups in mean OASIS and VAS scores. Spearman‘s correlation tests between the 3 scales gave low results. Conclusion: There was a low correlation between the OASIS, VAS and AC scale of IOTN in evaluating self-perception of dental aesthetics and orthodontic treatment need. The OASIS and VAS were able to discriminate between participants with different degrees of treatment need.

Objetivos: O objetivo do estudo foi avaliar a autopercepção da estética dentária e necessidade de tratamento ortodôntico em um grupo de adultos jovens. Materiais e métodos: A percepção da estética e a necessidade de tratamento ortodôntico foram avaliadas entre 189 estudantes universitários do primeiro ano, usando a Escala Ortodôntica de Impacto Subjetivo (OASIS), uma escala visual analógica (VAS), e a Escala de Componente Estético (AC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN). A análise dos dados foi feita usando SPSS versão 11.0. Estatística descritiva e Qui-quadrado foram utilizados. Análise de variância (ANOVA) foi utilizada para identificar diferenças entre as médias e pontuações de VAS e OASIS de acordo com a necessidade percebida de tratamento ortodôntico na escala AC de IOTN. A relação entre as várias escalas foi examinada utilizando ensaios de correlação. A significância estatística foi definida como p < 0,05. Resultados: As medias e desvios padrão de OASIS e VAS foram 13,61 ± 5,98 e 75,64 ± 18,40, respectivamente. De acordo com a escala AC de IOTN, 86,8% dos participantes se classificaram como não tendo necessidade de tratamento, 7,4% ficaram na situação limítrofe de necessidade, e 5,8% relataram grande necessidade de tratamento ortodôntico. A comparação entre as medias de OASIS e VAS de acordo com a categoria AC mostrou uma tendência de maior escore para OASIS e mais baixo escore para VAS, com maior necessidade de tratamento. ANOVA mostrou que houve diferenças significativas entre os grupos OASIS e VAS. Testes de correlação de Spearman entre as três escalas apresentaram resultados baixos. Conclusões: Houve uma baixa correlação entre o OASIS, VAS e escala de AC de IOTN na avaliação de autopercepção da estética dentária e necessidade de tratamento ortodôntico. OASIS e VAS foram capazes de discriminar entre os participantes com diferentes graus de necessidade de tratamento.

Impacto do tratamento ortodôntico na qualidade de vida dos adolescentes / Impact of orthodontic treatment on the quality of life of adolescents

O objetivo do presente estudo foi avaliar o impacto do tratamento ortodôntico na qualidade de vida de adolescentes. Após a aprovação do Comitê de Ética em Pesquisa da UFMG (Parecer 0421.0.203.000-1), foi realizado um estudo prospectivo no qual adolescentes de 11 e 12 anos de ambos os gêneros, que iniciaram tratamento ortodôntico com aparelho fixo na Faculdade de Odontologia da Universidade Federal de Minas Gerais responderam à versão brasileira curta do Child Perceptions Questionnaire (CPQ11-140. Puderal participar do estudo, indivíduos com necessidade de tratamento ortodôntico com aparelho fixo...

Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics.

Aim: The purposes of this research were to investigate factors influencing patients' satisfaction with their present dental esthetic, received previous dental treatments on anterior teeth and basic treatments that they wanted to undergo to improve their dental appearance. Materials and Methods: A total of 1014 patients who attended a dental school in a major city in Turkey participated in the study. The participants were surveyed with a questionnaire containing questions about gender, age, education level, self-reported tooth appearance, received previous dental treatments on anterior teeth and desired basic esthetic dental treatments. Statistical analysis of the verifying data was made with descriptive statistics, χ2 test and multiple logistic regression analyses. Results: According to the analyses of the verifying data, 55.1% of the patients were dissatisfied with the color of their teeth, 42.7% with dental appearance, 29.9% with crowding of anterior teeth, 23.3% were hiding teeth while smiling, 16.1% had non-esthetic restorations and 11.9% thought that their anterior teeth were protruding. Esthetic restoration was found to be the most-performed treatment recently (29.0%) and whitening of teeth was the most-desired dental treatment (49.0%). Gender, age and education level had an effect on satisfaction and received previous and desired dental treatments for improvement of esthetics. Conclusion: Many of the Turkish patients surveyed in the study were dissatisfied and desired the improvement of dental esthetics. Therefore, dentists should consider this as an important dimension in their practice.

Conducta terapéutica ante tratamientos ortodóncicos condicionados por el paciente: caso clínico / Therapeutic behavior when facing patient-conditioned orthodontic treatments: a clinical case

El requerimiento de tratamientos ortodóncicos no derivados por el odontólogo generalista es cada ez más frecuente dentro de la sociedad actual. La gran mayoría de los pacientes concurre a la consulta por necesidades puramente estéticas y en menor frecuencia, la causa del requerimiento es por alteraciones funcionales. Esta demanda en adolescentes y adultos, viene acompañada de determinados condicionamientos, no siempre aceptables para el logro de un resultado ortodóncico satisfactorio. Mientras el odontólogo ortodoncista apunta a la salud del sistema estomatognático, en un marco de armonía estética, el paciente requiere sólo la estética como resultado final y también durante el tratamiento. Los tratamientos aceptados, sabiendo previamente que no se obtendrán todos los objetivos posibles de lograr, han pasado a llamarse en la jerga profesional "tratamientos de compromiso" con el paciente. Es motivo de este artículo remarcar hasta dónde el profesional puede complacer las condiciones del paciente y aceptar estos tratamientos.

El paciente Ortodóntico: Un abordaje psicoanalítico / The ortodontinc pattient: A psychoanalytic approach

El interés de este trabajo es poner de manifiesto algunas consideraciones entre la Psicología y la Odontología. Es brindarle al odontólogo una herramienta de trabajo basada en una sólida apoyatura teórica-psicoanalítica que le permita situar a su paciente tanto en relación a su historia como en relación al tratamiento ortodóntico. El éxito del tratamiento ortodóntico depende de la puesta en juego de algunos elementos ajenos a la Odontología pero no a su práctica. La singularidad del caso, el análisis de la relación afectiva médico-paciente en términos de transferencia, el reconocimiento de la enfermedad por parte del paciente, la posibilidad de construir una demanda y un deseo de cura junto a él, como así también el análisis de las resistencias, son instrumentos fundamentales para el éxito del tratamiento ortodóntico