Longitudinal assessment of the impact of orthodontic treatment on adolescents' quality of life: a comparison between boys and girls using a condition specific questionnaire.

The aim of this study was to compare the impact of the first year of wearing of a fixed orthodontic appliance on the Oral Health-Related Quality of Life (OHRQoL) between boys and girls, by means of a condition-specific instrument. The study included 69 adolescents aged 10 to 18 years, who were undergoing orthodontic treatment with a fixed appliance. Of the 69 adolescents, 38 were girls (55.1%) and 31 were boys (44.9%). They answered the Brazilian version of the Impact of Fixed Appliance Measure (B-IFAM) questionnaire three months (T1) and one year (T2) after the fixed appliance was installed. This questionnaire contains 43 questions, distributed across nine domains. The higher the scores, the more negative the perception of the adolescent concerning the impact of the fixed appliance on his/her OHRQoL. Sociodemographic and clinical variables were also analyzed, and statistical analysis was performed. For the domains, the effect size (the magnitude of the difference between girls and boys) and the minimal clinically important difference were also calculated. The adjusted regression showed that there was a significantly greater increase in the overall B-IFAM score in girls than in boys, indicating a more negative perception of the OHRQoL over the study time [Coefficient=11.77 (3.47- 20.60), p=0.006]. From T1 to T2, there was a significantly greater increase in the scores (more negative perception of OHRQoL over time) in girls than in boys for the domains aesthetics (p=0.034) and physical impact (p=0.011). These differences were clinically significant. The effect size (the magnitude of the difference) was moderate. The impact of wearing a fixed appliance on the OHRQoL was more negative in girls than in boys during the first year of orthodontic treatment.

O objetivo deste estudo foi comparar o impacto do primeiro ano de uso do aparelho fixo na qualidade de vida relacionada a saúde bucal (QVRSB) entre meninas e meninos, através de um instrumento condição específica. Sessenta e nove adolescentes entre 10 e 18 anos, em tratamento ortodôntico com aparelho fixo foram incluídos. Adolescentes responderam ao questionário Impact of fixed appliance measure (B-IFAM) no terceiro mês de uso do aparelho fixo (T1) e um ano após a colagem do aparelho fixo (T2). Este questionário possui 43 perguntas, distribuídas em nove domínios. Quanto maior os escores, mais negativa a percepção do adolescente com relação ao impacto do aparelho fixo na QVRSB. Variáveis sociodemográficas e clínicas também foram avaliadas. Análise estatística foi realizada. Para os domínios, tamanho de efeito (a magnitude da diferença entre meninas e meninos) e diferença mínima clinicamente importante também foram calculadas. Dos 69 adolescentes, 38 eram meninas (55,1%) e 31 eram meninos (44,9%). Na regressão ajustada, meninas apresentaram um aumento significativamente maior do escore total do B-IFAM do que meninos, indicando uma percepção mais negativa da QVRSB ao longo do tempo de acompanhamento [Coeficiente=11,77 (3,47­20,60), p=0.006]. Meninas apresentavam um aumento significativamente maior dos escores de T1 para T2 (percepção mais negativa da QVRSB ao longo do tempo) em relação aos meninos para os domínios estética (p=0,034) e impacto físico (p=0,011). Estas diferenças também foram clinicamente significativas. O tamanho do efeito (a magnitude da diferença) foi moderado. Meninas demonstraram um impacto mais negativo do uso do aparelho fixo na QVRSB do que meninos nos 12 primeiros meses de tratamento ortodôntico.

Longitudinal assessment of the impact of orthodontic treatment on adolescents' quality of life: a comparison between boys and girls using a condition specific questionnaire / Avaliação longitudinal do impacto do tratamento ortodôntico na qualidade de vida de adolescentes: comparação entre meninos e meninas utilizando um questionário condição especifica

ABSTRACT The aim of this study was to compare the impact of the first year of wearing of a fixed orthodontic appliance on the Oral Health-Related Quality of Life (OHRQoL) between boys and girls, by means of a condition-specific instrument. The study included 69 adolescents aged 10 to 18 years, who were undergoing orthodontic treatment with a fixed appliance. Of the 69 adolescents, 38 were girls (55.1%) and 31 were boys (44.9%). They answered the Brazilian version of the Impact of Fixed Appliance Measure (B-IFAM) questionnaire three months (T1) and one year (T2) after the fixed appliance was installed. This questionnaire contains 43 questions, distributed across nine domains. The higher the scores, the more negative the perception of the adolescent concerning the impact of the fixed appliance on his/her OHRQoL. Sociodemographic and clinical variables were also analyzed, and statistical analysis was performed. For the domains, the effect size (the magnitude of the difference between girls and boys) and the minimal clinically important difference were also calculated. The adjusted regression showed that there was a significantly greater increase in the overall B-IFAM score in girls than in boys, indicating a more negative perception of the OHRQoL over the study time [Coefficient=11.77 (3.47- 20.60), p=0.006]. From T1 to T2, there was a significantly greater increase in the scores (more negative perception of OHRQoL over time) in girls than in boys for the domains aesthetics (p=0.034) and physical impact (p=0.011). These differences were clinically significant. The effect size (the magnitude of the difference) was moderate. The impact of wearing a fixed appliance on the OHRQoL was more negative in girls than in boys during the first year of orthodontic treatment.

RESUMO O objetivo deste estudo foi comparar o impacto do primeiro ano de uso do aparelho fixo na qualidade de vida relacionada a saúde bucal (QVRSB) entre meninas e meninos, através de um instrumento condição específica. Sessenta e nove adolescentes entre 10 e 18 anos, em tratamento ortodôntico com aparelho fixo foram incluídos. Adolescentes responderam ao questionário Impact of fixed appliance measure (B-IFAM) no terceiro mês de uso do aparelho fixo (T1) e um ano após a colagem do aparelho fixo (T2). Este questionário possui 43 perguntas, distribuídas em nove domínios. Quanto maior os escores, mais negativa a percepção do adolescente com relação ao impacto do aparelho fixo na QVRSB. Variáveis sociodemográficas e clínicas também foram avaliadas. Análise estatística foi realizada. Para os domínios, tamanho de efeito (a magnitude da diferença entre meninas e meninos) e diferença mínima clinicamente importante também foram calculadas. Dos 69 adolescentes, 38 eram meninas (55,1%) e 31 eram meninos (44,9%). Na regressão ajustada, meninas apresentaram um aumento significativamente maior do escore total do B-IFAM do que meninos, indicando uma percepção mais negativa da QVRSB ao longo do tempo de acompanhamento [Coeficiente=11,77 (3,47-20,60), p=0.006]. Meninas apresentavam um aumento significativamente maior dos escores de T1 para T2 (percepção mais negativa da QVRSB ao longo do tempo) em relação aos meninos para os domínios estética (p=0,034) e impacto físico (p=0,011). Estas diferenças também foram clinicamente significativas. O tamanho do efeito (a magnitude da diferença) foi moderado. Meninas demonstraram um impacto mais negativo do uso do aparelho fixo na QVRSB do que meninos nos 12 primeiros meses de tratamento ortodôntico.

The Dental Aesthetic Index and dental health component of the Index of Orthodontic Treatment Need as tools in epidemiological studies.

The present study assesses the validity and reproducibility of two occlusal indices for epidemiological studies--the Dental Aesthetic Index (DAI) and the Dental Health Component of the Index of Orthodontic Treatment Need (DHC-IOTN) for the identification of orthodontic treatment needs. The total of 131 study models was examined by an examiner (orthodontic specialist) for the determination of the DAI and DHC-IOTN. Thirty days later, further assessment was performed to determine the reproducibility. The duration of each exam was measured in seconds with a stopwatch. The indices were compared by a panel of three experts in orthodontics to evaluate validity. The intra-examiner reliability evaluation resulted in an intraclass correlation coefficient of 0.89 for the DAI (95% CI = 0.64 to 1.0) and 0.87 for the DHC-IOTN (95% CI = 0.56 to 0.96). The time spent on the evaluation of the DHC-IOTN was less than the time spent on that of the DAI (P < 0.001). The accuracy of the indices, as reflected by the area under the receiver-operating characteristic curve, was 61% for the DAI (95% CI = 51 to 70; p = 0.037) and 67% for the DHC-IOTN (95% CI = 58 to 77; p = 0.001). Both indices presented good reproducibility and validity.