A qualitative study of health-related quality of life and psychosocial adjustments of Thai adolescents with repaired cleft lips and palates.

OBJECTIVE: The purposes of the present study were (1) to study the meaning of Health-Related Quality of Life (HRQoL) from the insider's perspective and (2) to explore the relevant psychosocial adjustments involved in the HRQoL of Thai 12-to-17-year-old adolescents with repaired cleft lip and cleft palate (CLP). MATERIAL AND METHOD: The study included a sample of 18 adolescents with non-syndromic repaired CLP and 6 parents of these adolescents. The participants were recruited from an orthodontic clinic in the Faculty of Dentistry, Mahidol University, and all were in-depth interviewed. RESULTS: HRQoL can be categorized into four domains: physical symptoms,functional limitations, emotional well-being and social well-being. In the affected group they were striking differences in psychological assets, psychosocial resources and socioeconomic disparities. The majority of these participants were well-adjusted and able to cope with the adversities they experienced as a result of their conditions; hence it was noted that, participants with consistent support from parents,friends and professionals were likely to have a positive health status and satisfaction with treatment. CONCLUSION: These findings have important implications in measuring a multidimensional HRQoL construct, and will enhance issues regarding adaptation strategies which have an impact on HRQoL of adolescents with CLP.

The effect of different surface preparation techniques on the survival probabilities of orthodontic brackets bonded to nanofill composite resin.

OBJECTIVE: To analyze the survival probabilities of different surface preparation techniques for bonding brackets to nanofill composite resin. DESIGN: In vitro, laboratory study. SETTING: Mahidol University, Bangkok, Thailand. MATERIALS AND METHODS: Thirty-five nanofill composite resin specimens/group were subjected to four surface preparation techniques as follows: (1) sandblast using aluminium oxide powder of 90 microm; (2) abrasion using diamond bur; (3) hydrofluoric acid etching for 2 min; and (4) 37% orthophosphoric acid etching for 30 s. Plastic conditioner was applied then brackets were bonded. Shear bond strength tests were carried out on a universal testing machine. MAIN OUTCOME MEASURES: Shear bond strength (MPa) and debonding force (N) were analyzed using Weibull analysis. RESULTS: The maximum stress and debonding force levels with a 95% probability of survival ranking from highest to lowest were: (1) sandblast group (4.2 MPa, 45.5 N); (2) diamond bur group (2.2 MPa, 25.3 N); (3) orthophosphoric group (1.9 MPa, 19.8 N); and (4) hydrofluoric group (0.8 MPa, 10.9 N). There was a significant difference in the adhesive remnant index scores between the surface preparation techniques (chi squared P<0.001). CONCLUSION: Bonding orthodontic brackets to nanofill composite resin materials may result in lower bond strengths and special surface preparation techniques might be required to avoid increased numbers of bond failures. Surface treatment with sandblasting followed by plastic conditioner could increase the survival probability. The use of a diamond bur, orthophosphoric etching or hydrofluoric etching cannot be recommended.