| The concept of oral health-related quality of life (OHRQoL) describes the patient-perceived impact of oralfacial conditions and effect of dental interventions. It is a broad and comprehensive concept which is widely influenced by physical health, psychological state, social relationship, environment and so on. In order to evaluate it objectively, measuring instrument (OHIP-14) covering seven specific domains were originally developed and examined by Slade GD. As a sensitive assessment tool, it can not only help clinicians to assess patient’s current oral state but also worked as an indicator to help researchers to supervise changes in oral health-related quality of life. Within the field of orthodontics there is long-standing recognition that malocclusion is definitely associated with poor OHRQoL. Although OHRQoL may be compromised during the first month of fixed orthodontic appliance therapy, it can be considerably improved at the end of whole course of treatment, In order to investigate the effects of orthodontic treatment on "OHRQoL," most researchers monitored various time points during fixed orthodontic appliance therapy such as 1 week,1 month,3 months,6 months and 12 months. However, it has long been accepted that comprehensive orthodontic treatment differs from most other medical interventions in that it has clear stage of clinical treatment including alignment and leveling, space closure and finishing. Therefore, greater understanding of how OHRQoL change over the three-stage process and whether or not OHRQoL of patients with different classifications of malocclusion consistent is very important in orthodontic care. In addition, although it has long been known that OHIP-14 has 7 conceptualized domains, previous studies unilaterally attached importance to aggregate score and ignored details of certain domain. Hence, exploring variations of each domain throughout the treatment process should be emphasized instead of being neglected. These information are useful to inform patient about the likely consequences of undergoing orthodontic treatment to their lives and thus can give them realistic expectations of treatment. The aims of this study were to investigate the responses of patients with Class I, Class II, Class III malocclusion to comprehensive orthodontic treatment in terms of oral health-related quality of life respectively, and to explore relationships between OHIP scores and clinical stage among groups with different Angle classification, and third, to characterize changes in each domain resulting from every treatment stage.Purpose:The objectives of this study were to investigated changes in OHRQoL among patients with different classifications of malocclusion during comprehensive orthodontic treatment.Method:Clinical data were collected from 81 patients (aged 15 to 24) who had undergone comprehensive orthodontic treatment. Participants were classified 3 groups: Class â… (n=35), â…¡ (n=32) and â…¢ (n=14) by Angle classification. OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). All subjects were examined and interviewed at baseline (TO), after alignment and leveling (T1), after correction of molar relationship and space closure (T2), after finishing (T3). Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the relative changes of OHRQoL among the different time points. A Bonferroni correction with P<0.005 was used to declare significance.Results:Significant reductions were observed in all seven OHIP-14 domains of three groups except for social disabilityin class I and class II, Handicap in class II and class â…¢. Class â… patients showed significant changes for psychological disability and psychological discomfort domain at T1, functional limitation, physical pain at T2. Class â…¢ patients showed a significant benefit in all domains except-physical pain and functional limitation. Class â…¡ patients showed significant changes in the physical pain, functional disability, and physical disability domains at T1.Conclusions:The impact of comprehensive orthodontic treatment on patients’ OHRQoL do not follow the same pattern among patients with different malocclusion. Class â…¡ patients benefits the most from the stage of space closure, while class I patients benefits the first stage (alignment and leveling) of treatment in psychological disability and psychological discomfort domains. |
