The aim: The overall aim of this licentiate thesis was to describe and analyze oral health-related quality of life measured with OHIP-14. The thesis comprises two studies, each with a specific aim.   Study I: To describe oral health-related quality of life measured with OHIP-14 in an Swedish adult population Study II: To study the relationship between oral health-related quality of life, measured with OHIP-14, and subjective as well as objective dry mouth conditions in fragile old people. Furthermore, the aim was to study the reliability and validity of a new instrument (VAS) to measure dry mouth   Material and methods: Study I comprised a stratified random sample of 519 individuals 20-80 years of age. In Study II, 41 randomly selected fragile old people, residents at three different community care centers, participated. In both studies, the questionnaire OHIP-14 was used for measurement of oral health-related quality of life. The participants in Study II answered a questionnaire for subjectively experienced dry mouth (VAS). For objective dry mouth measurements, saliva was absorbed into a preweighted cotton roll. Results: In Study I, 21% of the respondents stated that they had no oral problems that had a negative impact on their well-being. In Study II, the corresponding figure was 71%. In study I the mean value for OHIP-14 was 6.4 (SD=7.1) for the entire population; 5.9 (SD=7.1) for men and 6.8 (SD=7.2) for women in. Subjects, who frequently experienced problems related to oral health, with scores ranging from 16 to 41 points, accounted for 10% of the study group. In Study II, significant associations were identified between both objectively measured respective subjectively experienced dry mouth and oral health-related quality of life. The validity of the VAS instrument was good for subjective mouth dryness, but poor for objectively measured dry mouth in fragile old people. Conclusion: From Study I it can be concluded that, in this Swedish population, a number of individuals, both young and old, experience oral problems that have a negative impact on their well-being. From Study II, the conclusion is that dry mouth (both objective and subjective) is significantly associated with poorer oral health-related quality of life, underlining the value of monitoring dry mouth conditions in the care of fraigile old people.

<p><em>The aim:</em> The overall aim of this licentiate thesis was to describe and analyze oral health-related quality of life measured with OHIP-14. The thesis comprises two studies, each with a specific aim.</p><p> </p><p><em>Study I: </em>To describe oral health-related quality of life measured with OHIP-14 in an Swedish adult population</p><p><em>Study II: </em>To study the relationship between oral health-related quality of life, measured with OHIP-14, and subjective as well as objective dry mouth conditions in fragile old people. Furthermore, the aim was to study the reliability and validity of a new instrument (VAS) to measure dry mouth</p><p> </p><p><em>Material and methods: </em>Study I comprised a stratified random sample of 519 individuals 20-80 years of age. In Study II, 41 randomly selected fragile old people, residents at three different community care centers, participated. In both studies, the questionnaire OHIP-14 was used for measurement of oral health-related quality of life. The participants in Study II answered a questionnaire for subjectively experienced dry mouth (VAS). For objective dry mouth measurements, saliva was absorbed into a preweighted cotton roll.</p><p><em> </em></p><p><em>Results:</em> In Study I, 21% of the respondents stated that they had no oral problems that had a negative impact on their well-being. In Study II, the corresponding figure was 71%. In study I the mean value for OHIP-14 was 6.4 (SD=7.1) for the entire population; 5.9 (SD=7.1) for men and 6.8 (SD=7.2) for women in. Subjects, who frequently experienced problems related to oral health, with scores ranging from 16 to 41 points, accounted for 10% of the study group. In Study II, significant associations were identified between both objectively measured respective subjectively experienced dry mouth and oral health-related quality of life. The validity of the VAS instrument was good for subjective mouth dryness, but poor for objectively measured dry mouth in fragile old people.</p><p><em>Conclusion:</em> From Study I it can be concluded that, in this Swedish population, a number of individuals, both young and old, experience oral problems that have a negative impact on their well-being. From Study II, the conclusion is that dry mouth (both objective and subjective) is significantly associated with poorer oral health-related quality of life, underlining the value of monitoring dry mouth conditions in the care of fraigile old people.</p>

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A literatura científica ainda não é consistente em relação aos benefícios psicossociais proporcionados pelo tratamento ortodôntico. Os objetivos deste estudo foram conhecer as alterações na qualidade de vida relacionada com a saúde bucal (OHRQoL) e com a autopercepção estética de adolescentes brasileiros de 12 a 15 anos de idade tratados ortodonticamente, durante dois anos de avaliação prospectiva longitudinal. A amostra foi constituída de 318 jovens: 92 que iniciaram tratamento ortodôntico em uma instituição de ensino (grupo orto), e 226 indivíduos não tratados: 124 que procuraram avaliação ortodôntica na mesma instituição e não receberam tratamento durante os dois anos em que foram acompanhados na pesquisa, pois estavam aguardando uma vaga na lista de espera para iniciar o tratamento (grupo de espera), e 102 que nunca buscaram tratamento ortodôntico e que estudam em uma escola vizinha à instituição (grupo escola). A qualidade de vida foi mensurada utilizando o OHIP-14. A necessidade normativa e estética de tratamento ortodôntico foi avaliada com o índice IOTN, o nível social com o Critério de Classificação Econômica Brasil e a saúde dental com o índice CPO-D. As avaliações foram repetidas em três momentos: no exame inicial (T1); um ano depois do início do tratamento ortodôntico, para o grupo orto, e um ano após o exame inicial, para os grupos de espera e escola (T2); e dois anos depois do início do tratamento para o grupo orto, e dois anos depois do exame inicial para os grupos de espera e escola (T3). O tratamento ortodôntico reduziu significativamente os escores de OHRQoL: as médias do escores tiveram uma redução de 10,4 para 9,2 e para 1,6 entre a primeira, segunda e terceira avaliações (p<0,001). A autopercepção estética se comportou de maneira similar, com uma redução progressiva e significativa (p<0,001) nos pacientes tratados, que também tiveram melhora significativa na gravidade da má oclusão (p<0,001). Porém, os indivíduos que removeram o aparelho tiveram OHRQoL e autopercepção estética significativamente melhores em relação aos pacientes que não finalizaram o tratamento no período de dois anos. Os adolescentes do grupo de espera tiveram significativa piora na OHRQoL, que sofreu um aumento de 10,8 para 12,0 da primeira para a terceira avaliações (p<0,001), o que também ocorreu na autoavaliação estética, que sofreu um aumento significativo (p<0,001). Por outro lado, os adolescentes do grupo escola não tiveram nenhuma alteração desses índices nos períodos de avaliação, apresentando uma tendência estacionária para OHRQoL (p=0,34) e para a autopercepção estética (p=0,09). A gravidade da má oclusão não foi alterada nos grupos não tratados durante os dois anos de avaliação e o CPO-D não teve alteração significativa para nenhum dos três grupos. Foi possível concluir que o tratamento ortodôntico melhorou significativamente a qualidade de vida relacionada com a saúde bucal e a autopercepção estética dos adolescentes brasileiros submetidos a tratamento. / Literature is not yet conclusive about orthodontic treatments psychosocial benefits. The aim of this study was to assess oral health-related quality of life (OHQoL) and self-perceived aesthetics in brazilian adolescents who was under orthodontic treatment during two years of prospective evaluation. The sample consisted of 318 subjects, 12 to 15 years of age; 92 of these had sought and started orthodontic treatment in an university (ortho group) and the other 226 were not treated adolescents: 124 had sought orthodontic treatment at the same university but did not started, once they were waiting a vacant in the wait list to initiate the treatment (waiting group), and 102 were from a public school right next door to the university clinic and had never undergone or sought orthodontic treatment (school group). OHQoL was assessed with the Brazilian version of the short form of the Oral Health Impact Profile (OHIP-14), malocclusion severity and aesthetic impairment with the IOTN index, socioechonomic status with the Brazilian Economic Classification Criteria, and oral health with the DMTF Index. All subjects completed three distinct intervals of interviews: first interview before treatment (T1), one year after the placement of the fixed appliance for ortho group and one year after the first interview for school and waiting groups (T2) and two years after the placement of the fixed appliance for ortho group and two years after the first interview for school and waiting groups. Orthodontic treatment reduced OHRQoL scores from 10.4, to 9.2 and 1.6, among first, second and third interviews (p<0.001), and also produced a significant reduction in self-perceived aesthetics (p<0.001), and in malocclusion severity (p<0.001). Patients who have finished the treatment had significant better results in all scores than the ones who received treatment for two years but still were wearing braces. Adolescents from waiting group reported worse scores in OHRQoL, wich rised from 10.8 to 12.0 between first and third interviews (p<0.001). Self-perceived aesthetics scores also worsened (p<0.001) during the evaluation period in this group. On the other hand, adolescents from school group did not had alterations in any of the evaluated indexes, including OHRQoL (p=0.34) and self-perceived aesthetics (p=0.09). In patients from not treated groups (waiting and school groups), malocclusion severity did not change during the two years, as well as DMTF did not worsened in any of the three groups. Orthodontic treatment in brazilian adolescents resulted in significant better OHRQoL and self-perceived aesthetics.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A literatura científica ainda não é consistente em relação aos benefícios psicossociais proporcionados pelo tratamento ortodôntico. Os objetivos deste estudo foram conhecer as alterações na qualidade de vida relacionada com a saúde bucal (OHRQoL) e com a autopercepção estética de adolescentes brasileiros de 12 a 15 anos de idade tratados ortodonticamente, durante dois anos de avaliação prospectiva longitudinal. A amostra foi constituída de 318 jovens: 92 que iniciaram tratamento ortodôntico em uma instituição de ensino (grupo orto), e 226 indivíduos não tratados: 124 que procuraram avaliação ortodôntica na mesma instituição e não receberam tratamento durante os dois anos em que foram acompanhados na pesquisa, pois estavam aguardando uma vaga na lista de espera para iniciar o tratamento (grupo de espera), e 102 que nunca buscaram tratamento ortodôntico e que estudam em uma escola vizinha à instituição (grupo escola). A qualidade de vida foi mensurada utilizando o OHIP-14. A necessidade normativa e estética de tratamento ortodôntico foi avaliada com o índice IOTN, o nível social com o Critério de Classificação Econômica Brasil e a saúde dental com o índice CPO-D. As avaliações foram repetidas em três momentos: no exame inicial (T1); um ano depois do início do tratamento ortodôntico, para o grupo orto, e um ano após o exame inicial, para os grupos de espera e escola (T2); e dois anos depois do início do tratamento para o grupo orto, e dois anos depois do exame inicial para os grupos de espera e escola (T3). O tratamento ortodôntico reduziu significativamente os escores de OHRQoL: as médias do escores tiveram uma redução de 10,4 para 9,2 e para 1,6 entre a primeira, segunda e terceira avaliações (p<0,001). A autopercepção estética se comportou de maneira similar, com uma redução progressiva e significativa (p<0,001) nos pacientes tratados, que também tiveram melhora significativa na gravidade da má oclusão (p<0,001). Porém, os indivíduos que removeram o aparelho tiveram OHRQoL e autopercepção estética significativamente melhores em relação aos pacientes que não finalizaram o tratamento no período de dois anos. Os adolescentes do grupo de espera tiveram significativa piora na OHRQoL, que sofreu um aumento de 10,8 para 12,0 da primeira para a terceira avaliações (p<0,001), o que também ocorreu na autoavaliação estética, que sofreu um aumento significativo (p<0,001). Por outro lado, os adolescentes do grupo escola não tiveram nenhuma alteração desses índices nos períodos de avaliação, apresentando uma tendência estacionária para OHRQoL (p=0,34) e para a autopercepção estética (p=0,09). A gravidade da má oclusão não foi alterada nos grupos não tratados durante os dois anos de avaliação e o CPO-D não teve alteração significativa para nenhum dos três grupos. Foi possível concluir que o tratamento ortodôntico melhorou significativamente a qualidade de vida relacionada com a saúde bucal e a autopercepção estética dos adolescentes brasileiros submetidos a tratamento. / Literature is not yet conclusive about orthodontic treatments psychosocial benefits. The aim of this study was to assess oral health-related quality of life (OHQoL) and self-perceived aesthetics in brazilian adolescents who was under orthodontic treatment during two years of prospective evaluation. The sample consisted of 318 subjects, 12 to 15 years of age; 92 of these had sought and started orthodontic treatment in an university (ortho group) and the other 226 were not treated adolescents: 124 had sought orthodontic treatment at the same university but did not started, once they were waiting a vacant in the wait list to initiate the treatment (waiting group), and 102 were from a public school right next door to the university clinic and had never undergone or sought orthodontic treatment (school group). OHQoL was assessed with the Brazilian version of the short form of the Oral Health Impact Profile (OHIP-14), malocclusion severity and aesthetic impairment with the IOTN index, socioechonomic status with the Brazilian Economic Classification Criteria, and oral health with the DMTF Index. All subjects completed three distinct intervals of interviews: first interview before treatment (T1), one year after the placement of the fixed appliance for ortho group and one year after the first interview for school and waiting groups (T2) and two years after the placement of the fixed appliance for ortho group and two years after the first interview for school and waiting groups. Orthodontic treatment reduced OHRQoL scores from 10.4, to 9.2 and 1.6, among first, second and third interviews (p<0.001), and also produced a significant reduction in self-perceived aesthetics (p<0.001), and in malocclusion severity (p<0.001). Patients who have finished the treatment had significant better results in all scores than the ones who received treatment for two years but still were wearing braces. Adolescents from waiting group reported worse scores in OHRQoL, wich rised from 10.8 to 12.0 between first and third interviews (p<0.001). Self-perceived aesthetics scores also worsened (p<0.001) during the evaluation period in this group. On the other hand, adolescents from school group did not had alterations in any of the evaluated indexes, including OHRQoL (p=0.34) and self-perceived aesthetics (p=0.09). In patients from not treated groups (waiting and school groups), malocclusion severity did not change during the two years, as well as DMTF did not worsened in any of the three groups. Orthodontic treatment in brazilian adolescents resulted in significant better OHRQoL and self-perceived aesthetics.

O objetivo do presente estudo foi avaliar o efeito do tratamento periodontal na qualidade de vida de pacientes portadores de Síndrome Metabólica (SM), em uma amostra de 48 pacientes. Os pacientes apresentavam diagnóstico de Periodontite e SM e foram randomizados para dois grupos de tratamento: um grupo ao qual era oferecido tratamento periodontal imediato e outro grupo de tratamento tardio, que receberia o tratamento periodontal após seis meses da sua inclusão no estudo. Para aferir qualidade de vida relacionada à saúde bucal e qualidade de vida geral, foram usados os instrumentos OHIP-14 e WHOQoL-bref, respectivamente. Exames periodontais completos avaliaram Índice de placa visível, Índice de sangramento gengival, Fatores retentivos de placa, Profundidade de sondagem, Sangramento à sondagem e Nível de inserção clínica, em seis sítios por dente. Além disso, exames antropométricos, exames sorológicos e entrevistas com os questionários de qualidade de vida foram realizados no momento inicial e após seis meses do início do estudo. Os dois grupos se mostraram semelhantes no momento inicial. Após seis meses, foram observadas reduções significativas no grupo de tratamento imediato para todos os parâmetros periodontais clínicos. A análise do WHOQoL-bref por domínios mostrou pequenas alterações não significativas em ambos os grupos. Na avaliação dos escores totais de OHIP-14 foi observada, após 6 meses, uma redução de 18,6 para 15 (Δ=3,6) no grupo tardio e de 15 para 5,7 (Δ=9,3) no grupo imediato, com diferenças estatisticamente significantes entre os grupos (p=0,003). Essas diferenças resultaram em um tamanho de efeito de 0,27 (pequeno) para o grupo tardio e 0,78 (moderado) para o grupo imediato. Na análise por domínios, foram encontradas diferenças significativas para o grupo imediato nos domínios limitação funcional (p=0,006), desconforto psicológico (p=0,001), incapacidade física (p=0,009) e incapacidade psicológica (p=0,007), comparado ao grupo tardio. Em pacientes portadores da SM, as mudanças na percepção da qualidade de vida aferidas pelo OHIP-14 foram significativas para o grupo de pacientes que recebeu tratamento periodontal imediato, em comparação ao grupo que recebeu o tratamento tardio. / The aim of this study was to assess the effect of periodontal treatment in quality of life of patients with Metabolic Syndrome, in a sample of 48 patients. The patients showed diagnosis of Periodontitis and Metabolic Syndrome and were randomized for two treatment groups: 1) immediate periodontal treatment 2) later treatment, six months after study inclusion. The instruments OHIP-14 and WHOQoL-bref were used to assess oral health related quality of life and general quality of life, respectively. Complete periodontal exams evaluated plaque visible index, gingival bleeding index, plaque retentive factors, probing depth, bleeding on probing and clinical attachment level, on six sites per tooth. Furthermore, antropometrics, blood exams and interview with quality of life measures instruments were performed in baseline and six months after the beginning of the study. Both groups were similar in baseline. After six months, significant reductions on immediate treatment group for all clinical periodontal parameters were observed. The WHOQoL-bref analysis by domains showed no significant small changes, for both groups. After six months, a decrease of 18,6 to 15 (Δ=3,6) for the later treatment group and 15 to 5,7 (Δ=9,3) for the immediate treatment group was observed in the evaluation of OHIP-14 for total scores, with statistical significant differences between the groups (p=0,003). These differences resulted in an effect size of 0,27 (small) for the later treatment group and 0,78 (moderate) for the immediate treatment group. In domains analysis, significant differences for the immediate treatment group on functional limitation (p=0,006), psychological discomfort (p=0,001), physical incapacity (p=0,009) and psychological incapacity (p=0,007) domains, were found compared to later treatment group. In patients with Metabolic Syndrome, changes on quality of life perception measured by OHIP-14 were significant for immediate treatment group, compared to the later treatment group.

O objetivo do presente estudo foi avaliar o efeito do tratamento periodontal na qualidade de vida de pacientes portadores de Síndrome Metabólica (SM), em uma amostra de 48 pacientes. Os pacientes apresentavam diagnóstico de Periodontite e SM e foram randomizados para dois grupos de tratamento: um grupo ao qual era oferecido tratamento periodontal imediato e outro grupo de tratamento tardio, que receberia o tratamento periodontal após seis meses da sua inclusão no estudo. Para aferir qualidade de vida relacionada à saúde bucal e qualidade de vida geral, foram usados os instrumentos OHIP-14 e WHOQoL-bref, respectivamente. Exames periodontais completos avaliaram Índice de placa visível, Índice de sangramento gengival, Fatores retentivos de placa, Profundidade de sondagem, Sangramento à sondagem e Nível de inserção clínica, em seis sítios por dente. Além disso, exames antropométricos, exames sorológicos e entrevistas com os questionários de qualidade de vida foram realizados no momento inicial e após seis meses do início do estudo. Os dois grupos se mostraram semelhantes no momento inicial. Após seis meses, foram observadas reduções significativas no grupo de tratamento imediato para todos os parâmetros periodontais clínicos. A análise do WHOQoL-bref por domínios mostrou pequenas alterações não significativas em ambos os grupos. Na avaliação dos escores totais de OHIP-14 foi observada, após 6 meses, uma redução de 18,6 para 15 (Δ=3,6) no grupo tardio e de 15 para 5,7 (Δ=9,3) no grupo imediato, com diferenças estatisticamente significantes entre os grupos (p=0,003). Essas diferenças resultaram em um tamanho de efeito de 0,27 (pequeno) para o grupo tardio e 0,78 (moderado) para o grupo imediato. Na análise por domínios, foram encontradas diferenças significativas para o grupo imediato nos domínios limitação funcional (p=0,006), desconforto psicológico (p=0,001), incapacidade física (p=0,009) e incapacidade psicológica (p=0,007), comparado ao grupo tardio. Em pacientes portadores da SM, as mudanças na percepção da qualidade de vida aferidas pelo OHIP-14 foram significativas para o grupo de pacientes que recebeu tratamento periodontal imediato, em comparação ao grupo que recebeu o tratamento tardio. / The aim of this study was to assess the effect of periodontal treatment in quality of life of patients with Metabolic Syndrome, in a sample of 48 patients. The patients showed diagnosis of Periodontitis and Metabolic Syndrome and were randomized for two treatment groups: 1) immediate periodontal treatment 2) later treatment, six months after study inclusion. The instruments OHIP-14 and WHOQoL-bref were used to assess oral health related quality of life and general quality of life, respectively. Complete periodontal exams evaluated plaque visible index, gingival bleeding index, plaque retentive factors, probing depth, bleeding on probing and clinical attachment level, on six sites per tooth. Furthermore, antropometrics, blood exams and interview with quality of life measures instruments were performed in baseline and six months after the beginning of the study. Both groups were similar in baseline. After six months, significant reductions on immediate treatment group for all clinical periodontal parameters were observed. The WHOQoL-bref analysis by domains showed no significant small changes, for both groups. After six months, a decrease of 18,6 to 15 (Δ=3,6) for the later treatment group and 15 to 5,7 (Δ=9,3) for the immediate treatment group was observed in the evaluation of OHIP-14 for total scores, with statistical significant differences between the groups (p=0,003). These differences resulted in an effect size of 0,27 (small) for the later treatment group and 0,78 (moderate) for the immediate treatment group. In domains analysis, significant differences for the immediate treatment group on functional limitation (p=0,006), psychological discomfort (p=0,001), physical incapacity (p=0,009) and psychological incapacity (p=0,007) domains, were found compared to later treatment group. In patients with Metabolic Syndrome, changes on quality of life perception measured by OHIP-14 were significant for immediate treatment group, compared to the later treatment group.

O objetivo do presente estudo foi avaliar o efeito do tratamento periodontal na qualidade de vida de pacientes portadores de Síndrome Metabólica (SM), em uma amostra de 48 pacientes. Os pacientes apresentavam diagnóstico de Periodontite e SM e foram randomizados para dois grupos de tratamento: um grupo ao qual era oferecido tratamento periodontal imediato e outro grupo de tratamento tardio, que receberia o tratamento periodontal após seis meses da sua inclusão no estudo. Para aferir qualidade de vida relacionada à saúde bucal e qualidade de vida geral, foram usados os instrumentos OHIP-14 e WHOQoL-bref, respectivamente. Exames periodontais completos avaliaram Índice de placa visível, Índice de sangramento gengival, Fatores retentivos de placa, Profundidade de sondagem, Sangramento à sondagem e Nível de inserção clínica, em seis sítios por dente. Além disso, exames antropométricos, exames sorológicos e entrevistas com os questionários de qualidade de vida foram realizados no momento inicial e após seis meses do início do estudo. Os dois grupos se mostraram semelhantes no momento inicial. Após seis meses, foram observadas reduções significativas no grupo de tratamento imediato para todos os parâmetros periodontais clínicos. A análise do WHOQoL-bref por domínios mostrou pequenas alterações não significativas em ambos os grupos. Na avaliação dos escores totais de OHIP-14 foi observada, após 6 meses, uma redução de 18,6 para 15 (Δ=3,6) no grupo tardio e de 15 para 5,7 (Δ=9,3) no grupo imediato, com diferenças estatisticamente significantes entre os grupos (p=0,003). Essas diferenças resultaram em um tamanho de efeito de 0,27 (pequeno) para o grupo tardio e 0,78 (moderado) para o grupo imediato. Na análise por domínios, foram encontradas diferenças significativas para o grupo imediato nos domínios limitação funcional (p=0,006), desconforto psicológico (p=0,001), incapacidade física (p=0,009) e incapacidade psicológica (p=0,007), comparado ao grupo tardio. Em pacientes portadores da SM, as mudanças na percepção da qualidade de vida aferidas pelo OHIP-14 foram significativas para o grupo de pacientes que recebeu tratamento periodontal imediato, em comparação ao grupo que recebeu o tratamento tardio. / The aim of this study was to assess the effect of periodontal treatment in quality of life of patients with Metabolic Syndrome, in a sample of 48 patients. The patients showed diagnosis of Periodontitis and Metabolic Syndrome and were randomized for two treatment groups: 1) immediate periodontal treatment 2) later treatment, six months after study inclusion. The instruments OHIP-14 and WHOQoL-bref were used to assess oral health related quality of life and general quality of life, respectively. Complete periodontal exams evaluated plaque visible index, gingival bleeding index, plaque retentive factors, probing depth, bleeding on probing and clinical attachment level, on six sites per tooth. Furthermore, antropometrics, blood exams and interview with quality of life measures instruments were performed in baseline and six months after the beginning of the study. Both groups were similar in baseline. After six months, significant reductions on immediate treatment group for all clinical periodontal parameters were observed. The WHOQoL-bref analysis by domains showed no significant small changes, for both groups. After six months, a decrease of 18,6 to 15 (Δ=3,6) for the later treatment group and 15 to 5,7 (Δ=9,3) for the immediate treatment group was observed in the evaluation of OHIP-14 for total scores, with statistical significant differences between the groups (p=0,003). These differences resulted in an effect size of 0,27 (small) for the later treatment group and 0,78 (moderate) for the immediate treatment group. In domains analysis, significant differences for the immediate treatment group on functional limitation (p=0,006), psychological discomfort (p=0,001), physical incapacity (p=0,009) and psychological incapacity (p=0,007) domains, were found compared to later treatment group. In patients with Metabolic Syndrome, changes on quality of life perception measured by OHIP-14 were significant for immediate treatment group, compared to the later treatment group.

Syfte Syftet med denna studie var att undersöka hur tandförlust påverkar den orala hälsorelaterade livskvalitén genom ett OHIP-14 fråge-formulär samt ytterligare konstruerade frågor, bland patienter som besöker Kantipur Dental College and Hospital (KDCH) i Katmandu, Nepal. Material och metod Data erhölls från ett frågeformulär baserat på OHIP-14, kompletterande frågor och klinisk undersökning. Studien var av beskrivande karaktär och undersökte konsekutiva patienter (n=249) som besökte KDCH. Data från ifyllda formulär analyserades genom SPSS för att undersöka sambandet mellan tandförlust och påverkan på livskvalitén. Resultat Medelåldern var 47.6 år med en könsfördelning på 48 % (n=119) män och 52 % (n=130) kvinnor. Det genomsnittliga antalet saknade tänder var 5, och den genomsnittliga totala OHIP-poängen var 21.57 (SD 12.55). De mest påverkade dimensionerna för OHIP-14 var "Fysisk smärta" (77 %) och "Psykologiskt obehag" (82.5 %). 96.8 % av den undersökta befolkningen upplevde någon form av påverkan på deras orala hälsorelaterad livskvalitet. Slutsats Resultaten i denna studie visar att en stor majoritet av patienterna som besöker KDCH upplever någon form av påverkan på sin oral-hälsorelaterade livskvalitet relaterad till tandförlust. De saknade tändernas position hade ingen signifikant effekt på den orala hälsorelaterade livskvaliteten medan en större inverkan på livskvalitén kunde observeras vid ökande antal saknade tänder. De OHIP-poäng, utifrån de kriterier som använts i denna studie, visade sig vara högre i jämförelse med andra internationella fynd. / Aim The aim of this study was to investigate how tooth loss affects the oral health related quality of life through an OHIP-14 questionnaire and additional questions among patients visiting the Kantipur Dental College and Hospital (KDCH) in Kathmandu, Nepal. Materials and method Data was obtained from a questionnaire based on the OHIP-14 form, additional questions and a clinical examination. The study was of a descriptive nature and investigated consecutive patients (n=249) visiting the KDCH. Data from completed forms were analysed with SPSS to investigate how tooth loss affects the oral health related quality of life (OHRQoL) Results Mean age was 47.6 years with a gender ratio of 48 % (n=119) male and 52 % (n=130) female. The mean number of missing teeth was 5, and the mean total OHIP-score was 21.57 (SD 12.55). The most frequently impacted dimensions for the OHIP-14 were “Physical pain” (77 %) and “Psychological discomfort” (82.5 %). 96.8 % of the investigated population experiencing some form of impact on their OHRQoL. Conclusion A large majority of the patients visiting the KDCH experienced an impact on their OHRQoL related to missing teeth. The number of missing teeth had an impact on OHRQoL, but the position of missing teeth had not. The OHIP score with the criteria used in this study was found to be higher in comparison to other international findings.

Abstract The retention of a complete denture and the patient’s adaptation varies considerably among different individuals. Resorption of the edentulous alveolar ridge differs greatly and some patients need implant-retained overdentures to enable adequate retention of their prostheses. In some extreme cases it is necessary to increase the volume of the alveolar ridge with bone grafts. The aim of this study was to examine the outcome of implant-supported overdenture treatment conducted in Oulu University Hospital. The aim was also to assess the impact of treatment on oral health-related quality of life and patient satisfaction. The study group was comprised of patients treated with a mandibular or maxillary implant overdenture and a group of patients with extreme mandibular bone resorption treated with extraoral bone grafts and implants. The treatments were performed in 1985–2013 thus also providing long-term results. The results of this study showed predictable and successful treatment outcomes also among elderly patients and in severe situations with bone deficiency. The most frequent complication in the clinical follow-up was loosening of the retention mechanism, commonly noted in other previous studies. Despite some minor mechanical defects in prosthetic structures or mild mucosal inflammation around the implants, they did not hinder everyday use of the prostheses. Neither the number of supporting implants nor the connection type seemed to have a great impact on patient satisfaction. Older patients with a mandibular overdenture seemed to be most satisfied. In conclusion, treatment with implant overdentures seems to be successful also in the long-term. / Tiivistelmä Kokoproteesin pysyvyys ja potilaan sopeutuminen proteesiin vaihtelee huomattavasti eri yksilöiden välillä. Hampaattoman luuharjanteen resorptiossa on eroja, ja osalle potilaista implanttikiinnitteinen peittoproteesi on välttämätön riittävän proteesin pysymisen mahdollistamiseksi. Hyvin pitkälle edenneissä luuharjanteen resorptioissa voi leukaluun lisääminen luusiirteillä olla tarpeellista. Tutkimuksen tarkoituksena oli selvittää Oulun yliopistollisessa sairaalassa tehtyjen implanttikiinnitteisten peittoproteesihoitojen tuloksia. Tavoitteena oli myös arvioida hoidon vaikutusta suunterveyteen liittyvään elämänlaatuun ja potilastyytyväisyyteen. Tutkittava ryhmä koostui potilaista, joille oli valmistettu alaleukaan tai yläleukaan implanttikiinnitteinen peittoproteesi, ja potilasjoukosta, jolle hyvin pitkälle edenneen luuresorption vuoksi implanttihoito oli tehty luusiirteiden avulla. Hoidot tehtiin vuosina 1985–2013, ja tutkimuksissa voitiin arvioida myös peittoproteesihoidon pitkäaikaistuloksia. Tutkimus osoitti, että hoitotulokset olivat ennustettavia ja onnistuneita myös iäkkäillä potilailla sekä potilailla, joilla luupuutos oli kaikkein vaikein. Yleisin todettu komplikaatio kliinisessä tutkimuksessa oli proteesin kiinnitysmekanismin löystyminen. Pienet proteesirakenteiden rikkoutumiset tai lievät limakalvon tulehdusreaktiot implanttien ympärillä eivät kuitenkaan haitanneet proteesin toimintaa ja päivittäistä käyttöä. Peittoproteesia tukevien implanttien määrällä tai kiinnitystyypillä ei todettu olevan suurta vaikutusta potilastyytyväisyyteen. Kaikkein tyytyväisimpiä vaikuttivat olevan iäkkäät potilaat, joille oli tehty alaleuan peittoproteesi. Tutkimus osoittaa, että implanttikiinnitteinen peittoproteesihoito on menestyksellistä myös pitkällä aikavälillä.