Magister Chirurgiae Dentium (MChD) / An analysis of the oral health related quality of life (OHRQoL) of patients with orofacial clefts at the Wentworth Foundation in Durban, KZN is presented. Objectives: To assess whether the OHRQoL of orofacial cleft patients varies amongst different age groups, genders or cleft types as well as demographic factors. Method: 46 participants, aged 8- 18, completed a self-administered Child Oral Health Impact Profile (COHIP) questionnaire. Results: The most prevalent cleft type was the Unilateral Cleft Left, 45.7%. The COHIP mean score was 84.195 (SD 18.244) ranging from 35 to 110. The age related subscales which were statistically significant included Functional well-being (p value: 0.0456), School Environment (p value: 0.0145) and Treatment Expectancy. The subscale School Environment was statistically significant for: Transport (p value: 0.0267) and Place of accommodation (p value 0.028). The Oral Health subscale and the Educational level were statistically significant (p value 0.043). Conclusion: Statistically significant age-related differences and demographic factors were noted. The OHRQoL of cleft patients was low largely due to socioeconomic factors and difficulty accessing multidisciplinary care. Therefore, our findings highlight the importance of establishing a Cleft lip and palate multidisciplinary facility for these patients in the Wentworth foundation and subsidised transport to the Wentworth Foundation is recommended.

Philosophiae Doctor - PhD / Rehabilitation of edentulous jaws without the option of osseointegrating implants will remain the only treatment option within reach of many older patients for the foreseeable future. Many routine prosthodontic procedures are based on dogmas, because no high-level scientific evidence exists to either accept or reject them, among these is the “neutral zone” (NZ) concept. In spite of paucity of evidence using approved patient-based outcome instruments, it is generally agreed that the NZ should be respected when constructing complete dentures. The purpose of this research project was to determine how shapes of conventional and NZ mandibular dentures differ, and if the two different types of dentures impact differently on oral health–related quality of life by using an accepted oral health-related quality of life instrument as a patient-based outcome. Thirty nine edentulous patients were selected for his prospective, randomised, cross-over, single-blinded clinical trial. Two sets of complete dentures were made for each patient. One denture set was made following conventional biometric guidelines for determining the position of the mandibular posterior denture teeth in relation to the ridge; another set was made following a functional impression of the potential denture space. Each set of dentures was worn for at least two months. A similar number of types of dentures were delivered first. Widths of residual ridges and mandibular denture arches were measured using digital measuring software. Position of denture teeth was related to the ridge. Denture dimensions were compared by means of analysis of variance using the mixed procedure. Using formula of parabola, arch-widths were compared using paired t-tests. Pre- and post-treatment patient feedback was obtained by means of the 20-item Oral Health Impact Profile (OHIP-20) and a preference score. Treatment effect size (ES) was established based on the OHIP-20 scores. Relevant associations among denture dimensions, OHIP-20 scores, preference, age, gender, marital status, education, income, period of edentulousness, and quality of denture-bearing tissue were done using the generalised linear model and correlation analysis. For all statistical analysis, level of significance was determined at p<0.05. The mean age of the sample was 62.3 years. Twenty four patients were female. Mean period of edentulousness was 31 years and mean number of denture sets worn prior to the trial was 2.5. Except for the canine region, NZ dentures were statistically wider than anatomic dentures. The difference in mean widths between the two types of dentures was larger for female patients. Older patients had smaller differences in denture dimensions. More unfavourable denture-bearing tissue was associated with a larger difference in the two types of dentures. Both types of mandibular dentures significantly improved the OHRQoL of patients. Both types of dentures had a high treatment ES. The OHIP-20 instrument could not distinguish a statistical difference in impact on OHRQoL between the two treatment options. There was a minute difference in treatment ES between the two types of treatment. The only domain representing a small clinical benefit between NZ and anatomic dentures was “physical pain”, with the NZ dentures scoring better. There was no correlation between pre- and post-treatment scores for both types of dentures. No significant associations were found between post-treatment OHIP- 20 scores on the one hand and tissue scores, gender, age, education, marital status, period of edentulousness and denture dimension differences on the other hand. Based on OHIP-20 scores, there was a significant association between denture preference and NZ dentures, but not for the other preferences. No significant associations were found between denture preferences on the one hand and tissue scores, gender, age, period of edentulousness and denture dimension differences on the other hand. Even though no significant relationship was found between preference and gender, the majority of female patients preferred the NZ denture and the majority of male patients did not express a preference.Providing new complete dentures improved OHRQoL of edentulous patients. The majority of female patients preferred the NZ compared over the ANA denture. The NZ technique appeared to have a higher positive impact on OHRQoL of female patients compared to male patients.

No description available.

The aim of this thesis is to describe the development of oral health and possible associations with socioeconomic and socio-behavioural factors, in an adult population over a period of 30 years. A further aim is to describe attitudes to, and demands of dental care, and the impact of oral conditions on quality of life. The study sample consisted of 787-1158 individuals, aged between 35-85 years, randomly selected from Dalarna’s population register in 1982, 2002, 2007 and 2012. The studies were carried out in 1983, 2003, 2008 and 2013, and the participants responded to a questionnaire and a clinical examination of oral status. There has been a substantial improvement in oral status in regard to the mean number of teeth, intact teeth, and less removable dentures over this period of 30 years. The proportion of individuals with alveolar bone loss decreased significantly between 1983 and 2008, but increased significantly between 2008 and 2013. Smoking was the overall strongest factor associated with alveolar bone loss, after adjustment for socioeconomic and socio-behaviour factors, age and number of teeth. Calculus, visible on radiographs, increased significantly between 2003 and 2013. The proportion of individuals with manifest caries declined significantly between 1983 and 2008, but seems to level out between 2008 and 2013. Socioeconomic and socio-behaviour factors were significantly associated with manifest caries. Preventive treatment, meeting the same caregiver as on previous visits, and information about treatment cost was reported to a significantly lower degree as important in 2013, compared with 2003 and 2008, and booking time for treatment was reported as more difficult in 2013, compared with earlier years. Regular recalls was reported as less important in 2013, compared with 2008. A third of the respondents reported oral impact on daily performance and irregular dental visits, limited economy for dental care, less than 20 remaining teeth, manifest caries and temporomandibular disorder were significantly associated with oral impact on daily performance.

Os objetivos deste estudo de corte transversal, analítico e descritivo, foram: 1) Avaliar a percepção dos pais e/ou cuidadores em relação a qualidade de vida (QVRSB) relacionada à saúde e à saúde bucal de crianças e adolescentes com diagnóstico do TEA. 2) Avaliar se a condição bucal das crianças e adolescentes com diagnóstico do TEA pode interferir na QVRSB e QVRS. Material e métodos: Este estudo transversal contou com a participação de 74 crianças e adolescentes com TEA cadastrados no CAPE (Centro de atendimento a Pacientes Especiais) / FOUSP, entre 2017 e 2018, com idades entre 5 e 18 anos (9,81± 3,70).A Saúde bucal foi caracterizada por meio da avaliação do Índice de sangramento gengival (ISG), Índice de placa (IP), Índice de dentes cariados, perdidos e obturados ceo-d/(CPO-D), Índice de defeito de desenvolvimento do esmalte dentário (DDE), Anomalias dentárias (AD), Hábitos parafuncionais e a Escala comportamental de Venham. Para avaliação da QVRS e QVRSB foi selecionado o instrumento Peds QL® 4.0 - relato dos pais/responsáveis e PedsQL®Escala bucal - relato de crianças pais/responsáveis, uttilizamos a análise de Regressão de Poison. Resultados: as variáveis explanatórias que atuaram negativamente determinado uma pior QVRSB foram: aglomeração domiciliar maior ou igual à 4 pessoas, 3 ou mais filhos, presença de ceo-d/CPO-D maior que zero e e protesto generalizado durante atendimento odontológico. Maior comprometimento emocional esteve associado à renda familiar menor que 2 salários mínimos, ceo-d/CPO-D maior que dois e protesto moderado durante o atendimento odontológico. A piora na atividade escolar esteve associada ao maior número de filhos (3 ou mais filhos) e protesto generalizado durante o atendimento odontológico. Houve associação entre capacidade física e idade da criança, aglomeração familiar e protesto generalizado durante o atendimento odontológico, sendo que valores maiores dessas variáveis determinaram efeito negativo na capacidade física. Houve associação entre construto social e algumas variáveis explanatórias clínicas. Observamos que a pior interação social estava associada com maior CEOd/ CPO-D e protesto intenso durante o atendimento odontológico. Conclusão: De acordo com a percepção dos pais/responsáveis houve impacto negativo reduzido tanto na QVRS, como na QVRSB das crianças/adolescentes com TEA. O construto emocional e o de saúde bucal foram os mais associados às variáveis socioeconômicas e clínicas. / The objectives of this cross-sectional, analytical and descriptive study were: 1) To evaluate the perception of parent sand / or caregivers regarding quality of life (HRQoL) related the health and oral health of children and teenagers diagnosed with Austism Spectrum Disorder (ASD) 2) Evaluateif oral condition of children and adolescents diagnosed with ASD interfere with HRQoL and HRQoL. Material and methods:This cross-sectional study comprised 74 children and teenagers with ASD, enrolled in the CAPE (Special Patient Care Center) / FOUSP between years 2017 and 2018, aged between 5 and 18 years (9.81 ± 3 , 70). Oral health was characterized by evaluation of gingival bleeding index, plaque index, ceo-d /CPO-D, enamel development defect index (DDE). To evaluate behavior durind dental care, the Vehan\'s Behavioral Scale was used. For the evaluation of the HRQoL and QRSRS, the Peds QL® 4.0 instrument - parent / guardian reportand PedsQL® Oral Scale - parent / guardian report were used. Poison Regression analysis was performed to identify possible associations amongs planatory variables. Results:The explanatory variables that negatively worsed OHRQoL were house hold agglomeration greater than or equalto 4 people, 3 or more children, presence of CEO-d/CPO-D greater than 2 and wides pread protest during dental treatment. Highe remotion alimpairment was associated with family income less than 2 minimun wages, CEO-d/CPO-D higher than 2 and moderate protest dudring dental care. The worsening of school activity was associated with higher number of children (3 or more) and wides pread protest during dental care. There wasan association between physical capacity and age of children, family agglomeration and generalized protest during dental care. A higher value of these variables was associated with a negative effect on physical activity. There was also an association between social constructand some clinical explanatory variables. The worse the social interaction, higher the CEO-d/CPO-D and intense protest during dental care. Conclusion: According to the perception of parents there was a reduced negative impact in both HRQoL and OHRQoLof children/adolescents with ASD. The emotional and oral health construcs were the most associated with socioeconomic and clinical variables.

In der vorliegenden Untersuchung sollte ein möglicher Zusammenhang zwischen mundgesundheitsbezogener Lebensqualität (MLQ) und Depression untersucht und bei prothetischen Patienten und Personen der Allgemeinbevölkerung vergleichend betrachtet werden. Es handelt sich um eine Querschnittsstudie, in welche 311 zahnärztlich-prothetische Patienten und 811 erwachsene Probanden der Bundesrepublik Deutschland einbezogen wurden. Zur Erfassung von MLQ und Depression wurden als standardisierte Instrumente zum einen die deutsche Version des Oral Health Impact Profile (OHIP) und zum anderen das Vereinfachte-Beck-Depressions-Inventar (BDI-V) eingesetzt. Die statistischen Zusammenhänge der Konstrukte wurden mit Hilfe von Korrelationsanalysen sowie Strukturgleichungsmodellen ermittelt. Die konfundierenden Variablen Alter und Geschlecht wurden dabei kontrolliert. In beiden Populationen wurde ein signifikanter Zusammenhang zwischen Depression und MLQ festgestellt. Diese gegenseitige Beeinflussung zwischen MLQ sowie deren Dimensionen und der Depression war jedoch zwischen den beiden Probandengruppen signifikant unterschiedlich stark ausgeprägt. Bei den prothetischen Patienten war der Zusammenhang nur halb so stark ausgeprägt wie bei den Personen der Allgemeinbevölkerung. Die OHIP-Dimension „Psychosozialer Einfluss“ der MLQ korrelierte in beiden Probandengruppen signifikant stärker mit Depression als die anderen Dimensionen. Folglich könnte sie auf eine mögliche Depression hinweisen und als zahnärztliches Diagnostikum eingesetzt werden. Zudem legt diese Studie nahe, dass eine eingeschränkte MLQ möglicherweise erst zeitversetzt zu depressiven Symptomen führen kann.

Das Ziel der vorliegenden Arbeit war es die Mundgesundheit sowie die mundgesundheitsbezogene Lebensqualität (MLQ) von Patienten mit rheumatoider Arthritis (RA) zu erfassen und mit Allgemeingesunden zu vergleichen. Des Weiteren wurden das Mundhygiene- sowie das zahnärztliche Verhalten erfasst. In die Untersuchung wurden RA-Patienten gemäß den ACR-Kriterien einbezogen. Entsprechend des Alters, Geschlechtes und Rauchverhalten der RA-Patienten wurde soweit möglich eine Kontrollgruppe aus Allgemeingesunden zusammengestellt (Matching). Für die Erfassung der Mundgesundheit wurden alle Probanden hinsichtlich dentaler (DMF-T) und parodontaler Befunde (Sondierungstiefen = ST, Blutung auf Sondierung = BOP sowie klinischer Attachmentverlust = AV) untersucht. Anhand von ST und/oder AV erfolgte die Einteilung der Parodontalerkrankung nach Schweregrad in: gesund/milde, moderate oder ausgeprägte Parodontitis. Die subjektiv wahrgenommene MLQ wurde mit Hilfe des Oral Health Impact Profile G14 (OHIP G14) erfasst. Das Mundhygiene- und zahnärztliche Verhalten wurde im Rahmen einer Befragung mit Hilfe eines speziellen Fragebogens erhoben. Insgesamt wurden 103 RA-Patienten und 104 Gesunde einbezogen. Hinsichtlich dentaler Befunde (DMF-T) sowie gingivaler Entzündung (PBI) konnten keine signifikanten Unterschiede zwischen beiden Gruppen festgestellt werden, jedoch wiesen die RA-Patienten eine größere Anzahl fehlender Zähne (M-T) auf. Beim parodontalen Befund konnten in der RA-Gruppe geringfügige aber signifikant bessere parodontale Zustände (ST, AV und Parodontitisschweregrad) im Vergleich zur Kontrollgruppe detektiert werden. Jedoch wurde im Vergleich zur Kontrollgruppe ein signifikant höherer BOP festgestellt. Im Mundhygiene- und zahnärztlichen Verhalten zeigten sich zwischen beiden Gruppen nur geringfügige Unterschiede. So zeigten sich insbesondere signifikante Differenzen beim Informationsstand über Mundhygienemaßnahmen sowie den –hilfsmitteln; dabei wiesen RA-Patienten vornehmlich Defizite auf. Die untersuchten RA-Patienten nahmen eine signifikant höhere Beeinträchtigung in der MLQ wahr, als die Kontrollgruppe. Dabei ist diese subjektive Einschätzung der MLQ scheinbar unabhängig von der vorliegenden Mundgesundheitssituation (dental sowie parodontal). Hingegen war bei den allgemeingesunden Probanden ein signifikanter Zusammenhang von schlechteren dentalen und parodontalen Mundgesundheitszuständen mit einer zunehmenden Beeinträchtigung der MLQ zu verzeichnen. Weitere Einflussfaktoren, wie Geschlecht und Rauchverhalten, lassen sowohl bei den RA-Patienten als auch in der Kontrollgruppe keinen Einfluss auf die MLQ erkennen. Während bei den allgemeingesunden Probanden für das Alter ebenfalls kein Zusammenhang mit der MLQ festgestellt wurde, war in der RA-Gruppe ein signifikanter Einfluss des Alters (>60 Jahre) zu erkennen.:Inhalt 1. Einleitung 1.1 Erkrankungen der Mundhöhle 1.1.1 Karies 1.1.2 Parodontitis 1.2 Rheumatoide Arthritis 1.3 Zusammenhang zwischen Mundgesundheit und Rheumatoider Arthritis 1.4 Mundgesundheitsbezogene Lebensqualität und Rheumatoide Arthritis 1.5 Zielsetzung und Fragestellung 2. Publikationsmanuskript 3. Zusammenfassung der Arbeit 4. Ausblick 5. Literatur 6. Wissenschaftliche Präsentationen 7. Darstellung des eigenen Beitrages 8. Erklärung über die eigenständige Abfassung der Arbeit 9. Lebenslauf 10. Danksagung

Magister Chirurgiae Dentium (MChD) / Oral Squamous Cell Carcinoma (OSCC) patients suffer from the terrible consequences of the disease and its treatment modalities, and as a result, their Quality of Life (QoL) and Oral Health-related Quality of Life (OHRQoL) is badly affected, especially due to functional limitation, physical disability and psychological disability that they encounter before, during and after treatment. There is a need for more research on OHRQoL of OSCC patients at various treatment intervals. The present study focused on investigating OHRQoL of OSCC patients at the post-treatment phase.

Objectives: The aim of this systematic review was to assess the oral-health-related quality of life (OHRQoL) of adult patients with rheumatic diseases. Material and Methods: A systematic literature search was performed, including clinical studies on adults (aged at least 18 years) with a verified diagnosis of rheumatic disease. Results: 26 out of 41 clinical studies including rheumatoid arthritis (RA, seven studies), systemic sclerosis (SSc, five), Sjögren syndrome (SS, eight), Behcet disease (BD, four), systemic lupus erythematosus (SLE, one) and ankylosing spondylitis (AS, one) were found. In 15 studies, a healthy control group was recruited. The short form of the Oral Health Impact Profile (OHIP 14) was most frequently applied. The majority of studies (14/15) reported worse OHRQoL in patients with rheumatic disease compared to healthy individuals. In particular, patients with SS (salivary flow and composition) or BD (oral ulcers) showed a relation between OHRQoL and disease-specific oral manifestations. Most studies investigating subscales of OHRQoL (5/6) found the subscale physical disability to be predominantly affected in patients with rheumatic diseases. About half of the studies reported impaired psychosocial aspects. Conclusion: Patients with rheumatic diseases exhibit reduced OHRQoL, especially in diseases with oral manifestations like SS and BD. Physical affections due to oral diseases and psychosocial impairments caused by disease-related parameters must be recognized within patient-centered dental care.

Background: Treatment of oral diseases can have a long-lasting impact on a child’s life well beyond its childhood years. The purpose of this study was to compare the impact of treatment on the oral-health-related quality of life (OHRQoL) of children with severe caries and severe molar incisor hypomineralization (MIH). Methods: A total of 210 children (mean age 9 years; 49% female) with severe caries (inner third of dentin) and severe MIH (post-eruptive breakdown, crown destruction) were included in the study. Both groups were matched according to age, gender, and social status. The German version of the Child Perception Questionnaire for 8–10-year-olds (CPQ-G8–10) was used before and after treatment to analyze the impact on OHRQoL. Results: Patients with severe MIH showed a significantly higher total CPQ score (17.8 (±10.6)) before treatment compared to the caries group (13.8 (±14.3)). The mean CPQ score in all subdomains decreased significantly after therapy in the MIH group. Children with severe carious lesions had similar results except in the domain “functional limitations”, as treatment led to only minor changes (2.9 (±3.6) to 2.2 (±2.6)). Conclusions: Despite a narrower treatment spectrum, patients with severe MIH experienced a greater overall improvement in OHRQoL compared to the caries group.