Qualidade de vida de adolescentes em tratamento ortodôntico corretivo com aparelho fixo: avaliação longitudinal utilizando um instrumento condição específica

Abstract

The aim of this study was to evaluate the impact of the first year of orthodontic treatment with fixed appliances on adolescents’ oral health-related quality of life (OHRQoL), in an assessment employing a condition-specific instrument. Adolescents between 10 and 18 years were included. Data on the sociodemographic variables, such as sex, age, parents’ schooling, family income (minimum wage-MW), and number of individuals depending on this income were collected. Data on the clinical variables orthodontic extraction, malocclusion severity (assessed with the Dental Aesthetics Index), and treatment time were also collected. OHRQoL was evaluated with the Brazilian version of the “Impact of fixed appliance measure” (B-IFAM) with questions distributed across nine domains: aesthetics, functional limitations, dietary impact, oral hygiene impact, maintenance, physical impact, social impact, time constraints, and travel/cost/inconveniences. Response options followed a Likert scale ranging between 1 and 5; 1=strongly disagree and 5=strongly agree. The higher score, the more negative was the perception of the adolescent regarding his/her OHRQoL. Participants answered the questionnaire at T1, T2, T3, and T4 (1, 3, 6, and 12 months after fixed appliance bonding). Two scientific articles were drafted. Descriptive statistics was performed. For the analysis of comparison between girls and boys, Pearson’s test, Student t test, Fisher’s test, linear regression, calculation of the minimal clinically important difference (MCID) and effect size were performed. The association of sociodemographic and clinical variables with OHRQoL was evaluated with the Analysis of Covariance. Statistical significance was set at p<0.05. In the first article, 38 girls and 31 boys were assessed. Girls had a more negative impact of the fixed appliance wearing on the B-IFAM total score (p=0.006) and on the aesthetics (p=0.034) and physical impact (p=0.011) domains, when compared with boys between T2 and T4. For both domains, differences between boys and girls were greater than the MCID. The effect size was moderate. In the second article, 75 adolescents were assessed. Individuals who were ≤12 years had a more negative perception of the domain dietary impact than individuals who were >12 years (p=0.026). Individuals whose parents/caregivers had ≥8 years of schooling had a more negative perception of the domain oral hygiene impact than individuals whose parents/caregivers had <8 years of schooling (p=0.024). Individuals whose families had an income ≤2 MWs had a more negative perception of the domain maintenance impact than individuals whose families had an income >2 MWs (p=0.016). Girls had a more negative perception of the domain physical impact than boys (p<0.018). Girls, adolescents whose families had an income ≤2 MWs, and adolescents with severe malocclusion had a more negative perception of the domain travel/cost/inconveniences than boys (p=0.011), adolescents with slight malocclusion (p=0,026) and adolescents whose families had an income >2 MWs (p=0.003). Girls exhibited a total score of the B-IFAM significantly higher than boys (p=0.041). Adolescents’ sex, age, and malocclusion as well as parents’/caregivers’ schooling and family income were associated with the impact of orthodontic treatment on adolescents’ OHRQoL.