Análise da associação entre diferentes diagnósticos de maloclusão e do impacto do uso do aparelho ortodôntico fixo na qualidade de vida de adolescentes

Abstract

The aim of this thesis was to determine association between different diagnoses of malocclusion and the impact of wearing fixed orthodontic appliance on quality of life oral health-related quality of life on among Brazilian adolescents. The population-based study with adolescents aged 11-14 years was carried out from Brumadinho, Brazil. OHRQoL was measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14) - Impact Short Form (ISF: 16), self-reported by adolescents. The clinical examination assessed the malocclusion through the Angles Classification and Dental Aesthetic Index (DAI) and the wearing orthodontic appliance. The study is presented into two manuscripts. The first manuscript describes a cross-sectional design involving a representative sample of 474 adolescents. The aim of study was evaluate the association between different diagnoses of malocclusion on quality of life in adolescents. The dependent variable was OHRQoL and main independent variable was malocclusion. The exclusion criteria were carious lesions in the anterior and posterior teeth, crown fractures and wearing the orthodontic appliance fixed or removable. Data analysis involved descriptive statistics, Mann Whitney test and Pearsons chi-squared test. The data showed that the score the total scale (TS) CPQ11-14 and Emotional wellbeing (EWB) subscale score were associated significantly with malocclusion both diagnosed by Angles Classification (TS p= 0,034; EWB p= 0,043), and DAI (TS p= 0,048; EWB p= 0,025). Based on these results it was concluded different measures of diagnosis of malocclusion may exhibit similar results of negative impact on OHRQoL of adolescents. The second manuscript describes a population-based case-control study with a sample of 327 adolescents. The aim the study was evaluate the impact of wearing fixed orthodontic appliance on quality of life in adolescents. The case and controls groups were defined by tercil. The case group was composed of adolescents with a high negative impact on OHRQoL (n= 218) and the control group was composed of adolescents with a low negative impact on OHRQoL (n=109). Two controls were assigned to each case and matched for age and gender. The dependent variable was OHRQoL and main independent variable was the use of a fixed orthodontic appliance. Malocclusion and type of school were identified as possible confounding factors. Data analysis involved descriptive statistics, bivariate and multivariate conditional logistic regression analysis (for case-control study), were performed with the significance level set at 5%. The multivariate logistic regression revealed that adolescents who wore a fixed orthodontic appliance had a 4.88-fold (95% CI: 2.93-8.13) greater chance of experiencing a high negative impact on OHRQoL than those who did not wear an appliance. Concluded that adolescents who wearing a fixed orthodontic appliance had more chance to report a high negative impact on OHRQoL than those adolescents who did not wearing.