Impacto do tratamento com alinhadores ortodônticos na qualidade de vida relacionada à saúde bucal: um estudo transversal

Abstract

The aim of the study that gave rise to this thesis was to assess the impact of the wearing of orthodontic aligners on the oral health-related quality of life (OHRQoL) of individuals. Data collection was carried out at the Graduate Program in Orthodontics of the Associação Brasileira de Odontologia (ABO). Adolescents and adults were divided into two groups; Group 1 (G1): individuals wearing orthodontic aligners. Group 2 (G2): individuals wearing conventional fixed appliances. During orthodontic treatment, all participants answered the Oral Health Impact Profile (OHIP-14) with seven subscales: functional limitation (FL), physical pain (PP), psychological discomfort (PD), physical disability (PhyD), psychological disability (PsyD), social disability (SD), and handicap (H). The higher the score, the more negative was the erception of OHRQoL. Participants' malocclusion was evaluated using the Dental Aesthetics Index (DAI). The variables sex and age of participants, family income e time of orthodontic treatment were collected. Artigo 1: one aimed to compare the impact of the wearing of orthodontic aligners with the wearing of conventional fixed appliances on the OHRQoL of individuals. Group 1 (G1) consisted of 33 individuals undergoing treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals undergoing treatment with conventional fixed appliances. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect size (ES) and minimal clinically important difference (MCID) were also determined. Participants’ mean age was 30.69 years. Individuals in G1 had a significantly lower score for PP and for the total score compared to those in G2 (p<0.05). The TE for PP was high (TE=0.74) and moderate for the total score (TE=0.46). TE was moderate for PhyD (TE=0.50). The difference between groups for the PP subscale (1.30) and for the PhyD subscale (0.90) was greater than the MCID (0.87 and 0.88, respectively). The results of Poisson regression showed that individuals in G2 had a score on the PP subscale 1.40 times higher than those in G1 in the adjusted model (OR=1.40, [1.03-1.90], p=0,03). We conclude that wearers of orthodontic aligners have a more positive perception of OHRQoL compared to wearers of conventional fixed appliances. Article 2: one aimed to explore the factors associated with the OHRQoL of wearers of orthodontic aligners. Thirty-four individuals participated. One performed descriptive statistics and Poisson regression with robust variance to evaluate the factors that may be associated with the impact of the wearing of orthodontic aligners. On OHRQoL. Beta coefficients (coef) and standard errors (SE) were determined. Individuals with higher DAI had significantly higher scores in the subscales FL [p=0.014, Coef (SE)=0.12 (0.51)], PP [p= 0.004, Coef (SE)= 0.08 (0.02)], PhyD [p=0.001, Coef (SE)=0.21 (0.06)], PsyD [p=0.007, Coef (SE)=0.15 (0.05)], SD[p=0.001, Coef (SE)=0.21 (0.05) )], and the total score [p=0.001, Coef (SE)=0.12 (0.02)]. For the subscale H [p=0.011, Coef (SE)=-0.07 (0.02)], younger individuals scored significantly higher. One can conclude that younger individuals and those with a more severe malocclusion exhibited worse OHRQoL.