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Oral health-related quality of life before and after crown therapy in young patients with amelogenesis imperfecta

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      Abstract

      Background

      Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization associated with poor esthetics and dental sensitivity. Because the condition is associated with negative social outcomes, this study evaluated oral health-related quality of life (OHRQoL), dental fear, and dental beliefs before and after early prosthetic crown therapy for AI during adolescence.

      Methods

      The study included 69 patients with AI, aged 6–25 yr: 33 males and 36 females (mean age 14.5 ± 4.3); healthy controls (n = 80), patients with cleft lip and palate (CLP; n = 30), and patients with molar incisor hypomineralization (MIH; n = 39). All matched in age and gender, and all but the CLP group insocioeconomic area. Patients completed three questionnaires measuring OHRQoL (OHIP-14), dental fear (CFSS-DS), and dental beliefs (DBS-R). Twenty-six patients with severe AI between ages 9 and 22 yr received crown therapy and completed the questionnaires twice: before and after therapy.

      Results

      OHIP-14 scores were significantly higher among patients with AI (7.0 ± 6.7), MIH (6.8 ± 7.6) and CLP (13.6 ± 12.1) than healthy controls (1.4 ± 2.4) ( p < 0.001). After crown therapy, quality of life problems in the 26 patients with severe AI decreased significantly, from 7.8 ± 6.1 to 3.0 ± 4.8 ( p < 0.001). Early prosthetic therapy did not increase dental fear or negative attitudes toward dental treatment.

      Conclusions

      OHRQoL increased after early crown therapy in patients with severe AI. Therapy did not increase dental fear or negative attitudes toward dental treatment.

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      Most cited references 47

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      A power primer.

       Todd J. Cohen (1992)
      One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided here. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for eight standard statistical tests: (a) the difference between independent means, (b) the significance of a product-moment correlation, (c) the difference between independent rs, (d) the sign test, (e) the difference between independent proportions, (f) chi-square tests for goodness of fit and contingency tables, (g) one-way analysis of variance, and (h) the significance of a multiple or multiple partial correlation.
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        Measurement of health status. Ascertaining the minimal clinically important difference.

        In recent years quality of life instruments have been featured as primary outcomes in many randomized trials. One of the challenges facing the investigator using such measures is determining the significance of any differences observed, and communicating that significance to clinicians who will be applying the trial results. We have developed an approach to elucidating the significance of changes in score in quality of life instruments by comparing them to global ratings of change. Using this approach we have established a plausible range within which the minimal clinically important difference (MCID) falls. In three studies in which instruments measuring dyspnea, fatigue, and emotional function in patients with chronic heart and lung disease were applied the MCID was represented by mean change in score of approximately 0.5 per item, when responses were presented on a seven point Likert scale. Furthermore, we have established ranges for changes in questionnaire scores that correspond to moderate and large changes in the domains of interest. This information will be useful in interpreting questionnaire scores, both in individuals and in groups of patients participating in controlled trials, and in the planning of new trials.
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          Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes.

          Our model proposes a taxonomy or classification scheme for different measures of health outcome. We divide these outcomes into five levels: biological and physiological factors, symptoms, functioning, general health perceptions, and overall quality of life. In addition to classifying these outcome measures, we propose specific causal relationships between them that link traditional clinical variables to measures of HRQL. As one moves from left to right in the model, one moves outward from the cell to the individual to the interaction of the individual as a member of society. The concepts at each level are increasingly integrated and increasingly difficult to define and measure. AT each level, there are an increasing number of inputs that cannot be controlled by clinicians or the health care system as it is traditionally defined.
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            Author and article information

            Affiliations
            [ ]Department of Dental Medicine, Division of Pediatric Dentistry, Karolinska Institutet, POB 4064, SE-141 04 Huddinge, Stockholm, Sweden
            [ ]Department of Pediatric Dentistry, Public Dental Service, Dalarna County, Falun, Sweden
            [ ]Department of Dental Medicine, Division of Orthodontics, Karolinska Institutet, Stockholm, Sweden
            Contributors
            +46730866338 , gunilla.pousette-lundgren@ki.se
            Journal
            Health Qual Life Outcomes
            Health Qual Life Outcomes
            Health and Quality of Life Outcomes
            BioMed Central (London )
            1477-7525
            10 December 2015
            10 December 2015
            2015
            : 13
            4676094
            393
            10.1186/s12955-015-0393-3
            © Pousette Lundgren et al. 2015

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            Funding
            Funded by: Public dental service,County of Dalarna
            Funded by: Center for clinical research, County of Dalarna
            Funded by: Karoliniska Institutet, Emelie och Gotthard Thourens fond
            Categories
            Research
            Custom metadata
            © The Author(s) 2015

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