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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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      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.


      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.


      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.


      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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          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.

            Author and article information

            [ ]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
            +46730866338 ,
            Health Qual Life Outcomes
            Health Qual Life Outcomes
            Health and Quality of Life Outcomes
            BioMed Central (London )
            10 December 2015
            10 December 2015
            : 13
            © Pousette Lundgren et al. 2015

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, 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 ( applies to the data made available in this article, unless otherwise stated.

            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
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