Personal experiences and social perception of a modified twin block appliance

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Bowe, John C.
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University College Cork
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Aims • To evaluate patient experiences over the first 6 months of Modified Twin Block Appliance (MTBA) treatment for the correction of Class II division 1 malocclusion. • To investigate whether social judgements are made by peers of patients with Class II division 1 malocclusion with and without an MTBA. Materials and methods • Following ethical approval, 50 children, with Class II division 1 malocclusion (overjet greater than 7 mm) were recruited. Treatment was undertaken with an MTBA and the children were followed up for 6 months. Two validated questionnaires were completed at prescribed time-points. One questionnaire recorded pain and discomfort scores; the second questionnaire, the Child Perception Questionnaire (CPQ), assessed the impact treatment with an MTBA had on the child’s OHRQoL. Statistical analysis was performed using SAS (Version 9.4) • Following ethical approval, a cross-sectional questionnaire study was conducted on 461 children from 30 randomly selected primary schools in Cork City and County. Each child was randomly assigned one full face smiling photograph of a boy or girl, with or without an MTBA in situ. Children were asked to make judgements concerning the subject’s social competence (SC), psychosocial adjustment (PA) and intellectual ability (IA). Four point Likert scales were used to record their opinions. Statistical analyses were performed using SAS (Version 9.4) Results • After fitting an MTBA, mean pain scores peaked in the incisors in the first 2 days, lip and soft tissue pain peaked on day 2, with the former greater than the latter. Discomfort in the jaws peaked on day 1. Over a 6 month period, the mean levels of pain and discomfort reported after fitting of an MTBA were mild. The frequency of headaches was lower after 6 months of MTBA treatment than before fitting the MTBA. • The mean CPQ scores were highest at the 6 week time-point (p=0.0155) in the OS, FL, SWB domains. Patients who reported wearing the MTBA full time (p=0.0070) or full time except while eating (p=0.0288) had lower CPQ scores than those with poor compliance. The larger the pre-treatment overjet, the greater the CPQ scores in the EWB and SWB domains (p=0.0258 and p=0.0458) respectively. • There was no significant difference between social competence (SC) (p=0.2614), psychosocial ability (PA) (p=0.6890), and intellectual ability (IA) (p=0.2564) for the presence or absence of an MTBA. For SC, 11 year old children gave a more positive rating than 12 year old children when the child in the photograph was male. For PA and IA, females tended to give more positive ratings than males, particularly when the child in the photograph was male. Conclusions • After fitting an MTBA, peak dental and soft tissue pain was experienced on day 1 and day 2 respectively. • Peak discomfort in the teeth and jaws occurred on the evening of fit and decreased after day 1. In general over the first 6 months after fitting an MTBA mean pain and discomfort levels in the teeth, soft tissues and jaws were mild. • MTBA wear had its greatest impact on OHRQoL at 6 weeks and those with good compliance had overall better OHRQoL than those with poor compliance. • Social perceptions of children do not differ in the presence or absence of an MTBA.
Experiences , Social perception , Modified twin block appliance
Bowe, J. C. 2018. Personal experiences and social perception of a modified twin block appliance. PhD Thesis, University College Cork.