Children and adolescents and modified twin block for Class II division 1 malocclusion compared to controls: quantitative and qualitative analyses

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dc.availability.bitstreamembargoed
dc.check.date2024-09-30
dc.contributor.advisorMillett, Declanen
dc.contributor.authorO'Dwyer, Caroline
dc.date.accessioned2021-09-21T15:11:45Z
dc.date.available2021-09-21T15:11:45Z
dc.date.issued2021-07
dc.date.submitted2021-07
dc.description.abstractAims • To evaluate the impact Modified Twin Block (MTB) treatment has on oral health related quality of life (OHRQoL), self-esteem, self-perception of aesthetic treatment need and 3D soft tissue facial changes in children with Class II division 1 malocclusion (II/1M) compared to children with II/1M awaiting treatment who served as controls. • To assess the effect MTB treatment has on family quality of life (QoL) and on both the parent’s perception of their child’s OHRQoL and aesthetic treatment need compared to controls. • To assess the level of agreement of child OHRQoL and perception of aesthetic treatment need by child and parent between groups. Materials and methods Following ethical approval, 60 subjects (31 males; 29 females) received MTB treatment (MTB group) and 47 subjects (22 males; 25 females) with II/1M awaiting treatment served as controls (Control group). At baseline (T1) and following MTB treatment/recall (T2) all subjects completed the Child Perception Questionnaire (CPQ11-14), Child Health Questionnaire short from (CHQ-CF45) and self-assessed aesthetic treatment need (IOTN-AC). Each child also had a 3D facial image captured at rest. At the same time points, a parent of each child completed the Parent-Caregiver Perception Questionnaire (P-CPQ) and assessed their child’s aesthetic treatment need (IOTN-AC). Comparisons of patient demographics were made using ANOVA and Chi-square tests. ANOVA was used for comparisons in CPQ, P-CPQ, CHQ-CF45 and 3D soft tissue facial changes at T1 and T2 between groups and paired t-tests were used within both groups. Bowker’s symmetry test was used to compare IOTN-AC within groups and Fisher’s Exact test was used between groups. ANOVA was used to test for associations between CPQ, CHQ, IOTN-AC, and 3D soft tissue facial change. Results Forty-two subjects (20 males; 22 females) completed MTB treatment (average duration 8.5 months; range 5-12 months) and 35 untreated II/1M subjects (15 males; 20 females) were recalled after an average time of 11 months (range 9-13 months). At T1, groups were similar in age (p=0.1402) and gender (p=0.2973) but overjet in the MTB group was slightly greater (p=0.0016). At T2, there was a significant improvement in the MTB group in overall OHRQoL (p<0.0001) and self-perception of aesthetic treatment need (p=0.018) but there was no change in self-esteem (p=0.144). Significant improvements occurred in family QoL (p=0.0001), in parent’s perception of both their child’s OHRQoL (p<0.0001) and aesthetic treatment need (p<0.0001). In the MTB and Control groups and at both time points, the level of agreement between child and parent perception of the child’s OHRQoL was poor with parents rating it worse [MTB group T1, p=0.0001; T2, p=0.003]; [Control group T1, p=0.001; T2, p=0.008]. At T1, parents rated the aesthetic treatment need to be greater than their child in the MTB group (p=0.054) and Control group (p=0.04). At T2, the level of agreement between the child and parent in their aesthetic treatment need was similar (p=0.262) but in the MTB group children perceived their aesthetic treatment need to be greater than their parents (p=0.019). From T1 to T2, significant 3D soft tissue changes occurred at Pogonion in the MTB group 4.26 mm (p= 0.001) and in the Control group 3.29 mm (p=0.002) but the mean difference between the groups (0.97 mm; p=0.011) was not clinically significant. Conclusions • MTB treatment significantly improved the OHRQoL and self-perception of aesthetic treatment need in children with II/1M but had no significant impact on self-esteem or 3D soft tissue facial changes compared to controls. • MTB treatment significantly improved the family QoL and both the parent’s perception of their child’s OHRQoL and aesthetic treatment need compared to controls. • In children following MTB treatment or awaiting treatment, poor agreement existed between the child and parent perception of OHRQoL and aesthetic treatment need.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'Dwyer, C. 2021. Children and adolescents and modified twin block for Class II division 1 malocclusion compared to controls: quantitative and qualitative analyses. PhD Thesis, University College Cork.en
dc.identifier.endpage109en
dc.identifier.urihttps://hdl.handle.net/10468/11974
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2021, Caroline O'Dwyer.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectClass II malocclusionen
dc.subjectQuality of lifeen
dc.subjectOral health related quality of lifeen
dc.subjectChildren and adolescentsen
dc.subjectClass II division 1en
dc.subjectIncreased overjeten
dc.titleChildren and adolescents and modified twin block for Class II division 1 malocclusion compared to controls: quantitative and qualitative analysesen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnameDClinDent - Doctor of Clinical Dentistryen
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