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Perceptions of Class II malocclusions
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Date
2024
Authors
Brosnan, Sinead
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Aims
• To investigate if Oral Health Related Quality of Life (OHRQoL), self-esteem and perception of orthodontic aesthetic treatment need differ in children/adolescents with Class II division 1 malocclusion (II/1M) compared to children/adolescents with Class II division 2 malocclusion (II/2M).
• To investigate if perceived OHRQoL, perceived self-esteem and perception of orthodontic aesthetic treatment need differ in parents of children/adolescents with II/1M compared to parents of children/adolescents with II/2M.
• To investigate if OHRQoL, self-esteem and perception of orthodontic aesthetic treatment need are associated in children/adolescents and their parents, separately and across II/1M and II/2M groups.
• To investigate if family impact differs for children/adolescents with II/1M compared to those with II/2M.
Materials and Methods
Following ethical approval, 240 individuals were invited to participate, 120 children/adolescents aged 10-16-years (60 with II/1M and 60 with II/2M) and 120 parents. Subjects were recruited from treatment waiting lists in a publicly funded orthodontic service. Informed consent/assent was obtained from each child/adolescent and their parent. Children/adolescents completed a generic (Child Oral Health Impact Profile, COHIP) and a condition-specific questionnaire (Malocclusion Impact Questionnaire, MIQ) to assess OHRQoL, a self-esteem questionnaire (Child Health Questionnaire- Self-Esteem component, CHQ-SE) and self-assessed orthodontic aesthetic treatment need (Index of Orthodontic Treatment Need- Aesthetic Component, IOTN-AC). A parent of each child/adolescent completed the parent version of COHIP, assessed the family impact of their child’s oral health (Family Impact Scale, FIS), completed the parent version of CHQ-SE and rated their child’s orthodontic aesthetic treatment need (IOTN-AC). Demographic and clinical variables were also recorded for each child/adolescent which included age, child/parent gender, socioeconomic status (SES), caries, dental trauma, overjet, overbite, severity of crowding, as well as IOTN both dental health and aesthetic components. ANOVA was used to investigate associations of OHRQoL, family impact and self-esteem between II/1M and II/2M groups. Perceived orthodontic aesthetic treatment need was compared between II/1M and II/2M groups using ordinal logistic regression models. P < 0.05 was considered as statistically significant.
Results
In children/adolescents OHRQoL, self-esteem and perception of orthodontic aesthetic treatment need did not differ significantly between malocclusion groups (MIQ p = 0.1480; COHIP p = 0.8067; CHQ-SE p = 0.9505; Child IOTN-AC p = 0.8987). There was also no significant difference in parent-reported OHRQoL, self-esteem or perception of orthodontic aesthetic treatment need or their child between malocclusion groups (Parent COHIP p = 0.2361; Parent CHQ-SE p = 0.9161; Parent IOTN-AC p = 0.3191). Comparing child/adolescents versus parents for each malocclusion, there was no significant difference in OHRQoL (II/1M p = 0.3110; II/2M p = 0.2317), self-esteem (II/1M p = 0.5585; II/2M p = 0.5) or perceived orthodontic aesthetic treatment need (II/1M p = 0.0645; II/2M p = 0.4050). Furthermore, there was no significant difference in family impact for children/adolescents with II/1M compared to those with II/2M (p = 0.3480).
Increased age and female gender had a significantly negative impact on child-reported OHRQoL (p = 0.0001 and p < 0.0001, respectively) and self-esteem (p < 0.0001 and p = 0.0016, respectively), while female parent gender and SES i.e. those without medical cards, negatively influenced parent-reported OHRQoL (p = 0.0014 and p = 0.0450, respectively). SES influenced parent-reported self-esteem of their child (p = 0.0125), whereby those with medical cards reported worse self-esteem, while caries experience negatively influenced family impact (p = 0.0295). Younger age and having a medical card had a significantly negative impact on child reported perceived orthodontic aesthetic treatment need (p = 0.0365 and p = 0.0174, respectively). Child and parent perceived orthodontic aesthetic treatment need were significantly lower than clinician-reported (p < 0.05).
Conclusions
• There were no significant differences between II/1M and II/2M in relation to child-reported or parent-reported OHRQoL, self-esteem, perception of orthodontic aesthetic treatment need or family impact.
• For each malocclusion, there were no significant difference between child/adolescent versus parent for all measures recorded.
• Other variables, however, were found to impact perceptions, such as age, gender and SES. Increased age and female gender negatively impacted child-reported OHRQoL and self-esteem. Female parents and parents without medical cards reported worse OHRQoL for their child, while parents with medical cards reported worse self-esteem for their child.
• Clinician-reported perceived orthodontic aesthetic treatment need was more severe than parent and child perceptions, regardless of malocclusion type.
Description
Keywords
Perception , Malocclusion , Class II division 1 malocclusion , Class II division 2 malocclusion , OHRQoL , Self-esteem , Self-concept , Orthodontic treatment need , Class II malocclusion
Citation
Brosnan, S. 2024. Perceptions of Class II malocclusions. DClinDent Thesis, University College Cork.