STANDARDIZATION OF DENTAL PATIENT-REPORTED OUTCOMES MEASUREMENT USING OHIP-5 - VALIDATION OF "RECOMMENDATIONS FOR USE AND SCORING OF ORAL HEALTH IMPACT PROFILE VERSIONS"

Psychometric Validation of the Macedonian-Language Version of the Ultrashort Five-Item Oral Health Impact Profile in the North Macedonian Population (OHIP5-MAC)

Background and Objectives: Due to a lack of an ultrashort questionnaire for Oral Health-Related Quality of Life (OHRQoL) assessment in the North Macedonian population, the OHIP5 was translated into Macedonian language with aim to test its psychometrical properties. Materials and Methods: Two types of reliability were tested: internal consistency by calculating Cronbach's alpha coefficient (general population), and test-retest reliability by calculating intraclass correlation coefficients (ICC) in a convenient sample of dental students who answered the same questions twice. Two types of validity were also tested: convergent validity (via a Spearman rank correlation) and known-group validity (via a Mann-Whitney U test). Responsiveness was tested by calculating the significance of the differences between the pre-treatment and after-treatment scores and by calculating the effect sizes of different dental treatments. Results: The Cronbach alpha coefficient of 0.756 and inter-item correlations above 0.2 pointed out good internal consistency. The test-retest reliability was confirmed by high ICCs and no significant differences between the OHIP5-MAC scores in a period of two weeks as dental students had no oral health changes. The Spearman rank correlation of -0.88 (p < 0.01) between the OHIP5-MAC summary scores and one simple question scoring self-perceived oral health (1-5; 1-worst oral health; 5-excellent oral health) confirmed the convergent validity. Significant differences between subjects with natural teeth and those with removable dentures (p < 0.01) confirmed the know-group validity, as it was predicted that removable denture wearers would have more impairment of oral health than individuals with natural teeth. The sensitivity of a questionnaire to measure changes elicited by dental treatments, i.e., responsiveness, was confirmed in individuals who received different dental treatments and scored significantly better (lower scores) their OHRQoL one month after the treatment, compared to their pretreatment scores (p < 0.05). Conclusions: Generally good psychometric properties of the OHIP5-MAC justify the recommendation for its future use in clinical settings and research.

Comparing oral health-related quality of life and satisfaction: root canal therapy vs. extraction for first permanent molars in children - a case-control study

BACKGROUND

This study addresses a literature gap by examining Oral Health Related Quality of Life (OHRQoL) and children-parental satisfaction concerning the management of compromised first permanent molars (FPMs) through root canal therapy (RCT) versus extraction.

METHODS

Children who extracted or received RCT and their parents were interviewed using a validated questionnaire that includes sociodemographic data, OHIP5-Ar questionnaire and satisfaction question.

RESULTS

There were 305 patients with RCT (197 (37.1%)) or extraction (108 (87.8%)). RCT increased the adjusted odds ratio (AOR) of the child's OHRQoL (3.76; P < 0.001) and parent-satisfaction at assessment-time (AOR = 1.82; P = 0.02). Additionally, increase in the duration between treatment and assessment-time elevated the AOR of patient's OHRQoL (AOR = 1.69; P = 0.001). Significantly fewer children reported being uncomfortable with the appearance of their teeth following RCT compared to those who underwent extraction (P < 0.001). Although not statistically significant, patients tended to express greater satisfaction with extraction compared to RCT at the assessment-time (AOR: 0.64; P = 0.081).

CONCLUSION

While the choice between performing RCT or extraction of compromised FPM in children depends on various factors, both can lead to substantial success in improving the child's OHRQoL and satisfaction. Nevertheless, RCT resulted in fewer concerns about dental appearance.

Self-efficacy, social support and oral health-related quality of life in patients with kidney transplantation and under hemodialysis

BACKGROUND

Aim of this questionnaire-based cross-sectional study was to compare self-efficacy, social support, oral hygiene-related self-efficacy (OHRSE) and oral health-related quality of life (OHRQoL) between patients under chronic hemodialysis (HD) and patients after kidney transplantation (KTx) as well as a healthy comparison group (HC).

METHODS

Patients under HD were recruited during their routine outpatient dialysis therapy, KTx patients during their maintenance appointment and HC patients during their regular dental check-up in the dental clinic. General self-efficacy, the OHRSE, social support (F-SozU-K14) and the OHRQoL (OHIP-G5) were assessed by specific validated questionnaires. The survey was performed by one experienced dentist.

RESULTS

44 HD, 40 KTx and 45 HC patients were included, between which the age and gender distribution was comparable (p > 0.05). With a median of 1.5 [IQR: 0-3], HD patients showed higher OHIP-G5 than the participants in KTx group (p < 0.01). Similarly, a significant difference was found between KTx (0, [0-0.5]) and HC (0, [0-3]; p < 0.01). HD patients showed a lower sum score of OHRSE, tooth-brushing, interdental-cleaning and dental-visit self-efficacy than the HC (p < 0.01). Similarly, HD patients had a lower sum score of OHRSE, tooth-brushing and dental-visit self-efficacy than the KTx group (p < 0.01). Moreover, the KTx group had a lower interdental-cleaning self-efficacy (p < 0.01) and sum score (p = 0.02) than the HC. The sum score of the general self-efficacy was comparable between the three groups (p = 0.19). The F-SozU-K14 revealed higher values in KTx (65.40 ± 5.33) compared with HD (60.95 ± 9.28) and HC group (61.71 ± 9.24; p = 0.03). Only in the KTx group, a significant association between F-SozU-K14 and OHIP-G5 was revealed (p = 0.05).

CONCLUSIONS

Patients under HD show a reduced OHRSE compared to KTx and HC and a slightly reduced OHRQoL compared to KTx patients. While general self-efficacy was comparable between groups, social support of HD patients was lower than of KTx patients. The OHRSE and OHRQoL might receive increased attention in dental care of HD patients.

Relationships Between Test Results for Oral Hypofunction, Subjective Frailty Symptoms and Oral Health-Related Quality of Life of Japanese Dental Outpatients: A Multicentre, Cross-Sectional Study

BACKGROUND

Oral hypofunction is the stage before oral dysfunction. The subjective symptoms of poor oral function and the decline in oral health-related quality of life (OHRQoL) that occur in the oral hypofunction stage can be missed.

OBJECTIVE

This multicentre cross-sectional study was performed to examine the relationships between the test results for oral hypofunction, subjective frailty symptoms and OHRQoL of outpatients in dental clinics.

METHODS

The basic characteristics and oral function test results of 637 dental clinic outpatients were evaluated. The subjective symptoms of physical and oral frailty were investigated using a questionnaire. OHRQoL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP-JP16) and OHRQoL dimension score.

RESULTS

The overall prevalence of oral hypofunction was 37.8%, with no significant difference between men and women. No significant differences in the presence or absence of subjective symptoms of frailty and a high OHIP score were observed based on sex. However, the prevalence of oral hypofunction was significantly different among the age groups and increased with age. The subjective symptoms of frailty score, OHIP score and OHRQoL dimension score were significantly higher in patients with versus without oral hypofunction. Age, number of underlying diseases, total score for subjective symptoms of frailty, total score for OHIP and OHRQoL dimension score were significantly associated with oral hypofunction.

CONCLUSION

Oral hypofunction may affect the subjective symptoms of frailty and OHRQoL in older adults.

Analysis of Oral Health-Related Quality of Life in Elderly Romanian Edentulous Patients: Implant-Supported Versus Conventional Complete Dentures

Background/Objectives: The integration of quality of life (QoL) assessments into dental health evaluations acknowledges the profound impact of oral health on overall well-being. This study aims to compare the impact of implant-supported complete dentures versus conventional complete dentures on oral health-related quality of life (OHRQoL) in elderly Romanian edentulous patients. Methods: This longitudinal study involved 93 initially recruited edentulous patients, with 52 completing the study over an 18-month period. Data collection utilized the OHIP-5 questionnaire, assessing the OHRQoL at baseline with conventional dentures and three months post-implant-supported denture placement. Ethical approval was secured from the Faculty of Medicine and Pharmacy University of Oradea, adhering to the Helsinki Declaration principles. A statistical analysis was conducted using SPSS version 25 and included non-parametric tests for score comparisons and Fisher's exact test for categorical data. Results: The comparative analysis of the questionnaire responses revealed significant improvements in all five OHRQoL dimensions post-treatment with implant-supported dentures. For instance, the proportion of patients reporting "never" experiencing difficulty chewing any foods increased from 1.9% at baseline to 57.7% post-treatment. Similarly, those reporting "never" experiencing painful aching rose from 3.8% to 76.9%. There was also a notable reduction in discomfort regarding the appearance of mouth, dentures, or jaws from 3.8% reporting "never" at baseline to 75% post-treatment. The improvements in sense of taste and difficulty in performing usual activities saw comparable increases. Conclusions: The findings support the hypothesis that implant-supported complete dentures significantly enhance OHRQoL among elderly edentulous patients compared to conventional dentures, with improvements noted in mastication ability, pain reduction, aesthetics, taste perception, and activity performance. These results underscore the value of prosthetic interventions in dental care to substantially improve patients' OHRQoL.

Psychological problems and their impact on oral mucosal disease patients' quality of life: A cross-sectional study in the Chinese population

Objectives

We aimed to investigate the presence of common psychological factors (i.e., stress, depression, anxiety) and their impact on the Oral health-related quality of life (OHRQoL) in patients diagnosed with four oral mucosal diseases (OMDs): recurrent aphthous ulcers (RAU), oral lichen planus (OLP), oral leukoplakia (OLK), and oral submucous fibrosis (OSF).

Methods

A total of 229 patients with clinically diagnosed OMDs were enrolled in this study, consisting of 55 RAU, 68 OLK, 50 OLP, and 56 OSF patients. The patients were statistically analyzed for psychological problems and OHRQoL using the Visual Analog Scale (VAS)､ the 5-item Oral Health Impact Profile (OHIP-5) and the Depression Anxiety Stress Scale-21 (DASS-21) scales.

Results

There were 229 valid questionnaires collected, consisting of 83 females and 146 males with a mean age of 45.24 (SD = 11.88) years. Multiple regressions between DASS-21 scores and OHIP-5 scores revealed generally negative impacts of psychological problems on OHRQoL, with depression on OLP (β = 0.47), OLK (β = 0.65) and OSF (β = 0.38), stress on RAU (β = 0.29), OLP (β = 0.72), OLK (β = 0.38) and OSF (β = 0.60), and anxiety on OLP (β = 0.33), OLK (β = 0.49) and OSF (β = 0.51).

Conclusions

Psychological problems like depression, stress, and anxiety were found to be prevalent in OMDs patients and adversely affected their OHRQoL. The results support the biopsychosocial medical model in the treatment of OMDs patients.

Clinical significance

The present study reinforced the crucial roles of psychological factors in impacting OMDs patients' OHRQoL. Therefore, it is necessary to monitor patients' psychological status and OHRQoL using questionnaires like DASS-21 and OHIP-5. Followed by psychological interventions, the treatment is expected to be enhanced.

The use of patient-related outcomes (PRO) and experience (PRE) in assessing the periodontal and implant patient

The purpose of this review was to summarize the evidence with regard to behavioral and psychosocial assessment of the periodontitis patient, the candidate for implant therapy, and the peri-implantitis patient. Periodontitis has an adverse effect on quality of life and its treatment can lead to significant improvements experienced by the patient. The latter is true for rehabilitation with dental implants, although patients harbor diverse expectations and perceptions of implant therapy, which can often interfere with satisfaction and/or influence long-term success. A thorough behavioral assessment of the candidate for implant therapy is essential, which should include, perceptions, expectations, as well as risk for behavioral disorders. Remedial action is essential to correct misperceptions and any identified risks. Finally, patients have limited awareness of limited ability to identify signs of peri-implantitis. The diagnosis of peri-implantitis can be a cause of significant distress, resentment, and loss of trust to the treatment and the caregivers. Despite documented value in clinical research, currently available instruments assessing patient-reported outcomes have little application in day-to-day clinical practice. Face-to-face patient to doctor open-ended communication remains the most effective way to comprehensively establish the long-term "therapeutic alliance" essential for the long journey for the periodontitis patient.

Linking patient-reported oral and general health-related quality of life

Background

The relationship between oral and overall health is of interest to health care professionals and patients alike. This study investigated the correlation between oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL) in a general adult population.

Methods

This cross-sectional study used a convenience sample of adult participants (N = 607) attending the 2022 Minnesota County and State fairs in USA, the 5-item Oral Health Impact Profile (OHIP-5) assessed OHRQoL, and the 10-item PROMIS v.1.2 Global Health Instrument assessed HRQoL. Spearman and Pearson correlations were used to summarize the bivariable relationship between OHRQoL and HRQoL (both physical and mental health dimensions). A structural equation model determined OHRQoL-HRQoL correlations (r). Correlations' magnitude was interpreted according to Cohen's guidelines (r = 0.10, 0.30, and 0.50 to demarcate "small," "medium," and "large" effects, respectively).

Results

OHRQoL and HRQoL correlated with r = 0.52 (95% confidence interval, CI: [0.50-0.55]), indicating that the two constructs shared 27% of their information. According to Cohen, this was a "large" effect. OHRQoL, and the physical and mental HRQoL dimensions correlated with r = 0.55 (95% CI: [0.50-0.59]) and r = 0.43 (95% CI: [0.40-0.46]), respectively, indicating a "large" and a "medium" effect. OHRQoL and HRQoL were substantially correlated in an adult population.

Conclusion

Using OHIP-5 to assess their dental patients' oral health impact allows dental professionals to gain insights into patients' overall health-related wellbeing.

Association between self-reported oral habits and oral health related quality of life of adolescents in Ibadan, Nigeria

Oral habits such as nail biting, thumb/digit sucking and teeth grinding could be harmful, and may lead to teeth misalignment, anterior open bite, protruded or flared upper anterior teeth especially if they persist into adolescence. Such orofacial dysfunction may result to impairment of the Oral Health Related Quality of Life (OHRQoL) of an individual. The extent to which oral habits affect the major domains of the self-reported outcomes remains understudied especially during adolescence, a unique period of growth, where there is increased aesthetic desire, increased self-awareness, and unique social and psychological needs. The aim of this study, therefore, was to determine the prevalence of oral habits and its association with oral health related quality of life of adolescents. This cross-sectional study was conducted among 700 adolescents aged 10 to 19 years (with mean age 14.6 (±1.3) years) attending 14 secondary schools in Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed sociodemographic characteristics of the students, oral habits and OHRQoL with Oral Health Impact Profile 5 (OHIP-5). Data were analyzed with SPSS and p value was at <5%. Mann Whitney U statistics was used to test for associations between OHIP-5 scores and presence or absence of oral habits. Logistic regression was used for multivariate analysis. A total of 363 (51.9%; 95%CI = 48.1%-55.6%) bite their nails, 216 (30.9%; 95%CI = 27.5%-34.4%) breathe with their mouth, 122 (17.4%; 95%CI = 14.7%-20.4%) suck their lips, 89 (12.7%; 95%CI = 10.3%-15.4%) grind their teeth together and 32 (4.6%; 95%CI = 3.1%-6.7%) sucked their thumbs. A total of 403 (81.1%) adolescents who engaged in at least an oral habit reported an impairment of their OHRQoL. Painful aching in the mouth was the most frequently affected OHRQoL item reported by the adolescents who engaged in oral habits. Those who sucked their thumbs (OR = 2.3, 95%CI = 1.1-4.7, p = 0.028) and those who sucked their lips were more likely to have poorer OHRQoL (OR = 1.6, 95%CI = 1.1-2.5, p = 0.024). Oral habits were prevalent among the adolescents and affected their OHRQoL. Those who sucked their thumbs and lips were more likely to report poorer OHRQoL than those who did not.

The oral and systemic health impact profile for periodontal disease (OSHIP-Perio)-Part 1: development and validation

OBJECTIVES

This study aimed to develop and validate the Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio), a disease-specific instrument for assessing the impact of periodontal disease on both general and oral health-related quality of life.

METHODS

A pool of 58 items, developed from the Oral Health Impact Profile (OHIP-49) and data generated through semi-structured patient interviews, was tested on 80 case subjects with periodontal disease and 80 control subjects. The dimensionality of the preliminary measure was evaluated using exploratory factor analysis (EFA). Rasch analysis was then performed on the primary dimension using the Winsteps software (Version 5.1.4.0) to render the final items for the OSHIP-Perio. The reliability and validity of the final OSHIP-Perio were subsequently determined.

RESULTS

Using an EFA factor loading >0.50, the primary dimension comprised 18 items. Using Rasch analysis, four items were subsequently excluded. The final OSHIP-Perio with 14 items showed excellent test-retest reliability (overall intraclass correlation coefficient index = 0.99) and internal consistency (overall Cronbach's alpha coefficient = 0.96). It also exhibited good discriminant validity when case and control groups were compared (p < 0.001). It showed very strong correlations (rho coefficients >0.90) with the OHIP-5, OHIP-14 and OHIP-49, exhibiting good concurrent validity. It demonstrated a moderate correlation (rho coefficient = 0.60) with the global health rating, exhibiting a moderate convergent validity.

CONCLUSIONS

The 14-item OSHIP-Perio exhibited good psychometric properties comparable to the OHIP-5, OHIP-14 and OHIP-49 for evaluating the impact of periodontal disease on quality of life.

The oral and systemic health impact profile for periodontal disease (OSHIP-Perio)-Part 2: Responsiveness and minimal important difference

OBJECTIVES

The Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio) was developed to measure health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL). This study aimed to determine the responsiveness and minimal importance difference (MID) of the OSHIP-Perio.

METHODS

Subjects with periodontal disease completed the OSHIP-Perio at baseline and six to ten weeks after non-surgical periodontal therapy. Comparisons of the clinical variables and the OSHIP-Perio scores before and after treatment were analysed using the Wilcoxon signed-rank test, together with the Oral Health Impact Profile (OHIP-49, OHIP-14 and OHIP-5) scores. The MIDs for all the instruments were calculated using distribution-based methods.

RESULTS

Fifty-one case subjects who completed periodontal treatment and the OSHIP-Perio instrument were included for analysis. Significant improvement in all clinical variables after treatment (p < 0.001) was observed. The OSHIP-Perio total score as well as its four-dimensional scores (periodontal, oral function, orofacial pain and psychosocial impact) were significantly reduced after treatment (p < 0.001), indicating better OHRQoL. Findings were consistent with the other OHIP instruments. In determining the MID, the percentage point change of the OSHIP-Perio was found to be lower than the shorter OHIP-5 instrument when using both effect sizes (ES) (10.71% vs. 15.0% at 0.5SD) and standard error of measurement (SEM) (5.36% vs. 10.0% at 1SEM; 8.93% vs. 20.0% at 2SEM) calculations.

CONCLUSIONS

The OSHIP-Perio demonstrated good responsiveness which was comparable to the OHIP-49 and its short-form derivatives. Its required percentage point change in determining its MID is smaller than the OHIP-5.

Health-related quality of life, jaw function and sleep-disordered breathing among patients with dentofacial deformity

BACKGROUND AND OBJECTIVES

Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment.

METHODS

A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM).

RESULTS

Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ.

CONCLUSION

Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.

A critical look at outcome measures: Comparison between four dental research journals by use of a hierarchical model

AIM

To assess the status quo of outcome measures used in treatment studies in Endodontics, and potentially identify strategies for improvement, by (i) systematically assessing the outcome measures using a conceptual model and (ii) comparing these with measures used in corresponding studies in the adjacent fields.

METHODOLOGY

The International Endodontic Journal, Caries Research, The Journal of Clinical Periodontology and The Journal of Oral & Facial Pain and Headache were selected to cover four adjacent dental disciplines. In each journal, the 50 most recent consecutive publications fulfilling inclusion criteria were included. A hierarchical model for diagnostic imaging studies was modified to assess studies related to treatment. The model comprised six levels, with technical as the lowest level and societal as the highest. Extracted data included study origin, study type, and identified outcome measures. Fisher's Exact Tests with Bonferroni corrections compared studies. p < .05 was considered statistically significant.

RESULTS

Amongst 756 publications, the 200 most recent studies matching the inclusion criteria were identified. Less than half (36.5%) assessed the clinical, patient, or societal aspects of treatment; 10.0% in International Endodontic Journal, 28.0% in Caries Research, 38.0% in Journal of Clinical Periodontology, and 70.0% in Journal of Oral & Facial Pain and Headache (p < .001).

CONCLUSIONS

According to included publications, research on treatment within the endodontic field is mainly focusing on technical and biological outcomes. The benefits of patients and society were less frequently examined than in corresponding journals in adjacent disciplines. When designing studies, including higher-level outcomes should be considered.

Validation of the HeLD-14 functional oral health literacy instrument in a general population

Background

Oral health literacy (OHL) is recognized as an important determinant of oral outcomes. Measuring OHL with a valid and reliable instrument that accurately captures the functional nature of this construct across cultures is needed. The short version of the Health Literacy in Dentistry scale (HeLD-14) shows promise as an appropriate instrument due to its inclusion of comprehensive domains hypothesized to comprise OHL. While studies validating the instrument in several languages have occurred, the number of dimensions in the various analyses range from one to seven. Validation of the HeLD-14 in a general English-speaking population is also lacking. The purpose of this study was to explore and confirm the dimensionality of the HeLD-14 in a general US English-speaking population.

Methods

The psychometric properties of HeLD-14 were evaluated in a sample of 631 participants attending the Minnesota State Fair. Construct validity was assessed using exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) on the data set split into two groups. Internal consistency reliability was assessed using the Cronbach's alpha coefficient. Concurrent validity was established between the HeLD-14 and the Oral Health Inventory Profile (OHIP-5) using Pearson's correlation.

Results

EFA found, and CFA reinforced, a unidimensional structure of the HeLD-14. Cronbach's alpha was acceptable at 0.92. Fit assessment also supported a unidimensional structure, comparative fit index = 0.992, Tucker-Lewis index = 0.991, root mean square error of approximation = 0.065, and standardized root mean square residual = 0.074. Concurrent validity analyses showed that the HeLD-14 correlated with the OHIP-5.

Conclusions

The HeLD-14 is a unidimensional reliable and valid instrument for measuring the oral health literacy in the general US English-speaking adult population.

How do implant patients experience complications? A cross-sectional multicentre pilot study

BACKGROUND

This cross-sectional study aimed to quantify the impact of implant-related complications on perceived pain, functional impairment, concern, quality of life (QoL) and confidence which were the study's primary outcomes.

MATERIALS AND METHODS

Patients were recruited in five centres over 19 months. They completed a structured ad hoc questionnaire scoring pain, chewing ability, concern, QoL and confidence in future implant treatment. Some potential independent variables were also recorded. The data were analysed descriptively and with a multiple-stepwise regression model for correlations of the five primary variables with the other data.

RESULTS

The sample consisted of 408 patients, with prosthesis mobility being the most common complication (40.7%). Most patients (79.2%) consulted because of a complication, while 20.8% were asymptomatic and consulted regularly. Pain was correlated with symptoms at consultation and in biological/mixed complications (p < .001; R2  = 44.8%). Chewing impairment with implant loss, prosthesis fracture and removable implant-supported or total prostheses (p < .001; R2  = 42.8%); patient concern was correlated with the clinical symptoms and removable implant-supported prostheses (p < .001; R2  = 36.1%); impact on QoL was correlated with implant loss, prosthesis fracture and removable implant-supported prostheses (p < .001; R2  = 41.1%). Patient confidence was relatively independent and only impact on quality of life significantly influenced it (r = 0.73).

CONCLUSIONS

Implant-related complications moderately impaired patients' perceptions of pain, chewing ability, concern and QoL. Nevertheless, complications only slightly reduced their confidence in future implant treatment.