Aesthetic dental treatment, orofacial appearance, and life satisfaction of Finnish and Brazilian adults

Patients' Preferences for the Treatment of a Single Missing Tooth in China: A Discrete Choice Experiment

Purpose

The main treatment options offered to patients to choose from when restoring a single missing tooth include tooth-supported three-unit fixed partial dentures (FPDs) and implant-supported single crowns (ISCs). However, due to the heterogeneity of current studies, it is difficult to objectively compare these two treatment strategies. In this study, a discrete choice experiment (DCE) was used to quantify the preferences of individuals undergoing restoration treatment for single tooth loss.

Patients and Methods

The DCE questionnaire was disseminated in a "snowball" fashion, with data collected from participants aged 18-60. Five important attributes of treatment were selected: (1) treatment procedure, (2) treatment time, (3) cost, (4) five-year survival rate, and (5) five-year complication rate. A conditional logit model was employed to ascertain the direction of participants' preferences for specific attribute levels and to derive their willingness to pay (WTP) through the principle of marginal utility.

Results

287 participants completed the questionnaire. The results of the questionnaire revealed that the five-year complication rate (42.42%) was the most important attribute, followed by cost (20.43%), five-year survival rate (14.23%), treatment time (13.44%), and treatment procedure (9.49%). Participants were willing to pay RMB$11076.2 (USD$1,772.2) to obtain a 10% extra reduction in the five-year complication rate, and RMB$7434.6 (USD$1,189.5) for a non-invasive treatment.

Conclusion

In the ranking of the relative importance of key factors affecting single missing tooth restoration, complication rates are most highly valued, suggesting that reducing the complication rate is a key issue to be addressed in prosthodontics. In addition, deriving the ranking of patients' concerns about key factors can help to improve doctor-patient communication and provide a reference for treatment technology development and medical decision-making.

Measuring concern about smile appearance among adults

BACKGROUND/OBJECTIVES

To adapt and estimate the psychometric properties of Utrecht Questionnaire for esthetic outcome assessment in rhinoplasty (OAR) to assess concern about smile appearance and to estimate the influence of demographic characteristics on this concern in adults.

MATERIAL/METHODS

This was a cross-sectional observational study. Individuals aged between 18 and 40 years participated in the study. The Portuguese version of OAR was adapted for smile assessment in dental practice and was named Questionnaire for Outcome Assessment of Smile Aesthetic (OA-Smile). Data validity was estimated using factorial validity [confirmatory factor analysis (CFA)-CFI, Tucker-Lewis index (TLI), SRMR)] and convergent validity (average variance extracted). Reliability was assessed using the alpha ordinal coefficient (αordinal) and the omega coefficient (ω). A structural model was elaborated to assess the contribution of demographic characteristics to smile appearance concerns. Model fit was evaluated, and the z-test (α = 5%) was used to estimate the significance of the path estimates (β).

RESULTS

2.523 subjects participated in the study [mean age = 32.86 (SD = 11.39) years, 68.1% female]. The factor model of orofacial appearance (OA)-Smile presented an adequate fit to the data [CFA: comparative fit index (CFI) = 0.99, TLI = 0.99, SRMR ≤ 0.05]. Convergent validity (AVE ≥ 0.80) and reliability (αordinal and ω ≥ 0.85) were adequate. The structural model presented an acceptable fit (CFI = 0.974; TLI = 0.991 and SRMR = 0.053). Women, younger people, single people, people with lower income, people using dental prostheses, undergoing dental treatment, and those who do not like their smile were more concerned about their smile appearance.

LIMITATIONS

Nonprobability sampling, online data collection, and cross-sectional design are considered limitations of the study.

CONCLUSIONS/IMPLICATIONS

OA-Smile is a suitable scale to assess smile appearance concerns, and the data obtained with this scale were valid and reliable. Demographic characteristics should be considered when measuring concerns about smile appearance.

General dentists' treatment plans in response to cosmetic complains; a field study using unannounced-standardized-patient

Background

This field study explored general dentists' treatment plans in response to the request for cosmetic services of an unannounced standardized patient (USP) in Mashhad, Iran.

Methods

The researcher, as a USP, visited 24 and 23 offices in a high-income and a low-income area, respectively. The primary complaint was that, according to her friend's comments, a dental student, her smile was "crooked and yellow" due to the congenitally missing tooth number 10 and peg-shaped tooth number 8. The dentists' treatment plans for teeth color and form and the cosmetic services expenses were recorded. The treatment plans of the two areas were compared.

Results

For dental form, most dentists' treatment plans were categorized as "No intervention" (privileged area: 37.5 %, less-privileged area: 56.53 %, and total: 46.80 %). The percentage of dentists in the privileged area who prescribed cosmetic services was twice that of the less-privileged area (33.33 % versus 17.39 %). The intervention for dental form varied from placing 1 unit of composite veneer to 10 units of ceramic laminates or orthodontics with a wide range of treatment costs ($42.09 to $1079.14). For tooth color, most dentists (privileged area: 62.50 %, less-privileged area: 30.43 %, and total: 46.80 %) were categorized as "Interventionists." For tooth color, the treatment plans varied from scaling and root planing, bleaching, and composite veneer with various costs ($7.19 to $197.84).

Conclusion

Cosmetic treatment plans and expenses varied significantly for a single USP, with many not aligning with the standard treatment plan. Some dentists offered treatments even without a chief complaint from the patient. Dentists in privileged areas were twice as likely to prescribe cosmetic treatments compared to those in less privileged areas. Therefore, cosmetic services necessitate monitoring, establishing clear diagnostic criteria, and implementing educational interventions.

Achieving excellence with interdisciplinary approaches in complex orthodontic adult patients

Over the last decades the percentage of adult orthodontic patients has substantially increased. Undeniably, an important motif for seeking orthodontic care at an older age is smile improvement, but this is not all. Frequently, impaired dentofacial aesthetics are combined with several other issues: severe dentoskeletal malocclusions; multiple tooth loss due to caries or endodontic failure; dental agenesis or trauma; periodontal breakdown; or functional problems, such as temporomandibular disorders or obstructive sleep apnoea. Therefore, comprehensive adult treatment mostly requires close collaboration of a team of equally well-trained dental specialists to select and execute the most suitable treatment option for the individual patient from day one. With joint planning, intensive communication with the patient and the involved specialists, and continuous monitoring of the treatment process, true patient-centred care can be delivered. In order to serve the individual patient best, the treating orthodontist does not only need thorough speciality training and continuing education, but furthermore, should be well-equipped with sufficient knowledge of the other dental fields of expertise. In combination with digital technology as an important tool for enhancing communication and efficient exchange of information between all involved team members, excellent joint clinical skills will take comprehensive interdisciplinary treatment to the next level.

Quality of Life After Orthognathic Surgery in Swedish Patients: A Register-Based Cohort

OBJECTIVE

This study aimed to evaluate the effect of orthognathic surgery on quality of life among Swedish patients.

MATERIALS AND METHODS

Patients subjected to orthognathic surgery due to dentofacial deformity (DFD) and registered in the National Register of Orthognathic Surgery (NROK) in Sweden between 2017 and 2020 were eligible for inclusion in this study. The Swedish-validated Orthognathic Quality of Life Questionnaire (S-OQLQ) was used to evaluate patient quality of life before and after surgery. The S-OQLQ measured each patient's subjective experience regarding social aspects.

RESULTS

Eighty-four participants were included in this cohort study, including 45 men (mean age 24.7 years), 48 women (mean age 23.4 years), and eight patients who stated no gender. Women generally graded several aspects of the S-OQLQ higher than men, including facial aesthetics p = 0.029), oral function (p < 0.001), and awareness of facial deformity (p = 0.0054). For all domains of the questionnaire (social, facial aesthetics, function, and awareness), a significant improvement was seen 6-24 months after surgery (p < 0.001). Women rated improvement of function and awareness of facial deformity higher than men (p < 0.001 and p = 0.039, respectively).

CONCLUSION

Quality of life aspects of orthognathic surgery have a strong impact on the treatment outcome. Although functional impairment is often considered a major indication for surgery, the social and aesthetic influence of DFD is highly rated by patients, whereas pain is not an issue before or after treatment.

Digital versus Manual Tracing in Cephalometric Analysis: A Systematic Review and Meta-Analysis

Background: Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the findings from the earlier studies and determine the potential advantages and limitations of each method. The present systematic review aimed to compare the accuracy of digital and manual tracing in cephalometric analysis for the identification of skeletal and dental landmarks. Methods: A systematic search was performed using the keywords "Digital" AND "Manual" AND "Cephalometry" to identify relevant studies published in the English language in the past decade. The electronic data resources consulted for the elaborate search included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PsycINFO, Scopus, ERIC, and ScienceDirect with controlled vocabulary and free text terms. Results: A total of n = 20 studies were identified that fulfilled the inclusion and exclusion criteria within the timeframe of 2013 to 2023. The data extracted from the included articles and corresponding meta-analyses are presented in the text. Conclusions: The findings of the present systematic review and meta-analysis revealed trends suggesting that digital tracing may offer reliable measurements for specific cephalometric parameters efficiently and accurately. Orthodontists must consider the potential benefits of digital cephalometry, including time-saving and user-friendliness.

Psychometric properties of the Arabic version of the perceived prosthodontic treatment need scale: Exploratory and confirmatory factor analyses

BACKGROUND

It is crucial to take into account the concerns of dental patients about their prosthodontic needs when planning the course of treatment. However, there is a dearth of research that examines these needs among adult dental patients.

OBJECTIVES

This study aims to translate and validate the perceived prosthodontic treatment need scale (PPTN) in Arabic.

METHODS

The 17-item PPTN scale was translated from English into Arabic and completed by 206 patients seeking prosthodontic treatment in a dental hospital in Saudi Arabia. Data collection was carried out in September and October 2023. Exploratory factor analysis (EFA) was used to ascertain the underlying factor structure; a unidimensional scale was hypothesised and tested using confirmatory factor analysis (CFA), including several multiple model fit indices. The assessment of reliability was conducted using Cronbach's alpha. The convergent and discriminant validity of the final scale were examined.

RESULTS

EFA produced an 11-item scale distributed into three factors that explain 65.43% of the total variance with eigenvalues > 1. All items showed acceptable reliability, ranging from 0.65 to 0.84. The first factor pertained to social issues, while the second item was concerning dental appearance. Lastly, the third factor included functional difficulties associated with tooth loss or dental problems. The results of the CFA demonstrate a satisfactory level of model fit, with the standardised factor loadings ranging from 0.51 to 0.89. Convergent and discriminant validity of the model factors were established.

CONCLUSION

The translated questionnaire was deemed legitimate and would be useful in comprehending patients' perceived treatment requirements, hence contributing to the advancement of prosthodontic research and practical implementation.