Einfluss der Dauer kieferorthopädischer Behandlung auf das subjektive Empfinden der mundgesundheitsbezogenen Lebensqualität

Zusammenfassung

Hintergrund Aufgrund der aktuell noch geringen Datenlage war es Ziel dieser Studie, den Einfluss der Dauer einer kieferorthopädischen Behandlung auf die mundgesundheitsbezogene Lebensqualität (MLQ) zu untersuchen.

Methode Die beobachtende, prospektive Längsschnittstudie erfolgte mit der deutschen Basisversion des Oral Health Impact Profile (OHIP-G14) im Zeitraum von 2008–2018. Die MLQ wurde zu drei Zeitpunkten (T₁, T₂, T₃) bei 598 Patient*innen innerhalb ihrer kieferorthopädischen Behandlung erhoben und die Ergebnisse statistisch analysiert. Ein durchschnittlicher Anstieg (∆OHIP-G14) von>2,00 Punkten wurde als klinisch relevant (Minimal Important Difference, MID) und Zeichen einer herabgesetzten mundgesundheitsbezogenen Lebensqualität definiert.

Ergebnisse Von initial 598 eingeschlossenen Patient*innen füllten 79 ProbandInnen die Fragebögen zu allen drei Zeitpunkten vollständig aus und konnten in die Studie aufgenommen werden. Das Durchschnittsalter lag zu Beginn der Behandlung bei 11,5 Jahren (SD=3,3), am Ende der Behandlung bei 16,3 Jahren (SD=3,1). Die durchschnittliche Behandlungsdauer betrug 4,7 Jahre (SD=2,3). Ein Vergleich der erreichten Summenwerte zu den Zeitpunkten T₁, T₂, T₃ der ernannten Subgruppen (Geschlechter, Altersgruppen, Behandlungsapparatur und -zeitraum) untereinander zeigte in keiner der Gruppen signifikante Unterschiede (Mann-Whitney-U-Test, Kruskal-Wallis-Test, Chi-Quadrat-Test p<0,05). Ein Vergleich der Gesamtwerte der jeweiligen Zeitpunkte zeigte eine klinisch (∆OHIP-G14>2,00) und statistisch signifikante Abnahme der MLQ während der initialen Behandlungsphase (T₁ vs. T₂, p<0,001). Die Verbesserung der MLQ am Ende der Behandlung (T₂ vs. T₃) war statistisch nicht signifikant (p=0,128) und hatte keine klinische Auswirkung (MID ∆OHIP-G14<2,00). Weitere Analysen der Behandlungsdauer und der OHIP-Summenwerte ergaben zu keinem Zeitpunkt signifikante Abhängigkeit oder Korrelation zwischen Behandlungsdauer und MLQ (β₂=− 0,078, β₃=0,191, multiple lineare Regression, p=0,05; r₂=0,073, r₃=0,103, Spearman Korrelation, p=0,05).

Schlussfolgerung Im Vergleich zu T₁ war die MLQ während der Behandlung sowohl zu T₂ als auch T₃ leicht herabgesetzt. Es kann jedoch festgestellt werden, dass der Durchschnitt der erhobenen Summenwerte zu allen drei Zeitpunkten der Befragung (T_1, T₂ und T₃) im Normbereich der gesunden Allgemeinbevölkerung lag. Hinsichtlich der Kernfrage dieser Studie konnte kein Zusammenhang zwischen Behandlungsdauer und MLQ gezeigt werden. Das Anstreben eines guten Behandlungsergebnisses im Rahmen einer differenzierten kieferorthopädischen Therapie sollte daher nach Möglichkeit einem raschen Abschluss der Behandlung vorangestellt werden.

Abstract

Background Due to currently limited amount of data, the aim of this observational, prospective study was to examine the impact of the duration of orthodontic treatment on oral health-related quality of life (OHRQoL) in patients.

Method Data was collected using the German basic version of the Oral Health Impact Profile (OHIP-G14) from 2008 to 2018. OHRQoL was conducted at three different points in time with 598 patients during their orthodontic treatment. The results were statistically analyzed.

Results79 out of 598 patients included initially completed the questionnaires completely and could be included in the study. A comparison of the appointed subgroups (gender, age groups, treatment apparatus and treatment period) with one another did not reveal any significant differences in any of the groups (Mann-Whitney U test, Kruskal-Wallis test, p<0,05). A clinically relevant increase in the OHIP-G14 total value and thus a decrease in OHRQoL could be determined applying the Minimal Important Difference (MID≥2,00) during the initial treatment phase. These findings were also statistically relevant (Friedmann test, p<0,05). An improvement in OHRQoL at the end of treatment was statistically significant (p<0,05), though not clinically significant (MID<2,00). A negative influence of the duration of treatment on OHRQoL could not be confirmed at any time (β_Z=− 0.078, β_E=0.191, multiple linear regression).

Conclusion During the initial treatment phase, OHRQoL appears to be slightly reduced, the average of the total values measured ranged within the standard values of the general population. Since the duration of treatment does not have a significant impact on OHRQoL, striving for a good treatment result in the context of a differentiated orthodontic therapy should, if possible, be chosen over a rapid completion of treatment.

Schlüsselwörter

Mundgesundheitsbezogene Lebensqualität (MLQ) - OHIP - Behandlungsdauer

Key words

oral health-related quality of life (OHRQoL) - Oral Health Impact Profile (OHIP) - duration of treatment

Publication History

Article published online:
02 December 2022

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