Improvement in esthetic satisfaction due to the treatment of severe malocclusion improves oral health-related quality of life, particularly by decreasing psychological discomfort and psychological disability.

The aim of this study was to evaluate the relationship between occlusal characteristics and oral health-related quality of life in adults who underwent orthodontic or orthodontic-surgical treatment. The study group consisted of 51 adult patients (35 women, 16 men) with severe malocclusion and considerable functional disorders. Thirty-six of the patients underwent combined orthodontic-surgical treatment, while 15 underwent orthodontic treatment. Data were collected before and after treatment. Mean follow-up period was 5.0 years (range 2.2-6.7 years). Occlusal characteristics were measured from dental casts by using Peer Assessment Rating (PAR) index. A self-completed Oral Health Impact Profile (OHIP-14) was used to measure oral impacts. The changes in PAR and OHIP-14 were measured, and correlation between PAR and OHIP tested before and after treatment and in the changes during the follow-up. Statistical significance was evaluated with the paired samples t-test and Mann-Whitney U-test, and the correlation between PAR and OHIP scores assessed using Pearson's and Spearman's correlation coefficient. The occlusion was significantly improved in all subjects, mean PAR reduction being 78.1 per cent. The prevalences of oral impacts at threshold `fairly often' or `very often' before and after treatment were 70.6 per cent and 9.8 per cent, respectively (P < 0.001). The PAR and OHIP scores correlated after treatment but not before treatment or in the changes. The treatment of severe malocclusion reduced the reported oral impacts to the level of general population and significantly improved oral health-related quality of life.

Introduction. The aim was to evaluate the relationships of changes in facial pain, temporomandibular disorders (TMDs) and oral health-related quality-of-life (OHRQoL) in adults who underwent orthodontic or orthodontic/surgical treatment. Methods. Sixty-four patients (46 women, 18 men, range 18-64 years) with severe malocclusion and functional problems were treated in Oulu University Hospital. Of these, 44 underwent orthodontic-surgical and 20 orthodontic treatment. Data were collected with questionnaires and clinical stomatognathic examinations before and on average 3 years after treatment. The OHRQoL was measured with OHIP-14 (The Oral Health Impact Profile), the intensity of facial pain with the Visual Analogue Scale (VAS) and the severity of TMD with the Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indices. Results. A significant improvement was found in facial pain, signs and symptoms of TMD and OHRQoL after the treatment (p < 0.05). The decrease in VAS was associated with improvement in OHIP-14 severity (r = 0.296, p = 0.019). The correlations between changes in OHIP-14 severity and Ai and Di were not statistically significant. Conclusion. Treatment of severe malocclusion seemed to improve OHRQoL via decreased facial pain. Decreased facial pain was associated especially with improved OHRQoL dimensions of physical pain, physical disability and social disability.

The aim of this study was to examine the pathways between temporomandibular disorders (TMDs), occlusal characteristics, facial pain, and oral health-related quality of life in patients with severe malocclusion. The study comprised 94 (34 men and 60 women, mean age 38 years) adult patients who were referred for orthodontic or surgical-orthodontic treatment. All the patients had severe malocclusion. Oral health-related quality of life was measured with the Oral Health Impact Profile-14 scale (OHIP-14), the intensity of facial pain using a Visual Analogue Scale (VAS), TMD with Helkimo's clinical dysfunction index (Di), and occlusal characteristics with the Peer Assessment Rating (PAR). A hypothetical model of the interrelationships between these factors was constructed based on the conceptual model of biological, behavioural, and psychosocial consequences of oral diseases. The associations were studied with path analysis. Women reported poorer oral health-related quality of life, higher pain levels, and had more severe TMD than men, but the gender difference was statistically significant only in pain and TMD. In contrast to the hypothetical model, among women the occlusal characteristics were not directly associated with oral health-related quality of life or facial pain. Among men, the occlusal characteristics were directly associated with oral health-related quality of life. In conclusion, patients with severe malocclusion who also have TMD and facial pain more often have impaired oral health-related quality of life. The associations of the occlusal characteristics with oral health-related quality of life differ between genders. Therefore, these associations should be studied separately among genders.