O tratamento ortodôntico em uma perspectiva a longo prazo: avaliação da estabilidade oclusal e do grau de satisfação dos pacientes
This study aimed to evaluate factors associated to orthodontic treatment stability and patient satisfaction in the long-term. A total of 209 patients (88 class I and 121 class II) treated with straight wire fixed appliance were selected at least 5 years post treatment. Six hundred twenty seven de...
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| Formato: | doctoralThesis |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/13267 |
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| Resumo: | This study aimed to evaluate factors associated to orthodontic treatment
stability and patient satisfaction in the long-term. A total of 209 patients (88
class I and 121 class II) treated with straight wire fixed appliance were selected
at least 5 years post treatment. Six hundred twenty seven dental casts were
examined with the PAR Index at pretreatment (T1), end of treatment (T2), and
at long-term follow up (T3, mean 8.5 years post treatment). At T3, a Dental
Impact on Daily Living questionnaire was used to assess patient satisfaction
with the dentition in the long-term. Friedman test and multiple regression
analysis were used to evaluate changes among the time points and factors
associated with stability and patient satisfaction. Predictive factors used to
exam the occlusion were: PAR Index at T1 and T2, age at T1, the amount of
time without retainer, length of Hawley retainer wear, length of follow-up, sex,
extraction and third molar status. To assess patient satisfaction were
considered: changes produced by the orthodontic treatment (PAR T2-T1), post
treatment stability (PAR T3), age at the start of treatment (T1), length of
treatment (T2-T1), gender, and extraction. Orthodontic treatment produced a
significant improvement of 94.2% in the PAR Index (T2-T1), but this change
was not associated with the level of satisfaction when the patient was
questioned at T3. No significant change was observed between T2 and T3.
However, when the sample was divided according to the level of finalization
(PAR T2), it was observed that well-finished patients experienced some
deterioration (P<.001), whereas the less well-finished ones showed some
improvement (P<.05). Even with the deterioration, the well-finished patients still
had a better PAR Index at T3 compared to the less well-finished ones (PAR T2-
T3). Regression analysis showed that PAR Index at T1 and T2, age at T1, and length of retainer wear had a slight association with occlusal stability (R2 =
0.27). Patient satisfaction was significantly associated only with PAR Index at
T3 (r2=0.125, P<.0001). We can conclude that, even thought orthodontic
treatment is quite stable, not so well-finished treatments tend to show some
improvement and well-finished ones deteriorate some in the long-term. Despite
of that, well-finished patients still have better occlusal characteristics. Patient
satisfaction is not related to the result of orthodontic treatment; nevertheless,
there is a slight association with dentition in the long-term |
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