Orthodontic treatment of children/adolescents with special health care needs: an analysis of treatment length and clinical outcome

Abstract

BackgroundThe aim of this retrospective study was to analyse the treatment time and differences between the pre- and post-treatment peer assessment rating (PAR) index and aesthetic component (AC) of the index of orthodontic treatment need (IOTN) scores in children/adolescents with special health care needs (SHCNs), compared to non-special health care needs (NSHCNs) controls.MethodsBased on certain inclusion and exclusion criteria, medical records of SHCNs and randomly selected NSHCNs controls at the Department of Orthodontics, University Hospital Muenster were analysed retrospectively for the treatment time, number of appointments, chair time (“moderate” or “considerable”), PAR scores, and AC scores. Sample size calculation, descriptive statistics, and explorative analyses were performed using the Mann–Whitney U Test.ResultsTwenty-nine children with SHCNs (21 boys, 9 girls; median age: 11 years, pre-treatment) and 29 children with NSHCNs (12 boys, 17 girls; median age: 12 years, pre-treatment) were enrolled in this study.The overall treatment time did not differ between the patient groups. However, more “considerable chair time” was needed for the SHCNs group compared to the control group (p < 0.05), whereas “moderate chair time” was more often needed in patients with NSHCNs (p = 0.001).The age of the patients at the first and last appointments showed significant statistical differences: children in the SHCNs group commenced orthodontic treatment earlier, by a median of 1 year, compared to children in the NSHCNs group.The SHCNs group had significantly higher pre- and post-treatment PAR scores (median 21/median 6) and AC scores (median 9/median 3) compared to NSHCNs patients (PAR: median 17/median 0; AC: median 5/median 1).However, the overall treatment time and the overall PAR and AC score reduction did not differ significantly between the SHCNs and NSHCNs groups.ConclusionsWhile the overall treatment time and number of appointments did not differ, the overall chair time was higher in the SHCNs group. The pre- and post-treatment PAR and AC scores were significantly higher in the SHCNs group.

Rare Disorders: Diagnosis and Therapeutic Planning for Patients Seeking Orthodontic Treatment

“…In overall terms, the treatment duration was similar for the RDG and SHCG, as has previously been reported in children with craniofacial malformations [48] and in patients with special healthcare needs [49]. However, studies have indicated that dental chair sessions are longer than for the general population [48,49], although this information was not collected in our study. The onset of gingivitis and caries is mainly related to deficient oral hygiene.…”

Orthodontic treatment of a particular subgroup of children with special health care needs, children with craniofacial anomalies: An analysis of treatment length and clinical outcome

“…15,16 Our intention was to explore the subject related to the orthodontic therapy of patients with SHCN in general and with CFAs in particular, considering that there is little in the literature of that nature. 4,[7][8][9][17][18][19][20][21] The aim of this study was to analyze treatment time and differences between pre-and posttreatment PAR and DHC, and AC scores of IOTN, in a SHCN/CFA group compared with a NO SHCN control group.…”

Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)

“…Pinskaya, for example, stated that long-term treatment (up to thirty-nine months) is accompanied by lower clinical results and a progressive deterioration in the quality of therapy due to the “patient burn out”, with a gradual reduction of patient cooperation [ 15 ]. Although other researchers have reported conflicting results [ 20 ], it should be stressed that long-term treatment increases the risk of iatrogenic injury. In this perspective, it becomes important to distinguish between cases where therapy extends due to lack of collaboration by the patient and those in which the orthodontist decides to enhance the active treatment phase in order to obtain better results [ 10 ].…”

“…This aspect is crucial to allow the prosecution and conclusion of orthodontic treatment, which would otherwise be suspended prematurely for lack of cooperation. In fact, several authors have agreed to affirm that the absence of a correct oral hygiene is the major cause of failure or poor success of therapy [ 20 ]. In particular, Beckwith et al have conducted a study about the factors that may affect the duration of orthodontic treatment, concluding that about half of the variations can be explained by patient collaboration [ 25 ].…”