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Impact of malocclusion treatments on Oral Health-Related Quality of Life: an overview of systematic reviews

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Abstract

Objective

To perform an overview of systematic reviews (SR) assessing the impact of malocclusion treatments (Orthodontic Treatment — OT and/or Orthodontic Surgical Treatment — OST) on Oral Health-Related Quality of Life (OHRQoL).

Materials and methods

A search strategy was conducted in electronic databases until June 7th, 2021, followed by a manual search in grey literature and registration databases. Two independent authors applied the eligibility criteria, extracted the data, assessed the risk of bias (AMSTAR-2), and performed the certainty of evidence (GRADE) evaluation. Meta-analysis was planned to be carried out in RevMan 5.3 (with 95% confidence intervals (CI) considering p < 0.05), in case of homogeneous studies considering OHRQoL instrument and time of follow-up.

Results

A total of 126 articles were accessed on the database, 18 registers, 33 records on grey literature and 3 articles by means of citation searching. After duplicates removal and eligibility criteria analyses, 15 SR were included. From that, 13 showed improvement in OHRQoL after OT and/or OST. The methodological quality ranges from high (n = 2), to critically low (n = 9). Meta-analysis was conducted. Improvement on OHRQoL after a 6-month OST using the OQLQ–22 (p < 0.00001; 19.65; CI: 12.60–26.70) and OHIP–14 instruments (p < 0.00001; 10.70; CI: 9.89–11.51); and after a 6-month OT using the CPQ 11–14 instrument (p = 0.010; 3.57; CI: 0.86–6.28) with very low certainty of the evidence for all outcomes was observed.

Conclusions

Although most SR selected in this overview are characterized by a critically low quality, as well as very low certainty of the evidence, OT and/or OST seem to have a positive impact in improving the OHRQoL.

Clinical Relevance

The overview of existing systematic reviews compiled that OT and/or OST seem to have a positive impact on improving the OHRQoL. This information will facilitate clinical decision-making considering the clinical and psychological parameters.

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Funding

This systematic review and meta-analysis study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001(Ribeiro), CNPq- Conselho Nacional de Desenvolvimento Científico e Tecnológico (Antunes/ Antunes) and by the Alexander von Humboldt Foundation (Küchler/Kirschneck accepted on July 4, 2019).

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Authors and Affiliations

  1. Postgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil

    Luciana Gonçalves Ribeiro, Leonardo Santos Antunes, Ludmila Silva Guimarães & Lívia Azeredo Alves Antunes

  2. Postgraduate Program in Dentistry, Institute of Health Sciences, Fluminense Federal University, St. Doutor Silvio Henrique Braune, 22, Centro, Nova Friburgo, RJ, 28625-650, Brazil

    Leonardo Santos Antunes & Lívia Azeredo Alves Antunes

  3. Department of Orthodontics, University Medical Centre of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Erika Calvano Küchler & Christian Kirschneck

  4. Department of Dentistry, University of Joinville Region - Univille, Joinville, SC, Brazil

    Flares Baratto-Filho

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  1. Luciana Gonçalves Ribeiro
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Luciana Gonçalves Ribeiro, Lívia Azeredo Alves Antunes, Ludmila Silva Guimarães, Flares Baratto-Filho, Erika Calvano Küchler and Leonardo Santos Antunes. The first draft of the manuscript was written by Luciana Gonçalves Ribeiro and Lívia Azeredo Alves Antunes. The final draft was written and revised by Lívia Azeredo Alves Antunes (systematic review methods), and Christian Kirschneck (orthodontics), and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Lívia Azeredo Alves Antunes.

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Ribeiro, L.G., Antunes, L.S., Küchler, E.C. et al. Impact of malocclusion treatments on Oral Health-Related Quality of Life: an overview of systematic reviews. Clin Oral Invest 27, 907–932 (2023). https://doi.org/10.1007/s00784-022-04837-8

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