Oral Health-Related Quality of Life (OHQoL) in implant-supported rehabilitations: a longitudinal prospective single-center observational cohort study

doi:10.21203/rs.3.rs-3124215/v1

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Research Article

Oral Health-Related Quality of Life (OHQoL) in implant-supported rehabilitations: a longitudinal prospective single-center observational cohort study

https://doi.org/10.21203/rs.3.rs-3124215/v1

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published 04 May, 2024

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Background.To evaluate Oral Health-Related Quality of Life (OHRQoL) perceived by the patient before and after implant-prosthetic rehabilitation, to determine the physical and psychological impact that dental implants and related prosthetic rehabilitations could have in partial or edentulous patients. Finally, it was evaluated if demographic and clinical variables could influence the patient's perceived OHRQoL.

Methods.A longitudinal prospective single-center observational cohort study was conducted with patients requiring implant-prosthetic rehabilitation to evaluate OHRQoL before (T0), during (T1), and after treatment (T2) with implant-prosthetic rehabilitations. The three scores obtained at T0, T1, and T2, respectively, were compared with the variables patient's sex, age, implants placed in the aesthetic zone versus nonaesthetic zone, number of implants used in the rehabilitation, site of rehabilitation, type of definitive prosthetic rehabilitation, and type of recipient's bone.

Results. A total of 100 patients rehabilitated with 427 implants were enrolled. Statistically significant data emerged regarding the total OHRQoL score, its 7 domains, and VAS score in the 3 times considered and in relation to gender, age, aesthetics, implants number, dental arch, type of prosthesis, and type of surgery.

Conclusions. Implant-prosthetic rehabilitations significantly improve OHRQoL and aesthetics in edentulous or partially edentulous patients. The change in OHRQoL is accompanied by a marked improvement in the patient's aesthetic perception of the new smile similar in all intervals of the study.

Dental implants

Dentistry

Implant-supported rehabilitations

Oral health

Psychosocial impact

Quality of life.

Oral Health-Related Quality of Life (OHRQoL) assessment is a relatively new but rapidly growing phenomenon that has emerged in the past two decades. Slade identified the change in health perception from the simple absence of disease and infirmity to complete physical, mental, and social well-being, echoing the original World Health Organization (WHO) definition [1]. This change took place in the second half of the 20th century and was assessed by WHO as the key issue in the conception of Health-Related Quality of Life (HRQoL) and later OHRQoL, as a "silent revolution" in the values of industrialized societies from materialistic values focusing on economic stability and security to values centered on self-determination and self-actualization [2].

In the 1970s, Davis stated how, apart from pain and life-threatening cancers, other oral diseases have no impact on social life, being related only to cosmetic problems [3].

Thereafter, the concept of OHRQoL began to evolve as evidence grew that oral diseases could also significantly impact social roles. The clinical indicators used in diagnosing and monitoring oral diseases such as dental caries or periodontal disease were not entirely adequate to capture the new concept of health declared by WHO, particularly aspects of mental and social well-being [4–7]. As a result, researchers began to develop alternative methods, particularly patient-completed questionnaires, that would assess the physical, psychological, and social impact of oral conditions on an individual [8].

Thus, the OHRQoL becomes "a multidimensional construct" that reflects people's comfort when eating, sleeping, and engaging in social interaction, their self-esteem, and their satisfaction concerning oral health [9]. OHRQoL is associated with functional factors, psychological factors, social factors, and experience of pain or discomfort [10].

Information on quality of life makes it possible to assess feelings and perceptions at the individual level, increasing opportunities for communication between professionals and patients, improving understanding of the impact of oral health on the subject's and family's lives, and measuring the clinical outcomes of the interventions performed [11].

In the scientific literature, to truly define OHRQoL, many questionnaires have been created to statistically assess the actual improvement of quality of life about oral health. To this end, the European Commission suggests using the Oral Health Impact Profile (OHIP) as a tool to assess OHRQoL, as it has been well designed, extensively tested, has longitudinal and discriminative validity, and focuses on psychological and behavioral issues [12]. The original extended version (OHIP-49) contained 49 items and was based on a conceptual framework regarding oral health and its functional and psychological consequences [13]. A reduced questionnaire was designed to simplify the original version: the OHIP-14. The latter is simple to use, tested with positive results for psychometric qualities (validity and reliability) in several studies and different populations, sensitive to the measurement of clinical effects of treatment, with measurement properties comparable to the OHIP-49 [14].

Currently, there is a lot of scientific evidence in the literature regarding OHRQoL associated with a neoplastic disease or associated with the patient's oral hygiene conditions, but few data are available on patient perception in terms of improvement or worsening of OHRQoL after implant-prosthetic rehabilitation, which mainly analyzes OHRQoL concerning the type of surgical-prosthetic technique used [15–20].

Therefore, this clinical study aimed to evaluate OHRQoL perceived by the patient before and after implant-prosthetic rehabilitation, to determine the physical and psychological impact that dental implants and related prosthetic rehabilitations could have in partial or edentulous patients. Moreover, patient-perceived OHRQoL and Visual Analogue Scale (VAS) were preliminarily assessed by comparing several demographic and clinical variables that could potentially influence OHRQoL itself, including age and sex of patients, implants placed in the esthetic zone vs implants placed in the nonaesthetic zone, number of implants used in the rehabilitation, location of the rehabilitation, type of definitive prosthetic, and type of recipient's bone.

2.1 Study design

This study was approved by the Ethics Committee of the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, No. 864_2021 (Trial ID 2444) and was held according to the Helsinki statements. The study follows the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines shown in Table S1 (Supplementary Materials) [21]. A longitudinal prospective single-center observational cohort study was conducted with patients who required implant-prosthetic rehabilitation, recruited from the Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit of the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico (Italy). The volunteers were recruited between September 2021 and June 2022. All recruited subjects were informed about the objectives and study design, and those who consented to participate signed a written informed consent form.

2.2 Endpoints and survey description

For the assessment of the patient's perceived OHRQoL before (baseline–T0), during (provisional prosthodontics–T1), and after treatment (definitive prosthodontics–T2) by implant-prosthetic rehabilitations, a single questionnaire will be used, given to the patient at T0, T1, and T2. The questionnaire is based on the OHIP-14, which consists of 14 questions divided into 7 domain items: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap [13]. Table S2 (Supplementary Material) shows the OHIP-14 questionnaire.

In the present protocol, the Italian version, IOHIP-14 will be used, which has been validated and has good equivalence to its original OHIP-14 version [22].

To each of the 14 questions related to a particular aspect of perceived oral health status, the subject responded by choosing the best situation from 5 response grades, with a score between 1 and 5 (1 = never; 2 = hardly never; 3 = occasionally; 4 = fairly often; 5 = very often) [14].

For the primary endpoint, the overall score obtained from the scores reported by each patient related to the 14 questions at T0, T1, and T2 was calculated. The three scores, obtained at T0, T1, and T2, respectively, were compared to assess any change in OHRQoL during the stages of implant-prosthetic treatment.

For the secondary endpoint, like the primary endpoint, the overall score obtained from the scores reported by each patient related to the 14 questions at T0, T1, and T2 was calculated.

Thereafter, to identify possible factors that could influence OHRQoL and VAS scores, the three scores obtained at T0, T1, and T2, respectively, were compared by dividing the questionnaires by subgroups considering the variables according to patient's gender, age, implants placed in the esthetic zone versus implants placed in the nonaesthetic zone, the number of implants used in the rehabilitation, the location of the rehabilitation (implants placed in the mandibular arch versus implants placed in the maxillary upper arch), the type of definitive prosthetic rehabilitation (single crown versus bridge versus implant-supported total denture), and the type of recipient's bone (implants placed in native bone versus implants placed following bone regeneration procedures).

There were no follow-up visits after T2. The study duration was variable according to the patient, being related to the duration of the patient's planned treatment.

2.3 Study population

The study population consisted of all fully or partially edentulous patients who presented for a visit to the Implant Center for Edentulism and Jawbone Atrophies requesting implant-prosthetic rehabilitation, and who met the eligibility criteria adopted at the same department in compliance with current clinical practice to be able to place and rehabilitate dental implants safely and predictably.

2.4 Eligibility criteria

In this prospective study, all patients who received implant-prosthetic rehabilitation were consecutively enrolled. Criteria for the selection of candidate patients to receive implants generally included the following: male or female patients, partially or edentulous, aged ≥ 18 years, in good general health through the American Society of Anesthesiologists (ASA) scale I or ASA II, in need of implant-prosthetic rehabilitation in the anterior and/or posterior sectors of the maxillary upper jaw and/or mandible, with adequate oral hygiene (plaque and bleeding indices < 25%), able to fully understand the nature of the proposed questionnaire, and able to sign the informed consent form. Additional exclusion criteria-local, systemic, and related to the patient's habits and lifestyle-were adopted on a case-by-case basis according to current clinical practice.

2.5 Planned visits and operating protocol

Each patient was enrolled in the present protocol after anamnestic framing and acceptance of the treatment plan. For the conduct of the present study, three visits were required for the delivery/collection of questionnaires: an initial visit at T0, a follow-up visit (T1) 3 months after completion of provisional implant-prosthetic rehabilitation, and a follow-up visit (T2) 3 months after completion of definitive implant-prosthetic rehabilitation.

During the first visit (T0), as per practice, the medical history was collected, and a clinical and radiographic evaluation was performed to verify the patient's eligibility for implant-prosthetic rehabilitation according to the eligibility criteria. Patients who met these requirements and agreed to be rehabilitated according to the planned treatment plan were offered to participate in the present study for OHRQoL evaluation explaining the rationale and operative protocol. Patients who agreed to participate in the present study were given the questionnaire for evaluation of OHRQoL at T0, and the rest of the protocol forms. The questionnaire and protocol forms, completed by the patient, were collected at the next visit.

Each patient followed the accepted implant-prosthetic treatment pathway discussed during the formulation of the treatment plan according to current clinical practice, with no difference from the treatment pathway that may have been proposed if the patient's consent to be enrolled in this protocol was denied.

Once the provisional implant-prosthetic rehabilitation was completed, at 3 months (T1), each patient was given the same questionnaire previously given at T0 to assess the subject's perceived OHRQoL. The patient was asked to return the completed questionnaire after 7 days.

Once the definitive implant-prosthetic rehabilitation was completed, at 3 months (T2), the patient was given the same questionnaire previously given at T0 and T1 for the evaluation of the subject's perceived OHRQoL. Again, the patient was asked to return the completed questionnaire after 7 days.

2.6 Data collection

Data on patients included in the study were collected in dedicated data collection forms. The source documents were outpatient medical records in which all data on the treatment plan, interventions, prosthetic steps, and follow-up visits were recorded. The data acquired from the questionnaires and medical records needed for the study were transferred and recorded in an electronic database (Excel, Microsoft Corporation).

2.7 Sample size calculation

For sample size calculation, dedicated software (PASS Sample Size Software, NCSS LCC) was used. Estimating as a positive response to perceived quality of life an OHIP-14 questionnaire score between 14 and 25, as mentioned above, it was assumed that at time T0 the proportion of subjects with positive responses is 40% and that at time T2 the proportion of positive responses given by the same people is 60%. Wanting to assume a first-type error of 5% and a power of 80% in demonstrating a difference between the proportions of subjects with positive responses between time T0 and time T2, the sample under study had to consist of at least 100 patients.

2.8 Statistical methods

Regarding statistical analysis, implant, prosthesis, and patient were considered as reference statistical units according to the type of variable analyzed. Continuous variables are reported through mean and standard deviation (SD) or according to median and interquartile range (IQR), by assumptions of normality. The Shapiro-Wilk test was used preliminarily to check the normality of the data distribution. Since the data did not meet the assumptions of normality and heteroscedasticity, nonparametric tests were used. Specifically, in the case of dependent variables, Friedman's test was used to check for differences in measurements taken at different times by comparing the ranks of the distributions. For pairwise comparisons, in the case of both times (considering Bonferroni's adjustment for multiple comparisons) and groups, Wilcoxon's signed ranks test was used. In the case of independent variables, the same analyses were performed by the Kruskal-Wallis test and Mann-Whitney's U test, respectively. Statistical analyses were performed with R software. Values for a p-value less than α = 0.05 are considered significant.

A total of 100 patients rehabilitated with 427 implants were enrolled. The delivered questionnaire (OHIP-14), as seen above, had 14 questions divided into 7 domains. Data were initially analyzed by assessing OHRQoL values in general across the three study intervals. Next, the differences in OHRQoL in the three study intervals for each domain were analyzed. In addition, again regarding the three study intervals, OHRQoL and VAS scores of other variables were evaluated, including gender, age (taking the median value of 65 years as the reference figure), the position of implant-prosthetic rehabilitation by domain (aesthetic domain, between 15 and 25 versus nonaesthetic domains), the position of implant-prosthetic rehabilitation according to arch (maxillary upper jaw versus mandible), the number of implants (median value of 3 elements), type of implant-prosthetic rehabilitation (single crown versus bridge versus Toronto-type prosthesis), the type of recipient's bone (implant placement in native bone versus implant placement in regenerated bone).

3.1 OHRQoL total score

Regarding OHRQoL total score, improved and statistically significant data emerged in all 3-time intervals, i.e., from T0 to T1 (p< 0.01), from T0 to T2 (p< 0.01), and from T1 to T2 (p< 0.01) as shown in the figure below (Fig. 1).

The summary data of the results (p-value) that emerged from the statistical analysis referring to the variables analyzed of OHRQoL domains are summarized in Table 1 (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, handicap).

Moreover, it was evaluated for the OHRQoL total score and VAS score if sex (females versus males), age (considering the median value of 65 years), esthetics (considering rehabilitation 15 to 25 as the esthetic area), number of implants, dental arch (maxillary upper versus mandibular), type of prosthesis (single crown versus bridge versus Toronto-type prosthesis), and the type of surgery (native bone implant placement versus regenerated bone implant placement), could be influential variables in patients' response. Table 2 shows the statistical significance of the OHRQoL total score, and VAS score related to the variables sex, age, aesthetics, implants number, dental arch, type of prosthesis, and type of surgery.

The descriptive statistics and significances of the 7 domains of the OHIP-14 questionnaire and patients' perceived aesthetics through the VAS scale are given below.

3.1.1 Functional limitation

Descriptive data of the functional limitation domain at the 3 study times are represented in Table S3 (Supplementary Material). The results showed that there was statistically significant data from T0 to T2 (p < 0.01) and from T1 to T2 (p < 0.01). In contrast, from T0 to T1 there was no statistical evidence as shown in Figure S1 (Supplementary Material).

3.1.2 Physical pain

Descriptive data for the physical pain domain at the 3 study times are represented in Table S4 (Supplementary Material). It was shown that there is statistically significant data from T0 to T2 (p < 0.01) and from T0 to T1 (p < 0.01) In contrast, no statistically significant data emerged from T1 to T2 as shown in the figure below (Fig. S2 Supplementary Material).

3.1.3 Psychological discomfort

Descriptive data for the psychological discomfort domain at the 3 study times are represented in Table S5 (Supplementary Material). It was shown that there are statistically significant data at all 3 times thus from T0 to T2 (p < 0.01), from T0 to T1 (p < 0.01), and from T1 to T2 (p = 0.01) as shown in Figure S3 (Supplementary Material).

3.1.4 Physical disability

Descriptive data for the physical disability domain at the 3 study times are represented in Table S6 (Supplementary Material). It was shown that there is statistically significant data at all 3 times thus from T0 to T2 (p < 0.01), from T0 to T1 (p = 0.01), and T1 to T2 (p < 0.01) as shown in the figure below (Fig. S4 Supplementary Material).

3.1.5 Psychological disability

Descriptive data for the psychological disability domain at the 3 study times are represented in Table S7 (Supplementary Material). The results showed that there are statistically significant data at the 3 times, thus from T0 to T1 (p < 0.01), from T0 to T2 (p < 0.01), and from T1 to T2 (p < 0.01) as shown in Figure S5 (Supplementary Material).

3.1.6 Social disability

Descriptive data of the social disability domain in the 3 study times are represented in Table S8 (Supplementary Material). It was found that there are statistically significant data in 2-time intervals from T0 to T2 (p < 0.01), and T1 to T2 (p < 0.01) as shown in the figure below (Fig. S6 Supplementary Material).

3.1.7 Handicap

Descriptive data for this OHRQoL domain at the 3 study times are represented in Table S9 (Supplementary Material). It was found that there are statistically significant data in 2-time intervals from T0 to T1 (p < 0.01), and T0 to T2 (p < 0.01) as shown in Figure S7 (Supplementary Material).

3.1.8 VAS score

The patients' perceived aesthetics was analyzed through a VAS scale from 0 to 100. It was found that there are statistically significant data in all 3-time intervals, thus from T0 to T1 (p < 0.01), from T0 to T2 (p < 0.01), and from T1 to T2 (p < 0.01) as shown in the figure below (Fig. S8 Supplementary Material).

3.2 Sex

OHRQoL total score. In the inter-group comparison, OHRQoL does not show significant differences according to the sex of the patient (male or female) at any time point (p > 0.05) (Table 2). In the intra-group comparison, statistically significant improvements in OHRQoL were found in both male and female groups from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

VAS score. In the inter-group comparison, statistically significant differences in the smile aesthetic perception emerged in the study intervals between males and females at T1 and T2 (Table 2) with higher values for the male group (Table 3). In intra-group comparison, a significant improvement in patients’ smile aesthetic perception was shown in both male and female groups from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

Table 3

Descriptive statistics of OHRQoL total score and VAS score for the sex variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Male	T0	28.60	8.10	15.00	30.00	42.00
		T1	22.97	6.04	14.00	22.00	37.00
		T2	19.34	4.63	14.00	18.00	30.00
	Female	T0	27.49	7.55	14.00	27.00	42.00
		T1	22.45	6.37	14.00	22.00	52.00
		T2	18.65	4.73	14.00	18.00	34.00
VAS score	Male	T0	29.23	21.33	0.00	23.00	83.00
		T1	63.31	16.73	20.00	67.00	91.00
		T2	85.23	9.67	68.00	86.00	100.00
	Female	T0	28.15	21.92	0.00	22.00	100.00
		T1	56.75	17.91	12.00	54.00	100.00
		T2	78.15	15.64	16.00	80.00	100.00

3.3 Age

OHRQoL total score. In the inter-group comparison, there were no statistically significant differences in OHRQoL according to the age of patients (over-65 and under-65 years old) at any time point (p > 0.05) (Table 2). In the intra-group comparison, both in the over-65 and under-65 years old groups, OHRQoL improved significantly from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

VAS score. In the inter-group comparison, statistically significant differences in smile aesthetic satisfaction emerged between patients older than 65 years and patients younger than 65 years at T1 (Table 2). Over-65-year-old patients showed greater smile aesthetic satisfaction than under-65-year-old patients (Table 4). In the intra-group comparison, smile aesthetic satisfaction improved significantly in both over-65 and under-65 years old patients from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

Table 4

Descriptive statistics of OHRQoL total score and VAS score for the age variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Over-65	T0	28.14	7.85	15.00	28.00	42.00
		T1	22.42	5.79	14.00	22.00	37.00
		T2	18.86	4.69	14.00	17.50	31.00
	Under-65	T0	27.38	7.55	14.00	25.00	42.00
		T1	23.03	7.09	14.00	21.00	52.00
		T2	18.94	4.73	14.00	18.00	34.00
VAS score	Over-65	T0	29.59	20.66	0.00	24.00	92.00
		T1	61.30	17.72	12.00	64.00	100.00
		T2	81.47	15.13	16.00	83.00	100.00
	Under-65	T0	26.47	23.53	0.00	22.00	100.00
		T1	54.68	17.10	20.00	52.00	100.00
		T2	79.00	12.26	49.00	78.00	100.00

3.4 Aesthetics

OHRQoL total score. In the inter-group comparison, the OHRQoL has no statistically significant differences between patients who received implants in the aesthetic or nonaesthetic zone at any time point (p > 0.05) (Table 2). In the intragroup comparison, in both groups of patients who received implants in the aesthetic and nonaesthetic areas, OHRQoL improved significantly from T0 to T1 (p < 0.05), T0–T2 (p < 0.05), and T1–T2 (p < 0.05) (Table 2).

VAS score. In the inter-group comparison, there were no statistically significant differences in the smile aesthetic satisfaction between patients who received implants in the esthetic zone compared with patients who received implants in the non-esthetic zone at any time point (p > 0.05) (Table 2). In the intragroup comparison, however, smile aesthetic perception was significantly enhanced in patients who received implants in the aesthetic and nonaesthetic areas in the 3-time intervals considered from T0 to T1 (p < 0.05), T0–T2 (p < 0.05), and T1–T2 (p < 0.05) (Table 2).

The descriptive statistics shown in Table 5 highlight that OHRQoL and patients' smile aesthetic satisfaction are both independent of the area considered.

Table 5

Descriptive statistics of OHRQoL total score and VAS score for the aesthetics variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Aesthetic area	T0	28.29	7.47	14.00	28.00	42.00
		T1	22.96	6.23	14.00	22.00	52.00
		T2	19.02	4.54	14.00	18.00	31.00
	Nonaesthetic area	T0	25.75	8.87	15.00	21.50	42.00
		T1	20.88	6.14	15.00	18.00	34.00
		T2	18.19	5.48	14.00	15.50	34.00
VAS score	Aesthetic area	T0	28.74	22.13	0.00	22.00	100.00
		T1	59.54	17.64	12.00	59.00	100.00
		T2	80.44	14.75	16.00	81.00	100.00
	Nonaesthetic area	T0	27.44	19.28	0.00	25.00	64.00
		T1	56.50	18.40	20.00	54.00	100.00
		T2	81.63	11.27	68.00	83.00	100.00

3.5 Implants number

OHRQoL total score. In the inter-group comparison, the number of dental implants inserted (> 3 or ≤ 3) does not show statistically significant differences in the OHRQoL of patients at any time point (p > 0.05) (Table 2). In the intra-group comparison, both patients receiving > 3 implants or ≤ 3 dental implants, OHRQoL improved significantly from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

VAS score. In the inter-group comparison, there were no significant differences in the smile aesthetic perception in patients who received > 3 dental implants or ≤ 3 implants at any time point (p > 0.05) (Table 2). In the intragroup comparison, smile aesthetic satisfaction improved significantly in patients receiving > 3 or ≤ 3 dental implants from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

The descriptive statistics in Table 6 show that OHRQoL and patients' smile aesthetic satisfaction are both independent of the number of dental implants placed.

Table 6

Descriptive statistics of OHRQoL total score and VAS score for the dental implants variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	> 3	T0	28.87	8.13	15.00	42.00	28.00
		T1	23.78	7.06	14.00	52.00	23.00
		T2	19.30	5.00	14.00	31.00	18.00
	≤ 3	T0	27.04	7.33	14.00	42.00	27.50
		T1	21.65	5.31	14.00	34.00	20.00
		T2	18.54	4.42	14.00	34.00	17.50
VAS score	> 3	T0	26.48	21.87	0.00	22.00	92.00
		T1	59.13	19.52	12.00	58.50	100.00
		T2	82.00	16.88	16.00	82.50	100.00
	≤ 3	T0	30.28	21.44	0.00	23.50	100.00
		T1	58.98	16.18	20.00	58.00	100.00
		T2	79.46	11.50	49.00	81.00	100.00

3.6 Dental arch

OHRQoL total score. In the inter-group comparison, the OHRQoL shows no significant difference between the type of implant-prosthetically rehabilitated dental arch (maxilla or mandible) at any time point (p > 0.05) (Table 2). However, In the intra-group comparison, OHRQoL improved significantly in both maxillary and mandibular implant-prosthetic rehabilitation patients from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

VAS score. In the inter-group comparison, the type of implant-prosthetically rehabilitated dental arch (maxilla or mandible) does not lead to a significant difference in the smile aesthetic perception at any time point (p > 0.05) (Table 2). However, in the intra-group comparison, statistically significant differences in smile aesthetic satisfaction emerged both in maxillary and mandibular implant-prosthetic rehabilitation patients from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

The descriptive statistics in Table 7 show that OHRQoL and patients' smile aesthetic satisfaction are both independent of the type of dental arch implant-prosthetically rehabilitated.

Table 7

Descriptive statistics of OHRQoL total score and VAS score for the dental arch variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Maxilla	T0	28.24	7.59	14.00	27.50	42.00
		T1	22.99	6.30	14.00	22.00	52.00
		T2	18.93	4.86	14.00	17.50	34.00
	Mandible	T0	28.06	8.05	15.00	28.00	42.00
		T1	23.17	6.67	14.00	22.00	52.00
		T2	19.85	5.11	14.00	19.00	31.00
VAS score	Maxilla	T0	28.66	22.97	0.00	22.50	100.00
		T1	59.82	18.88	12.00	59.00	100.00
		T2	81.52	15.71	16.00	81.00	100.00
	Mandible	T0	25.97	19.66	0.00	19.00	92.00
		T1	54.82	20.23	12.00	54.00	100.00
		T2	79.15	17.15	16.00	81.00	100.00

3.7 Type of prosthesis

OHRQoL total score. In the inter-group comparison, the type of prosthesis rehabilitation (crown, bridge, and Toronto) does not lead to a significant difference in OHRQoL at any time point (p > 0.05) (Table 2). In the intra-group comparison, OHRQoL improved significantly both in patients receiving a crown, bridge, or a Toronto from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

VAS score. In the inter-group comparison, smile aesthetic satisfaction perceived by patients does not show statistically significant differences according to the type of prosthetic rehabilitation (crown, bridge, and Toronto) at any time point (p > 0.05) (Table 2). However, in the intra-group comparison, smile aesthetic perception improved significantly in patients receiving a crown, bridge, or a Toronto from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

The descriptive statistics shown in Table 8 show that the OHRQoL and smile aesthetic satisfaction of patients are both independent of the type of prosthesis delivered to the patient.

Table 8

Descriptive statistics of OHRQoL total score and VAS score for the type of prosthesis variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Crown	T0	28.27	6,55	16.00	29.00	41.00
		T1	21.88	5.37	15.00	22.00	34.00
		T2	19.12	6.04	14.00	16.00	34.00
	Bridge	T0	27.95	7.90	14.00	27.00	42.00
		T1	22.88	6.63	14.00	22.00	37.00
		T2	19.30	4.80	14.00	18.00	31.00
	Toronto	T0	36.33	9.81	25.00	42.00	42.00
		T1	41.33	18.47	20.00	52.00	52.00
		T2	21.67	1.15	21.00	21.00	23.00
VAS score	Crown	T0	23.12	14.30	6.00	20.00	71.00
		T1	55 − 27	16.10	32.00	49.00	100.00
		T2	82.77	11.75	69.00	78.00	100.00
	Bridge	T0	28.36	22.57	0.00	22.00	100.00
		T1	58.28	20.35	12.00	58.00	100.00
		T2	80.02	17.17	16.00	81.00	100.00
	Toronto	T0	30.33	35.22	10.00	10.00	71.00
		T1	55.33	12.70	48.00	48.00	70.00
		T2	83.33	14.43	75.00	75.00	100.00

3.8 Type of surgery

OHRQoL total score. In the inter-group comparison, the OHRQoL showed statistically significant differences between patients who had placed a native bone implant and those who had placed a regenerated bone implant at T2 (p < 0.05) (Table 2) with the highest value for patients undergoing regenerative implant surgery (Table 9). In the intra-group comparison, OHRQoL improved significantly both when implants were placed in the native bone and in the regenerated bone from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01) (Table 2).

Table 9

Descriptive statistics of OHRQoL total score and VAS score for the type of surgery variable.
	Group	Time	Mean	St Dev	Min	Median	Max
OHRQoL total score	Native bone implant	T0	28.20	7.96	15.00	28.00	42.00
		T1	23.57	7.26	14.00	22.00	52.00
		T2	18.80	5.02	14.00	17.00	34.00
	Regenerated bone implant	T0	28.11	7.52	14.00	28.50	42.00
		T1	22.31	4.94	14.00	22.00	35.00
		T2	20.08	4.83	14.00	19.00	31.00
VAS score	Native bone implant	T0	28.80	23.39	0.00	23.50	92.00
		T1	58.15	20.80	12.00	55.00	100.00
		T2	80.53	15.69	16.00	78.00	100.00
	Regenerated bone implant	T0	25.69	18.76	5.00	19.00	100.00
		T1	57.11	17.71	12.00	58.50	100.00
		T2	80.53	17.33	16.00	83.00	100.00

VAS score. In the inter-group comparison, smile patient satisfaction does not show significant differences according to the type of bone in which the implants were placed (native or regenerated) at any time point (p > 0.05). In the intra-group comparison, smile aesthetic perception improved significantly when implants were placed in the native bone and in the regenerated bone from T0 to T1 (p < 0.01), T0–T2 (p < 0.01), and T1–T2 (p < 0.01).

The present study aimed to evaluate the change in OHRQoL, and aesthetic smile satisfaction perceived by the patient by VAS scale before and after the replacement of missing teeth by implant-prosthetic rehabilitation and to analyze the physical and psychological impact brought about by dental implants and related prosthetic restorations. Potential variables that could influence the total OHRQoL given by the sum of the 7 domains were also considered.

From the results achieved, it is possible to state that patients perceived an overall improvement in their quality of life after being rehabilitated by implant-prosthetic rehabilitations, furthermore, the transition from temporary to permanent played a significant role in improving OHRQoL, and, finally, patients perceived a significant esthetic improvement.

Regarding the sex variable, as shown in the study by Fillion et al. [23], in the intergroup comparison the OHRQoL did not show statistically significant differences between males and females at any time point. In the intragroup comparison, however, OHRQoL improves significantly in both males and females at all time points considered. These results support the hypothesis that implant-prosthetic rehabilitation improves patients' quality of life in the absence of substantial differences between males and females in terms of improvement or worsening of OHRQoL.

In this study, the data show that regardless of age (over-65 and under-65), OHRQoL improves significantly following implant-prosthetic therapy at all times considered, as also shown by Takemae et al. [24].

Patients benefited from implant-prosthetic rehabilitation both in terms of aesthetics and function. Specifically, the comparison between aesthetic and nonaesthetic areas showed that OHRQoL improved significantly regardless of the aesthetic position of implant-prosthetic rehabilitation at all time points.

In addition, it was shown that OHRQoL improves significantly in all-time points regardless of the number of implants placed (> 3 or ≤ 3). In fact, according to Yoshida et al. [25], the number of implants in implant-prosthetic rehabilitation does not seem to influence the final OHRQoL. For the evaluation of OHRQoL, this could be because the patient was asked questions focused on the outcome and not on clinical practice. As a result, patients did not perceive differences in OHRQoL, but an assessment of postoperative morbidity, which was not analyzed in the present study, could yield very different results.

As described by Gerritsen et al. [26], this study provides clear data that tooth loss affects the severity of impairment. As described by Imam et al. [27], in cases of loss of one or more teeth, the location of edentulism has some influence on OHRQoL. Anterior tooth loss has a wide-ranging impact in physical and psychosocial terms compared with posterior tooth loss, suggesting that restoration of anterior teeth should be prioritized in treatment planning. In the study by Hara et al. [28], the location of dental implants and their relationship to OHRQoL were considered. As in the present study, all questionnaire scores improved significantly after implant treatment regardless of the dental arch considered. In another study by Pavel et al. [29], an improvement in OHRQoL after implant placement and rehabilitation emerged demonstrating that implant-prosthetic rehabilitation led to improvements not only functional and psychological but also aesthetic. The same results were obtained through the present study.

Furthermore, the present study evaluated whether partial rehabilitation, such as a bridge or a single crown, could provide psychological and social support even though it was partial and not total rehabilitation. The results were promising in terms of improved OHRQoL in patients rehabilitated by partial rehabilitations, including 26 crowns and 129 bridges, which accounted for almost all the artifacts analyzed in the present study. As showed by Delle Piane et al. [15] and Xu et al. [30], immediate rehabilitation with implant-supported full-arch prostheses is a treatment associated with a positive long-term impact on OHRQoL, especially in terms of psychological, social, and functional effects in terms of chewing and phonetics.

The study by Yunus et al. [31] showed that improvement in OHRQoL occurs more in partial dentures on 2 implants than in overdentures. In the present study, similar results also emerged regarding the comparison of crowns on implants versus Toronto on implants. This finding suggests how edentulous patients who were subsequently rehabilitated with implant-supported total dentures using removable total dentures still had good overall compensation and thus a good perception of OHRQoL compared with partially edentulous patients who did not have partial dentures to replace missing elements. The low number of patients rehabilitated by implant-supported total prostheses analyzed in the present study should be considered when analyzing these data, which may not reflect the true perception of OHRQoL extended to a larger population. However, in this study, it was shown that OHRQoL improved significantly at all time points regardless of the type of prosthesis, whether crown, bridge, or Toronto, although it is interesting to highlight that the OHRQoL of patients before receiving a Toronto prosthesis (T0) is worse than the other patients and at the end of the rehabilitation process (T2) the OHRQoL is homogenous with the other values.

Finally, it was shown that OHRQoL significantly improves in both patients undergoing implant surgery in native and regenerated bone, however with significant differences between the two groups at the end of implant rehabilitation with higher OHRQoL values in patients undergoing pre-implant bone regeneration. This finding could be explained considering that such patients must undergo additional surgery as well as wait longer before receiving the prosthetic restoration.

Another parameter that was considered was aesthetic perception measured on a VAS scale to assess patients' satisfaction at T0, T1, and T2. The results obtained in the present study are in line with what has been described by Baracat et al. [21] i.e., patients benefited from implant-prosthetic rehabilitation and were satisfied at the end of treatment.

According to the results described by Wang et al. [16], the results showed that patients' smile aesthetic satisfaction improves significantly at all time points in both males and females with significant differences between the two groups in both the provisional and definitive phases, highlighting that men appreciate implant-prosthetic rehabilitation more than women.

In addition, it has been shown that the aesthetic perception of the smile is significantly higher in patients older than 65 years than in younger patients, hypothesizing that patients older than 65 years have larger edentulous areas and probably have had them longer than younger patients, so when they are rehabilitated, they perceive the aesthetic impact and changes in their smile more. In contrast, patients’ smile aesthetic satisfaction increased significantly at all time points regardless of the edentulous area rehabilitated (aesthetic or nonaesthetic), the number of implants placed, the arch rehabilitated, the type of prosthesis delivered to the patient, and, finally, the type of bone in which the implants were placed (native or regenerated), according to the study by Sidenö et al. [33].

In the present study, in addition to the overall assessment of OHRQoL and VAS, it was investigated whether there were subgroups in the 7 domains that constituted the questionnaire that showed improvements in each time interval. Some specific subpopulations, such as female patients and those over 65, showed statistically significant improvements from T0 to T2 in all 7 domains. Patients in whom more than 3 implants were placed also showed improvements in all domains from T0 to T2. In these terms, restoration of masticatory function seems to have played a crucial role in improving OHRQoL, probably because patients who receive multiple implants start from a more unfavorable OHRQoL condition. Subsequently, after being rehabilitated, they resume normal stomatognathic functions, thus improving their quality of life. It is interesting to highlight the fact that both implants placed in native bone and implants placed in regenerated bone reported improvement from OHRQoL from T0 to T2 in all 7 domains, with no significant differences between the two groups. Correct reconstruction of missing bone tissue and peri-implant soft tissue thus appears to result in restoration of the correct anatomy of peri-implant supporting tissues such that the OHRQoL reported at atrophic sites was superimposable compared with sites that did not require tissue regeneration procedures.

The analysis of OHRQoL before and after implant-prosthetic rehabilitation has also been examined in other studies [34–37]; however, this is the first longitudinal study with a large cohort that more precisely analyzes the changes of the 7 domains of OHRQoL as well as OHRQoL total score and VAS score in relation to sex, age, esthetics, number of implants, dental arch, type of prosthesis (crown, bridge, Toronto) and type of surgery (native bone and regenerated bone).

Several limitations require consideration in the interpretation of the findings. This is a single-center study without a control group. In addition, the recruitment of partially or fully edentulous patients could be an influencing factor in the perceived patients' responses. Finally, considering the impact that the pandemic COVID-19 has had on the quality of life, it must be recognized in the interpretation of the data.

In conclusion, it can be said that implant-prosthetic rehabilitations lead to significant improvement in OHRQoL and smile aesthetic satisfaction in edentulous or partially edentulous patients. All patients, regardless of the variables analyzed, reported substantial improvement in OHRQoL at both provisional and final prosthetic delivery, with significant differences from baseline. Thus, the provisional stage becomes critical not only to restore proper stomatognathic function but also to guide the healing of the peri-implant soft tissues to achieve an ideal architecture and anatomy at the time of delivery of the final prosthesis, significantly improving the patient-perceived OHRQoL from baseline to delivery of the final prosthesis.

The change in OHRQoL is accompanied by a marked improvement in the patient's aesthetic perception of the new smile similar in all intervals of the study. Finally, the OHRQoL could provide the basis for any dental health care program and should be considered an important element in the overall oral health program because it allows the focus to shift not only to clinical-radiographic variables but also to more subjective elements related to the patient himself to improve current clinical practice toward patients.

ASA: American Society of Anesthesiologists

HRQoL: Health-Related Quality of Life

IOHIP-14: Italian Oral Health Impact Profile-14

IQR: Interquartile Range

OHIP-14: Oral Health Impact Profile-14

OHIP-49: Oral Health Impact Profile-49

OHIP: Oral Health Impact Profile

OHRQoL: Oral Health-Related Quality of Life

SD: Standard Deviation

STROBE: STrengthening the Reporting of OBservational studies in Epidemiology

VAS: Visual Analogue Scale

WHO: World Health Organization

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, No. 864_2021 (Trial ID 2444). All participants were informed verbally and in writing and provided written informed consent. The authors confrm that all methods were performed in accordance with the relevant guidelines and regulations and were performed in line with the Declaration of Helsinki.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Availability of data and materials

The data are available for use upon request to the corresponding author.

Competing interests

The authors did not have any conflict of interest, financial or personal, in any of the materials described in this study.

Funding

This study was funded by Italian Ministry of Health - Current research IRCCS.

Authors' contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by MM, MB, CM, and PPP. Statistical analysis was performed by MR. The first draft of the manuscript was written by MP, and PPP. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Acknowledgements

Not applicable.

Slade GD. Oral health-related quality of life is important for patients, but what about populations? Commun. Dent. Oral. Epidemiol. 2012;40:39-43. https://doi.org/10.1111/j.1600-0528.2012.00718.x
Gift HC, Atchison KA, Dayton CM. Conceptualizing oral health and oral health-related quality of life. Soc. Sci. Med. 1997;44:601-608. https://doi.org/10.1016/s0277-9536(96)00211-0
Davis P. Compliance structures and the delivery of health care: the case of dentistry. Soc Sci Med. 1976;10:329-337. https://doi.org/10.1016/0037-7856(76)90079-2
Cohen LK, Jag JD. Toward the formulation of sociodental indicators. Int J Health Serv. 1976;6:681-698. https://doi.org/10.2190/LE7A-UGBW-J3NR-Q992
Bennadi D, Reddy CVK. Oral health related quality of life. J Int Soc Prev Community Dent. 2013;3:1-6. https://doi.org/10.4103/2231-0762.115700
Cushing AM, Sheiham A, Maizels J. Developing socio-dental indicators--the social impact of dental disease. Community Dent Health. 1986;3:3-17. https://pubmed.ncbi.nlm.nih.gov/3516317/
Ettinger RL. Oral disease and its effect on the quality of life. Gerodontics. 1987;3:103-106. https://pubmed.ncbi.nlm.nih.gov/3305120/
Al Shamrany M. Oral health-related quality of life: a broader perspective. East Mediterr Health J. 2006;12:894-901. https://pubmed.ncbi.nlm.nih.gov/17333837/
Rockville MD. Mental health: A report of the Surgeon General. US Department of Health and Human Services 1999. https://profiles.nlm.nih.gov/101584932X120
Alvarez-Azaustre MP, Greco R, Llena C. Oral Health-Related Quality of Life in Adolescents as Measured with the Child-OIDP Questionnaire: A Systematic Review. Int J Environ Res Public Health. 2021;18:12995. https://doi.org/10.3390/ijerph182412995
Locker D, Miller Y. Evaluation of subjective oral health status indicators. J Public Health Dent. Summer. 1994;54:167-176. https://doi.org/10.1111/j.1752-7325.1994.tb01209.x
Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2003;31:3-23. https://doi.org/10.1046/j..2003.com122.x
Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994;11:3-11. https://pubmed.ncbi.nlm.nih.gov/8193981/
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25:284-290. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x
Dellepiane E, Pera F, Zunino P, Mugno MG, Pesce P, Menini M. Oral Health-Related Quality of Life and Full-Arch Immediate Loading Rehabilitation: An Evaluation of Preoperative, Intermediate, and Posttreatment Assessments of Patients Using a Modification of the OHIP Questionnaire. J Oral Implantol. 2020;46:540-549. https://doi.org/10.1563/aaid-joi-D-19-00274
Wang Y, Bäumer D, Ozga AK, Körner AG, Bäumer A. Patient satisfaction and oral health-related quality of life 10 years after implant placement. BMC Oral Health. 2021;21:30. https://doi.org/10.1186/s12903-020-01381-3
Marković A, Mišić T, Janjić B, Šćepanović M, Trifković B, Ilić B, Todorović AM, Marković J, Dard MM. Immediate Vs Early Loading of Bone Level Tapered Dental Implants With Hydrophilic Surface in Rehabilitation of Fully Edentulous Maxilla: Clinical and Patient Centered Outcomes. J Oral Implantol. 2022;48:358-369. https://doi.org/10.1563/aaid-joi-D-21-00045
Van Doorne L, Fonteyne E, Matthys C, Bronkhorst E, Meijer G, De Bruyn H. Longitudinal Oral Health-Related Quality of Life in maxillary mini dental implant overdentures after 3 years in function. Clin Oral Implants Res. 2021;32:23-36. https://doi.org/10.1111/clr.13677
Gündoğar H, Uzunkaya M, Öğüt S, Sarı F. Effect of peri-implant disease on oral health-related quality of life in geriatric patients. Gerodontology. 2021;38:414-421. https://doi.org/10.1111/ger.12556
Patil PG, Seow LL. Oral health-related quality of life of patients using single or two-implant mandibular overdentures with immediate loading protocols: A randomized controlled trial. J Indian Prosthodont Soc. 2021;21:375-382. https://doi.org/10.4103/jips.jips_328_21
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344-349. https://doi.org/10.1016/j.jclinepi.2007.11.008
Franchignoni M, Giordano A, Brigatti E, Migliario M, Levrini L, Ferriero G. Psychometric properties of the Italian version of the reduced form of the Oral Health Impact Profile (OHIP-14). G Ital Med Lav Ergon. 2010;32:B71-B78. https://pubmed.ncbi.nlm.nih.gov/21302527/
Fillion M, Aubazac D, Bessadet M, Allègre M, Nicolas E. The impact of implant treatment on oral health related quality of life in a private dental practice: a prospective cohort study. Health Qual Life Outcomes. 2013;11:197. https://doi.org/10.1186/1477-7525-11-197
Takemae R, Uemura T, Okamoto H, Matsui T, Yoshida M, Fukazawa S, Tsuchida K, Tsunoda T. Changes in mental health and quality of life with dental implants as evaluated by General Health Questionnaire (GHQ) and Health Utilities Index (HUI). Environ Health Prev Med. 2012;17:463-473. https://doi.org/10.1007/s12199-012-0275-9
Yoshida T, Masaki C, Komai H, Misumi S, Mukaibo T, Kondo Y, Nakamoto T, Hosokawa R. Changes in oral health-related quality of life during implant treatment in partially edentulous patients: A prospective study. J Prosthodont Res. 2016;60:258-264. https://doi.org/10.1016/j.jpor.2016.01.010
Gerritsen AE, Finbarr Allen P, Witter DJ, Bronkhorst EM, Creugers NHJ. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2010;8:126. https://doi.org/10.1186/1477-7525-8-126
Imam AY. Impact of Tooth Loss Position on Oral Health-Related Quality of Life in Adults Treated in the Community. J Pharm Bioallied Sci. 2021;13:S969-S974. https://doi.org/10.4103/jpbs.jpbs_87_21
Hara M, Matsumoto T, Yokoyama S, Higuchi D, Baba K. Location of implant-retained fixed dentures affects oral health-related quality of life. Clin Implant Dent Relat Res. 2017;19:710-716. https://doi.org/10.1111/cid.12497
Pavel K, Seydlova M, Dostalova T, Zdenek V, Chleborad K, Jana Z, Feberova J, Radek H. Dental implants and improvement of oral health-related quality of life. Community Dent Oral Epidemiol. 2012;40:65-70. https://doi.org/10.1111/j.1600-0528.2011.00668.x
Xu TS, Di P, Jiang X, Luo J, Zhang Y, Lin Y. Implant-supported fixed full-arch prostheses on oral health-related quality of life and denture satisfaction. Chin J Stomatol. 2021;56:998-1004. https://doi.org/10.3760/cma.j.cn112144-20210508-00218
Yunus N, Masood M, Saub R, Al-Hashedi AA, Ali TBT, Thomason JM. Impact of mandibular implant prostheses on the oral health-related quality of life in partially and completely edentulous patients. Clin Oral Implants Res. 2016;27:904-909. https://doi.org/10.1111/clr.12657
Baracat LF, Teixeira AM, dos Santos MBF, de Paula Prisco da Cunha V, Marchini L. Patients' expectations before and evaluation after dental implant therapy. Clin Implant Dent Relat Res. 2011;13:141-145. https://doi.org/10.1111/j.1708-8208.2009.00191.x
Sidenö L, Hmaidouch R, Brandt J, von Krockow N, Weigl P. Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study. BMC Oral Health. 2018;18:182. https://doi.org/10.1186/s12903-018-0644-x
Berniyanti T, Palupi R, Alkadasi BA, Sari KP, Putri RI, Salma N, Prasita S, Regita AS. Oral Health-Related Quality of Life (OHRQoL) Analysis in Partially Edentulous Patients with and without Denture Therapy. Clin Cosmet Investig Dent. 2023;15:89-98. https://doi.org/10.2147/CCIDE.S407136
Schmalz G, Fenske F, Reuschel F, Bartl M, Schmidt L, Goralski S, Roth A, Ziebolz D. Association between oral health and oral health-related quality of life in patients before hip and knee endoprosthesis surgery: a cross-sectional study. BMC Oral Health. 2022;22:604. https://doi.org/10.1186/s12903-022-02650-z
Duong HY, Roccuzzo A, Stähli A, Salvi GE, Lang NP, Sculean A. Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses. Periodontol 2000. 2022;88:201-237. https://doi.org/10.1111/prd.12419
Leonard JF, Taxel P, Kuo, CL, Da Cunha Godoy L, Freilich M. Dental implant and bone augmentation treatment in bone-compromised patients: Oral health-related quality of life outcomes. J Prosthet Dent. 2023;S0022-3913. https://doi.org/10.1016/j.prosdent.2023.01.011

Tables 1 and 2 are available in the Supplementary Files section.

No competing interests reported.

SupplementaryMaterials.docx
Supplementary Material Table S1. STROBE Checklist of cohort studies. Table S2. The OHIP-14 questionnaire. Table S3. Descriptive statistics of the functional limitation domain in the 3 study times. Figure S1. Functional limitation domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S4. Descriptive statistics of the physical pain domain in the 3 study times. Figure S2. Physical pain domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S5. Descriptive statistics of the psychological discomfort domain in the 3 study times. Figure S3. Psychological discomfort domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S6. Descriptive statistics of the physical disability domain in the 3 study times. Figure S4. Physical disability domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S7. Descriptive statistics of the psychological disability domain in the 3 study times. Figure S5. Psychological disability domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S8. Descriptive statistics of the social disability domain in the 3 study times. Figure S6. Social disability domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Table S9. Descriptive statistics of the social disability domain in the 3 study times. Figure S7. Handicap domain statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001. Figure S8. VAS scale of patients' perceived aesthetics statistical significance in the 3-time intervals (T0, T1, T2). Legend: *=p<0.05; **= p<0.01; ***= p<0.001; ****=p<0.0001.
Table1.docx
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Oral Health-Related Quality of Life (OHQoL) in implant-supported rehabilitations: a longitudinal prospective single-center observational cohort study

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Journal Publication

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Abstract

Figures

1. BACKGROUND

2. METHODS

2.1 Study design

2.2 Endpoints and survey description

2.3 Study population

2.4 Eligibility criteria

2.5 Planned visits and operating protocol

2.6 Data collection

2.7 Sample size calculation

2.8 Statistical methods

3. RESULTS

3.1.1 Functional limitation

3.1.2 Physical pain

3.1.3 Psychological discomfort

3.1.4 Physical disability

3.1.5 Psychological disability

3.1.6 Social disability

3.1.7 Handicap

3.1.8 VAS score

3.2 Sex

3.3 Age

3.4 Aesthetics

3.5 Implants number

3.6 Dental arch

3.7 Type of prosthesis

3.8 Type of surgery

4. DISCUSSION

5. CONCLUSION

Abbreviations

Declarations

References

Tables

Additional Declarations

Supplementary Files

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