Comparación de la estética dental autopercibida por los adolescentes al inicio y al final del tratamiento de ortodoncia

Laburpena

Patients come to the dentist's office mainly for esthetic and occlusal reasons due to the notable evolution that has taken place in the information on the oral-facial area. Innumerable indexes have been described in this field to analyze the patient's occlusion and esthetics; in this study the IOTN-AC is used, which is the subjective component of the need for orthodontic treatment. Objetives: 1. To observe the perception of the adolescent patient, once orthodontic treatment has been completed. 2.To compare the final perception of the patient with respect to that before starting treatment, by means of the esthetic component of the Index of Orthodontic Treatment Need (IOTN-AC). 3.To analyze the differences in patient perception according to sex. Material and methods: prospective longitudinal study using a sample of 159 patients between 11 and 17 years of age who had completed their orthodontic treatment. They were given a questionnaire in which they had to rate their mouth with a score from 1 to 10, 1 being the most attractive and 10 the least attractive. The current perception of these patients was compared with the perception they had before starting treatment and, in turn, their self-perception once orthodontic treatment was completed using the IOTN_AC index. The Wilcoxon and Friedman non-parametric tests were used to contrast the mean values of quantitative variables. Results: in the global contrast, highly significant differences were found with p<0.001 (Friedman: Value=243.83; p-value=0.000000) which indicate that during the time between the 1st and 3rd evaluation there is a change in esthetic perception. These changes have a high magnitude, since they correspond to an eff ect size of 63.6%. When contrasting the Pre-Treatment baseline values in 2019 with the recall values in 2021, a worsening of aesthetic perception has been observed (from 3.52 to 4.28), a difference that is highly significant with p<0.001 (Wilcoxon: Value=6.09 ; p-value = 0.000000) equivalent to an already large effect size (21.2 %). Therefore, these results are solid evidence to affirm that between the initial evaluation and the recall there is a change for the worse in the esthetic perception. When contrasting the result at the end of treatment, 1.02 points: (a) with the initial assessment, 3.52 points, a very noticeable improvement in aesthetic perception was found which is highly significant, p<0.001 (Wilcoxon: Value= 10.30; p-value=0.000000) with very high effect size: 64.3%; and (b) with the recall rating, 4.28 points, there also appears a large improvement in aesthetic perception which is very highly signifi cant, p<0.001 (Wilcoxon: Value= 10.52; p-value=0.000000) with very high and even higher effect size: 71 %. When comparing the IONT means between boys and girls, in the three evaluations very similar values are observed that do not reach statistical significance (p>0.05). In the same sense the respective effect sizes are almost null (<=0.02 %). Therefore, there is no evidence of differences between sexes and we conclude that this is not a determining factor in aesthetic perception. In order to contrast age as a possible explanatory factor of esthetic perception, the patients were grouped into two blocks: pre-adolescents, between 10 and 14 years of age, and adolescents (10 and 14 years of age) and teenagers (10 and 14 years of age). 14 years of age and adolescents (between 15 and 17 years of age). In age, on the other hand, starting from a worse initial assessment (3.67 vs 3.03 difference reaching statistical significance (p<0.05) the pre-adolescents (10-14 years old) tend to end up scoring their perception better at the end of the treatment. Conclusions: there are high magnitude and very significant changes leading to a better aesthetic perception at the end of treatment. There are changes for the worse in the perception of esthetics between the initial evaluation and recall. Pre-adolescents (10 to 14 years) score better in their perception at the end of treatment.