Document Type: Original Article

Authors

1 Dental Sciences Research Center, Dept. of Periodontology, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.

2 Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Statement of the Problem: Information on patient-centered outcomes of periodontal disease and the impact of different periodontal treatment phases on the life quality of periodontal patients is limited.
Purpose: This study sought to compare patients’ perception of their oral health-related quality of life (OHQoL) following one-stage full mouth disinfection (OSFMD) and surgical periodontal treatment.
Materials and Method: A pre-and post-interventional study design was conducted in two phases on a single group of patients. Subjects were recruited from moderate to severe chronic periodontitis patients referred to a private clinic. At baseline and after each treatment phase, periodontal parameters were recorded by a blind examiner. Patients received OSFMD, followed by periodontal flap surgeries and completed the validated Iranian version of the OHIP-49 questionnaire (OHIP-35-IR) at three time points (baseline, two weeks post-initial therapy and after completion of surgical phase). Data were analyzed using repeated measure ANOVA, paired and independent t-tests, and multivariate regression analysis by SPSS software version 21.
Results: 38 patients (14 men, 24 women, mean age 40.30±11.93) completed the study. Periodontal parameters showed progressive improvement from baseline to the end of the study (p < 0.05). The total mean OHIP-35-IR score at baseline (89.25±19.26) was significantly improved (reduced) compared to each treatment phase (75.63±17.15 and 74.22±15.46, respectively; p < 0.001), with no significant difference between treatments. Improvements in subdomains of psychological discomfort, functional limitation, physical pain, and handicap accounted for the changes. The effect size was calculated to be 0.80 for the first and 0.66 for the second treatment phases. 
Conclusion: Within limits, OSFMD and periodontal surgical treatment have positive impacts on the OHQoL of patients. Intensive periodontal non-surgical treatment is as effective as surgical intervention for achieving desirable patient-centered outcomes.

Keywords

1. Jiao J, Shi D, Cao ZQ, Meng HX, Lu RF, Zhang L, et al. Effectiveness of non-surgical periodontal therapy in a large Chinese population with chronic periodontitis. J Clin Periodontol. 2017; 44: 42–50. [PubMed[Google Scholar]

2. Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement vs non-surgicaldebridement for the treatment of chronic periodontitis. J Clin Periodontol. 2002; 29 Suppl 3: 92–102. [PubMed[Google Scholar]

3. Drisko CL. Periodontal debridement: still the treatment of choice. J Evid Based Dent Pract. 2014; 14 Suppl: 33–41. [PubMed[Google Scholar]

4. Shanbhag S, Dahiya M, Croucher R. The impact of periodontal therapy on oral health-related quality of lifein adults: a systematic review. J Clin Perio-dontol. 2012; 39: 725–735. [PubMed[Google Scholar]

5. Brauchle F, Noack M, Reich E. Impact of periodontal disease and periodontal therapy on oral health-related quality of life. Int Dent J. 2013; 63: 306–311. [PubMed[Google Scholar]

6. Ohrn K, Jönsson B. A comparison of two questionnaires measuring oral health-related quality of life before and after dental hygiene treatment in patients with periodontal disease. Int J Dent Hyg. 2012; 10: 9–14. [PubMed[Google Scholar]

7. Wang TF, Fang CH, Hsiao KJ, Chou C. Effect of a comprehensive plan for periodontal disease care on oral health-related quality of life in patients with periodontal disease in Taiwan. Medicine (Baltimore) 2018;97:e9749. [PMC free article] [PubMed[Google Scholar]

8. D'Avila GB, Carvalho LH, Feres-Filho EJ, Feres M, Leão A. Oral health impacts on daily living related to four different treatment protocols for chronic periodontitis. J Perio-dontol. 2005; 76: 1751–1757. [PubMed[Google Scholar]

9. Durham J, Fraser HM, McCracken GI, Stone KM, John MT, Preshaw PM. Impact of periodontitis on oral health-related quality of life. J Dent. 2013; 41:370–376. [PubMed[Google Scholar]

10. Lopez R, Baelum V. Spanish version of the Oral Health Impact Profile (OHIP-Sp) BMC Oral Health. 2006; 6: 11. [PMC free article] [PubMed[Google Scholar]

11. Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994; 11: 3–11. [PubMed[Google Scholar]

12. Adulyanon S, Sheiham A. Oral impacts on daily performances. In: Slade G, editor. Measuring Oral Health and Quality of Life. Proceedings of the 4* Conference of the Californian Dental Association; 1996 Feb, 3. 1th ed. Los Angeles, USA, Chapel Hill: University of North Carolina; 1997. pp. 151–60. [Google Scholar]

13. Liu JY, Pow EH, Chen ZF, Zheng J, Zhang XC, Chen J. The Mandarin Chinese shortened version of Oral Health Impact Profile for partially edentate patients with implant-supported prostheses. J Oral Rehabil. 2012; 39:591–599. [PubMed[Google Scholar]

14. Shaghaghian S, Taghva M, Abduo J, Bagheri R. Oral health-related quality of life of removable partial denture wearers and related factors. J Oral Rehabil. 2015; 42: 40–48. [PubMed[Google Scholar]

15. Makino-Oi A, Ishii Y, Hoshino T, Okubo N, Sugito H, Hosaka Y, et al. Effect of periodontal surgery on oral health-related quality of life in patients who have completed initial periodon-tal therapy. J Periodontal Res. 2016; 51: 212–220. [PubMed[Google Scholar]

16. Lindhe J, Ranney R, Lamster I, Charles A, Chung C-P, Fleming T, et al. Consensus report: Chronic periodontitis. Ann Periodontol. 1999; 4: 38. [Google Scholar]

17. Lenox JA, Kopczyk RA. A clinical system for scoring a patient's oral hygiene performance. J Am Dent Assoc. 1973; 86: 849–852. [PubMed[Google Scholar]

18. Quirynen M, De Soete, M Boschmans, G Pauwels, M Coucke, W Teughels, W et. Benefit of "one-stage full-mouth disinfection" is explained by disinfection and root planing within 24 hours: a ran-domized controlled trial. J Clin Periodontol. 2006; 33:639–647. [PubMed[Google Scholar]

19. Atchison KA, Gift HC. Perceived oral health in a diverse sample. Adv Dent Res. 1997; 11: 272–280. [PubMed[Google Scholar]

20. Streiner DL, Norman GR. Validity. In: Streiner DL Editors. Health Measurement Scales. A Practical Guide to their Development and Use. 2th ed. New York: Oxford University Press; 1995. pp. 144–162. [Google Scholar]

21. Allen PF, McMillan AS, Locker D. An assessment of sensitivity to change of the Oral Health Impact Profile in a clinical trial. Community Dent Oral Epidemiol. 2001; 29: 175–182. [PubMed[Google Scholar]

22. John MT, Feuerstahler L, Waller N, Baba K, Larsson P, Celebić A, et al. Confirmatory factor analysis of the Oral Health Impact Profile. J Oral Rehabil. 2014; 41: 644–652. [PMC free article] [PubMed[Google Scholar]

23. Ozcelik O, Haytac MC, Seydaoglu G. Immediate post-operative effects of different periodontal treatment modalities on oral health-related quality of life: a randomized clinical trial. J Clin Periodontol. 2007; 34: 788–796. [PubMed[Google Scholar]

24. Saito A, Hosaka Y, Kikuchi M, Akamatsu M, Fukaya C, Matsumoto S, et al. Effect of initial periodontal therapy on oral health-related quality of life in patients with periodontitis in Japan. J Periodontol. 2010; 81: 1001–1009. [PubMed[Google Scholar]

25. Mendez M, Melchiors Angst, PD Stadler, AF Oppermann, RV Gomes. Impacts of supragingival and subgingival periodontal treatments on oralhealth-related quality of life. Int J Dent Hyg. 2017; 15: 135–141. [PubMed[Google Scholar]

26. Saito A, Ota K, Hosaka Y, Akamatsu M, Hayakawa H, Fukaya C, et al. Potential impact of surgical periodontal therapy on oral health-relatedquality of life in patients with periodontitis: a pilot study. J Clin Periodontol. 2011; 38: 1115–1121. [PubMed[Google Scholar]

27. Mailoa J, Lin GH, Khoshkam V, MacEachern M, Chan HL, Wang HL. Long-Term Effect of Four Surgical Periodontal Therapies and One Non-Surgical Therapy: A Systematic Review and Meta-Analysis. J Periodontol. 2015; 86: 1150–1158. [PubMed[Google Scholar]

28. Wong RM, Ng SK, Corbet EF, Keung Leung W. Non-surgical periodontal therapy improves oral health-related quality of life. J Clin Periodontol. 2012; 39: 53–61. [PubMed[Google Scholar]

29. Lindhe J, Westfelt E, Nyman S, Socransky SS, Haffajee AD. Long-term effect of surgical/non-surgical treatment of periodontal disease. J Clin Periodontol. 1984; 11: 448–458. [PubMed[Google Scholar]

30. Kloostra PW, Eber RM, Wang HL, Inglehart MR. Surgical versus non-surgical periodontal treatment: psychosocial factorsand treatment outcomes. J Periodontol. 2006; 77: 1253–1260. [PubMed[Google Scholar]

31. Chou YH, Yang YH, Kuo HC, Ho KY, Wang WC, Hu KF. Periodontal surgery improves oral health-related quality of life in chronic periodontitis patients in Asian popula-tion. Kaohsiung J Med Sci. 2017; 33: 523–529. [PubMed[Google Scholar]