Avaliação do impacto da expansão rápida da maxila e laserterapia na qualidade de vida relacionada à saúde bucal em crianças

Abstract

The aim of this research was to evaluate the impact of the interceptive orthodontic treatment with rapid maxillary expansion (RME) and lasertherapy in oral health related quality of life (OHRQoL) in children. A randomized clinical trial (RCT) was performed with 27 children, aged 8 to 12 years, in mixed dentition stage, who had maxillary atresia and apparent or relative posterior crossbite, divided into two groups: experimental group (EG, n= 13) – who underwent RME and laser therapy in 10 points of the palate, four on the midpalatal suture and six laterally; and control group (CG, n= 14) – who underwent RME only. Evaluation time intervals were: T0 – pre-treatment phase (before expander installation); T1 - screw stabilization day; T2 – 3 months after screw stabilization; T3 – immediately after expander removal (after 6 months of retention) and T4 – 3 months after expander removal. The OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) that the children answered at all experimental times. Multilevel Poisson regression analysis was used to compare general and domains questionnaire scores between groups of the RCT according to the evaluation time interval. Results: When considering the assessment of OHRQoL of all children, CPQ8-10 scores decreased 22% in 3 months (T2, Incidence Rate Ratio IRR 0.78; 95%, Confidence Interval, CI 0.68-0.90), 41% in 6 months (T3, IRR 0.59 95% CI 0.50-0, 69) and 50% after 9 months of follow-up (T4, IRR 0.50; 95% CI 0.42-0.59) when compared to T0. The scores for the specific domains of functional limitation, emotional well-being and social well-being decreased significantly over time, with a greater effect being observed after 9 months of follow-up in the domains of functional limitation 66% (IRR 0.34; 95% CI 0.25-0.48), emotional well-being 45% (IRR 0.55; 95% CI 0.34-0.89) and social well-being 65% (IRR 0.35; 95% CI 0.23-0.54). When the intergroup difference was assessed, there was no statistically significant difference in the general scores of CPQ8-10 (IRR 1.01; 95% CI 0.62 -1.63). Conclusions: There was a decrease in the general scores and specific domains of CPQ8-10 over the evaluation period, indicating a gradual improvement in OHRQoL in children treated with ERM. For the studied population, the use of laser therapy had no significant influence on the scores of CPQ8-10.