title: Impact of fixed orthodontic appliances on quality of life among adolescents' in India.
abstract: BACKGROUND
  Malocclusion can seriously impair quality of life and they may affect various aspects of life, including function, appearance, interpersonal relationships and even career opportunities.
  
  
  OBJECTIVE
  To assess and determine various factors that may influence the impact of orthodontic treatment on the quality of life of adolescents.
  
  
  METHODS
  Cross sectional study in adolescents of Moradabad was conducted on 109 males and 113 females (n=222) adolescents having a fixed orthodontic appliance, aged 13 to 22 years (mean 17.5±1.5). A pre-structured questionnaire designed by Mandall et al, with nine conceptual impact sub-scales to highlight the problem faced by the patient in daily life after wearing the appliance was used to collect the data. Unpaired t-test was used to determine the statistical significance and the influence of variables were analysed using multiple linear regression analysis.
  
  
  RESULTS
  Factors which demonstrated high impact were oral hygiene (Mean=3.42; SD=0.78) followed by time constraints (Mean=3.23; SD=0.72) and physical impact (Mean=3.00; SD=0.61). Gender difference showed statistical significance in social impact (p=0.009), time constraints (p=0.001) and travel or cost implications (p=0.009). Internal reliability of the questionnaire ranged from low to good (Cronbach's alpha 0.29-0.81). Test-retest reliability ranged from an intra-class correlation coefficient 0.09-0.42.
  
  
  CONCLUSIONS
  Patients who had been comprehensively informed about their treatment had greatest levels of satisfaction and compliance with treatment. Younger patients showed an earlier adaptation to treatment with fixed appliances which influenced the treatment to be started at the earliest possible age. Key words:Impact, malocclusion, quality of life.
authors.affiliation: MDS, Professor and Head. Department of Public Health Dentisty, Rama Dental College and Hospital, A-1/8, Lakhanpur, Kanpur - 208024, Uttar Pradesh, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Nagarajappa
authors.affiliation: MDS, Associate Professor. Department of Oral and Maxillofacial Pathology, Rama Dental College and Hospital, A-1/8, Lakhanpur, Kanpur - 208024, Uttar Pradesh, India.
authors.forename: Gayathri
authors.initials: G
authors.lastname: Ramesh
authors.affiliation: MDS, Associate Professor. Department of Public Health Dentistry, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India.
authors.forename: Nagarajappa
authors.initials: N
authors.lastname: Sandesh
authors.affiliation: MDS, Associate Professor. Department of Public Health Dentistry, Kothiwal Dental College and Hospital, Kanth Road, Moradabad, Uttar Pradesh, India.
authors.forename: Ravishankar-Telgi
authors.initials: RT
authors.lastname: Lingesha
authors.affiliation: MDS, Professor. Department of Prosthodontics, Taibah University, KSA.
authors.forename: Mohammed-Abid-Zahir
authors.initials: MA
authors.lastname: Hussain