title: Association of overjet and overbite with esthetic impairments of oral health-related quality of life.
abstract: OBJECTIVE
  Esthetics is an important part of quality of life and a frequent reason for orthodontic treatment demand. It was the aim of this study to investigate whether esthetic impairments, related to overjet and overbite, can be assessed with an established oral health-related quality of life instrument.
  
  
  METHODS
  Data from 1968 participants (age: 16-90 years; 69.8% female) from three German surveys were analyzed. Esthetic impairments of oral health-related quality of life were measured with four questions of the Oral Health Impact profile (OHIP), which comprise esthetic aspects of oral health-related quality of life. Higher values represent greater esthetic impairment (sum score: 0-16). Overbite and overjet values were categorized (≤ - 1 mm, 0-1 mm, 2-3 mm, 4-5 mm, ≥ 6 mm). The specific impact of each category on esthetic impairment, in relation to the reference category (2-3 mm), was calculated in linear regression analyses. The type of relationship and the specific impact of overbite and overjet were evaluated in regression analyses with fractional polynomials.
  
  
  RESULTS
  Overbite ranged from - 5 to 15 mm (mean: 3.2 mm) and overjet from - 7 to 19 mm (mean: 3.1 mm). Both an increase and a decrease in overjet, in relation to the reference category, resulted in more esthetic-related oral health-related quality of life impairments. However, in this model, only the effect for increased overjet was statistically significant (4-5 mm: + 0.4 OHIP points; ≥ 6 mm: + 0.9 OHIP points). In the regression analysis with fractional polynomials, both an increase and a decrease in overjet resulted in more esthetic impairments, characterized by a U-shaped relationship. No association could be verified for overbite.
  
  
  CONCLUSIONS
  A substantial increase or decrease of overjet from the reference values is associated with esthetic impairments of oral health-related quality of life, whereas the extent of overbite seems to have no impact on esthetics.
authors.affiliation: Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Assmannshauser Str. 4-6, 14197, Berlin, Germany. ira.sierwald@charite.de.
authors.forename: Ira
authors.initials: I
authors.lastname: Sierwald
authors.affiliation: Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Mike T
authors.initials: MT
authors.lastname: John
authors.affiliation: Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Schierz
authors.affiliation: Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Assmannshauser Str. 4-6, 14197, Berlin, Germany.
authors.forename: Paul-Georg
authors.initials: PG
authors.lastname: Jost-Brinkmann
authors.affiliation: Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA.|Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Reissmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004955:Esthetics, Dental / Q000523:psychology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D057887:Overbite / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010361:Patients / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anterior teeth; Anterior teeth relation; Orofacial esthetics; Overbite; Overjet