Adaptation and content validity by expert judgment of the Oral Health Impact Profile applied to Periodontal Disease

Background: In Mexico, there is no available instrument based on a biopsychosocial model to evaluate the impact of periodontal disease on oral health-related quality of life (OHRQL). The Oral Health Impact Profile(OHIP-14) was developed in Australia and the United States based on the same model and can be adapted to evaluate the impact of periodontal disease on OHRQL. Objectives: To adapt the OHIP-14 questions to periodontal disease evaluation and validate the content of this new instrument. Materials and Methods: One expert in periodontics and one expert in health psychology adapted the OHIP-14 to evaluate the impact of periodontal disease on OHRQL, creating the Oral Health Impact Profile applied to Periodontal Disease (OHIP-14-PD). Using the format proposed by Escobar and Cuervo, five experts in periodontics and public health performed the OHIP-14-PD content validation. Results: Item 7 had a compliance rate of 80% for clarity, and the other items, a compliance rate of 100%, for clarity, sufficiency, coherence and relevance. The kappa coefficient showed perfect agreement for items 1 to 6 (k= 1) and 8 to 14, and very high agreement for item 7 (k= 0.967)

Distribución y validez convergente de la Escala de Hábitos de Higiene Bucal

Introducción. En México recientemente ha sido desarrollada la Escala de Hábitos de Higiene Bucal (EHHB). Se ha determinado su consistencia interna y estructura factorial, pero su distribución no ha sido descrita. Esta investigación tiene como objetivos describir la distribución de la EHHB y aportar una prueba de validez convergente. Metodología: Se realizó un estudio descriptivo-correlacional con un diseño transversal y un muestreo no probabilístico. Se reclutaron dos muestras: una muestra de 256 participantes de población general y otra de 240 participantes de clínica odontológica. En las dos muestras se administró la EHHB y en la última el Índice de Higiene Oral Simplificado (IHOS). Resultados: La distribución de la puntuación total de la EHHB fue equivalente entre ambas muestras y no se ajustó a una curva normal. En un rango de 0 a 4 su mediana correspondió a una frecuencia de “a veces”. Puntuaciones en la EHHB de 0 a 0.999 (≤ percentil 20) permiten identificar hábitos de higiene bucal malos, de 1 a 2.124 regulares y de 2.125 a 4 buenos. Estos tres intervalos fueron: 0-1.749, 1.75-2.999 y 3-4 en cepillado dental; y 0-0.249, 0.25-1.249 y 1.25-4 en uso del hilo dental. La correlación entre EHHB e IHOS fue negativa y moderada. Conclusión. Se concluye que la EHHB requiere ser interpretada por percentiles; su tendencia central (mediana) evidencia unos hábitos de higiene bucal deficientes entre los participantes, sobre todo por mal uso del hilo dental; y presenta validez convergente, ya que muestra que deficientes hábitos de higiene bucal conllevan más detritos y cálculo dental

Salivary rheumatoid factor in primary and secondary Sjögren’s syndrome

Sjögren's syndrome is a chronic autoimmune disease, characterized by the presence of hyposalivation and xerophthalmia, which in addition to other factors is diagnosed by the presence of rheumatoid factor in blood. The objective of the present study is to evaluate the presence of rheumatoid factor (IgG-IgM) in the saliva of patients with primary and secondary Sjögren's syndrome. Materials and methods: Forty samples from patients with primary and secondary Sjögren's syndrome previously diagnosed by the Arthritis and Rheumatism Specialist Center of the Autonomous University of Nuevo Leon were analyzed. Samples were taken from the saliva using the Carlson-Crittenden device to evaluate the IgG-IgM immunocomplex using the ELISA method. Results: No significant difference was found between the presence of IgM in primary (0.099±0.016) and secondary Sjögren syndrome (0.098±0.017), however, a high presence of IgG was found in the group of patients with secondary Sjögren's syndrome (0.134±0.054). Conclusion: The search for diagnostic tools using salivary biomarkers has come with economic and clinical advantages, however, in the present study no significant changes were found in salivary rheumatoid factor between both groups

Alternativas diagnósticas y de tratamiento para la corrección de asimetrías faciales: Revisión bibliográfica.

Facial symmetry refers to a complete coincidence of each facial component on the sagittal plane, while asymmetry refers to the bilateral difference between these components. The presence of perfect bilateral symmetry is almost never present in human, so it is more common for individuals to predominate facial asymmetry. However, ocassionally, significant facial asymmetry results not only in functional but also in aesthetic problems. This research seeks to determine the alternatives, diagnosis and ideal treatment plan for the correction of each type of facial asymmetry through orthognathic surgery. For this purpose, a review of articles published between 2015 to date was carried out. Selecting those that were focused on describing or evaluating facial and dentofacial symmetry and asymmetry, type of diagnosis or treatment plan, including clinical cases. The Google search engine, SciELO and databases of medical interest, such as PubMed, PMC and Medigraphic were used. According to the research and treatments carried out during the last few years in the dental clinic, it has been proven that orthognathic treatment accompanied by previous planning is the best option for the management of skeletal facial asymmetries.La simetría facial hace referencia a una coincidencia completa de cada componente facial sobre el plano sagital, mientras que la asimetría se refiere a la diferencia bilateral entre dichos componentes. La presencia de una simetría bilateral perfecta casi nunca se presenta en el cuerpo humano, es decir no se encuentra con facilidad, por lo que es más común que en los individuos predomine la asimetría facial. Sin embargo, en ocasiones, una asimetría facial significativa da como resultado no solo a problemas funcionales, sino también estéticos. Mediante esta investigación se busca determinar las alternativas, el diagnóstico y plan de tratamiento ideal para la corrección de cada tipo de asimetría facial de la mano de la cirugía ortognática. Para ello, se realizó la revisión de artículos los cuales fueran publicados entre los años 2015 hasta la fecha. Seleccionando aquellos que estuvieran enfocados en describir o evaluar la simetría y asimetría tanto facial como dentofacial, tipo de diagnóstico o plan de tratamiento, incluyendo casos clínicos. Se utilizó el buscador de Google, SciELO y bases de datos de interés médico, como PubMed, PMC y Medigraphic. De acuerdo a las investigaciones y tratamientos realizados durante los últimos años dentro de la clínica dental, queda comprobado que el tratamiento ortognático acompañado de una planificación previa, es la mejor opción para el manejo de las asimetrías faciales esqueletales

Design and content validation of the Oral Hygiene Habits Scale.

The presence of dental plaque is associated with deterioration of oral health, tooth decay, gingivitis and periodontal disease. The study of content validity of a new instrument aims to determine whether the items included in the measuring instrument are representative of the assessed construct. The objective of this research was to design and validate the content of an oral hygiene habits scale. A Likert-like scale, named Oral Hygiene Habits Scale (OHHS), containing 10 items and five response options on frequency of behavior, was developed to assess the dimensions of toothbrushing and flossing. Six experts were recruited for the study. They were asked to conduct their evaluations individually. Four characteristics (adequacy, clarity, consistency and relevance) were evaluated for each item, using an assessment scale of four ordinal values (from 1="does not meet the criteria" to 4="high level of compliance"). Data were analyzed using the binomial test, Kendall’s W and Fleiss’s Kappa coefficient. The judges mostly indicated a high level of compliance with the characteristics evaluated for each item and their judgments were consistent with one another. It is concluded that the OHHS composed of 10 items showed content validity. Further studies are suggested to determine its reliability and construct validity

Diseño y validación de contenido de la Escala de Hábitos de Higiene Bucal

The presence of dental plaque is associated with deterioration of oral health, tooth decay, gingivitis and periodontal disease. The study of content validity of a new instrument aims to determine whether the items included in the measuring instrument are representative of the assessed construct. The objective of this research was to design and validate the content of an oral hygiene habits scale. A Likert-like scale, named Oral Hygiene Habits Scale (OHHS), containing 10 items and five response options on frequency of behavior, was developed to assess the dimensions of tooth brushing and flossing. Six experts were recruited for the study. They were asked to conduct their evaluations individually. Four characteristics (adequacy, clarity, consistency and relevance) were evaluated for each item, using an assessment scale of four ordinal values (from 1 = "does not meet the criteria" to 4 = "high level of compliance"). Data were analyzed using the binomial test, Kendall’s W and Fleiss’s Kappa coefficient. The judges mostly indicated a high level of compliance with the characteristics evaluated for each item and their judgments were consistent with one another. It is concluded that the OHHS composed of 10 items showed content validity. Further studies are suggested to determine its reliability and construct validity. La presencia de placa bacteriana se asocia con el deterioro de la salud oral, aparición de caries, gingivitis y enfermedad periodontal. El estudio de la validez de contenido de un instrumento nuevo se centra en que los ítems del instrumento de medición sean representativos del constructo evaluado. El objetivo de esta investigación fue diseñar y validar el contenido de una escala de hábitos de higiene bucal. Se creó una escala de 10 ítems tipo Likert con cinco opciones de respuesta sobre frecuencia de conducta para evaluar las dimensiones de cepillado y uso del hilo dental, denominada como Escala de Hábitos de Higiene Bucal (EHHB). Se reclutó a seis expertos quienes realizaron sus evaluaciones individualmente. Se valoraron cuatro características (suficiencia, claridad, coherencia y relevancia) en cada ítem, usando una escala de cuatro valores ordinales (de 1 = "no cumple" a 4 = "alto nivel"). Los datos fueron analizados mediante la prueba binomial, la W de Kendall y el coeficiente Kappa de Fleiss. Los jueces mayoritariamente indicaron alto nivel de cumplimiento de las características evaluadas para cada ítem y sus juicios fueron concordantes. Se concluye que la EHHB compuesta por 10 ítems presentó validez de contenido, y se sugiere seguir estudiando la escala para determinar su confiabilidad y validez de constructo

Validación cruzada del Perfil de Impacto de Salud Oral aplicado a enfermedad periodontal

Abstract The Oral Health Impact Profile (OHIP-14) is the most commonly used instrument to evaluate the effectiveness of dental treatments. In order to elucidate its factor structure and establish the cross-validity of the scale applied to periodontal disease (OHIP-14-PD), this study aims to: 1) explore the factor structure of the OHIP-14-PD, and 2) contrast invariance of the models proposed for the OHIP-14 and of those derived from exploratory factor analysis (EFA) across a general population sample (GPS) and a dental clinic sample (DCS). The OHIP-14-PD was applied to 249 adult patients seeking dental care and 256 general population adults from Monterrey, Mexico. The EFA revealed one-, two- and three-factor models. The proposed hierarchical models yielded inadmissible solutions. We conclude that the one-factor model had the best properties, but the two-factor model (physical impact [items from 1 to 7] and psychosocial [items from 8 to 14]) also was valid. The two models were invariant at measurement weights, but not at the variances of factors and residuals. In both models, the fit improved with the inclusion of the correlation between the residuals of items 5 and 6.Resumen El Perfil de Impacto de Salud Oral (OHIP-14) es el instrumento más empleado para evaluar la eficacia de tratamientos odontológicos. Con el propósito de dilucidar su estructura factorial y establecer la validez cruzada de la escala aplicada a la enfermedad periodontal (OHIP-14-PD), este estudio tiene como objetivos: 1) explorar la estructura factorial del OHIP-14-PD, y 2) contrastar la invarianza de los modelos propuestos para el OHIP-14 y de los derivados del análisis factorial exploratorio (AFE) entre una muestra de población general y una muestra clínica odontológica. Se aplicó el OHIP-14-PD a 249 pacientes adultos odontológicos y 256 adultos de población general de Monterrey, México. El AFE reveló modelos de uno, dos y tres factores. Los modelos jerarquizados propuestos arrojaron soluciones inadmisibles. Se concluye que el modelo unifactorial tuvo las mejores propiedades, aunque el bifactorial (impacto físico [ítems del 1 al 7] y psicosocial [ítems del 8 al 14]) también resultó válido. Los dos modelos fueron invariantes en pesos de medida, pero no en las varianzas de los factores y residuos. En ambos modelos, el ajuste mejoró con la inclusión de la correlación entre los residuos de los ítems 5 y 6

Adaptation and content validity by expert judgment of the Oral Health Impact Profile applied to Periodontal Disease.

Background: In Mexico, there is no available instrument based on a biopsychosocial model to evaluate the impact of periodontal disease on oral health- related quality of life (OHRQL). The Oral Health Impact Profile (OHIP-14) was developed in Australia and the United States based on the same model and can be adapted to evaluate the impact of periodontal disease on OHRQL. Objectives: To adapt the OHIP-14 questions to periodontal disease evaluation and validate the content of this new instrument. Materials and Methods: One expert in periodontics and one expert in health psychology adapted the OHIP-14 to evaluate the impact of periodontal disease on OHRQL, creating the Oral Health Impact Profile applied to Periodontal Disease (OHIP-14-PD). Using the format proposed by Escobar and Cuervo, five experts in periodontics and public health performed the OHIP-14-PD content validation. Results: Item 7 had a compliance rate of 80% for clarity, and the other items, a compliance rate of 100%, for clarity, sufficiency, coherence and relevance. The kappa coefficient showed perfect agreement for items 1 to 6 (k= 1) and 8 to 14, and very high agreement for item 7 (k= 0.967). Conclusion: The OHIP-14-PD shows content validity