Impact of periodontitis and orthodontic treatment on dental anxiety and self-esteem

Simona Santonocito, Francesco Indelicato, Alessandro Polizzi, Giuseppe Palazzo

Abstract


Background and aims: The concept of dental anxiety related to patients’ concerns about the psychosocial impact of their dental appearance has been demonstrated to have a significant influence on the initiation and adherence to certain dental treatments, particularly in adult patients with periodontitis undergoing orthodontic treatment. This study analyze the relationship between dental appearance and self-esteem and anxiety in adult periodontitis patients undergoing orthodontic treatment.


Methods: For the study were enrolled 38 patients, divided into test and control groups. The impact of dental appearance was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). State anxiety was assessed with the State Anxiety Inventory (STAI-S) and self-esteem with Rosenberg’s self-esteem scale.


Results: In both groups, self-esteem correlates negatively with all dimensions of dental appearance impact except for the positive dental self-confidence dimension, where all correlations were positive. Anxiety correlates positively with social impact, psychological impact and aesthetic concern, although it maintains no significant correlations with dental self-confidence. Nevertheless, in patients undergoing orthodontic treatment, anxiety plays a mediating role between dental impact dimensions and self-esteem, whilst for the control group anxiety only plays a mediator role between psychological impact and self-esteem.


Conclusion: Anxiety plays a fundamental role in the effect of perceived dental impact on self-esteem in adult patients undergoing orthodontic treatment. These results have important practical implications for the design of bio-psycho-social intervention programs that contemplate cognitive-affective variables as an essential part of orthodontic treatment in adults with periodontitis.

Keywords


Clinical Psychology; Dental treatment; Pain; Periodontitis; Self-esteem.

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References


Ahmed, M. Z., Ahmed, O., Aibao, Z., Hanbin, S., Siyu, L., & Ahmad, A. (2020). Epidemic of COVID-19 in China and associated psychological problems. Asian Journal of Psychiatry, 51, 102092. https://doi.org/10.1016/j.ajp.2020.102092

Azuma, S., Kohzuki, M., Saeki, S., Tajima, M., Igarashi, K., & Sugawara, J. (2008). Beneficial effects of orthodontic treatment on quality of life in patients with malocclusion. The Tohoku journal of experimental medicine, 214(1), 39-50. https://doi.org/10.1620/tjem.214.39

Badran, S. A. (2010). The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents. The European Journal Of Orthodontics, 32(6), 638-644. https://doi.org/10.1093/ejo/cjq014

Baños, R. M., & Guillén, V. (2000). Psychometric characteristics in normal and social phobic samples for a Spanish version of the Rosenberg Self-Esteem Scale. Psychological reports, 87(1), 269-274. https://doi.org/10.2466/pr0.2000.87.1.269

Belar, C. D., & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner's guidebook, Rev. American Psychological Association. https://doi.org/10.1037/10168-000

Birkeland, K., Bøe, O. E., & Wisth, P. J. (2000). Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. The European Journal of Orthodontics, 22(5), 509-518. https://doi.org/10.1093/ejo/22.5.509

Briguglio, F., Briguglio, E., Briguglio, R., Cafiero, C., & Isola, G. (2013). Treatment of infrabony periodontal defects using a resorbable biopolymer of hyaluronic acid: A randomized clinical trial. Quintessence International, 44(3). 10.3290/j.qi.a29054

Briguglio, F., Zenobio, E. G., Isola, G., Briguglio, R., Briguglio, E., Farronato, D., & Shibli, J. A. (2011). Complications in surgical removal of impacted mandibular third molars in relation to flap design: clinical and statistical evaluations. Quintessence International, 42(6).

Cannavale, R., Matarese, G., Isola, G., Grassia, V., & Perillo, L. (2013). Early treatment of an ectopic premolar to prevent molar-premolar transposition. American Journal of Orthodontics and Dentofacial Orthopedics, 143(4), 559-569. https://doi.org/10.1016/j.ajodo.2012.03.035

Cavuoti, S., Matarese, G., Isola, G., Abdolreza, J., Femiano, F., & Perillo, L. (2016). Combined orthodontic-surgical management of a transmigrated mandibular canine. The Angle Orthodontist, 86(4), 681-691. https://doi.org/10.2319/050615-309.1

Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Frontiers in psychology, 11, 1683. https://doi.org/10.3389/fpsyg.2020.01683

Craparo, G., Gori, A., Dell’Aera, S., Costanzo, G., Fasciano, S., Tomasello, A., & Vicario, C. M. (2016). Impaired emotion recognition is linked to alexithymia in heroin addicts. PeerJ, 4, e1864. https://doi.org/10.7717/peerj.1864

Currò, M., Matarese, G., Isola, G., Caccamo, D., Ventura, V. P., Cornelius, C., ... & Ientile, R. (2014). Differential expression of transglutaminase genes in patients with chronic periodontitis. Oral diseases, 20(6), 616-623. https://doi.org/10.1111/odi.12180

Cutroneo, G., Piancino, M. G., Ramieri, G., Bracco, P., Vita, G., Isola, G., ... & Trimarchi, F. (2012). Expression of muscle-specific integrins in masseter muscle fibers during malocclusion disease. International journal of molecular medicine, 30(2), 235-242. https://doi.org/10.3892/ijmm.2012.986

De Baets, E., Lambrechts, H., Lemiere, J., Diya, L., & Willems, G. (2012). Impact of self-esteem on the relationship between orthodontic treatment need and oral health-related quality of life in 11-to 16-year-old children. European Journal of Orthodontics, 34(6), 731-737. https://doi.org/10.1093/ejo/cjr088

de Paula, J., Delcides, F., Santos, N., da Silva, É. T., Nunes, M. F., & Leles, C. R. (2009). Psychosocial Impact of Dental Esthetics on Quality of Life in AdolescentsAssociation with Malocclusion, Self-Image, and Oral Health–Related Issues. The Angle Orthodontist, 79(6), 1188-1193. https://doi.org/10.2319/082608-452R.1

Di Giuseppe, M., Ciacchini, R., Micheloni, T., Bertolucci, I., Marchi, L., & Conversano, C. (2018). Defense mechanisms in cancer patients: a systematic review. Journal of psychosomatic research, 115, 76-86. https://doi.org/10.1016/j.jpsychores.2018.10.016

Di Giuseppe, M., Gemignani, A., & Conversano, C. (2020a). Psychological resources against the traumatic experience of COVID-19. Clin. Neuropsychiatry, 85-87. https://doi.org/10.36131/CN20200210

Di Giuseppe, M., Miniati, M., Miccoli, M., Ciacchini, R., Orrù, G., Sterzo, R. L., ... & Conversano, C. (2020b). Defensive responses to stressful life events associated with cancer diagnosis. Mediterranean Journal of Clinical Psychology, 8(1). https://doi.org/10.6092/2282-1619/mjcp-2384

Ferlazzo, N., Currò, M., Zinellu, A., Caccamo, D., Isola, G., Ventura, V., ... & Ientile, R. (2017). Influence of MTHFR genetic background on p16 and MGMT methylation in oral squamous cell cancer. International journal of molecular sciences, 18(4), 724. https://doi.org/10.3390/ijms18040724

Frejman, M. W., Vargas, I. A., Rösing, C. K., & Closs, L. Q. (2013). Dentofacial deformities are associated with lower degrees of self-esteem and higher impact on oral health-related quality of life: results from an observational study involving adults. Journal of Oral and Maxillofacial Surgery, 71(4), 763-767. https://doi.org/10.1016/j.joms.2012.08.011

Gazit-Rappaport, T., Haisraeli-Shalish, M., & Gazit, E. (2010). Psychosocial reward of orthodontic treatment in adult patients. Eur J Orthod, 32(4), 441-446. https://doi.org/10.1093/ejo/cjp144

Gugliandolo, M. C., Costa, S., Cuzzocrea, F., Larcan, R., & Martino, G. (2020). Adolescents and Body Uneasiness: the Contribution of Supportive Parenting and Trait Emotional Intelligence. Journal of Child and Family Studies, 29(9), 2453-2462. https://doi.org/10.1007/s10826-020-01779-1

Imperatori, C., Dakanalis, A., Farina, B., Pallavicini, F., Colmegna, F., Mantovani, F., & Clerici, M. (2020). Global storm of stress-related psychopathological symptoms: a brief overview on the usefulness of virtual reality in facing the mental health impact of COVID-19. Cyberpsychology, Behavior, and Social Networking, 23, 782–788. https://doi.org/10.1089/cyber.2020.0339

Iorio-Siciliano, V., Blasi, A., Nuzzolo, P., Matarasso, M., Isola, G., & Ramaglia, L. (2019). Treatment of Periodontal Intrabony Defects Using Enamel Matrix Derivative: Surgical Reentry After an Observation Period of at Least 5 Years. International Journal of Periodontics & Restorative Dentistry, 39(4). https://doi.org/10.11607/prd.4148

Iorio-Siciliano, V., Ramaglia, L., Isola, G., Blasi, A., Salvi, G. E., & Sculean, A. (2021). Changes in clinical parameters following adjunctive local sodium hypochlorite gel in minimally invasive nonsurgical therapy (MINST) of periodontal pockets: a 6-month randomized controlled clinical trial. Clinical Oral Investigations, 1-10. https://doi.org/10.1007/s00784-021-03841-8

Isola, G., Giudice, A. L., Polizzi, A., Alibrandi, A., Murabito, P., & Indelicato, F. (2021a). Identification of the different salivary Interleukin-6 profiles in patients with periodontitis: A cross-sectional study. Archives of Oral Biology, 122, 104997. https://doi.org/10.1016/j.archoralbio.2020.104997

Isola, G., Matarese, G., Cordasco, G., Rotondo, F., Crupi, A., & Ramaglia, L. (2015). Anticoagulant therapy in patients undergoing dental interventions: a critical review of the literature and current perspectives. Minerva Stomatol, 64(1), 21-46.

Isola, G., Matarese, G., Ramaglia, L., Pedullà, E., Rapisarda, E., & Iorio-Siciliano, V. (2020a). Association between periodontitis and glycosylated haemoglobin before diabetes onset: A cross-sectional study. Clinical oral investigations, 24(8), 2799-2808. https://doi.org/10.1007/s00784-019-03143-0

Isola, G., Perillo, L., Migliorati, M., Matarese, M., Dalessandri, D., Grassia, V., ... & Matarese, G. (2019). The impact of temporomandibular joint arthritis on functional disability and global health in patients with juvenile idiopathic arthritis. European journal of orthodontics, 41(2), 117-124. https://doi.org/10.1093/ejo/cjy034

Isola, G., Polizzi, A., Alibrandi, A., Indelicato, F., & Ferlito, S. (2020b). Analysis of Endothelin-1 concentrations in individuals with periodontitis. Scientific reports, 10(1), 1-8. https://doi.org/10.1038/s41598-020-58585-4

Isola, G., Polizzi, A., Alibrandi, A., Williams, R. C., & Leonardi, R. (2020c). Independent impact of periodontitis and cardiovascular disease on elevated soluble urokinase-type plasminogen activator receptor (suPAR) levels. J Periodontol, 1, 11. https://doi.org/10.1002/JPER.20-0242

Isola, G., Polizzi, A., Iorio-Siciliano, V., Alibrandi, A., Ramaglia, L., & Leonardi, R. (2021b). Effectiveness of a nutraceutical agent in the non-surgical periodontal therapy: A randomized, controlled clinical trial. Clinical Oral Investigations, 25(3), 1035-1045. https://doi.org/10.1007/s00784-020-03397-z

Isola, G., Polizzi, A., Patini, R., Ferlito, S., Alibrandi, A., & Palazzo, G. (2020d). Association among serum and salivary A. actinomycetemcomitans specific immunoglobulin antibodies and periodontitis. BMC Oral Health, 20(1), 283. https://doi.org/10.1186/s12903-020-01258-5

Jung, M. H. (2010). Evaluation of the effects of malocclusion and orthodontic treatment on self-esteem in an adolescent population. American Journal of Orthodontics and Dentofacial Orthopedics, 138(2), 160-166. https://doi.org/10.1016/j.ajodo.2008.08.040

Kenealy, P. M., Kingdon, A., Richmond, S., & Shaw, W. C. (2007). The Cardiff dental study: a 20‐year critical evaluation of the psychological health gain from orthodontic treatment. British Journal of Health Psychology, 12(1), 17-49. https://doi.org/10.1348/135910706X96896

Klages, U., Claus, N., Wehrbein, H., & Zentner, A. (2006). Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. The European Journal of Orthodontics, 28(2), 103-111. https://doi.org/10.1093/ejo/cji083

Martino, G., Caputo, A., Schwarz, P., Bellone, F., Fries, W., Quattropani, M. C., & Vicario, C. M. (2020a). Alexithymia and inflammatory bowel disease: a systematic review. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01763

Martino, G., Caputo, A., Vicario, C. M., Catalano, A., Schwarz, P., & Quattropani, M. C. (2020b). The relationship between alexithymia and type 2 diabetes: a systematic review. Frontiers in Psychology, 11.
https://doi.org/10.3389/fpsyg.2020.02026

Matarese, G., Curro, M., Isola, G., Caccamo, D., Vecchio, M., Giunta, M. L., . . . Ientile, R. (2015). Transglutaminase 2 up-regulation is associated with RANKL/OPG pathway in cultured HPDL cells and THP-1-differentiated macrophages. Amino Acids, 47(11), 2447-2455. https://doi.org/10.1007/s00726-015-2039-5

Matarese, G., Isola, G., Alibrandi, A., Lo Gullo, A., Bagnato, G., Cordasco, G., & Perillo, L. (2016). Occlusal and MRI characterizations in systemic sclerosis patients: A prospective study from Southern Italian cohort. Joint Bone Spine, 83(1), 57-62. https://doi.org/10.1016/j.jbspin.2015.04.014

Matarese, G., Isola, G., Anastasi, G. P., Cutroneo, G., Cordasco, G., Favaloro, A., . . . Perillo, L. (2013). Transforming Growth Factor Beta 1 and Vascular Endothelial Growth Factor Levels in the Pathogenesis of Periodontal Disease. European Journal of Inflammation, 11(2), 479-488. https://doi.org/10.1177/1721727X1301100217

Matarese, G., Isola, G., Anastasi, G. P., Favaloro, A., Milardi, D., Vermiglio, G., ... & Cutroneo, G. (2012). Immunohistochemical analysis of TGF-β1 and VEGF in gingival and periodontal tissues: a role of these biomarkers in the pathogenesis of scleroderma and periodontal disease. International journal of molecular medicine, 30(3), 502-508. https://doi.org/10.3892/ijmm.2012.1024

Merlo, E., Sicari, F., Frisone, F., Costa, G., Alibrandi, A., Avena, G., & Settineri, S. (2021a). Uncertainty, alexithymia, suppression and vulnerability during the COVID-19 pandemic in Italy. Health Psychology Report, 9(1). https://doi.org/10.5114/hpr.2021.104078

Merlo, E. M. (2019). Adolescent phobia as a "mask object". Mediterranean Journal of Clinical Psychology, 7(1). https://doi.org/10.6092/2282-1619/2019.7.2241

Merlo, E. M., Sicari, F., Frisone, F., Alibrandi, A., & Settineri, S. . (2020a). Personality types and dreaming in future health professionals: Effect of age and gender. International Journal of Dream Research, 160-172. https://doi.org/10.11588/ijodr.2020.2.70571

Merlo, E. M., Stoian, A., Motofei, I. G., & Settineri, S. (2020b). Clinical Psychological Figures in Healthcare Professionals: Resilience and Maladjustment as the" Cost of Care". Frontiers in Psychology, 11(4), 3166. https://doi.org/10.3389/fpsyg.2020.607783

Merlo, E. M., Stoian, A. P., Motofei, I. G., & Settineri, S. (2021b). The Role of Suppression and the Maintenance of Euthymia in the Clinical Settings. Frontiers in Psychology, 12, 1534. https://doi.org/10.3389/fpsyg.2021.677811

Myles, A.L.M., Merlo, E.M. (2020). Alexithymia and physical outcomes in psychosomatic subjects: a cross-sectional study. Journal of Mind and Medical Sciences, 8(1). https://doi.org/10.22543/7674.81.P8693

Nicodemo, D., Pereira, M. D., & Ferreira, L. M. (2008). Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal, 13(1), E48-51.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18167481

Özhayat, E. B. (2013). Influence of self-esteem and negative affectivity on oral health-related quality of life in patients with partial tooth loss. Community Dent Oral Epidemiol, 41(5), 466-472. https://doi.org/10.1111/cdoe.12032

Pabari, S., Moles, D. R., & Cunningham, S. J. (2011). Assessment of motivation and psychological characteristics of adult orthodontic patients. American Journal of Orthodontics and Dentofacial Orthopedics, 140(6), e263-e272. https://doi.org/10.1016/j.ajodo.2011.06.022

Perillo, L., Isola, G., Esercizio, D., Iovane, M., Triolo, G., & Matarese, G. (2013). Differences in craniofacial characteristics in Southern Italian children from Naples: a retrospective study by cephalometric analysis. European journal of paediatric dentistry, 14(3), 195-198. https://doi.org/10.1007/s40368-013-0074-z

Perillo, L., Padricelli, G., Isola, G., Femiano, F., Chiodini, P., & Mataresei, G. (2012). Class II malocclusion division 1: a new classification method by cephalometric analysis. European journal of paediatric dentistry, 13(3), 192.

Phillips, C., & Beal, K. N. E. (2009). Self-concept and the perception of facial appearance in children and adolescents seeking orthodontic treatment. The Angle orthodontist, 79(1), 12-16. https://doi.org/10.2319/071307-328.1

Piancino, M. G., Isola, G., Cannavale, R., Cutroneo, G., Vermiglio, G., Bracco, P., & Anastasi, G. P. (2017). From periodontal mechanoreceptors to chewing motor control: A systematic review. Archives of oral biology, 78, 109-121. https://doi.org/10.1016/j.archoralbio.2017.02.010

Piancino, M. G., Isola, G., Merlo, A., Dalessandri, D., Debernardi, C., & Bracco, P. (2012). Chewing pattern and muscular activation in open bite patients. Journal of Electromyography and Kinesiology, 22(2), 273-279. https://doi.org/10.1016/j.jelekin.2011.12.003

Rodd, H. D., Marshman, Z., Porritt, J., Bradbury, J., & Baker, S. R. (2012). Psychosocial predictors of children’s oral health-related quality of life during transition to secondary school. Quality of Life Research, 21(4), 707-716. https://doi.org/10.1007/s11136-011-9967-7

Rozensky, R. H. (2006). Clinical psychology in medical settings: Celebrating our past, enjoying the present, building our future. Journal of Clinical Psychology in Medical Settings, 13(4), 343-352. https://doi.org/10.1007/s10880-006-9045-4

Sari, Z., Uysal, T., Karaman, A. I., Sargin, N., & Üre, Ö. (2005). Does orthodontic treatment affect patients' and parents' anxiety levels?. The European Journal of Orthodontics, 27(2), 155-159. https://doi.org/10.1093/ejo/cjh072

Seehra, J., Newton, J. T., & DiBiase, A. T. (2013). Interceptive orthodontic treatment in bullied adolescents and its impact on self-esteem and oral-health-related quality of life. European journal of orthodontics, 35(5), 615-621. https://doi.org/10.1093/ejo/cjs051

Settineri, S., Frisone, F., Alibrandi, A., & Merlo, E. M. (2019a). Emotional Suppression and Oneiric Expression in Psychosomatic Disorders: Early Manifestations in Emerging Adulthood and Young Patients. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01897

Settineri, S., Frisone, F., Merlo, E. M., Geraci, D., & Martino, G. (2019b). Compliance, adherence, concordance, empowerment, and self-management: five words to manifest a relational maladjustment in diabetes. Journal of multidisciplinary healthcare, 12, 299. https://doi.org/10.2147/JMDH.S193752

Shigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., & Benedek, D. M. (2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry and Clinical Neurosciences, 74, 281–282. https://doi.org/10.1111/pcn.12988

Sud, S., Marcon, M., Assor, E., Daneman, D., & Mahmud, F. H. (2012). Quality of life in children with diabetes and celiac disease: minimal impact of the 'double diagnosis'. Pediatr Diabetes, 13(2), 163-169. https://doi.org/10.1111/j.1399-5448.2011.00785.x

Tsamakis, K., Triantafyllis, A. S., Tsiptsios, D., Spartalis, E., Mueller, C., Tsamakis, C., Chaidou, S., Spandidos, D. A., Fotis, L., Economou, M., & Rizos, E. (2020). COVID-19 related stress exacerbates common physical and mental pathologies and affects treatment. Experimental and Therapeutic Medicine, 20, 159–162. https://doi.org/10.3892/etm.2020.8671

Tanzilli, A., Di Giuseppe, M., Giovanardi, G., Boldrini, T., Caviglia, G., Conversano, C., & Lingiardi, V. (2021). Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1). https://doi.org/10.4081/ripppo.2021.531

Tovian, S. M., Rozensky, R. H., & Sweet, J. J. (2003). A decade of clinical psychology in medical settings: The short longer view. Journal of Clinical Psychology in Medical Settings, 10(1), 1-8. https://doi.org/10.1023/A:1022861728067

Trakyali, G., Isik-Ozdemir, F., Tunaboylu-Ikiz, T., Pirim, B., & Yavuz, A. E. (2009). Anxiety among adolescents and its affect on orthodontic compliance. Journal of Indian Society of Pedodontics and Preventive Dentistry, 27(4), 205. https://doi.org/10.4103/0970-4388.57654

Vaida, L., Pirte, A., Corega, C., Slavescu, D., & Mutiu, G. (2009). Correlations between the changes in patients' dental-facial morphology at the end of the orthodontic treatment and the psychological variables. Rom J Morphol Embryol, 50(4), 625-629. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19942957

Varela, M., & García-Camba, J. E. (1995). Impact of orthodontics on the psychologic profile of adult patients: a prospective study. American Journal of Orthodontics and Dentofacial Orthopedics, 108(2), 142-148. https://doi.org/10.1016/S0889-5406(95)70076-5

Vicario, C. M. (2013). Altered insula response to sweet taste processing in recovered anorexia and bulimia nervosa: a matter of disgust sensitivity?. American Journal of Psychiatry, 170(12), 1497-1497. https://doi.org/10.1176/appi.ajp.2013.13060748

Yu, D., Wang, F., Wang, X., Fang, B., & Shen, S. G. (2013). Presurgical motivations, self-esteem, and oral health of orthognathic surgery patients. Journal of Craniofacial Surgery, 24(3), 743-747. https://doi.org/10.1097/SCS.0b013e318285d5a4




DOI: https://doi.org/10.6092/2282-1619/mjcp-2971

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