Quality of life and implantbased treatment

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Quality of life and implant-based treatment
P-I Brånemark Scientific Symposium, 29-31 October
2009, Gothenburg

• Björn Söderfeldt
• Dept of Oral Public Health
• Malmö University, Sweden

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Two questions

• What is Quality of Life?
• How does it relate to implant treatment?

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Starting point The clinical encounter
Gender Age Training Personality
Gender Age Training Personality
Encounter
Clinical judgment
Health Fear Selfesteem
Dentist
Patient
Care organization Work load Control over
work Financing system
Social class Education Resources Ethnicity
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The encounter is not any human relation, but with
a specific objective Health and quality of life!
What is that?
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The health concept

• International declarations
• WHO charter 1948
• Lalonde report 1974
• New Public Health 1985

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WHO 1948
Health is a complete state of physical, mental,
and social well-being, and not just the absence
of infirmity
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The Health Field (Lalonde 1974)
Life style
Biology
Environment
Care organization
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The New Public Health
Health is not a condition but a dynamic process
where new needs emerge. Health is an essential
resource for a good life. Health for all will
be achieved by the people themselves. A well
informed , well motivated and actively
participating community is a key element for the
attainment of the common goal WHO, Health for
All 1985
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Oral health
Functioning -Mastication -Speech
Pain/discomfort -Acute -Chronic
Oral health related quality of life
Psychological aspects -Appearance -Self-esteem
Social aspects -Communication -Social interactions
Inglehart, Bagramian 2002
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Some measures of oral health and quality of life
(review by Johansson, Söderfeldt 2004)
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What is then the impact of implants on quality of
life?

• Literature search starting at the year 2000
  yielded only 6 empirical studies assessing the
  effect of implants on OHRQoL

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(No Transcript)
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In addition, there were 6 measurement/methodologic
al studies and 4 reviews

• Design and quality greatly varying
• One attempt to develop a specific measure
  (OHIP-Edent)

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In a qualitative study in Gothenburg by Ulrika
Trulsson(Hallberg) 2005, new ideas were brought
forward
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• Grounded theory interviews (a metod for discovery
  rather than for justification)
• For patients with implants, new categories
  emerged in addition to those addressed in OHRQoL
  measures
• Becoming the person one once was
• Relief from a sense being maimed

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Conclusions

• All evidence, although weak, points to dramatic
  effects on quality of life from implant therapy
• Further research is urgent, improving evidence
  and developing SPECIFIC measures, able to capture
  the uniqueness of implant therapy
• Thank you for your attention!