The condition of hypodontia exists across a spectrum of severity. Missing adult teeth has been reported to cause aesthetic and functional issues, with subsequent psychosocial impacts.
Hypodontia is usually diagnosed at the end of the first decade, when the individual transitions from the primary to the permanent dentition. However, rehabilitation may not be completed until the early 20s when growth is complete. Multidisciplinary care with orthodontic and restorative dentistry/prosthodontic input is usually required throughout the teenage years, with a large number of appointments for patients. Restorative treatment may involve surgical and non-surgical techniques (restorations, dentures, bridges and dental implants).
Hypodontia studies assessing quality of life for patients have either assessed children or young adults, with disparate OHRQoL tools used that are not comparable. This prevents the assessment of quality of life impacts from diagnosis to the completion of rehabilitation and into the maintenance phase of treatment. The CHOSEN study aims to develop a patient-relevant Core Outcome Set for hypodontia studies and provide the foundation for future hypodontia study cross-comparability. The Core Outcome Sets for orthodontics and dental implants have some relevance to hypodontia, but a bespoke Core Outcome Set is required to assess the specific impacts on these individuals as a result of their protracted and multidisciplinary treatment.
Supervisors: Prof Gerry McKenna and Prof Ciaran O'Neill
Centre for Public Health, Queen's University Belfast (QUB), Northern Ireland
Belfast Health and Social Care Trust (BHSCT), Northern Ireland
Disease Category: Dentistry & oral health
Disease Name: Hypodontia (dental agenesis)
Age Range: 9 - 50
Sex: Either
Nature of Intervention: Any
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Policy makers
- Researchers
- Service users
- COS for clinical trials or clinical research
- Consensus meeting
- Delphi process
- Focus group(s)
- Interview
- Systematic review
This study will proceed under the COMET guidelines for developing a Core Outcome Set for studies.
A primary systematic review will identify the current studies that analyse OHRQoL for individuals with hypodontia to assess whether they are comparable. Following this, scoping reviews will locate tools used to assess OHRQoL in hypodontia, orthodontic and prosthodontic studies. The included OHRQoL questionnaires will be reviewed, and the constituent items identified. The items will be grouped and classified thematically.
Qualitative semi-structured interviews with patients/caregivers and focus groups with clinicians/researchers/policymakers will be used to identify and confirm outcome themes that are of concern to individuals with hypodontia.
Statements for a two-round Delphi study will be generated from the analysis of the scoping review constituent items, the qualitative interviews with individuals with hypodontia and focus groups with clinicians/researchers/policymakers. The two-round stakeholder Delphi study using the GRADE scoring process to determine consensus will be used to identify which outcomes are identified as important for those with hypodontia. Priority will be given to outcomes reaching consensus by patients to produce a patient-centred Core Outcome Set.
A consensus meeting with a representative group of stakeholders will be used to discuss the findings, vote on outstanding statements and approve the proposed Core Outcome Set list. This study will aim to inform the development of a patient-focused Core Outcome Set that will be representative of their concerns throughout the stages of their rehabilitation.