A three-dimensional Oral health-related quality of life framework for temporomandibular joint disorders: A structural analysis of the Oral Health Impact Profile-14.

OBJECTIVES: the objective is to analyze the structure and relationship between the components of the Oral health-related quality of life using the Oral Health Impact Profile-14 (OHIP-14) for patients with temporomandibular joint disorders (TMJD). METHODS: two studies were examinated by means of factor analysis, multidimensional scaling and their spatial display in a cross-sectional design (n = 153). RESULTS: three-dimensional solutions with an adequate fit were found: residual distribution, root mean square of residuals (RMSR) = 0.04, Goodness of Fit Index (GFI) = 0.96, and Adjusted Goodness of Fit Index (AGFI) = 0.93; and Stress I = 0.023, respectively. The overall ordinal alpha coefficient was 0.92 (CI=0.90 to 0.94). The ordinal alpha coefficients for functional impact, psychosocial impact and psychological impact factors were 0.87 (CI=0.84 to 0.90), 0.88 (CI=0.84 to 0.91) and 0.78 (CI= 0.72 to 0.83), respectively. Item 9 was the most central, followed by 7 and 11. Items 1 and 2 had minor associations. There was no evidence of differences between centers: edge weight differences (M = 0.226, p = 0.94), global strength invariance test (S = 1.88, p = 0.1), centrality invariance test (p >0.05), edge invariance test (p >0.05). CONCLUSIONS: the links between the dimensions and the items seem to involve psychological components. Oral health-related quality of life emerged as a three-dimensional structure (Functional Impact, Psychosocial Impact and Psychological Impact) of functional and psychosocial elements in which physical, psychological, and social disability were essential, while theoretical functional limitation was least important. CLINICAL SIGNIFICANCE: the three-dimensional OHRQoL system for temporomandibular disorders (TMD) is a worthwhile alternative to interpret psychological and psychosocial aspects.