Assessing the Oral-Health-Related Quality of Life in Patients with Dental Prosthetics: A Cross-Sectional Study from Eastern Croatia

Abstract

Objectives: This cross-sectional study aimed to evaluate the oral-health-related quality of life (OHRQoL) among patients with fixed, removable, and combined dental prosthetic restorations in Osijek, Croatia, focusing on potential variations by gender, age, and prosthetic type. Methods: This study included 313 patients treated at dental clinics within the Osijek-Baranja County Health Center. The standardized Oral Health Impact Profile-14 (OHIP-14) questionnaire, validated in Croatian (OHIP-CRO14), was used to assess the participants’ OHRQoL. Statistical analyses were conducted to explore associations between demographic factors, prosthetic types, and OHRQoL domains. Results: Psychological discomfort emerged as the domain with the lowest reported OHRQoL, whereas social disability was the least affected. Gender showed no significant association with OHRQoL outcomes. However, age influenced OHRQoL scores. Patients with fixed prosthetic restorations reported better OHRQoL in functional limitation, physical pain, and physical disability compared to those with removable or combined prosthetics. Conclusions: Patients with fixed prosthetic restorations reported better OHRQoL, particularly in functional limitation, physical pain, and physical disability domains. While no significant gender differences were observed, age significantly influenced physical disability scores, with younger participants reporting lower scores and older participants higher scores. These results emphasize the importance of prosthetic type in improving OHRQoL and guiding clinical decision-making in dental practice.

1. Introduction

Oral health undergoes dynamic changes across different life stages, from childhood through to old age, and is widely recognized as an essential component of overall health. As oral health directly influences general well-being, maintaining its optimal state is essential for improving quality of life (QoL) [1,2]. Accordingly, the primary objective of dental care is to promote and sustain oral health throughout an individual’s lifespan, contributing to both functional and psychological well-being [3]. Oral-health-related quality of life (OHRQoL) is a specific dimension of overall QoL that focuses on the impact of oral health on physical, psychological, and social well-being [4]. Unlike general QoL, which includes broader health and life satisfaction measures, OHRQoL examines domains directly related to oral health, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap [4,5]. These components provide a targeted framework for understanding how oral health conditions affect daily life and overall well-being. OHRQoL is evaluated using social indicators, self-reported assessments, and standardized questionnaires. One of the most mentioned questionnaires in the literature for assessing the impact of oral health on quality of life is the Oral Health Impact Profile (OHIP) [6,7]. The OHIP’s strength lies in its ability to measure changes in patients’ perceptions of their oral health, bridging the gap left by traditional clinical indicators that often overlook the broader impact of oral disorders on well-being [8].

The OHIP-49 questionnaire consists of 49 questions divided into seven aforementioned dimensions of OHRQoL [7]. Although the OHIP-49 is reliable, sensitive to changes, and demonstrates cross-cultural consistency, its extensive length and the time required to complete it have limited its practical application in both research and clinical settings [9]. To address these limitations, the shortened OHIP-14 questionnaire was developed. It retains the core concepts of the OHIP-49 across the same seven dimensions but with only 14 questions, offering a more time-efficient alternative without compromising validity or reliability [8,10,11]. Recognizing the need for standardized tools in Croatian epidemiological, clinical, and longitudinal studies, the original OHIP-14 was translated and validated for the Croatian-speaking population, resulting in the OHIP-CRO14 [12]. This version is psychometrically reliable and suitable for assessing OHRQoL in Croatia, with higher scores indicating poorer oral health.

The impact of dental prosthetics on OHRQoL has been extensively studied globally [13,14,15,16,17,18], yet limited data are available from Croatia, particularly regarding regional variations such as eastern Croatia. Fixed, removable, and combined dental prosthetics can have varying impacts on patients’ physical, psychological, and social well-being [19]. While previous studies have validated the Croatian versions of the OHIP, their focus has primarily been on the psychometric properties of the instruments rather than evaluating the quality of life in diverse patient groups [11,20]. Also, there are studies evaluated on specific populations [21,22,23,24] or one prosthetic type [12], leaving significant gaps in understanding the broader impact of dental prosthetics and comparative impact of fixed, removable, and combined prosthetic restorations on OHRQoL in eastern Croatia. Understanding these differences is essential for guiding clinical decision-making and improving patient care [25,26]. Therefore, this study aims to address these gaps by evaluating the OHRQoL in patients with fixed, removable, and combined dental prosthetic restorations in the eastern Croatia area. A secondary aim was to assess potential differences in OHIP-CRO14 scores among participants based on gender, age, and place of residence.

2. Materials and Methods

2.1. Ethic Principles

This study was conducted in full compliance with the ethical principles outlined in the Declaration of Helsinki. Approval for the research was obtained from the Ethics Committee of the Faculty of Dental Medicine and Health in Osijek (Class: 602-01/24-12/02, No. 2158/97-97-10-24-08) and the Ethics Committee of the Health Center of Osijek-Baranja County (No. 03-300-2/24). All participants were informed about the purpose and protocol of the study and were assured of the confidentiality and anonymity of their responses. Written informed consent was obtained from all participants prior to their inclusion in the study.

2.2. Study Design, Timeframe, Location, and Participants

This cross-sectional study was conducted in adherence to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies, as detailed in Supplementary File S1. The sample size calculation was informed by previously published literature and aligned with commonly accepted parameters for cross-sectional studies, ensuring sufficient precision and statistical validity [23,24]. The data were collected over a period from 11 March to 29 May 2024, in three dental offices of the Community Healthcare Osijek-Baranja County, located in the city of Osijek. Participants were recruited from among patients with fixed, removable, and combined dental prosthetic restorations who visited dental offices during the study period. Recruitment was based on a random selection of eligible patients based on inclusion and exclusion criteria as they presented for routine dental care.

Inclusion criteria were as follows:

• Adults aged 18 years or older with good mental health.
• Patients with fixed, removable, or combined dental prosthetic restorations.
• Patients who provided written informed consent and demonstrated a clear understanding of the study aims and protocol.

Exclusion criteria were as follows:

• Patients with ongoing acute dental or medical conditions that could interfere with their ability to complete the questionnaire.
• Patients with cognitive impairments or language barriers.
• Patients with severe psychiatric disorders or requiring urgent medical attention.
• Patients who declined to provide informed consent.

A total of 331 patients were screened for participation in the study, 313 of whom met the inclusion criteria and were enrolled (Figure 1).

2.3. Data Collection and Instrumentation

Data were collected using a standardized questionnaire OHIP-CRO14. Permission to use the questionnaire was obtained from the primary author of the original study that validated the OHIP-14 for the Croatian population (Petričević et al. [11]). The questionnaire has been validated in the Croatian population through a forward–backward translation process, ensuring cultural and linguistic appropriateness. Its psychometric properties, including construct validity, internal consistency, and test–retest reliability, have been evaluated. Cronbach’s alpha coefficients ranged from 0.77 to 0.91, indicating high internal consistency, while intraclass correlation coefficients ranged from 0.79 to 0.94, confirming good test–retest reliability. These characteristics establish the OHIP-CRO14 as a reliable instrument for assessing OHRQoL in the Croatian context. The standardized OHIP-CRO14 consists of 14 multiple-choice questions addressing seven domains of oral health-related quality of life: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. Participants responded to the OHIP-CRO14 questions using a Likert-type scale, with the following options:

• 0: Never.
• 1: Rarely.
• 2: Sometimes.
• 3: Fairly often.
• 4: Very often.

The section composed of four sociodemographic and clinical questions was added at the first page of questionnaire to gather general information about the participants, including age, gender, place of residence (urban or rural), and type of dental prosthetic restoration (fixed, removable or combined prostheses). The complete questionnaire is provided in the Supplementary Materials (Supplementary File S2).

Participants independently completed the questionnaire, with clear written and oral instructions provided beforehand to minimize misunderstandings. The completion of the questionnaire took place in a private room located between the waiting area and the dental office. This setting ensured a quiet, undisturbed atmosphere, providing participants with the privacy needed to complete the questionnaire without distractions. The reliability of patients’ responses was verified, if necessary, by one of the three dentists where data collection took place. During this process, neutrality was maintained, with no opinions or reactions offered to the participants’ responses. Clarifications were made only when necessary, and any modifications to the responses were documented. Additionally, the same dentist performed a clinical examination to confirm the accuracy of participants’ self-reported information regarding the type of prosthetic restoration, while avoiding any influence on participants’ original answers. These measures minimized potential bias and ensured the reliability of the collected data.

2.4. Statistical Analysis

Categorical data were presented as absolute numbers and relative frequencies. Numerical data, due to their asymmetric distribution, are described using the median and interquartile range (IQR). The Mann–Whitney U test was chosen to compare two independent groups of non-normally distributed numerical data. The Kruskal–Wallis test was used to assess differences among more than two independent groups. All p values were two-tailed, with statistical significance set at α = 0.05. Statistical analyses were performed using MedCalc^® Statistical Software, version 14.12.0 (Ostend, Belgium). MedCalc^® is widely recognized and frequently used in medical and health sciences research for its comprehensive statistical tools, especially in the analysis of non-parametric data [27].

3. Results

This study included 313 participants, comprising 111 males (35.5%) and 202 females (64.5%). The largest proportion of participants (24.9%) belonged to the 61–70 age group, with 78 individuals. The mean age of participants was 62.6 years (standard deviation 14.2), with the youngest being 21 years old and the oldest 93 years old. The majority of participants, 174 (55.6%), resided in urban areas. In terms of prosthetic restorations, 176 participants (56.2%) used removable prostheses, 116 (37.1%) had fixed prostheses, and 21 (6.7%) utilized combined, fixed, and removable prostheses. These sociodemographic and clinical characteristics are summarized in

Table 1. Sociodemographic and clinical characteristics of the participants.

Sociodemographic and Clinical Characteristics of Respondents		N (%)
Gender	Male	111 (35.5)
	Female	202 (64.5)
Age	Up to 50 years	62 (19.8)
	51–60 years	72 (23.0)
	61–70 years	78 (24.9)
	70–80 years	72 (23.0)
	81 and more years	29 (9.3)
Place of residence	Urban area	174 (55.6)
	Rural area	139 (44.4)
Prosthetic type	Removable prostheses	176 (56.2)
	Fixed prostheses	116 (37.1)
	Combined protheses	21 (6.7)

for clarity and reference.

The domain of psychological discomfort recorded the highest scores, reflecting the lowest score in this area, with a median score of 2.0 (interquartile range [IQR]: 0.0–4.0). Conversely, the domain of social disability showed the lowest scores, with a median of 0.0 (IQR: 0.0–1.0), indicating minimal impact on quality of life in this domain. The overall median score for the OHIP-CRO14 questionnaire was 8.0 (IQR: 3.0–15.0), demonstrating variability in the impact of oral health on participants’ OHRQoL (

Table 2. OHIP-CRO14 questionnaire domains—median and interquartile range.

	Median (Interquartile Range)
Functional limitation	1.0 (0.0–2.0)
Physical pain	1.0 (0.0–3.0)
Psychological discomfort	2.0 (0.0–4.0)
Physical disability	1.0 (0.0–2.0)
Psychological disability	1.0 (0.0–2.0)
Social disability	0.0 (0.0–1.0)
Handicap	0.0 (0.0–2.0)
Total score of OHIP-CRO14	8.0 (3.0–15.0)

).

The analysis of OHIP-CRO14 scores revealed no statistically significant differences between male and female participants across all assessed domains. Also, no significant difference was observed in the total OHIP-CRO14 scores between genders (median [IQR]: males 7.0 [3.0–13.0] vs. females 8.0 [3.0–16.0]; p = 0.55). Detailed results for each domain are presented in

Table 3. Comparison of OHIP-CRO14 scores across domains by gender.

	Gender		p *
	Male	Female
	Median (Interquartile Range)
Functional limitation	1.0 (0.0–2.0)	1.0 (0.0–2.0)	0.84
Physical pain	1.0 (1.0–3.0)	1.0 (0.0–3.0)	0.35
Psychological discomfort	2.0 (0.0–4.0)	2.0 (0.0–4.0)	0.42
Physical disability	1.0 (0.0–2.0)	1.0 (0.0–2.0)	0.34
Psychological disability	1.0 (0.0–2.0)	1.0 (0.0–3.0)	0.15
Social disability	0.0 (0.0–1.0)	0.0 (0.0–1.0)	0.66
Handicap	0.0 (0.0–1.0)	0.0 (0.0–2.0)	0.17
Total score of OHIP-CRO14	7.0 (3.0–13.0)	8.0 (3.0–16.0)	0.55

* Mann–Whitney u test.

.

Participants younger than 50 years scored significantly lower in the domain of physical disability, while those older than 81 years scored significantly higher (Kruskal–Wallis test; p = 0.004). Similarly, participants younger than 50 years achieved significantly lower scores in the domain of handicap, whereas participants older than 71 years scored significantly higher (Kruskal–Wallis test; p = 0.02) (

Table 4. Differences in the results regarding the age of the respondents.

	Age (in Years)					p *
	Up to 50	51–60	61–70	71–80	81 and More
	Median (Interquartile Range)
Functional limitation	0.0 (0.0–1.0)	1.0 (0.0–2.5)	1.0 (0.0–2.0)	1.0 (0.0–3.0)	2.0 (0.0–3.0)	0.05
Physical pain	1.0 (0.0–2.0)	2.0 (0.5–3.0)	1.0 (0.0–3.0)	1.0 (0.5–3.0)	1.0 (1.0–4.0)	0.14
Psychological discomfort	2.0 (0.0–4.0)	3.0 (0.0–4.0)	2.0 (0.0–4.0)	2.0 (0.0–4.0)	2.0 (0.0–4.0)	0.45
Physical disability	0.0 (0.0–1.0)	1.0 (0.0–2.0)	1.0 (0.0–2.0)	1.0 (0.0–3.0)	2.0 (0.0–3.0)	0.004
Psychological disability	0.5 (0.0–2.0)	1.0 (0.0–2.5)	1.0 (0.0–3.0)	1.0 (0.0–3.0)	1.0 (0.0–4.0)	0.41
Social disability	0.0 (0.0–1.0)	0.0 (0.0–2.0)	0.0 (0.0–1.0)	0.0 (0.0–1.0)	1.0 (0.0–3.0)	0.20
Handicap	0.0 (0.0–1.0)	0.5 (0.0–2.0)	0.5 (0.0–1.0)	1.0 (0.0–2.0)	1.0 (0.0–3.0)	0.02
Total score of OHIP-CRO14	6.5 (3.0–13.0)	8.0 (3.0–16.0)	7.5 (2.0–16.0)	9.0 (3.0–16.0)	8.0 (3.0–22.0)	0.45

* Kruskal–Wallis test.

).

Respondents living in the urban area scored significantly higher in the domain of psychological discomfort compared to respondents living in rural areas (Mann–Whitney U test, p < 0.001). No significant differences were observed in the results of the other domains of the OHIP-CRO14 questionnaire with respect to the respondents’ place of residence (

Table 5. The differences in the results obtained from the OHIP-CRO14 questionnaire based on the respondents’ place of residence.

	Place of Residence		p *
	Urban	Rural
	Median (Interquartile Range)
Functional limitation	1.0 (0.0–2.0)	1.0 (0.0–2.0)	0.10
Physical pain	2.0 (0.0–3.0)	1.0 (0.0–3.0)	0.39
Psychological discomfort	3.0 (1.0–4.0)	1.0 (0.0–3.0)	<0.001
Physical disability	1.0 (0.0–2.0)	1.0 (0.0–2.0)	0.50
Psychological disability	1.0 (0.0–3.0)	1.0 (0.0–2.0)	0.42
Social disability	0.0 (0.0–1.0)	0.0 (0.0–1.0)	0.37
Handicap	0.0 (0.0–2.0)	0.0 (0.0–1.0)	0.12
Total score of OHIP-CRO14	9.0 (3.0–16.0)	6.0 (2.0–14.0)	0.09

* Mann–Whitney u test.

).

Participants with fixed prosthetic restorations had significantly lower scores in functional limitation (p = 0.001), physical pain (p = 0.004), physical disability (p < 0.001), and overall OHIP-CRO14 scores (p = 0.005). In contrast, participants with combined prosthetic restorations scored significantly higher in psychological disability (p = 0.03) and handicap (p = 0.02) compared to other groups (

Table 6. The differences in the achieved results of the OHIP-CRO14 questionnaire based on the type of prosthetic work.

	Dental Prosthetic Type			p *
	Removable	Fixed	Combined
	Median (Interquartile Range)
Functional limitation	1.0 (0.0–3.0)	0.0 (0.0–2.0)	2.0 (0.0–2.0)	0.001
Physical pain	2.0 (1.0–3.0)	1.0 (0.0–2.0)	2.0 (1.0–3.0)	0.004
Psychological discomfort	2.0 (0.0–4.0)	2.0 (0.5–4.0)	3.0 (2.0–6.0)	0.21
Physical disability	1.0 (0.0–3.0)	0.0 (0.0–1.5)	1.0 (0.0–3.0)	<0.001
Psychological disability	1.0 (0.0–3.0)	1.0 (0.0–2.0)	2.0 (0.0–3.0)	0.03
Social disability	0.0 (0.0–1.0)	0.0 (0.0–1.0)	0.0 (0.0–1.0)	0.10
Handicap	0.0 (0.0–2.0)	0.0 (0.0–1.0)	1.0 (0.0–3.0)	0.02
Total score of OHIP-CRO14	9.0 (3.0–17.0)	5.0 (2.0–12.0)	10.0 (6.0–21.0)	0.005

* Kruskal–Wallis test.

).

4. Discussion

Using the validated OHIP-CRO14 questionnaire as an instrument for assessing OHRQoL, this research explored the influence of prosthetic type, gender, age, and place of residence on patients’ oral well-being. The findings revealed no significant differences in OHIP-CRO14 scores between genders but highlighted the prosthetic type as key factor influencing specific domains of OHIP-CRO14. These results contribute to bridging the knowledge gap regarding the comparative impacts of various prosthetic restorations on patients’ OHRQoL and acknowledges the importance of individualized treatment planning in prosthetic dentistry.

4.1. Demographic Findings and Socioeconomic Context

Gender and age are important factors in understanding how dental prosthetics impact OHRQoL. In this study, 313 patients participated, predominantly females, with the average age represented by a median of 62.6 years. This demographic distribution aligns with other studies, indicating that older adults have a greater need for prosthetic work due to the increased loss of teeth associated with aging [28]. The predominance of female participants may be attributed to a higher likelihood of females seeking dental care and participating in health-related surveys, as previously documented in the literature [29]. Interestingly, the analysis of OHIP-CRO14 data showed no significant differences in scores between males and females, suggesting that dental prosthetic restorations impact both genders similarly. This result contrasts with studies like Tosun et al. [30], which found that females reported higher scores in domains such as physical pain, psychological discomfort, and psychological disability, indicating greater dissatisfaction with certain aspects of oral health. However, our findings are consistent with those of Kranjčić et al. [23], who reported no statistically significant differences between genders in OHRQoL among elderly participants wearing complete removable prostheses. This study was conducted in Croatian territory which may contribute to the similarity of the achieved scores.

The analysis revealed that younger patients (<50 years) had significantly lower scores, while older patients (>71 years) had higher scores in the domains of physical disability (p = 0.004) and handicap (p = 0.02), indicating age-related differences in these aspects of OHRQoL. This finding aligns with the expected decline in physical abilities associated with aging and the progressive loss of alveolar bone volume, which can impact the stability and function of dental prosthetic restorations [31]. This also aligns with previously reported results on the Croatian elderly population, demonstrating that younger participants (under 65 years) experienced significantly higher psychological discomfort compared to those older of 65 years [23]. This may implicate that younger patients face psychological challenges due to higher expectations for esthetics and function or difficulties adapting to prosthetic devices [32]. Overall, these results contribute to the growing understanding of how age and gender influence OHRQoL while also emphasizing the importance of providing suitable and high-quality dental care to meet the unique needs of diverse patient groups.

The observed discrepancies reflect the socioeconomic challenges in eastern Croatia. In that context, it is important to discuss how socioeconomic status significantly impacts OHRQoL by influencing access to dental care, oral health maintenance, as well prosthetic choices [33,34]. Lower socioeconomic status is associated with limited access to high-quality dental treatments, lower health literacy, and financial status, often resulting in choosing prosthetic options, such as removable prostheses [35,36,37]. It is well known that eastern Croatia is characterized by significant socioeconomic disparities compared to other regions of Croatia. Indicators such as lower GDP per capita, high population drain, and low regional development index highlight the region’s lagging development within the rest of the country and the European Union in general [38]. These differences are reflected in the health status of the population, as studies have shown that self-perceived health status is lowest in eastern Croatia and is influenced by income, education level, and urban–rural residence [39,40]. Taking into account socioeconomic disparities in eastern Croatia, these have likely influenced the findings of our study, particularly in the domains of psychological discomfort. Psychological discomfort, which was the most affected domain, may reflect the financial stress and limited access to high-quality dental in this region. Additionally, patients with fixed prosthetic restorations reported better results in functional limitation, physical pain, and physical disability. These findings address the importance of access to fixed prosthetics for improving OHQoL outcomes in general [41]. Also, it supports the need to address financial barriers to ensure equal access to higher-quality dental care. The relationship between socioeconomic status and health should be integrated as social determinants into patient care and regional healthcare planning in Eastern Croatia. Therefore, addressing these disparities through affordable care, legal frameworks, education, and public health initiatives should be in focus of local and state facilities.

4.2. Psychological and Functional Impacts

The analysis of the collected data revealed that the most frequently reported issues were in the domain of psychological discomfort, particularly related to patients’ thoughts about their teeth, mouth, jaw, or prosthetic restoration, as well as discomfort while eating certain foods. These findings align with previous research indicating that oral health significantly impacts daily activities and mental well-being [4].

A similar study conducted on 89 adults visiting the Dental Clinic of the Faculty of Dentistry in Pančevo, Serbia, found that most patients also scored the highest in the domain of psychological discomfort [42]. The psychological discomfort associated with dental prosthetic restoration highlights the need for ongoing support and counseling for patients adjusting to new prosthetic devices. The lowest scores were achieved in the domain of social disability, indicating a satisfactory quality of life for the patients. In contrast, a study conducted in a dental prosthetics clinic in Riyadh, Saudi Arabia, found that the highest scores were in the domain of social disability, indicating the poorest quality of life for patients in that area [43].

Patients with fixed dental prosthetic restoration achieved significantly lower scores in the domains of functional limitation, physical pain, and physical disability, which aligns with the findings of the previous mentioned study by Lalić et al. [42]. In the same study, fixed dental prosthetic restoration scored lower on the overall OHIP results, indicating a satisfactory OHRQoL for these individuals. Similarly, a longitudinal study conducted from 2010 to 2012 at the University of Rome found that patients with fixed dental prosthetic restoration were generally very satisfied and rarely experienced problems with their fixed dental prosthetics restorations [42,44]. Peršić et al. [24] assessed the impact of various prosthetic rehabilitation options on OHRQoL, orofacial esthetics, and chewing function. Their study revealed significant improvements across all evaluated parameters following prosthetic rehabilitation, with implant-supported fixed partial dentures and conventional fixed partial dentures achieving the best post-treatment scores on the OHIP-CRO14. The findings of this study similarly emphasize the functional and psychological advantages of fixed prosthetic restorations, which were associated with lower scores in domains such as functional limitation, physical pain, and physical disability. The psychological discomfort observed in patients with removable prosthetics may be attributed to challenges in achieving stability and esthetics compared to fixed restorations [45]. Findings from this study mostly align with previously mentioned international and regional studies, yet cultural and systemic differences should be considered. The prevalence of removable prosthetics reflects Croatia’s public healthcare system, which completely coverages the expenses of these devices but provides minimal support for fixed restorations. This contrasts with healthcare systems in wealthier regions, where fixed prosthetics are more accessible, leading to better overall OHRQoL outcomes [4,24,46,47,48].

4.3. Limitations

Lastly, it is important to address that this study has a few limitations. As a cross-sectional analysis, it provides a look of patients’ OHRQoL at one point in time, making it difficult to assess the long-term effects of dental prosthetic restorations. The external validity of the study is influenced by its focus on a clinical population in eastern Croatia, a region with unique socioeconomic and healthcare characteristics. While the findings provide a look into OHRQoL in this context, their applicability to other regions or populations with different cultural, socioeconomic, and healthcare dynamics may be limited. Further studies in diverse populations are needed to enhance the generalizability of these results. Finally, while the validated OHIP-CRO14 questionnaire was used, it focuses on general quality of life domains rather than aspects specific to dental prosthetic restorations, limiting its ability to capture certain details, such as those addressed in OHIP for edentulous patients [22]. Future studies should consider tracking changes over time, including a wider geographic area, as well developing the tools that directly assess prosthetic-specific factors.

5. Conclusions

This study showed the variation in OHIP-CRO14 scores in patients according to different prosthetic types. The better QoL was reported by patients with fixed restorations, specifically in functional limitation, physical pain, and physical disability domains. No significant differences in OHIP-CRO14 scores were found between male and female participants across all assessed domains. Age significantly influenced specific domains, with younger participants reporting lower scores in physical disability and older participants, especially those above 81 years, reporting higher scores in the same domain. Additionally, urban residents scored significantly higher in psychological discomfort compared to rural residents, suggesting that living environment influences certain aspects of OHRQoL. These results can guide clinical decision-making and inform future research aimed at improving patient-centered care and designing prosthetic treatments to improve OHRQoL.