Prevalence of malocclusion traits and orthodontic treatment in a Finnish adult population

Objective The aim of the study was to examine the prevalence of malocclusion traits and the extent of orthodontic treatment in a Finnish adult population. Materials and methods The study population comprised subjects (n?=?1964) from the Northern Finland Birth Cohort 1966 living in the city of Oulu and within 100?km of it. A clinical oral and dental examination with registration of occlusion was carried out in 2012 in connection with a 46-year follow-up survey. Data on previous orthodontic treatment were collected based on a questionnaire. Results In the clinical examination, 39.5% of the subjects had at least one malocclusion trait. The most common malocclusion traits were lateral crossbite (17.9%), overbite?≥?6?mm (11.7%) and overjet?≥?6?mm (9.7%). Crossbite on the left premolars, negative overjet and increased overbite were found more frequently in men. The prevalence of malocclusion traits was at the same level in treated and untreated groups. Overall, 18.6% of the subjects had undergone orthodontic treatment. Women showed a significantly higher prevalence of orthodontic treatment. Conclusions The most common malocclusion trait in the present study was lateral crossbite. Significant male dominance in the prevalence of malocclusion was observed, which has not been reported earlier in Finland. Orthodontic treatment of malocclusion traits was more common among females in Northern Finland. This study indicates that orthodontic treatment provided in childhood was, on average, adequate in reducing malocclusion traits to the level observed in the general population.     

Occlusal traits,orthodontic treatment need and treatment complexity among untreated 17–21-year-olds in Estonia

Objective: To analyze data on occlusal traits, orthodontic treatment need and treatment complexity in orthodontically untreated 17–21-year-old Estonians.

Materials and methods: Clinical records and plaster casts of 390 untreated young adults (219 females and 171 males, mean age 18.5 years, range 17–21 years) were analyzed. Assessed occlusal traits included first molar and canine sagittal relationship, overjet, overbite, crowding, midline diastema, crossbite and scissor bite. The Index of Complexity, Outcome and Need (ICON) was used to assess orthodontic treatment need and complexity. Participants’ opinions regarding their teeth were determined with a questionnaire.

Results: The most prevalent occlusal traits were Class I sagittal relationship in canines (76%) and molars (70%), crowding (51%), overbite ≥3.5?mm (48%), the end-to-end sagittal relationship in canines (48%) and overjet ≥3.5?mm (47%). Antero-posterior asymmetry was common both in canines (39%) and molars (37%). According to ICON, 36% of participants had orthodontic treatment need.

Conclusions: Desire for orthodontic treatment was associated with crowding and increased overjet, and with no gender difference, participants’ main expectation of treatment was an improvement in dentofacial aesthetics. Treatment needs determined with ICON was moderate and in line with the participants’ desire for orthodontic treatment.     

Descriptive epidemiology of dental malocclusion in Najran patients seeking orthodontic treatment

BackgroundUntreated malocclusion can lead to compromised aesthetic function, depression, and low self-esteem. The aim of this study was to evaluate dental malocclusion in Najran, Saudi Arabia as no data existed before.MethodThis was a retrospective study analyzing the casts of all patients in Najran, Kingdom of Saudi Arabia, seeking orthodontic management for malocclusion between 2017 and 2019.MeasurementsThe consultant orthodontist is the single investigator involved in collecting the details of demographics followed by molar relationships, overjet, overbite, crowding and spacing using digital caliper on each dental cast. Data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp.ResultsA total of 326 patients sought treatment for different types of malocclusion. There were 143 males and 183 females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. The prevalence for Class I, II and III malocclusions at 95% CI was (0.76 (0.757, 0.774)), 0.251 (0.243, 0.260) and 0.529 (0.519, 0.539) respectively. Fifty-one (15.6%) patients had reversed overjet, 65 (19.9%) reduced overjet, and 86 (26.4%) increased overjet. One hundred and sixty-four (50.3%) cases of reduced overbite and 99 (30.4%) cases of deep overbite were also observed. Tooth size arch length discrepancy were noticed with crowding and spacing in 83 (26.4%) and 71 (21.8%) patients, respectively.ConclusionsThis study has shown the prevalence of Class I, Class II, and Class III malocclusion to be 72.7%, 11.6% and 15.6% respectively. Increased over jet and crowding was demonstrated in more patients, though it is not statistically significant.     

PAR指数评价萌出诱导器对混合牙列中期错的矫治疗效

目的采用PAR指数研究萌出诱导器对混合牙列中期错畸形患者的矫治疗效。方法采用前瞻性队列研究设计,纳入混合牙列中期牙列轻度拥挤、安氏I类或II类患儿56例。试验组(29例)采用萌出诱导器进行矫治,直至上前牙排齐;对照组(27例)不作处理,仅随访观察。采用PAR指数评价试验组治疗前后、对照组随访前后模型数据。结果试验组患者矫治后PAR加权后总分减少率为67.49%±13.47%,对照组随访前后PAR加权后总分减少率为18.69%±12.99%。两组患者在前牙排列、磨牙关系、覆覆盖关系改善上的差异均存在明显统计学意义(P<0.05)。结论萌出诱导器可以改善混合牙列中期患者上下前牙排列,纠正磨牙关系,明显减少患儿覆盖。     

The Effect of Retention on the Relapse of Class II Division I Cases

Abstract

Sixty cases of Class II Division 1 malocclusion were studied; 30 of them had been retained after the completion of orthodontic treatment, the other 30 had not and acted as a control group. Using measurements from lateral skull radiographs and statistical analysis, the two groups were compared in respect of skeletal pattern, soft tissue, overjet, overbite and interincisal angle. Both the retained and the non-retained group showed a tendency to relapse after the completion of active treatment; a tendency to relapse even while in retention was observed. The relapse in overjet was found to be more significant than the relapse in overbite. In both groups the relapse in overjet was found to be associated with the size of the original overjet, the overbite at the end of active treatment and the interincisal angle at the end of active treatment. In both groups the relapse in overbite was found to be associated with the size of the original overbite, the change in maxillary-mandibular planes angle and the interincisal angle at the end of active treatment.     

Stability of orthodontic treatment outcomes after 1-year treatment with the eruption guidance appliance in the early mixed dentition: A follow-up study

Objectives:To investigate occlusal stability from the early mixed to the permanent dentition in children after early treatment with the eruption guidance appliance (EGA).Materials and Methods:Of 46 participants who received 1-year early EGA treatment, 35 attended a follow-up examination at age 12. Group 1 (n = 21) started their EGA treatment at mean age 7.7 years, and group 2 at 9.1 years. Following 1-year treatment, the EGA was used as a retainer. Changes in overjet, overbite, sagittal molar relationship, and anterior crowding were measured on casts obtained before EGA treatment, after EGA treatment, and at follow-up to evaluate occlusal stability.Results:Mean overjet, overbite, sagittal molar relation, and mandibular crowding improved significantly during the study period. Participants with good compliance during the retention period had significantly smaller overjet and overbite values than those with poor compliance.Conclusions:Early correction of increased overjet, overbite, and class II molar relation with the EGA is maintainable and can also be effective in the permanent dentition, provided the EGA is worn regularly as a retainer.     

Normative and self-perceived orthodontic treatment need in Nigerian school children

Abstract

Objective. The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. Materials and methods. The sample consisted of 441 randomly selected school children, aged 11–18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11–13 years old and 195 14–18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. Results. A definite need for orthodontic treatment was found among 21.5% (grades 4–5 of DHC) and 6.3% (grades 8–10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8–10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). Conclusion. The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.     

Bullying in orthodontic patients and its relationship to malocclusion,self-esteem and oral health-related quality of life

Abstract

Objectives: To measure the self-reported frequency and severity of bullying amongst patients referred for orthodontic treatment and to investigate whether there is a relationship between levels of self-reported bullying, malocclusion and need for orthodontic treatment and an individual’s self-esteem and oral health-related quality of life (OHRQoL).

Design and setting: Cross-sectional study of an adolescent group referred for orthodontic assessment at three UK hospitals.

Subjects and methods: Three hundred and thirty-six participants aged between 10 and 14 years were recruited. Validated questionnaires were used to measure the self-reported frequency and severity of bullying, self-esteem and OHRQoL. Orthodontic treatment need was assessed using IOTN.

Results: The prevalence of bullying was 12·8%. Being bullied was significantly associated with Class II Division 1 incisor relationship (P?=?0·041), increased overbite (P?=?0·023), increased overjet (P?=?0·001) and a high need for orthodontic treatment assessed using AC IOTN (P?=?0·014). Bullied participants also reported lower levels of social competence (P<0·001), athletic competence (P<0·001), physical appearance related self-esteem (P<0·001) and general self-esteem (P<0·001). Higher levels of oral symptoms (P?=?0·032), functional limitations (P<0·001), emotional (P<0·001) and social impact (P<0·001) from their oral condition, resulting in a negative impact on overall OHRQoL (P<0·001), were also reported.

Conclusions: Significant relationships exist between bullying and certain occlusal traits, self-esteem and OHRQoL.     

An orthodontic oral appliance: A randomized,controlled pilot study

Objective:This pilot study was performed to test the hypothesis that an orthodontic oral appliance (OA) that is designed to work against the backwardly directed forces on the upper incisors may counteract the reduction in overjet from these devices.Materials and Methods:Thirty patients with normal bites, good oral health, and milder sleep apnea were randomized to treatment with either OAs or orthodontic OAs. Bite changes were evaluated on plaster casts and radiographs and by questionnaires after a mean of 2.4 years in 19 frequent users.Results:Four of nine patients in the orthodontic OA group increased their overjet by ≥0.4 mm, while none of the 10 patients in the OA group experienced that effect.Conclusion:Only the orthodontic OA increases the overjet; this design may therefore be beneficial to patients at risk of negative effects on their bite during OA treatment.     

Desire for orthodontic treatment and associated factors among adolescents in southern Brazil

Objective:To estimate the prevalence of the desire for orthodontic treatment and investigate associated factors among adolescents in southern Brazil.Materials and Methods:A cross-sectional study was carried out with 704 adolescents aged 12 and 13 years at municipal public schools in the city of Balneário Camboriú (southern Brazil). The adolescents answered a previously tested questionnaire addressing satisfaction with their dental appearance, speech function, chewing function, and the desire for orthodontic treatment. The parents/guardians answered a questionnaire addressing satisfaction with their child''s dental appearance and socioeconomic variables. A trained and calibrated orthodontist collected clinical data on malocclusion using the Dental Aesthetic Index (DAI). Statistical analysis was performed using multivariate Poisson regression with robust variance.Results:The prevalence of the desire for orthodontic treatment was 69.6% (490/704). In the adjusted analysis, the outcome was significantly more prevalent among girls (P < .001), those with difficulty chewing (P  =  .026), those dissatisfied with their dental appearance (P < .001), and those with greater malocclusion severity (P < .001). The following orthodontic characteristics were associated with the desire for orthodontic treatment in the multivariate model: diastema in anterior segment (P < .001), anterior maxillary irregularity (P < .001), maxillary overjet ≥6 mm (P < .001), and mandibular overjet (P  =  .047).Conclusions:The desire for orthodontic treatment among 12- and 13-year-old adolescents is influenced by gender, dissatisfaction with one''s dental appearance, difficulty chewing, malocclusion severity, and orthodontic characteristics. These findings should be considered together with normative indications regarding the need for orthodontic treatment in adolescents.     

Treatment of Class II malocclusions with removable appliances. 1. Case assessment

Successful correction of overbite and overjet after orthodontic treatment may be judged in terms of incisor overbite and inter-incisal angle. Removable appliances can produce worthwhile overbite reductions, but the final inter-incisal angle depends upon skeletal pattern. It is vital, therefore, to make an assessment of this factor when planning treatment for a Class II malocclusion.     

正畸治疗后稳定性探讨

目的：探讨影响正畸治疗后稳定性的相关因素。方法：采用PAR（peer assessment rating)指数对74例错He畸形患者正畸治疗后2－8年（平均50．5个月）的治疗前后及保持后模型进行评估分析。结果：（1）保持后，加权总分值的复发率为13．01％，牙齿排列、覆盖、覆He和后牙段横向He关系复发率分别为6．38％、15．56％、28．36％和22．41％。（2）保持后明显改善者从治疗后77．03％减至64．86％。PAR分值增加53例，分值不变6例，分值减少15例。（3）Begg矫治器保持后加权总值大于方丝弓矫治器（P＜0．05）。（4）安氏Ⅱ类错He保持后牙排列和总分值大于I类错He（P＜0．05）。（5）不对称拔牙组保持后加权总分值大于其他组（P＜0．01）。结论：（1）保持停止后，牙齿有回复到原来位置的倾向。牙齿排列、覆盖、 覆He和后牙段横向He关系复发较明显。（2）正畸治疗后的稳定性与矫治器、错He及拔牙类型有关。     

Congenital macroglossia: surgical and orthodontic management

ObjectivesA case of congenital macroglossia is reported. The most important sign of macroglossia is tongue protrusion through the lips. Tongue protrusion might influence skeletal growth and can cause anterior open bite, proclination of upper and lower incisors and development of diastemas.Materials and methodsA 4 year-old female patient was diagnosed with congenital macroglossia. Parents referred an abnormal tongue dimension since birth and the development of a progressive anterior open bite. The treatment of macroglossia included tongue reduction by partial glossectomy. She was seen regularly and at the age of eight years old a lingual frenectomy was performed and an orthodontic treatment was planned.ResultsAt the end of the orthodontic treatment a Class I occlusion was obtained with correct overbite and overjet values.ConclusionsEarly interception of macroglossia and surgical reduction in combination with orthodontic treatment can be seen as preventive measures to avoid the tongue influence on the development of malocclusions.     

Outcome of a scheme for orthodontic care: a comparison of untreated and treated 19-year-olds

The organization of the orthodontic service within the Public Dental Health Service in the southern part of the county of Halland, Sweden is described, and data for the provision of treatment are presented. The aim of this study was to examine the outcome of this service by studying the prevalence of malocclusion and residual need, as well as attitudes to treatment in previously treated and untreated individuals. Three samples of 19-year-olds were established: patients treated by specialists (n=132), patients treated by general practitioners (GP) (n=132), and untreated individuals (n=492). All samples were examined clinically, and radiographs, photographs, and study casts were obtained from the two treated groups. Attitudes to own teeth and orthodontic treatment were recorded by use of questionnaires. Deviant occlusal traits were recorded, and all the individuals were categorised according to a treatment need index. Generally, good occlusal conditions were observed in all samples. More deviant traits were observed in individuals that had been treated by GPs, and significant differences were observed for overjet, overbite, and crowding compared to the other samples. The majority of individuals belonged to the little/no treatment need index categories. Of those treated by GPs, one third belonged to the moderate (22%) or urgent (11%) need categories. About 10% reported dissatisfaction with their dental appearance, but only 2% expressed a desire for (further) orthodontic treatment.     

Mini-implants for en masse intrusion of maxillary anterior teeth in a severe Class II division 2 malocclusion

Abstract

This case report describes the treatment of a 16-year-old post pubertal male patient with a severe Class II division 2 malocclusion and 100% deep bite. In the first phase of treatment, a ‘Jones-Jig’ molar distalization appliance was used to distalize the maxillary molars by more than 6 mm, to achieve a Class I molar relation. In the second phase of treatment, mini-implants were inserted between the roots of the maxillary lateral incisor and canine to intrude all the maxillary anterior teeth en masse in a single step. Four millimetres of intrusion was achieved. The implants remained stable throughout treatment. In the mandibular arch the incisors were proclined to alleviate the severe crowding. Good overjet and overbite was achieved and has been maintained one year after completion of active orthodontic treatment.     

Stability of maxillary interincisor diastema closure after extraction orthodontic treatment

ObjectivesTo evaluate the stability of maxillary interincisor diastema closure and the relationship between space relapse and interincisor diastema width, overjet, overbite, angulations between adjacent maxillary anterior teeth and presence of intermaxillary osseous cleft after orthodontic treatment with extractions.Materials and MethodsTwenty-four individuals with a maxillary interincisor diastema pretreatment, treated with maxillary first premolar extractions were evaluated. Dental casts and panoramic radiographs taken at pretreatment (T1), posttreatment (T2), and posttreatment follow-up (T3) were assessed. Periapical radiographs at T1 and T2 were also evaluated. Diastema relapse was assumed when T3-T2 interincisor space change was greater than zero. Diastema relapse was considered clinically significant when it was at least 0.50 mm. Data were analyzed using repeated-measures analysis of variance followed by post hoc Tukey tests or Friedman followed by Wilcoxon tests. T-test or Mann-Whitney U-test, Pearson correlation coefficient, and multiple linear regression analyses were also performed.ResultsNo statistically significant relapse of maxillary interincisor diastemas was found. The percentage of clinically significant relapse of the maxillary interincisor diastemas was 27.78%. Specifically, for the interincisor midline diastema, it was 8.33%.ConclusionsMaxillary interincisor diastema closure showed no statistically significant relapse after orthodontic treatment with premolar extractions. Clinically significant stability for maxillary interincisor diastema closure was 72.22% and, specifically, for interincisor midline diastema closure, it was 91.67%.     

Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need

Early interceptive treatment for the elimination of factors inhibiting dental arch development and mandibular and maxillary growth is applied varyingly by orthodontists, possibly because there is little scientific evidence that such interventions are of actual benefit. The aim of this study was to determine specific factors for treatment need in the early mixed dentition period in order to obtain basic data to support early intervention. The study was part of a larger survey of 8768 children aged between 6 and 17 years. From this sample, 1975 children aged between 6 and 8 years were used to estimate the prevalence of malocclusions using the Index of Orthodontic Treatment Need (IOTN) during the early mixed dentition period. The results showed that deep overbite and overjet, both more than 3.5 mm, were the most frequent discrepancies, affecting 46.2 and 37.5 per cent of patients, respectively. An anterior open bite was registered in 17.7 per cent, crossbite in 8.2 per cent, and a reverse overjet in 3.2 per cent. A tooth width to arch length discrepancy was recorded in 12 per cent of teeth in the upper arch and in 14.3 per cent in the lower arch. The proportion of children estimated using the Dental Health Component of the IOTN to have a great or very great treatment need (grades 4 and 5) was 26.2 per cent. The higher values of treatment need during the mixed dentition period may account for temporary changes in the dentition and for the discrepancy in overjet and overbite. These discrepancies will be compensated in part during mandibular growth and development of the dental arch. Nevertheless, the findings indicate the early development of progressive malocclusion symptoms which are evidenced in the IOTN and concur with the acronym 'MOCDO' hierarchy (missing, overjet, crossbite, displacement, overbite). This early formation of progressive symptoms inhibiting or disturbing mandibular or maxillary growth or the development of the normal dental arch, i.e. crossbite, reverse overjet and increased overjet with myofunctional disorders, should be treated at an early stage.     

Malocclusion and treatment need in children and adolescents with sickle cell disease

Objective:To assess the prevalence of malocclusion and treatment need in children and adolescents with sickle cell disease (SCD).Materials and Methods:In this cross-sectional study, the sample size comprised 35 five-year-old children and 36 adolescents of both sexes, aged between 12 to 18 years, with SCD. Dental occlusion was assessed using two indexes: the Malocclusion Index (World Health Organization) and the Dental Aesthetic Index (DAI).Results:The prevalence of malocclusion in the preschool children was 62.9%. The main malocclusions observed in this age group were Class II (37.1%), increased overjet (28.6%), reduced overbite (28.6%), and open bite (17.1%). In the 12- to 18-year-old subjects, the prevalence of malocclusion was 100%, and the most prevalent types of malocclusion were maxillary overjet (63.9%) and maxillary misalignment (58.3%). It is noteworthy that the majority of adolescents (80.6%) had very severe or disabling malocclusions.Conclusion:The results revealed a high prevalence of malocclusion in children and adolescents with SCD. According to DAI score, the majority of the sample presented with very severe malocclusion and a compulsory treatment need.     

Oral habits in a group of consecutively treated orthodontic patients,using standardized video recordings for diagnosis

Abstract

Objective. To investigate the prevalence and correlation of soft tissue dysfunctions documented by standardized video recordings in a group of orthodontic patients and to evaluate orthodontic treatment changes. Subjects and methods. The presence of an oral habit was evaluated from standardized pre- and post-treatment video recordings of 80 consecutive patients (30 boys and 50 girls, mean age 12.2 ± 1.7 years). Any digit-sucking habit was noted during a routine interview. Pre- and post-treatment cephalograms were traced to assess sagittal and vertical jaw and incisor relationships. Correlations and differences were tested for statistical significance using the t-test and Odds-ratio. Results. 56.3% had one or more habits before treatment. The total prevalence fell during treatment. A clear correlation was found between digit sucking and atypical tongue activity. Pre-treatment cephalograms showed that patients with a habit had a larger overjet, smaller overbite, more proclined and protruded incisors, a greater ANB angle and a greater inter-maxillary angle (ML/NL) than those without a habit. Cephalometric differences between the groups after orthodontic treatment were much less pronounced. Those with an oral habit also showed a tendency for increased treatment time/number of visits. Conclusions. Standardized video recordings improved the reliability of the recordings of the oral soft tissue dysfunctions. Their overall reduction after the end of orthodontic treatment coincided with a normalization of the sagittal skeletal and dental variables.     

Malocclusion and orthodontic treatment need evaluated among subjects with Down syndrome using the Dental Aesthetic Index (DAI)

Objective:To determine the prevalence of malocclusion and need for orthodontic treatment among persons with Down Syndrome (DS).Materials and Methods:Study participants were 113 persons with DS from the selected community-based rehabilitation center who fulfilled the inclusion and exclusion criteria. Ten occlusal characteristics of the Dental Aesthetic Index (DAI) were measured on study models to determine the degree of malocclusion. A single score represented the dentofacial anomalies, determined the level of severity, and determined the need for orthodontic treatment.Results:Crowding in the anterior maxillary and mandibular arch was the main malocclusion problems among the subjects with DS. Comparison between age group and genders revealed no significant differences in four categories of orthodontic treatment need (P > .05).Conclusion:Most of the subjects with DS (94; 83.2%) had severe and very severe malocclusion, which indicated a desirable and mandatory need for orthodontic treatment.