The effect of overbite and overjet on clinical parameters of periodontal disease: A case control study

AimTo investigate the association of overjet and overbite with clinical parameters of periodontal disease.Material and methodsThe study was performed in Riyadh, Saudi Arabia, from March 2017 to March 2018. 600 Saudi males aged 20–30 years old were included. Participants were divided into three groups (n: 200) depending on the presence of overjet (OJ) or overbite (OB) and its relationship with periodontal disease. Periodontal parameters were assessed clinically and radiographically. One-way analysis of variance was used to test for any significant differences between groups. Tukey’s post hoc comparison test was used to evaluate correlations among parameters.ResultsOJ exceeding 8 mm was correlated with debris, calculus, and periodontal scores on mandibular anterior teeth, especially on the lingual surfaces.Both OJ and OB groups showed significantly increased PD, compared to that of the control group in measurement at the lingual (P = 0.004, 0.003) and proximal (P = 0.002, 0.002) surfaces of the lower anterior teeth. Finally, the CEJ-AB was statistically significantly higher in the OB group compared to the OJ and control groups (P = 0.091, 0.008).ConclusionThe present study found a correlation between OJ and OB and periodontal disease, as measured using specific parameters. This indicates that periodontal treatment may be insufficient unless the overjet or overbite is corrected.     

Occlusal traits in a group of school children in an isolated society in Jerusalem.

Abstract

The prevalence of occlusal features in 939 children, aged 6-13 years, belonging to an ultra-orthodox community of Jewish Ashkenazi descent living in Jerusalem was studied clinically. Sexual dimorphism was found for overjet, overbite, and habit practising. About one-quarter of the sample exhibited some degree of occlusal mutilation due to caries, thus creating a 'caries-affected' subgroup, the rest forming the 'caries-free' subgroup. In the latter set, normocclusion was scarce (7.4 per cent), Class I being the most frequent malocclusion (49.1 per cent). Caries had a significant effect on the symmetry of bilateral occlusal relationships, lower dental midline deviation, and on crowding/spacing conditions in the mixed dentition stage (except for the maxilla in late mixed dentition). The low prevalence of normocclusion can be attributed to genetic background, environmental influences and the definition attached to normal occlusion.     

Occlusal changes from adolescence to adulthood in untreated patients with Class II Division 1 deepbite malocclusion

A sample of 47 untreated children (M 32:F 15) with Class II Division 1 (II/1) deep-overbite malocclusion was collected from a group of patients who declined orthodontic therapy. Longitudinal records consisted of plaster dental casts and lateral cephalograms at original diagnosis and plaster dental casts at a follow-up observation in adulthood, an average of 11.5 years later. To study retrospectively natural changes in dental occlusion during this interval, plaster-cast millimetric measurements were recorded of sagittal dental relationships (first molar and canine), overjet, overbite, and crowding/spacing at the two registrations. Results showed statistically significant improvements in untreated II/1 deepbite malocclusion from adolescence to adulthood for all measured occlusal variables except development of mild crowding. Therefore, assumptions that untreated II/1 distoclusion will worsen with age appear to be unfounded. The evidence indicates that the absence of orthodontic correction for adolescent patients with Class II Division 1 deepbite malocclusion will not usually lead to measurable occlusal deterioration in young adulthood.     

Prevalence of malocclusion among children of the Kingdom of Saudi Arabia – A systematic review and meta-analysis

ObjectiveSystematic review and meta-analysis are of a great tool in assessment of malocclusion, which is major public health concern. This study aims to explore the prevalence of malocclusion among the children of the Kingdom of Saudi Arabia through a meta-analysis and systematic review.Materials and methodsRegistered with PROSPERO as CRD42020198427, an authentic and global scale database search using relevant MeSH (Medical Subject Headings) terms was performed. Literature search and articles screening done following PRISMA guidelines.For the dichotomous variables, 95% confidence intervals (CIs) were set for statistical data analysis. The heterogeneity index between the studies was determined using indices Tau², Chi², df and I² and Test for overall effect as Z.ResultsA total of 7930 candidates were reported to have either one of the three malocclusions. Prevalence of Class I, Class II and Class III Malocclusions were found to be 66.51%, 17.70%, 15.79% respectively. Among the small subsample of these candidates, male children with Class I, Class II and Class III Malocclusion were 43.80%, 12.27% and 7.40% respectively whereas female children were 22.07%, 10.93 %, 3.52 % respectively.ConclusionsAccording to the 26 studies included in the systematic review, there were 72% of the candidates with malocclusion in Saudi Arabia. Prevalence of Class I, Class II and Class III malocclusion were 66.51%, 17.70%, and 15.79% respectively. In both male and female participants, the prevalence of Class I was the highest followed by class II and III malocclusion.     

Prevalence of Defined Symptoms of Malocclusion among Probands Enrolled in the Study of Health in Pomerania (SHIP) in the Age Group from 20 to 49 Years

SUBJECTS AND METHODS: SHIP is a complexly structured, population-based cross-sectional study of adults in the German region of Pomerania (age group covered: 20-79 years). Findings in a population subgroup (age group 20-49 years; n = 1777; 53.1% women; 46.9% men) were subjected to orthodontic evaluation. Graduated registration of anterior crowding, overjet, frontal overbite and sagittal intermaxillary relationship of the posterior teeth; registration of ectopic canines, posterior crowding, anterior and posterior crossbite, negative overjet, retroclination of the upper incisors, buccal nonocclusion, and lateral open bite. The prevalence of almost regular dentition and of symptoms of malocclusion as well as the frequency of orthodontic treatment (subjective patient data) undergone by men and women were recorded. The correlation between the registered symptoms of malocclusion was calculated. RESULTS: 92.2% of the subjects had symptoms of malocclusion varying in number and severity. An anatomically correct dentition was found in only 7.8% of cases, and an "almost regular dentition" (inclusion criteria defined) in 14.2%. 32.8% of the subjects had severe malocclusion (inclusion criteria defined). The most frequent symptoms were anterior crowding, increased overjet, and distoclusion. These symptoms were significantly more frequent in women, while spacing and edge-to-edge bite, excessive overbite and mesioclusion were more frequent in men. 26.7% of the probands (28.0% women, 25.3% men) reported having received orthodontic treatment. The prevalence of craniofacial malformations (cleft lip and palate, syndromes) was 0.09% in women and 0.2% in men. Increased overjet was most frequently correlated with other symptoms of malocclusion.     

Prevalence of malocclusion among children of the Kingdom of Saudi Arabia – A systematic review and meta-analysis

ObjectiveSystematic review and meta-analysis are of a great tool in assessment of malocclusion, which is major public health concern. This study aims to explore the prevalence of malocclusion among the children of the Kingdom of Saudi Arabia through a meta-analysis and systematic review.Materials and methodsRegistered with PROSPERO as CRD42020198427, an authentic and global scale database search using relevant MeSH (Medical Subject Headings) terms was performed. Literature search and articles screening done following PRISMA guidelines.For the dichotomous variables, 95% confidence intervals (CIs) were set for statistical data analysis. The heterogeneity index between the studies was determined using indices Tau², Chi², df and I² and Test for overall effect as Z.ResultsA total of 7930 candidates were reported to have either one of the three malocclusions. Prevalence of Class I, Class II and Class III Malocclusions were found to be 66.51%, 17.70%, 15.79% respectively. Among the small subsample of these candidates, male children with Class I, Class II and Class III Malocclusion were 43.80%, 12.27% and 7.40% respectively whereas female children were 22.07%, 10.93 %, 3.52 % respectively.ConclusionsAccording to the 26 studies included in the systematic review, there were 72% of the candidates with malocclusion in Saudi Arabia. Prevalence of Class I, Class II and Class III malocclusion were 66.51%, 17.70%, and 15.79% respectively. In both male and female participants, the prevalence of Class I was the highest followed by class II and III malocclusion.     

上海市浦东新区青少年错牙合畸形调查分析

目的了解上海市浦东新区生长发育期青少年错牙合畸形的患病情况，重点了解牙列拥挤、前牙深覆合覆盖和前牙反牙合的患病率。方法按Ａｎｇｌｅ分类法进行分类，以个别正常牙合和错牙合分类为标准。结果错牙合畸形的患病率替牙期为４４．０２％，恒牙期为４８．７８％。牙列拥挤、前牙深覆合覆盖和前牙反牙合的患病率替牙期分别为２２．７４％、１７．１８％和４．４４％；恒牙期分别为３２．３６％、１１．０６％和４．０７％。结论上海市浦东新区生长发育期青少年错牙合畸形的患病率替牙期与恒牙期无明显差异。提示前牙深覆合覆盖和前牙反牙合的患者并伴有上下颌骨异常需尽早矫治，以改善牙合颌关系。     

Diagnostic criteria for pseudo-Class III malocclusion.

The aim of this study is to identify the diagnostic criteria for pseudo-Class III malocclusion and compare it with Class I malocclusion in the southern Chinese population. Sixty-seven patients (mean age, 10.9 +/- 1.8 years) were included in this study; 36 patients represented pseudo-Class III malocclusion. Selection criteria included the following: (1) anterior crossbite (at least 2 incisors with negative overjet and overbite); (2) mandibular displacement; (3) all patients were southern Chinese who had been followed after the growth spurt, none had developed a skeletal Class III malocclusion; (4) the patients were treated for an average of 7 months to procline upper incisors and retrocline lower incisors. None of the cases received any treatment that might affect skeletal growth. Thirty-one patients with Class I malocclusion were included in the Class I malocclusion group for the comparison of dentoskeletal characteristics with the pseudo-Class III malocclusion group. Selection criteria included the following: (1) skeletal Class I malocclusion with normal overjet and overbite, (2) mild to moderate crowding with Class I molar relationship, (3) straight facial profile. The following were included in the assessment of pseudo-Class III malocclusion cases: (1) family history, (2) molar and canine relationships at habitual occlusion and centric relation, and (3) dentoskeletal morphology. The results were that 72% of the examined cases in the pseudo-Class III malocclusion group showed no family history and 75% showed Class I molar relationship at habitual occlusion. Compared with the Class I malocclusion group, subjects in the pseudo-Class III malocclusion group showed a significantly decreased midface length, increased maxillary-mandibular difference, more retroclined upper incisors, and a retrusive upper lip. In conclusion, a pseudo-Class III malocclusion is characterized by retroclined upper incisors, retrusive upper lip, decreased midface length, and increased maxillary-mandibular difference. Findings of this study showed that patients with a pseudo-Class III malocclusion exhibit certain morphologic, dental, and skeletal characteristics that should be of aid in the diagnosis of pseudo-Class III malocclusion.     

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.     

上海市浦东新区青少年错He畸形调查分析

目的 了解上海市浦东新区生长发育期青少年错Ｈｅ畸形的患病情况,重点了解牙列拥挤、前牙深覆合覆盖和前牙反Ｈｅ的患病率。方法 按Ａｎｇｌｅ分类法进行分类,以个别正常Ｈｅ和错Ｈｅ分类为标准。结果 错Ｈｅ畸形的患病率替牙期为４４．０２％,恒牙期为４８．７８％。牙列拥挤、前牙深覆合覆盖和前牙反Ｈｅ的患病率替牙期分别为２２．７４％、１７．１８％和４．４４％;恒牙期分别为３２．３６％、１１．０６％和４．０７％。     

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.     

Dentoskeletal effects produced by a Jasper Jumper with an anterior bite plane

Objective:The aim of this retrospective study was to evaluate the dentoskeletal effects produced by a modified Jasper Jumper with an anterior bite plane for the correction of Class II division 1 malocclusion.Materials and Methods:A sample of 32 growing patients (mean age  =  11.9 ± 1.4 years) with Class II division 1 malocclusion and increased overbite were treated with a modified Jasper Jumper (JJ) and anterior bite plane protocol and compared with a matched control group of 30 subjects with untreated Class II malocclusion (mean age 12.2 ± 0.8 years). Lateral cephalograms were taken before treatment (T1) and at the end of comprehensive treatment (T2). Mean treatment duration was 2.1 ± 0.4 years. The T1–T2 changes in the two groups were compared with Student’s t-tests for independent samples.Results:The JJ group was successfully treated to a Class I occlusal relationship with a significant reduction in overjet (–3.9 mm, P < .001) and overbite (–3.1 mm, P < .001). The JJ group exhibited a significant increase in mandibular length and a significant improvement in maxillomandibular sagittal skeletal relationships. The lower incisors were significantly proclined, while the lower first molars demonstrated significant movement in a mesial direction.Conclusions:Use of a modified JJ appliance and anterior bite plane is an effective protocol for the treatment of Class II malocclusion with increased overbite and greater skeletal (75%) than dentoalveolar (25%) effects mainly at the mandibular level.     

An American Board of Orthodontics case report

A case report is presented of a Class II, Division 1 malocclusion with severe overjet and deep overbite with crowding and irregularities of the anterior teeth. The case was treated according to the standards of the American Board of Orthodontics.     

A comparison of second premolar extraction and mini-implant total arch distalization with interproximal stripping

Objective:The effect of total arch distalization using orthodontic mini-implants (OMIs) combined with interproximal stripping (IPS) and second premolar extraction was investigated in Class I malocclusion patients.Materials and Methods:A total of 66 consecutively treated Class I malocclusion (Class I molar relationship; 0 mm < overbite and overjet < 4.5 mm) patients ranging in age from 17 to 44 years who received single-phase treatment were included in this study. Pre- and posttreatment lateral cephalograms and dental casts were measured and compared statistically.Results:In the distalization with IPS group, 3.6 mm and 3.8 mm of crowding in the upper and lower arches, respectively, were resolved, and 3.8 mm and 3.2 mm of upper and lower incisor retraction, respectively, were achieved simultaneously by the treatment. As a result of the second premolar extraction treatment, 3.9 mm and 3.6 mm of crowding in the upper and lower arches, respectively, were resolved, and 3.3 mm and 3.2 mm of incisor retraction, respectively, were achieved during treatment. There was no statistically significant difference in the amount of crowding and incisor retraction between the two groups.Conclusions:Total arch distalization using an OMI with IPS did not yield a significantly different treatment result compared to second premolar extraction treatment.     

Overjet,overbite and dental midline shift as predictors of tooth size discrepancy in a Bangladeshi population and a graphical overview of global tooth size ratios

Abstract

Objectives. This study aimed to measure and compare tooth size ratios in a Bangladeshi population across the following groups: those with normal occlusion, crowding or spacing; those with normal, increased or decreased overjet; those with normal, increased or decreased overbite; those with or without dental mid-line discrepancy; and those with or without lip competence. It also presents a graphical overview of the anterior and overall ratios from the study and using available global data. Materials and methods. This study was performed on dental casts of 260 Bangladeshi individuals, comprising 114 males and 146 females (age range, 18–24 years, mean age = 20). The Bolton anterior ratio and overall ratio were determined for the following groups: those with normal occlusion, crowding or spacing; those with normal, increased or decreased overjet; those with normal, increased or decreased overbite; those with or without dental mid-line discrepancy; and those with or without lip competence. Results. There were statistically significant differences in the anterior tooth size ratios between those with or without dental mid-line discrepancy, with a mean value of 78.83% and 80.05%, respectively. Statistically significant differences were also found in overall tooth size ratios between those with normal, increased or decreased overjet and also between those with normal, increased or decreased overbite. Graphical presentations of anterior and overall ratios from the present study and using global data showed variations between populations. Conclusion. In the Bangladeshi population, increased tooth size ratios in subjects with dental mid-line discrepancy (anterior ratio) and also in those with decreased overjet or decreased overbite (overall ratio) may be predictors of tooth size discrepancies. The graphical overview also suggests that different international ethnic groups display unique Bolton ratios.     

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.     

Treatment and posttreatment effects induced by the Forsus appliance: A controlled clinical study

Objective:To evaluate treatment and posttreatment dentoskeletal effects induced by the Forsus device (FRD) in growing patients with Class II malocclusion in a retrospective controlled clinical study.Materials and Methods:Thirty-six Class II patients (mean [SD] age 12.3 [1.2] years) were treated consecutively with the FRD protocol and compared with a sample of 20 subjects with untreated Class II malocclusion (mean [SD] age 12.2 [0.9] years). Lateral cephalograms were taken at the beginning of treatment, at the end of comprehensive treatment (after 2.3 ± 0.4 years), and at a postretention period (after 2.3 ± 1.1 years from the end of comprehensive treatment). Statistical comparisons were carried out with the unpaired t-test and Benjamini-Hochberg correction (P < .05).Results:After comprehensive treatment, the FRD sample showed a significant restriction of the sagittal maxillary growth together with a significant correction in overjet, overbite, and molar relationship. During the overall observation interval, the FRD group exhibited no significant sagittal or vertical skeletal changes, while significant improvements were recorded in overjet (−3.8 mm), overbite (−1.5 mm), and molar relationship (+3.7 mm).Conclusion:The FRD protocol was effective in correcting Class II malocclusion mainly at the dentoalveolar level when evaluated 2 years after the end of comprehensive treatment.     

Digital images as an alternative to orthodontic casts in assessing malocclusion and orthodontic treatment need

Objective. To investigate the potential use of two-dimensional digital images as an alternative to orthodontic casts in the assessment of malocclusion and orthodoantic treatment need. Material and Methods. Assessment of malocclusion (Angle's classification of molars, overjet, and overbite) and orthodontic treatment need (Index of Orthodontic Treatment Need (IOTN): Dental Health Component (DHC) and Aesthetic Component (AC)) was conducted on 313 study casts and their images by two trained and calibrated examiners. Agreement of orthodontic treatment need and Angle's molar classification was assessed employing Kappa statistics (κ). Agreement of overjet and overbite (measured in mm) was assessed in comparison and correlation analyses. Inter- and intra-examiner reliability of assessment was investigated. Results. There was substantial agreement of the molar relationship classifications (κ >0.70), orthodontic treatment need as assessed by IOTN-DHC (κ =0.79) and IOTN-AC (κ =0.56) between measurements obtained from orthodontic casts and their images. There was also substantial agreement of measurements of overjet and overbite as obtained from orthodontic casts and their images. The standardized directional differences of overjet and overbite were ≤0.2. The intra-class correlation coefficients of assessments of overjet and overbite obtained from orthodontic casts and their images were >0.90. Inter- and intra-examiner reliability for the assessment of malocclusion and orthodontic treatment need was acceptable. Conclusion. Two-dimensional digital images can be used as an alternative to casts in assessment of malocclusion and orthodontic treatment need.     

替牙期假性安氏Ⅲ类错He的牙颌特征

目的研究替牙期假性安氏III类错(牙合)的牙颌特征,为早期诊断提供依据.方法假性安氏III类错(牙合)组包括替牙期拍摄的36张头颅侧位片.该组为追踪观察至生长发育期后确定为假性安氏III类错(牙合)的患者(女15名,男21名),替牙期拍摄头颅侧位片时的平均年龄为10.7±2.0岁.选择标准为①安氏Ⅰ类磨牙关系,前牙反(牙合);②功能性下颌前移位.真性安氏III类错组包括替牙期拍摄的40张头颅侧位片.该组为追踪观察至生长发育期后确定为真性安氏III类错并接受正颌手术治疗的患者(女21名,男19名),替牙期拍摄头颅侧位片时的平均年龄为9.7±2.2岁.选择标准为安氏III类磨牙关系,前牙反(牙合).安氏Ⅰ类错(牙合)组包括31名安氏Ⅰ类错(牙合)患者(女17名,男14名),平均年龄为11.2±1.4岁.选择标准为①安氏Ⅰ类骨面型,②覆(牙合)覆盖正常,③轻度或中度牙列拥挤,④正中(牙合)位时为直面型.结果假性安氏III类错组中,女性"A"点到N perp的距离平均值为-1.63mm,与安氏Ⅰ类错(牙合)女性平均值0.52 mm相比,差异有显著性(P＜0.05).假性安氏III类错(牙合)组上切牙较直立.结论替牙期假性安氏III类错(牙合)组的牙颌特征为①面中部长度(Co-A)稍短,②下颌功能性前移位,但下颌长度正常,③上前牙舌倾,下前牙倾斜度正常,④垂直向生长发育正常.     

Predicted versus executed surgical orthognathic treatment

ObjectivesThis study aimed to analyse combined surgical-orthodontic treatment plans, compare them with the actual surgery performed, and define factors resulting in changes of the original plan during orthodontic pre-surgical preparation.Study designThe clinical files of 312 orthognathic surgery patients, operated between January 2008 and December 2010, were retrospectively reviewed. Of these 312 patients, 129 had a bimaxillary operation. One hundred sixty patients had osteotomy of the lower jaw only and 23 had osteotomy of the upper jaw only. Factors analysed in the study include Angle Class malocclusion, patient sex, and age. Lip-to-incisor relationship, overjet, overbite and midline deviations of the upper and lower jaw were recorded. Effects of surgical assisted rapid palatal expansion (SARPE) on the eventual surgery were also investigated. Reasons for changing the original treatment plan at the time of the finished pre-surgical-orthodontic alignment were analysed.ResultsThe original treatment plan was changed in 42 of the 312 patients (13.5%). Changes occurred generally in case of a larger interval between set-up of the first treatment plan and the eventual operation (average 22.4 versus 16.4 months for patients with changed versus unchanged treatment plan, respectively). All Class I patients had surgery performed as planned. Class III patients had a significantly higher rate of altered treatment plan (27.3%) than Class II patients (7.6%). More men (52.4%) saw their treatment plan changed, although there were more women than men in the study population (59.6 versus 40.4%).ConclusionOne in seven patients (13.5%) had a different operation than was planned at the start of treatment. Class III patients with small overjet and overbite commonly have a treatment plan for a monomaxillary operation that, after decompensation, needs to be adapted to a bimaxillary operation.