基于牙美学指数对青年人群正畸需要的评估

目的：使用牙美学指数评估青年人群的正畸需要,并分析牙外观自我评估值同牙美学指数分值之间的关系。方法：358名大学生参加了牙美学指数检查,同时每位被调查者使用视觉模拟量表对牙外观进行自我评估。对牙美学指数分值和牙外观自我评估进行简单线性相关分析,并基于牙美学指数分组对牙外观自我评估进行秩合检验。结果：37.7%的被调查对象牙美学指数分值≥31,属于需要正畸治疗人群。牙美学指数与牙外观自我评估间呈中度负相关（P〈0.001）,基于牙美学指数分组对牙外观自我评估进行秩合检验表明4组间得分差异有统计学意义（P〈0.001）。结论：本样本中,37.7%的被调查对象需要正畸治疗;牙美学指数与牙外观自我评估呈反向关系。表明牙美学指数可用于青年人群口腔健康相关生活质量的相关研究。     

Assessment of orthodontic treatment needs in Brazilian schoolchildren according to the Dental Aesthetic Index (DAI)

OBJECTIVE: To assess the distribution, prevalence and severity of malocclusion and orthodontic treatment needs in schoolchildren from the northeast of Brazil aged between 13 and 15 years. RESEARCH DESIGN: Cross-sectional study. PARTICIPANTS: A sample of 600 adolescents (264 males and 336 females) randomly selected and representative of schoolchildren living in Recife (Brazil) was obtained from 12 public schools. METHOD: The need for orthodontic treatment was measured using the Dental Aesthetic Index (DAI). RESULTS: Most of the subjects (77%) were deemed to require orthodontic treatment. Only about 5.8% had a handicapping malocclusion that needed mandatory treatment. A severe malocclusion for which treatment was highly desirable was recorded in 47.5% of the adolescents and 23.7% had a definite malocclusion for which treatment was elective. Three main occlusal features were responsible for allocating subjects into the group of "orthodontic treatment required": crowding (47.3%), tooth loss (22.3%) and maxillary overjet of more than 3 mm (21.8%). There were no significant differences (p > 0.05) in mean DAI scores between males and females. CONCLUSIONS: 77% of adolescents from northeast Brazil were in need of orthodontic treatment for dental health reasons. The distribution of DAI scores among Brazilian adolescents is different from that reported in other populations. This study provides baseline data on the need and demand for orthodontic treatment among Brazilian students.     

Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the Dental Aesthetic Index

OBJECTIVE: To evaluate the prevalence of malocclusion and orthodontic treatment need among Spanish adolescents and compare with other populations. METHODS: The study sample comprised 744 schoolchildren from urban and rural populations in Granada province (Southern Spain), aged from 14-20 years, who had received no orthodontic treatment. The measurement instrument was the Dental Aesthetic Index (DAI). RESULTS: The mean DAI score of the whole series was 25.6 (SD, 7.94). The distribution of the four DAI grades was: DAI 1, no anomaly or malocclusion, 58.6%; DAI 2, definite malocclusion, 20.3%; DAI 3, severe malocclusion, 11.2%; DAI 4, very severe or disabling malocclusion, 9.9%. There were no statistically significant differences in DAI score between genders or those in rural vs. urban residence, but a significant difference was found between social classes, with subjects of low social class presenting the worst scores (p<0.05). CONCLUSION: The distribution of DAI scores among Spanish adolescents is similar to that reported in other populations.     

Orthodontic treatment needs: comparison of two indices.

The Index of Orthodontic Treatment Needs (IOTN) and the Dental Aesthetic Index (DAI) were developed and both claimed to contain the aesthetic and dental components in their criteria of assessing malocclusion. This study was undertaken to assess the reliability of these two indices in assessing orthodontic treatment needs. The indices were applied to 120 pre-treatment study models selected from orthodontic patient records treated at the Department of Orthodontics, University of North Carolina, United States of America. The sample consisted of 60 African-Americans (Black) and 60 American Caucasians (White), age ranged from 12 to 16 years (Mean 13.8). The results showed that the IOTN and the DAI were highly correlated and highly associated statistically (p < 0.0001). The findings of this study indicated that the two indices could be used consistently to identify orthodontic treatment needs in different ethnic groups and are capable of classifying the subjects according to their malocclusion severity for those subjects eligible for treatment in fund constrained situation.     

Establishing malocclusion severity levels on the Dental Aesthetic Index (DAI) scale

The Dental Aesthetic Index (DAI) is an orthodontic index based on socially defined aesthetic standards. It is useful in both epidemiological surveys to identify unmet need for orthodontic treatment and as a screening device to determine priority for subsidized orthodontic treatment. An earlier study established the score of 36 on the DAI scale to identify handicapping malocclusions. The purpose of the present study was to determine decision points on the DAI scale that identify malocclusion severity levels less severe than handicapping. Two sources of data were used: 1) The frequency distribution of DAI scores on a probability sample of 1306 study models representing the untreated occlusions found in half a million adolescents. 2) The per cent distribution of US youths aged 12–17 by specified case severity reported in an assessment of the occlusion of youths? by the National Center for Health Statistics (NCHS). The decision points separating specific case severities on the DAI scale were determined by relating the proportions of the NCHS population with specified case severities to the cumulative percentages of the frequency distribution of DAI scores on the 1306 models. The NCHS report found 45.8 per cent of the sample to have normal or minor malocclusion with no need or slight need for treatment. DAI scores 25 and below corresponded to that proportion of the sample. The NCHS report found 25.2 per cent of the sample to have definite malocclusion with treatment being elective. DAI scores between 26 and 30 corresponded to that proportion of the sample. The NCHS report found 13 per cent of the population to have severe malocclusion with treatment highly desirable. Fifteen per cent were included in this category. DAI scores 31 to 35 corresponded to that proportion of the sample.     

An assessment of relationship between self-esteem,orthodontic concern,and Dental Aesthetic Index (DAI) scores among secondary school students in Ibadan,Nigeria

OBJECTIVE: To ascertain the correlation between self-esteem, orthodontic concern and orthodontic status using DAI scores in a group of Nigerian potential orthodontic patients. DESIGN: A cross-sectional analytical study. SETTING: Secondary schools reflecting a good socio-economic spread of adolescents in the town. PARTICIPANTS: Randomly selected 520 junior and senior students 276 (53.1%) males and 244 (46.9%) females with mean age of 15.02 +/- 3.26 (SD) years participated in the study. METHODS: Each student was asked to fill in the questionnaire on orthodontic concern and Global Negative Self-Evaluation scale (GSE) with subsequent assessment of the occlusion according to the DAI by one orthodontist. After obtaining consent, thirty students were re-examined to test intra-examiner reliability which was good (r = 0.98, P < 0.001). RESULTS: The correlations between self-esteem, orthodontic concern and DAI scores were tested using Spearman rank order correlation coefficient. Significant positive correlations were observed between self-esteem and orthodontic concern according to DAI treatment category needs (r = 0.274, p<0.01; r = 0.396, p<0.01; r = 0.347, p<0.05) except for the severe malocclusion group which was positive but not statistically significant (r = 0.136, p> 0.05). Significant correlation was equally noted between DAI scores and orthodontic concern (r = 0.191, p<0.01). CONCLUSION: Significant positive correlation existed between self-esteem in a group of Nigerian adolescents and their orthodontic concern as well as between their DAI scores and orthodontic concern. DAI should be a relevant and useful occlusal index for the Nigerian orthodontic population.     

Is the Child Perceptions Questionnaire for 11–14 year olds sensitive to clinical and self‐perceived variations in orthodontic status?

OBJECTIVES: To assess the association between scores on the Child Perceptions Questionnaire for 11-14 year olds (CPQ11-14) and clinical and self-perceived measures of malocclusion. METHODS: Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the CPQ11-14 and a short questionnaire concerning their feelings about the condition of their teeth. Study models were taken and rated according to the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index by two sets of three examiners. Intra and inter-rater reliabilities for the two sets of examiners ranged from 0.80 to 0.99. CPQ11-14 scores were calculated for the full 35-item version and for 16 and 8-item short forms by summing the item response codes. The association between these scores, the DAI and PAR ratings and self-perceived measures of malocclusion were examined using appropriate parametric and nonparametric tests. RESULTS: Complete data were collected for 141 children, 63 boys and 78 girls. The mean age was 12.5 (SD = 1.0). DAI scores ranged from 17.0 to 58.0 with a mean of 35.0 (SD = 8.0). The distribution of subjects across the four severity categories was minor/none - 6.6%, definite - 35.2%, severe - 15.6% and handicapping 42.6%. PAR scores ranged from 8.0 to 66.0 with a mean of 31.4 (SD = 11.1). Eight percent had scores of 50 or above indicating marked deviation from an ideal occlusion. Both the long and the short forms of the CPQ11-14 identified substantial variability in the impacts of malocclusion. Correlations between CPQ11-14 scores and the orthodontic indices ranged from 0.26 to 0.31 (P < 0.01). There was a clear gradient in CPQ11-14 scores across four categories of the PAR based on quartiles. The gradient across the DAI categories was less clear. There were significant associations between all CPQ11-14 scores and the children's self-ratings of oral health, ratings of the extent to which the condition of the teeth affected life overall and expressions of happiness with the appearance and arrangement of the teeth. CONCLUSION: The results provide some evidence of the validity of the CPQ11-14 when used with children needing orthodontic treatment. However, because clinical samples are biased the study needs to be repeated in different treatment settings in order to confirm the utility of the measure.     

Orthodontic concern of parents compared with orthodontic treatment need assessed by Dental Aesthetic Index (DAI) in Ibadan, Nigeria.

The purpose of this study was to investigate the concerns for orthodontic treatment by parents of adolescents in Ibadan, Nigeria for their children, and to compare the observations with objectively determined orthodontic treatment need using DAI. A total of 271 students aged 12-18 years (mean 14.8 +/- 1.1) drawn from five secondary schools in Ibadan were clinically examined while their parents were asked about their opinions in a questionnaire. About 61.3% of the adolescents had normal or minor malocclusions needing no treatment. The rest needed orthodontic treatments ranging from definite to mandatory treatment needs. No sex difference was noted (P > 0.05). Their psychosocial treatment need indicated by parental orthodontic concern revealed that 86% of them needed no orthodontic treatment. Most parents (87.1%) perceived dental aesthetics to be equally important for girls and boys and no sex difference was observed in their orthodontic concern (P > 0.05). Parents orthodontic concern had significant weak correlation with DAI scores. The results suggest a need for more orthodontic awareness in our community and confirm that there is a difference of opinion on orthodontic treatment need between laypersons and orthodontists, as would be expected.     

Prevalence of malocclusion in high school students in Japan according to the Dental Aesthetic Index

Abstract – The Dental Aesthetic Index (DAI) was used to evaluate malocclusion in Japanese high school students ( n = 409, ages 15–18 yr). The purpose of this study was to obtain basic data concerning malocclusion in Japanese high school students. This study used a sample of students from randomly selected urban and rural high schools in Japan's Kyushu district. The DAI scores for urban and rural high school students, as well as the total DAI scores from these two areas were significantly higher than that of American high school students. These results showed that the number of students with an acceptable dental appearance among Japanese high school students is significantly lower than among American high school students. This indicates a higher need for orthodontic treatment among Japanese high school students.     

Age changes in orthodontic treatment need: a longitudinal study of 10- and 13-year-old children,using the Dental Aesthetic Index

The Dental Aesthetic Index (DAI) was used to assess the prevalence of unmet orthodontic treatment need in 150 13-year-old schoolchildren in Dunedin, New Zealand, and to compare the findings with those obtained in the same children at 10 years of age. Fewer 13-year-olds (27%) had a "mandatory" need of orthodontic treatment than when they were 10 years old (33%), 20% had "no/little" need for orthodontic treatment, 33% had an "elective" need for treatment and 20% had a "desirable" need for treatment. The fall in DAI scores is attributed to over-sensitivity of the Index to mixed dentition traits. When the individual scores were analysed, only 7% of the 10-year-olds were given the same scores as when they were 13 years old, 52% were given higher scores and 41% were given lower scores. This disagreement between scores was masked to a limited extent by the DAI categories: 49% of the 10-year-olds were assigned to the same DAI category at 13 years of age, 20% to a greater treatment-need category and approximately 30% to a lower treatment-need category. The DAI, in common with other malocclusion indices, is unreliable over time because it is affected by developmental changes in the occlusal traits measured.     

Malocclusion and TMJ disorders in teenagers from private and public schools in Mexico City

Objective: To identify, among Mexican teenagers from public and private schools, the frequency, severity of malocclusion and orthodontic treatment needs, and their possible association with temporomandibular joint disorders. Material and Methods: Fifteen-year-old students were recruited from public and private schools. Clinical findings were registered as follows: oral hygiene status with the Oral Hygiene Index-Simplified, malocclusion using the Dental Aesthetic Index (DAI), and TMJ disorders following WHO criteria. Negative binomial and logistic regression models were constructed for data analysis. Results: A total of 249 fifteen-year old students were included in the study (118 female 47.4%). 68% had a DAI score ≤ 25 (minor or no occlusal anomalies), 18% scored 26-30 (mild anomalies), 7% scored 31-35 (evident anomalies), and 6% scored ≥ 36 (major malocclusion). The most frequent anomalies were dental crowding in 50%, maxillary dental irregularity in 44.6%, mandible irregularity in 41.2% and excessive maxillary overjet in 37.8%. Among the students, 26.1% had clicking/muscle or TMJ pain, of these 12.3% showed pain during palpation. OHI-S > 1 was found in 34% of the participants. The negative binomial model showed an association between DAI score and TMJ disorders (P=0.041). Also the logistic regression model showed an association between malocclusion (DAI>25) and TMJ disorders (OR=2.58, p=0.002). Malocclusion was associated also with poor oral hygiene (OR=1.65, p=0.007), and with attendance to public schools (OR=1.97, p=0.039). Conclusions: TMJ disorders and DAI scores were significantly associated. Screening/Diagnostic programs for ortho-dontic and TMJ-disorders are needed, to identify and offer treatment to teenagers with major malocclusion and TMJ/muscle pain. Key words:Dental Aesthetic Index, DAI, crowding, Temporo Mandibular Joint disorders (TMJ disorders), Temporo Mandibular Disorders (TMD), occlusal anomalies, OHI-S.     

Orthodontic treatment need in a 12-year-old population in the Western Sahara

The aim of this study was to establish orthodontic treatment need according to the Dental Aesthetic Index (DAI) and Aesthetic Component (AC) and Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and to determine its association with gender among Saharan schoolchildren. The study was carried out in accordance with World Health Organization (WHO) recommendations for oral health surveys at 12 years of age. The sample comprised 248 Sahrawi children (135 girls and 113 boys) living in refugee camps in Tindouf, Algeria. None of the children had previously received any orthodontic treatment. A chi-square test was used to analyse the IOTN results by gender, and a Student's t-test was employed for the DAI results. The mean DAI was 23.32 with a standard deviation of 6.05, 4 percent with a very severe and 9.2 per cent with severe malocclusion. Orthodontic treatment need was 16.1 and 2.0 percent, respectively, according to grades 4 and 5 of the IOTN DHC, 13.7 percent according to the IOTN AC, and 28.6 percent according to the modified IOTN (IOTN DHC grades 4-5 and/or IOTN AC grades 8-10). There were no statistically significant differences by gender. The orthodontic treatment need of Western Saharan schoolchildren is similar to that reported by many recent studies in European and in Sub-Saharan countries.     

Orthodontic status and treatment need of 12-year-old children in South Africa using the Dental Aesthetic Index.

OBJECTIVE: The aim of this study was to determine the prevalence and severity of malocclusion and orthodontic treatment needs in a sample of 12-year-old South African school children using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and certain socio-demographic variables. METHODOLOGY: The sample comprised 6142, 12-year-old children attending school in seven of the nine provinces of South Africa. For each subject the standard demographic information such as gender, population group, location type and employment status of the parents was collected, after which an intra-oral examination for occlusal status using the DAI was performed. Before the survey, the examiners were calibrated and trained and only examiners with an agreement score greater or equal to 80 per cent were included in the final study. RESULTS: The results showed that 47.7 per cent of the children in the sample presented with good occlusion or minor malocclusion, just over 52.3 per cent presented with identifiable malocclusion, a DAI score larger than 26. Of these, 21.2 per cent had definite malocclusion, 14.1 per cent had severe malocclusion and 16.9 per cent had very severe or handicapping malocclusion. Malocclusion as defined in this study was found to be significantly associated with the different population groups in South Africa, with gender and with dentition stage, but not with the location type or the employment status of parents. CONCLUSIONS: The results of this study show a high prevalence of malocclusion in 12-year-old South African children. The findings provide reliable base-line data regarding the prevalence, distribution and severity of malocclusion as well as useful epidemiological data on the orthodontic treatment needs of 12-year-old children in South Africa.     

Orthodontic treatment need,self‐esteem,and oral health‐related quality of life among 12‐yr‐old schoolchildren

The aim of this study was to investigate the association between orthodontic treatment need and oral health‐related quality of life (OHRQoL) among 12‐yr‐old children. The study also assessed whether self‐esteem modifies and/or moderates this relationship. Cross‐sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio‐economic and demographic characteristics, dental pain, self‐esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self‐esteem with OHRQoL. A modifying effect of self‐esteem on the relationship between DAI and OHRQoL was observed. Self‐esteem did not mediate the abovementioned relationship. Children with lower scores of self‐esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self‐esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self‐esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self‐esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.     

DAI scores and its relation to self-perceived dental aesthetic and orthodontic concern in Bangladesh and Japan

PurposeTo investigate the relationship between the severity of occlusal irregularities and orthodontic treatment concern among the population of a developing country using DAI score and to compare with the relationship found in a developed country.Materials and methodsThe sample comprised 400 randomly selected university students of Bangladesh, a developing country, 210 males and 190 females, aged 20–27 years. A pretested questionnaire was used to assess the subjects’ satisfaction with own dental appearance and orthodontic treatment concern; the actual severity of malocclusion was determined using the Dental Aesthetic Index (DAI). Statistical analysis was carried out using t-test for gender differences; Spearman rank-order correlation coefficients, Scheffe's post hoc test, one way ANOVA and logistic regression analysis were done for correlation between malocclusion severity and response to questionnaire. The data from a similar study that was carried out on the university students of Japan, a developed country, was compared.ResultIn Bangladeshi sample, males were more affected by malocclusion. Moderate correlation was found between malocclusion, self-satisfaction and treatment concern where satisfaction was decreased and treatment desire was increased with the severity of malocclusion. In Japanese sample, the prevalence of malocclusion was found more in females. Self-satisfaction and malocclusion showed weak correlation and no significant correlation was found between treatment concern and malocclusion.ConclusionAlthough DAI can be used universally to evaluate malocclusion and self-perception, it should be used carefully to determine the subjects’ actual desire for orthodontic treatment where the socio-economic condition can be a provocative factor.     

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.     

An insight into four orthodontic treatment need indices

Occlusal indices have been introduced and used to rank or categorize the occlusion. According to Dr. William Shaw and colleagues (1995), there are five types of occlusal indices, diagnostic, epidemiologic, orthodontic treatment need, orthodontic treatment outcome, and treatment complexity indices. Orthodontic treatment need indices are used to rank the malocclusion. They were devised to minimize the subjectivity associated with the diagnosis, referral and complexity assessment of malocclusion. Some are also multifunctional and used to assess the outcome of orthodontic treatment. The overall aim of the present article is to provide an overview on four commonly used American and European orthodontic treatment need indices, review their modifications, advantages, and limitations. These indices are the Index of Orthodontic Treatment Need (IOTN), the Dental Aesthetic Index (DAI), the Handicapping Labio-Lingual Deviation index (HLD), and the Index of Complexity, Outcome and Need (ICON).