Dental crowding in primary dentition and its relationship to arch and crown dimensions among preschool children of Davangere

The purpose of the present study was to evaluate dental crowding in the deciduous dentition and its relationship to the crown and the arch dimensions among preschool children of Davangere. Stratified randomized selection of one hundred, 3-4 year old healthy children with all primary teeth erupted was done and divided into two groups. One group had children with anterior crowding in both the arches while the other had spacing. Alginate impressions of the upper and lower arches were made and the study casts were obtained. The tooth and arch dimensions were determined. Mesiodistal dimensions of all the teeth were significantly larger in the crowded arch group. However, the buccolingual dimensions of the maxillary right central incisor, mandibular lateral incisors and the maxillary molars and the crown shape ratio of maxillary lateral incisors, mandibular canines and mandibular right second molar was statistically different. No significant correlation was found between the arch width and the presence of crowding of deciduous dentition. The arch depth of the spaced dentition was greater when compared to the crowded ones. The arch perimeter of the crowded arches was significantly less than the spaced arches.     

Dental arch dimensions in Class II division 1 malocclusions with mandibular deficiency

OBJECTIVE: To test the hypothesis that there is no difference in the dimensions of the upper and lower dental arches in Class II division 1 malocclusion with a mandibular deficiency compared to normal Class I occlusion dental arches. MATERIALS AND METHODS: Photocopies of the dental arches of 48 patients exhibiting Class II division 1 malocclusion with mandibular deficiency and of 51 individuals with normal occlusion were compared. Mandibular deficiency was diagnosed clinically. All 99 individuals were in the permanent dentition. The ages of the subjects ranged from 11 years 4 months to 20 years (mean age = 12 years 5 months). RESULTS: When compared to subjects with normal occlusion, the upper dental arches of the Class II division 1 patients presented reduced transverse dimensions and longer sagittal dimensions while the lower arches were less influenced. CONCLUSION: The hypothesis is rejected. Significant differences are present between the dimensions of the upper and lower dental arches in Class II division 1 malocclusion (with a mandibular deficiency and in the permanent dentition) compared to normal Class I occlusion dental arches.     

Cranio-facial morphology in children with and without enlarged tonsils

The purpose of the present study was to compare the cranio-facial morphology in children with and without enlarged tonsils. The material consisted of 73 children with enlarged tonsils, and a control group of children with normal tonsils, matched for age, sex, and number. The mean age for the groups was 10.1 and 10.0 years, respectively. Evaluation of anamnestic history, clinical examination, and lateral skull radiographs were undertaken. Compared to the control children, the children with enlarged tonsils had more retrognathic and posteriorly inclined mandibles, larger anterior total and lower facial heights, and larger mandibular plane angles. Regression analyses revealed that functional, postural, and morphological factors, such as open mouth posture, low posture of the tongue, large depth of oropharynx at the site of the tonsils as well as mouth-breathing at night, were associated with skeletal features expressing an increased open vertical configuration and mandibular retrognathism.     

Dentofacial characteristics of growing patients with Duchenne muscular dystrophy: a morphological study

Occlusal traits and craniofacial morphology were studied in growing patients with Duchenne muscular dystrophy (DMD). Sixteen patients from 6 to 20 years of age were examined and compared with 16 healthy male individuals matched according to age. The dental arches and occlusal traits of both groups were analysed on dental casts and compared with the norms of healthy individuals from the literature. Lateral cephalograms of the patients were compared with normal individuals by using scored values based on standard deviations in order to compensate for heterogeneity in the age of the subjects. Statistical analysis was undertaken for continuous variables with a paired Student's t-test and non-continuous variables with a chi-square test. Linear regressions were used to evaluate the influence of age. A high prevalence of malocclusions was found, including posterior crossbites, anterior and lateral open bites, a tendency towards mesio-occlusion due to a skeletal Class III malocclusion, and dental compensations of the Class III relationship by retrusion of the lower incisors. Both upper and lower arches were widened posteriorly. The lower arches were even wider than the upper arches, resulting in frequent posterior crossbites. No significant skeletal vertical deviations were observed in this group of DMD patients, except for the maxillary plane angle (NL/NSL) that was larger than normal, while the anterior upper face height (NSp) was smaller. However, no difference was found in lower face height. The posterior enlargement of the dental arches and the dentoalveolar development towards an Angle Class III relationship were significantly related to age and found more frequently among the older subjects.     

Posture of the head, the hyoid bone, and the tongue in children with and without enlarged tonsils

The purpose of this investigation was to analyse whether there were any differences between children with and without enlarged tonsils with regard to the posture of the head, the hyoid bone, and the tongue. Twenty-two children with enlarged tonsils were compared with a matched normal control group. Of the children in the tonsil group, 59 per cent were mouth-breathers during the day and 82 per cent during the night. None of the control children was a mouth-breather. The results showed that, compared with the control children, children with enlarged tonsils had an extended posture of the head, a lowered position of the hyoid bone, and an antero-inferior posture of the tongue. The vertical position of the hyoid bone also reflected the vertical position of the tongue. The antero-posterior position of the tongue was closely related to the oro-pharyngeal depth. The postural pattern in children with enlarged tonsils appears to be associated with the need for maintenance of free oro-pharyngeal airway capacity.     

Dental abnormalities in permanent dentition in children with submucous cleft palate

Seventy-three children with submucous cleft palate (38 girls and 35 boys), mean age 8.2 years (range 7.7-9.5), were studied retrospectively from orthopantomograms. Dental abnormalities in permanent dentition were found in 26 patients (36%). Missing teeth, mainly lower 2nd premolars, upper lateral incisors, and upper 2nd premolars, were found in 12 patients (16%). Most of the patients had 1 or 2 missing teeth, 2 had 3 missing teeth. In 5 patients hypodontia was associated with another dental abnormality. Other dental abnormalities included peg-shaped lateral incisors in 7 patients (10%), ectopic eruption of upper 1st molars in 6 patients (8%), transposition of upper canines and 1st premolars in 3 patients (4%), supernumerary teeth in 2 patients (3%), and palatally displaced upper canines in 1 patient (1%). As children with submucous cleft palate have a tendency towards increased frequency of missing teeth and other dental abnormalities, the need for thorough clinical and radiological dental examination is emphasized.     

Mixed dentition space analysis in a Jordanian population: comparison of two methods

AIMS: To test the reliability of the Moyers charts and the Tanaka and Johnston equations in Jordanians and to derive coefficients of correlation between the combined mesiodistal widths of the four permanent mandibular incisors and the combined widths of the canine and premolars of the maxillary and mandibular quadrants. METHODS: The dental models of the dentition of 130 male and 96 female Jordanian subjects (age range is 14-16 years) with complete permanent dentition were randomly selected. The mesiodistal width of the four permanent mandibular incisors, maxillary and mandibular canines, and premolar teeth were measured using a vernier gauge caliper to the nearest 0.1 mm. The actual teeth measurements were then compared with the predicted values derived from the Tanaka and Johnston equations and Moyers probability tables. Correlation and linear regression analyses were performed between the predicted and actual tooth size for Jordanian children and standard regression equations were developed. RESULTS: Except for the maxillary arch in male subjects, Tanaka and Johnston regression equations underestimated the mesiodistal widths of permanent canines and premolars. On the other hand, there were no statistically significant differences between actual mesiodistal widths of canines and premolars and the predicted widths from Moyers charts at the 65% and 75% level for the lower and upper arches in male subjects and at the 85% level for the upper and lower arches in female subjects. For the newly developed regression equations, the correlation coefficients between the sum of the mandibular four incisors and the sum of the canine and premolars were 0.60 (for lower) and 0.51 (for upper) in male subjects and 0.59 and 0.64, respectively, in female subjects. CONCLUSIONS: (1) Tanaka and Johnston prediction method was not accurate when applied to a Jordanian population. (2) Moyers method for prediction can be used for Jordanian children at different probability levels for male and female subjects.     

The effects of early headgear treatment on dental arches and craniofacial morphology: a report of a 2 year randomized study

The aim of the present study was to determine the effects of early headgear treatment on dental arches and craniofacial morphology in children in the early mixed dentition. The total study group comprised 68 children of both sexes (40 boys and 28 girls) aged 7.6 years [standard deviation (SD) 0.3]. The children, who had a Class II tendency in occlusion and moderate crowding of the dental arches, were randomly divided into two groups of equal size, matched according to gender. In the headgear (HG) group, treatment was initiated immediately. The mean treatment time was 16 months. In the second group, which served as the control, only interceptive procedures were performed during the follow-up period. The records, which included dental casts and lateral cephalograms, were obtained after follow-up periods of 1 and 2 years. The lengths and the widths of the maxillary and mandibular dental arches were significantly increased in the HG group after the 2 year follow-up period. The mean increase in lower arch length and width was 2.4 mm (SD 1.7) and 2.2 mm (SD 1.2), respectively. On average, the space gain in the lower arch was half that of the upper arch. No significant changes were found in the arch dimensions of the control group. Maxillary growth restraint and labial tilting of the incisors were the most significant cephalometric findings in the HG group when compared with the controls. The use of headgear in the early mixed dentition is effective in the treatment of moderate crowding. It is noteworthy that significant space gain in the dimensions of the lower arch can be achieved by headgear application to the upper first molars.     

Emergence of the deciduous incisors in CLP children

A longitudinal study of the time of emergence of the deciduous incisors was performed in Dutch cleft lip and/or palate (CLP) children (n = 52). A group of normal children (n = 62) served as control. Emergence dates were registered by the parents and checked regularly by one of the investigators. Mean emergence times of the deciduous upper incisors--including both the cleft-sided lateral in the distal segment and in the premaxilla--and lower incisors were studied. The lateral incisor on the cleft side situated in the distal segment was delayed 8 months in children with a cleft lip and alveolus and 13 months in cleft lip and palate children. The delay for the lateral incisor situated in the premaxilla increased by nearly 4 months in these children. The upper lateral incisors on the non-cleft side and in cleft palate children were not delayed as compared with normal children. The central lower incisors emerged one month earlier than normal when there was a palatal cleft. Presurgical orthopaedics used in these groups could have caused this acceleration. The central upper and lateral lower incisors showed no significant differences in mean emergence ages as compared with the control group, nor between the various cleft types. Sex differences were not found in any of the groups.     

Palate morphology of bruxist children with mixed dentition. A pilot study

Summary  The objective of the study was to analyse quantitatively palatal morphology in bruxist and non-bruxist children with mixed dentition. Twenty-three children with mixed dentition were classified as bruxist according to their anxiety level, audible occlusal sounds related by the parents and signs of temporomandibular disorders; 23 children were control subjects matched for gender, age, and dental formula. The maxillary dental arches of all subjects were reproduced from alginate impressions cast in dental stone with a standardized technique. The casts were digitalized and mathematical equations were used to obtain the form of the palate in the sagittal, frontal and horizontal planes. Bruxist children had a statistically significant longer palate in the sagittal plane than control children; palatal shape differed especially in correspondence of the third, fourth and fifth teeth, bruxist children showing a relatively higher palate than control children. In this pilot study, sagittal plane differences in the palate between bruxist and non-bruxist children matched for age and gender were found. Further investigations are needed to understand better the clinical implications of the findings. Results should be taken into account in the diagnosis of the occlusal development in children with parafunctions to prevent future abnormalities: a bruxist child may have bigger dental arches than a normal child.     

Factors that affect alignment of upper permanent lateral incisors in early mixed dentition

The purpose of the present study was to find the factors that affect the alignment of the upper permanent lateral incisors in early mixed dentition. The materials, consisting of dental casts and lateral cephalograms which were taken from 30 children (15 males and 15 females) who had normal occlusion in deciduous dentition and normal permanent central incisor relationship, were divided into three groups, according to the bilateral symmetry alignment of the upper permanent lateral incisors (Group A: Normal alignment, Group B: Linguoversion, Group C: Mesiolinguotorsiversion). The principal component analysis was carried out to clarify the characteristics among the multi-variates, which are upper incisor shape, dental arch form, craniofacial morphology and amount of dento-craniofacial development, in Groups A, B and C. The results obtained were as follows: Group A shows a tendency to be harmonious in upper permanent incisor shape, dental arch form, craniofacial morphology and dento-craniofacial development. Group B shows a tendency to have a larger labio-lingual width of the upper permanent incisors, less anterior arch length development and less forward movement of the upper permanent lateral incisor in the maxilla before eruption. Group C shows a tendency to have a larger mesio-distal width of the upper permanent incisors, less anterior arch width development, longer distance between the upper permanent lateral incisor edge and the nasal floor and more forward and descent movement of the upper permanent lateral incisor in the maxilla before eruption.     

Dental morphology and crowding. A multivariate approach

The objective of this study was to compare, combined and individually, the mesiodistal (MD) and buccolingual (BL) tooth sizes as well as their respective crown proportions in the permanent dentition in dental arches with moderate, mild, and no crowding. Dental casts from two-hundred 12 to 16-year-old school children from a typical high school from Lima, Peru, were used. The MD and BL tooth sizes of all permanent teeth except second and third molars were measured, and their crown proportion (MD/BL ratio) was estimated. Each dental arch was classified as presenting moderate (-5.1 mm or more of discrepancy), mild (-0.1 and -5 mm of discrepancy), and no crowding (zero or a positive discrepancy). Combined and tooth-specific comparisons among the crowding groups for the tooth sizes as well as crown proportions were performed with a multivariate analysis of variance (MANOVA, using Wilks lambda). Combined MD tooth sizes and crown proportions differed among crowding groups. Subsequent individual comparisons indicated differences for MD tooth size of all upper teeth and for lower premolars and central incisors. Differences were also detected for crown proportions of the upper second premolar, canine, and both incisors; as well as for the lower first premolar, canine, and central incisor. No differences were found for the BL tooth sizes among crowding groups. MD tooth sizes and crown proportions from specific teeth are significantly different between dental arches with moderate, mild, and noncrowded arches. This study helps to understand the odontometric component of the dental crowding multifactorial origin.     

Difference in dental arch size between obese and non-obese patients with obstructive sleep apnoea

Summary A large tongue is recognised as a factor that increases the collapsibility of the upper airway in obstructive sleep apnoea (OSA) patients. We hypothesised that the propensity to develop severe OSA could be minimised if the dental arches were enlarged in obese OSA people who are thought to have a large tongue. We therefore compared the size of the dental arches in obese and non‐obese OSA patients. Using a lateral cephalogram and study models, we compared the sizes of the tongue and dental arches in 23 obese and 23 non‐obese Japanese male OSA patients, who were matched for age, apnoea hypopnea index (AHI) and maxillomandibular size. The median age (years) and AHI (events per hour) for the obese and non‐obese groups were 36·5 and 39·0, and 13·4 and 14·3, respectively. The maxillomandibular size was matched with regard to SNA, SNB and lower face cage obtained from cephalometric measurements. The parameters that were measured for the study model included dental arch width, dental arch length, overjet and overbite. Tongue size (P < 0·05) and both upper (P < 0·01) and lower (P < 0·05) dental arch widths were significantly larger in obese than in non‐obese OSA patients, and there was no difference in the severity of OSA between the two groups. These findings suggest that the tongue was larger and dental arches were enlarged in obese patients compared with non‐obese patients under the same disease severity. Wider dental arches in obese OSA patients may help to offset the impact of the enlarged tongue on upper airway patency.     

Ultrasonographic evaluation of effectiveness of circumoral muscle exercises in adenotonsillectomized children

Mouth breathing due to obstructive adenoids and tonsils has deleterious effects on craniofacial morphology especially on dentition and dental arches. Reports confirm that removal of nasal obstruction, adenoids and tonsils has not given beneficial development of circumoral musculature. Use of muscles to correct malocclusion was first recommended by Alfred Paul Rogers. This study highlights the imaging of circumoral musculature using ultrasound to evaluate the effectiveness of muscle exercises in adenotonsillectomized children. Definite changes in muscle thickness were noted in subjects, who were given muscle exercises.     

Some observations on spacing in the normal deciduous dentition of 100 Indian children from Gujarat

Plaster casts of 50 boys and 50 girls aged 3-6 years, from Gujarat, India, were studied to observe the pattern of spacing in the normal deciduous dental arches. Spaced type of dental arches were more common than closed type or 'no spaces' type. Spacing/no spacing appeared to behave independently between upper and lower arches and between the sexes. The amount of spacing was greater in males than in females. Bilateral anthropoid spaces did not exist as a single phenomenon. They occurred when some other spaces were also present. Anthropoid spaces were more in the upper arch than in the lower and more in males than in females. If anthropoid spaces occurred in the upper arch, they were frequently missing from the lower arch; this was observed more in females than males. Spacing on the left side was more than the right side. Spacing between the mandibular incisors was the greatest of all.     

The occurrence of plaque and gingivitis and its relationship to tooth alignment within the dental arches

Abstract The aim of the present investigation was to evaluate whether and to what degree discrepancies in tooth alignment can influence plaque accumulation and gingival status, An intra-individual study was performed on 30 children with unilateral malposition of upper lateral incisors (15 children) and lower second premolars (15 children). Corresponding contralateral teeth were used as controls. The meanage was 14.4 years. The degree of malalignment in individual cases was assessed using a new malposition index (MPI). Plaque and gingival condition were assessed according to Silness & Löe (1964) and Löe & Silness (1963), respectively. The test and control areas were compared with regard to plaque accumulation and gingival status. Correlation analysis was performed to test the connection between these two parameters and tooth malalignment. The frequency of visible plaque (P1I 2+ 3) and gingival bleeding (GI 2 + 3) was generally higher for the test areas compared with the control areas. A comparison between the test and control areas showed the difference in gingival bleeding to be significant and of similar magnitude as regards upper laterals and lower second premolars. The difference in visible plaque was less marked but still significant. The correlation analysis did not show any connection between the degree of plaque accumulation or gingival inflammation and the degree of tooth malalignment. The differences found between normal and malaligned teeth thus showed a difnite trend, namely:

• – plaque and gingivitis were more widespread around malaligned upper lateral incisors and lower second premolars than around contralateral teeth well positioned within the dental arches.
• – the degree of malalignment was of secondary importance.

     

A case of oculo-facio-cardio-dental syndrome with integrated orthodontic-prosthodontic treatment.

OBJECTIVE: Oculo-facio-cardio-dental (OFCD) syndrome is a very rare condition that requires comprehensive dental management because of associated multiple dental anomalies such as canine radiculomegaly, delayed dentition, oligodontia, persistent primary teeth, microdontia, and macrodontia. This report presents a case of OFCD in a Japanese girl (13 years 1 month old). We analyzed cephalograms, panoramic roentgenograms, and dental casts and discuss our integrated orthodontic-prosthodontic treatment. DESIGN: The sizes of the tooth crown and root as well as lateral cephalograms were compared with those from a Japanese control group. The outcome of orthodontic treatment was evaluated by comparing cephalograms taken before and after treatment. RESULTS: Radiculomegaly was found not only in the upper and lower canines but also the upper central incisors and lower first premolars. Macrodontia was found in the upper central incisors, upper canines, lower canines, and lower first premolars. Microdontia was found in the upper lateral incisor. Lateral cephalometric analysis showed a remarkable hypoplastic midface in both the sagittal and vertical dimensions, coupled with a significantly decreased cranial base length and an increased gonial angle. Serial lateral cephalograms during orthodontic treatment from 13 to 23 years of age demonstrated only slight maxillary growth and significant downward mandibular growth with clockwise rotation in addition to pronounced labial tipping of the upper central incisors. CONCLUSIONS: Characteristic dental anomalies together with a unique craniofacial dysmorphology were clarified. Successful oral rehabilitation was achieved by integrated orthodontic-prosthodontic treatment.     

Relation between combined widths of incisors and dimensions of the dental arches

abstract – The correlation between the total widths of the incisors and the widths and lengths of the dental arches was studied in 149 boys and 175 girls, aged 8 years 10 months to 11 years 10 months. Eighty-two of the children were judged as having normal occlusion. The widths and lengths of the dental arches were positively correlated with the total widths of the incisors. The correlation coefficients were higher for the arch lengths than for the arch widths. The correlation was, however, only weak or moderate. Calculation of the width of the maxillary dental arch from the total widths of the incisors according to Pont's Index is of little diagnostic value because of the weak correlation between the variables. The determination coefficient between the total widths of the maxillary incisors and the anterior maxillary dental arch length was found to be 0.62, so that the total widths of the maxillary incisors is of some value for predicting the anterior dental arch length.     

Dental morphologic characteristics of normal versus delayed developing dentitions with palatally displaced canines.

An earlier study reported on the delayed dental age in about 50% of patients with palatally displaced canines (PDC), suggesting the possible existence of 2 different PDC phenotypes. The present study aimed to determine whether the PDC subgroup with late dental age displays different dental features from the PDC subgroup with normal dental age, supporting the above assumption. The 3 dental parameters examined were mesiodistal and buccolingual tooth sizes, the presence of anomalous maxillary lateral incisors, and other congenitally missing teeth. Fifty-eight subjects with PDC, 37 girls and 21 boys, were divided according to dental age and compared with age- and sex-matched controls. The results revealed marked sexual dimorphism. Delayed dental development was twice as prevalent among the PDC males. The existence of 2 distinct PDC subgroups was supported for males only. One subgroup was characterized by delayed dental development, smaller-than-average teeth, and a marked increase in the prevalence of anomalous lateral incisors. The second subgroup more closely resembled the controls, presenting a timely developed dentition, a moderate and nonsignificant increase of anomalous lateral incisors, and a reduction in the dimensions of only the central incisors and the first molars. In females, although the prevalence of anomalous lateral incisors was slightly increased in the late dental age subgroup, tooth sizes were remarkably similar, negating the existence of 2 distinct subpopulations. Studying the overall PDC group as a single entity produced confusing results because important differences were obscured when the 2 sexes and the 2 dental age subgroups (in males) were combined.     

Head posture and dental wear evaluation of bruxist children with primary teeth

The aim of the present study was to compare the head position and dental wear of bruxist and non-bruxist children with primary dentition. METHODS: All the subjects had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist or non-bruxist according to their anxiety level, bruxism described by their parents and signs of temporomandibular disorders. The dental wear was drawn in dental casts and processed in digital format. Physiotherapeutic evaluation and a cephalometric radiograph with natural head position were also performed for each child to evaluate the cranio-cervical position for the bruxist group (n = 33) and the control group (n = 20). The variables of the two groups were compared, using the Student t-test and Mann-Whitney U-test. RESULTS: A more anterior and downward head tilt was found in the bruxist group, with statistically significant differences compared with the controls. More significant dental wear was observed in the bruxist children. CONCLUSIONS: Bruxism seems to be related to altered natural head posture and more intense dental wear. Further studies are necessary to explore bruxism mechanisms.