Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents

Objectives:To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents.Materials and Methods:A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis.Results:A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02–1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021).Conclusions:Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.     

Prevalence and association of dental injuries with socioeconomic conditions and alcohol/drug use in adolescents between 15 and 19 years of age

Abstract –  Background: The aim of the present study was to investigate the prevalence of dental trauma, etiological factors, predisposing factors, and associations with socioeconomic status and the risk of alcohol and illicit drug use among adolescents in the city of Belo Horizonte, Brazil. Methods: A cross‐sectional study was carried out that included clinical examinations and self‐administered questionnaires. The sample population was composed of 891 adolescents from public and private schools. The Social Vulnerability Index (SVI) was used for socioeconomic classification. Information on alcohol and illicit drug use was obtained using two questionnaires: the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Results: The prevalence of traumatic dental injury (TDI) was 24.7%. Falls (17.7%) was the most frequently cited etiological factor in dental injury. Among the participants with TDI, 32.8% were students in the private school system (P = 0.006). A total of 56.8% of individuals with accentuated overjet had some type of TDI (P = 0.000). There was a high prevalence of adolescents who consumed alcoholic beverages (50.3%) and used illicit substances (15.2%). However, no statistically significant associations were found between these variables and the presence of TDI. The results of the analysis demonstrate that individuals in a private school system [prevalence ratio (PR) = 1.11; 95% confidence interval (CI): 1.03–1.20] and those with accentuated overjet (>3 mm) (PR = 1.17; 95% CI: 1.10–1.25) had a 1.11‐ and 1.17‐fold greater chance of belonging to the group of individuals diagnosed with some type of TDI. Conclusions: The prevalence of dental trauma in the study population was high. The same was true regarding alcohol and illicit drug use among the adolescents examined, although no statistically significant associations were found between these variables and a history of TDI. Private school system and accentuated overjet were significantly associated with dental trauma.     

Association between malocclusion in the mixed dentition with breastfeeding and past nonnutritive sucking habits in school-age children

ObjectivesTo evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children.Materials and MethodsA total of 547 school children in the mixed dentition, in the age range between 7 and 13 years, were evaluated by means of questionnaire and clinical examination. Binomial and multinomial logistic regression models were used to evaluate the associations between breastfeeding and finger and pacifier sucking habits, the malocclusion characteristics of posterior crossbite, and excessive or deficient overjet and overbite.ResultsIndividuals who had nonnutritive sucking habits had 2.16 times greater chance of having anterior open bite (odds ratio [OR] 2.16; 95% confidence interval [CI], 1.07–4.33) and 2.39 times greater chance of having posterior crossbite (OR 2.39; 95% CI, 1.56–5.49). Children who were exclusively breastfed up to at least 6 months of age had a higher frequency of normality for overjet and overbite and the lowest posterior crossbite index. However, in adjusted analysis, breastfeeding showed no association with malocclusion characteristics in the mixed dentition stage.ConclusionsBreastfeeding was not associated with the presence of malocclusion in the mixed dentition, whereas past nonnutritive sucking habits were associated with the occurrence of malocclusion.     

A comparison of the effects of Forsus appliances with and without temporary anchorage devices for skeletal Class II malocclusion:: A systematic review and meta-analysis

ObjectivesTo compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion.Materials and MethodsThrough a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations.ResultsElectronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were –0.27 (95% confidence interval [CI]: –0.59, 0.05) for SNA, 0.58 (95% CI: –0.07, 1.23) for SNB, –0.86 (95% CI: –1.74, –0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, –7.56 (95% CI: –11.37, –3.76) for L1-MP, 0.47 (95% CI: –0.98, 1.91) for overjet, 0.39 (95% CI: –0.57, 1.35) for overbite, –1.84 (95% CI: −5.15, 1.47) for SN-OP, and 4.97 (95% CI: –1.22, 11.17) for nasolabial angle.ConclusionsTADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.     

Predictors of patient compliance during Class II division 1 malocclusion functional orthodontic treatment

ObjectivesTo determine factors that could predict Class II/1 malocclusion patient compliance during functional treatment.Materials and MethodsThe sample consisted of 77 subjects (aged 11–13 years; 47% girls) presenting with Class II/1 malocclusion. Inclusion criteria were distal molar relationship, overjet greater than 5 mm, and confirmed pubertal growth spurt. Removable functional appliances (62% Twin Block [TB], 38% Sander Bite Jumping [BJ]) with built-in maxillary expansion screws were used. Follow-up period was 1 year. Patients and parents independently filled out the Child Perception Questionnaire, Parental/Caregiver Perception Questionnaire, and Family Impact Scale to assess emotional and social well-being, oral symptoms, functional limitations, parental emotions, family activities, conflicts, and financial burden as possible predictors of compliance during treatment. Sex, overjet, and appliance type were also analyzed.ResultsThere were more noncompliant than compliant patients (55% vs 45%). Parental perception of altered emotional well-being of their children was the strongest predictor, increasing compliance odds 3.4 times (95% confidence interval [CI], 1.2–9.4; P = .017). Patients were 3.2 times (95% CI, 1.1–9.3; P = .033) more likely to cooperate with TB compared with BJ appliance. OJ ≥ 8 mm increased compliance odds 3.1 times (95% CI, 1.0–9.4; P = .044).ConclusionsParental perception of child''s emotional well-being alteration, severity of malocclusion, and type of appliance are major predictors of compliance. Psychosocial issues and oral function limitations reported by children and family impact are of negligible influence.     

Is the adolescent's esthetic concern associated with anterior occlusal conditions or the malocclusion severity level?

ObjectivesTo assess the esthetic impact of anterior occlusal conditions and malocclusion severity levels.Materials and MethodsA population-based cross-sectional study of 700 adolescents aged 15 to 19 years was conducted. The Oral Aesthetic Subjective Impact Scale (OASIS) was used to evaluate the subjective esthetic impact of malocclusion. The Dental Aesthetic Index (DAI) criteria were used to diagnose the anterior occlusal characteristics in isolation and the severity levels of malocclusion. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).ResultsOf the adolescents, 42% showed negative self-perception of malocclusion. In addition, 15.4% of adolescents had severe malocclusion (DAI 3) and 18.9% very severe malocclusion (DAI 4). Crowding and spacing were shown to be 2.90 (CI: 2.06–4.09) and 2.53 (CI: 1.65–3.86) times, respectively, more likely to cause a negative esthetic impact in adolescents (P < .05). In addition, adolescents with orthodontic treatment need (DAI 2, 3, and 4) were more likely to report a negative esthetic impact (P < .05).ConclusionsAnterior crowding and spacing are the conditions that most influence the esthetic concern of adolescents. Adolescents with very severe malocclusion and higher orthodontic treatment need are more likely to report a negative esthetic impact.     

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.     

Malocclusion and oral health-related quality of life in Brazilian school children: A population-based study

Objective:To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument.Materials and Methods:A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05).Results:Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15–1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35–1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income.Conclusions:Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.     

Contextual and Individual Determinants of Anterior Open Bite in Adolescents

ObjectiveStudying the broader determinants of anterior open bite (AOB) may guide more equitable policies.This study estimates the prevalence of AOB in Brazilian adolescents and its association with contextual and individual determinants.MethodologyThe data for dentofacial anomalies in 15- to 19-year-olds from the National Oral Health Survey SBBrasil 2010 were analysed (N = 4748). AOB was based on the Dental Aesthetic Index (AOB = 0; AOB > 0); the contextual variables were the Human Development Index (HDI) and the Gini Index (2010). The individual sociodemographic variables included sex (male, female), self-reported skin colour/race (white, black, brown, and indigenous + yellow), family income (≥4 minimum wage [MW]; 0–3 MW), and educational attainment (ideal, delayed). The individual clinical variables were decayed, missing, and filled teeth (DMFT) (0, ≥1), first permanent molar loss (0, ≤3, 4), and molar relationship (normal, half cusp, full cusp). Multilevel logistic regression models with random intercepts and fixed slopes were used to estimate odds ratios (ORs) and confidence intervals (95% CIs).ResultsAOB prevalence in Brazil was 8.78% (95% CI, 6.85–11.20) at 15 to 19 years of age. The lowest prevalence was in São Luis (2.63%; 95% CI, 0.58–11.03) and the highest was in João Pessoa (29.85%; 95% CI, 15.93–48.85), both capitals of the northeast Brazilian region. A higher prevalence of AOB (OR, 1.71; 95% CI, 1.04–2.80) was observed in municipalities with a lower HDI. Adolescents who declared their skin colour black, with lower family income, with delayed education, with DMFT ≥ 1, who lost 4 permanent first molars, and who had a complete molar cusp relationship were more likely to have AOB.ConclusionsAOB varied amongst Brazilian municipalities. The HDI plays an important role in the prevalence of AOB; individual social determinants have also been associated with AOB malocclusion in adolescents.     

Self-Perception of Teeth Alignment and Colour in Adolescents: A Cross-sectional Study

ObjectiveThis study aimed to evaluate the prevalence and factors associated with self-perception of teeth alignment and colour in adolescents.MethodsThis cross-sectional study was carried out in public and private schools in Passo Fundo, Brazil. A representative sample of students aged 15 to 19 years were included. The outcome of this study was self-perception of teeth alignment and colour according to selected items from a structured and validated questionnaire (the Child's and Parent's Questionnaire about Teeth Appearance). Bivariate and multivariable analysis, using Poisson regression with robust variance, were used. A P value <.05 was established for statistical significance.ResultsThe study included 736 adolescents. The worst self-perception of teeth alignment and colour was observed in 46.5% (n = 342) of the adolescents. Nonsmokers presented a prevalence ratio (PR) 29% lower (95% CI, 0.57-0.89) for the worst self-perception of teeth alignment and colour when compared to smokers/former smokers. Adolescents with highly educated mothers presented a lower prevalence of negative self-perception than those with mothers with a low level of education (PR: 0.66; 95% CI, 0.51-0.86). Presence of orthodontic treatment with (PR: 0.76; 95% CI, 0.62-0.94) or without (PR: 0.61; 95% CI, 0.46-0.76) tooth whitening were associated with better self-perception of teeth alignment and colour.ConclusionsExposure to smoking and lower maternal level of education were associated with worse self-perception of teeth alignment and colour in adolescents. A history of orthodontic treatment with or without tooth whitening was associated with a lower concern with aesthetics.     

Twin Block appliance with acrylic capping does not have a significant inhibitory effect on lower incisor proclination

Objective:To investigate the effect of acrylic capping, treatment duration, overjet, and lower incisor inclination on the posttreatment tooth position in patients treated with 2 Twin Block (TB) appliance versions.Materials and Methods:Cephalograms of 56 patients with Class II malocclusion (21 boys, 35 girls; mean age before treatment [T1] = 12.5 years; standard deviation, 0.7) treated with a TB appliance with either acrylic capping or ball-ended clasps on lower incisors were retrospectively collected and traced. Lower incisor inclination (L1-GoGn, L1-GoMe, L1-MP) was measured at T1 and after TB appliance removal (T2). Regression analysis was performed to evaluate the effect on the lower incisor inclination of appliance type, overjet, lower incisor inclination at T1, and treatment duration after adjusting for baseline measurements.Results:Appliance design was not a significant predictor for either incisor inclination measurement (P< .05). Pretreatment lower incisor inclination was the only factor significantly associated with final tooth inclination (L1-GoGn: β = 0.57, 95% confidence interval [CI] = 0.30, 0.84, P < .001; L1-GoMe: β = 0.56, 95% CI = 0.28, 0.84, P < .001; L1-MP: β = 0.46, 95% CI = 0.17, 0.75, P = .003). There was weak evidence that treatment duration excluding L1-MP (95% CI = –1.85, –0.02; P = .045) and overjet might be associated with inclination of lower incisors at T2.Conclusions:TB appliance design with acrylic capping on lower incisors appears not to significantly control incisor proclination. Pretreatment lower incisor inclination may be significantly associated with tooth inclination after active TB treatment and should be considered in treatment planning.     

Traumatic dental injuries in adolescents from a town in southern Brazil: a cohort study

PURPOSE: To estimate the incidence of traumatic dental injuries (TDI) and determining risk factors in adolescents in Luzerna, Brazil, over a period of three years. MATERIALS AND METHODS: A longitudinal study was carried out with adolescents born in 1988 and 1989 attending the schools of the city. Two examinations were performed in the adolescents in the year 2001 and 2004. The sample size was 176 individuals; however, it was decided to invite all 246 students enrolled in 2001. Clinical examinations were carried out through criteria for TDI used in the National Survey, UK, in 1994. RESULTS: The incidence ratio was of 13.2% (CI 95% 7.9-18.5). The incidence among males was 15.1% (CI 95% 7.6-22.6) and among females 11.0% (CI 95% 3.9-18.1) (p = 0.440) with a relative risk (RR) of 1.38 (CI 95% 0.60-3.14). In relation to increased incisal overjet, the incidence ratio in the exposed individuals was found to be 21.2% (CI 95% 7.3-35.1) and in the nonexposed 11.1% (CI 95% 5.7-16.8) (p = 0.122). Individuals exposed to an increased incisal overjet presented an RR of 1.91 (CI 95% 0.84-4.34). The incidence in the individuals exposed to inadequate lip coverage was 12.5% (CI 95% 2.3-22.7) and in the non-exposed it was 13.4% (CI 95% 7.4-19.5) (p = 0.879). The RR among the exposed was 0.93 (CI 95% 0.36-2.38). CONCLUSION: The incidence of TDI was 13.2%. For males, having increased incisal overjet and inadequate lip coverage were not considered as risks factors.     

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.     

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Abstract – Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross‐sectional survey was conducted with 376 children aged 36–59 months who attended the National Day of Children’s Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.     

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.     

Impact of traumatic dental injuries on the quality of life of schoolchildren

Abstract – Background: Knowledge of the impact of traumatic dental injuries (TDI) on children’s quality of life is sparse. Aim: To determine the association between TDI and oral health–related quality of life (OHRQoL) among schoolchildren aged 11–14 years. Material and methods: A cross‐sectional study was carried out involving a representative sample of 409 schoolchildren from 13 municipalities in the Midwest Region of the Brazilian Southern State of Santa Catarina. Clinical examination included the presence and type of TDI and the treatment provided (or needed) according to criteria used in the UK Children’s Dental Health Survey. Dental caries in anterior teeth and malocclusion status were also collected according to WHO criteria. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ11–14), and the outcome was the prevalence of one or more adverse impacts on quality of life occurring often/very often. Results: The prevalence of TDI was 16.6% (95% CI 13.0–20.2). The prevalence of one or more adverse impacts occurring often/very often was 46.6% (95% CI 41.7–51.5). Logistic regression modeling for the outcome indicated an independent and significant association between the prevalence of one or more adverse impacts occurring often/very often and the presence of TDI even after adjustment for gender, presence of dental caries in anterior teeth and malocclusion. A prevalence ratio of 1.79 (95% CI 1.16–2.76) of one or more adverse impacts occurring often/very often in schoolchildren with TDI was found, compared to those without TDI. Conclusions: Traumatic dental injuries appear to affect schoolchildren’s OHRQoL.     

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.     

Cone-beam computed tomography versus periapical radiograph for diagnosing external root resorption: A systematic review and meta-analysis

Objective:To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and periapical radiographs (PR) for the detection of external root resorption (ERR).Material and Methods:An electronic search in databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the China National Knowledge Infrastructure, and System for Information on Grey Literature in Europe (SIGLE), was performed until August 2016. A manual search of relevant journals and reference lists of enrolled studies was conducted. The studies investigating the diagnostic accuracy of CBCT or PR for ERR, with simulated ERR as the reference test, were considered eligible. The diagnostic accuracy of CBCT and PR was statistically pooled using a bivariate model. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was used to test the stability of the overall results in the meta-analysis.Results:A total of 15 studies were included in this systematic review. The pooled results showed that CBCT had significantly higher sensitivity (0.89; 95% confidence interval [CI]: 0.77–0.96) and area under curve (0.96; 95% CI: 0.77–0.96) than PR (sensitivity: 0.68; 95% CI: 0.56–0.78; area under curve: 0.88; 95% CI: 0.85–0.90). No difference in sensitivity, specificity, and area under the curve between conventional and digital PR was observed.Conclusions:Currently available evidence suggests that CBCT could be reliable to detect the presence of ERR in clinical practice and has a higher diagnostic efficacy than PR.     

Treatment Effects of Twin-Block and Mandibular Protraction Appliance-IV in the Correction of Class II Malocclusion

Objective:To evaluate the treatment effects of twin-block and Mandibular Protraction Appliance-IV (MPA-IV) in the treatment of Class II division 1 malocclusion.Methods:Fifty North Indian girls with Class II division 1 malocclusion, in the age range of 9–13 years, were chosen. The subjects were divided among a control group (n  =  10), a twin-block group (n  =  25), and an MPA group (n  =  15). Pre–follow-up and post–follow-up lateral cephalograms of control subjects and pretreatment and posttreatment lateral cephalograms of the treatment subjects were traced manually and subjected to a pitchfork analysis.Results:Neither twin-block nor MPA-IV significantly restricted the forward growth of maxilla. Mandibular growth and improvement in the sagittal skeletal relation were significantly greater in the twin-block subjects. Distal movement of the maxillary dentition and mesial movement of the mandibular dentition were more prominent in the MPA-IV subjects. Molar correction and overjet reductions were significantly greater in the treatment subjects (P < .001).Conclusion:Twin-block and MPA-IV were effective in correcting the molar relationships and reducing the overjet in Class II division 1 malocclusion subjects. However, twin-block contributed more skeletal effects than MPA-IV for the correction of Class II malocclusion.     

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.