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Prevalence of malocclusions in Hungarian adolescents.

The aim of this epidemiological study was to assess the prevalence of malocclusion, associated caries experience, and level of oral hygiene in the Hungarian population using the World Health Organisation (WHO) questionnaire designed to assess dentofacial anomalies. A total of 483 adolescents (289 girls, 194 boys), aged 16-18 years, were assessed. Orthodontic anomalies were detected in 70.4 per cent of the sample. Crowding and spacing were observed in 14.3 and 17 per cent, respectively, with the latter being more prevalent in the maxilla than in the mandible (10.4 and 2.9 per cent, respectively). A Class I occlusion was found in 52.8 per cent of the subjects. A half cusp anomaly in the antero-posterior molar relationship was more prevalent than a full cusp anomaly (26.9 and 20.3 per cent, respectively). The decayed, missing, and filled teeth (DMFT), the decayed, missing, and filled surfaces (DMFS), and the visible plaque indices scores (VPI) of the 340 adolescents with malocclusion were significantly higher (P < 0.05) than those of the adolescents who displayed no anomalies. The prevalence of malocclusion in the Hungarian population seems to be comparable with other European communities.

Adolescent↗

Finite element analysis of the cranial base in subjects with Class III malocclusion.

The association between cranial base morphology and Class III malocclusion is poorly understood. This study analyses local shape- and size differences in cranial base configurations of Class I and Class III subjects, employing finite element (FEM) analysis. Seventy-three prepubertal European-American children with Class III malocclusion were compared to their counterparts with a normal, Class I molar occlusion. Lateral cephalographs were traced, checked and subdivided into age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized, providing a geometrical cranial base representation. Average cranial geometries were scaled to an equivalent size and a FEM analysis, capable of depicting and quantifying local shape- and size-change, employed to highlight regionalized, morphological differences. While the anterior cranial base was more homogeneous for shape-change, significant, localized anisotropy in the posterior regions of the cranial base and around sella turcica was evident. For size-change, areas of negative allometry were located posteriorly, but dilations in the mid- and anterior cranial base also were apparent. It is concluded that morphological alterations within the petro-occipital complex accompanied by changes in the sphenoidal and ethmoidal regions induce deviation from a normal cranial base configuration to one associated with deficient orthocephalization and an appearance of Class III malocclusion.

Age Factors↗

The heritability of malocclusion: Part 1--Genetics, principles and terminology.

The relative contribution of genes and the environment to the aetiology of malocclusion has been a matter of controversy throughout the twentieth century. Genetic mechanisms are clearly predominant during embryonic craniofacial morphogenesis, but environment is also thought to influence dentofacial morphology postnatally, particularly during facial growth. Orthodontic and orthopaedic techniques are used in the treatment of malocclusion and other dentofacial deformities, but with limited effectiveness. The key to the determination of the aetiology of malocclusion, and its treatability lies in the ability to differentiate the effect of genes and environment on the craniofacial skeleton in a particular individual. Our ability to do this is limited by our lack of knowledge on the genetic mechanisms that control facial growth and lack of scientific evidence for the influence of environmental factors on human craniofacial morphogenesis.

Craniofacial Abnormalities↗

Craniofacial morphology of Japanese girls with Class II division 1 malocclusion.

OBJECTIVE: To identify the craniofacial features of Japanese girls with Class II division 1 malocclusions. METHOD: One hundred and ninety lateral cephalometric radiographs were analysed, and the subjects whose age ranged from 7 years 6 months to 15 years 10 months were divided into three groups by their dentition: middle mixed dentition, late mixed dentition, and early permanent dentition. The mean values of 5 linear and 16 angular cephalometric parameters were compared with established Japanese Class I control values. RESULTS: Japanese girls with Class II division 1 malocclusion had a significantly small S-N-B angle (p < 0.001), short mandibular ramus (p < 0.05-0.001), and a large mandibular plane angle (p < 0.05-0.001). CONCLUSION: Japanese girls with Class II division 1 malocclusion had a high-angle facial pattern associated with the short mandibular ramus.

Adolescent↗

Synergistic effect of malocclusion and oral parafunctions on craniomandibular dysfunction in children with and without unpleasant life events.

An epidemiological study was conducted on 386 children aged 6-10, with and without unpleasant life events, to investigate the synergistic effect of malocclusion and oral parafunctions on craniomandibular dysfunction. The results showed that the synergistic effect of certain occlusal factors and oral parafunctions was significantly correlated with clicking and symptoms of dysfunction in both groups and with TMJ and muscle tenderness in subjects without unpleasant life events. In children with unpleasant life events TMJ and muscle tenderness were not correlated with any combination of malocclusion and oral parafunction. The present study suggests that the synergistic effect of malocclusion and oral parafunctions is a 'sufficient' cause for development of clicking and symptoms of dysfunction in both groups and TMJ and muscle tenderness in subjects without unpleasant life events. Also, in children with unpleasant life events, other aetiologic factor(s) can be responsible for the development of TMJ and muscle tenderness.

Anxiety↗

Prevalence and awareness of malocclusion in Swedish men.

Previous orthodontic treatment, the awareness of malocclusion, the demand for orthodontic treatment and the prevalence of malocclusion were studied in 389 Swedish men, aged 21-54 years (mean age 32 years). Nine percent had been treated with an orthodontic appliance and 15% reported that permanent teeth had been extracted on orthodontic indications. Malposition of teeth was found in 75%, with rotation as the most common type of malposition. Crowding was recorded in 43% and spacing in 18%. Fifty-seven percent had some occlusal anomaly. The need for orthodontic treatment was rated on a four-point scale. It was found that 76% were in need of treatment. The need for treatment was only slight in half of the men but moderate to urgent in 25% of the sample. About a quarter of the men were aware of malposition of front teeth, equally often for maxillary and mandibular teeth, but only about 1% were aware of malposition of posterior teeth. Only a few percent thought they were in need of orthodontic treatment. The presence of malocclusion was correlated to age, place of birth and educational level. This might perhaps be a consequence of tooth loss.

Adult↗

Attitudes to malocclusion among 18- and 35-year-old Norwegians.

Knowledge about age-related changes in attitudes to dental appearance and orthodontic treatment may guide the orthodontist in educating and providing advice to potential patients and their parents. The purpose of the present study was to compare attitudes to malocclusion in groups of young and middle-aged adults from populations having been exposed to similar provision of care. The material comprised samples of orthodontically untreated 18-yr-olds (n = 50) and 35-yr-olds (n = 73) from Oslo, Norway. From a clinical examination, radiographs, and measurements on dental study casts, the subjects were classified according to the Need for Orthodontic Treatment Index (NOTI) used by the Norwegian Health Insurance System. Satisfaction with dental appearance and desire for orthodontic treatment were investigated using questionnaires. The 35-yr-olds exhibited significantly more malocclusion compared to the 18-yr-olds (P < 0.01). Among subjects classified to have obvious need for orthodontic treatment, 54% and 21% expressed dissatisfaction at ages 18 yr and 35 yr, respectively, indicating a lower level of concern for malocclusion in the older age group.

Adolescent↗

Occurrence of malocclusion in attritive environment: a study of a skull sample from southwest Finland.

Occlusal variation and occurrence of malocclusion were examined in a Finnish skull sample derived from the 15th and 16th centuries. The material consisted of 207 adult individuals; 141 maxillas and 159 mandibles, including 93 pairs, were in observable condition. In the skull sample, only dental anomalies were observed; no skeletal malocclusions were found. The frequency of an Angle Class I lateral relationship was 97.7%. The mean values for overjet and overbite were 1.6 and 1.4 mm, respectively. A comparison with present-day Finns revealed that the skull sample showed less variation in all occlusal variables studied. An Angle Class II type occlusion, deep bite, crowding, spacing, and lateral crossbite occurred with significantly lower frequencies in the skull sample than in the present-day Finns. Advanced dental wear in the skull sample shows that a hard and attritive diet was eaten at that time. It is suggested that a dietary transition from hard to soft food is the most probable cause of the increased occlusal variation and high frequency of malocclusion in present-day Finns.

Diet↗

Malocclusion prevalence in an ethnic Chinese population.

Population norms derived from one ethnic group may not necessarily be valid and accurate for other ethnic groups. With the increasing number of ethnic Chinese immigrants in Australia, Europe, and America, it would be useful for dental practitioners to be informed about malocclusion prevalence among Chinese. This study was carried out on 1050 Chinese school children (aged 12-14 years) to assess both qualitatively and quantitatively certain occlusal features. The population was found to have a high incidence of Class III malocclusions compared with caucasians. However, the incidence of Class II malocclusions was quite similar to those reported in caucasians. Normal occlusions occurred in about 7 per cent of this population. Although this percentage was much lower than those reported in blacks, it was similar to those reported in caucasians. Crowding occurred in about 50 per cent of cases, which was slightly less than for those reported for caucasians. Increased overbites were also less common in this Chinese population compared with caucasians. Compared with caucasians, crossbites were also less frequent in this Chinese population.

Adolescent↗

Thoughts on the early treatment of Class II malocclusion.

The timing of Class II, division 1 malocclusion treatment is discussed in the context of the development of the dentition within the craniofacial environment. The occlusion of the dentition actually serves as the key that controls and maintains the exact position of the mandible vis-à-vis the maxilla during childhood, pubescence and throughout adulthood. Research and clinical evidence suggest that treatment which 'disturbs' the interdigitation of teeth in the Class II malocclusion can lead to correction of the distocclusion. This correction can theoretically be undertaken throughout childhood and adolescence, and even thereafter. Treatment at a very young age was thought to normalize the occlusion, and consequently the growth process, leading to more stable results. Re-examination of this concept shows that, for practical purposes, the presence of the first premolars signals an early indication for treatment of Class II, division 1 malocclusion. The mobility of the deciduous second mandibular molars provides the last opportunity to prevent, whenever possible, a four premolar extraction approach.

Adolescent↗

Response of zygomaticomaxillary suture to experimental malocclusion in rats.

The purpose of this study was to examine the response of the zygomaticomaxillary suture (ZMS) to experimental malocclusion in rats. Thirty-two male Wistar rats were divided into two groups. Malocclusion was produced in the experimental group (n = 20) by gluing a wire, 1 mm in diameter, on the upper left first molar. Duration of the procedure was 20 min. In the control group (n = 12), rats were forced to open their mouths for the same time as in the experimental group. Histomorphological changes of the ZMS were examined at intervals of 1, 2, 4 and 8 weeks. The specimens were stained with hematoxylin-eosin and Mallory's azan. The suture in the control group showed a regular functional arrangement of component fibers, and osteoblasts lined the periphery of new bone at the inner half of the suture. On the untreated side in the experimental group, osteoclasts were most abundant after 2 weeks. Histomorphometric quantification of the sutural width revealed that, at the inner half of the suture, the width of the sutural space on the treated side in the experimental group was greater than that in the control group after 4 weeks (p < 0.05). The argyrophilic nucleolar organizer region (AgNOR) technique was used to investigate the transcriptional activity of fibroblasts in the suture. At the inner half of the suture, the number of AgNORs on the untreated side in the experimental group was greater than that on the treated side and that in the control group after 2 weeks (p < 0.05). Around the tip of the suture and at the outer half of the suture, there was no appreciable difference in the AgNOR number between the experimental and control groups. It was concluded that unilateral changes in occlusion had different effects on the treated and untreated sides of the ZMS. Moreover, the inner and outer halves of the suture showed different histological changes in response to experimental malocclusion.

Animals↗

Acrylic bite plane for treatment of malocclusion in a young horse.

A 5-month-old quarter horse filly was presented for evaluation of a congenital overbite. The horse was diagnosed with a class 2 malocclusion. A non-removable, acrylic bite plane was constructed to provide a surface for the occlusal forces to be directed in a manner maintaining the normal anatomic position of the premaxilla. The preservation of normal anatomic relationships provided free range of motion of the mandible and maximized its growth potential, limiting the malocclusion. Although normal occlusion was not attained, partial incisor occlusion was present 20-months following initial treatment. Regular occlusal equilibration is mandatory to optimize occlusion and minimize future complications associated with malocclusion.

Acrylic Resins↗

The importance of the level of the lip line and resting lip pressure in Class II, Division 2 malocclusion.

Many clinicians hypothesize that retroclination of the maxillary central incisors in Class II, Division 2 malocclusion is caused by increased resting lip pressure against these teeth. The purpose of this study was (1) to verify this assumption by means of simultaneous lip-pressure measurements at two different levels on the maxillary central incisor crowns, and (2) to examine factors that could possibly contribute to the increased resting lip pressure. This is the first study to prove that individuals with Class II, Division 2 malocclusion (n = 21) have the upper central incisors exposed to significantly higher lip pressure than those with Class I malocclusion (n = 21). Our statistical evaluation revealed that this is primarily attributed to a high lip line and not to a hypertonic peri-oral musculature. We concluded that orthodontic treatment of Class II, Division 2 cases should include intrusion of the maxillary incisors, to eliminate the non-physiologically high pressure exerted by the lower lip on these teeth and, consequently, to reduce the high risk of a post-orthodontic relapse.

Adult↗

Children's perceptions of their own malocclusions.

Recognition by a parent or child of an occlusal abnormality is one of the many factors which may influence a desire for orthodontic treatment. Non-orthodontists may not estimate the severity of malocclusion reliably and may use different criteria from orthodontists for the process. The present study therefore sought to examine the reliability of parents' and children's perceptions of the children's own malocclusions with rating scales under two anchoring conditions and to test the discrepancy between their estimates and those of a panel of orthodontists. The children's and parents' assessments had limited test-retest reliability but instead of making guesses about the severity of their malocclusions they consistently gave low estimates. These effects were not influenced by the additional anchoring stimuli.

Adolescent↗

The prevalence and severity of malocclusion and the need for orthodontic treatment in 9-, 12-, and 15-year-old Glasgow schoolchildren.

An epidemiological investigation involving 765 Glasgow schoolchildren aged nine, twelve, and fifteen years was undertaken to assess the severity of malocclusion, the need for orthodontic treatment, and the proportion of children in each age group who had previously received treatment. An index termed the Malocclusion Severity Index (MSI) was developed to establish objectively the severity of malocclusion in each individual. Fifty sets of orthodontic study models and six orthodontists assessed the reproducibility and validity of the index. Although there was a significant reduction in the proportion of children in need of orthodontic treatment between 9 and 15 years of age, a considerable number were still in need of treatment; crowding of their dentitions being responsible for the majority of the treatment requirement. The MSI was found to be as precise and valid as previously developed occlusal indices, for estimating the treatment needs of sample populations.

Adolescent↗

Horizontal skeletal typing in an ethnic Chinese population with true Class III malocclusions.

Eighty Chinese adults with true Class III malocclusions were analysed cephalometrically to determine the percentage in each horizontal skeletal subtype. The maxillary and mandibular skeletal bases for each subject were analysed using angular (SNA/SNB) as well as linear (point A/B to McNamara's line) criteria. Results indicated that mandibular hyperplasias with normal anteroposterior maxillary position comprised the majority of true Class III malocclusions. While the majority of Class III in males were due to hyperplastic mandibles and normal maxillary antero-posterior relationship, most of the female Class III malocclusions were due to normal mandibles and hypoplastic maxillae. There was no significant difference between the incidence in Class III subtypes when using either angular or linear criteria.

Adult↗

Malocclusion in inbred strain-2 weanling guineapigs.

The incidence of malocclusion was recorded for 4 years. Malocclusion occurred only in animals less than 2 months old. The incidence was significantly reduced (P greater than 0.001) by breeding from animals without affected siblings: it is suggested that malocclusion in this colony has a genetic basis.

Age Factors↗

Ultrastructural abnormalities of muscle spindles in the rat masseter muscle with malocclusion-induced damage.

Human temporomandibular disorders due to disturbed occlusal mechanics are characterized by sensory, motor and autonomic symptoms, possibly related to muscle overwork and fatigue. Our previous study in rats with experimentally-induced malocclusion due to unilateral molar cusp amputation showed that the ipsilateral masseter muscles undergo morphological and biochemical changes consistent with muscle hypercontraction and ischemia. In the present study, the masseter muscle spindles of the same malocclusion-bearing rats were examined by electron microscopy. Sham-operated rats were used as controls. In the treated rats, clear-cut alterations of the muscle spindles were observed 26 days after surgery, when the extrafusal muscle showed the more severe damage. The fusal alterations affected predominantly capsular cells, intrafusal muscle fibers and sensory nerve endings. These results suggest that in the malocclusion-bearing rats, an abnormal reflex regulation of the motor activity of the masticatory muscles may take place. They also allow us to hypothesize that muscle spindle alterations might be involved in the pathogenesis of human temporomandibular disorders.

Animals↗