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PubMed2006

The orthodontic condition of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys in the United Kingdom. AIMS: This paper reports on the orthodontic condition of children aged 12 and 15 years. METHODOLOGY: A representative sample of children across the UK were invited to participate in a clinical dental examination in school. Two thousand, five hundred and ninety-five 12-year-olds and 2,142 15-year-olds were examined. Current and past orthodontic treatment and type of appliance worn were recorded. Orthodontic treatment need was assessed by the Modified IOTN in those not undergoing treatment. A postal questionnaire sought parents' views on the orthodontic condition of their children and perceived need for treatment. RESULTS: At age 12, 35% were judged to have an orthodontic treatment need, 57% had no need and 8% were wearing an appliance. The corresponding figures at age 15 were, 21% (need), 65% (no need) and 14% (wearing appliance). A higher proportion of girls (p < 0.05) were wearing an appliance than boys. A greater proportion of 15-year-olds were undergoing treatment than in the 1993 and 1983 surveys and the use of fixed appliances had increased. CONCLUSIONS: In this representative sample of UK children, one in five were still judged as having an orthodontic treatment need at age 15 years, as determined by the modified index of orthodontic treatment need. However, considerable variation was observed between professional and lay perceptions of need.

Adolescent↗
PubMed2002

Alkaline phosphatase activity in gingival crevicular fluid during human orthodontic tooth movement.

Bone remodeling that occurs during orthodontic tooth movement is a biologic process involving an acute inflammatory response in periodontal tissues. A sequence characterized by periods of activation, resorption, reversal, and formation has been recently described as occurring in both tension and compression tooth sites during orthodontic tooth movement. We used a longitudinal design to investigate alkaline phosphatase (ALP) activity in gingival crevicular fluid (GCF) to assess whether it can serve as a diagnostic aid in orthodontics. Sixteen patients (mean age, 15.5 years) participated in the study. The maxillary first molars under treatment served as the test teeth (TT) in each patient; in particular, 1 first molar was to be retracted and hence was considered the distalized molar (DM), whereas the contralateral molar (CM) was included in the fixed orthodontic appliance but was not subjected to the distal forces. The DM antagonist first molar (AM), free from any orthodontic appliance, was used as the baseline control. The GCF around the experimental teeth was harvested from mesial and distal tooth sites immediately before appliance activation, 1 hour after, and weekly over the following 4 weeks. The clinical gingival condition was evaluated at the baseline and at the end of the experimental term. ALP activity was determined spectrophotometrically at 30 degrees C, and the results were expressed as total ALP activity (mUnits/sample). GCF ALP activity was significantly elevated in the DMs and the CMs as compared with the AMs at 1, 2, 3, and 4 weeks; conversely, in the AMs, GCF ALP activity remained at baseline levels throughout the experiment. Moreover, the enzyme activity in the DMs was significantly greater than in the CMs. In the DMs, a significantly greater ALP activity was observed in sites of tension compared with sites of compression. This difference was not seen with the CMs, in which the enzyme activity increased to the same extent in tension and compression sites. These results suggest that ALP activity in GCF reflects the biologic activity in the periodontium during orthodontic movement and therefore should be further investigated as a diagnostic tool for monitoring orthodontic tooth movement in clinical practice.

Adolescent↗
PubMed2001

Orthodontic finalization strategies in dysfunctional adult patients.

Although orthodontic treatment for the finalization of temporomandibular dysfunction (TMD) patients is often advocated, it represents a risk of failure. Furthermore, in the literature there are few articles that illustrate appropriate orthodontic strategies for the finalization of these patients. In this article the authors suggest a step-by-step clinical procedure in order to: 1. verify the rationale for orthodontic finalization in TMD patients; 2. illustrate the guidelines for correct orthodontic treatment; and 3. suggest a strategy to stabilize the mandible during orthodontic treatment and to retain that stabilization after treatment. If splint therapy is successful in relieving the TMD symptoms, a fixed posterior bilateral stop is used for occlusal stability. After one or two months during which the bilateral stop is shown to be adequate in maintaining TMJ health without a splint, orthodontic finalization can be performed with minimal risk of failure. The essential sequences of Class I, Class II, and Class III treatment for the finalization of TMD patients are also presented. The difficult goal of a long term stability in cases that have been orthodontically finalized is reached by the conversion of the posterior bilateral stops (crown build-ups) into permanent vertical stops.

Adolescent↗
PubMed2000

Temporomandibular disorders and the need for stomatognathic treatment in orthodontically treated and untreated girls.

The aim of this investigation was to study symptoms of temporomandibular disorders (TMD) and headaches longitudinally in girls with Class II malocclusions receiving orthodontic treatment in comparison with subjects with untreated Class II malocclusions and girls with normal occlusion, and to evaluate the need and demand for stomatognathic treatment. The frequency and location of subjective symptoms of TMD and headaches were registered by means of an interview and a questionnaire in three groups of age-matched adolescent girls. Sixty-five Class II subjects received orthodontic fixed straight-wire appliance treatment (Orthodontic group), 58 with Class I malocclusion were orthodontically untreated (Class II group) and 60 had a normal occlusion (Normal group). Individual fluctuations of reported symptoms of TMD were found in all three groups over the 2-year period of the study. Subjects with untreated Class II malocclusions rated their overall symptoms of TMD as more severe than the Orthodontic and the Normal groups. In the Orthodontic group, the prevalence of symptoms of TMD decreased over the 2 years. The overall prevalence of symptoms of TMD was, however, lower in the Normal group than in the other two groups. The need for stomatognathic treatment in the whole sample was estimated to be 13 per cent, while the actual demand was 3 per cent. The large fluctuation of symptoms of TMD over time leads us to suggest a conservative treatment approach when stomatognathic treatment in children and adolescents is considered. The results show that orthodontic treatment did not increase the risk of TMD.

Adolescent↗
PubMed1999

The provision and outcome of orthodontic services in a Norwegian community: a longitudinal cohort study.

In a systematic child dental care system, professionals, consumers, and purchasers have a common interest in ensuring that provision and outcome of orthodontic care fulfill the goals of the service and the public's expectations. The purpose of this prospective study was to examine whether treatment was in fact provided to children with a normative treatment need, and also to assess the outcome of treatment. The baseline data were established for a sample of 83 11-year-olds before decisions about orthodontic treatment had been made, by recording the individuals' orthodontic concern as reported in questionnaires and their occlusal condition according to an index of orthodontic treatment need (NOTI). At re-examination at the age of 16 years, it was also recorded whether the individual had received orthodontic treatment. Most individuals (83%) with a normative need had been treated as well as some individuals without need but who had expressed orthodontic concern. Treatment had resulted in occlusal improvement ('health gain') in most patients, and generally this improvement paralleled a decrease in concern. The goals of the orthodontic service seem to have been fulfilled to the extent that residual treatment need was infrequent. The high treatment rate (63%) and standard may explain why all individuals, both treated and untreated, expressed satisfaction with their dental appearance at 16 years of age.

Adolescent↗
PubMed1997

Measuring beliefs about orthodontic treatment: a questionnaire approach.

OBJECTIVES: Few studies have examined what parents and orthodontists expect from and value about orthodontic treatment. In this study, we designed and tested a questionnaire to outline what drives consumer demand for children's orthodontic care. Further, we present data from the questionnaire to illustrate how expectations and values pertaining to orthodontic treatment relate to sociodemographic variables. METHODS: Subjects were 220 Pennsylvania orthodontists and 220 parents at a university orthodontic clinic who were administered a questionnaire designed to assess what parents and orthodontists value about and expect from orthodontic treatment. Items for the questionnaire were developed via a qualitative, telephone interview process. Data were analyzed using factor analysis and reliability analysis for scale development, and analysis of variance for preliminary validity assessment. RESULTS: Through factor analysis, the questionnaire was reduced from 84 to 52 items, and eight scales were examined: expected treatment benefits, expected treatment risks (short- and long-term), expected treatment inconveniences, value of treatment benefits, value of risks (short- and long-term), and value of treatment inconveniences. For parents, the reliability for all scales was in the acceptable range. For orthodontists, only the "short-term risks" scale failed to attain an acceptable reliability. Preliminary validity was assessed through examining relationships between demographic variables and subscale scores. For parents, income, father's education level, and sex of respondent were related to treatment expectations and values. For orthodontists, age, sex, and patient volume were related to treatment values. CONCLUSIONS: The questionnaire developed in the present study was found to be practical and reliable for use with providers and consumers of orthodontic care and can be used to explore factors affecting the demand for orthodontic care. Implications of possible unrealistic treatment expectations on the part of orthodontists and parents also are discussed.

Adolescent↗
PubMed2004

Demand and referral pattern for orthodontic care at University College Hospital, Ibadan, Nigeria.

OBJECTIVE: To assess the demand and pattern of referral for orthodontic services at University College Hospital, Ibadan, Nigeria. DESIGN: A 21-month prospective clinic-based study of consecutive orthodontic patients. SETTING AND SAMPLE POPULATION: The orthodontic clinic of University College Hospital, Ibadan, Nigeria. One hundred and seventy-eight (178) consecutive patients, consisting of 79 (44.4%) males and 99 (55.6%) females with mean age of 16.21+/-7.81 years were studied. RESULTS: 80% of subjects were 20 years of age or younger, while less than 2% were over 40 years of age. More females sought orthodontic care than males. Over 43% of the patients needed removable orthodontic appliances while close to 17% required treatment with fixed appliances. Extractions of retained primary teeth and other grossly malpositioned teeth accounted for 9.6% while 24.7% needed observation of occlusal developments before any treatment decisions could be made. Dentists were noted to be the main referrers of these patients, accounting for over 49% of the referrals, followed by 25.4% who were self referred, and 18.3% who attended under parental influence. CONCLUSION: More girls than boys demanded orthodontic care and dentists were the major referrers of orthodontic patients.

Adolescent↗
PubMed2006

Implantable devices as orthodontic anchorage: a review of current treatment modalities.

UNLABELLED: Recently, there has been a dramatic increase in the use of implantable devices as direct adjuncts to orthodontic treatment. Whereas the use of conventional dental implants has been researched extensively, the body of literature associated with the more recent uses of implantable devices in orthodontics is relatively small. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. CLINICAL SIGNIFICANCE: This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.

Alveolar Process↗
PubMed2001

Profile of orthodontic services provided in private practice by general practitioners and specialist orthodontists for an insured population.

In Australia, the proportion, volume and type of orthodontic care provided by general practitioners and orthodontists are largely unknown. The overall objective of this study was to create a profile of orthodontic services provided by general practitioners and orthodontists for a cohort of insured patients using private practices in New South Wales, Australia, from 1st January 1992 to 31st December 1995. Data were derived from claims records submitted by members of a health insurance fund for rebates for fees paid to private practitioners for orthodontic services they received during the study period. Distribution of the volume and type of service provided by general practitioners and orthodontists was compared using the Chi-squared test. Statistical significance was taken at the 5 per cent level. Orthodontic services were provided predominantly by orthodontists (80%). Fixed orthodontic treatment was provided almost exclusively (91%) by orthodontists. The majority of removable appliance services was provided by general practitioners. Orthodontists provided more orthodontic services in the capital city and other metropolitan areas, whereas general practitioners provided more orthodontic services in rural areas. Orthodontists provided more services to members in the highest socio-economic group, whereas general practitioners provided more services to members in the lowest socio-economic group.

Age Factors↗
PubMed2003

Orthodontic training in pediatric dental residencies.

The purpose of this study was to determine the amount and types of orthodontic training in pediatric dental residencies. A twenty-one-item survey was mailed to sixty directors of pediatric dental residencies. Follow-up surveys were sent to those who had not responded. Fifty-two surveys were returned for a response rate of 87 percent. Most programs provided forty-eight formal orthodontic course hours, one-half to one day of clinical orthodontic experience per week, and six to ten case starts for each resident. Most program directors anticipated this amount of experience would increase or stay the same in the future. Though most programs had an affiliated graduate orthodontic program, fewer than half of the programs had an orthodontist on faculty from the affiliated program (43 percent). As expected, orthodontic training varies with different program characteristics. The faculty members teaching orthodontics in pediatric dental residencies are often not from affiliated graduate orthodontic programs. Most program directors do not anticipate a decrease in the didactic or clinical components in the next five years.

Analysis of Variance↗
PubMed2005

An orthodontic information package designed to increase patient awareness.

BACKGROUND: Most patients and their parents experience difficulty in fully appreciating the implications and demands of orthodontic treatment. This is largely because of inadequate understanding of the process of treatment or the commitment required. OBJECTIVES: To determine if a specifically developed video information package could significantly increase patient awareness of the implications of a full course of orthodontic treatment. Changes in attitude to orthodontic treatment after viewing the package were also measured. METHODS: Year 7 (12 year-old) students in two primary schools in the City of Gold Coast, Australia were randomly allocated to either a study group or a control group. Knowledge of and attitude to orthodontic treatment were measured with self-administered questionnaires before and after viewing the information package. RESULTS: The intervention group showed a 15 per cent gain in knowledge (p < 0.001). There was no gain in knowledge for the 45 students in the control group. There was no measured change in perception of need for orthodontic treatment in the study group. There was, however, an increase in potential compliance and positive attitude to the appearance of orthodontic appliances. There was a small increase in willingness to undertake treatment, but this was not statistically significant. CONCLUSIONS: The information package developed for this study increased awareness of the implications and practical difficulties which may be encountered during a course of orthodontic treatment, and produced some changes in attitude to treatment.

Attitude to Health↗
PubMed1990

[A study of active induction of orthodontic therapy in TMJ dysfunction syndrome--from the data of patients with TMJ dysfunction in adolescents].

It seems that active orthodontic therapy using multi-bracket appliances presents effective assurance of a physiological stable occlusion for TMJ dysfunction syndrome in adolescents. The efficiency and problems concerning the progress of active orthodontic therapy after splint therapy were examined from the data of the change of occlusal conditions, and the function of masticatory muscles before and after therapy for TMJ dysfunction from four cases for which we performed orthodontic therapy activity. 1. All of the occurring symptoms of the TMJ dysfunction syndrome (limitation, pain, sound) in the progress of orthodontic therapy were concerned with using intermaxillary elastic. The symptom which occurred in process of using only intra-maxillary elastic was just a malaise of the TMJ. Also the sound of the TMJ relapsed in the process of using class III intermaxillary elastic and recurred after the multi-bracket appliance was removed. In this case, the condylar vertical position after orthodontic therapy changed from the lower position to the center position compared with the first visit. 2. Malocclusion was improved with orthodontic therapy in all four patients. 3. The function of the masticatory muscles after orthodontic therapy was improved in comparison with the first visit by evaluation of the masticatory muscles activity and the state of silent period.

Adolescent↗
PubMed1996

Orthodontic care in Sweden. Outcome in three counties.

The purpose of this series of studies was to evaluate the outcome of orthodontic care in Sweden from the professional's and the patient's perspective. In addition, a model was devised for the priority-planning of orthodontic care and for evaluating the different factors influencing the decision for orthodontic treatment. The results may be summarized as follows: Treatment Decision. Treatment desire, followed by treatment need and treatment benefit were the most important factors to consider when deciding whether or not treatment should be carried out. Regardless of the differences in resources and the structure of the free public care, a substantial proportion of the untreated 19-year-olds had malocclusions with treatment need, but they had no desire for treatment. Most of the 27-year-old individuals were satisfied with their earlier treatment decision, regardless of whether they had undergone orthodontic treatment. Dental professionals were considered to have had the greatest influence on this decision, which means that desire for treatment may be guided by the orthodontist. Individuals with malocclusions and treatment need--but who had refused proposed orthodontic treatment--were in general more discontented with their dental arrangement than other respondents, and a majority of them regretted their decision. Greater information to these individuals would have been desirable. Resources and Treatments Provided by General Practitioners or by Specialists. The sparsity of specialist resources resulted in either a greater restriction on the number necessary treatments being initiated or a greater proportion of the treatment being provided by general practitioners. In the 3 counties analysed, the treatment standard correlated well with the available resources: the greater the number of orthodontic specialists and ability to supervise the work of general practitioners and taking care of patients in need of specialist treatment, the higher the standard of treatment. Individuals treated by specialists were more contented than individuals treated by general practitioners. The measures of treatment outcome in general yielded more favourable scores for specialist treatments than for treatments provided by general practitioners, despite the specialist treatments on the average being classified as more difficult than those provided by general practitioners. Perceived treatment difficulty. About one-fourth of all treatments were classified as easy, one-fourth as moderately difficult, and one-half as difficult. The perceived treatment difficulty was associated on a group basis with the pretreatment need. The treatment investment increased and the treatment outcome became less favourable with increasing perceived difficulty. The treatment outcome was least favourable in the group where no treatment was suggested. Almost every fourth treatment was successfully carried out by mere extraction therapy. Attitudes in 27-year-olds. Orthodontic treatment was considered important by three out of four individuals, even in cases where irregularities of the teeth were small. A majority of the individuals thought that they would have been able to wear visible braces if needed, even in adult age. Methodological aspects. Studies that have used different indices to evaluate treatment outcome can only be compared with great caution. Measures with wide bases for evaluation may be more valid than measures with narrow bases. To estimate treatment outcome in terms of decrease of treatment need, the Indication Index may be recommended.

Adolescent↗
PubMed1990

Distribution of 3H-proline within transseptal fibers of the rat following release of orthodontic forces.

Maxillary right first molar teeth of rats were tipped mesially with an orthodontic appliance for 2 weeks (experimental group), 3H-proline was injected, and orthodontic forces were removed 6 hr later (time 0). The contralateral molar teeth of treated (internal control group) and age- and weight-matched untreated animals (external control group) were also studied. Diastemata were created between the molar teeth by the orthodontic appliance, and transseptal fibers between first and second (P less than 0.001) and second and third molars (P less than 0.005) were significantly lengthened as compared to external and internal controls at time 0. Diastemata between molar teeth were closed 5 days after removal of orthodontic force. Transseptal fibers adjacent to the source of the orthodontic force (mesial region) had the highest mean number of 3H-proline-labeled proteins at time 0 and at all times following removal of the force (P less than 0.001), and had the highest rate of labeled protein removal (P less than 0.001). Half-lives for removal of 3H-proline-labeled transseptal fiber proteins were significantly greater in mesial and distal regions and significantly less in middle regions of experimentals than in corresponding regions of external controls (P less than 0.001). These data suggest the following: 1) transseptal fibers adjust their length by rapid remodeling in regions experiencing a tensile force; 2) collagenous protein turnover within the middle third of the transseptal fibers is more rapid subsequent to release of orthodontic force than during normal physiologic drift, suggesting that this region adapts rapidly to changes in adjacent tooth position and that these fibers do not play a significant role in relapse of orthodontically relocated teeth; and 3) significant differences in turnover rates of 3H-proline-labeled transseptal ligament proteins of external and internal control quadrants suggest that tooth movement produces both local and systemic effects on collagenous protein metabolism.

Animals↗
PubMed2007

Metallurgical characterization, galvanic corrosion, and ionic release of orthodontic brackets coupled with Ni-Ti archwires.

In orthodontics, a combination of metallic alloys is placed into the oral cavity during medical treatment and thus the corrosion resistance and ionic release of these appliances is of vital importance. The aim of this study is to investigate the elemental composition, microstructure, hardness, corrosion properties, and ionic release of commercially available orthodontic brackets and Copper Ni-Ti archwires. Following the assessment of the elemental composition of the orthodontic wire (Copper Ni-Ti) and the six different brackets (Micro Loc, Equilibrium, OptiMESH(XRT), Gemini, Orthos2, and Rematitan), cyclic polarization curves were obtained for each material to estimate the susceptibility of each alloy to pitting corrosion in 1M lactic acid. Galvanic corrosion between the orthodontic wire and each bracket took place in 1M lactic acid for 28 days at 37 degrees C and then the ionic concentration of Nickel and Chromium was studied. The orthodontic wire is made up from a Ni-Ti alloy with copper additions, while the orthodontic brackets are manufactured by different stainless steel grades or titanium alloys. All tested wires and brackets with the exception of Gemini are not susceptible to pitting corrosion. In galvanic corrosion, following exposure for 28 days, the lowest potential difference (approximately 250 mV) appears for the orthodontic wire Copper Ni-Ti and the bracket made up from pure titanium (Rematitan) or from the stainless steel AISI 316 grade (Micro Loc). Following completion of the galvanic corrosion experiments, measurable quantities of chromium and nickel ions were found in the residual lactic acid solution.

Copper↗
PubMed1999

Factors influencing the decision about orthodontic treatment. A longitudinal study among 11- and 15-year-olds and their parents.

The aims of the study were to evaluate the attitude towards orthodontic treatment among 11-(T1) and 15-year-old children (T2) and their parents, to present the distribution of referral rate and treatment uptake by a treatment need index assessed at T1 and to elucidate factors influencing the decision about orthodontic treatment in the period from T1 to T2. A group of 359 children and their parents answered separate questionnaires at T1, and 293 families responded to a follow-up study 4 years later. For the clinical examination, 224 children participated after exclusion of children in active treatment. The dental study casts were assessed by the Index of Orthodontic Treatment Need (IOTN). The mean referral rate was 56%, with a variation from 40% to 71% among different dental clinics. About 44% of the children had completed or were undergoing orthodontic treatment at T2. No significant sex differences among referred and treated children were discovered. Aesthetic motives were the most frequently reported subjective reason for orthodontic care. The untreated group expressed diminishing treatment desire in the follow-up period. The logistic regression analysis selected Dental Health Component (DHC) grades as a strong predictor for treatment uptake, followed by parents' concern and attitude to braces, while the 11-year-olds' own orthodontic concern was less significant. Children in the untreated group with late treatment decisions (T2) were best predicted by Aesthetic Component (AC) changes from T1 to T2. The results indicate that dentists play a key role in determining orthodontic treatment levels. High referral rates secured low risk of denying care to some patients. Treatment decision may be guided by the orthodontist. However, individual variation in attitude and desire influence treatment uptake even among children with great need.

Adolescent↗
PubMed2000

Briefing of orthodontic patients.

The aim of this study was to record the level of relevant knowledge among orthodontic patients and their parents in order to determine how they prepare for the first consultation and what level of orthodontic briefing is needed. The focus was on the response of young patients to briefing, with other objectives being to investigate what briefing media are used by orthodontists for patient motivation and improved compliance as well as the extent to which new briefing media are needed. Two hundred 9- to 12-year-old patients and their parents were interviewed, using a standardized questionnaire to record their knowledge and their need for information on orthodontic matters. In addition, 200 orthodontists were asked to fill in a questionnaire and to return it together with the briefing material used by them. The response rate was 62%.--To obtain an overview of the orthodontic briefing material available, various institutions (PR offices of health insurance companies, professional associations, specialist publishing houses, regional study groups) were approached with written requests for relevant material. Currently available children's books with dental or orthodontic subject matter were also scrutinized. 74% of children wanted to learn more about their orthodontic treatment and 40% expressed anxiety, in particular towards fixed appliances and impression-taking. 98% of orthodontists reported that the briefing interview was the main source of information. Despite being the person primarily in need of motivation, however, the child was not the focus of attention at the first consultation, even though that consultation was the preferred source of information for 51% of children. Other briefing media, consisting mainly of demonstration models and leaflets, were used primarily in the orthodontist's waiting room and surgery. Space-taking media (video films, computers) were rarely used, as were books. It is concluded that there is a clear-cut need for the orthodontic briefing process to be improved.

Audiovisual Aids↗
PubMed2003

Interdisciplinary study of orthopedic and orthodontic findings in pre-school infants.

BACKGROUND AND AIM: The assessment of correlations between orthopedic and orthodontic data based on interdisciplinary studies is of scientific and practical interest in the differentiation of preventive diagnostic and therapeutic fields between orthodontics and orthopedics. In the published literature there are various studies analyzing the correlations between specific Angle classes and orthopedic parameters. Results of these studies indicate a potential correlation between scoliosis and Class II malocclusion as well as between weak body posture and Class II malocclusion. The aim of the present interdisciplinary study was to examine correlations between orthodontic and orthopedic findings in pre-school infants and to evaluate them with respect to preventive recommendations. PATIENTS AND METHOD: 59 pre-school infants (29 boys, 30 girls) aged 3.5-6.8 years (mean: 5.0 years) were enrolled in this study. A standardized orthodontic and orthopedic examination protocol was used. RESULTS: The orthodontic examination showed Angle class distributions comparable with those in non-selected groups (Class I: 63%, Class II: 32%, Class III: 5%). The orthopedic examination revealed pathologic findings in 52% of the subjects, with statistically significant correlations between scoliosis and Class II malocclusion (p = 0.033) and between weak body posture and Class II malocclusion (p = 0.028). CONCLUSION: It can be concluded from the results that the orthodontic finding of Angle Class II in pre-school infants should induce prophylactic screening. The orthodontist could then not only initiate early orthodontic treatment to prevent incisor trauma in patients with extreme overjet, but could also take account of potential orthopedic malformations on a preventive interdisciplinary basis in pre-school infants with Class II malocclusions.

Child↗