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PubMed2005

Midfacial and mandibular morphometry of children with Class II and Class III malocclusions.

There is insufficient evidence in conventional cephalometric analysis of the actual sites of putative maxillofacial change in Class II and Class III malocclusions. The purpose of this study was to provide more information about the morphological characteristics of the midfacial complex and mandible in children with Class II or III malocclusions. Seventy children with Class II, division 1 malocclusion and 70 children with Class III malocclusion were compared with 70 children with normal occlusion. This study was conducted to carry out geometric morphometric assessments to localize alterations using Procrustes analysis and thin-plate spline analysis. Procrustes analysis indicated the midfacial and mandibular morphologies differed between normal occlusion subjects and subjects with Class II or Class III malocclusion (P<0.0001). The deformations in subjects with Class II malocclusion may represent a developmental elongation of the palatomaxillary complex and a shortening of the mandible anteroposteriorly, which leads to the appearance of a protruding midface and retruding mandibular profile. In contrast, the deformations in subjects with Class III malocclusion may represent a developmental shortening of the palatomaxillary complex and elongation of the mandible anteroposteriorly, which leads to the appearance of a retrognathic midface and prognathic mandibular profile.

Cephalometry↗
PubMed2006

[Morphological characteristics of craniofacial complex in adults with skeletal class III malocclusions].

OBJECTIVE: To identify the morphological characteristics of craniofacial structure in patients with skeletal class III malocclusions. METHODS: The study samples consisted of 63 lateral cephalometric radiographs of adult with class I malocclusion (32 male and 31 female, ages >17 years) and 27 patients with skeletal class III malocclusion (14 male and 13 female, ages >17 years, ANB >-3). The proportion of posterior cranial base and the mandibular length were measured. RESULT: There was an increase in total mandibular length (Go-Gn, Cd-Gn) in female patients with class III malocclusion. There was a decrease in the posterior cranial base length (S-Ar) and an increase in mandibular length (Go-Gn) in male patients with class III malocclusion. CONCLUSION: The major craniofacial characteristics of skeletal class III malocclusion compared with those of class I malocclusion are smaller posterior cranial base in males and larger mandibular length in both sexes.

Adolescent↗
PubMed2004

Malocclusion and crowding in an orthodontically referred Turkish population.

This study was conducted to evaluate malocclusion and crowding in 1356 patients (793 girls, 563 boys) referred to the Department of Orthodontics, Suleyman Demirel University, Turkey. Class I was the most frequently seen malocclusion in this referred Turkish orthodontic population whereas Class II, division 2 was the least frequently seen. Comparison of mean ages of the malocclusion groups indicated statistically significant difference between Class I and Class II, division 1 groups (P < .05). The lowest mean age was present in the Class II, division 1 group. Mild mandibular crowding was the most common finding whereas severe mandibular crowding was seen least frequently in all malocclusion groups. Cross tabulation of maxillary and mandibular crowding indicated that mild maxillary and severe mandibular crowding in the same patient was rarely seen in all types of malocclusions. Moderate maxillary and severe mandibular crowding in the same patient was another rare finding for all malocclusion groups.

Adolescent↗
PubMed2003

Malocclusion and caries prevalence: is there a connection in the primary and mixed dentitions?

The purpose of this epidemiological cross-sectional study was to determine the prevalence of malocclusion and caries in children and to investigate whether a relationship exists between prevalence of caries and studied malocclusion. The study consisted of 8,864 preschool and schoolchildren with primary dentitions (mean age 4.5 years) and mixed dentitions (mean age 8.9 years). 1997 WHO dental caries criteria were applied to both groups. The existence of an increased caries risk was deducted from the dmft and DMFT indices related to age. Malocclusion in primary and mixed dentitions was classified into seven types. Fifty-seven percent of all children had some form of malocclusion. Prevalence of malocclusion increased and was significantly greater in the mixed dentition sample (p < 0.001) than in the primary dentition sample. Seventy-four percent of children with primary dentitions and 23% of children with mixed dentitions had zero dmft and DMFT scores. Mean dmft indices in subjects with primary and mixed dentitions were 1.02 and 1.53, respectively. No positive correlation between prevalence of caries and malocclusion could be established in the sub sample with primary teeth only. However, statistically significant parallelism in prevalence of malocclusion and caries were found for posterior cross-bite (p= 0.050) and mandibular overjet (p= 0.013) in children with mixed dentitions.

Child↗
PubMed1993

Heritability of cephalometric and occlusal variables as assessed from siblings with overt malocclusions.

It has been thoroughly documented that measurements of the craniofacial complexes have moderate to high heritabilities--that they are primarily a consequence of "nature" rather than "nurture." In contrast, recent studies, which used twin and sibship analyses, have shown that malocclusions per se (i.e., measures of tooth position and dental interrelationships) have low heritabilities; malocclusions sensu stricto are primarily acquired (environmentally induced), not inherited. All such studies have, however, focused on persons not treated orthodontically. This can introduce selection bias since cases with moderate to severe malocclusions would have received treatment and, thus, be excluded from study. The present analysis addresses this issue of ascertainment bias by examining just that portion of the adolescent population receiving comprehensive orthodontics. Initial treatment records of 104 pairs of siblings were studied, all of whom subsequently received full-banded treatment. In this selected series of overt malocclusions, heritability estimates for craniometric variables were significantly lower than in a comparable series of adolescents with naturally occurring good occlusions, whereas heritability estimates for occlusal variations (e.g., rotations, crossbites, displacements) were significantly higher. This vindicates the clinical perception that siblings often present with similar malocclusions. We propose that the substantive measures of intersib similarity for occlusal traits reflect similar responses to environmental factors common to both siblings. That is, given genetically influenced facial types and growth patterns, siblings are likely to respond to environmental factors (e.g., reduced masticatory stress, chronic mouth-breathing) in similar fashions. Malocclusions appear to be acquired, but the fundamental genetic control of craniofacial form often diverts siblings into comparable physiologic responses leading to development of similar malocclusions.

Adolescent↗
PubMed2005

Intermaxillary tooth size discrepancy and malocclusion: is there a relation?

The aims of this study were to identify the possible sex differences in tooth size ratios between males and females, to determine whether there is a difference in the incidence of tooth size discrepancies for both the anterior and overall ratios when comparing with Angle Class I; Class II, division 1; Class II, division 2; and Class III malocclusion groups, to compare the tooth size ratios of different malocclusion groups with the anterior and overall tooth size ratios of 150 untreated normal occlusion subjects. In addition, the aim was to determine the percentage of tooth size discrepancies outside 2 SD from Bolton means for tooth ratios present in each malocclusion group and in the overall sample of this study. This study consisted of 150 subjects who served as the normal occlusion group and 560 patients who showed four different malocclusion characteristics (Angle Class I; Class II, division 1; Class II, division 2; and Class III). Tooth size measurements were performed on the models of normal occlusion and pretreatment models. For statistical evaluation, Student's t-test, analysis of variance and Tukey Honestly Significant Difference tests were performed. A significant sex difference was found only in the overall ratio for normal occlusion subjects (P < .001). All malocclusion groups showed statistically significant higher overall ratios than the normal occlusion group (P < .001). There were no statistically significant differences among malocclusion groups; however, there were a large number of patients within each group who had discrepancies greater than 2 SD from the mean. Further investigations are needed to explain the probable racial differences and relationships between malocclusion and tooth size measurements.

Adult↗
PubMed1998

A retrospective comparison of functional appliance treatment of Class III malocclusions in the deciduous and mixed dentitions.

This retrospective study compared the effectiveness of treatment of Class III malocclusions with the removable mandibular retractor in the deciduous and mixed dentitions. A group of 20 children with Class III malocclusions started treatment at a mean age of 5 years 1 month +/- 7 months (deciduous dentition), while a group of 18 children with Class III malocclusions started treatment at a mean age of 8 years 2 months +/- 9 months (mixed dentition). The mean observation period was 2 years 3 months +/- 6 months for the first group, and 2 years 4 months +/- 7 months for the second group. Matched control groups of children with untreated Class III malocclusions in the deciduous and in the mixed dentition (16 subjects and 15 subjects, respectively) were used. The cephalometric analysis was based on a stable basicranial reference system appropriate for longitudinal studies that begin at early developmental ages. The results showed that treatment of Class III malocclusions in the deciduous dentition produced a more significant anterior morphogenetic rotation of the mandible, due to a more upward and forward direction of condylar growth (P < 0.01). This leads to significantly smaller increments in mandibular total length (Co-Pg) in children with Class III malocclusions under-going very early treatment (P < 0.01). On the contrary, maxillary dento-alveolar protrusion induced by therapy was greater in Class III subjects treated in the mixed dentition (P < 0.01). The optimum timing to improve skeletal relationships in Class III malocclusions by means of a functional appliance appears to be in the deciduous dentition.

Age Factors↗
PubMed2006

Prevalence of malocclusion among 12-15-year-olds in Moshi, Tanzania, using Bjork's criteria.

OBJECTIVE: To assess the prevalence of malocclusion in 12-15 -year-olds in Moshi, Tanzania. DESIGN: Cross-sectional study. SETTING: Moshi Municipality, Kilimanjaro region, Tanzania. SUBJECTS: Two hundred and eighty nine randomly selected primary school children (153 males and 136 females) had a clinical examination for malocclusion traits done. RESULTS: The overall prevalence of malocclusion was 97.6%. Angle's Class II and III malocclusion occurred in 6.9% and 11% of the sample respectively. Crowding was encountered very frequently in both jaws, especially in the lower anterior segments. Anterior open bite occurred in 6.2% and the deep bite in 10.7% of the sample. There was no significant gender difference in either the overall prevalence of malocclusion or in the occurrence of the different occlusal traits. CONCLUSION: It was noteworthy that some of the malocclusion traits recorded were relatively minor deviations from the normal occlusion. Hence the high prevalence of malocclusion did not necessarily imply a heavy burden of need and demand for orthodontic treatment.

Adolescent↗
PubMed2002

A comparative study on the intercuspal occlusion among TMD patients, malocclusion patients and university students.

OBJECTIVE: The relationship between occlusion and temporomandibular disorders (TMD) remains disputed. The related epidemiological studies have been carried out focused on the occlusal characteristics in motion, for example in protrusion, retrusion or laterally extension and on some of malocclusion features. Very few studies were carried out on the intercuspal occlusion which is the most important occlusal relationship. Angle's classification of occlusion and the relationship of over-jet and over-bite are two prominent features now generally used in clinical practice for occlusal evaluation. In present study two kinds of features of occlusion were compared among TMD patients, malocclusion patients and university student volunteers, who of the laters represented nature population. METHODS: 100 continued cases visiting our TMD Clinic during the year of 2 000 with complain of TMD problem, 100 malocclusion patients in continued orthodontic department records, and 268 university student volunteers were included. All subjects were with complete dentitions, except of age-related third or second molar tooth eruption difference. Study cast were obtained for all 468 subjects involved and following characters were studied. 1. Angle's classification; 2. Over-jet and over-bite relationship. Anteriorly it included cross-bite, cusp-to cusp bite, deep over-bite (without deep over-jet), deep over-jet (with or without deep-bite), open bite, and others. Posteriorly it included cross-bite, reverse cross-bite and others. 3. Abnormal occlusal index: For the purpose of quantitatively comparing the abnormal occlusal relationship of over-bite and over-jet, the occlusal index was introduced. The anterior continued abnormal was scored as 3 while posterior continued oclcusal abnormal scored as 5. The sum of the scores in the same subject was taken as his abnormal occlusion index. RESULTS: 1. Ratio of Angle's I patients in malocclusion group was significantly lower than those in TMD group and US group (P < 0.05), while the later two groups had no difference (P > 0.05). 2. The ratios of anterior cross-bite and deep over-jet were higher in malocclusion group than those in other two groups. No significant difference for the other kinds of abnormal over-jet and over-bite relationship were found among the three groups. 3. The abnormal occlusion index of malocclusion group was higher than that of US group, but not than that of TMD group which had no difference with US group either. CONCLUSIONS: 1. Aesthetic related anterior abnormal occlusion such as anterior cross-bite and deep-over-jet attract more attention of popular. But they had no relationship with TMD. 2. TMD patients had not significant occlusal features on Angle's classification and over-jet and over-bite relationship compared to malocclusion and nature population subjects.

Dental Occlusion↗
PubMed2005

[The malocclusion of primary dentition in the suburb of Chengdu: a cross-section survey].

OBJECTIVE: To reveal malocclusion of primary dentition in the suburb of Chengdu. METHODS: Cross-section survey and malocclusion rate calculation were performed. RESULTS: There are 491 children with malocclusion from total 1 279 children; the rate of malocclusion is 38.38%. The most important malocclusion in primary dentition are over bite (III degrees), anterior cross bite, edge to edge bite, early loss of deciduous teeth, fused teeth. CONCLUSION: The rate of malocclusion of primary dentition in the suburb of Chengdu is a little bit light. Much work should be done to prevent or treat the malocclusion of primary dentition.

Child↗
PubMed2005

[Angle class I malocclusion in primary dentition and findings in permanent dentition--a follow-up study].

The aim of the study was to examine stability and changes in Angle Class I malocclusion from deciduous to permanent dentition in 168 subjects. All the subjects had Class I malocclusion in deciduous dentition, and were examined by the same orthodontist on two occasions during deciduous and permanent dentition. None of the subjects had received orthodontic therapy in the meantime. The results showed considerable changes from primary to permanent dentition. Crowding in primary dentition was retained in permanent dentition in 45.2% cases. In 16.2% cases it changed into normocclusion and 38.6% subjects developed other types of malocclusion. Open bite was retained in permanent dentition in 17.8% cases and in 17.8% subjects transformed into normocclusion. 64.4% subjects developed other types of malocclusion. Cross bite was retained in permanent dentition in 21.4% cases and in 28.6% subjects changed to normocclusion. Other types of malocclusion in permanent dentition developed in 50% subjects. In 30.8% of cases finding of premature loss of deciduous teeth was accompanied by extraction of some permanent teeth. Normocclusion was retained in 19.2% cases while 50% of children developed some type of malocclusion. Crowding, which was retained in permanent dentition in 45.2% cases, showed the highest degree of stability. Children with this type of anomaly in primary dentition displayed the highest frequency of total malocclusions (83.3% subjects). Out of all anomalies in primary dentition, cross bite most frequently switched to normal occlusion in permanent dentition (in 28.6% cases).

Adolescent↗
PubMed2006

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children.

UNLABELLED: Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce. PURPOSE: The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits. METHODS: The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed. RESULTS: The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit. CONCLUSION: It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Adolescent↗
PubMed1989

[Trends of the patients with malocclusion on dental clinic of pediatric dentistry].

The factors which determine the situation of continuation in malocclusion treatment and characteristic of patient with malocclusion in pediatric dentistry were estimated from the status and the trend of patients undergoing denture guidance at the outpatient clinic for pediatric dentistry. The following results were obtained. 1. Among the patients undergoing denture guidance, a majority were females. Among the different types of malocclusion, the reversed occlusion was the most frequent, being 54.3% among all malocclusions. 2. In particular the age for first visit was from under 3 years of age with reversed occlusion, and at this age, females were more numerous than males. 3. The first examination for denture guidance was related to the time which made effective diagnosis possible, and the patients with reversed occlusion had their first examinations consistently from 3 years of age, and the patients with crowding had their first examinations from 6 years of age to 11 years of age. 4. From the difference between the age of first visit and first examination, it was shown that the patients with reversed occlusion did not have their first examination under 3 years of age and for the patients with crowding who visited first at 3, 4 and 5 years of age, the first examination was performed after 6 years of age. The patients with crowding in the group who came for consultation by reference were later about two years compared with other two groups in the difference of motivation for visiting. 5. It is suggested that the factors which had an influence upon the situation of continuation of malocclusion treatment were; an existence of the use of an appliance, a substantial program of correspondence in regard to dental care for malocclusion before malocclusion treatment and concrete indication of the treatment.

Child↗
PubMed1995

Malocclusion in Labrador Inuit youth: a psychosocial, dental and cephalometric evaluation.

Epidemiological studies of malocclusion of world populations have been previously limited to dental parameters. This cross-sectional study examined the prevalence of malocclusion in the dentitions of Inuit (Eskimo) youth aged between 5-22 years from Labrador, Canada, using psychosocial, dental and skeletal (radiographic) parameters. Data were obtained from two communities, Nain (population 1079) and Hopedale (population 534). About 82% (n = 363) of the Inuit youth and 50% (n = 222) of their parents responded to the psychosocial questionnaires. In total, 78% (n = 348) of the Inuit youth were examined intraorally to determine the prevalence of malocclusion using the Treatment Priority Index (TPI), and 23% (n = 100) had cephalometric radiographs taken using a portable cephalometer. The results indicated that 95% of the Labrador Inuit youth examined had some degree of malocclusion, 10-16% were aware of their occlusal disharmonies, 55-65% wanted to have their teeth straightened, and 5% were teased by others because of their malocclusions. In addition, 63% of the parents seemed to be aware of their child's occlusal problems and 70% wished their children to wear orthodontic appliances if they were needed. Prevalence and awareness to malocclusion were positively correlated. According to the TPI, 18% had "severely handicapping" and 20% had "very severely handicapping" malocclusions. The TPI score increased with age from 5.25 in the young group to 8.05 in the older age group (mean 6.7). There were high prevalences of crowded anterior teeth, upper lingual posterior crossbites, and open or edge to edge bites. A prevalence of 35% Angle Class I, 49% Angle Class II and 16% Angle Class III molar relationships were observed. Cephalometric analysis demonstrated a mean wits measurement of -2.0 mm, a mean ANB angle of 4.7, a mean lower face height of 68.3 mm, a mean interincisal angle of 125 degrees and a mean frankfort mandibular plane angle of 31.3 degrees. A need for orthodontic care and further education were clearly indicated and highly recommended.

Adolescent↗
PubMed1982

Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions.

We attempted to assess the role of heredity in the development of Angle's Class II and Class III malocclusions by comparing craniofacial morphologic differences between parents with Class II offspring and those with Class III offspring and by analyzing the parent-offspring correlations within each Class II and Class III malocclusion group. Lateral and frontal roentgenographic cephalograms were obtained for ninety-six patients with Class II malocclusion, 104 patients with Class III malocclusion, and their respective parents. Mean cephalometric profile diagrams were superimposed between the two groups of parents as well as between their offspring. Within the two groups, the parent-offspring correlation coefficients were computed for nineteen variables connecting cephalometric landmarks. The differences in the craniofacial complex were evident in the two groups of parents as well as in their offspring. High correlation coefficient values were seen between parents and their offspring in the Class II and Class III groups. Thus, there appears to be a strong familial tendency in the development of Class II and Class III malocclusions. We conclude that the hereditary pattern must be taken into consideration in the diagnosis and treatment of patients with these classes of malocclusion.

Adolescent↗
PubMed2005

Variation in dental and skeletal open bite malocclusion in humans with amelogenesis imperfecta.

The amelogenesis imperfectas (AI) are a diverse group of genetic disorders primarily affecting the quality and or quantity of enamel, however, affected individuals often have an open bite malocclusion. Three main AI types are recognized based on the perceived developmental mechanisms involved and the enamel phenotype. The purpose of this investigation was to evaluate the association of the AI enamel defect with craniofacial features characteristic of an open bite malocclusion. The sample consisted of 54 AI affected and 34 unaffected family members from 18 different kindreds. Lateral cephalograms were digitized and measurements evaluated for vertical plane alterations using Z-scores. Forty two percent of AI affected individuals and 12% of unaffected family members had dental or skeletal open bite malocclusions. Skeletal open bite malocclusion was variably expressed in AI affected individuals. The enamel phenotype severity did not necessarily correspond with the presence or severity of open bite malocclussion. Open bite malocclusion occurred in individuals with AI caused by mutations in the AMELX and ENAM genes even though these genes are considered to be predominantly or exclusively expressed in teeth. Affected AI individuals with cephalometric values meeting our criteria of skeletal open bite malocclusion were observed in all three major AI types. The pathophysiological relationship between AI associated enamel defects and open bite malocclusion remains unknown.

Adolescent↗
PubMed2002

[Dental malocclusion among juveniles in Hangzhou municipality]

OBJECTIVE: To investigate the prevalence rate, malocclusion type and treatment rate as well as awareness of malocclusion among children and adolescents living in the Hangzhou municipality. METHODS: 1818 children and adolescents ages 7 approximate, equals 16 living in Hangzhou municipality were evaluated. RESULTS: The overall malocclusion rate was 35.75%. In Angle's classification: Angle I 593 cases (32.62%), Angle II 48 cases(2.64%),Angle III 9 cases (0.49%). Among the malocclusion type of crowding was mixed dentition 70.66%,permanent dentition 85.89%. In the overjet malocclusion mixed dentition was noted in 60.57% and permanent dentition in 51.05%.The type of overbite was mixed dentition 67.82%,permanent dentition 31.23%. In the crossbite of anterior teeth mixed dention was noted in 12.30% and permanent dention in 9.91%. Overall treatment rate for malocclusion was 10.15%.CONCLUSION: Among Hangzhou municipality juveniles there is both inadequate prevention and treatment of dental malocclusion.

Journal Article↗
PubMed1999

Relationship between fossa-condylar position, meniscus position, and morphologic change in patients with Class II and III malocclusion.

OBJECTIVE: To evaluate fossa-condylar-meniscus morphologic changes in patients with skeletal and dental Class III and Class II division 1 and 2 malocclusion to determine which type is related to internal derangement of the temporomandibular joint (TMJ) and whether the variation of TMJ structure is related to a particular type of malocclusion. MATERIALS AND METHODS: Seventy-two pretreatment orthodontic patients, ranging in age from 10 to 27 years, underwent examination of the right and left TMJs with corrected Schöller's position radiographs. Bilateral TMJ relationships of the fossa-condyle were examined through subjective evaluation and linear and area measurements. In addition, in 20 of the 72 patients, meniscus positions and morphologic changes were imaged with a 0.5 T sagittal magnetic resonance imaging system on the right and left TMJ. RESULTS: (1) The variation of condyle-fossa positions for identical types of malocclusion was very large. (2) Skeletal and functional Class III malocclusion patients demonstrated significantly more anteriorly positioned condyles. (3) Class II division 1 patients showed concentrically positioned condyles, but with slightly anterior displacement. (4) Class II division 2 patients demonstrated more posteriorly positioned condyles. (5) When condyles were in anterior or concentric positions, meniscus positions and morphology were normal and in concavoconcave shapes. (6) When condyles were in posterior positions, most meniscus positions were in normal or slightly anterior range and their shapes were also concavoconcave. The rest were significantly more anterior and their shapes were abnormal, as evidenced by thickened anterior bands. CONCLUSION: Class III and Class II division 1 malocclusion demonstrated normal structure and function of the TMJ. Class II division 2 malocclusion was obviously associated with abnormal structure and function of the TMJ.

Adolescent↗