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PubMed2004

Prevalence of malocclusion among adolescents in Ibadan, Nigeria.

The objective of this study was to determine the prevalence of malocclusion among predominantly Yoruba adolescents in Ibadan, Nigeria, and to compare the results with those of other authors. The sample for this epidemiological survey comprised 636 secondary school students, (334 [52.5%] boys and 302 [47.5%] girls), aged 12-17 years (mean age, 14.72 +/- 1.16 SD). The subjects were randomly selected, and none had received previous orthodontic treatment. Occlusal anteroposterior relationships were assessed based on the Angle classification. Other variables examined were overjet, overbite, crowding, and midline diastema. The results showed that about 24% of the subjects had normal occlusions, 50% had Class I malocclusions, 14% had Class II malocclusions, and 12% had Class III malocclusions. Over 66% had normal overbites, and 14% and 9% had increased and reduced values, respectively. Overjet relationship was normal in 66%, increased in 16%, and decreased in 8%. Crowding was observed in 20% of the subjects and midline diastema in 37%. No statistically significant differences were observed for any occlusal variables (P > .05). Class I malocclusion is the most prevalent occlusal pattern among these Nigerian students. Different patterns of Class II and Class III might be present for the dominant ethnic groups in the country. Therefore, a survey of the occlusal pattern in southeastern Nigerians (Ibo ethnic group) would appear to be worthwhile.

Adolescent↗
PubMed2003

Bolton anterior tooth size discrepancies among different malocclusion groups.

Orthodontic treatment comprises different phases with unique characteristics and challenges. The orthodontic "finishing" phase is recognized for the multitude of details necessary to achieve an excellent result. In some cases, the finishing phase is very difficult, requiring the production of complicated biomechanical forces to reach a satisfactory orthodontic solution. A high percentage of these finishing-phase difficulties arise because of tooth size imbalances that could have been detected and considered during initial diagnosis and treatment planning. The present study aimed to investigate the correlation between anterior tooth size discrepancies and Angle's Class I, II, and III malocclusions, as well as their prevalence in the Brazilian population from Belo Horizonte. We assessed the mesiodistal width of six anterior teeth in 300 patients, who were selected randomly. These patients were allocated to three groups according to their malocclusion. A chi-square test was performed to statistically compare the prevalence of anterior tooth size discrepancies among the three malocclusion groups and two genders. Analysis of variance was used to compare the mean Bolton anterior tooth size ratios as a function of Angle classification and gender. Statistical differences were determined at the 95% confidence level (P < .05). The important conclusions of our study are as follows: (1) Individuals with Angle Class I and Class III malocclusions show significantly greater prevalence of tooth size discrepancies than do individuals with Class II malocclusions; and (2) Mean anterior tooth size discrepancy for Angle Class III subjects was significantly greater than for Class I and Class II subjects.

Analysis of Variance↗
PubMed2001

Prevalence of malocclusion among Latino adolescents.

Although numerous studies have documented malocclusion in various ethnic groups in the United States, the prevalence of malocclusion in the Latino population is not well known. The Latino population may be the largest minority group in the United States by the year 2004. This study analyzes the occlusion of 507 Latino adolescents between the ages of 12 and 18 years. More than 93% of the subjects demonstrated some form of malocclusion. The distribution of malocclusion patterns is presented and contrasted with data published for other ethnic groups. Information about the prevalence and types of malocclusion in the Latino population should be of interest to general dental practitioners and specialists.

Adolescent↗
PubMed2002

Intermaxillary tooth size discrepancies among different malocclusion classes: a comparative study.

The purpose of this study is to determine whether a difference exists in intermaxillary tooth size among different malocclusion groups in Saudi patients The study consisted of 240 pretreatment orthodontic casts (Sixty cases in each malocclusion class, in addition to normal occlusion). The results of the study shows no significant difference in the incidence of tooth size discrepancies for the overall ratio and anterior ratio between the different malocclusion groups, except for the anterior ratio in class III malocclusion. Further, no statistical significant difference was observed between males and females When the mean values of the present study were compared to that of Bolton's, a significant difference was found in all the malocclusion classes. We can conclude from this study that Bolton tooth size analysis is an important diagnostic tool, and should be taken into consideration before initiation of orthodontic treatment.

Adolescent↗
PubMed1999

[Analysis of mandibular movement and functional classification for malocclusion patients].

OBJECTIVE: To classify the paths of mandibular movements of patients with malocclusion. METHODS: 223 patients were examined clinically and mandibular Kinesiograph(MKG) was applied. RESULTS: Each kind of malocclusion has its corresponding characteristic paths of mandibular movement. The paths of mandibular movements of patients with the same class of malocclusion are similar. It was also found that the mandibular movement was related not only with occlusion but also with jaws, muscles, and joints. Meanwhile, they affect each other. CONCLUSION: Functional malocclusion classification includes functional class I, II, III and IV malocclusion.

Adolescent↗
PubMed2000

[Analysis and comparison of dental arch symmetry between different Angle's malocclusion categories and normal occlusion].

OBJECTIVE: To analyze and compare dental arch symmetry between different Angle's malocclusion categories and normal occlusion. METHODS: 300 subjects were divided into four different malocclusion groups and normal occlusion group. Data points representing the dental arches on the casts were precisely marked by YM-2115 three Dimension Measuring Machine. Arch forms were fitted with conic sections, and then dental arch symmetry was analyzed by rotation angle. RESULTS: There were no absolute symmetric dental arch, and the direction of asymmetry was unsteady. In normal occlusion, dental arch was generally symmetric, but there was asymmetry in a very small degree. As to malocclusion, the frequency and degree of dental arch asymmetry were higher than that of normal occlusion, and the lower arch showed more asymmetry than the upper arch except ClassIII. The frequency of asymmetry in ClassII2 and ClassIII groups was higher than that in other malocclusion groups. CONCLUSION: The frequency and degree of dental arch asymmetry were different in different malocclusion groups.

Adolescent↗
PubMed1998

Prevalence of malocclusion and abnormal oral habits in North Indian rural children.

This epidemiological investigation was conducted on a sample of 3164 rural children aged 6-15 years in Raipur Rani and Naraingarh blocks in the district of Ambala in Haryana. 29. 2 percent of rural children were found to have malocclusion whereas 70.8 per cent had normal occlusion. Class I malocclusion was found to be maximum in 14.4 per cent of children, while malocclusion with class II molar relationship was observed in 13.5 per cent of children. Malocclusion with Class III molar relationship was seen in 1.3 per cent of the population studied. Three per cent of rural children were found to have abnormal oral habits, predominantly tongue thrusting and thumb sucking. The frequency distribution of abnormal oral habits in children with malocclusion was found to be 10.3 per cent.

Adolescent↗
PubMed1999

Morphologic determinants in the etiology of class III malocclusions: a review.

Morphospatial disharmony of the craniomaxillary and mandibular complexes may yield apparent mandibular prognathism, but Class III malocclusions can exist with any number of aberrations of the craniofacial complex. Deficient orthocephalization of the cranial base allied with a smaller anterior cranial base component has been implicated in the etiology of Class III malocclusions. Whereas the more acute cranial base angle may affect the articulation of the condyles resulting in their forward displacement, the reduction in anterior cranial size may affect the position of the maxilla. As well, intrinsic skeletal elements of the maxillary complex may be responsible for maxillary hypoplasia that may exacerbate the anterior crossbite seen in the Class III condition. Conversely, with an orthognathic maxilla, condylar hyperplasia and anterior positioning of the condyles at the temporo-mandibular joint may produce an anterior crossbite. Aside from the skeletal components, soft tissue matrices, particularly labial pressure from the circumoral musculature, may influence the final outcome of craniofacial growth of a child skeletally predisposed to Class III conditions. Indeed, as some Asian ethnic groups demonstrate an increased prevalence of Class III malocclusions, it is likely that the skeletal components and soft tissues matrices are genetically determined. Presumably, the co-morphologies of the craniomaxillary and mandibular complexes are likely dependent upon candidate genes that undergo gene-environmental interactions to yield Class III malocclusions. The identification of such genes is a desirable step in unraveling the complexity of Class III malocclusions. With this knowledge, the clinician may elect an early course of dentofacial orthopedic and orthodontic treatments aimed at preventing the development of Class III malocclusions.

Humans↗
PubMed2000

Early orthodontic treatment of Class-III malocclusion in Germany.

In order to evaluate current attitudes to early interceptive treatment, 2001 orthodontic offices in Germany were asked to fill in a questionnaire comprising the following topics: indication, appliances for the early correction of Class-III malocclusions, diagnostic records, duration, and benefits to overall therapy. Based on the 677 evaluable questionnaires, the following statistically significant conclusions could be drawn: 92.6% of the orthodontists see Class-III malocclusion as an indication for early treatment. Early treatment of severe crowding, diastemata, Class-II malocclusion, deep bite, increased overjet and impacted incisors was declined by most orthodontists. The interceptive treatment of further malocclusions was controversially discussed. Functional appliances (67.5%), in particular the Fränkel III (47.3%), were dominant in correction of Class-III malocclusions. Typical orthodontic records relating to early interceptive treatment include panoramic radiographs, lateral headfilms, photos and dental casts. 2.5% of the orthodontists routinely take a hand-wrist radiograph. Although recently published studies support the use of facial masks in theory, they are rarely used in practice. To what extent early interceptive treatment of Class-III malocclusion influences the overall treatment is the subject of further studies.

Attitude of Health Personnel↗
PubMed1983

Prevalence and severity of malocclusion in Israeli Arab urban children 13 to 15 years of age.

Israeli Arab children between the ages of 13 and 15 years, living in the town of Nazareth, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. The survey encompassed 803 children, of whom 2.5 percent were under orthodontic treatment at the time of the study and 0.3 percent showed ideal occlusion. The remainder showed various measures of deviation from normal, distributed as follows: 85 percent had Angle Class I malocclusion, 8.5 percent had Angle Class II, Division 1 malocclusion, 1.7 percent had Angle Class II, Division 2 malocclusion, and 1.3 percent belonged to the Angle Class III category. The severity of malocclusion was appraised qualitatively by subjective evaluation, while for quantitative determination the Handicapping Malocclusion Assessment Record (HMAR) was used. There was a positive correlation between the two modes of assessment as expressed in the 12.4 percent of the children who were classified "treatment highly desirable or mandatory" and who scored 30 or more points on the HMAR chart. Further examination of the deviations underlying the scoring revealed that the 52.1 percent of the children with scores of 15 points or more would benefit greatly from orthodontic treatment. Selected items of the TPI and OI charts were incorporated into the HMAR to evaluate the latter's sensitivity. Supplementing the HMAR with some deviations from normal, such as cusp-to-cusp relationships, amplifies the sensitivity of this record.

Adolescent↗
PubMed1998

Management of posttraumatic malocclusion caused by condylar process fractures.

PURPOSE: The aim of the study was to evaluate the results of orthognathic surgery in cases with posttraumatic malocclusion as a long-term complication of condylar process fractures. PATIENTS AND METHODS: A retrospective study on 21 patients with posttraumatic malocclusions attributable to condylar process fractures was performed. In group I, 15 patients were treated for asymmetric malocclusion with unilateral or bilateral mandibular ramus osteotomies. In group II, six patients were treated for anterior open bit with either a Le Fort I osteotomy (n=5) or a bilateral ramus osteotomy (n=1). All patients had clinical and radiographic follow-up for at least 1 year. RESULTS: Stable dental and cephalometric results were obtained in all patients except the one in group II who was treated with bilateral sagittal split osteotomies. In two cases, both in the asymmetric group, minor occlusal interferences had to be treated by equilibration in the early postoperative period. CONCLUSIONS: Orthognathic surgery is a predictable and stable method for the treatment of posttraumatic malocclusion due to condylar process fractures. Maxillary orthognathic surgery is successful in correcting symmetric anterior open bites due to bilateral condylar process fractures. Because posttraumatic malocclusion is a rare complication after closed treatment of condylar process fractures, and it can be treated satisfactorily using orthognathic surgery, routine open reduction and fixation of condylar process fractures is not indicated to prevent posttraumatic malocclusion.

Adolescent↗
PubMed1997

Herbst appliance treatment of Class II, division 2 malocclusions.

The purpose of this investigation was to analyze quantitatively the sagittal skeletal and dental changes that contribute to occlusal correction in Herbst treatment of 14 Class II, Division 2 malocclusions. Forty Class II, Division 1 Herbst subjects were used for comparison. Lateral head films from before and after Herbst treatment were analyzed, according to the method of Pancherz. The results revealed that all patients were treated to Class I or overcorrected Class I molar and edge-to-edge incisor relationships. The maxillary and mandibular skeletal changes were similar in both examination groups. In the Class II, Division 2 subjects, sagittal molar and overjet corrections amounted to an average of 5.9 mm and 3.1 mm, respectively. When comparing the Class II, Division 2 with the Class II, Division 1 subjects, overjet correction was, for natural reasons, significantly larger (p < 0.001) in the Class II, Division 1 subjects. In the subjects with Class II, Division 2 malocclusions, the upper incisors were proclined (mean = 3.0 mm), whereas in the subjects with Class II, Division 1 malocclusions, the incisors were retroclined (mean = 2.3 mm). The lower incisors were on the average proclined more (p < 0.05) in the Class II, Division 2 subjects (mean = 3.4 mm) than in the Class II, Division 1 subjects (mean = 2.4 mm). For sagittal molar correction, no differences in tooth movements were seen between the two malocclusions groups. In conclusion, it was found that the Herbst appliance is most effective in the therapy of Class II, Division 2 malocclusions. Proclination of the lower incisors during treatment (anchorage loss) is advantageous in this type of malocclusion.

Adolescent↗
PubMed1999

Comparison of intermaxillary tooth size discrepancies among different malocclusion groups.

The purpose of this study was to determine whether there is a prevalent tendency for intermaxillary tooth size discrepancies among different malocclusion groups. This study consisted of 60 subjects who served as the normal occlusion group and 300 patients divided into 5 malocclusion groups (ie, Class I with bimaxillary protrusion, Class II Division 1, Class II Division 2, Class III, and Class III surgery). Tooth size measurements were performed on the models of normal occlusion and pretreatment models of patients by the Three Dimension Measuring Machine. Moreover, tooth size ratios, analyzed as described by Bolton and the Student t test showed no sexual dimorphism for these ratios in each of 6 groups, so the sexes were combined for each group. Then these ratios were compared among different malocclusion groups. The results showed no significant difference between subcategories of malocclusion, so these groups were combined. There were now 120 cases in each of 3 categories: Class I, Class II, and Class III. A significant difference was found for all the ratios between the groups, the ratios showing that Class III > Class I > Class II. It demonstrated that intermaxillary tooth size discrepancy may be one of the important factors in the cause of malocclusions, especially in Class II and Class III malocclusions. Thus this study proved the fact that Bolton analysis should be taken into consideration during orthodontic diagnosis and therapy.

Adolescent↗
PubMed2001

Dental and facial skeletal characteristics and growth of females and males with Class II Division 1 malocclusion between the ages of 10 and 14 (revisited). Part II. Anteroposterior and vertical circumpubertal growth.

Growth changes in the dentition and the facial skeleton of boys and girls with Class I malocclusion from 10 to 14 years of age are presented, and the changes are compared with those for children with Class II Division 1 malocclusion. Radiographs of 335 children with Class II Division 1 malocclusion and 273 Class I controls were assessed. Radiographs were converted to x and y coordinate data, and 52 commonly used linear, angular, and coordinate axis measurements were made. Both the Class II Division 1 and the control groups were subdivided into 6 samples according to sex and skeletal age (10, 12, and 14 years +/- 6 months; chronological age ranged from 8.5 to 15.5 years). The mean plots from the coordinate data for the Class I boys and girls at 14 years were superimposed over the mean plots for the 10-year-old groups, creating circumpubertal growth standards. The standards are supported by growth vector diagrams and other data and lead to the following conclusions: (1) boys and girls with Class I malocclusion differ distinctly from each other in the amount and the direction of circumpubertal growth; (2) radiographic composite standards are useful and accurate clinical tools to show mean dentofacial skeletal growth and change between 10 and 14 years of age; (3) compared with the controls, the maxillary dentition of girls with Class II Division 1 malocclusion grows more horizontally, the maxillary (but not the mandibular) incisors procline farther, and the mandible grows more horizontally; (4) compared with the controls, the midfacial convexity in Class II Division 1 boys is markedly increased, due to more horizontal growth at A-point and less horizontal growth at nasion and pogonion, and maxillary and mandibular anterior teeth are proclined farther; (5) angular measurements involving S, N, A-point, B-point, and Pog are useful only when the position of N is known; and (6) cranial base flexure bears no relationship to the development of Class II Division 1 malocclusion.

Adolescent↗
PubMed2004

Comparison of intra-oral and study cast measurements in the assessment of malocclusion.

Malocclusion assessment methods are based on registrations and measurements made on study casts, which requires that impressions be taken. In addition to being costly and time-consuming, this process can be unpleasant for very young children. Therefore, the aim of this study was to evaluate the reliability of intra-oral measurements that compute a malocclusion index score to determine malocclusion severity in the mixed dentition. The research was part of a longitudinal study in Slovenia on a sample of 530 3-year-old children. At 8 years of age (mean 8.5 years, standard deviation 0.2), a cohort of 101 children (44 boys, 57 girls) was randomly selected in a cross-sectional study. Quantitative registrations of space and occlusal anomalies were performed intra-orally as well as on study casts. Kappa (kappa) statistics were used to evaluate the agreement between clinical and study cast malocclusion assessments. Systematic bias of measurements was tested using Wilcoxon's signed rank test. The results showed complete agreement between the two measurements for anterior crossbite, anterior open bite and overjet scores (kappa = 1); excellent reliability for the buccal segment relationship (kappa = 0.93), transverse occlusion of posterior teeth (kappa = 0.87); and substantial agreement for overbite (kappa = 0.79) and midline deviation (kappa = 0.71). For the remainder of the traits the agreement was moderate: rotation of incisors (kappa = 0.58), crowding of upper incisors (kappa = 0.51), axial inclination of teeth (kappa = 0.44) and lower incisor crowding (kappa = 0.41). Intra-orally small, but statistically significant scoring of lower incisor rotation and crowding was identified. On the study casts the most favourable axial inclination was found for buccal segment occlusion. Overall classification into severity grades, based on the total malocclusion score, showed excellent agreement between the two methods (kappa = 0.89), without statistically significant bias. Malocclusion assessment, recorded and measured intra-orally, is as reliable as assessment on study casts. The proposed method can be used in screening, in epidemiological studies and in clinical orthodontic assessment.

Child↗
PubMed2006

Comparison of tooth size discrepancies among different malocclusion groups.

This retrospective investigation was designed to compare tooth size discrepancies among subjects with different skeletal malocclusions in an orthodontic population. The study employed the pre-treatment models of 200 patients (100 males, 100 females, aged from 14 to 20 years) selected from the records of the Orthodontic Department, Shiraz Dental School. The subjects were from four malocclusion groups, Class I, Class II division 1, Class II division 2, and Class III, with the corresponding skeletal characteristics. Each group comprised 50 healthy individuals (25 males, 25 females). The mesio-distal dimensions of teeth were measured using digital electronic callipers (accurate to 0.01 mm) and the Bolton indices were determined. The data were statistically analysed using analysis of variance and Duncan's multiple range test, with the level of significance set at P < 0.05. The results revealed that the mean anterior ratio (79.01) for the whole sample was statistically significantly different from Bolton's (77.2) but no significant difference was found for the overall ratio. The posterior and overall ratios of the Class III malocclusion group were statistically greater than the other malocclusion groups (P < 0.05). The mean anterior ratio of the Class III group was greater than that of the Class II group. However, there was no difference when compared with the Class I malocclusion group. For the two types of Class II malocclusion, no significant ratio differences were observed.

Adolescent↗
PubMedDate not supplied

Malocclusions and traumatic injuries in disabled schoolchildren and adolescents in Kuwait.

The present study was carried out to determine the prevalence of malocclusion and traumatic injuries in disabled children and adolescents attending the special-needs schools in Kuwait. Included in the study were 818 children (438 males and 380 females), in the age groups of 3-20 years, who have visual impairment, hearing impairment, physical handicaps, or developmental disorders. The mean age of participants was 11.9 years. The survey was carried out according to the methods of WHO. The prevalence of severe malocclusion was 23.6%, and that of slight malocclusion was 37.0%. Children with Down syndrome (OR = 2.3; 95% CI = 1.51-3.52), those of increasing age (OR = 1.1; 95% CI = 1.01-1.10), and males (OR = 1.5; 95% CI = 1.05-2.07) had higher risk for the occurrence of severe malocclusion. Less than one-fifth of the subjects (16.9%) had traumatized anterior teeth. Severe malocclusion (OR = 1.8; 95% CI = 1.17-2.77) and increasing age (OR = 1.2; 95% CI = 1.13-1.26) were significant risk factors for the occurrence of traumatic injuries. We concluded that malocclusion and traumatic injuries are more prevalent among these subjects with disabilities than among the healthy population in Kuwait.

Adolescent↗
PubMedDate not supplied

Prevalence and severity of malocclusion in adolescent Kuwaitis.

OBJECTIVES: Our aim was to evaluate prevalence and severity of malocclusion in an adolescent Kuwaiti population. SUBJECTS AND METHODS: Using a stratified cluster sampling method and excluding non-Kuwaitis, subjects with mesial migration and/or loss of first molars, and subjects with orthodontic treatment experience without availability of initial study models, we examined 1,299 Kuwaitis (674 boys and 625 girls) of mean age 13.2 +/- 0.4 years in a regular well lit classroom. We scored molar and canine relationship, overjet, overbite, anterior and posterior cross bite as well as spacing and irregularity of the incisors using gloves, mirrors, rulers, and spatulas. RESULTS: Fourteen, 15, and 71% met the criteria for almost ideal, mild, and moderate to severe malocclusion, respectively. Of the 86% with malocclusion, occurrence of class 1, half step class 2, full step class 2, half step class 3, and full step class 3 was 57.8, 24.9, 6.3, 8.8, and 2.2% for the first molars, and 36.1, 50.0, 6.2, 5.4, and 2.3% for the canines, respectively. Incisor malalignment was the most prevalent malocclusion trait (73.2%). Overjet > or = 9.5 mm occurred in less than 1.5%, open bite in less than 3.5%, deep bite with gingival contact in less than 2.0%, complete posterior cross bite in less than 1.5%, and complete anterior crossbite in less than 2.0%. Median diastema was present in about 2/3 of the cases with maxillary anterior spacing as opposed to only about 1/3 of those with mandibular spacing. CONCLUSION: Our findings suggest that more than 70% of young adolescent Kuwaitis have moderate to severe malocclusion, with incisor malalignment as the most prevalent malocclusion trait.

Adolescent↗