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The community and orthodontic care. Part II: Community-perceived importance of correcting various dentofacial anomalies. Part III: Community perception of the importance of orthodontic treatment.

Part II. A professionally-managed telephone survey was undertaken to assess the community-perceived importance of correcting various dentofacial anomalies. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. This article forms part two of a series. It was found that the correction of functional problems such as "difficulty chewing or speaking" was considered to be very important, regardless of age, sex or geographical area. The correction of other factors such as "top teeth which stick out in front", "bottom teeth which stick out in front" or "crooked or crowded front teeth" was also considered to be important. "Spaced front teeth" was the factor considered least important for correction within all groups. It is interesting to note that, for all factors, correction seemed to be considered more important by females and non-metropolitan respondents than by males and metropolitan respondents, In contrast to previous studies in which it has been suggested that patients seek treatment mainly for reasons of aesthetics, the results of this study have shown a definite community recognition of the importance of functional problems as well. Part III. A professionally-managed telephone survey was undertaken to assess the community's perceptions of the importance of having "straight teeth and a nice smile", to assess if a Medicare (the Australian government health benefit scheme) rebate should be provided for orthodontic treatment and to assess whether respondents had any private health insurance that would help cover the cost of orthodontic treatment. The sample included 505 respondents, aged eighteen and over,, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. It was found that a very large percentage of respondents considered the need for "straight teeth and a nice smile" to be very important. This finding is supported by the many studies showing the importance of facial attractiveness to the lives of all people, young and old. Only a small percentage of respondents indicated that they had any private dental health insurance that would help cover the cost of orthodontic treatment. Efforts should be made to inform those responsible for the planning of orthodontic services in both the public and private sectors of the importance of the community's perceptions of aesthetics, and the large amount of published work that reinforces the impact of facial attractiveness on people's lives.

Adolescent↗

Effects of patient age and sex on treatment: correction of Class II malocclusion with the Begg technique.

When children are treated orthodontically during a phase of active growth-notably adolescence-there is the opportunity to harness growth to achieve some of the correction, especially in the sagittal plane in which differential jaw growth can harmonize dental relationships. All correction must be from tooth movement when there is no growth. Three questions were addressed in the present study: (1) how much orthodontic correction is achieved by bone growth? (2) do the proportions of tooth and bone movement depend on patient age? and (3) do the jaws of boys and girls grow at discernibly different rates during treatment? A sample of 139 children aged 9 to 17 years at the start of treatment with Class II division 1 malocclusions was studied cephalometrically using Johnston analysis. Maxillary and mandibular growth were highest in the youngest children, with rates decreasing to effectively zero in the oldest adolescents. Means adjusted for age were significantly higher for boys than for girls for upper and lower jaw growth. Age had little influence on the amount of tooth movement except for a marked decline with age in the mesial movement of the maxillary first molar, which was greatest in the youngest patients of both sexes. The amount of orthodontic correction was independent of age, but in the youngest quartile of the sample, most of the correction (87%) was due to differential jaw growth in the youngest quartile of the sample, and the rest (13%) resulted from tooth movement, whereas in the oldest quartile, most of the correction was due to tooth movement (64% tooth movement and 36% bone growth). Overall, the influence of age and sex had significant influences on multiple skeletodental variables, suggesting that research designs need to account for these demographic sources of variability. Although all cases were treated to a Class I occlusion, the nature of the correction was affected measurably by the patient's age and sex.

Adolescent↗

Case report RW: correction of a mandibular transverse discrepancy resulting from anteroposterior skeletal disharmony.

Patients with severe Class II malocclusion commonly have transverse problems upon advancement of the mandible. These problems are due to maxillary transverse deficiency and need to be addressed by archwires, maxillary expansion, or mandibular constriction. This report illustrates management of a transverse problem opposite in nature where the mandibular dentition is too narrow upon advancement of the mandible. A removable bite plane to help correct the dental compensations, headgear with Class III elastics to prevent additional incisor proclination, and post-orthodontic restoration to enhance the stability are demonstrated.

Adult↗

Missing upper lateral incisors: orthodontic considerations in young patients.

Missing lateral incisors are usually discovered by age 9 when general orthodontic treatment needs are becoming apparent. Whether to close, open or maintain a space for a missing lateral incisor is an orthodontic decision that needs to fit within a total plan of dental management. Factors to consider include:- Skeletal base relationship, severity of crowding, overjet, overbite, position into which the canine erupts, crown sizes, crown shapes, crown colours, gingival contours, gingival display on smiling, patient and parent attitude toward options, availability of appropriate prosthetic services, time delay before effecting "final" prosthetic treatment, space and bone required for implant fixtures and financial and biological costs.

Anodontia↗