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PubMed2002

Does malocclusion affect masticatory performance?

This purpose of this study was to evaluate the largely untested assumption that malocclusion negatively affects masticatory performance. A sample of 185 untreated subjects (48% male and 52% female) from 7 to 37 years of age, representing subjects with normal occlusion (n = 38), Class I (n = 56), Class II (n = 45), and Class III (n = 46) malocclusion, were evaluated. Masticatory performance was evaluated objectively using artificial (CutterSil, median particle size and broadness of the distribution) and real foods (number of chews for jerky and almonds), and subjectively using a visual analog scale. The results showed no significant differences in age or the body mass index (Wt/Ht2) between the occlusion groups. Subjects with normal occlusion had significantly smaller particle sizes (P = .001) and broader particle distributions (P < .001) than subjects with malocclusion. Compared with the normal occlusion group, the median particle sizes for the Class I, II, and III malocclusion groups were approximately 9%, 15%, and 34% larger, respectively. There were also significant group differences in their subjective ability to chew fresh carrots or celery (P = .019) and firm meat (P = .003). Class III subjects reported the greatest difficulty, followed by Class II subjects, Class I subjects, and subjects with normal occlusion, respectively. We conclude that malocclusion negatively affects subjects' ability to process and break down foods.

Adolescent↗
PubMed2001

A classification and characterization of skeletal class III malocclusion on etio-pathogenic basis.

Skeletal Class III malocclusion has been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The authors hypothesized that there were different patterns of mutual relation of the skeletal components contributed to pathologic equilibrium of skeletal Class III malocclusion. The purpose of this study is 3-fold; (1) to classify skeletal Class III malocclusion in subgroups that can show the architectural characteristics of the deformity, (2) to analyze the craniofacial architecture of each subgroup on etio-pathogenic basis, and (3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 untreated skeletal Class III malocclusion adults, which were analyzed with modified Delaire's analysis. Linear and angular measurements of each subject were obtained and cluster analysis was used for grouping. In the results, seven groups were identified and presented as prototypes, which could show the etio-pathology of the skeletal architecture. The classification and description presented in this study is thought to be biologic and helpful in the understanding of skeletal Class III malocclusion and treatment planning.

Adolescent↗
PubMed2002

Masticatory performance and areas of occlusal contact and near contact in subjects with normal occlusion and malocclusion.

This preliminary study evaluated relationships between masticatory performance and areas of interocclusal distance contact (<50 microm) and near contact (50-350 microm) of the buccal segments during maximum intercuspation. The sample included subjects with normal occlusion (n = 18) and Class I (n = 14), Class II (n = 13), and Class III (n = 6) malocclusions. Chewing performance was evaluated on the basis of the breakdown of CutterSil (Heraeus Kulze, South Bend, Ind); chewing ability was assessed by the number of chews necessary to swallow jerky and almonds. Impressions of the buccal segments, taken with Blu Mousse (Parkell Bio-Materials, Farmingdale, NY) impression material, were scanned and enlarged, and each subject's first molars and premolars were manually traced bilaterally to estimate the platform area. The areas of contact and near contact (ACNC) that measured between 0 and 350 microm thick were estimated optically on the basis of the amount of light transmitted through the impression. The results showed no significant differences in platform area between the right and left sides or between the malocclusion groups. ACNC were negatively related to median particle size and broadness of particle distribution. There were no correlations between ACNC and the number of chews necessary to swallow jerky or almonds. Subjects with normal occlusion had significantly larger ACNC than those with Class I, Class II, and Class III malocclusions, in descending order. Subjects with Class III malocclusions had the smallest areas of near contact (<350 microm). We concluded that ACNC are similar on the right and left sides; that subjects with larger ACNC are better able to break down foods; and that subjects with malocclusions have smaller ACNC than those with normal occlusions.

Adolescent↗
PubMed2003

Osteotomy to treat malocclusion following reconstruction of the mandible with the free fibula flap.

Malocclusion may result after free fibula flap reconstruction of the mandible, because of inadequate positioning of the temporomandibular joint, inaccurate contouring of the reconstruction plate, or subsequent fracture of a miniplate. Factors that alter the vascularity of the transplanted fibula may also result in a delayed presentation of malocclusion. Seven cases are presented, in which primary surgical treatment consisted of segmental mandibulectomy and reconstruction with a free fibula osteoseptocutaneous flap. Fixation was achieved with a reconstruction plate in five cases and a miniplate in two cases. Malocclusion was corrected with an osteotomy performed at the junction of the fibula and the native mandible. The new osteotomy sites were fixed with miniplates and maintained with intermaxillary fixation. Complete bony union was achieved at the osteotomy sites. The correction of malocclusion was successful in all cases, and all patients have resumed a normal diet. This report demonstrates that osteotomy and realignment of the mandible are effective for the secondary correction of malocclusion after mandibular reconstruction with the free fibula osteoseptocutaneous flap.

Adult↗
PubMed1994

Relationship between craniomandibular dysfunction and malocclusion in white children with and without unpleasant life events.

An epidemiologic study was conducted to investigate the relationship between craniomandibular dysfunction and malocclusion in 386 children aged 6 to 10 years with and without unpleasant life events. The results showed no statistically significant correlations between each clinical sign and each type of morphologic malocclusion in both groups. The chi-square test, however, revealed statistically significant correlation between the pain in the temple region and posterior crossbite in the calm group but not in the not calm group. With respect to the functional malocclusion, the chi-square test showed statistically significant correlations between interferences in the terminal hinge movement and TMJ tenderness and difficulties in opening wide. However, these correlations were found only in the calm group. When the definitional symptoms of craniomandibular dysfunction were aggregated, no statistically significant correlations were found between them and each type of malocclusion in both groups. The results of this study showed that the correlations between malocclusion and craniomandibular dysfunction were inconsistent.

Chi-Square Distribution↗
PubMed1987

Relationship between malocclusion and maintenance of teeth.

The relationship between the presence of malocclusion and maintenance of teeth in adulthood was studied in a randomly drawn sample of 499 35-44-yr-old Danes. Maintenance of teeth in the past was expressed through the number of teeth present, attachment level and information of regularity of dental visits. Maintenance at present was expressed as caries present, plaque and gingivitis. The relationship of these parameters to the presence of a malocclusion symptom was analyzed directly and the indirect influence was studied through the influence of a subjectively perceived malocclusion and its impact on satisfaction. It appeared that satisfaction was significantly related to maintenance of teeth and to a positive dental behavior. A perceived malocclusion was shown to have a negative influence on satisfaction and thus indirectly on maintenance. If a public orthodontic service is aiming at lifetime maintenance of teeth, malocclusions leading to dissatisfaction with teeth and a subjectively perceived need should be taken into consideration when ranking children with regard to treatment priority.

Adult↗
PubMed1996

Establishing malocclusion severity levels on the Dental Aesthetic Index (DAI) scale.

The Dental Aesthetic Index (DAI) is an orthodontic index based on socially defined aesthetic standards. It is useful in both epidemiological surveys to identify unmet need for orthodontic treatment and as a screening device to determine priority for subsidized orthodontic treatment. An earlier study established the score of 36 on the DAI scale to identify handicapping malocclusions. The purpose of the present study was to determine decision points on the DAI scale that identify malocclusion severity levels less severe than handicapping. Two sources of data were used: 1) The frequency distribution of DAI scores on a probability sample of 1306 study models representing the untreated occlusions found in half a million adolescents. 2) The percent distribution of US youths aged 12-17 by specified case severity reported in an assessment of the occlusion of youths by the National Center for Health Statistics (NCHS). The decision points separating specific case severities on the DAI scale were determined by relating the proportions of the NCHS population with specified case severities to the cumulative percentages of the frequency distribution of DAI scores on the 1306 models. The NCHS report found 45.8 percent of the sample to have normal or minor malocclusion with no need or slight need for treatment. DAI scores 25 and below corresponded to that proportion of the sample. The NCHS report found 25.2 percent of the sample to have definite malocclusion with treatment being elective. DAI scores between 26 and 30 corresponded to that proportion of the sample. The NCHS report found 13 percent of the population to have severe malocclusion with treatment highly desirable. Fifteen percent were included in this category. DAI scores 31 to 35 corresponded to that proportion of the sample.

Adolescent↗
PubMed2004

Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the Dental Aesthetic Index.

OBJECTIVE: To evaluate the prevalence of malocclusion and orthodontic treatment need among Spanish adolescents and compare with other populations. METHODS: The study sample comprised 744 schoolchildren from urban and rural populations in Granada province (Southern Spain), aged from 14-20 years, who had received no orthodontic treatment. The measurement instrument was the Dental Aesthetic Index (DAI). RESULTS: The mean DAI score of the whole series was 25.6 (SD, 7.94). The distribution of the four DAI grades was: DAI 1, no anomaly or malocclusion, 58.6%; DAI 2, definite malocclusion, 20.3%; DAI 3, severe malocclusion, 11.2%; DAI 4, very severe or disabling malocclusion, 9.9%. There were no statistically significant differences in DAI score between genders or those in rural vs. urban residence, but a significant difference was found between social classes, with subjects of low social class presenting the worst scores (p<0.05). CONCLUSION: The distribution of DAI scores among Spanish adolescents is similar to that reported in other populations.

Adolescent↗
PubMed2000

[The relationship between oral habits and malocclusion in preschool children].

OBJECTIVE: To evaluate the way oral habits and speech problems affect dental occlusion in preschool children. METHODS: A random sample of 2,139 boys and girls aged 3-5 years old was evaluated. The children were enrolled in private and state institutions in the city of Bauru, São Paulo State, Brazil. The cross-sectional study was developed in two steps: occlusion assessment, and a questionnaire about their social and economic status. The occlusal anatomical-functional characteristics assessment was done according to Angle classification. Additionally, overjet, overbite, crowding, anterior open bite, posterior crossbite, and anterior crossbite were evaluated. A sub-sample of 618 children filled out the questionnaire. The prevalence of malocclusion and some variables of exposure were tested by bivariate analysis. RESULTS: The prevalence of malocclusion was 51.3% for boys and 56.9% for girls. There was no difference related to gender. In regard to age, there was a higher prevalence of malocclusion in the 3 year-old group, which decreased significantly with age (p<0.05). CONCLUSIONS: Among the environmental factors evaluated, the habit of sucking a pacifier was the most important in the association with malocclusion (OR=5.46) followed by the habit of sucking fingers (OR=1.54). Speech problems did not show any influence in malocclusion occurrence.

Articulation Disorders↗
PubMed2006

Longitudinal evaluation of the intermaxillary relationship in Class III malocclusions.

OBJECTIVE: To analyze the sagittal, vertical, and transverse relationship of the maxilla and mandible in Japanese girls with Class III malocclusions. MATERIALS AND METHODS: This longitudinal study utilized biannual posteroanterior and lateral cephalograms of 44 untreated subjects from age 8 to 14 years (Class I, 23 girls; Class III, 21 girls). Sagittal and vertical growths were analyzed on the basis of lateral cephalograms, and transverse growth was analyzed on the basis of posteroanterior cephalograms. RESULTS: There was no significant difference in sagittal intermaxillary relationships in Class III malocclusion from age 8 to 14 years, whereas significant difference in vertical and transverse intermaxillary relationships appeared with ages during this period. When comparing Class III to Class I malocclusions at the same age point, there were significant differences in sagittal and transverse intermaxillary relationships, whereas significant difference in vertical intermaxillary relationship appeared after 12 years of age. CONCLUSION: The results suggest that the sagittal intermaxillary relationships in Class III malocclusions were established before 8 years of age and remained through puberty and that the vertical and transverse intermaxillary relationships in Class III malocclusions changed with ages from 8 to 14 years.

Adolescent↗
PubMed1989

Causal relation between malocclusion and caries.

In this second report of a follow-up study of long-term adverse oral health effects of malocclusion it is assessed whether various occlusal and space anomalies imply an increased risk of caries. In 1965-66 malocclusion was recorded in 176 adolescents who were re-examined in 1986-87 at the age of 33-39 years. DMFS scores, in the dentition as a whole and in the segments of the dental arches, were compared between subjects displaying specified traits of malocclusion at both examinations and a comparison group comprising subjects without malocclusion at both examinations. No relationship was found between the malocclusion traits and caries prevalence.

Adolescent↗
PubMed1989

Causal relation between malocclusion and periodontal health.

The purpose of this 20-year follow-up study was to assess whether persistent traits of morphologic malocclusion imply an increased risk of periodontal disease. In 1965-66 malocclusion was recorded in 176 adolescents who were re-examined in 1986-87 at the age of 33-39 years. Markedly healthier periodontal conditions were found in women than men, in the higher social group than the lower one, and in the maxilla than the mandible. Subjects with specified malocclusion traits at both examinations were compared with subjects without malocclusion for the occurrence of calculus, gingivitis (bleeding), and pocketing. Controlling for the effect of sex and social group, periodontal disease was significantly more frequent in the maxilla in connection with crowding, extreme maxillary overjet, and cross-bite (p less than 0.05). No association was found in the mandible. The presence of certain malocclusion traits in adolescence may probably often call for special professional efforts of oral hygiene education rather than orthodontic therapy.

Adolescent↗
PubMed1996

The prevalence of malocclusion in 13- to 15-year-old children in Nairobi, Kenya.

Data on occlusal features and the need for orthodontic treatment in Kenya is scanty. This study was carried out to determine the prevalence of malocclusion in children in Nairobi, Kenya. Nine hundred and nineteen children aged 13-15 years (468 male, 451 female) were examined. The registration method used was that described by Björk et al. The prevalence of malocclusion was 72%. The predominant anteroposterior relationship of the dental arches was neutral occlusion (93%). Specific malocclusion traits were highest for crowding (19%), rotations (19%), posterior crossbite (10%), maxillary overjet (10%), and frontal open bite (8%). There was no statistically significant difference in the overall prevalence of malocclusion between males and females, but some occlusal traits were significantly higher in males. Although the findings indicate that the present population is not characterized by a substantial difference in the overall prevalence of malocclusion compared with other communities, some traits differed in prevalence from those reported elsewhere.

Adolescent↗
PubMed2005

Class-III malocclusion: genetics or environment? A twins study.

Etiology of class-III malocclusion is generally believed to be genetic. A wide range of environmental factors have been suggested as contributing factors for the development of class-III malocclusion. Twin study is one of the most effective methods available for investigating genetically determined variables of malocclusion. Discordancy for class-III malocclusion is a frequent finding in dizygotic twins. However, class-III malocclusion discordancy in monozygotic twins is a rare finding. The purpose of this study of monozygotic twins is to assess the genetic and environmental components of variation within the cranio-dento-facial complex.

Cephalometry↗
PubMed2006

Awareness and concern about malocclusion among 12-15 year-old children in Moshi, Tanzania.

OBJECTIVE: To assess awareness and concern about malocclusion in 12-15 year-olds in Moshi, Tanzania. DESIGN: A cross-sectional study. SETTING: Moshi Municipality in Kilimanjaro region, Tanzania. SUBJECTS: Two hundred and ninety eight randomly selected Public primary school children aged 12-15 years (158 males and 140 females). RESULTS: About 56% of the respondents thought their teeth were properly aligned. However only 29.1% of the respondents reported being dissatisfied with the way their teeth appeared in their mouth. About 25% of the respondents found their teeth to have been worse than most of their age-mates. Children who reported to have been teased due to their malocclusion comprised 25.8%. Those who thought it was unpleasant to stay with malaligned teeth constituted 55.7% of the respondents. Subjective orthodontic treatment need was reported by 69.1% of the sample. Majority of the children (75%) were ready to accept orthodontic treatment. There were significant correlations between factors of awareness and those of concern about malocclusion among the subjects. CONCLUSIONS: In spite of very little orthodontic treatment exposure in this population, awareness and concern about malocclusion was reported by a significant proportion of the children. These findings form a baseline line for future studies on the trends of awareness and concern towards malocclusion in this population. They will also be useful in the planning of orthodontic services in Tanzania.

Adolescent↗
PubMed1990

[A comparative study of five indices in malocclusion for evaluating treatment needs].

The purpose of this study was to investigate the utility of five indices of malocclusion (NMT, MI, HLDI, OFI and DI) for evaluating the necessity of orthodontic treatment. One dentist scored malocclusion in 40 females (Age: 18-23). Then, another orthodontist assessed the treatment needs for malocclusion on the same subjects. We compared each score with the assessment by the orthodontist and determined the screening level score of the treatment needs for malocclusion. The sensitivity and specificity were calculated for 5 indices respectively. The selection using MI (screening level score: 12) resembled mostly the assessment by the orthodontist, followed by NMT (screening level score: 8) and DI (screening level score: 8). But the time required to score using MI was longer than using DI, and the reproducibility of NMT was inferior to DI. The subjects in this study had a high frequency of crowding (22.5%), and DI was highly correlated to the arch length discrepancy (r = -0.898). From these results, it was suggested that DI was a suitable index for evaluating the treatment needs for malocclusion, particularly crowding.

Adolescent↗
PubMedDate not supplied

Components of soft tissue deformations in subjects with untreated angle's Class III malocclusions: thin-plate spline analysis.

While the dynamics of maxillo-mandibular allometry associated with treatment modalities available for the management of Class III malocclusions currently are under investigation, developmental aberration of the soft tissues in untreated Class III malocclusions requires specification. In this study, lateral cephalographs of 124 prepubertal European-American children (71 with untreated Class III malocclusion; 53 with Class I occlusion) were traced, and 12 soft-tissue landmarks digitized. Resultant geometries were scaled to an equivalent size and mean Class III and Class I configurations compared. Procrustes analysis established statistical difference (P < 0.001) between the mean configurations. Comparing the overall untreated Class III and Class I configurations, thin-plate spline (TPS) analysis indicated that both affine and non-affine transformations contribute towards the deformation (total spline) of the averaged Class III soft tissue configuration. For non-affine transformations, partial warp 8 had the highest magnitude, indicating large-scale deformations visualized as a combination of columellar retrusion and lower labial protrusion. In addition, partial warp 5 also had a high magnitude, demonstrating upper labial vertical compression with antero-inferior elongation of the lower labio-mental soft tissue complex. Thus, children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the maxillary soft tissue complex in combination with antero-inferior mandibular soft tissue elongation. This pattern of deformations may represent gene-environment interactions, resulting in Class III malocclusions with characteristic phenotypes, that are amenable to orthodontic and dentofacial orthopedic manipulations.

Age Factors↗
PubMed2001

Epidemiology of malocclusion and orthodontic treatment need of 12-13-year-old Malaysian schoolchildren.

OBJECTIVE: Data on malocclusion and orthodontic treatment need in Malaysia are limited. The purpose of this study was to evaluate malocclusion and orthodontic treatment need in a sample of 12-13-year-old schoolchildren using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and socio-demographic variables, perceptions of need for orthodontic treatment, aesthetic perception and social functioning. METHOD: The sampling procedure involved a multistage, clustered and stratified random sampling. The sample comprised of 1,519 schoolchildren attending 20 secondary government and government-aided schools in urban and rural areas of Klang District in Peninsular Malaysia. There were 772 males and 747 females. Each subject was administered a questionnaire eliciting standard demographic information such as gender, parents' income and ethnic origin and questions on perception of need for orthodontic treatment and satisfaction with dental appearance and function. Intra-oral examination for occlusal status using the DAI was performed for each subject. RESULTS: Most subjects (62.6%) require no orthodontic treatment. Only about 7% had handicapping malocclusion that needed mandatory treatment. Malocclusion, as defined in this study, was found to be significantly associated with gender and subjects' area of residence. There were no significant differences in mean DAI scores for Malays, Chinese and Indian children. Significant associations were found between DAI scores and perception of need for orthodontic treatment, satisfaction with dental appearance and social functioning (P<0.01). CONCLUSION: The findings will be useful for the public dental service to determine priority for orthodontic treatment as part of the comprehensive care provided by the School Dental Service (SDS).

Adolescent↗