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PubMed2000

Occlusal and oral health status of a group of 3-8-year-old South African black children.

This study determined the oral health status of a group of 3-8-year-old South African black children, comprising a total of 214 children from the townships of Garankuwa, Shosanguwe, Mabopane, Hebron and Erasmus who attended a school in Akasia, Greater Pretoria Metropolitan Substructure. The decayed, missing and filled teeth (dmft), oral hygiene status, dental IQ and malocclusion status were determined. The study found that the children's oral health status and occlusal status were unacceptable. The level of their dental IQ scores was low, their oral hygiene poor, and they were in urgent need of primary and secondary dental care. In addition they were in need of both preventive and interceptive orthodontic care. A national strategy to address primary dental health care is recommended.

Ankylosis↗
PubMed2003

Outcome of orthodontic care in 19-year-olds attending the Public Dental Service in Sweden: residual need and demand for treatment.

The study analyses residual need and demand for orthodontic treatment in 19-year-olds attending the Swedish Public Dental Service (PDS). The general practitioners (GPs) had selected individuals for orthodontic specialist consultation and some were treated by GPs or specialists or not considered to be in need for treatment. Altogether 164 individuals were called for clinical investigation at the age of 19 years and also given a questionnaire asking for residual orthodontic treatment demand and satisfaction with information and orthodontic care. Ninety-one per cent of the individuals who had had an orthodontic consultation and 53 per cent of those who had not seen an orthodontist took part in the investigation. The study revealed that half of the 19-year-olds at the PDS clinic had received orthodontic consultations and one third had received orthodontic appliance treatment. Seven percent of the investigated individuals had a residual subjective demand for treatment. Several individuals with removable appliance treatment had overjet and deep bite and laterally forced cross-bite, but with little remaining subjective demand for treatment. Individuals with fixed appliance treatment showed few malocclusions. Nineteen-year-olds in general were uncertain about their present need for orthodontic treatment. The following conclusions were drawn: the total amount of orthodontic treatment in different areas in Sweden is comparable but the distribution between GP and specialist treatment differs. Interceptive treatment to reduce overjets seemed not successful. Fixed appliances seemed to reduce the majority of the malocclusion traits. The information given in connection with orthodontic consultation or treatment was clearly inadequate.

Adult↗
PubMed2005

Arch development with trans-force lingual appliances.

Trans-Force lingual appliances are designed to correct arch form in patients with contracted dental arches. Interceptive treatment with this new series of pre-activated lingual appliances offers new possibilities for arch development, in combination with fixed appliances. Palatal and lingual appliances insert in horizontal lingual sheaths in molar bands. No activation is required after the appliance is fitted, and this principle is extended to a series of appliances for sagittal and transverse arch development. Both sagittal and transverse appliances have additional components to achieve 3-way expansion where this is indicated. The invisible lingual appliances may be used in correction of all classes of malocclusion at any stage of development, from mixed dentition through permanent dentition, and this approach has wide indications in adult treatment.

Activator Appliances↗
PubMed2004

Need for preventive/interceptive orthodontic treatment among 7-10-year-old children in Ibadan, Nigeria: an epidemiological survey.

The aim of this epidemiological survey was to assess the level of needs for preventive/interceptive orthodontics among 7-10-year-old children in Ibadan, Nigeria, which is the second vigilance period in the study of developing occlusions. The sample consisted of 493 school children--237 (48.1%) boys and 256 (51.9%) girls randomly selected from various schools and different socio-economic groups. They were all examined in their school environments under natural illumination and the findings entered into a pre-structured form. The study revealed that about 27% of the children had need for one form of preventive/interceptive orthodontic treatment or the other with some having multiple needs. Some of the needs detected were as follows: prolonged retention of primary teeth (6.9%), cross bite (10.3%), early loss of primary teeth (4.3%), oral habits (7.3%), over jet of more than 6mm (4.9%), carious lesions (14.8%) crowding (18.9%) and clinically missing upper lateral incisors (3.7%). The relationship between observed occlusal discrepancies and oral habits was found very statistically significant (p=0.001). No gender differences were noted among the children with preventive/interceptive needs (p>0.05). Children from the working class accounted for 55.2% of the study sample, while 44.8% were from the middle class families. It was concluded that over one third of these children would benefit from preventive interceptive orthodontics and that such care should be encouraged in our environment due to their known numerous benefits especially in a country like Nigeria where many can not afford the cost of comprehensive orthodontic services.

Age Distribution↗
PubMed2006

Class III dento-skeletal anomalies: rotational growth and treatment timing.

AIM: The interception of a Class III malocclusion requires a long-term growth prediction in order to estimate the subject's evolution from the prepubertal phase to adulthood. The aim of this retrospective longitudinal study was to highlight the differences in facial morphology in relation to the direction of mandibular growth in a sample of subjects with Class III skeletal anomalies divided on the basis of their Petrovic's auxological categories and rotational types. MATERIALS AND METHODS: The study involved 20 patients (11 females and 9 males) who started therapy before reaching their pubertal peak and were followed up for a mean of 4.3 years (range: 3.9-5.5 years). RESULTS: Despite the small sample size, the definition of the rotational type of growth was the main diagnostic element for setting the correct individualised therapy. CONCLUSION: We therefore believe that the observation of a larger sample would reinforce the diagnostic-therapeutic validity of Petrovic's auxological categories, allow an evaluation off all rotational types, and improve the statistical significance of the results obtained.

Age Factors↗
PubMedDate not supplied

Early treatment mechanics of the dental alveolar class II division I malocclusion.

The most common type of early Class II Division I malocclusion is dental alveolar in development. It is the type of maloccusion that is etiologically environmental in nature, but delay in treatment can influence negative changes in dental, facial and skeletal pattern. This malocclusion is readily available for interception at age 7 or 8 to achieve a state of dental and skeletal normalcy with a protocol of defined objectives and predictable outcomes. With efficient and effective arch development (NPE) and utility arch wire (UAW) mechanics, a state of normalcy can be achieved within nine to twelve months of treatment.

Biomechanical Phenomena↗
PubMedDate not supplied

[From the mixed dentition to the permanent dentition: how to manage space while guiding eruption?].

In the mixed dentition, when there is a discrepancy between the bony structures and the teeth, in certain cases, serial extractions are performed in order to guide the eruption of permanent teeth and obtain a correct occlusal function. The treatment consists in the extraction of primary teeth and then of first bicuspids. The choice of the first tooth to be extracted is based upon the position of the crowns of the permanent teeth and their degree of root maturation. Then the first bicuspid is extracted as soon as or prior to its eruption. This interceptive treatment has limited indications which need to be respected in order to preserve the child's future dental health. This treatment is indicated for Class I malocclusions with severe crowding or moderate crowding associated with bi-maxillary protrusion.

Child↗
PubMedDate not supplied

[Epidemiological study and orthodontics].

Prevention is now playing a major role in all fields. An epidemiological survey of malocclusions has evaluated 6 years old children in one district in the Regione Veneto (Northern Italy). Some indications are provided as regards preventive and interceptive orthodontics (including treatment aimed to reducing the severity of problems) in the therapy of the most frequent malocclusions in this age group.

Child↗
PubMed1990

Early orthodontic screening.

Preventive and interceptive orthodontics encourages inappropriate expectations from treatment. It implies that if the right treatment is done at the early age, no further treatment would be needed. This is obviously not true but assessment and/or treatment in the mixed dentition can be very helpful in many cases. This paper discusses some of the indications for early assessment/treatment.

Child↗
PubMed1981

Removable orthodontic appliances.

One of the goals of this article has been to emphasize the limitation of removable appliances. It is also stressed that if the right preconditions are present, the removable appliance is a tool that should be used by a general dentist as well as by the orthodontist. Interceptive treatment carried out with removable appliances at the correct time may save the patient from a more complicated treatment at a later stage. Minor tooth movements can often facilitate the fabrication of a bridgework and should therefore be included in reconstruction. It has been pointed out that the construction and design of the appliance may be of crucial importance. A careful treatment plan and detailed description of the appliance should therefore precede treatment.

Activator Appliances↗
PubMed1994

The longitudinal development of malocclusion in postnormal children with little respectively urgent need for orthodontic treatment.

The development of overjet, overbite and first molar relationship was followed longitudinally in 30 children with Class II malocclusion. They received no orthodontic treatment during the 7-year registration period. Models were taken each year between 7 and 14 years of age. The need for orthodontic treatment was defined using a 4-grade treatment priority index issued by the National Swedish Board of Health. The postnormal children were classified into two groups according to the need for treatment at the time when the first model was taken (age 7). The "treatment index 1" group (= group 1) consisted of 18 mild postnormal cases with little need for treatment. The "treatment index 3" group (= group 3) consisted of 12 cases with urgent need for treatment according to the priority index. All cases were Class II:division 1 with proclined incisors. For group 1 a significant increase in overjet and overbite was found over years. No uniform pattern in the longitudinal development of overjet and overbite was found for group 3. No clear changes in the first molar relationship in either group were found. Interceptive treatment in the mixed dentition is suggested favourable in postnormal cases, even when the malocclusion initially is mild in order to avoid an increase in overjet and overbite.

Adolescent↗
PubMed1996

Orthodontic care provided by general practitioners and specialists in three Swedish counties with different orthodontic specialist resources.

Three counties in Sweden (A, G, and W) with free orthodontic care and different orthodontic resources and geographic structures were studied in 1987. Samples of totally 942 young adults (mean age 18.8 years, SD 0.44) were examined concerning malocclusions and all orthodontic treatment provided by general practitioners or by orthodontic specialists. The care in a rural area (county G) with abundant specialist resources was based on specialist treatments easy assessable to the patients and supplemented by treatments, mainly without appliances and provided by general practitioners. There was a generous attitude of consultation with specialists and of providing treatment. The sparsity of specialist resources had in an urban area (county A) resulted in a greater restriction on providing treatments. The treatments were performed in a higher age and were, to a greater extent, not completed by the age of 19, and a smaller percentage of individuals were treated than in the other two counties. The care in a large rural area (county W) with long distances to the only specialist clinic was based on treatments provided by general practitioners. In spite of the few specialist resources there was a generous attitude of providing treatments. Interceptive methods were used to a great extent, and later completed with appliance therapy. According to a treatment priority index 44% of the untreated individuals in the three counties had malocclusions and an objective treatment need, and there were no significant differences between the counties. Regardless of differences in specialist resources and structure of the free public orthodontic care, a substantial and equal proportion of the untreated individuals in the counties had malocclusions with treatment need, but they had no treatment desire.

Adolescent↗
PubMedDate not supplied

Open bite: a review of etiology and management.

Diagnosis and treatment of open bite malocclusion challenges pediatric dentists who attempt to intercept this malocclusion at an early age. This article updates clinicians on the causes and cures of anterior open bite based on clinical data. Patients with open bite malocclusion can be diagnosed clinically and cephalometrically, however, diagnosis should be viewed in the context of the skeletal and dental structure. Accurate classification of this malocclusion requires experience and training. Simple open bite during the exchange of primary to permanent dentition usually resolves without treatment. Complex open bites that extend farther into the premolar and molar regions, and those that do not resolve by the end of the mixed dentition years may require orthodontic and/or surgical intervention. Vertical malocclusion develops as a result of the interaction of many different etiologic factors including thumb and finger sucking, lip and tongue habits, airway obstruction, and true skeletal growth abnormalities. Treatment for open bite ranges from observation or simple habit control to complex surgical procedures. Successful identification of the etiology improves the chances of treatment success. Vertical growth is the last dimension to be completed, therefore treatment may appear to be successful at one point and fail later. Some treatment may be prolonged, if begun early. Long-term clinical outcomes are needed to determine treatment effectiveness and clinicians should consider the cost-effectiveness of these early initiated and protracted plans.

Behavior Therapy↗
PubMed1997

Possibilities for prevention of malocclusions in South African children.

An effective preventive and interceptive (P & I) orthodontic programme for young children would reduce the need for comprehensive orthodontic treatment. The aim of this study was to determine the incidence of the development of preventable malocclusions amongst a group of children at the mixed dentition stage. An examination (T1) was performed on 951 8-9 year old children from 9 primary schools in Pretoria. Of these, 493 children could be traced for re-examination 2 years later (T2). The following changes in the occlusion were noted: In 12.1 per cent of the 493 children, an acceptable occlusion at T1 had developed into a malocclusion at T2. A malocclusion was recorded for 97 per cent of the sample at T2, yet only 32.4 per cent of the subjects had received orthodontic treatment between T1 and T2. A mere 3.3 per cent of the children examined were treated at state clinics. In 64.6 per cent of cases the malocclusion was not diagnosed nor addressed. It is suggested that bi-annual orthodontic screening of all 7-12 year old children and implementation of P & I orthodontic treatment at community clinics would contribute to achieving the primary health care objectives of the Reconstruction and Development Programme for South Africa.

Child↗
PubMedDate not supplied

Inherited dental anomalies and abnormalities.

A considerable body of evidence exists to suggest that genes play a dominant role in the etiology of the dental anomalies reviewed. It has been postulated that some kind of genetically controlled interrelationship may exist for some of these coincidental dental anomalies, as evidenced by their frequency of association. It has also been speculated that a "common genetic defect" may give rise to different phenotypic manifestations, including missing, malformed, and even ectopic and malpositioned teeth. The maxillary teeth that develop in the critical marginal areas of the dental lamina, namely the lateral incisors, canines and second premolars, seem most susceptible. Such dental anomalies may be symptoms of an inheritable developmental disturbance of tooth structures. Knowing that these dental anomalies can be inherited, a familial history and early clinical or radiographic detection of one anomaly, could alert parents and clinicians to the high likelihood of detection of other defects in the same individual and similar defects in other family members. Early diagnosis is important so that interceptive pediatric and orthodontic opportunities in relation to missing, malformed and ectopically erupting teeth are not overlooked. Further family studies are necessary to reveal the mode of inheritance of some of these dental anomalies and twin studies comparing monozygous and dizygous twins would enable an estimation of the extent of their inheritance.

Anodontia↗
PubMedDate not supplied

Mandibular lateral incisor-canine transposition in monozygotic twins.

Mandibular tooth transposition, involving the right lateral incisor and canine, is described in monozygotic twin girls. This report provides evidence suggesting that genetic factors influence the development of mandibular lateral incisor-canine (Mn.I2.C) transposition. Interceptive orthodontic treatment for children with this rare occlusal abnormality should be considered.

Child↗
PubMed1996

Completely submerged primary molars.

Two mixed dentition cases have been presented which became quite complicated because of ankylosed and submerged primary second molars. These cases demonstrate the need for an early orthodontic evaluation and interceptive orthodontics. The orthodontic and surgical procedures required for these two patients could have easily been avoided by removing the ankylosed primary molars and placing space maintainers. (Of course this depends upon the parents responding to their dental recall notices.) If a submerging primary molar is retained too long, the second premolar may become displaced superiorly and the permanent first molar may migrate mesially as it erupts. Both of these problems can be prevented by extracting the ankylosed primary second molar before it submerges below the mesial height of contour of the permanent first molar. A fixed space maintainer then becomes necessary to prevent loss of arch length by mesial migration of the permanent molar.

Ankylosis↗