Effects of buccal corridors on smile esthetics in Japanese and Korean orthodontists and orthodontic patients

INTRODUCTION

The purpose of this study was to evaluate the influence of the size of buccal corridors on the assessment of attractive smile esthetics by Japanese and Korean orthodontists and orthodontic patients.

METHODS

Buccal corridors were modified digitally from 0% to 25% compared with the inner intercommissural width. Using a visual analog scale, 41 Japanese and 25 Korean orthodontists, and 96 Japanese and 72 Korean orthodontic patients (15-29 years old) rated the attractiveness of 6 smiles with altered buccal corridors. The influence of the size of the buccal corridor on smile esthetics was assessed.

RESULTS

Although there was no significant sex difference in judging the effects of buccal corridors for the Korean and Japanese orthodontists, significant sex differences were shown for the Japanese orthodontic patients. There were significant differences in the 6 levels of median esthetic scores for all groups: 0%, 5%, and 10% buccal corridors in the smiles tended to be preferred to the other smiles, to become clinically significant for all groups. The median esthetic score decreased to become clinically significant from 10% to 15% buccal corridors for all groups.

CONCLUSIONS

Japanese and Korean orthodontists and orthodontic patients prefer narrow or medium buccal corridors to broad buccal corridors.

Acceptance and discomfort in growing patients during treatment with two functional appliances: a randomised controlled trial

AIM

To evaluate the levels of acceptance and discomfort between two types of functional appliances.

STUDY DESIGN

Randomised controlled trial.

MATERIALS AND METHODS

A sample of patients who met the inclusion criteria were distributed randomly and equally into two groups: the Trainer for Kids™ made up of 26 patients with an average age of 10.3 years (Group A), and the modified Activator with 28 patients, with an average age of 10.6 years (Group B), as control. A special questionnaire including eight questions about tension, pressure, sensitive teeth, pain, impaired speech, impaired swallowing, oral constraint and lack of confidence in public caused by the appliance was administered at T1 (7 days), T2 (14 days), T3 (3 months), and T4 (6 months).

RESULTS

The sensation of pressure, teeth sensitivity, pain and impaired speech declined significantly in Group A. All complaints decreased significantly in Group B, but the changes in 'lack of confidence in public' were not significant. Moreover the sensation of pressure, teeth sensitivity, oral constraint and impaired speech were significantly higher in Group A than in Group B.

CONCLUSION

The modified Activator caused less discomfort than the Trainer for Kids™ and was more acceptable.

Dental anxiety, dental visits and oral hygiene practices

PURPOSE

The present study investigated the effects of dental anxiety and dental visits on oral hygiene practices, which included brushing, flossing and amount of time brushing.

MATERIALS AND METHODS

The study included a dental questionnaire developed to measure aspects of dental visits, oral hygiene and dental anxiety. A demographic questionnaire included questions pertaining to age, ethnicity and citizenship. Participants included 77 undergraduate students attending a diverse southern United States university enrolled in psychology courses.

RESULTS

Linear regression was conducted to explore the association between dental anxiety and oral hygiene practices. Results revealed the model explained a significant proportion of variance in oral hygiene practices, R2 = 0.141, F(1,76) = 12.441, P < 0.001. Specifically, higher dental anxiety was associated with poorer oral hygiene practices. A correlation was conducted to investigate the association between dental visits and oral hygiene practices. Results revealed a correlation between dental visits and brushing r(75) = 0.342, P = 0.002, and flossing frequency r(75) = 0.294, P = 0.009. There was no association between visits to the dentist and time spent brushing teeth.

CONCLUSION

Results indicate that dental anxiety is associated with oral hygiene practices. Additionally, those who visit the dentist more often have somewhat better oral hygiene practices. The present study indicates that there may be a learned association between dental anxiety and oral hygiene practices. Methods of education can be developed to disassociate anxieties that may inhibit optimum oral hygiene practices. It may also be beneficial for dental professionals to emphasise the value of the amount of time patients spend brushing their teeth.

Orthodontic treatment need, outcome and residual treatment need in 15- and 20-year-olds

The aim of the study was to investigate orthodontic treatment need and the outcome of orthodontic treatment in 15-, and 20-year-olds in Jönköping, Sweden, with special reference to residual treatment need. An offer to participate in a clinical investigation was extended to random samples of 130 15-year-olds and 130 20-year-olds. Ninety-six of the 15-year-olds (73.3%; 45 boys and 51 girls) and 82 of the 20-year-olds (62.6%; 47 males and 35 females) accepted and presented for examination The participants filled in a questionnaire and impressions were taken for study models, which were graded according to the ICON index. In all, 39 (40.6%) of the 15-year-olds and 38 (46.3%) of the 20-year-olds had undergone or were currently undergoing orthodontic treatment. Ninety-one per cent of the 15-year-olds and 84% of the 20-year-olds considered that the orthodontic treatment goals had been fully or almost fully attained. Two of the 15-year-olds and two of the 20-year-olds currently wanted orthodontic treatment. This indicates a residual treatment demand of about 2%.

Dental aesthetic self-perception and desire for orthodontic treatment among school children in Benin City, Nigeria

BACKGROUND

The availability of information on the individual perception of own's dental appearance and desire to uptake orthodontic treatment is of importance in the planning of orthodontic care within a population.

OBJECTIVE

The subjective assessment of personal dental appearance and desire for orthodontic treatment was appraised among Nigerian children.

METHODS

The study was conducted among 91 school children (33 boys, 58 girls) aged 12 years old in Benin City, south-southern region of Nigeria. The satisfaction of the subjects with the arrangement of their anterior teeth and desire to straighten their teeth was determined using a questionnaire. The subjects were further asked to rank their dental attractiveness in relation to the photographs in the Aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). The need for orthodontic treatment among the subjects was also assessed by the examiner with the Aesthetic component of IOTN. Chi-square tests were used for data analysis.

RESULTS

The result revealed that more than three-quarters (76.9%) of the subjects were satisfied with their dental aesthetics while 23.1% desired to have orthodontic treatment. The boys expressed significantly higher level of dissatisfaction with their dental aesthetics and a greater desire to have orthodontic treatment (P < 0.05). Most subjects (92.3%) rated their dental attractiveness in the "little to no need" orthodontic treatment grade on the AC scale. The normative borderline treatment need was higher than subjective borderline need but there was consistency in distribution of 4.4% in definite need treatment grade by the subjects and examiner.

CONCLUSION

The majority of the children rated their teeth as aesthetically satisfactory but there were gender differences in perception of dental aesthetics and desire for orthodontic treatment among this sample of Nigerian children.

Parents' perceptions of oral health conditions depicted in photographs of anterior permanent teeth

AIM

The aim of this study was to evaluate parents' perceptions of dental fluorosis and other oral health conditions depicted in photographs of anterior teeth.

MATERIALS AND METHODS

The sample comprised 120 parents (average age 39.3 years) whose children were undergoing dental treatment at the School of Dentistry of the Federal University of Minas Gerais. Seven photographs were selected: P1, open bite; P2, dental fluorosis TF 1 associated with open bite; P3, dental fluorosis TF 1; P4, midline deviation and crowding; P5, dental hypoplasia; P6, teeth without oral problems; P7, dental fluorosis TF 3. All photographs were randomly shown to all the parents, who classified the conditions observed based on a numeric scale: 0-19 (very unsatisfactory), 20-39 (unsatisfactory), 40-59 (neutral), 60-79 satisfactory and 80-100 (very satisfactory). The reasons for dissatisfaction and the possible treatment choice were examined.

RESULTS

P6 (normal teeth) was the most satisfactory photograph according to the parents (mean 61.2), and all photographs were statistically significantly different from one another (Mann-Whitney test, p ≤ 0.05), except the following pairs: P1 (mean 52.9) and P7 (mean 50.2) (p 0.537); P2 (mean 32.6) and P3 (mean 39.0) (p 0.073); and P5 (mean 18.9) and P4 (mean 18.4) (p 0.923). Alignment and crowding were considered the most prevalent problem in all cases (27.5 to 90.8% of parents) and orthodontic treatment was the most frequently cited option for treating all conditions (34.2 to 89.2% of parents).

CONCLUSION

In general, parents were dissatisfied with the oral conditions depicted in all photographs. Midline deviation associated to crowding (P4) and dental hypoplasia (P5) were considered the most unsatisfactory conditions. The most frequently cited oral problems by the parents were alignment and crowding. Orthodontic treatment was considered the best option by the majority of parents.

Influence of lower facial height changes on frontal facial attractiveness and perception of treatment need by lay people

OBJECTIVE

To test the hypothesis that lower facial height has no influence on frontal facial attractiveness and treatment need perception of lay people.

MATERIALS AND METHODS

Frontal facial silhouettes of a man and a woman with normal lower facial height values (male: 81.5 mm; female: 70.5 mm) were modified by increasing and decreasing their lower facial heights in steps of 1 mm to obtain frontal images with different lower facial height alterations ranging from +6 mm to -6 mm for each sex. A panel of 100 lay people scored each silhouette's attractiveness on a 100-mm visual analogue scale (VAS) and also indicated whether they would seek treatment if the image represented their own. The Wilcoxon signed rank test was used to compare the VAS scores.

RESULTS

Unaltered +/-1-mm and +/-2-mm silhouettes got the highest VAS scores. Scores were significantly lower (P < or = .001) as the divergence from the normal value exceeded 2 mm. Beyond +3 mm and -4 mm in females and +4 mm and -3 mm in males the difference between the scores became statistically insignificant. At +/-4 mm, more than 75% of the raters elected to have treatment.

CONCLUSION

The hypothesis was rejected.

Is orthodontics an option in the management of bimaxillary protrusion?

Successful orthodontic treatment is based on a clear perception by the clinician of a patient's facial preference and treatment needs. Bimaxillary protrusion is a normal facial trait seen in the Black population and the most acceptable bimaxillary facial profile in a sample of Black subjects was determined by Beukes et al in 2007. Variations from this ideal profile may require extractions as part of orthodontic treatment in order to attain the ideal. The objective of this study was to determine whether Black subjects with bimaxillary protrusion would want to change their facial profile to the ideal and at what financial cost. A sample of 586 school learners and 321 university students were presented with four silhouetted profiles of varying degrees of bimaxillary protrusion. One of the silhouette profiles represented the ideal and treatment procedures required to achieve this ideal were explained to the sample. They were then requested to answer a questionnaire that would assist in identifying their perception of their own profile and their desire to change their appearance. The ideal silhouette was confirmed to be the most attractive (91.51%) and the sample felt that any severe deviations from this ideal profile should be treated. The financial cost of treatment was found to be a concern, as more subjects (62.84%) would undergo the required treatment if it were free. Many subjects (43.55%) would be prepared to pay for the necessary treatment to achieve the ideal profile. Females were found to be more definite in their decision making, reflecting a greater awareness about their aesthetic appearance than their male counterparts. Findings from this study can serve as an essential tool to assist both orthodontists and maxillofacial surgeons in the treatment planning and management of Black patients with bimaxillary protrusion.

Patients' perceptions of orthognathic treatment, well-being, and psychological or psychiatric status: a systematic review

OBJECTIVE

To conduct a systematic review of studies concerning the psychosocial well-being of surgical-orthodontic patients.

MATERIAL AND METHODS

Articles published between 2001 and 2009 were searched using PubMed, Web of Science, and PsycInfo. Only articles written in English were included. Articles on methodological issues or on patients with clefts or syndromes or studies in which treatment had included surgically assisted maxillary expansion or intermaxillary fixation were excluded. The exclusion of articles was carried out in collaboration with two reviewers. To find new relevant articles, references from all the obtained review articles were hand-searched. Thirty-five articles fulfilled the selection criteria and were included in this review.

RESULTS

The main motives for seeking treatment were improvements in self-confidence, appearance, and oral function. Patients were not found to suffer from psychiatric problems. Treatment resulted in self-reported improvements in well-being, even though these improvements were not found with current assessment methods. Changes in well-being were most often registered using measures designed for evaluation of the impact of oral health on quality of life (e.g. the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile).

CONCLUSIONS

Surgical-orthodontic patients do not experience psychiatric problems related to their dentofacial disharmony in general. However, subgroups of patients may still experience problems, such as anxiety or depression, as many studies only report patients' mean problem scores and compare them to controls' scores or population norms. New assessment methods focusing on day-to-day changes in mood and well-being, as well as prospective studies with controls, are needed.

Influence of supplemental written information on adolescent anxiety, motivation and compliance in early orthodontic treatment

OBJECTIVES

To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on (1) anxiety, motivation and apprehension related to treatment and (2) compliance in the early stages of fixed appliance therapy.

MATERIALS AND METHODS

Seventy-six adolescents who were due to start fixed appliance therapy were randomly allocated to receive verbal information only or verbal and written information before orthodontic treatment. Participants' anxiety, motivation, and apprehension were assessed using a questionnaire that was completed prior to meeting the orthodontic clinician (T1), following consent to treatment (T2), and after 12 weeks of treatment (T3). Appointment attendance, appliance breakages, and periodontal scores were used as measures of patient compliance.

RESULTS

Sixty participants completed the study. At T2 there was no change in anxiety scores for either group (P = .412); however, increased motivation was detected in the group that had been given both written and verbal information (P = .049). At T3 both groups demonstrated similar reductions in anxiety (P = .311) and apprehension (P = .790) and similar levels of motivation (P = .756). A reduction in periodontal scores (P = .065), better appointment attendance (P = .732), and fewer breakages (P = .525) were reported in the group that was given additional information, although these changes were not statistically significant.

CONCLUSIONS

Supplementation of verbal information with written information resulted in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety, apprehension, or patient compliance.

Immigrant background and orthodontic treatment need. Quantitative and qualitative studies in Swedish adolescents

During the last three decades there has been an increased influx of refugees and immigrants into Scandinavia. The overall aim of this thesis was primarily to improve our knowledge of malocclusion and orthodontic treatment need, both normative and self-perceived, in adolescents of varying geographic origin. A further aim was to determine whether any differences with respect to perception of general appearance and psychosocial well-being were related to geographic origin. Papers I and II concerned self perceived and normative orthodontic treatment need. About 500 12-13 year-old subjects, stratified into different groups: A-Sweden, B-Eastern/Southeastern Europe, C-Asia and D-other countries, answered a questionnaire and underwent clinical examination by the author. In paper III the association between the two variables in papers I and II was investigated. Paper IV was a follow up study, at 18-19 years of age, of the relationship between geographic origin and prevalence of malocclusion, self-perceived treatment need, temporomandibular symptoms and psychosocial wellbeing. In Paper V a qualitative study of 19-20-year-old subjects was conducted, to identify the strategies they had adopted to handle the issue of persisting poor dental aesthetics. The main findings were that at 12-13 years of age, immigrant subjects had a lower perceived orthodontic treatment need than subjects of Swedish background. Girls of Swedish background had the highest self-perceived treatment need, whilst girls of non-Swedish background were most concerned that fixed appliance therapy would be painful. In a few of the clinical variables measured at 12-13 years of age, the Swedish group exhibited the greatest space deficiency and irregularity in both the maxillary and mandibular anterior segments and greater overjet, compared to the Eastern/Southeastern European and Asian groups. The clinical implications were negligible. The orthodontic treatment need according to "Index of Orthodontic Treatment Need--Dental Health Component" (IOTN-DHC) grades 4 and 5, ranged from 30 to 40 per cent, without any inter-group differences. There were strong associations between subjects perceiving a need for orthodontic treatment and IOTN-DHC grades 4 and 5, anterior crossbite and avoiding smiling because they were self-conscious about their teeth. At the age of 18-19 years, the frequency of malocclusion was similar in all groups. Subjects of Asian origin had a higher self-perceived orthodontic treatment need than their Swedish counterparts and a higher frequency of headache than those of Eastern/Southeastern European origin. Psychological wellbeing was reduced in nearly one quarter of the sample, more frequently in girls than boys. No association was found between self-perceived orthodontic treatment need and psychological wellbeing. The theory "Being under the pressure of social norms" was generated in Paper V, and it can be applied to improve our understanding of young adults who have adjusted to living with poor dental aesthetics and also aid to identify those who are not as well-adjusted and would probably benefit from treatment. Undisclosed dental fear is an important barrier to acceptance of orthodontic treatment in early adolescence. Despite demographic changes due to immigration, no major change in the prevalence of malocclusion and normative orthodontic treatment need has been disclosed. This does not apply to adolescents and adults who immigrated at an older age.

Self-perceived orthodontic treatment need and prevalence of malocclusion in 18- and 19-year-olds in Sweden with different geographic origin

Orthodontic treatment need and demand in 19-year-olds in Sweden has not previously been analysed in relation to geographic origin. The aim of this follow-up study was to examine the prevalence of self-perceived treatment need, malocclusion, earlier orthodontic treatment, self-perceived dental aesthetics and prevalence of symptoms indicative oftemporomandibular disorders in 18-19 year-olds and to analyze any differences between native born and immigrants. Body esteem and psychological wellbeing were also evaluated. The subjects, n=316, were grouped according to family origin: Group A: both parents born in Sweden (98 girls, 80 boys); Group B:the subject or at least one parent born in Eastern /South Eastern Europe (24 girls, 26 boys) and Group C: Asia (44 girls, 44 boys). Two hundered and sixty-eight participants presented for clinical examination and answered the full questionnaire, and 48 who rejected clinical examination,were interviewed by telephone using selected questions from a questionnaire. The results show that adolescents of Asian origin had a higher self-perceived treatment need than adolescents of Swedish origin. There were negligible inter-group differences with respect to frequency of malocclusion. Forty-four per cent of all participants had previously undergone orthodontic treatment, significantly more Swedish than Asian subjects. Dissatisfaction with dental aesthetics was attributed primarily to tooth colour (38 per cent) and irregular anterior teeth (34 per cent). Adolescents of Asian origin had a higher frequency of headache than those of Eastern/South Eastern European origin. Compared to boys, girls had a higher self-perceived treatment need, a higher frequency of headache and TMD and were more concerned about body appearance. Psychological wellbeing was reduced in nearly one quarter of the participants, predominantly girls: girls of Asian origin had the highest frequency. No association was found between self-perceived orthodontic treatment need and psychological wellbeing.

Self-perception regarding the need for orthodontic treatment among impoverished schoolchildren in Brazil

AIM

The objectives of the present study were to assess predictive factors associated to self-perception regarding the need for orthodontic treatment among 170 impoverished schoolchildren.

MATERIALS AND METHODS

A cross- sectional study was conducted in public schools in the city of Belo Horizonte-MG (Brazil). Children's self-perception regarding the need for treatment was assessed using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a questionnaire addressing biopsychosocial factors. The chi-square test and multiple logistic regression were used in the data analysis.

RESULTS

The predictive factors for the self-perception of orthodontic treatment need on the part of the impoverished schoolchildren included ridicule from persons close to the children regarding the appearance of the teeth (OR 2.81; 95%CI 1.2 to 6.4), dissatisfaction with oral aesthetics due to the alignment of the teeth (OR 2.45; 95%CI 1.1 to 5.4) and missing teeth (OR 3.02; 95%CI 1.0 to 9.23).

CONCLUSION

The alignment of the teeth, missing teeth and ridicule from others regarding the appearance of the teeth are the factors that most strongly influence self- perception regarding the need for orthodontic treatment among impoverished schoolchildren.

I want braces: factors motivating patients and their parents to seek orthodontic treatment

OBJECTIVE

To determine patients' and parents'/guardians' motivation for orthodontic treatment.

BASIC RESEARCH DESIGN

A self-completion postal questionnaire survey of new patients referred for orthodontic assessment.

CLINICAL SETTING

Kent and Canterbury Hospital (January 2003-January 2004).

PARTICIPANTS

Five hundred patients referred from general dental practice and community dental service within East Kent.

RESULTS

Response rate was 66%. Fifty percent of the patients were between 11 and 13-years-old. In 81% of cases referral was initiated by the dentist. Most of the patients (87%) were concerned with the appearance of their teeth, 38% reported teasing related to their dental appearance. Only 20% of patients thought there was nothing wrong with their teeth.

CONCLUSIONS

The patients' general dental practitioner initiated referral for orthodontic treatment in the majority of the cases. Most patients and parents appeared to be highly motivated and accepting of appliances for orthodontic treatment. Teasing was a commonly reported consequence of malocclusion with negative psychosocial impact.

Does orthodontic treatment affect patients' quality of life?

The oral-facial region is usually an area of significant concern for the individual because it draws the most attention from other people in interpersonal interactions and is the primary source of vocal, physical, and emotional communication. As a result, patients who seek orthodontic treatment are concerned with improving their appearance and social acceptance, often more than they are with improving their oral function or health. Enhancing these aspects of quality of life is an important motive for undergoing orthodontic treatment. Regardless of age, patients' and their parents' or caregivers' expectations about improvements in oral function, esthetics, social acceptance, and body image are important for both general dentists and orthodontists to consider when advising patients about these procedures and during the treatment process. This review of research on the impact of conventional and surgical orthodontics on quality of life examines the association between oral health-related quality of life and severity and type of malocclusion, as well as the impact of treatment and patient characteristics on quality of life. The article will emphasize the importance of clinicians' having a clear understanding, before initiating treatment, of their patients' quality of life and their expectations about improvements in specific domains of quality of life.

Combining normative and psychosocial perceptions for assessing orthodontic treatment needs

Whereas perceptions of malocclusion by the public are mainly subjective, currently orthodontic treatment needs are predominantly determined using normative need. There are considerable differences between normative and subjective perceptions of orthodontic need. Yet clinical measures determine current provision of orthodontic services, whereas subjective oral health-related quality of life (OHRQoL) measures are seldom used and play a small part in need assessment despite predicting perceived need. The sociodental approach to assessing orthodontic treatment needs overcomes deficiencies of the sole use of normative need. It is a gradual integration process, estimating orthodontic needs by combining normative and psychosocial perspectives, as well as considering behavioral factors affecting outcomes of orthodontic treatment and scientific evidence about the effectiveness of interventions. To be appropriately used in needs assessment, an OHRQoL measure should provide condition-specific estimates of the impact of malocclusion on daily life. The sociodental approach attempts to replicate the characteristics of good clinical practice using a structured, rational, and coherent system for assessing orthodontic needs and, therefore, is a useful tool in planning oral health services.

Orthodontic evolution: an update for the general dental practitioner. Part 2: psychosocial aspects of orthodontic treatment, stability of treatment, and the TMJ-orthodontic relationship

As a result of recent innovations and improvements, orthodontic treatment has become easier and more efficient to carry out, allowing greater numbers of patients to receive treatment. The main result of orthodontic treatment is improved dental alignment and aesthetics. Treatment has no effect on caries or periodontal disease, and the dental health gain is modest, apart from a very small percentage of destructive malocclusions. Psychological improvements using different psychological parameters show differing results and it is not clear that any psychological gains are long lasting. Social gain (greater willingness to smile, feeling good about oneself, satisfaction with dental appearance, etc.), and reported improved quality of life (QoL measures), are now becoming more important as consumer-related outcomes and may, ultimately, contribute to psychosocial and psychological status. Stability of orthodontic treatment results cannot be guaranteed and all patients need to be informed of this, and of the need for long-term retention. Malocclusion has little or no relationship to temporo-mandibular joint dysfunction and orthodontic treatment neither causes nor cures such problems. Extractions as part of orthodontic treatment do not cause TMD, nor do they cause collapse of the vertical dimension. The major improvements in dental health in the last 40 years have been accompanied by a great increase in demand for treatment. In any public health service that is free at the point of use, demand for treatment invariably exceeds the ability of resources to supply this. Indices of treatment need are widely used to determine treatment need and eligibility for treatment in public health systems. Demand for orthodontic treatment among adolescents can be as high as 60% in the general population, while the professionally-assessed need for treatment is approximately half this figure. Age, sex, socio-economic status, perceived unattractiveness of dental appearance, and availability of orthodontic services all influence receipt of treatment.

Awareness of malocclusion and desire for orthodontic treatment in 11 to 14 year-old Nigerian schoolchildren and their parents

OBJECTIVES

To investigate Nigerian children's and their parents' satisfaction with the children's facial and dental appearances and their desire for orthodontic treatment, and to compare their assessments of treatment need with those determined by an orthodontist.

METHODS

The subjects were 242 11-14 year-old schoolchildren randomly selected from private and public schools in the Ife Central Local Government area, Nigeria. A questionnaire was used to obtain information from the children and their parents of their liking of the facial and dental appearances of the children and the need and desire for orthodontic treatment. The children, the parents and an orthodontist used the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to assess the need for treatment.

RESULTS

More parents liked their child's facial and dental appearances than the children liked themselves. Almost twice as many schoolchildren thought they needed (27 per cent) and desired (29 per cent) orthodontic treatment than their parents (115 per cent). Low, but statistically significant correlations, were found between the children's, their parents' and an orthodontist's assessments of treatment need using the AC scale. Only 8 per cent of the children and 3 per cent of the parents considered that there was a 'moderate-definite' need of treatment. The orthodontist considered 38 per cent of the children had a 'moderate-definite' need of treatment.

CONCLUSIONS

The children's responses suggest greater concern about their facial and dental appearances, a greater perception of the need for orthodontic treatment and greater desire for treatment than their parents. These findings require further investigation as previous studies have reported that parents are usually more motivated for orthodontic treatment than their children.

Satisfaction with dental appearance in 8-9 years-old children. Validation of COAS questionnaire for Italian-speaking children and evaluation of social and geographical context

AIM

This study was designed to adapt the original English-language COAS (Children's Orthodontic Attitude Survey) for third- grade schoolchildren to the Italian cultural environment and to investigate its properties in typical populations, as well as to evaluate children self-perception of their dental appearance.

STUDY DESIGN

The COAS questionnaire for third-grade schoolchildren was translated and culturally adapted for Italian-speaking children. The Italian version of the questionnaire was tested on 169 (73 females, 96 males) children. Test-retest reliability was assessed on 34 children one week after the first administration. We also analysed correlations between social status and questionnaire findings.

METHODS

All children filled in the questionnaire and then they were clinically examined by three residents. The clinical parameters were correlated with the questionnaire findings to evaluate children's satisfaction with their dental appearance.

RESULTS

Ninety-five per cent of children thought it was important to have straight teeth and 87 per cent considered that crooked teeth were ugly. Comparison with clinical parameters showed a statistically significant correlation between crowding and overjet and some answers. Urban children have a better opinion on braces: they would like to have braces and they think they need braces statistically more than rural subjects.

CONCLUSION

The Italian version of the modified-COAS questionnaire had a very good reliability. Social status and geographical context play a very important role in children's satisfaction with dental appearance. Children with different social context demonstrate they have very different approaches towards their dental aspect and braces.

Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery

OBJECTIVE

To assess self-esteem and depression in patients submitted for orthognathic surgery.

METHODS

Assessment was realized on 29 patients, male and female, aged 17 to 46, presenting Angle Class III malocclusion and referred for surgical treatment, during the preoperative (orthodontic preparation) and postoperative (six-month postoperative) periods. Either maxillomandibular or isolated procedures were performed. Two previously validated standardized measurement instruments for this area were used: the UNIFESP-EPM Rosenberg Self-Esteem Scale and the Self-Report Questionnaire-20 (SRQ-20). Descriptive and inferential statistical analysis (Repeated Measures Analysis of Variance and the Bonferroni test) verified possible interactions between the pre and postoperative periods, genders and types of surgery. Significance was determined at 5%.

RESULTS

Females showed improved self-esteem, presenting lower mean values after surgery (8.9 to 6.3). Regarding depression, a significant reduction in the number of depressive symptoms (p=0.002) occurred for female patients.

CONCLUSIONS

Female patients presented improved self-esteem and diminished depressive symptoms due to surgical intervention; whereas male patients showed no alteration in self-esteem and depression with surgical intervention.