Need for preventive and interceptive orthodontic treatment in 3-5 year-old Nigerian children in two major cities

There is a growing emphasis world-wide for early orthodontic treatment but in Nigeria there is very little information regarding the occlusal development in pre-school children reported. The need for preventive and interceptive intervention for malocclusion was studied in a sample of 563 Nigerian children (289 boys and 274 girls) aged 3-5 years. Orthodontic intervention was estimated to be needed in 12.8% of the children due to cross bite of the anterior or lateral segments. Education was needed in 12.5% of the children in cases of digit sucking, lip sucking and tongue thrusting. Extraction was indicated in 0.4% of children in cases of retained primary incisors causing displacement of the erupting successors. The need for further follow-up of occlusal development was noted in 1.4% of the children due to double primary teeth (0.4%), numerical variation of primary teeth (0.4%), crown dilaceration of a tooth (0.2%) and true class III skeletal malocclusion (0.4%).

The role of prevention and simple interceptive measures in reducing the need for orthodontic treatment

The purpose of the interceptive orthodontic treatment is to eliminate or reduce the need for treatment in the permanent dentition. The major advantage of such a treatment may also be that it is technically simple and relatively cheap, compared to comprehensive treatment with full fixed appliances. The need for interceptive measures to avoid adverse occlusal and dental consequences, which are effects of the early loss of primary molars and nonnutritive sucking habits, is discussed. The need for prevention and early intervention in patients with anterior open bites, posterior functional crossbites and signs of ectopic erupting canines is also discussed.

Space maintenance in the primary and mixed dentition

The maintenance of arch length in the primary, mixed and early permanent dentition is important for the normal development of the occlusion. Premature loss of primary teeth can result in the loss of arch length leading to malocclusion. Space maintenance can often prevent space loss and either prevent the development of a later malocclusion or reduce its severity. The pattern of space loss depends on many factors including age, stage of development, which teeth have been lost, the presence of crowding or spacing, and occlusal relationships. Careful consideration of many factors is required when deciding whether space maintenance is indicated. Radiographs and space analysis can be helpful. Space maintainers can be fixed or removable. Band and loop space maintainers have fewer problems than other types. Frequent follow-ups to check for any problems following space maintainer insertion is recommended.

Initial tooth displacement in vivo as a predictor of long-term displacement

In the past, the dry skull has been used as a hypothetical model to test initial orthodontic and orthopaedic force systems. However, the question as to whether this hypothetical model can be used as a predictor of long-term displacements in vivo remains unanswered. In this study, an attempt was made to compare initial tooth displacement with the long-term effect after application of the force system for a longer period of time, in six adult dogs. Tooth displacement was obtained by applying a force by means of a coil spring (push) system. Following application of a force of 50 g in the first series (n = 3) and 80 g in the second series (n = 3), initial displacements were registered by means of speckle interferometry. The long-term displacement was registered by means of standardized cephalometry in the same dog by leaving the force system in place for 5 weeks. The mean values of the displacement vectors of the second premolars in the six dogs were compared. A paired t-test revealed no significant differences between the initial and long-term displacements in any of the dogs. The results show that both groups of measurements belong statistically to the same sample and that initial tooth displacement measured by means of speckle interferometry is a valuable predictor for forecasting long-term displacement in vivo after 5 weeks.

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.

The impacted maxillary canine. Further observations on aetiology, radiographic localization, prevention/interception of impaction, and when to suspect impaction

Adjacent anomalous or missing maxillary lateral incisors have been implicated in the aetiology of palatally displaced canines by not providing proper guidance to the canine during its eruption. However, a recent review of the literature suggests that the aetiology of palatally displaced canines is genetic in origin. The aetiology of labially impacted canines differs, being due to inadequate arch space. Vertex occlusal radiographs have been recommended for localization but have limitations, and a case is illustrated where this radiograph is deceptive. The prevention/interception of a palatally displaced canine by the extraction of the deciduous canine is best carried out as early as the displacement is detected, mostly soon after 10 years of age. Usually, prevention/interception will avoid the surgical and orthodontic treatment needed to align a palatally impacted canine and may help prevent resorption of the adjacent incisor root. Suspicions that an impaction could occur or has occurred arise a) before the age of 10 years if there is a familial history and/or the maxillary lateral incisors are anomalous or missing; b) after the age of 10 years if there is asymmetry in palpation or a pronounced difference in eruption of canines between the left and right side; or the canines cannot be palpated and occlusal development is advanced; or, the lateral incisor is proclined and tipped distally; and, on a panoramic radiograph of the late mixed dentition if the incisal up of the canine overlaps the root of the lateral incisor.

The provision of orthodontic services by general dental practitioners. 1. Methods and descriptive results

Information regarding orthodontic service provision by general dental practitioners in Australia is limited. The aim of this survey was to determine the amount and variety of orthodontic services provided by general dental practitioners in the Melbourne Statistical Division, Victoria, Australia. A random sample of 307 dentists drawn from the Victorian Dentists Register was surveyed by mailed questionnaire: 218 (71%) replied. Data were collected using a fortnight log. During this time 59 per cent of the dentists saw at least one orthodontic patient; one dentist saw 66 orthodontic patients. Removable orthodontic appliances were used by 35 per cent of the dentists and fixed orthodontic appliances by 18 per cent. Twenty-six per cent provided comprehensive orthodontic treatment, 22 per cent aligned incisors, and 21 per cent corrected anterior crossbites. The general dental practitioners surveyed provided a wide range of preventive and interceptive orthodontic services to generally a small percentage of their patients.

[Indications for preventive removal of impacted third molars]

The impacted third molars are clinically important due to the pathological alterations caused by them. It is important from orthodontic viewpoint, that during their development the anomalies combined with the constriction, or unsuitable length of the dental arch may lead to recrudescence. For this reason the preventive removal of impacted third molars is suitable at the proper stade of their development.

[Autotransplantation of teeth]

Autotransplantation of teeth has become a common procedure in oral surgery. The most usual procedures are autotransplantation of premolars, canines and third molars. The method can be performed on young patients in combination with orthodontic treatment, creating optimal occlusal relationship. Indication, selection and timing in connection with the surgical procedure are of paramount importance for optimal results.

Reducing the incidence of palatally impacted maxillary canines by extraction of deciduous canines: a useful preventive/interceptive orthodontic procedure. Case reports

The early detection of palatally impacted permanent maxillary canines is stressed. Appropriate radiographs to determine impactions are suggested and removal of deciduous canines to eliminate impactions in patients who have good dental arches with no space deficiency is recommended. Two case histories are presented to illustrate the method.

[Preventive gnathology; maintenance of the functional status quo]

Preventive gnathology concerns all the procedures contributing to the maintenance of a physiologic occlusion. This demands an early recognition of patients at risk and a correct 'occlusal hygiene'. The importance of the use of preventive measures to preserve the existing functions in all patients during dental treatment is stressed.

[The anatomical and physiological aspects in the treatment of temporomandibular joint disorders]

The specialty of orthodontics and its relationship to TMJ problems is in the thick of controversy. Several anatomic and physiologic aspects are discussed so as to improve the understanding of the multi-faceted problems. The use of this biologically-based information is likely to make therapy more successful. From a therapeutic point of view, it is incumbent on the dentist to institute early preventive or interceptive procedures.

[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.

[Epidemiological study of the prevalence of malocclusion in a Bersaglio group]

The Authors planned an epidemiological survey to evaluate the prevalence of malocclusion in a target group of children living in the Ussl 8-Vicenza. The results confirm the data in the literature. The Authors think necessary to carry on more precise longitudinal epidemiological studies, orthodontic prevention of malocclusion during childhood and interceptive therapy.

[Juvenile rheumatoid arthritis: the role of the TMJ and stomatognathic system]

Juvenile chronic arthritis (j.c.a) often affects the maxillo-facial complex over all in relation to jaw and temporo-mandibular joint (TMJ). In this work 35 j.c.a. patients (aged 6 to 16 years) have been selected and studied in order to detect functional and morphostructural involvement of stomatognathic apparatus and TMJ. The involvement of these structures is appeared significantly increased during j.c.a. also in patients without clinic symptoms referable to a stomatognathic apparatus pathology. Therefore an early diagnosis as well as a preventive orthognatodontic treatment are necessary to reduce long term effects on the stomatognathic apparatus multifunctions.

[Etiological problems of anterior tooth crowding: the role of the third molar]

The authors discussed about the extraction or not of the 3 degrees molar either to prevent or correct the dental crowding. They state that, since there is no definitive evidence of the real importance of the 3 degrees molar in creating dental crowding, it is not possible to perform without discrimination 3 degrees molar germectomy nor the extraction for prevention.