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Kirschneck C, Kuhr K, Ohm C, Frenzel Baudisch N, Jordan AR. Comparison of orthodontic treatment need and malocclusion prevalence according to KIG, ICON, and mIOTN in German 8- to 9-year-old children of the Sixth German Oral Health Study (DMS 6). J Orofac Orthop 2023; 84:26-35. [PMID: 36723623 PMCID: PMC9892091 DOI: 10.1007/s00056-023-00446-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of the present study was to compare the malocclusion indices KIG (Kieferorthopädische Indikationsgruppen, Orthodontic Indication Groups), ICON (Index of Complexity, Outcome and Need), and mIOTN (modified Index of Orthodontic Treatment Need) regarding differences in malocclusion prevalence and their assessment of orthodontic treatment need in German 8‑ to 9‑year-old children of the Sixth German Oral Health Study (Deutsche Mundgesundheitsstudie, DMS 6). METHODS The necessary data for the calculation of the KIG, mIOTN, and ICON were collected by a dentist as part of a clinical orthodontic examination during the field phase of the DMS 6 and by a subsequent digital orthodontic model-analytical evaluation of intraoral scans of the dental arches and the occlusal situation in habitual occlusion. RESULTS Prevalence, severity, and treatment need of tooth and jaw misalignments differed in part considerably depending on the index used for assessment. On the other hand, there were several outcomes which yielded quite similar results for the different indices used, such as orthodontic treatment need, which ranged from 40.4% (KIG) over 41.6% (ICON) to 44.2% (mIOTN). Interestingly, orthodontic treatment need for the individual subject could differ considerably, when assessed using different indices. CONCLUSIONS In general, the results show that the mIOTN is much more conservative in assessing malocclusion prevalences often being smaller than those derived by KIG or ICON. In contrast, KIG and ICON often yield similar prevalences with certain distinct differences due to discrepancies in the respective definitions and also clearly differentiate between treatment possibility and arbitrarily determined treatment need.
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Affiliation(s)
- Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Kathrin Kuhr
- Institute of German Dentists, Universitätsstr. 73, 50931, Cologne, Germany
| | - Cristiana Ohm
- Institute of German Dentists, Universitätsstr. 73, 50931, Cologne, Germany
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Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127446. [PMID: 35742703 PMCID: PMC9223594 DOI: 10.3390/ijerph19127446] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents. Methods: The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias. Results: The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively. Conclusions: There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.
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Sepp H, Vinkka-Puhakka H, Peltomäki T. Mandibular movements in children with deciduous and mixed dentition and in young adults with permanent dentition-the association between movements and occlusal traits. Eur J Orthod 2021; 43:338-345. [PMID: 32524135 DOI: 10.1093/ejo/cjaa033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cross-sectional studies of mandibular movements provide data on developmental trends of dentition and support planning of public health services. OBJECTIVE The aim of this study was to measure mandibular movement capacities in children with deciduous and mixed dentition and in young adults with permanent dentition. The influence of age and gender on mandibular movements and the association between mandibular movements and occlusal traits were analysed. METHOD The sample consisted of 1172 Estonians: group 1: children with deciduous dentition; group 2: children with mixed dentition; and group 3: young adults with permanent dentition. Maximum opening, mandibular laterotrusion, and protrusion were registered. RESULTS Age was correlated with mandibular movements. Young adults had statistically significantly larger mandibular movements as compared to children with deciduous and mixed dentition, and children with mixed dentition had larger mandibular movements as compared to children with deciduous dentition. Young adult males had larger mandibular movements than females of the same age. Associations were found between mandibular movement capacities and some occlusal traits. Mandibular movement capacities were smaller in children with crossbite and open bite as compared with children without corresponding occlusal traits. Mandibular movement capacities were larger in children with deep bite and increased overjet as compared with those without corresponding occlusal traits. CONCLUSION Mandibular movement capacities are age and gender dependent. Maximum mouth opening, mandibular laterotrusion, and protrusion are related, and mandibular movement and some occlusal traits are associated.
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Affiliation(s)
- Hettel Sepp
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Heli Vinkka-Puhakka
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Timo Peltomäki
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland.,Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Maaniitty E, Vahlberg T, Lüthje P, Rautava P, Svedström-Oristo AL. Malocclusions in primary and early mixed dentition in very preterm children. Acta Odontol Scand 2020; 78:52-56. [PMID: 31401921 DOI: 10.1080/00016357.2019.1650954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To compare the prevalence of malocclusions in the primary and early mixed dentition of very preterm and full-term children.Material and methods: Study subjects consisted of 205 very preterm (90 girls and 115 boys), and 205 age- and gender-matched full-term children. Data were collected from the register of Turku University Hospital (children born before the 37th week of pregnancy with a birth weight of less than 1500 g, and all infants born before the 32nd week of pregnancy) and from public health centre dental registers.Results: In primary dentition, case children had a higher odds of dental crowding (OR = 2.94, 95% CI 1.17-7.35, p = .021), a tendency toward increased overbite (OR = 1.55, 95% CI 0.93-2.59, p = .096), and a lower odds of increased overjet (OR = 0.19, 95% CI 0.07-0.57, p = .003) compared to control children. In early mixed dentition, there were no statistically significant differences in occlusal traits; however, case children were significantly more likely to have received orthodontic treatment (OR = 2.80, 95% CI 1.50-5.23, p = .001) compared to controls.Conclusions: The results indicate that in primary dentition, the prevalence of malocclusion varies between very preterm and full-term children. In early mixed dentition, the distribution of occlusal traits is more similar.
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Affiliation(s)
| | - Tero Vahlberg
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Petra Lüthje
- Institute of Dentistry, University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Anna-Liisa Svedström-Oristo
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
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Sepp H, Saag M, Vinkka‐Puhakka H, Svedström‐Oristo A, Peltomäki T. Occlusal traits of 4-5-year-old Estonians. Parents' perception of orthodontic treatment need and satisfaction with dental appearance. Clin Exp Dent Res 2019; 5:199-204. [PMID: 31249699 PMCID: PMC6586095 DOI: 10.1002/cre2.170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 11/06/2022] Open
Abstract
This study aims to evaluate the prevalence of occlusal traits and to assess parents'/caregivers' satisfaction with child's dental appearance and perception of orthodontic treatment need in 4-5-year-old Estonians. Clinical records and plaster casts of 390 children (190 girls and 200 boys, mean age 4.7 years, range 4 - 5 years) were analyzed. Assessed occlusal traits included deciduous canine and second molar sagittal relationship, overjet, overbite, crowding, midline diastema, crossbite, and scissor bite. Parents'/caregivers' opinions regarding their child's teeth were determined with a questionnaire. The most prevalent occlusal traits were symmetrical sagittal relationship in deciduous canines (78.2%) and molars (75.1%), Class I sagittal relationship in deciduous canines (69.7%) and midline diastema (67.7%). Asymmetrical sagittal canine relationship was registered in 21.8% deciduous canines and in 24.9% second deciduous molars. Parents'/caregivers' perceived orthodontic treatment need was related to Class III sagittal relationship in canines, increased overjet and overbite, negative overbite, and crossbite. Prevalence of most occlusal traits in Estonian children were in line with those reported in neighboring countries. Parents/caregivers were well able to observe occlusal traits that deviated from acceptable occlusion.
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Affiliation(s)
- Hettel Sepp
- Department of Stomatology, Faculty of MedicineUniversity of TartuTartuEstonia
| | - Mare Saag
- Department of Stomatology, Faculty of MedicineUniversity of TartuTartuEstonia
| | - Heli Vinkka‐Puhakka
- Department of Oral Development and Orthodontics, Institute of DentistryUniversity of TurkuTurkuFinland
| | | | - Timo Peltomäki
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
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Sepp H, Saag M, Peltomäki T, Vinkka-Puhakka H, Svedström-Oristo AL. Occlusal traits, orthodontic treatment need and treatment complexity among untreated 17-21-year-olds in Estonia. Acta Odontol Scand 2019; 77:44-48. [PMID: 30084695 DOI: 10.1080/00016357.2018.1498126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To analyze data on occlusal traits, orthodontic treatment need and treatment complexity in orthodontically untreated 17-21-year-old Estonians.Materials and methods: Clinical records and plaster casts of 390 untreated young adults (219 females and 171 males, mean age 18.5 years, range 17-21 years) were analyzed. Assessed occlusal traits included first molar and canine sagittal relationship, overjet, overbite, crowding, midline diastema, crossbite and scissor bite. The Index of Complexity, Outcome and Need (ICON) was used to assess orthodontic treatment need and complexity. Participants' opinions regarding their teeth were determined with a questionnaire.Results: The most prevalent occlusal traits were Class I sagittal relationship in canines (76%) and molars (70%), crowding (51%), overbite ≥3.5 mm (48%), the end-to-end sagittal relationship in canines (48%) and overjet ≥3.5 mm (47%). Antero-posterior asymmetry was common both in canines (39%) and molars (37%). According to ICON, 36% of participants had orthodontic treatment need.Conclusions: Desire for orthodontic treatment was associated with crowding and increased overjet, and with no gender difference, participants' main expectation of treatment was an improvement in dentofacial aesthetics. Treatment needs determined with ICON was moderate and in line with the participants' desire for orthodontic treatment.
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Affiliation(s)
- Hettel Sepp
- Department of Stomatology, University of Tartu, Tartu, Estonia
| | - Mare Saag
- Department of Stomatology, University of Tartu, Tartu, Estonia
| | - Timo Peltomäki
- Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Faculty of Health Sciences, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Heli Vinkka-Puhakka
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
| | - Anna-Liisa Svedström-Oristo
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
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Sepp H, Saag M, Svedström-Oristo AL, Peltomäki T, Vinkka-Puhakka H. Occlusal traits and orthodontic treatment need in 7- to 10-year-olds in Estonia. Clin Exp Dent Res 2017; 3:93-99. [PMID: 29744185 PMCID: PMC5719823 DOI: 10.1002/cre2.64] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/24/2017] [Accepted: 03/03/2017] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to evaluate the distribution of occlusal traits and orthodontic treatment need and complexity in Estonian 7- to 10-year-old children. This data provides solid information for planning of orthodontic care. Data of 392 Estonian children (198 girls and 194 boys, mean age 9.0 years, range 7.1-10.4 years) was analysed in this cross-sectional study. Assessed traits included first molar and canine sagittal relationship, overjet, overbite, crowding, midline diastema, crossbite, and scissor bite. Orthodontic treatment need and complexity were assessed using the Index of Complexity, Outcome, and Need. Parents' opinion regarding their child's teeth was determined using a questionnaire. The most prevalent occlusal traits were canine class I sagittal relationship (73.7%), midline diastema (73.0%), molar class I sagittal relationship (57.4%), and overbite ≥3.5 mm (51.8%). According to the Index of Complexity, Outcome, and Need, 64.3% of Estonian elementary school children were in need of orthodontic treatment. Treatment complexity was simple in 12.5%, mild in 38.8%, moderate in 22.7%, difficult in 14.0%, and very difficult in 12.0% of the children. Approximately 66.4% of the parents felt that their child needed orthodontic treatment. This study confirms earlier findings indicating that the most frequent sagittal relationship is class I in the first molars and class I in the canines. However, the sagittal relationship was asymmetric in more than half of the children. Correlation between objectively defined treatment need and parents' desire for treatment was high in Estonia.
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Affiliation(s)
- Hettel Sepp
- Department of Stomatology University of Tartu Estonia
| | - Mare Saag
- Department of Stomatology University of Tartu Estonia
| | | | - Timo Peltomäki
- Faculty of Medicine and Life Sciences University of Tampere Finland
| | - Heli Vinkka-Puhakka
- Department of Oral Development and Orthodontics, Institute of Dentistry University of Turku Finland
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