Prevalence of malocclusions and orthodontic treatment need in 8- to 12-year-old schoolchildren in Casablanca, Morocco

A comprehensive national survey on malocclusion prevalence among Palestinian children

BACKGROUND

This study aims to evaluate the prevalence of malocclusion and orthodontic features among schoolchildren in the West Bank, Palestine.

METHODS

A stratified cluster sample of 1278 schoolchildren (620 males, 658 females, mean age 12 years and 5 months (± 0.5)) were examined. Candidates who had not received any previous orthodontic treatment were only included. Dental anomalies like missing and ectopic teeth were recorded. The anteroposterior occlusal relationship was assessed based on Angle classification. Overjet and overbite were measured. Crowding and spacing were recorded subjectively. In addition, crossbite, openbite, and midline displacement were recorded. The chi-square test and descriptive analysis were used statistically.

RESULTS

The study found Angle Class I molar relationship in 65%, Class II div 1 in 17%, Class II div 2 in 6%, and Class III in 12% of the sample. An overjet (OJ) of more than 4 mm was present in 17%, and 4% had OJ of more than 6 mm; an OJ of at least 0 mm or less in 36%, and 6% had a reverse OJ. A normal overbite was observed in 53%, while 28% had an increase and 19% had a decreased overbite. An anterior openbite (AOB) was present in 9%, and a scissor bite or anterior crossbite in 6% and 14%, respectively. A posterior crossbite was observed in 12% (9% unilateral and 3% bilateral). Midline displacement was found in (9%). Crowding was observed in 35% and 31% and spacing in 24% and 15% of the maxillary and mandibular arches, respectively. A statistically significant relationship between gender and midline shift, a diastema, spacing in the upper arch, and most dental anomalies was found; males were more affected (p < 0.05).

CONCLUSION

This study reported a high prevalence of malocclusion among schoolchildren in Palestine. A collaborative effort should be directed to obtain more monitoring and surveillance of malocclusion more frequently to prevent and control the exacerbation of the problem.

An epidemiological study on early orthodontic treatment need among eastern Saudi Arabian children in the mixed dentition stage

Estimation of early orthodontic treatment need among children is essential for planning orthodontic interventions in the mixed dentition stages thereby reducing the burden in a publicly funded healthcare system. The present study aimed to assess the early orthodontic treatment need among children with mixed dentition in the Eastern Saudi Arabia. A descriptive cross-sectional study was conducted among Saudi children visiting the outpatient clinics in a University dental setting, and data were collected based on Index for preventive and interceptive orthodontic need (IPION). Descriptive statistics, chi-square test and Fisher's exact test were used for data analysis with statistical significance set at p < 0.05. The category of 'no treatment need' accounted for 11.3% while 'moderate treatment need' and 'definite treatment need' categories accounted for 29.3% and 59.4% respectively. There was no statistical difference between males and females in the distribution of the three categories of treatment need (p = 0.513). This study demonstrated a very high need for early orthodontic treatment among Saudi children in the mixed dentition stage. Emphasis should be placed on increased awareness and benefits of seeking early orthodontic treatment involving preventive and interceptive procedures in the mixed dentition.

Prevalence and contributing factors of malocclusion in Zhuang children aged 7-8 years in southern China

Introduction

Malocclusion, a common oral health problem in children, is associated with several contributing factors. This study aimed to investigate the prevalence of mixed dentition stage malocclusion and its contributing factors in Chinese Zhuang children aged 7-8 years.

Methods

Overall, 2,281 Zhuang children, about 7-8 years old, were randomly selected using a stratified whole-cluster sampling method from schools in counties in Northwestern Guangxi, China. The children were examined on-site for malocclusion and caries by trained dentists, and basic data on the children were collected using questionnaires, including age, sex, parental education, parental accompaniment, and children's knowledge of malocclusion and treatment needs. Data were analyzed using the chi-square test and logistic regression analysis.

Results

The total prevalence of malocclusion in Zhuang children aged 7-8 years was 58.5%, with the highest prevalence of anterior crossbite tendency, and the prevalence of anterior crossbite and anterior edge-to-edge occlusion was 15.1% and 7.7%, respectively. This was followed by an anterior increased overjet of 13.3% and an inter-incisor spacing of 10.3%. The lowest prevalence was 2.7% for anterior open bite. Sex, parental accompaniment, parental education, and decayed, missing, and filled teeth of the first primary molar were factors that contributed to malocclusion in Zhuang children.

Conclusion

Malocclusion is a common oral problem among Zhuang children. Therefore, more attention must be paid to the intervention and prevention of malocclusion. The impact factors should be controlled as early as possible.

Prevalence of malocclusion and orthodontic treatment needs among adolescents in Najran City, Saudi Arabia

AIM

To determine the prevalence of malocclusions and the need for orthodontic treatment in a sample of school-going adolescents in the Najran city, Kingdom of Saudi Arabia (KSA).

METHODOLOGY

This cross-sectional study was conducted among 1094 school-going Saudi male adolescents. The age range of the sampled adolescents was 13-18 years, and none of them had any history of orthodontic treatment. A survey chart related to malocclusion was designed and filled up after clinical examination by a single experienced and calibrated examiner. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN).

RESULT

The present study's findings demonstrated 61.2% of the samples with Angle's Class I malocclusions, 27.5% with Class II, and 11.4% of samples with Class III malocclusion. A significant difference was observed between the different classes of malocclusion (P < 0.001). Most samples presented normal overjet, crossbite, and no reverse overjet, deep bite, or open bite. The number of samples with no treatment need was 573 (52.37%), with slight treatment in 185 (16.91%) samples, moderate treatment needs in 123 (11.24%) samples, and severe and extreme treatment needs were 109 (9.96%) and 104 (9.50%), respectively. A significant difference was observed between the samples with no or slight treatment need (grades 1 and 2), moderate need (grade 3), and definite treatment need (grades 4 and 5) (p < 0.001).

CONCLUSION

The prevalence of malocclusion and IOTNs among the sample of school-going adolescents in the Najran city was 47.63%. However, 9.63% of those samples required immediate attention for orthodontic treatment.

Who Seeks Clear Aligner Therapy? A European Cross-National Real-World Data Analysis

A key step prior to clear aligner therapy (CAT) is the clinical examination and case selection, which includes understanding the specific orthodontic problem to be managed and the wider evaluation of oral health. Seeking CAT may further differ along sociodemographic parameters or across countries, as may perceived orthodontic treatment needs and oral health. We aimed to characterize patients seeking CAT across five European countries. Anonymized real-life data from one large CAT provider (DrSmile, Berlin, Germany) was retrospectively sampled for the period 1 November 2021−31 December 2021. A total of 15,015 patients (68.4% females, 31.6% males, with an age range of 18−81 years, median 30.0 years) were included. The cross-national comparison revealed a significant difference in gender distribution (p < 0.001/Chi-square), with the highest proportion of males in Italy (434/1199, 36.2%) and the lowest in Poland (457/1600, 28.6%); generally, more females sought CAT. The largest motivational factor in all countries for seeking CAT was crowding, in both males and females. By and large, patients paid out of pocket for CAT. The prevalence of caries, periodontitis, and craniomandibular dysfunction as well as the numbers of missing teeth were generally low, albeit with significant differences between sociodemographic groups and countries for caries and periodontitis. Patients seeking CAT showed a low prevalence in oral conditions but differed in their sociodemographic characteristics across countries. Dentists and orthodontists should consider these country-specific differences when planning CAT.

Pooled prevalence estimates of malocclusion among Indian children and adolescents: a systematic review and meta-analysis

OBJECTIVES

To estimate the pooled prevalence estimates of the malocclusion among child and adolescent population of India.

CONTENTS

A comprehensive electronic search was carried to find studies related to assessing malocclusion in Indian children and adolescent population. Indices and classifications considered for pooled analysis were Dental Aesthetic Index, Index of Orthodontic Treatment Needs, Angles classification and terminal plane relationship of primary secondary molars. An eligibility criterion was prepared and quality assessment was done for all the eligible studies. Initial search produced 1090 titles. After removal of duplicates, 850 records were left for further screening. Eighty one articles were found eligible for full text reading. Finally 60 studies were included in this meta-analysis. Pooled prevalence was used to estimate overall effect, with 95% confidence intervals (CI). Statistical difference between the two genders was calculated using chi square test.

SUMMARY AND OUTLOOK

The high prevalence of malocclusion is a public health problem around the world. The current status of burden of malocclusion among Indian children and adolescents is not known. Results of this pooled analysis showed that prevalence of malocclusion among Indian children and adolescents has increased since the last national oral health survey. Prevalence of malocclusion ranged from 28.4% (CI 25.02, 31.9) to 66.7% (CI 50.7, 81.06) depending on the type of index or classification used for recording. Boys recorded higher cumulative prevalence than girls. These findings can be utilized by oral health policy makers to draft measures required for reducing this burden of malocclusion.

Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review

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.

Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review

The World Health Organization (WHO) considers malocclusion one of the most important oral health problems, after caries and periodontal disease. Its prevalence is highly variable and is estimated to be between 39% and 93% in children and adolescents. Due to the importance of malocclusions in dentistry, the aim of our review is to assess the frequency of malocclusions among different geographical regions. A literature research was performed through the Pubmed, Medline, Scopus, Web of Science, LILACS, Open Grey and Cochrane Library databases. The “PRISMA” guidelines were used for the following review. Fourteen studies were analysed for this review. Class I was found most frequently, followed by class II and finally class III. Considering the other anomalies, crowding was one of the most frequent with a prevalence of up to 84%, followed by spacing, which reached a frequency of 60%. Prevalence of crossbite and openbite was quite variable, while the evaluation of deepbite revealed more uniform values. The prevalence varied widely for most of the types of malocclusion in relation to the different populations, which suggests a role of genetics and environmental influences, typical of each population in determining dental problems.

Morphological features of Class I, II and III malocclusions of Saudi adolescents

Aims

This cross-sectional study compared and contrasted the morphological characteristics of Class I, II and III malocclusions in an adolescent Saudi population.

Methods

Adolescent Saudis with Angle’s Class I, II and III malocclusions were selected from orthodontic patients’ records. Angular and linear measurements were compared between the three groups. Cephalometric analysis was performed using the VistadentOC® software. Multifactorial ANOVA for angular and linear measurements between and within groups.

Results

Orthodontic records of 300 patients were included. There was no significant difference between and within groups in age and distribution of Angle’s classification, p > 0.05. Multifactorial ANOVA showed that there were significant interactions between gender and malocclusions in skeletal, dental and soft tissue measurements, p < 0.05. There were significant differences in the sagittal and vertical skeletal measurements between groups, p < 0.05. The dental measurements were also significantly different in most of the measurements (p < 0.05). Moreover, there were significantly different readings among the groups in the soft tissue analysis.

Conclusion

Morphological characteristics of adolescent Saudis show unique differences between gender and malocclusions, more so in Class III malocclusions. Class II and III malocclusions also show skeletal differences amongst the groups.

Environmental Factors Associated with Malocclusion in Children Population from Mining Areas, Western Romania

Our study is based on the hypothesis that the prevalence of malocclusions in children is higher in the mining areas from North-Western (NW) Romania than in other geographic areas. We also considered that the distribution of the different types of malocclusions can be correlated with environmental factors. Therefore, the main purpose of the current study was to assess the prevalence of malocclusions in children from the mining areas in NW Romania. Another purpose was to establish the influence of certain environmental factors such as gender, geographical area of origin, and ethnicity on the distribution of malocclusions in order to provide an epidemiological reference for the planning of preventive and treatment programs adapted to the particularity of the mining areas. This cross-sectional study was performed in 2015-2016. The study batch consisted of 960 children from the mining areas, aged 7-14 years, in the period of mixed dentition and early permanent dentition. The clinical examination was conducted by a single examiner, an orthodontic specialist (TBI), in order to avoid inter-operator bias. Occlusion was registered according to Bjoerk. Occlusal clinical signs were followed for the determination of malocclusions. Most children had malocclusions (93.5%). The percentage of anomalies was significantly higher in subjects from Rosia Montana, in girls, and in the Romanians. Data showed that Angle Class I was the most prevalent malocclusion (60.21%), followed by crowding (47.5%), midline shift (43.33%), and deep bite (28.65%). The independent association between ethnicity and total malocclusions shows that the Romanian subjects presented a 3.31 higher chance of developing malocclusions than the Romani ones. The presence of malocclusions was independently influenced by all the studied environmental factors, namely gender, geographical area, and ethnicity. Our results could be relevant for oral health policy-making, i.e., planning preventive and treatment measures of malocclusions, adapted to the peculiarity of the studied mining areas.

The prevalence of malocclusion and orthodontic treatment need of school children in Northern Saudi Arabia

OBJECTIVE:

To evaluate the incidence of malocclusion and requirement for orthodontic treatment in the Saudi region of Hail city.

MATERIALS AND METHODS:

520 Saudi participants between 7 and 12 years from Hail city were used in the research, all of whom were selected using a simple randomization method. For every participant, various malocclusion variables such as molar, canine, and incisor relationship, overjet, overbite, open bite, cross bite, scissor cross bite, and the score for the orthodontic treatment need [Index of Orthodontic Treatment Need (IOTN)] were recorded. A light source was used for examination, in addition to mouth mirrors, a calibrated ruler, and a portable dental chair.

RESULTS:

The prevalence of class I molar relationship was 70.4%, with class II being 21.3% and class III being 8.3%. As for the incisor relationships, class I was found at a prevalence of 72.5%, class II at 19.8%, and class III at 7.7%. Additionally, the following malocclusion characteristics were also found: deep overbite (>4 mm) (16.2%), increased overjet (>4 mm) (14.4%), posterior cross bite (13.3%), anterior open bite (7.7%), anterior cross bite (5.2%), scissor bite (4%), and posterior open bite (0.6%). A total of 4.4% were identified as requiring orthodontic treatment. Grades 1 and 2 were 25.5% and 58.5%, respectively. There was a significant relationship found between grades 3 and 4, and the anterior open bite, cross bite, and scissor bite.

CONCLUSION:

This research showed that class I malocclusion was most dominant, followed by classes II and III, respectively. When the Hail city school pupils in the study were assessed for IOTN index, grades 3 and 4 were found to be highly related to anterior open bite, cross bite, and scissor bite.

Prevalence of malocclusion among school children of Southern Saudi Arabia

OBJECTIVE:

To evaluate the status of occlusion among school children in city of Abha, Saudi Arabia.

MATERIALS AND METHODS:

The current study was based on the clinical examination of 1998 Saudis (mean age 14.13 ± 0.99 years) who were randomly selected by a multi-stage random sampling technique from the city of Abha. The occlusal parameters recorded in this study were molar and canine relationships, overbite, overjet, crowding, spacing, anterior open bite, anterior crossbite, posterior crossbite, and scissors bite using gloves, light source, mouth mirror, and ruler.

RESULTS:

Class I molar relationship was observed in 1219 (61%) of the total sample, while Class II and III molar relationships were observed in 326 (16.3%) and 154 (7.7%), respectively. Class I–III canine relationships were seen in 1255 (62.8%), 231 (11.6%), and 112 (5.6%) of the sample, respectively. Normal overbite was found in 1490 (74.6%) of cases, while 1515 (75.8%) had normal overjet. The most prevalent malocclusion trait was crowding (26.6%), followed by spacing (20.6%), increased overjet (19.5%), increased overbite (19.4%), posterior crossbite (8.5%), and anterior open bite (6.1%).

CONCLUSIONS:

Crowding was the highest occlusal trait in frequency followed by spacing, increased overjet, and increased overbite. Class I molar and canine relationships, normal overjet, and normal overbite were frequent findings among Saudi adolescents in Abha city.

The Prevalence of Major Types of Occlusal Anomalies among Saudi Middle School Students

INTRODUCTION

Malocclusion is the most common dental anomaly among children and adolescents. Accordingly, this study was conducted to investigate the prevalence of major types of occlusal anomalies in permanent dentition among Saudi Arabian middle school adolescent students seeking orthodontic treatment in Jeddah.

MATERIALS AND METHODS

The sample comprised 150 males and 150 females with mean age of 14.25 (±1.09) for both males and females. Data were registered using the Bjork method.

RESULTS

The results of the study showed that postnormal occlusion, prenormal occlusion, and bimaxillary protrusion represented 22, 14.7, and 8.3% of the studied sample respectively. Moderate and severe overjet accounted for 24.7 and 5.7% and for overbite 28 and 13% respectively. Midline deviation was detected in 25.3% of the sample. Mild, moderate, and severe maxillary and mandibular crowding represented 10, 27.3, and 10% and 13, 40, and 9.7% respectively.

CONCLUSION

The prevalence of occlusal anomalies was 90% and some occlusal anomalies were higher in females.

CLINICAL SIGNIFICANCE

The prevalence of occlusal anomalies in Saudi Arabian middle school students necessitates the demand for obtaining baseline data for planning orthodontic services.

Sleep-disordered breathing and orthodontic variables in children--pilot study

INTRODUCTION

Sleep Disordered Breathing (SDB) is a highly prevalent condition associated with orofacial and dentofacial characteristics.

OBJECTIVE

The aim of this study was to verify the association of dental malocclusion, molar relationship, crossbite, open bite, overjet, overbite, and crowding with SDB in children aged 7-9 years.

MATERIALS AND METHODS

Participating schools were selected randomly from within the public elementary school system. In the first phase of the study, the parents of 1216 children aged between 7 and 9 years old completed the Sleep Disturbance Scale for Children (SDSC) questionnaire and the children had to participate in a dental examination. The evaluation of occlusion was divided into sagittal analysis, vertical analysis, and transverse analysis. In the second phase, 60 children were selected randomly to be undergone polysomnography (PSG) at a sleep clinic.

RESULTS

Among the children included, 242 (19.9%) children had normal occlusion. Of the 60 children, 50 underwent PSG and 40 (80%) had SDB. The crossbite and open bite showed association with SDB, p=0.04 in both.

CONCLUSION

Crossbite and open bite malocclusions were associated with SDB, and may be predictive of SDB in children. Studies with larger numbers of participants are needed to investigate the association of other malocclusions with SDB, and randomized clinical trials are also needed to see whether orthodontic and/or functional jaw orthopedic treatment is an option for treating children with malocclusion and SDB.

The impact of malocclusion on the quality of life among children and adolescents: a systematic review of quantitative studies

BACKGROUND

Among child and adolescent patients, persistent but untreated malocclusions may or may not have psychological and social impacts on the individual's quality of life.

OBJECTIVES

To gain knowledge of malocclusions and its impact on oral health-related quality of life (OHRQOL), we conducted a systematic review of quantitative studies for evidence regarding the influence of malocclusions on OHRQOL in children and adolescents.

MATERIALS AND METHODS

Five databases (MEDLINE via PubMed, EMBASE, Psychinfo, CINAHL, and the Cochrane Library) were searched using specified indexing terms. The following inclusion criteria were used: child or adolescent study population; healthy study participants without syndromes such as cleft lip/palate or severe illness; no previous or ongoing orthodontic treatment among participants; a focus on malocclusions and quality of life; controlled or subgrouped according to malocclusions/no malocclusions; malocclusions and/or orthodontic treatment need assessed by professionals using standardized measures; self-assessed OHRQOL estimated using validated questionnaire instruments; full-text articles written in English or Scandinavian languages. Quality of evidence was classified according to GRADE guidelines as high, moderate, or low.

RESULTS

The search produced 1142 titles and abstracts. Based on pre-established criteria, the full-text versions of 70 articles were obtained, 22 of which satisfied the inclusion criteria. After data extraction and interpretation, six publications were deemed eligible for full inclusion. All six were of cross-sectional design, and the quality of evidence was high in four cases and moderate in the remaining two. The four studies with a high level of quality reported that anterior malocclusion had a negative impact on OHRQOL, and the two with a moderate level of quality reported that increased orthodontic treatment need had a negative impact on OHRQOL.

CONCLUSION

The scientific evidence was considered strong since four studies with high level of quality reported that malocclusions have negative effects on OHRQOL, predominantly in the dimensions of emotional and social wellbeing.