A review of the evidence supporting the aesthetic orthodontic treatment need indices

Oral Health-Related Quality of Life among Adolescents in the First 6 Months of Fixed Orthodontic Therapy

Clarification on disabilities that may arise during orthodontic treatment allows patients to have more realistic expectations. This prospective study assessed the impact of fixed orthodontic therapy on adolescents' quality of life over 6 months. A total of 78 adolescents aged 11-17 years were included. Quality of life was measured using the Child Perceptions Questionnaire (CPQ11-14, short form) at five moments: before treatment (T0), one week (T1), one month (T2), three months (T3), and six months (T4) after treatment initiation. Multiple and pairwise comparisons were conducted for CPQ11-14 scores (Friedman and Wilcoxon test; effect size). Changes in the quality of life were assessed as mean differences (T0-T1 and T0-T4) in total and domain scores (Kruskal-Wallis and Mann-Whitney test) (α = 5%). Significant differences were observed between T0 and T4 in the oral symptoms' domain (p < 0.001), and between T0 and T1, T2, T3, and T4 for emotional well-being (p < 0.001 for all). Significant differences in impact were also found between T0 and T2, T3, and T4 with regard to social well-being (p = 0.004, =0.049, and <0.001, respectively). Orthodontic therapy positively impacted the emotional and social aspects of adolescents' quality of life. Negative effects were primarily related to pain, mouth sores, and difficulty biting or chewing. Understanding the symptoms and feelings of orthodontic patients aids professionals in decision-making.

Accuracy in predicting soft tissue changes of orthodontic class III cases using Dolphin® software

OBJECTIVES

The prediction of posttreatment outcomes is conducive to the final determination of ideal therapeutic options. However, the prediction accuracy in orthodontic class III cases is unclear. Therefore, this study conducted exploration on prediction accuracy in orthodontic class III patients using the Dolphin® software.

MATERIALS AND METHODS

In this retrospective study, lateral cephalometric radiographs of pre- and posttreatment were collected from 28 angle class III adults who received completed non-orthognathic orthodontic therapy (8 males, 20 females; mean age = 20.89 ± 4.26 years). The values of 7 posttreatment parameters were recorded and inserted into the Dolphin® Imaging software to generate a predicted outcome, and then the prediction radiograph and actual posttreatment radiograph were superimposed and compared in terms of soft tissue parameters and landmarks.

RESULTS

The prediction showed significant differences with the actual outcomes in nasal prominence (the difference between the prediction and the actual value was - 0.78 ± 1.82 mm), the distance from the lower lip to the H line (0.55 ± 1.11 mm), and the distance from the lower lip to the E line (0.77 ± 1.62 mm) (p < 0.05). Point subnasale (Sn) (an accuracy of 92.86% in the horizontal direction and 100% in the vertical direction in 2 mm) and point soft tissue A (ST A) (an accuracy of 92.86% in the horizontal direction and 85.71% in the vertical direction in 2 mm) were proven to be the most accurate landmarks, while the predictions in the chin region were relatively inaccurate. Furthermore, the predictions in the vertical direction were of higher accuracy compared to the horizontal direction except for the points around the chin.

CONCLUSIONS

The Dolphin® software demonstrated acceptable prediction accuracy in midfacial changes in class III patients. However, there were still limitations for changes in the chin and lower lip prominence.

CLINICAL RELEVANCE

Clarifying the accuracy of Dolphin® software in predicting soft tissue changes of orthodontic class III cases will facilitate physician-patient communication and clinical treatment.

The Attitudes of Children Undergoing Orthodontic Treatment toward Face Mask Wearing during the COVID-19 Pandemic: A Cross Sectional Study

During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children’ attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1—Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2—Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children.

Machine Learning-Based Evaluation on Craniodentofacial Morphological Harmony of Patients After Orthodontic Treatment

Objectives: Machine learning is increasingly being used in the medical field. Based on machine learning models, the present study aims to improve the prediction performance of craniodentofacial morphological harmony judgment after orthodontic treatment and to determine the most significant factors.

Methods: A dataset of 180 subjects was randomly selected from a large sample of 3,706 finished orthodontic cases from six top orthodontic treatment centers around China. Thirteen algorithms were used to predict the value of the cephalometric morphological harmony score of each subject and to search for the optimal model. Based on the feature importance ranking and by removing features, the regression models of machine learning (including the Adaboost, ExtraTree, XGBoost, and linear regression models) were used to predict and compare the score of harmony for each subject from the dataset with cross validations. By analyzing the prediction values, the most optimal model and the most significant cephalometric characteristics were determined.

Results: When nine features were included, the performance of the XGBoost regression model was MAE = 0.267, RMSE = 0.341, and Pearson correlation coefficient = 0.683, which indicated that the XGBoost regression model exhibited the best fitting and predicting performance for craniodentofacial morphological harmony judgment. Nine cephalometric features including L1/NB (inclination of the lower central incisors), ANB (sagittal position between the maxilla and mandible), LL-EP (distance from the point of the prominence of the lower lip to the aesthetic plane), SN/OP (inclination of the occlusal plane), SNB (sagittal position of the mandible in relation to the cranial base), U1/SN (inclination of the upper incisors to the cranial base), L1-NB (protrusion of the lower central incisors), Ns-Prn-Pos (nasal protrusion), and U1/L1 (relationship between the protrusions of the upper and lower central incisors) were revealed to significantly influence the judgment.

Conclusion: The application of the XGBoost regression model enhanced the predictive ability regarding the craniodentofacial morphological harmony evaluation by experts after orthodontic treatment. Teeth position, teeth alignment, jaw position, and soft tissue morphology would be the most significant factors influencing the judgment. The methodology also provided guidance for the application of machine learning models to resolve medical problems characterized by limited sample size.

Is the adolescent's esthetic concern associated with anterior occlusal conditions or the malocclusion severity level?

OBJECTIVES

To assess the esthetic impact of anterior occlusal conditions and malocclusion severity levels.

MATERIALS AND METHODS

A population-based cross-sectional study of 700 adolescents aged 15 to 19 years was conducted. The Oral Aesthetic Subjective Impact Scale (OASIS) was used to evaluate the subjective esthetic impact of malocclusion. The Dental Aesthetic Index (DAI) criteria were used to diagnose the anterior occlusal characteristics in isolation and the severity levels of malocclusion. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).

RESULTS

Of the adolescents, 42% showed negative self-perception of malocclusion. In addition, 15.4% of adolescents had severe malocclusion (DAI 3) and 18.9% very severe malocclusion (DAI 4). Crowding and spacing were shown to be 2.90 (CI: 2.06-4.09) and 2.53 (CI: 1.65-3.86) times, respectively, more likely to cause a negative esthetic impact in adolescents (P < .05). In addition, adolescents with orthodontic treatment need (DAI 2, 3, and 4) were more likely to report a negative esthetic impact (P < .05).

CONCLUSIONS

Anterior crowding and spacing are the conditions that most influence the esthetic concern of adolescents. Adolescents with very severe malocclusion and higher orthodontic treatment need are more likely to report a negative esthetic impact.

How is orthodontic treatment need associated with perceived esthetic impact of malocclusion in adolescents?

INTRODUCTION

The purpose of this research was to evaluate the esthetic impact of orthodontic treatment need in adolescents.

METHODS

This cross-sectional study was performed with 1172 adolescents aged 12 (n = 638) years and 15 (n = 534) years from Salvador, Bahia, Brazil. The esthetic impact was the following outcome variables: Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale. The normative orthodontic treatment need was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and by the Dental Aesthetic Index (DAI). Logistic regression models were adjusted, estimating crude odds ratio with the respective 95% confidence intervals. The variables with P ≤0.20 in the individual analyses were tested in multiple logistic regression models, remaining the variables with P ≤0.05.

RESULTS

The results showed a statistically significant association for the esthetic impact (Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale) when assessing the normative orthodontic treatment need by the DAI (P <0.05). However, there was no significant association between subjective esthetic impact and normative needs when using the IOTN-DHC (P >0.05).

CONCLUSIONS

DAI was more associated with the adolescents' esthetic concern than IOTN-DHC and should be the Index of Orthodontic Treatment Need to be selected to complement the patient's self-perception.

Epidemiology of orthodontic treatment need in southwestern Ethiopian children: a cross sectional study using the index of orthodontic treatment need

Background

The planning of orthodontic treatment within a public health system requires information on the orthodontic treatment needs of the population. It is important to have epidemiological data to estimate the total need for orthodontic care in any region. The present study aimed to determine the orthodontic treatment need in 12 years old Southwestern Ethiopian children.

Methods

The institution-based cross-sectional study was conducted which involved 347 twelve years old school children randomly selected from seven different public schools in Jimma Town, Southwestern Ethiopia. A structured interview and clinical examination were used to assess the subjects. One examiner used Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to estimate the treatment need. Descriptive statistics and chi-square tests were used for data analysis with statistical significance set at P < 0.05.

Results

According to the DHC of IOTN, almost half of the subjects in the sample were in moderate to the great need for orthodontic treatment. About 15% of the children had a great need for orthodontic treatment based on IOTN-AC. The most prevalent occlusal traits for defining the DHC categorization include increased Overjet (30.8%) and Crowding (23.3%). There was no statistical difference in the distribution of DHC grades and AC scored based on gender.

Conclusion

This study revealed that the need for orthodontic treatment was high. The percentage of the need for orthodontic treatment is higher in comparison to most of the studies conducted in African regions. Therefore, publicly subsidized orthodontic treatment should be planned and provided to those who are in great need for orthodontic treatment. Besides, awareness about orthodontic treatment should also be considered.

Evaluation of commonly used occlusal indices in determining orthodontic treatment need

OBJECTIVE

The main objective of this study was to validate commonly used occlusal indices in measuring treatment need, irrespective of their original objective: Index of Orthodontic Treatment Need (IOTN) that includes a dental health component (DHC) and an aesthetic component (AC), Peer Assessment Rating (PAR) index, Index of Complexity, Outcome, and Need (ICON), Discrepancy Index (DI), and Facial Aesthetic Index (FAI).

METHODS

The dental casts, x-rays, and photographs of 101 participants were randomly selected among patients whose orthodontic treatment was completed. The indices were validated against the panel assessments of four experts using the receiver operating characteristic curve analysis. The area under the curve (AUC) helped to determine their optimal cut-off points.

RESULTS

The raters exhibited an excellent level of inter-rater reliability in assessing need scores [intra-class correlation coefficients (ICC) = 0.85]. The DHC, AC, ICON, and PAR demonstrated 'good' diagnostic properties (AUC = 0.85, 0.84, 0.83, and 0.82, respectively). Adding the AC and the DHC into a combined index score [our proposed Combined Index of Orthodontic Treatment Need (CIOTN)] yielded the strongest correlation with need (r = 0.79) and the highest AUC value of 88 per cent with 91 per cent sensitivity and 71 per cent specificity. The DI had poor discriminating abilities (AUC = 0.69), however, its dental component was substantially better (AUC = 0.81). The supplemental FAI did not enhance the correlation of indices with need.

CONCLUSION

The DHC, AC, ICON, PAR, and only the dental component of the DI reliably captured treatment need. The newly combined CIOTN had superior diagnostic properties than its components and all other indices, probably because of the cumulative values of its components. The FAI could not be validated as a supplemental measure of treatment need.

Orthodontic Treatment Need and the Psychosocial Impact of Malocclusion in 12-Year-Old Hong Kong Children

Objectives

To determine the prevalence of orthodontic treatment need in 12-year-old children in Hong Kong and its relationship with the psychosocial impact of malocclusion and to assess their associations with sociodemographic factors.

Materials and Methods

A random sample of 687 12-year-old children was recruited from 45 secondary schools in Hong Kong. Orthodontic treatment need was assessed on study models by five indices: the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC), the Aesthetic Component of the IOTN (IOTN-AC), the Dental Aesthetic Index (DAI), the Index of Complexity Outcome and Need (ICON), and the Peer Assessment Rating (PAR). The psychosocial impact of malocclusion on participants and sociodemographic factors were obtained from a questionnaire. Logistic regression was used to examine the correlations between treatment need and the psychosocial impact of malocclusion as well as their associations with sociodemographic factors.

Results

The final number of participants was 667 (339 boys and 328 girls, participation rate 667/687 = 97.1%). The prevalence of orthodontic treatment need varied depending on the indices used (10.9–47.8%), but significant correlations were found among the five indices (p < 0.01). The uptake of treatment among the cohort was 2.3%. Boys had higher IOTN-DHC (p < 0.05), DAI (p < 0.05), and PAR (p = 0.05) scores than girls. IOTN-AC was significantly associated with the psychosocial impact of malocclusion (p < 0.05). Parents' level of education and household income were not significantly associated with either treatment need or the psychosocial impact of malocclusion (p > 0.05).

Conclusion

The need for orthodontic treatment in 12-year-old children in Hong Kong remained high, and the uptake of treatment was low. Boys had a higher normative treatment need than girls. Among the five indices, IOTN-AC appears to be the best indicator of the psychosocial impact of malocclusion.

Agreement and association between normative and subjective orthodontic treatment need using the Index of Orthodontic Treatment Need

AIMS:

To determine the association and level of agreement between young adults’ perception of orthodontic treatment need (subjective need) and the orthodontists’ assessment of treatment need (normative objective need).

METHODOLOGY:

For this study, 670 students [280 males and 390 females; mean age (standard deviation) of 15.32 (1.81) years] were selected from public and private schools from different demographic areas of Jeddah city, Saudi Arabia, and divided into two age groups (12–15 years) and (16–19 years). All the participants were examined, and the Index of Orthodontic Treatment Need (IOTN) components [dental health component (DHC) and aesthetic component (AC)] were recorded.

RESULTS:

Kappa statistics showed a statistically significant but fair agreement between clinician AC (CAC) and student AC (SAC) assessments in both age groups (k = 0.343 and 0.334, respectively; P < 0.001), whereas Spearman's correlation coefficient showed a statistically significant but moderate association (r = 0.487 and 0.517, respectively; P < 0.001). The degrees of agreement were 76.4% and 76.7% at the no-need and mild-need levels of treatment, respectively. There was a statistically significant but weak association between the subjective and normative needs (SAC and IOTN-DHC) in both age groups (r = 0.336 and 0.360, respectively; P < 0.001). However, the degrees of agreement were 58.9% and 61.5% at the no-need and mild-need levels of treatment, respectively.

CONCLUSION:

Significant but weak positive association was found between the normative and subjective orthodontic treatment needs, indicating a lack of understanding of the nature of malocclusion and its consequences. Thus, promoting further knowledge and awareness of malocclusion are indicated.

Agreement of young adults and orthodontists on dental aesthetics & influencing factors of self-perceived aesthetics

BACKGROUND

The aim of this study is to assess the agreement between orthodontist's and Chinese young adult's self-perceived aesthetics, the normative treatment need based on the Index of Orthodontic Treatment Need (IOTN), and the main factors affecting the self-perceived aesthetics.

METHODS

A random sample of 348 Chinese young adults (116 males and 232 females) aged 17-24 years were recruited in this study. Two orthodontists were involved in rating the cases. Orthodontic treatment need was assessed according to the Index of Orthodontic Treatment Need, including Aesthetic components and Dental Health Components (AC and DHC). Personality traits were assessed according to Eysenck Personality Questionnaire (EPQ). Cohen's kappa test was used to assess the agreement, and spearman's correlation coefficient was used to analyze the association among all variables.

RESULTS

A statistically significant level of agreement was observed between young adult's perception and orthodontist's perception in IOTN (kappa = 0.14). A positive relationship (p < 0.001)existed between the young adult's AC and the orthodontist' s AC (r = 0.275), and between the young adult' s AC and the normative need DHC (r = 0.195). The orthodontist's AC was strongly related to the normative need (r = 0.743, p < 0.001). Association between the young adult's AC and gender and EPQ-E were also observed.

CONCLUSIONS

Young adults tend to be less critical in assessing orthodontic treatment needs than orthodontists. The orthodontist's AC reflecting subjective treatment need is strongly connected to the normative need. The adult's perception of aesthetic component is affected by factors such as gender and personality traits.

A decision-making process to undergo orthodontic treatment: a qualitative study

BACKGROUND

Orthodontics is a medical treatment and a rehabilitation service provided for individuals in need. Due to the high cost involved in performing this type of treatment along with the current attitude in communities toward it as a cosmetic service, it is essential to investigate the decision-making process to undergo orthodontic interventions among Iranian individuals and families.

METHODS

To conduct this qualitative study using grounded theory, 18 participants were selected through purposive sampling method and received semi-structured interviews each lasting 50-70 minutes. Eventually, the data were saturated after the fulfillment of 19 interviews. During the interviews, simultaneous analysis was also performed according to the method proposed by Strauss and Corbin (1998) and then the data were analyzed within three stages of open, axial, and selective coding.

RESULTS

Analysis of the clients' statements produced 207 codes, 22 sub-categories, and 9 main categories, including distorted mental self-image, hope to look more attractive, inappropriate interactions with family and those around, family's views toward the problem, social conditions, financial constraints, challenges in the family, as well as decision making to undergo orthodontic treatment, and finally, the main factor of hope for a better future were highlighted.

CONCLUSION

The results showed that the main facilitating factor was "hope for a better future" for which families could accept numerous difficulties, such as high cost and repeated follow-ups due to the importance of beauty and meeting their children's sense of satisfaction.

Role of facial attractiveness in patients with slight-to-borderline treatment need according to the Aesthetic Component of the Index of Orthodontic Treatment Need as judged by eye tracking

INTRODUCTION

Previous eye-tracking research has demonstrated that laypersons view the range of dental attractiveness levels differently depending on facial attractiveness levels. How the borderline levels of dental attractiveness are viewed has not been evaluated in the context of facial attractiveness and compared with those with near-ideal esthetics or those in definite need of orthodontic treatment according to the Aesthetic Component of the Index of Orthodontic Treatment Need scale. Our objective was to determine the level of viewers' visual attention in its treatment need categories levels 3 to 7 for persons considered "attractive," "average," or "unattractive."

METHODS

Facial images of persons at 3 facial attractiveness levels were combined with 5 levels of dental attractiveness (dentitions representing Aesthetic Component of the Index of Orthodontic Treatment Need levels 3-7) using imaging software to form 15 composite images. Each image was viewed twice by 66 lay participants using eye tracking. Both the fixation density (number of fixations per facial area) and the fixation duration (length of time for each facial area) were quantified for each image viewed. Repeated-measures analysis of variance was used to determine how fixation density and duration varied among the 6 facial interest areas (chin, ear, eye, mouth, nose, and other).

RESULTS

Viewers demonstrated excellent to good reliability among the 6 interest areas (intraviewer reliability, 0.70-0.96; interviewer reliability, 0.56-0.93). Between Aesthetic Component of the Index of Orthodontic Treatment Need levels 3 and 7, viewers of all facial attractiveness levels showed an increase in attention to the mouth. However, only with the attractive models were significant differences in fixation density and duration found between borderline levels with female viewers. Female viewers paid attention to different areas of the face than did male viewers.

CONCLUSIONS

The importance of dental attractiveness is amplified in facially attractive female models compared with average and unattractive female models between near-ideal and borderline-severe dentally unattractive levels.

Perinatal health and malocclusions in preschool children: Findings from a cohort of adolescent mothers in Southern Brazil

INTRODUCTION

Pregnancy in adolescence has long-term consequences that can negatively influence oral conditions. In this study, we aimed to assess malocclusion in deciduous dentition and its association with prolonged breastfeeding, pacifier use, and perinatal health indicators pertaining to the periods immediately before and after birth.

METHODS

This cross-sectional study was nested in a cohort of adolescent mothers who became pregnant from 13 to 19 years of age (mean age, 17.3 ± 1.6 years). A total of 509 mother-child dyads were included. Information on perinatal indicators, including Apgar score (0-10), which is a standardized assessment of the condition of the infant at birth (heart rate, breath rate, muscle tone, reflex irritability, and skin color), head circumference, birth weight, and need for intensive care unit admission were collected after delivery through interviews with the mothers. By the time the children were 24 to 36 months of age, malocclusion was assessed, and information on the use of pacifiers and breastfeeding was collected. Multivariate Poisson regression was used to assess the effect of independent variables on the outcome (malocclusion).

RESULTS

The prevalence of malocclusion was 62.33%, and open bite was the most frequent one (47.45%). After adjustments, children with no need for intensive care unit admission had a lower risk of malocclusion (prevalence ratio [PR] = 0.75; 95% CI, 0.56-0.99), whereas those with an Apgar score less than 7 had a higher risk (PR = 1.32; 95% CI, 1.06-1.64). Children who had used a pacifier (PR = 1.82; 95% CI, 1.02-3.24) or were still using it (PR = 3.88; 95% CI, 2.65-5.68) had a higher chance of malocclusion compared with children who never used a pacifier. Children breastfeeding for 24 months or longer were less likely to have malocclusion (PR = 0.46; 95% CI, 0.34-0.73).

CONCLUSIONS

Poor perinatal health and pacifier use may be risk factors for malocclusion development in deciduous teeth. Long duration of breastfeeding is associated with better occlusal conditions in children of adolescent mothers. Further studies are needed with other age groups.

Case Report. Prosthetic Rehabilitation of Crowded Maxillary Anterior Teeth

In this case report we present the aesthetical correction of crowded anterior teeth in a patient who has refused the orthodontic treatment. We also discuss how this correction can be resolved from the point of view of dental prosthetic and what measurements can be helpful in order to collect the data used to restore a satisfying smile on the patient’s face using dental ceramic restoration. Case presentation: A 32-year-old patient complained about his crowded incisors. We examined the incisal curvature, the proportion between the height and the width of the teeth, and the relation between the widths of the teeth and the golden proportion. The results of the measurements were compared to the characteristic values of the ideal denture. After the examination of the dental plaster cast, calculating the difference between the existing space and the necessary space, we were able to calculate the lack of space, which caused the crowded teeth. Conclusion: Along the prosthetic planning, these measurements may serve as a guideline to the dentist as an objective basis for the formation of an aesthetic denture and smile.

Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents

OBJECTIVES

To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents.

MATERIALS AND METHODS

A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis.

RESULTS

A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02-1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021).

CONCLUSIONS

Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.

Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh

Objective

To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices.

Materials and methods

This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13–21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test.

Results

Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics (P=0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics (P<0.0001).

Conclusion

Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics.

Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study

BACKGROUND

The normative orthodontic treatment need, established by dental professionals during the dental appointment, becomes ineffective when it does not evaluate all the factors that influence the decision-making process, including individuals' perception and satisfaction with their dental appearance. Therefore, the purpose of this study was to investigate the perception of children and their mothers as regards orthodontic treatment need and satisfaction with dental aesthetics and test if these variables are associated with the objective orthodontic treatment needs, assessed by the Dental Aesthetic Index (DAI).

METHODS

A cross-sectional study was conducted on 308 children aged 12 years, and their mothers were randomly selected by cluster sampling (primary schools). The variables "orthodontic treatment need," "satisfaction with chewing," and "dental appearance" were assessed by means of a questionnaire. The questions were answered individually at school or home, in cases of children or mothers, respectively. DAI was assessed to make an objective clinical assessment. The variables were dichotomized and statistically analyzed by the chi-square and Fisher's exact tests, contingency coefficient C, and logistic regression.

RESULTS

The results of the clinical evaluation (DAI) were statistically associated with the perception of orthodontic treatment need and satisfaction with dental appearance in children (p ≤ 0.01). However, no association was observed with regard to satisfaction with chewing and DAI (p = 0.10). The children's perception of orthodontic treatment need and satisfaction with the appearance of their teeth was statistically associated (p ≤ 0.01) with their mothers' perception. Maxillary overjet, maxillary and mandibular misalignment, and dental crowding were associated with the orthodontic treatment need by children and their mothers, with p value -0.05 and 5 % level of significance. Maxillary overjet was a significant predictor for the perception of orthodontic treatment need in children (OR 1.86, 95 % CI 0.98-3.55) and mothers (OR 3.02, 95 % CI 1.54-5.92).

CONCLUSIONS

Children and parents realize the need for orthodontic treatment according to the different types of malocclusion, as noted in the association between orthodontic treatment need and dental appearance perceived by children and their mothers, which was also observed-with low correlation-with regard to DAI.

Dental aesthetics perception and eating behavior in adolescence

BACKGROUND

This correlational study explored the psychosocial aspects related to eating behavior in different age samples of adolescents in treatment from 0 to 60 months at the Clinic of Orthodontics and Dentistry of Messina, Messina, Italy. The aim of the study was to investigate the relationship between psychosocial impact, levels of self-esteem, and the possible connection with eating habits of adolescents under orthodontic treatment.

METHODS

Sixty-one adolescents, aged between 12 and 22 years (mean=15.6 ± 2.8) participated to the study. Each adolescents was interviewed with the Eating Attitudes Test, the Rosenberg Self Esteem Scale, and the Psychosocial Impact of Dental Aesthetics Questionnaire.

RESULTS

Data did not show a direct connection between eating disorder and dental aesthetics, nevertheless, adolescents under orthodontic treatment, especially in the earliest phase of wearing braces, showed peculiar eating habits and underwent a higher psychological impact of dental aesthetics. Eating behaviors are strictly linked to global self-esteem. The processing of the results was made through the Student's t-test and using Pearson's correlation analysis.

CONCLUSION

Increased knowledge of the psychological aspects involved in orthodontic treatment compliance may have positive effects in the relationship between adolescent patients and orthodontists. More attention should be paid to aspects that are often underestimated in clinical practice, thus, influencing the outcome of treatment and patient satisfaction, not only in terms of dental health, but also of mental health.

Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population

INTRODUCTION

The aim of this study was to evaluate the effect of malocclusion severity on oral health-related quality of life and food intake ability in adult patients, controlling for sex, age, and the type of dental clinic visited.

METHODS

The sample consisted of 472 Korean patients (156 male, 316 female) with a mean age of 21.1 (SD, 8.6) years in a dental hospital and a private clinic. The correlations between the Korean version of the Oral Health Impact Profile-14 (OHIP-14K), subjective food intake ability (FIA) for 5 key foods, and Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) were investigated.

RESULTS

The mean IOTN-DHC and OHIP-14K scores were significantly higher for the dental hospital patients than for the private clinic patients (IOTN-DHC, P <0.001; OHIP-14K, P <0.05). Malocclusion severity was significantly higher in male than in female subjects (P <0.001). Older patients perceived their oral health-related quality of life more negatively than did the teens (P <0.001). As the severity of the malocclusion increased, oral health-related quality of life and masticatory function worsened (OHIP-14K, P <0.001; FIA, P <0.05).

CONCLUSIONS

As the severity of the malocclusion and the age of the patients increased, oral health-related quality of life and masticatory function relatively deteriorated. This finding provides evidence that severe malocclusions are associated with lower quality of life and less masticatory efficiency in older patients.

Comparison of esthetics perception and satisfaction of facial profile among male adolescents and adults with different profiles

Objective:

To evaluate esthetics perception and satisfaction of the facial profile among Iranian male adolescents and adults.

Materials and Methods:

In this cross-sectional study, male subjects referred to Orthodontic Department of Mashhad Dental School were enrolled (n = 84) and were divided into two groups: Adolescents (n = 39), and adults (n = 45). They were also assigned to straight, convex, or concave profile groups based on the facial profile angle (G-Sn-Pog’). An ideal silhouette of the lower facial profile was designed in Adobe® Photoshop® CS2 software (Kansas, USA). Then, eight other silhouettes representing different relations of the maxilla and mandible were constructed. Patients were asked to use numbers 1–10 to rank the facial profiles in the order of the attractiveness, and choose a silhouette that best closely resembled their own profile. Moreover, using a questionnaire patients were asked to rank their satisfaction with their profile, and asked to assign a number (1–5) to each question as follows; one represented the least satisfaction, while five reflected the highest satisfaction.

Results:

Adult and adolescent subjects with straight (adults: 12.0 ± 1.9, adolescents: 12.8 ± 1.05) and concave (adults: 10.0 ± 2.14, adolescents: 10.0 ± 2.08) profile showed the highest and the least satisfaction with their own profile, respectively. Both adult and adolescent group selected “retrognathic maxilla, prognathic mandible” as the least attractive profile. Overall, “straight” and “bimaxillary dentoalveolar retrusion” were chosen as the most attractive silhouettes in adolescent and adults, respectively. In comparison to a professional opinion (clinician ranking), 42.9% of adolescents and 22% of adults were able to correctly diagnose their own profiles type.

Conclusion:

Most of the male adolescents and especially adults diagnosis of their own profile differed with a professional assessment.

Functional evaluation in orthodontic surgical treatment: long-term stability and predictability

Background

The introduction of electromyographic and kinesiographic technology in orthodontics allows to obtain objective data regarding the functional aspects of the mandibular movements and the masticatory muscular activity. It is then important to be able to correlate the data obtained by instrumental activity with the clinical ones. The aim of this study consists to analyse the post ortodontic surgical stability through instrumental evaluation of the masticatory muscles and mandibular movements.

Method

30 patients undergo electromyographic and kinesiographic evaluations through all the surgical orthodontic iter and were than followed during other 4 years. JMP software was used to analyze and correlate the electromyographic and knesioographic data during treatment and during the follow up.

Results

A linear correlations between some functional objective values collected from the examinations at the beginning and during therapy and the follow up one has been demonstrated.

Conclusion

It is important to submit patients in surgical ortodontic treatment to instrumental analysis which can evidence how masticatory function and mandibular movements are performed. It is also important to highlight some functional values also from the beginning of the treatment because an alteration of such values can be related to a better or worse postsurgical rehabilitation.

Craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem

INTRODUCTION

Self-esteem is a psychological trait that may develop in interaction with craniodentofacial esthetics. The aim of this study was to explore the relationship among craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem in adolescents and young adults.

METHODS

The study was cross-sectional; the sample included 200 pupils and university students (58% female) aged 13 to 33 years. The Rosenberg Self-Esteem Scale and the Psychosocial Impact of Dental Aesthetics Questionnaire were used. Craniodentofacial features were estimated by the method of Martin and Saller, the Index of Orthodontic Treatment Need, and the Index of Complexity, Outcome and Need.

RESULTS

When malocclusion severity increases, dental esthetics-related quality of life decreases. The multiple linear regression showed that with the control of all other predictors in the model, the social impact of dental esthetics, borderline dental self-confidence, and facial type contribute the most to explain the variability of self-esteem, accounting for 3.2%, 1.3%, and 1.4%, respectively, of the variability values. The whole model accounts for 24.2% of the variability of self-esteem.

CONCLUSIONS

In adolescents and young adults, self-esteem appears to be more influenced by the self-perceived psychosocial impacts of dental esthetics than the normative level of malocclusion, craniofacial typology, sex, or age.

Oral health conditions in an Albanian adolescent population: an epidemiological study

Background

The aim of this study was to determine the oral health conditions of an adolescent population of Tirana.

Methods

A cross-sectional epidemiological study was carried out in a sample (n = 1885), aged 16-19, mean age 17.4 (SD = 1.0), attending public schools in Tirana and province; 1200 adolescents were included into the analysis. A clinical observation without radiographs was conducted in the medical room of the schools during the 2012-2013 school year.

Results

Very severe and severe orthodontic treatment need, grade 5 and 4 of IOTN (Index of Orthodontic Treatment Need), were found in 17.0 % of the sample. DMFT (Decayed, Missing and Filled Teeth) was 4.9, whereas OHI (Oral Hygiene Index) was documented in the highest number of subjects (n = 384), 32 % of the total sample possessed “good” grade of oral hygiene. CPI (Community Periodontal Index) was observed at score 0 (healthy gingival condition) in most of the subjects (53.1 %), score 1 (gingival bleeding) in 33.4 % of the total sample. PI (Plaque Index) results showed 43.9 % of the sample (527 subjects) with score 0.

Conclusions

The study findings highlight the need for preventive care programs to improve oral health conditions as well as to reduce oral pathology risk factors in Albania.

Orthodontic treatment need among special health care needs school children in Dharwad, India: A comparative study

Objectives:

The aim was to assess and compare the prevalence of orthodontic treatment need among various special health care needs (SHCN) schoolchildren and adolescents in Dharwad, India.

Materials and Methods:

This cross-sectional study was carried out among 492 subjects in age group of 12-19 years (mean age 14.02 ± 1.84 standard deviation [SD]) who were examined for occlusal anomalies using dental aesthetic index (DAI). They were classified into five groups as: Visual impairment, speech and hearing disability (SH), physical disability, mentally subnormal and multiple disabilities (MD). Chi-square test was used to compare the orthodontic treatment need among various SHCN groups. One-way ANOVA and ANCOVA were performed to test any significant differences in mean DAI scores among the SHCN groups.

Results:

None of the children were undergoing or had undergone orthodontic treatment for malocclusion. Mean DAI score was 28.81 ± 11.64 (SD). Orthodontic treatment was indicated in 50.2% of study population who had DAI scores of 26 and above. Mandatory orthodontic treatment (DAI >=36) was required in as high as 29% of MD individuals when compared to only 10% of SH individuals. Significant differences in DAI scores were found between the SHCN groups.

Conclusions:

The need for orthodontic treatment among SHCN individuals was found to be high. Yet, absence of any orthodontic treatment for any child points out to the fact that the dental services are highly needed in these individuals.

Agreement between orthodontist and patient perception using Index of Orthodontic Treatment Need

OBJECTIVES

The primary objective of the study was to assess the agreement between orthodontist and patient perception regarding the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) at pre-orthodontic treatment levels. The secondary objective was to determine how well the subjective assessment of malocclusion (IOTN-AC) correlated with the normative Dental Health Component of the IOTN (IOTN-DC).

MATERIALS AND METHODS

A cross-sectional analytical study was conducted on patients between the ages of 16 and 25, presenting for initiation of orthodontic treatment with no history of prior orthodontic treatment. The mean age of the total sample population was 19.50 ± 3.15 years. The mean age of the males was 19.05 ± 3.09 years and for females it was 19.75 ± 3.18 years. The sample consisted of 41 males and 80 females. Patients were shown their pretreatment monochrome intraoral frontal photographs to rate according to the IOTN-AC. Simultaneously, the orthodontist reviewed the photographs with each patient. The IOTN-DHC of pretreatment casts was also recorded by the orthodontist. The frequency of specific traits that had led to increased severity of malocclusion was also identified. All readings were recorded manually on a data collection form. The data were assessed using the chi-square test, Spearman's correlation and Cohen's kappa test. Intra- and inter-examiner reliability was assessed using Spearman's correlation.

RESULTS

A significant positive relationship (p < 0.05) was observed between orthodontist and patient perception (r = 0.516), orthodontist perception and the normative need (r = 0.430), and between the patient perception and the normative need (r = 0.252). A statistically significant level of agreement was observed between orthodontist and patient perception (kappa = 0.339, p ⩽ 0.001, 95% CI, 0.207-0.470) and between orthodontist perception and the normative need (kappa = 0.331, p ⩽ 0.001, 95% CI, 0.197-0.424). A weak and insignificant level of agreement was observed between patient perception and normative treatment need (kappa = 0.107, 95% CI, 0.02-0.187).

CONCLUSIONS

Patient understanding of their treatment need or aesthetic classification may not always be as accurate as that of orthodontists. This may be a cause for concern when an orthodontist finds a certain condition to be severe, and a patient who does not agree may limit their treatment needs.

Facial profile preferences, self-awareness and perception among groups of people in the United Arab Emirates

Objectives:

The objective of this study is to assess the differences in facial profile preference among different layers of people in the United Arab Emirates. Facial profile self-awareness among the different groups was also evaluated.

Materials and Methods:

A total sample of 222 participants (mean [standard deviation] age = 25.71 [8.3] years, almost 80% of the participants were of Arab origin and 55% were males); consisting of 60 laypersons, 60 dental students, 60 general practitioners, 16 oral surgeons, and 26 orthodontists. Facial profile photographs of a male and female adult with straight profiles and a Class I skeletal relationship were used as a baseline template. Computerized photographic image modification was carried out on the templates to obtain seven different facial profile silhouettes for each gender. To assess differences in facial profile perception, participants were asked to rank the profiles of each gender on a scale from most to least attractive (1 [highest score] and 7 [least score]). Awareness and satisfaction with the facial appearance on a profile view was assessed using questionnaires completed by the non-expert groups.

Results:

The straight facial profile was perceived to be highly attractive by all five groups. The least attractive profiles were the bimaxillary protrusion and the mandibular retrusion for the male and the female profiles, respectively. Lip protrusion was more esthetically acceptable in females. Significant differences in perception existed among groups. The female profile esthetic perception was highly correlated between the expert groups (P > 0.05). Overall agreement between the non-expert group's perceptions of their own profiles and evaluation by the expert orthodontist was 51% (κ = 0.089). Candidates who perceived themselves as having a Class III facial profile were the least satisfied with their profile.

Conclusions:

Dental professionals, dental students, and laypersons had a similar perception trends in female and male aesthetic preference. Laypersons were more tolerant to profiles with bi-maxillary retrusion. The expert group's esthetic perception was highly correlated only for the female profiles. Most of the non-experts were unable to correctly identify their facial profile.

Craniofacial cephalometric analysis of Bangladeshi and Japanese adults with normal occlusion and balanced faces: A comparative study

Aims:

To determine the cephalometric norm among Bangladeshi adults and to investigate the differences in craniofacial morphology compared with Japanese and Caucasian normative data.

Materials and Methods:

Cephalometric radiographs were obtained from 46 Bangladeshi males (mean age 23.8 years) and 52 Bangladeshi females (mean age 24.6 years). Inclusion criteria were the following: Both parents from the same ethnic group, class-I occlusion with an arch length discrepancy less than 2 mm, overbite and overjet from 2 to 4 mm, balanced face, all teeth present except third molar, no previous orthodontic treatment, and no prosthetic replacement of teeth. Nine angular and five linear measurements were constructed for skeletal hard tissue analysis, four angular and six linear measurements for dental hard tissue analysis, and two angular and seven linear measurements for soft tissue analysis. Mean and standard deviations of measurements were determined for each gender. Polygonal chart and profilogram were made. Independent t-test was used to determine differences.

Results:

The present Bangladeshi population has a smaller lower face height (P<0.01) and the antero-posterior position of the maxilla and mandible was found to be significantly (P<0.01) more protruded compared with the Japanese and the Caucasian norms. Significantly (P<0.01) more protruded upper incisor, less steep occlusal plane, and thinner soft tissue chin were the characteristics in Bangladeshi adults.

Conclusions:

Relative to the cranial base (SN), the maxillo-mandibular complex was more anteriorly placed compared with the Japanese and Caucasian adults. Further, the effective length of the maxilla and mandible was shorter compared with the Japanese and Caucasian adults. These findings should be considered carefully during orthodontic treatment planning of Bangladeshi adults.

Orthodontic management of dentition in patients with periodontally compromised dentition

Background:

An increasing number of adult patients are seeking orthodontic treatment to improve their dental appearance. However, special attention must be given to the periodontal status of the adults as periodontal disease and its sequel, such as pathologic migration of anterior teeth, result in esthetic and functional problems. In such adult patients, an interdisciplinary approach often offers the best option for achieving a predictable outcome to solve complex clinical problems.

Materials and Methods:

A prospective study was carried out on 20 adult patients [mean age = 33.3 ± 4.52 (SD), 11 females and nine males] with periodontally compromised and malaligned dentition. Loe and Silness Gingival Index (GI), Ramfjord's Periodontal Disease Index (PDI) and Dental Aesthetic Index (DAI) were recorded at the start and after completion of treatment.

Results:

Comparison of GI, PDI and DAI before and after completion of treatment showed statistically significant differences, indicating the relevance of combined orthodontic–periodontic treatment in periodontally compromised dentition (P < 0.01).

Conclusion:

The outcome of the study showed that an interdisciplinary approach is a simple solution for complex clinical problems arising as a sequel to periodontitis, such as pathological tooth migration, restoring function, esthetics and periodontal health.

Orthodontic treatment need of Yemeni children assessed with dental aesthetic index

OBJECTIVE

The aim of this study was to estimate the orthodontic treatment need in a sample of 12-year-old Yemeni school children using the dental aesthetic index (DAI).

MATERIALS AND METHODS

The sample comprised 3003, 12-year-old children attending school in six of the governorates of Yemen. For each subject, the standard demographic information such as gender and age was collected, after which an intraoral examination for occlusal status using the DAI was performed.

RESULTS

The mean (SD) of DAI score was 24.86 (8.44) points (95% CI, 24.07-25.65). Overall, 36.6% of the sample found to have a dental appearance that requires orthodontic treatment, ranging from 'selective' to 'mandatory'. Of whom, 19.0% presented with severe and handicapping malocclusion, requiring 'definite' and "mandatory' treatment according to the DAI (DAI ≥ 31). Although there was no gender difference in the mean DAI score (P > 0.05), the sex distribution of the DAI treatment categories was significantly different (Chi-square = 13.258, df = 3, P = 0.004). The results of the individual DAI components showed that about 8% of the sample had more than one missing permanent teeth. Anterior maxillary and mandibular irregularity occurred in more than 33% of the sample. More than 30% of the children examined showed signs of crowding. Spacing in the incisal segments occurred in almost 25% of the sample. Almost 30% of the sample had an antero-posterior molar relation discrepancy.

CONCLUSION

According to the findings of this study, almost one in five of the evaluated Yemeni school children had a DAI score above or equal to 31 points, suggesting highly desirable or mandatory orthodontic treatment need.

The analgesic effect of benzocaine mucoadhesive patches on orthodontic pain caused by elastomeric separators, a preliminary study

OBJECTIVES

To study the effect of benzocaine mucoadhesive patches (20%) on orthodontic pain caused by elastomeric separators.

SUBJECTS AND METHODS

A split-mouth design was used in 30 patients (12 female, 18 male, aged 23 ± 3.75 years). They were instructed to apply benzocaine and placebo patches randomly for right or left first permanent molars of maxillary/mandibular arches for 20 min and repeat this procedure every 6 h with a similar type patch. A 10 cm Visual Analogue Scale (VAS) was used for pain perception assessment in patients who were given benzocaine (benzocaine group) or placebo (placebo group) patches. Pain perception (VAS) was recorded immediately after separator placement and after 2, 6, 12, 18, 24, 48 and 72 h.

RESULTS

The mean VAS (SD) for the placebo and benzocaine groups were 2.28 (1.08) and 1.63 (0.67), respectively. The pain peaked at 24 h. Significant pain perception differences were observed between groups at 2, 18, 24, 48 and 72 h. Pain perception was not different between genders or jaws investigated (p > 0.05). The Friedman test revealed significant differences in pain perception among various time intervals for benzocaine (χ (2) = 99.84, p = 0.000) and placebo (χ (2) = 102.361, p = 0.000) groups. Significant negative correlations (ρ) were found only between pain perception scores and patient's ages in the placebo group at 18 (-0.438), 24 (-0.526), 48 (-0.565) and 72 h (-0.458).

CONCLUSION

The recorded mean VAS values were relatively low; however, the benzocaine 20% patches significantly reduced the post-separation orthodontic pain.

Longitudinal study of cephalometric soft tissue profile traits between the ages of 6 and 18 years

OBJECTIVE

To study the longitudinal changes in 19 soft tissue cephalometric traits (according to the Bergman cephalometric soft tissue facial analysis).

MATERIALS AND METHODS

Cephalograms and photographs of 40 subjects (20 male, 20 female, from the Burlington Growth Centre) that were obtained at ages 6, 9, 12, 14, 16, and 18 years were used. Subjects were orthodontically untreated whites and had Class I dentoskeletal relationships (ideal overjet and overbite). Images were obtained with the lips in a relaxed position or lightly touching.

RESULTS

Three groups of soft tissue traits were identified: (1) traits that increased in size with growth (nasal projection, lower face height, chin projection, chin-throat length, upper and lower lip thickness, upper lip length, and lower lip-chin length); (2) traits that decreased in size with growth (interlabial gap and mandibular sulcus contour [only in females]); and (3) traits that remained relatively constant during growth (facial profile angle, nasolabial angle, lower face percentage, chin-throat/lower face height percentage, lower face-throat angle, upper incisor exposure, maxillary sulcus contour, and upper and lower lip protrusion).

CONCLUSION

Current findings identify areas of growth and change in individuals with Class I skeletal and dental relationships with ideal overjet and overbite and should be considered during treatment planning of orthodontic and orthognathic patients.

Malocclusion, dental aesthetic self-perception and quality of life in a 18 to 21 year-old population: a cross section study

BACKGROUND

Aesthetic alterations in the face can be self-perceived and can affect quality of life. For young people, physical attractiveness is an important factor affecting social relationships. The aim of this study was to estimate the prevalence of malocclusion, identify the most common types and test its association with oral aesthetic self-perception in 18 to 21 year-old population of male young adults.

METHODS

A cross-sectional study was carried out involving 138 Brazilian Army soldiers. Data collection included socio demographic profile, malocclusion status through the Dental Aesthetic Index (DAI) and oral aesthetic self-perception as indicated by the Oral Aesthetic Subjective Impact Scale (OASIS). The chi-square and Fisher's exact test were used to test for homogeneity of proportions. The stepwise multivariate logistic regression analysis was used to test for the relationship between the poorer oral aesthetic self-perception and parental and soldier's education, per capita income, history of caries in all teeth and only on anterior teeth, dental trauma, previous orthodontic treatment and malocclusion.

RESULTS

The prevalence of malocclusion was 45.6%. Incisor teeth crowding and misalignment of lower incisors were the most common types of malocclusions. A statistically significant and independent association between malocclusion and poorer oral aesthetic self-perception in the multivariate analysis was observed. Subjects with severe malocclusion conditions showed 88% higher prevalence [prevalence ratio =1.88 (95% CI, 1.30 - 2.72); p = 0.001] of poorer aesthetic self-perception comparing to those with minor malocclusion.

CONCLUSIONS

A high prevalence of malocclusion was observed. The young adults presenting severe malocclusion had a higher and independent prevalence of poorer oral aesthetic self-perception.

Occlusal traits in developmental dyslexia: a preliminary study

AIM

The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD).

PATIENTS AND METHODS

A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years) were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7-10 years). Reading and writing skills were evaluated along with orthodontic features.

RESULTS

The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441) and writing skills (P = 0.805 and P = 0.240, respectively), whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000) and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000). Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006), midline diastemas (46.42%, P = 0.007), overbite > 4 mm (71.42%, P = 0.006) and overjet > 4 mm (53.57%, P = 0.001), was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61-11.65), midline diastemas (OR 4.68; 95% CI 1.61-13.43), an overbite >4 mm (OR 1.75; 95% CI 0.64-4.71), or an overjet >4 mm (OR 2.76; 95% CI 1.06-7.20) seems to play a role in the relationship between occlusal abnormalities and DD in children.

CONCLUSION

Children with DD tend to present with altered dental features, particularly in the area of the incisors, suggesting that a persistently different tongue kinematic profile may thus affect both the developmental variability of the tongue and lip and the occlusion.