Prevalence of malocclusions, oral habits and orthodontic treatment need in a 7- to 15-year-old schoolchildren population in Tirana

Association between self-reported oral habits and oral health related quality of life of adolescents in Ibadan, Nigeria

Oral habits such as nail biting, thumb/digit sucking and teeth grinding could be harmful, and may lead to teeth misalignment, anterior open bite, protruded or flared upper anterior teeth especially if they persist into adolescence. Such orofacial dysfunction may result to impairment of the Oral Health Related Quality of Life (OHRQoL) of an individual. The extent to which oral habits affect the major domains of the self-reported outcomes remains understudied especially during adolescence, a unique period of growth, where there is increased aesthetic desire, increased self-awareness, and unique social and psychological needs. The aim of this study, therefore, was to determine the prevalence of oral habits and its association with oral health related quality of life of adolescents. This cross-sectional study was conducted among 700 adolescents aged 10 to 19 years (with mean age 14.6 (±1.3) years) attending 14 secondary schools in Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed sociodemographic characteristics of the students, oral habits and OHRQoL with Oral Health Impact Profile 5 (OHIP-5). Data were analyzed with SPSS and p value was at <5%. Mann Whitney U statistics was used to test for associations between OHIP-5 scores and presence or absence of oral habits. Logistic regression was used for multivariate analysis. A total of 363 (51.9%; 95%CI = 48.1%-55.6%) bite their nails, 216 (30.9%; 95%CI = 27.5%-34.4%) breathe with their mouth, 122 (17.4%; 95%CI = 14.7%-20.4%) suck their lips, 89 (12.7%; 95%CI = 10.3%-15.4%) grind their teeth together and 32 (4.6%; 95%CI = 3.1%-6.7%) sucked their thumbs. A total of 403 (81.1%) adolescents who engaged in at least an oral habit reported an impairment of their OHRQoL. Painful aching in the mouth was the most frequently affected OHRQoL item reported by the adolescents who engaged in oral habits. Those who sucked their thumbs (OR = 2.3, 95%CI = 1.1-4.7, p = 0.028) and those who sucked their lips were more likely to have poorer OHRQoL (OR = 1.6, 95%CI = 1.1-2.5, p = 0.024). Oral habits were prevalent among the adolescents and affected their OHRQoL. Those who sucked their thumbs and lips were more likely to report poorer OHRQoL than those who did not.

Malocclusion: Prevalence and Determinants among Adolescents of Karachi, Pakistan

OBJECTIVES

 The aim of this study was to determine the prevalence of malocclusion and its associated demographic and clinical factors in young adolescents (13-15 years) of Karachi, Pakistan.

MATERIALS AND METHODS

 An epidemiological survey included 500 young adolescents of registered schools, madrassas (Islamic education system), and shop workers of Gulshan-e-Iqbal Town. It was a cross-sectional analytical study design. Multistage random sampling technique was used to enroll participants. The pattern of occlusion was recorded with other related features using Angle's classification. Health status was recorded through World Health Organization-guided indices (decayed, missing, and filled permanent teeth [DMFT], community periodontal index of treatment needs [CPITN], and body mass index [BMI]). The information, thus, obtained was analyzed through SPSS using the chi-squared test and regression models.

RESULTS

 Forty four percent of the participants were female, while overall estimated prevalence of malocclusion in young adolescents of Karachi was 57.4%. After adjustments, participants going to any kind of education system had less malocclusion in comparison to those who were not going to any education system (adjusted odds ratio [aOR] = 0.305, 95% confidence interval [CI] = 0.12-0.73); mother's education especially higher level (aOR = 2.02, 95% CI = 1.08-3.75) and presence of periodontal disease (aOR = 1.57, 95% CI = 1.06-2.33) were significantly associated with malocclusion.

CONCLUSION

 This study showed that the class I malocclusion is prevalent in the local community. Demographic factors like gender, age, self-reported ethnicity, and BMI did not show any significant role. Education or knowledge of parents and young adolescents does play an influential role in decreasing malocclusion. Young adolescents, who are more prone to oral health problems at an early age, would have more chances to develop occlusal discrepancies.

Prevalence and influencing factors of malocclusion in adolescents in Shanghai, China

BACKGROUND

The main purpose of the study was to investigate the prevalence and related risk factors of malocclusion in permanent dentition among adolescents in Shanghai, and provide basic data for government's preventive strategies and intervention plans.

METHODS

1799 adolescents aged 11-15 years old from 18 middle schools in 6 districts of Shanghai were recruited to investigate oral health status and related risk factors using cluster random sampling method in 2021. Malocclusion and caries were examined by on-site inspection. The investigation criteria referred to Bjoerk and the recommendation of the WHO. The malocclusion inspection items included molars relationship, canine relationship, overbite, overjet, midline displacement, anterior crossbite, posterior crossbite, scissors bite, crowding and spacing. The subjects were asked to fill in a questionnaire including parents' education level, oral health behaviors and dietary habits. The chi-square test and logistic regression analysis were used to analyze the relationship between malocclusion and risk factors.

RESULTS

1799 adolescents were included in the study and the prevalence of malocclusion in adolescents in Shanghai was 83.5%, and the proportion of molar relationship class I, class II, and class III was 48.9%, 14.7%, and 19.0%, respectively. The most common occlusal characteristic of malocclusion was anterior crowding, followed by midline irregularities and deep overbite, with prevalence rates of 44.8%, 39.0% and 38.6%, respectively. The prevalence rate of adolescents with caries was 34.3%. Those who had dental caries and preferred soft food were more likely to have abnormal occlusal characteristics (p < 0.05).

CONCLUSION

The prevalence of malocclusion in adolescents in Shanghai is high, so it is of great significance to strengthen oral health education, allocate proper preventive strategies and carry out the early correction if necessary.

Prevalence of malocclusion in public school students in the mixed dentition phase and its association with early loss of deciduous teeth

Objective:

To determine the prevalence of malocclusion and its association with the early loss of deciduous teeth and other factors in children in the mixed dentition phase, aged six to eight years, enrolled in public schools in southern Brazil.

Methods:

A cross-sectional study was conducted with a representative sample of 528 children from municipal public schools in 2009. Data collection involved a clinical examination for the determination of early tooth loss, dental caries, tongue pressure and malocclusion (outcome), as well as the administration of a questionnaire. Poisson regression analysis with robust variance was used to model the association between malocclusion and the independent variables.

Results:

The prevalence of malocclusion and early tooth loss was 69.1% and 21.8%, respectively. In the raw data analysis, malocclusion was associated with age, early tooth loss, dental caries and tongue pressure. After the adjustment, the likelihood of malocclusion was greater among children older than eight years, those who exerted tongue pressure on the teeth and those with early tooth loss. The likelihood of malocclusion was 24% greater among children with early tooth loss, compared to those without tooth loss.

Conclusion:

The early loss of deciduous teeth was associated with the occurrence of malocclusion in the children studied.

Family and case–control genetic study of MSX1 polymorphisms in peg-shaped teeth Jordanian population

Background

This study aimed to investigate the genetic association of specific Single Nucleotide Polymorphisms (SNPs) within the muscle segment homeobox gene 1 (MSX1) with susceptibility to the peg-shaped teeth in 36 Jordanian Arab families and case–control samples in the Jordanian Arab population.

Methods

This cohort involved 108 individuals (36 trios families), which were used for family-based genetic study. Additionally, 56 patients and 57 controls were used for case–control study. Genomic DNA samples from both families and case–control were extracted according to distinguished processes. Then, polymerase chain reaction technique (PCR) was conducted using specific primers for the axons of the MSX1. Moreover, DNA sequencing genotyping method analysis of SNPs was used to detect specified SNPs in the MSX1 linked with peg-shaped teeth. Hardy–Weinberg Equilibrium and Chi-square were used to evaluate the data quality and the presence of any genotypic error. In addition, Transmission Disequilibrium Test (TDT) was used identify family-based association in which trios of parents and proband are used.

Results

The results of this study showed fourteen polymorphic sites in this gene, eight of them (rs121913129, rs104893852, rs104893853, rs121913130, rs104893850, rs1095, rs3775261, and rs1042484) were none-polymorphic. Meanwhile, the minor allele frequencies of the rest of the SNPs were polymorphic (rs8670, rs12532, rs3821949, rs4464513, rs1907998, and rs6446693). However, none of these SNPs were associated with peg-shaped teeth. Moreover, the haplotype genetic analysis revealed that there was no genetic association with peg-shaped teeth disorder susceptibility (P > 0.05) in the Jordanian families of Arab descent.

Conclusions

The present findings can be used in estimation of prevalence of peg-shaped teeth in the Jordanian population. However, our findings revealed that there is no evidence that the MSX1 polymorphisms had a crucial role in the peg-shaped teeth phenomenon, emphasizing that other genes might have this role. These findings are beneficial for clinicians to comprehensively understand the molecular aspects of teeth abnormalities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02051-2.

Malocclusion and occlusal traits among dental and nursing students of Seven North-East states of India

BACKGROUND

Any irregularity of the teeth or a mal-relationship of the dental arches is known as malocclusion. Among all the oro-facial problems, tooth decay is considered the most prevalent one followed by periodontal disease and dental malocclusion. Dental malocclusion is not a life-threatening condition. However, it is closely related to an individual's self-esteem and psychosocial wellbeing. The prevalence of malocclusion varies among different ethnic groups, age-groups, and gender.

OBJECTIVES

This study was conducted with the objective to find out the prevalence of normal occlusal traits and to identify the proportion of different types of malocclusions among dental and nursing students of Seven North-Eastern states studying at a tertiary care Medical Institute.

METHODS AND MATERIALS

This cross-sectional study included 432 students with a mean age of 21.42 years, who satisfied the inclusion criteria. Inclusion criteria consisted of the presence of all permanent teeth with or without third molars. The oral cavity was examined using a sterile mouth mirror and flashlight followed by evaluation of all the occlusal relationships in centric occlusion position (COP). COP was achieved by asking the participant to swallow, and then to bite on his or her teeth together. The occlusion traits were assessed as normal occlusion or malocclusion using the first permanent molars as described by E.H. Angle and deviation from line of occlusion. Descriptive statistics like mean and proportions were calculated.

RESULTS

The prevalence of normal occlusal traits was 48.4%, and that of malocclusion was 51.6%. Class I malocclusion was most prevalent occlusal trait followed by Class II malocclusion and Class III malocclusion showed the least prevalence.

CONCLUSIONS

Class I malocclusion was most prevalent followed by Class II malocclusion and Class III malocclusion showed the least prevalence.

Evaluation of the Association of Oral Stereognosis with Malocclusion in Children

Aim and objective

To evaluate the association between oral stereognosis with malocclusion in children.

Materials and methods

Stereognostic investigation was made with a set of seven different geometric configurations (circle, square, triangle, star, clover, diamond, and heart shapes) cut out from fresh, raw carrots using preformed iron molds. Any five of the seven geometric forms were randomly placed inside the mouth on the dorsum of the tongue by the investigator with the subject's eyes closed. A minimum of three shapes correctly identified out of the five offered to each child was considered as an indicator of the adequate stereognostic ability of that particular child.

Results

Among the children under Index of Orthodontic Treatment Needs (IOTN) grade I group, 82.4% of children came under the positive response group. Among IOTN grades II, III, and IV, the percentages of children with positive responses were 72.1%, 58.1%, and 18.8%, respectively. There is a statistically significant (p < 0.001) decrease in positive response with increasing IOTN grades.

Conclusion

The observations from the present study show that there is altered oral sensory perception in children graded as with malocclusion according to the index used and belonging to the age group selected in the study.

Clinical significance

Sensory and motor components of the orofacial region, like any other part of the human body, are inseparable in their structure and function, the association between orofacial growth and development and sensory maturation cannot be overlooked.

How to cite this article

Janardhanan R, Soman A, George S, et al. Evaluation of the Association of Oral Stereognosis with Malocclusion in Children. Int J Clin Pediatr Dent 2021;14(S-1):S18–S21.

Healthcare Management During a Pandemic: The Other Side of the Coin for the Treatment of Covid-19 Infection

BACKGROUND

World Health Organization (WHO) has increasingly improved the guidelines to tackle the spread of Coronavirus Disease 2019 (COVID-19) among the worldwide population. In this context, each country has introduced specific social, healthcare, political and macroeconomic measures to face COVID pandemic locally.

OBJECTIVE

The general aim of this comparative overview is to highlight the most significant effects of COVID-19 pandemic on the main healthcare systems. Also, we critically analyzed the macroeconomic variables and the most promising solutions to improve both healthcare system and its related risk management, taking into specific consideration the most industrialized countries.

METHOD

The main strategy has been built on a renewed concept of the hospital, rebuilding the old concepts of "triage" and "intensive care". Recently, COVID-19 hospitals have allowed to cater the patients affected by COVID-19. Moreover, the reshaping of several healthcare policies and requirements has led to several positive effects, such as the recruitment of a huge number of human resources in the healthcare systems. Nevertheless, several negative effects have also impacted the communities mostly subjected to infections.

CONCLUSION

Undoubtedly, the national healthcare systems have somehow addressed the people's needs, trying not to neglect the social, healthcare, economic and political aspects. In our overview, we have reported how the different actions taken in the last months, have resulted in different outcomes.

Correlation of Growth Pattern and Palatal Rugae Pattern in South Indian Population

Aim:

To determine the correlation between palatal rugae (PR) pattern and subjects with vertical, average, and horizontal growth pattern and to determine gender variation if any.

Material and Methods:

One hundred and twenty study models were divided into horizontal, vertical, and average growth patterns with 40 (20 males and 20 females) samples in each group. The pattern of PR was assessed in each group using a template.

Result:

Type B (wavy type) PR occurs more often in horizontal and average growth pattern (80% and 72.5% respectively), whereas its occurrence in vertical growth pattern subject is the least among other growth patterns, that is, 42.5% of the total subjects. Type E (curved type) PR has appeared highest in 27.5% of average growth pattern patient followed by 12.5% of vertical growth pattern subjects. The occurrence of type E PR is least in horizontal growth pattern which is just 5% of the total subjects.

Conclusion:

Curved-type PR was more prevalent in vertical and average growth patterns. Diverging PR pattern was mainly seen in vertical growth pattern. PR also shows sexual dimorphism. The association is clinically significant as it will lead to determination of facial vertical growth pattern at early age; thus, it serves as a diagnostic adjunct for different malocclusions very early in life and aids in preventive or interceptive orthodontic measures to alleviate forthcoming growth pattern.

Prevalence of oral conditions and associated factors among schoolchildren in Accra, Ghana: a cross-sectional study

OBJECTIVE

The impact of oral diseases on children cannot be overemphasized because their effects may go beyond the individual to the household and the community at large. This study aimed to determine the prevalence of common oral conditions in children between the ages of 9 and 16 years in Accra.

METHODS

A cross-sectional study was carried out among participants from 16 selected junior high schools in Accra. Their caries experience was assessed using the decayed, missing, and filled teeth (DMFT) index. Other variables recorded were age, sex, previous history of a dental visit, and the presence of other common oral conditions (ie, periodontal disease, traumatised teeth, oral mucosal lesions, neoplasia, cysts, and malocclusion). Summaries and descriptive statistics were generated and reported. The DMFT was compared between subgroups, and the χ² test was used to compare outcomes of categorical variables.

RESULTS

A total of 1118 students participated in the study. This consisted of 37.8% males and 62.2% females. The mean age was 12.8 (standard deviation = 1.7) years. Common oral conditions were found in 49.7% of the participants and the prevalence of caries, periodontal disease, and malocclusion were found to be 13.3%, 30.4%, and 11.3%, respectively. The population's mean DMFT was found to be 0.27 (standard deviation = 0.76).

CONCLUSIONS

The prevalence of caries and periodontal disease calls for additionaleffort to reduce the burden of common oral conditions in Ghanaian children.

Prevalence of malocclusion in Chinese schoolchildren from 1991 to 2018: A systematic review and meta-analysis

BACKGROUND

Malocclusion is a common oral health problem in schoolchildren. Literature describing the prevalence of malocclusion varies substantially across China.

AIM

This study identified the epidemiological characteristics of malocclusion among Chinese schoolchildren from 1991 to 2018.

DESIGN

Six English and Chinese electronic databases were searched through November 2018. The search was supplemented by hand searching to identify relevant surveys. The overall prevalence of malocclusion was estimated by a random-effects meta-analysis model, and variations in different groups were assessed by subgroup meta-analysis.

RESULTS

Thirty-seven eligible articles describing 117 682 samples were investigated. The pooled national prevalence for malocclusion was 47.92% (95% CI: 58.6%-71.9%). For the Angle classification, the overall prevalence rates were 30.07% (95% CI: 25.37%-35.48%), 9.91% (95% CI: 7.41%-13.79%), and 4.76% (95% CI: 3.85%-6.54%) for Class I, Class II, and Class III malocclusion, respectively. A deep overbite (16.67%, 95% CI: 11.50%-23.08%) was shown to be the most common trait of malocclusion. When stratified by sex, males had a slightly higher prevalence than females (RR = 1.04, 95% CI: 1.01-1.06). More importantly, an ascending trend and substantial variations across the country were observed.

CONCLUSIONS

Our results confirmed that malocclusion has become a serious oral health problem in Chinese schoolchildren, highlighting the need for proactive interventions at an early age. Moreover, high-quality epidemiological studies on malocclusion are still required.

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 orthodontic treatment need and malocclusion problems in 8–9-year-old schoolchildren: A study in the south of Thailand

Aims

This study aims to find the prevalence of orthodontic treatment need and malocclusion problems in 8–9-year-old schoolchildren in the south of Thailand.

Materials and Methods

A number of 202 children (100 boys and 102 girls) samples were randomly selected from all schools in Hat Yai District, Songkhla Province, Thailand. A cross-sectional survey of dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and malocclusion problems was investigated by clinical examination and dental model.

Results

Levels 4 and 5 of orthodontic treatment need according to DHC of IOTN of the sample were presented in 18.8% and 1.49%, respectively. Children who need orthodontic treatment (Grade 2–4) showed more than one highest DHC problem that indicated the level of treatment need (39.68%). Normal occlusion was found at 6.43%. Malocclusions such as Class I, Class II division 1, Class II division 2, and Class III malocclusion were observed in 78.71%, 7.92%, 3.47%, and 3.47%, respectively. Reversed overjet and overjet >9 mm were detected in 5.64% and 1.58%, respectively. Approximately half of the children (46.67%) had overbite >3.5 mm.

Conclusions

High percentage of children in mixed dentition period who need orthodontic treatment was found in this study. Some children who presented with the orthodontic treatment need Grade 2–4 had more than one DHC problem which identified the grade of treatment need. Class I malocclusion was most frequently found in this group of children.

PLATOON: Premature Loss of bAby Teeth and its impact On Orthodontic Need - protocol

OBJECTIVE

To investigate the impact of premature extraction of primary teeth (PEPT) on orthodontic treatment need in a cohort of children participating in the Born in Bradford (BiB) longitudinal birth cohort.

DESIGN

Observational, cross-sectional cohort.

PARTICIPANTS

We aim to recruit 1000 children aged 7-11 years: 500 with a history of PEPT and 500 matched non-PEPT controls.

METHODS

After informed consent/assent, orthodontic records will be collected, including extra and intra-oral photographs and alginate impressions for study models. Participants will also complete a measure of oral health-related quality of life (COHIP-SF 19). The records will be used to quantify space loss, identify other occlusal anomalies and assess orthodontic treatment need using the Index of Orthodontic Treatment Need. For each outcome, summary statistics will be calculated and the data for children with and without PEPT compared. The records of the children identified to be in need of orthodontic treatment will be examined by an expert orthodontic panel to judge if this treatment should be undertaken at the time of the records or delayed until the early permanent dentition. Collecting robust records in the mixed dentition provides the clinical basis to link each stage of the causal chain and enable the impact of PEPT on orthodontic need to be characterised. This study is the first to provide the foundations for future longitudinal data collection allowing the long-term impact of PEPT to be studied.

[Orthognathic surgery of mandibular asymmetry: which results can we expect with and without chin wing? A cohort out of 51 cases]

INTRODUCTION

The aim of this retrospective cohort is to evaluate the amount of postsurgical correction of soft and hard tissues in patients with mandibular asymmetries and to compare the results with and without surgery of the lower mandibular contour (chin wing…).

MATERIAL AND METHOD

Mandibular asymmetries cases of three surgeons were systematically included. The angles of deviation of the chin, bi-commissural, bi-gonic and occlusal were measured on face photography and radiography. A pre and post-surgical comparison was performed and the amount of correction was analyzed via the Wilcoxon statistical test.

RESULTS

51 patients (44 women and 7 men) were included. After surgery, the correction is significant for all measurements with an improvement of 44 to 60% depending on the measured angles. No patient is normalized but the small initial mandibular asymmetries are the closest to normal after surgery. The correction of the bi-commissural angle is controlled without being optimal (60% correction). The difficulty remains the horizontalization of the bi-gonial plan which is only corrected at 45%. Patients with mandibular margin surgery (chin wing…) showed the greatest improvement in bi-gonial (p = 0.0142) and occlusal (p = 0.0154) angles.

CONCLUSION

If surgery allows a significant correction of facial dissymmetry, this is not complete. Surgical procedures on the lower edge of the mandible such as the chin wing could provide a better correction especially for bi-gonial and occlusal angles.

Prevalence of malocclusion and occlusal traits in the early mixed dentition in Shanghai, China

Background

Epidemiological data on malocclusion among Chinese children are scant. The aim of this study was to provide detailed information on the prevalence of malocclusion in early mixed dentition children in Shanghai, China.

Methods

A cross-sectional survey was conducted from September 2016 to April 2017, and 2,810 children aged 7- to 9- years were selected from 10 primary schools by cluster random sampling. Several occlusal parameters, including Angle molar relationship, overjet, overbite, open bite, anterior and posterior crossbite, midline displacement, scissors bite, and teeth crowding and spacing, were clinically registered by five calibrated orthodontic dentists.

Results

We found that 79.4% children presented one or more occlusal anomalies. Angle Class I, Class II and Class III molar relationship were recorded in 42.3%, 50.9% and 5.9% of the sample, respectively. The proportion of Class III increased from 5.0% at age 7 to 7.8% at age 9. In the sagittal plane, increased overjet >3 mm was observed in 40.8% subjects, while the prevalence of severe overjet (>8 mm), anterior edge-to-edge (zero overjet) and anterior crossbite were 5.2%, 8.1% and 10.5%, respectively. Vertically, deep overbite >2/3 overlap was found in 6.2% of the children and open bite in 4.3%. Boys exhibited a higher rate of overbite than girls. For the transversal occlusal anomalies, 36.1% of the children had a midline displacement, which was followed by posterior crossbite (2.6%) and scissors bite (1.0%). Teeth space discrepancies were also common anomalies and anterior crowding (>2 mm) affecting 28.4% of the children, while anterior spacing (>4 mm) affecting 9.5%. Girls showed a higher prevalence of anterior crowding and a lower frequency of teeth spacing than boys.

Conclusions

Our study demonstrated that malocclusion is prevalent among children in the early mixed dentition, and more health resources should be warranted to meet the challenge of prevention or early intervention of malocclusion.

Oral habits and malocclusion in children resident in Ile-Ife Nigeria

AIM

To determine the: prevalence of oral habits in children aged 1-12 years in Ife Central Local Government Area of Osun State Nigeria; association between oral habits and malocclusion in children aged 6-12 years; differences in orthodontic treatment needs of children with and without oral habits and the effect of digit sucking severity on occlusal profile.

METHODS

This was a cross-sectional study that collected data through a household survey. Information collected included the age, gender, and oral habits of study participants. Intra-oral examination was conducted. The Dental Aesthetic Index (DAI) was used to assess orthodontic treatment needs for 6-12-year-old participants. Independent sample t test was used to compare mean DAI scores of participants with and without oral habits. A digit sucking severity index was developed and digit sucking severity was determined.

RESULTS

One hundred and thirty (13.1%) study participants had 142 oral habits. The most common oral habit was digit sucking. The most common malocclusion traits were spacing (29.9%), crowding (21.7%) and increased overjet (16.4%). DAI scores were significantly higher in participants with tongue thrusting (p < 0.001) and bruxism (p = 0.01) habits compared with participants without the habits. Among the 67 participants with oral habits, 54 (80.6%) had no need for treatment, 9 (13.4%) needed elective treatment and treatment was mandatory for 4 (6.0%) participants.

CONCLUSIONS

Digit sucking was the most frequently practiced oral habit in the study population. Tongue thrusting and bruxism were significantly associated with greater severity of malocclusion in children 6-12 years old when compared with peers who had no habits. Most children with oral habits had no need for treatment.

Prevalence of Deleterious Oral Habits among 3- to 5-year-old Preschool Children in Bhubaneswar, Odisha, India

Aim

Oral habits during and beyond preschool age are one of the important etiological factors in developing malocclusion and other ill effects on orofacial structures. The objective of the present study was to know the prevalence of deleterious oral habits among 3- to 5-year-old preschool children in Bhubaneswar, Odisha, India.

Materials and methods

This cross-sectional study was conducted among preschool children, in the age group of 3 to 5 years in the city of Bhubaneswar, Odisha, India. To carry out this study, six private schools, two from each of the three electoral constituency, were selected using cluster sampling technique. A total of 500 students, studying in LKG and UKG and their respective mothers/caregivers were selected for the study as per the inclusion/exclusion criteria. Prevalence of different oral habits in children was calculated from the data obtained. Using Statistical Package for the Social Sciences (SPSS), version 17.0 software, Chi-square test was applied to compare the differences present between boys and girls and their significant values (p < 0.05).

Results

The result of this study showed a high prevalence of oral habits (36%) among preschool children in Bhubaneswar, Odisha, India. Lip biting was found to be the most prevalent habit (13.4%), followed closely by thumb sucking (12.8%), bruxism (12.8%), and mouth breathing (11%).

Conclusion

The study revealed a great dearth of a well-established dental education program for preschool children as well as their parents, caretakers, teachers, and pediatricians in order to provide an effective and timely care to the children.

How to cite this article: Dhull KS, Verma T, Dutta B. Prevalence of Deleterious Oral Habits among 3- to 5-year-old Preschool Children in Bhubaneswar, Odisha, India. Int J Clin Pediatr Dent 2018;11(3):210-213.

Prevalence of Need of Orthodontic Treatment in 7-16-Year-Old School Children in Udaipur City, India

Objective

The study aimed to estimate the need of orthodontic treatment in 7-16-year-old school children in Udaipur city, India.

Methods

This cross sectional study enrolled 1029 subjects (661 males and 368 females) belonging to Udaipur city, Rajasthan, India. Subjects who had not undergone orthodontic treatment were randomly selected. The need for orthodontic treatment was assessed using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN) by the same calibrated examiner. Collected data were quantitatively analyzed, and the difference pertaining to prevalence between males and females was measured using the chi-square test.

Results

A Grade 1 IOTN score was observed in 48.4% of the population. Grade 2 was observed in 22.9% of the population. A significant difference was noted for the prevalence of Grades 1, 2, and 3 between male and female children, with male children showing greater prevalence of malocclusion grades. Grades 4 and 5, which were noted less frequently, did not show a significant difference with respect to sex.

Conclusion

A higher percentage of the sample required moderate orthodontic treatment. This necessitates proper education and motivation to undergo orthodontic treatment.

[Mandibular asymmetry: determination of a reliable skin measurement technique]

INTRODUCTION

Clinical measurements in the frontal view underevaluate chin deviation in mandibular asymmetry. The aim of this descriptive study is to search for a reliable method of measuring deviant chins using a facial X-ray as reference.

MATERIAL AND METHOD

Seventy patients with mandibular asymmetry who had consulted a maxillofacial surgeon were systematically included. Age, sex, cephalometric characteristics, reasons for patient consultation and type of surgery were collected. Two cephalometric methods were tested with respect to the medial sagittal plane (PSM) to compare the assessment of mandibular asymmetry on soft tissue and by cephalometry.

RESULTS

On average, the patients selected were young (26 years +/- 9), women (75% of cases), presented open bite (average FMA: 28° +/- 8°), a skeletal class III tendency, a left-side shift of the chin (63% of cases). They consulted for both aesthetic and functional reasons (51% of cases) and required bimaxillary surgery (66% of cases). Comparison between the photographic angle (formed by the PSM and the line passing through the nasion and reaching the chin point) and the radiographic angle (formed by the PSM and the line passing through the Crista Galli process and the bony chin point angle) showed no significant difference (p = 0.937) and is thus reliable.

Associations between tooth agenesis and displaced maxillary canines: a cross-sectional radiographic study

Background

The aim of present study was to test the association between hypodontia and displaced maxillary canine when compared with a control group.

Methods

The study group was composed of 336 subjects with a mean age of 10.7 ± 1.2 years, presenting with at least one missing tooth. Exclusion criteria included syndromes, craniofacial malformations, extractions and trauma history and previous orthodontic treatment. The control group consisted of 336 subjects with a mean age of 10.7 ± 1.2 years, without agenesis. Stepwise multiple logistic regression using the backwards elimination and the Wald test method was performed to identify the best combination of hypodontia and displaced maxillary canine (P < 0.05).

Results

The most represented category in study group consisted in mild agenesis (86.9%); moderate and severe agenesis groups respectively represented the 11.7 and 1.4% of study group. Agenesis was diagnosed in both arches in 46 subjects. Maxillary hypodontia and mandibular hypodontia was respectively detected in 156 and 134 subjects. The most frequent missing teeth were mandibular second premolars (45.8%), lateral incisors (41.7%) and maxillary second premolars (17.8%). A significant correlation between agenesis and displaced maxillary canine was observed in the study group (P < 0.05). Only the agenesis of maxillary lateral incisors remained in the final model during backward stepwise deletion. Significant association between the severity of dental agenesis and prevalence of displaced maxillary canine was not assessed.

Conclusions

The outcomes revealed no difference related to the severity of dental agenesis and prevalence of displaced maxillary canine. Only the agenesis of maxillary lateral incisors should be considered directly connected with displaced maxillary canine.

Electronic supplementary material

The online version of this article (10.1186/s40510-018-0226-0) contains supplementary material, which is available to authorized users.

Salivary Cortisol and Alpha-amylase-Biomarkers of Stress in Children undergoing Extraction: An in vivo Study

Aim

The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction.

Materials and methods

The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children.

Results

The values of cortisol and alpha-amylase showed a significant increase postextraction.

Conclusion

Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children.

Clinical significance

Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This can aid in better cooperation of the child during treatment as well as helps in internal motivation toward future dental treatment.

How to cite this article: Chaturvedi Y, Chaturvedy S, Marwah N, Chaturvedi S, Agarwal S, Agarwal N. Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An in vivo Study. Int J Clin Pediatr Dent 2018; 11(3):214-218.

The effect of pacifier sucking on orofacial structures: a systematic literature review

BACKGROUND

Non-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier sucking on orofacial structures.

METHODS

A search on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to find all pertinent articles published from inception until February 2018, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was evaluated using the risk of bias judgements in non-randomized studies of interventions (ROBINS-I).

RESULTS

Among the 2288 articles found, 17 articles met the selection criteria: seven prospective cohort studies, nine cross-sectional studies, and one randomized clinical trial. Using ROBINS-I, 12 studies were evaluated to have a serious overall risk of bias and five, a moderate one. These studies claimed a strong association between a pacifier sucking habit and the presence of an anterior open bite and posterior crossbite. Functional/orthodontic pacifiers were shown to cause significantly less open bites than the conventional ones.

CONCLUSIONS

High level of evidence of the effect of sucking habits on orofacial structures is missing. The available studies show severe or moderate risk of bias; hence, the findings in the literature need to be very carefully evaluated. There is moderate evidence that the use of pacifier is associated with anterior open bite and posterior crossbite, thus affecting the harmonious development of orofacial structures. Functional/orthodontic pacifiers reduce the prevalence of open bite when compared to the conventional ones, but evidence is needed concerning the effects on posterior crossbite. Well-designed randomized controlled trials are needed to further analyze the effects of functional/orthodontic and conventional pacifiers on orofacial structures.

Prevalence of Malocclusion in Permanent Dentition of Iranian Population: A Review Article

BACKGROUND

The aim of this study was systematic review and meta-analysis of prevalence in current and relevant literature about this developmental disorder to present the profile of malocclusion in Iran.

METHODS

This review study was carried out with systematically identified and critically assessed studies reporting malocclusion prevalence among Iranian population in permanent dentition. National and international databases were searched for articles about prevalence of malocclusion by Angle classification in different regions of Iran from 1994 to 2015. After applying inclusion and exclusion criteria, the quality of articles was checked by professional checklist. Data extraction and meta-analysis was performed. A random-effect model was employed. Publication bias was checked.

RESULTS

Of 2768 articles, 21 cases were included. The pooled prevalence of malocclusion was about 87% (95% CI: 78.3-92.2) in Iranian population; however, the prevalence of malocclusion across individual studies varied considerably (ranging from 23.7% to 99.7%). Prevalence of normal occlusion, class I, II and III malocclusion were reported as 13.3% (CI 95%: 7.8-21.7), 50.7% (CI 95%: 42.9-58.4), 21% (CI 95%: 17.5-25.1), 5.5% (CI 95%: 3-10); respectively. Maximum prevalence of malocclusion was in the East of Iran.

CONCLUSION

The results showed a high prevalence of malocclusion in Iranian population. The baseline information could be appropriately utilized for the future planning to meet the orthodontic treatment need among the Iranian population.

Correlations between dental malocclusions, ocular motility, and convergence disorders: a cross-sectional study in growing subjects

Objective

The purpose of the study was to analyze the association between dento-skeletal malocclusions, ocular motility, and convergence disorders in growing subjects.

Materials and methods

84 subjects (49 males, 35 females) with a mean age of 7.3±1.7 years were enrolled in a screening procedure for celiac disease at the Department of Gastroenterology of the University of Rome "Tor Vergata". Each child underwent an orthodontic, orthoptic, and ophtalmological examination. Pearson's Chi-Square test with Yates' correction and Fisher's exact test were conducted to assess the association between orthoptic defects and malocclusions (p<0.05).

Results

Ocular motility disorders were present in 44.9% of males and in 57.1% of females, while convergence defects were present in 10.2% of males and in 2.9% of females. Ocular motility disorders were more frequent in subjects with Angle Class III malocclusion (66.7%) than in subjects with Angle Class II (59.1%) and Class I (45.8%) malocclusion. Convergence defects were equally frequent in Angle Class I and Class II malocclusion (5.1%), while none subject presenting with Angle Class III malocclusion exhibited convergence defects. A statistically significant correlations was found between ocular motility disorders and unilateral cross-bite with midline deviation.

Conclusion

Ocular motility defects had a significant greater prevalence in subjects presenting with unilateral cross-bite and midline deviation. The importance of role of orthodontic diagnosis among interdisciplinary treatment in growing children should be recognized.

Prevalence of malocclusion among Iranian children: A systematic review and meta-analysis

BACKGROUND

The high prevalence of malocclusion is a public health problem in the world and the third priority in oral care. Numerous primary studies have presented reports on the prevalence of malocclusion among Iranian children. In combination, the results of these studies using meta-analysis are highly valuable for health policy-making. Similarly, this study aimed at determining the prevalence of different types of malocclusion among Iranian children.

MATERIALS AND METHODS

Using relevant keywords, national and international databases were explored. After narrowing down the search strategy and leaving out the duplicates, the remaining articles were screened based on titles and abstracts. To increase search sensitivity, reference lists of the papers were examined. To identify unpublished articles and documentations, a set of negotiations were done with the people involved and research centers. Finally, the heterogeneity index between the studies was determined using Cochran (Q) and I2 tests. According to the results of heterogeneity, the random effects model was used to estimate the prevalence of malocclusion in Iran.

RESULTS

In total, 25 articles were included in the meta-analysis process. The prevalence of dental malocclusion was estimated in 28,693 Iranian children aged 3-18 years. The total prevalence of Class I, II, and III malocclusion was 54.6% (46.5-62.7), 24.7% (20.8-28.7), and 6.01% (4-7.1), respectively. The prevalence of Class I, II, and III malocclusion was 44.6% (32.9-56.2), 21.5% (18.01-25.1), and 4.5% (3.2-5.9) in boys and 48.8% (36.8-60.8), 21.5% (16.9-25.1), and 5.5% (3.9-7.1) in girls, respectively.

CONCLUSION

This study showed a high prevalence of malocclusion among Iranian children. Also, the results indicated that the prevalence is higher in girls.

Prevalence of malocclusion and assessment of treatment needs in β-thalassemia major children

Background

The objective of this study is to evaluate the prevalence of malocclusion and treatment needs in transfusion dependent β-thalassemia major children.

Methods

One hundred transfusion dependent β-thalassemia major children visiting the Department of Pediatrics were selected randomly and evaluated for malocclusion with Angle’s classification and Dewey’s modification. The orthodontic treatment needs were also assessed using Grainger’s treatment priority index (TPI). The orthodontic treatment needs were compared to normal children.

Results

The assessment of treatment needs revealed a higher prevalence of handicapping and severely handicapping malocclusion in thalassemic children compared to normal children. The thalassemic patients were found to show significantly more Angle’s Class II malocclusion (55 % vs. 15.7 %) when compared to normal children.

Conclusions

The higher prevalence of Angle’s Class II malocclusion and definitive malocclusion in thalassemic children indicates the importance of preventive orthodontic procedures and efforts towards providing orthodontic treatment to these children.

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.

Effective and Efficient Herbst Appliance Therapy for Skeletal Class II Malocclusion Patient with a Low Degree of Collaboration with the Orthodontic Treatment

The current concept for effective and efficient treatment of skeletal Class II malocclusion prescribes that interceptive approach should be delivered during the pubertal growth stage. However, psychosocial issues and a greater risk of dental trauma are also factors that should be addressed when considering early Class II therapy. This paper reports a case of a patient that sought orthodontic treatment due to aesthetic discomfort with the incisors' protrusion. Two previous treatments failed because patient's collaboration with removable appliances was inadequate. Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment. Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability.