The prevalence of malocclusion and the need for orthodontic treatment among adolescents in the northern border region of Saudi Arabia: an epidemiological study

Characteristics of dental malocclusion in a 18th/19th century population from Radom (Poland)

OBJECTIVE

The aim of the study was to assess the diachronicity of factors that produce malocclusion from the 18th century to the present.

MATERIALS

A total of 74 adult individuals Radom (Poland) of both sexes were examined (males: 46, females: 28).

METHODS

The skulls were grouped according to the type of malocclusion found: i) anterio-posterior (skeletal Class I/II/III), ii) transverse (cross bite/scissor bite), and iii) vertical (open bite/deep bite).

RESULTS

Normal bites were recorded in 14 % (10/74) of the study group. Malocclusion was observed in the remaining cases (64/74, 86 %). Class I was diagnosed most often (53 %), and Class III (8 %) was the least common in the study group.

CONCLUSIONS

The observed order of frequency of Angle's Classes (I > II > III) in the population from Radom indicates malocclusion was similar to that of the contemporary population. In the population from Radom, similar to other contemporary European populations, Class II defects were found at a higher frequency than Class III defects.

SIGNIFICANCE

The research demonstrates the diachronic nature of the factors that produce different types of malocclusion in Polish populations over the past four centuries, even if these factors cannot be identified.

LIMITATION

The main limitation of this research is the relatively small sample size.

SUGGESTIONS FOR FURTHER RESEARCH

Future studies should evaluate malocclusion in older populations from Radom and other areas of Poland and Europe.

Genetic factors underlying Mandibular prognathism: insights from recent human and animal studies

This review aims to provide an updated overview of the genetic etiology of mandibular prognathism (MP), focusing on recent research efforts, to summarize the findings from human studies utilizing genome-wide association studies (GWAS), candidate gene analyses, whole exome sequencing (WES) and single-nucleotide polymorphisms (SNPs) in relation to MP. Additionally, insights from animal studies are incorporated to understand the molecular mechanisms underlying mandibular development and the pathogenesis of MP. A comprehensive literature search was conducted to identify relevant studies on the genetic basis of MP. Human studies employing GWAS, candidate gene analyses, and SNPs investigations were reviewed. Animal studies, including European seabass, zebrafish, transgenic mouse and miniature horse were also examined to provide additional insights into mandibular development and MP's pathogenesis using GWAS, WES, transgenic techniques, morpholino antisense oligos and homozygote. Human studies have identified multiple loci and genes potentially associated with MP through GWAS, candidate gene analyses, and SNP investigations. Animal models have contributed valuable information about the molecular mechanisms involved in mandibular development and the development of MP. Recent research efforts have enhanced our understanding of the genetic etiology of MP. Integration of genetic studies with functional analyses has shed light on key signaling pathways and gene regulatory networks implicated in MP.

Well-Being of Orthodontic Patients Wearing Orthodontic Appliances

Background and Objectives: Orthodontic appliances may cause discomfort for patients. This could influence the person's psychological well-being. The aim of this study was to examine the psychological health of patients wearing orthodontic appliances. It is important to analyze the well-being of patients during orthodontic treatment because it is started in a young age and it may affect one's psychological health. Therefore, for doctors and patients, it is important to understand and take every aspect of the treatment into consideration when deciding when to start the treatment and what appliance to choose. Materials and Methods: A total of 339 patients filled out an anonymous questionnaire. They were divided into four groups according to their age and type of appliance. The main reasons to seek treatment were crooked teeth and a bad bite. There was a statistically significant difference between women and men as women sought treatment because of crooked teeth; meanwhile, men indicated bad bite as their main reason for seeking treatment. Results: A total of 48.7% of subjects noted that they were feeling good during treatment; however, 4% of all patients noted that they were feeling bad. A total of 45% of subjects stated that they felt unhappy at least sometimes. A total of 43% of subjects felt stress. Conclusions: Even though patients indicated various negative aspects on their well-being during treatment, for the majority of the subjects, the end results significantly increased their psychological well-being.

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

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

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.

Effect of Plant-Based Mouthwash (Morinda citrifolia and Ocimum sanctum) on TNF-α, IL-α, IL-β, IL-2, and IL-6 in Gingival Crevicular Fluid and Plaque Scores of Patients Undergoing Fixed Orthodontic Treatment

Background and Objectives: To investigate the antiplaque properties of two plant-based mouthwashes, Morinda citrifolia (MC) and Ocimum sanctum (OS), and their effect on TNF-α, IL-α, IL-β, IL-2, and IL-6 in gingival crevicular fluid (GCF) of patients undergoing fixed orthodontic treatment. Materials and Methods: Seventy-five individuals were recruited according to defined inclusion and exclusion criteria. This study was structured into two distinct phases. Phase I was a combination of toothbrushing using toothpaste containing fluoride (Protocol A), while Phase II toothbrushing included fluoride toothpaste and use of a mouthwash (Protocol B). For Phase II, individuals participating in this study were allocated into different groups through a randomization process: Group 1-0.12% CHX, Group 2-5% MC, and Group 3-4% OS. Each individual's Phase I and Phase II scores were assessed. GCF was measured in three phases to determine the level of inflammatory biomarkers. The paired t-test evaluated the disparities between the pre- and post-plaque index. Categorical data were subjected to crosstab analysis to assess qualitative variables. The mean values of cytokine levels were presented. An unpaired t-test was employed to assess the levels of cytokines between individuals in Phase I and Phase II. Results: Toothbrushing, fluoride toothpaste, and the supplementary use of mouthwash (Phase II) resulted in mean plaque scores significantly lower than group A (p < 0.001). Cytokines TNF-α, IL-α, and IL-β demonstrated a significant downward trend in herbal mouthwash users. Conclusions: In conjunction with fluoridated toothpaste and brushing, OS and MC can serve as a viable alternative to conventional synthetic mouthwash CHX. This combination demonstrates reducing mean plaque scores and diminishing the levels of cytokines TNF-α, IL-α, and IL-β.

Prevalence of orthodontic treatment needs in permanent dentition in the population of Gulf Cooperation Council countries: A systematic review and meta-analysis of observational studies

The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in the permanent dentition stage among populations in Gulf Cooperation Council (GCC) countries. For observational studies in GCC countries, the key terms were electronically searched in Science Direct, PubMed, Embase, Cochrane Reviews, Google Scholar, and Sage databases (1990-2021). The bias risk for the selected studies was evaluated using the modified Strengthening the Reporting of Observational Studies in Epidemiology statement. Thirteen studies reported on the prevalence of orthodontic treatment needs among 33,134 children in GCC countries in permanent dentition with an age range of 11-19 years satisfied the inclusion criteria. Out of the 13 studies, 9 reported on the prevalence of malocclusion, 11 reported on the prevalence of occlusal traits, and 12 reported on the prevalence of orthodontic treatment needs as per the Dental Health Component (DHC) of Index of Orthodontic Treatment Need (IOTN), 4 reported as per both DHC and Aesthetic Component (AC) of IOTN, and 1 reported as per only AC of IOTN. Meta-analysis of the included studies indicated that the pooled malocclusion prevalence rate was 10.60% (confidence interval [CI] 95%: 0.093-0.076) with 8.58% Class I (CI 95%: 0.074-0.188), 2.09% Class II (CI 95%: 0.014-0.058), and 0.93% Class III (CI 95%: 0.005-0.018) malocclusions. The most prevalent type of occlusal trait was spacing (13.10%, CI 95%: 0.018-0.169), followed by crowding (4.96%, CI 95%: 0.017-0.091). The pooled prevalence of borderline and definite needs for orthodontic treatment based on DHC and AC of IOTN was 0.82% (CI 95%: 0.014-0.035), 1.13% (CI 95%: 0.011-0.091), 4.08% (CI 95%: 0.009-0.114), and 2.06% (CI 95%: 0.002-0.048), respectively. The findings were heterogeneous (P < 0.05). These findings indicated that the prevalence of malocclusion and orthodontic treatment needs was not high in the GCC population.

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

AIM

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

METHODOLOGY

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

RESULT

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

CONCLUSION

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

Assessment of Perception and Barriers toward Orthodontic Treatment Needs in the Saudi Arabian Adult Population

Patients’ decisions regarding orthodontic treatment are influenced by a variety of factors, such as their subjective opinions of how their oral cavity looks, age, gender, educational level, and income. The present study aimed to measure the orthodontic treatments needs for the Saudi Arabian population, and also to report potential barriers towards it. It is an observational study with cross sectional design. Data was collected from nationals and residents living in Saudi Arabia and who are at least 18 years old. A total of 1184 adult patients (880 females and 304 males) were included in this study. The population for the study was reached and chosen using a non-probability snowball sampling method. A validated and reliable questionnaire was distributed to the participants electronically through google form. Inferential statistics was applied using Pearson Chi Square test. p value < 0.05 was considered significant. The majority of the sample (73.2%) exhibited a favorable attitude toward orthodontic treatment. Most participants including male and female gender wanted orthodontic treatment primarily to have their protruding teeth fixed. The proportion of persons who cited chewing difficulty as the reason they needed orthodontic treatment was strongly influenced by the monthly income variable (p = 0.005). Cost and time of orthodontic therapy were the biggest obstacles to undergoing treatment, accounting for 34.5% and 19.5%, respectively. There was highly significant difference between the underlying medical conditions and the age and monthly income variables (p = 0.000). Based on the findings of the present study, it can be concluded that protruding teeth are the most important treatment needs perceived by the Saudi population, followed by spacing in between teeth, crowding of teeth, and unaesthetic smile. Cost of the orthodontic treatment was identified as the most significant barrier to the treatment needs, followed by long duration of orthodontic treatment, and pain.

Assessment of anterior open bite prevalence in children visiting a dental hospital - A retrospective evaluation

Anterior open bite (AOB) is the insufficient vertical overlapping between the maxillary and mandibular anteriors when the teeth are in centric occlusion. The purpose of this study was to determine the prevalence of AOB in children and adolescents who visited a private dental hospital. In this study, subjects aged between 16 and 18 years with AOB were included. Data about orthodontic examination of patients were taken from preentered dental records of the hospital. Data of patients with AOB regarding age, gender, and intraoral and extraoral features were collected from the case records of the subjects, and statistical analysis was performed (Chi-square test and nonparametric correlations). The prevalence percentage of open bite in the anteriors was 2.7%, with more prevalence in Class 1 subjects (81.5%). Subjects with AOB had competent lips (81.8%), straight nasolabial angle (86.8%), and shallow palatal vault (49.5%). AOB had no significant relationship with the type of malocclusion, palatal vault, and lip competency, according to the Chi-square test. AOB and the nasolabial angle had a significant association. Both acute and right-angled nasolabial angles were commonly seen in adolescent patients with AOB. In children and adolescents visiting a private dental hospital in Chennai, the prevalence of AOB was found to be 2.7%. A significant association was observed between AOB and nasolabial angle.

Association of severity of malocclusion with socioeconomic status in the South Indian population

Malocclusion has been linked to various factors out of which certain dietary patterns and unhealthy habits are the most overlooked. The dietary patterns and unhealthy habits vary according to socioeconomic status. The present research was aimed to perform an association of malocclusion severity with socioeconomic status. This study was done in a retrospective manner and was conducted at Saveetha Dental College. A total of 241 clinical case records of the participants with malocclusion reporting for orthodontic therapy were selected and enrolled for the study. Data on the socioeconomic status and the severity of malocclusion as assessed with the Index of Orthodontic Treatment Needs (IOTNs) index were noted. All these records were collected and entered into Excel and then analyzed through statistics. Descriptive statistics and nonparametric Chi-square tests were performed. From the analysis, the proportion of IOTN Grade 1 malocclusion (30%) was found to be the highest. The highest number of patients with Grade 1 malocclusion belonged to the lower socioeconomic class. Socioeconomic status and the severity of malocclusion were significantly associated with each other. Malocclusion prevalence and severity were more among participants belonging to lower socioeconomic groups.

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

The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents. Methods: The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias. Results: The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively. Conclusions: There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.

Skeleto-dental features among a sample of Saudi female children compared to British standards: A cephalometric study

Aim

This cross-sectional observational retrospective study aimed at assessing the cephalometric skeleto-dental features of class I, II, and III skeletal relationship of Saudi female school children sample and comparing the results to the established British Caucasian cephalometric standards.

Materials and Methods

The sample consisted of 205 retrospective lateral cephalometric radiographs of female school children. The age range of the subjects were between 10 and 13 years old with a mean age of 11 ± 1 years. Several cephalometric and constructed points were identified. Angular, linear, and proportional measurements were obtained and analyzed. The skeleto-dental features of class II and class III were compared to class I of this sample and then compared with the established British Caucasian population. Different angular, linear, and proportional variables were investigated. Descriptive statistics and Student's t-test were used for data analysis.

Results

The distribution of the skeletal relationship revealed that 68.3% of the sample showed class I relationship, 16.1% class II, and 15.6% class III. The result indicates significant differences among the different classes. A greater tendency towards class II facial pattern and more convex profile among Saudis were detected in the present study compared to Caucasians. Furthermore, The dento-alveolar relationship results showed more bi-maxillary protrusion among Saudi females compared to the British Caucasians.

Conclusion

The results of the study can serve as a base-line for future investigations in Saudi Arabia. Furthermore, the results obtained can also be of great value in distinguishing the various skeleto-dental features in the different skeletal classes among the Saudi females, and in the clinical diagnosis and treatment planning.

Comparative Study of Malocclusions between Cancer Patients and Healthy Peers

Background. There is lack of data related to dental occlusion among children cured from cancer. The aim of our study was to compare the prevalence of malocclusion in cancer survivors and in healthy peers. Methods. A cross-sectional study was conducted on 225 children aged between 4 and 18 years, including 75 cancer survivors, and 150 sex and age-matched controls. All patients were orthodontically examined and malocclusion traits were recorded. In the cancer group, 75 panoramic radiographs were used to evaluate the prevalence of dental anomalies and dental age using the Demirjian scale. Data were analyzed by univariate statistical analysis with p-values p < 0.05 considered as statistically significant. Results. Malocclusion was found in 49 (65.33%) cancer survivors and 99 (65.56%) controls (p > 0.05). The cancer group demonstrated significantly higher likelihood of crossbite (p < 0.01) and malalignment of teeth (p = 0.031). The healthy controls were more likely to demonstrate open bite (p = 0.038). Cancer patients with posterior crossbite (p = 0.023) or dental malalignment had a more advanced dental age (p = 0.022). Survivors with crossbite had more teeth with short roots (p = 0.016). Those who were older when they started their cancer therapy were more likely to suffer from tooth disturbances (p = 0.019). Conclusion. Oncological treatment can alter the development of occlusion in cancer patients.

A Nation-wide Prevalence of Malocclusion Traits in Saudi Arabia: A Systematic Review

Objectives

The aim of this article is to establish a comprehensive nation-wide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in Saudi Arabia.

Materials and Methods

A systematic search was conducted in three databases (Medline via PubMed, Embase, and Web of Science) and complemented with a manual search of Google Scholar and the reference list of included studies. Original studies of Saudi Arabian healthy individuals at any age were included. The quality and the risk of bias of the included studies were assessed using the Joanna Briggs Institute's appraisal tool. The data about the selected malocclusion traits on the sagittal, vertical, and transverse planes of space were extracted and pooled.

Results

Out of 7163 identified titles, 11 studies were finally included. The risk of bias was high in two studies, moderate in eight studies, and low in one study. The studied age groups were from early childhood to late adulthood, with a total sample size of 19,169 participants. The majority of the studies recruited their sample from school/public sources, whereas the remaining three studies recruited their sample from dental (non-orthodontic) clinics.

Conclusions

Within the limitations of this study, pooled prevalence of Angle's Class I molar relation in Saudi Arabia was similar to other populations but Angle's Class II and Class III molar relations were lower and higher, respectively. These differences could be attributed to population-related differences in craniofacial morphology. Teeth crowding, teeth spacing, and midline shift, along with increased overjet and overbite, were among the most common malocclusion traits occurring in Saudi Arabia.

Alamoudi R, Alturki G. Factors influencing the desire for orthodontic treatment among patients and parents in Saudi Arabia: A cross-sectional study

OBJECTIVES:

MATERIALS AND METHODS:

RESULTS:

CONCLUSIONS:

Establishing a technique for isolation and characterization of human periodontal ligament derived mesenchymal stem cells

Mesenchymal stem cells (MSCs) are extensively used in tissue regenerative procedures. One source of MSCs is the periodontal ligament (PDL) of teeth. Isolation of MSCs from extracted teeth is reasonably simple, being less invasive and presenting fewer ethical concerns than does the harvesting of MSC’s from other sites. The objectives of this study were to isolate and characterize the PDL stem cells (PDLSC) from healthy adults’ extracted teeth and then to characterize them by comparing them with bone-marrow derived MSCs (BMMSC).

Methods

The PDL tissue was scraped from the roots of freshly extracted teeth to enzymatically digest using collagenase. The cells were sub-cultured. Flow-cytometric analysis for the MSC surface-markers CD105, CD73, CD166, CD90, CD34, CD45 and HLA-DR was performed. To confirm the phenotype, total RNA was extracted to synthesize cDNA and which was then subjected to RT-PCR. The gene-expression for Oct4A, Sox2, NANOG and GAPDH was determined by gel-electrophoresis. To assess their multilineage potential, cells were cultured with osteogenic, chondrogenic and adipogenic medium and then stained by Alizarin-red, Alcian-blue and Oil-Red-O respectively. MSCs from the bone-marrow were processed similarly to serve as controls.

Results

The cells isolated from extracted teeth expanded successfully. On flow-cytometric analysis, the cells were positive for CD73, CD90, CD105, CD166 and negative for CD34, CD45 and HLA-DR. The PDLSCs expressed Oct4A, Sox2, and NANOG mRNA with GAPDH expression. Cells cultured in the osteogenic, chondrogenic and adipogenic media stained positive for Alizarin-red, Alcian-blue and Oil- Red-O respectively. The surface marker expression and the trilineage differentiation characteristics were comparable to those of the BMMSCs.

Conclusions

The periodontal ligament tissue of extracted teeth is a potential source of therapeutically useful MSCs. Harvesting them is not invasive and are a promising source of MSC as the PDLSCs showed characteristics similar to those of the highly regarded MSC’s derived from bone-marrow.

Descriptive epidemiology of dental malocclusion in Najran patients seeking orthodontic treatment

Background

Untreated malocclusion can lead to compromised aesthetic function, depression, and low self-esteem. The aim of this study was to evaluate dental malocclusion in Najran, Saudi Arabia as no data existed before.

Method

This was a retrospective study analyzing the casts of all patients in Najran, Kingdom of Saudi Arabia, seeking orthodontic management for malocclusion between 2017 and 2019.

Measurements

The consultant orthodontist is the single investigator involved in collecting the details of demographics followed by molar relationships, overjet, overbite, crowding and spacing using digital caliper on each dental cast. Data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp.

Results

A total of 326 patients sought treatment for different types of malocclusion. There were 143 males and 183 females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. The prevalence for Class I, II and III malocclusions at 95% CI was (0.76 (0.757, 0.774)), 0.251 (0.243, 0.260) and 0.529 (0.519, 0.539) respectively. Fifty-one (15.6%) patients had reversed overjet, 65 (19.9%) reduced overjet, and 86 (26.4%) increased overjet. One hundred and sixty-four (50.3%) cases of reduced overbite and 99 (30.4%) cases of deep overbite were also observed. Tooth size arch length discrepancy were noticed with crowding and spacing in 83 (26.4%) and 71 (21.8%) patients, respectively.

Conclusions

This study has shown the prevalence of Class I, Class II, and Class III malocclusion to be 72.7%, 11.6% and 15.6% respectively. Increased over jet and crowding was demonstrated in more patients, though it is not statistically significant.

Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review

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

Methods of mandibular condyle position and rotation center used for orthognathic surgery planning: a systematic review

We aimed to evaluate whether there is a consensus among bi- (2D) and three-dimensional (3D) evaluations of mandible condyle position and its rotation center. Also, if this data can be replicated in orthognathic surgery planning. The survey was carried out on the major databases (PubMed, SCOPUS, Embase, Cochrane). Human or human bio models evaluations in 2D or 3D of mandibular condylar position concerning its fossa and rotational axis for orthognathic surgery planning were eligible. The heterogeneity of the studies and uncertainties in methodological biases did not allow us to identify the superiority of 2D or 3D methodology in determination of the condylar rotational axis. There is a lot of divergences in the definition of occlusal relationships among dental specialties. Although there was no consensus regarding condylar position in relation to the fossa, the most reported axis of rotation was positioned posterior-inferior. Weak scientific evidence and divergences in dental vocabulary shows the need for clinical studies with more accurate and transparent methodological design to standardize concepts. Despite we cannot affirm, we can suggest that the centric relation (CR) is not the condylar position when clinically manipulated in the posterior superior direction. This condylar position is the retruded contact position (RCt) while CR is the functional position of the condyle. In this way, the orthognathic surgery has two occlusal relationships during planning and execution. The ideal axis of rotation for orthognathic surgery planning must be fixed, permit individualization for each condyle and be reproducible. The 2D planning is obsolete as cannot provide all the necessary tools for an accurate planning.

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.

FOXO3 Mediates Tooth Movement by Regulating Force-Induced Osteogenesis

The high prevalence of malocclusion and dentofacial malformations means that the demand for orthodontic treatments has been increasing rapidly. As the biological basis of orthodontic treatment, the mechanism of mechanical force-induced alveolar bone remodeling during orthodontic tooth movement (OTM) has become the key scientific issue of orthodontics. It has been demonstrated that bone mesenchymal stem cells (BMSCs) are crucial for bone remodeling and exhibit mechanical sensing properties. Mechanical force can promote osteoblastic differentiation of BMSCs and osteogenesis, but the key factor that mediates mechanical force-induced osteogenesis during OTM remains unclear. In this study, by performing reverse-phase protein arrays on BMSCs exposed to mechanical force, we found that the expression level of forkhead box O3 (FOXO3) was significantly upregulated during the mechanical force-induced osteoblastic differentiation of BMSCs. The number of FOXO3-positive cells was consistently higher on the OTM side as compared with the control side and accompanied by the enhancement of osteogenesis. Remarkably, inhibiting FOXO3 with repaglinide delayed OTM by severely impairing mechanical force-induced bone formation in vivo. Moreover, knockdown of FOXO3 effectively inhibited the mechanical force-induced osteoblastic differentiation of BMSCs, whereas the overexpression of FOXO3 enhanced this effect. Mechanistically, we revealed a novel regulatory model in which FOXO3 promoted osteocalcin transcription by activating its promoter in cooperation with runt-related transcription factor 2 (RUNX2). We collectively obtained the first evidence that FOXO3 is critical for OTM, where it responds to mechanical force and directly regulates downstream osteoblastic differentiation in an efficient manner.

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

Aims

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

Methods

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

Results

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

Conclusion

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

Prevalence of malocclusion and assessment of orthodontic treatment needs among Syrian refugee children and adolescents: a cross-sectional study

Background

There is a scarcity of data concerning the prevalence and pattern of malocclusion and orthodontic treatment needs in Syrian refugee. In this study, extra and intra-oral features of malocclusion and the dental health component of the Index of Orthodontic Treatment Need (IOTN) were reported.

Methods

Examination of 606 Syrian children/adolescents refugees attending Zaatari clinic was carried out (males = 280, females = 326, mean age = 11.84 ± 2.1 years). Subjects not within the age limit, with a history of orthodontic treatment, or with craniofacial anomalies were excluded. Both extra and intra-oral features of malocclusion were assessed. Intra-oral features included inter- and intra-arch occlusal characteristics: crowding, spacing, crossbite, overjet, overbite, molar and canine relationship, incisor relationship, and centerline shift. In addition, the dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN) was recorded. Gender and age variations in malocclusion characteristics and IOTN grading were tested using chi-square and nonparametric tests respectively (P < 0.05).

Results

The prevalence of malocclusion was 83.8% (52.6% class I, 24.2% class II, 7% class III). The most common features of malocclusion were crowding (71.1%) followed by centerline shift (52.1%), increased overjet (36.1%), high vertical proportions (34%) and deep overbite (31.2%); there were significant gender and age differences for a number of occlusal traits. The prevalence of moderate to severe need for orthodontic treatment was 67.7%.

Conclusions

This study provides baseline data on the prevalence of malocclusion in Syrian refugee children/adolescents in Zaatari camp where data concerning oral health of this population are lacking. The prevalence of orthodontic treatment need was high warranting the need for a comprehensive interceptive orthodontic program to prevent increasing oral health problems in the future. This high burden of oral diseases has a negative financial impact on the hosting country which can be reduced through public health interventions and implementing community-based dental healthcare for this underprivileged population.

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.

Parental Satisfaction with Their Children's Rapid Palatal Expansion Treatment Provided by Orthodontists and Pediatric Dentists

BACKGROUND

Dentofacial problems have a definitive impact on patients' psychological well-being, quality of life, and satisfaction. Therefore, patients' satisfaction with their dentition should be an essential goal for dental caregivers.

AIM

To compare parental satisfaction with their children's rapid palatal expansion treatment outcome provided by orthodontists and pediatric dentists.

MATERIALS AND METHODS

The authors reviewed 605 medical records and contacted 134 parents whose children received early orthodontic treatment from orthodontists and pediatric dentists using a rapid palatal expander. Eighty-eight parents (65.7%) responded to a validated questionnaire about patients' satisfaction with orthodontic treatment outcomes.

RESULTS

At baseline; there were no significant differences in relation to parent-related demographic variables. However, there were statistically significant differences between patients' ages and treatment duration (p < 0.001). Independent t-tests showed statistically significant differences in the means for the subscales of doctor-patient relationship and situational aspects (p < 0.05). Spearman's rho correlation coefficients and multivariate linear regression analysis showed that the overall satisfaction is significantly related to, and can be predicted by, parents' educational level, child's gender, and the specialty of the dentist who provided the treatment (p < 0.05).

CONCLUSION

Overall parental satisfaction with their children's rapid palatal expansion treatment is significantly higher when provided by pediatric dentists as compared with orthodontists. Factors related to doctor-patient relationship and situational aspects (ie, office location and design, appointment waiting, and treatment duration) significantly impacted parental satisfaction.

Relationship between the Normative Need for Orthodontic Treatment and Oral Health in Mexican Adolescents Aged 13-15 Years Old

This cross-sectional study aimed to establish a relationship between the Normative Need for Orthodontic Treatment (NNOT) and oral health among Mexican adolescents aged 13–15 years old. A convenience sample of 424 subjects in Mexico City participated in the study. The dependent variable used was NNOT, which was determined via the dental health component (grades 4 and 5) of the Index of Orthodontic Treatment Need (IOTN). The variables for oral health were as follows: caries experience, oral hygiene, self-reported temporomandibular joint pain, and self-reported bruxism. Logistic regression models were fitted to determine the association between NNOT and oral health. The prevalence of NNOT was 66.0% (280/424), and the crowding was the most prevalent occlusal anomaly with 36.1% (n = 135). Multivariate models showed that subjects with NNOT were more than twice as likely to present poor hygiene (OR = 2.56; p = 0.001) as subjects presenting crowding (>4 mm) (OR = 1.99; p = 0.004) and increased overjet (>6 mm) (OR = 1.74; p = 0.046). Those schoolchildren who presented anterior guidance were 72% less likely to present NNOT (OR = 0.28; p < 0.001). In conclusion, the risk of presenting NNOT in Mexican adolescents is high, with a prevalence of over 50% of which the most prevalent occlusal anomaly was crowding. On the other hand, poor oral hygiene was associated with crowding and increased overjet.

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.

Three-Dimensional Evaluation of Slow Maxillary Expansion with Leaf Expander vs. Rapid Maxillary Expansion in a Sample of Growing Patients: Direct Effects on Maxillary Arch and Spontaneous Mandibular Response

The aim is to evaluate the effects of slow maxillary expansion on maxillary and mandibular arch, using a slow maxillary expander (SME-Leaf Expander) banded on primary second molar. Ninety patients with transverse maxillary deficiency and posterior crossbite were selected. Sixty-nine patients (33 males/36 females; 7.6 ± 1.7 years old) who underwent SME and 21 patients (10 males/11 females; 7.4 ± 1.2 years old) who were treated with rapid maxillary expander (RME). Digital models obtained pre- and post-treatment at appliance removal (9 to 11 months) were processed by means of a 3D scanner (Trios 3, 3Shape D250 laser, Copenhagen, Denmark). Interdental width in both maxilla and mandible were measured with 3 SHAPE Ortho Analyzer. Four Maxillary and four mandibular interdental width were traced and evaluated. The adequate Student’s t-test (dependent or independent) was used to compare intra and intergroups interdental width differences (p < 0.05). The efficacy of the SME was confirmed both on maxillary and mandibular arch. All the maxillary and mandibular interdental widths increased significantly (p < 0.001). The comparison with the RME group showed significant statistical differences between the two treatments with a greater increase in primary first and second intermolar and canine width for the test group (p < 0.001). SME with Leaf Expander produced statistically significant effects for the correction of transverse maxillary deficiencies with a significant indirect effect on the mandibular arch.

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

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

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Prevalence of Malocclusion among Schoolchildren in Makkah, Saudi Arabia

BACKGROUND:

The prevalence of malocclusion varies from one region to another and among different age groups and ethnicities. According to the World Health Organization, malocclusion is the third most common abnormal dental condition.

AIM:

This study aims to establish the prevalence of malocclusion among schoolchildren in the Holy City of Makkah, Saudi Arabia.

METHODS:

A cross-sectional study was conducted among 400 Saudi schoolchildren, 12-15 years of age, of both genders, randomly selected from 15 schools in different regions of Makkah. Molar and canine relationships were examined, in addition to traits such as crowding, spacing, overjet, overbite, cross-bite, scissor bite, and maxillary diastema.

RESULTS:

The most prevalent molar relationship was Class I (52.3%), followed by Class II (25%), and Class III (20.5%). Crowding was the most prevalent malocclusion trait (74%), and scissor bite was the least common (2.5%). A statistically significant difference was found between males and females in most of the recorded criteria (P < 0.005).

CONCLUSION:

Among schoolchildren in Makkah, Class I molar relationship was the most prevalent type of occlusion, and the most prevalent malocclusion trait was crowding.

Prevalence of malocclusion among school children of Southern Saudi Arabia

OBJECTIVE:

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

MATERIALS AND METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

Self-Perception Of Malocclusion And Barriers To Orthodontic Care: A Cross-Sectional Study In Al-Madinah, Saudi Arabia

PURPOSE

This study was conducted to assess adult levels of knowledge, awareness of malocclusion and barriers to the uptake of orthodontic care alongside the associated factors (sex and gender).

METHODS

A convenience sample aged 18 years and above, residing in Al-Madinah Al-Munawwarah, Saudi Arabia, was recruited. A self-administrated validated questionnaire was used to collect the data, and data descriptive and inferential statistical analysis were performed.

RESULTS

Of the 700 distributed questionnaires, 554 usable were returned (response rate = 79%). The mean±SD age of participants was 26.40 (±7.87) years and 55.2% were females. Over 60% of the participants reported high oral health knowledge with respect to the alignment of teeth being important for esthetics and neglected malocclusion had consequences, eg, caries. Likewise, high percentages were having knowledge that thumb sucking (80%) contributed to malocclusion although early extraction of primary teeth and genetics was reported by just 52% and 40%, respectively. Awareness of the importance of teeth alignment was reported by 81.6%; however, 37.7% were only advised for orthodontic treatment. Notably, most of the aforementioned knowledge and awareness was statistically significantly higher among females compared to counterpart males (p < 0.05). As for barriers, high orthodontic treatment fees were the barrier for 80% of the total participants irrespective of age and gender. Females were statistically significantly more likely to report barriers for orthodontic care, eg, accessibility and length of treatment (p < 0.05).

CONCLUSION

The majority of the participants scored high levels of knowledge and awareness of oral health-specific conditions in relation to malocclusion. Although females were significantly knowledgeable and aware of malocclusion compared to males, social and orthodontic treatment factors were perceived as barriers to uptake of orthodontic care.

Orthodontic treatment needs in Saudi young adults and manpower requirements

Objectives:

To evaluate orthodontic treatment needs using the index of orthodontic treatment need (IOTN) components and to estimate the required manpower in the city of Jeddah, Saudi Arabia.

Methods:

A cross-sectional study involving 670 participants (390 females and 280 males) collected between November 2016 and April 2017, whose ages ranged from 12-19 years from secondary and high school students. Treatment needs were estimated using the IOTN components, dental health component (DHC), and aesthetic component (AC).

Results:

The results according to the severity of malocclusion using IOTN-DHC found that 24.3% of the cases required severe/extreme need and 54.3% were in the no/slight need category. The most frequent types of malocclusion were crowding (48.8%) followed by increased overjet (21.8%), and spacing (16.1%). Using Pearson’s Chi-squared test, there was a statistically significant association (p<0.001) between IOTN-DHC and IOTN-AC; 51.2% of the sample was in agreement at the mild need category, indicating a strong correlation, with a coefficient of 0.687.

Conclusion:

According to the IOTN’s components, the present study showed that almost one-quarter of the sample had a severe/extreme need for orthodontic treatment. The most frequent type of malocclusion traits according to the severity was crowding followed by increased overjet and then spacing. The Ministry of Health must employ 90-110 orthodontists in Jeddah to meet the demands of the definite needs for orthodontics in adolescents.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia

Objectives:

To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA).

Methods:

Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index>15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p<0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion.

Results:

A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA.

Conclusion:

The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Orthodontic Treatment Need in Higher Primary Schoolchildren of Central Bengaluru, India

Aims and Objective:

The aim of this study was to evaluate the orthodontic treatment need in 11–14-year-old schoolchildren of Central Bengaluru, India, using the index of orthodontic treatment need (IOTN) and to analyze the treatment needs between males and females and correlation between the esthetic to aesthetic (AC) and dental health component (DHC) of IOTN.

Materials and Methods:

The sample comprised 500 schoolchildren (187 females and 313 males) who had not undergone orthodontic treatment. No radiographs, study casts, were used; IOTN was calculated from clinical examination and photographs. The data were analyzed using SPSS 20 IBM version.

Results:

The results for DHC were as follows: 12% students in no need, 52.5% students in little need, 20.5% students in moderate or borderline, 11.5% students in severe need, and 3.5% students were in the category of very severe need for treatment. On evaluating AC components, 91.6% were in the category of no or little need, 2% students in moderate need, and 6.4% in great need category. Mild positive correlation (r = 0.153) between DHC and AC of IOTN was observed. The difference between the IOTN values of boys and girls was not statistically significant.

Conclusions:

More than 50% of the population in our study showed little/no need category which undergoes undiagnosed and may not seek dental treatment at right time to prevent the future complications. This study provides baseline data on the need and demand for orthodontic treatment among the sample which is important for planning public orthodontic and dental services.