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

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 family linked factors on sibling's oral health

The association between family factors and dental caries/dental plaque development in children is of interest. The parents of pediatric age group seeking treatment from the Government Chengalpattu Medical college hospital, who accompanied with two or more siblings, were included. A questionnaire was given to gather data on the parents' socioeconomic status and family size. The children underwent clinical examination to evaluate the state of their oral health. Results showed a significant relationship between dental plaque and caries experience of child with gender, parents' education, occupation and socioeconomic status. So we conclude that the family related factors such as parent's education, occupation, income and SES exerted a definite impact in the oral health of children than the family size and sibling factors.

Prevalence and risk indicators of primary dentition malocclusion in Riyadh-Saudi Arabia using a new case definition: A cross-sectional study

Objectives

To determine the prevalence of primary dentition malocclusion and its linked risk indicators among a group of Saudi preschool children.

Methods

A cross-sectional study was carried out on preschool children aged 3 to 5 years residing in Riyadh City, the capital of Saudi Arabia. The study sample included 709 Saudi children of both genders with complete primary dentition. Oral examination was conducted for children to assess the anteroposterior, transverse, and vertical dimensions, arch spacings, and oral habits.

Results

The prevalence of malocclusion was 59.1% among the study participants. A deep overbite and increased overjet were found in 26.23 % and 25.11%, respectively. Arch space problems were reported, including missing primate spaces in 24.12%, missing developmental spacing in 27.93%, and crowding in 14.1%. An association between mothers aged 25 years and younger at childbirth was linked with their child's malocclusion in the primary dentition (p-value of 0.03).

Conclusion

The prevalence of primary dentition malocclusion among a specific group of Saudi preschool children was significantly high. Increased overbite and overjet were the most prevalent occlusal discrepancies, followed by arch spacing problems. The younger mother's age at childbirth is significantly associated with her child's malocclusion. The study results can serve as a baseline for future investigations.

Narrating the Genetic Landscape of Human Class I Occlusion: A Perspective-Infused Review

This review examines a prevalent condition with multifaceted etiology encompassing genetic, environmental, and oral behavioral factors. It stands as a significant ailment impacting oral functionality, aesthetics, and quality of life. Longitudinal studies indicate that malocclusion in primary dentition may progress to permanent malocclusion. Recognizing and managing malocclusion in primary dentition is gaining prominence. The World Health Organization ranks malocclusions as the third most widespread oral health issue globally. Angle's classification system is widely used to categorize malocclusions, with Class I occlusion considered the norm. However, its prevalence varies across populations due to genetic and examination disparities. Genetic factors, including variants in genes like MSX1, PAX9, and AXIN2, have been associated with an increased risk of Class I occlusion. This review aims to provide a comprehensive overview of clinical strategies for managing Class I occlusion and consolidate genetic insights from both human and murine populations. Additionally, genomic relationships among craniofacial genes will be assessed in individuals with Class I occlusion, along with a murine model, shedding light on phenotype-genotype associations of clinical relevance. The prevalence of Class I occlusion, its impact, and treatment approaches will be discussed, emphasizing the importance of early intervention. Additionally, the role of RNA alterations in skeletal Class I occlusion will be explored, focusing on variations in expression or structure that influence craniofacial development. Mouse models will be highlighted as crucial tools for investigating mandible size and prognathism and conducting QTL analysis to gain deeper genetic insights. This review amalgamates cellular, molecular, and clinical trait data to unravel correlations between malocclusion and Class I phenotypes.

Oral health-related quality of life and orthodontic treatment need in thalassemia major patients

Background

Thalassemia major (TM) is a severe life-threatening hemoglobinopathy. It causes a typical chipmunk face due to increased hematopoiesis. Severe malocclusion often accompanies facial deformity, which may affect Oral Health-related Quality of Life (OHRQoL). The aim of this study was to assess the relationship between orthodontic treatment needs and OHRQoL in TM patients.

Materials and Methods

One hundred and five adult patients with TM participated in this cross-sectional study. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure OHRQoL and the patient's need for orthodontic treatment was evaluated using the Index of Orthodontic Treatment Need (IOTN). The comparison of OHIP-14 scores between groups regarding orthodontic treatment need was carried out using t-test (SPSS software); P < 0.05 was considered statistically significant.

Results

The mean age of participants was 24.92 (±9.33) years, with 52% female versus 48% male. Orthodontic treatment need was 27.6%. The mean score of OHIP-14 was 12.95 (±7.02). A statistically significant relationship was found between OHIP-14 score and age, gender, and orthodontic treatment need (P < 0.05). All domains of OHIP-14 were significantly related to orthodontic treatment need (P < 0.05), except for "physical disability" (P = 0.282).

Conclusion

OHRQoL was lower in TM patients with orthodontic treatment needs. Planning to treat malocclusion seems necessary to improve the quality of life in these patients.

Evaluation of Quantitative Aspects of Craniofacial Deformities in Transfusion Dependent Beta-Thalassemia Major Patients: A Cephalometric Study

PURPOSE

To evaluate the quantitative (cephalometric) aspects of the craniofacial deformities in transfusion-dependent beta-thalassemia (TDT) patients.

MATERIALS AND METHODS

Sixty-five TDT patients receiving a regular blood transfusion in the Department of Pediatrics of age group 5 to 8 years (younger) and 15 years and above (older) were compared with control groups of similar age using cephalograms (lateral and posterior-anterior view).

RESULTS AND OBSERVATION

The prevalence of skeletal class II tendency is higher in thalassemic patients that do not improve with age. The thalassemic patients were found to show large angle ANB i.e.. Angle between points point a, nasion and point B (ANB), large flexure angle, small angle SNB i.e.. Angle between points sella, nasion and point B (SNB), and normal angle SNA i.e.. Angle between points sella, nasion and point A (SNA) angles suggestive of retrognathic mandible. The thalassemic patients were observed to have smaller transverse widths and thickened calvarium on the posterior-anterior view.

CONCLUSION

The skeletal class II malocclusion appears to be a manifestation of generalized growth retardation/delayed puberty in thalassemic patients leading to diminished mandibular growth, rather than maxillary prognathism due to marrow hyperplasia.

Implications of β-thalassemia on oral health status in patients: A cross-sectional study

Background:

β-Thalassemia is a chronic disease of autosomal recessive origin that is identified by the presence of a severe form of anemia. This hematological disease has been shown to directly influence a person’s physical as well as psychological well-being along with their families.

Aim:

This study aimed to find an association between dental health status and oral health-related quality of life (QoL) among children who have been diagnosed with β-thalassemia.

Materials and Methods:

This prospective cross-sectional study was carried out in the dental outpatient department; blood bank and pediatric outpatient departments that were associated with the primary institute. All study participants were age-ranged from 3 to 15 years. Informed written consent was obtained from caregivers or parents of all the study participants. This study was conducted for a total duration of 1 year (from June 2020 to June 2021). All study participants were categorized into two groups: (a) Group I (n = 150) comprised children who were diagnosed with β-thalassemia and (b) Group II (n = 150) comprised normal controls. Exclusion criteria in the study included children suffering from any systemic disease that predisposes them to dental caries or periodontal diseases. The intra-oral examination was performed using Decayed-Missing-Filled Teeth Index (DMFT/dmft Index) and Oral Hygiene Index-Simplified (OHI-S). Assessment of QoL was done by using the “Child Perceptions Questionnaire for children.” Collected data were recorded in Microsoft Excel workbook, 2007. Statistical comparison between both the groups was performed by using statistical tools such as the Chi-square test, Fisher’s exact test, independent t-test, and Mann–Whitney U test. The probability values lesser than 0.05 were considered to be statistically significant.

Results:

Maxillofacial findings—rodent facies, saddle nose, lip incompetence, pale oral mucosa, anterior open-bite, lower anterior teeth crowding, and maxillary anterior teeth spacing or crowding—were seen. Class II malocclusion was present in significant numbers of subjects. On comparing dmft/DMFT scores, no significance was observed while on comparing OHI-S index, statistical significance was seen. A statistically significant difference in the QoL was noted between thalassemic children and the control group.

Conclusion:

Thalassemic children showed a significant association between dental health and QoL.

Malocclusion Among 10- to 12-Year-Old Male Schoolchildren in Qassim Region of Saudi Arabia: A Retrospective Epidemiological Study

Objective To identify the prevalence of malocclusion in late mixed dentition in Qassim region of Saudi Arabia. This will be the first epidemiological study of its kind in this region. It will be very helpful for planning effective preventive measures and therapy programs. Materials and methods This study was performed in Qassim region, Saudi Arabia starting from October 2018 to March 2019. The examination was performed by two well-trained general dentists after using a specially prepared clinical examination form. A total of 536 children aged between 10 and 12 and those who met the inclusion criteria have been examined for Angle's relationship, overjet, overbite, crossbite, midline deviation and lip competent. Results Class I relation accounted for the highest percentage of the sample, whilst 31.3% presented with Class I ideal occlusion, and 48.9% Class I with malocclusion. This was followed by Class II malocclusion (12.5% of the sample), and Class III accounted for the lowest proportion (7.3%). Increased overjet was present in 34.4% of the sample, whereas 3.9% had edge-to-edge and 2.2% a reverse overjet. Regarding overbite, 39% reported increased overbite, whilst 3% had open bite. A total of 63 children presented with crossbite - 6.15% had anterior crossbite, 5% unilateral posterior, and 0.5% bilateral posterior. Regarding the midline, only visible and noticed deviation was recorded. The results showed that 90% had no deviation, while 10% had a deviated midline. Regarding lip competence, only 12.1% had an incompetent lip. Conclusion Early intervention and correction of occlusal discrepancies will facilitate the treatment and eliminate possible defects in developing dental arches.

Prevalence of malocclusion among children of the Kingdom of Saudi Arabia - A systematic review and meta-analysis

Objective

Systematic review and meta-analysis are of a great tool in assessment of malocclusion, which is major public health concern. This study aims to explore the prevalence of malocclusion among the children of the Kingdom of Saudi Arabia through a meta-analysis and systematic review.

Materials and methods

Registered with PROSPERO as CRD42020198427, an authentic and global scale database search using relevant MeSH (Medical Subject Headings) terms was performed. Literature search and articles screening done following PRISMA guidelines.

For the dichotomous variables, 95% confidence intervals (CIs) were set for statistical data analysis. The heterogeneity index between the studies was determined using indices Tau², Chi², df and I² and Test for overall effect as Z.

Results

A total of 7930 candidates were reported to have either one of the three malocclusions. Prevalence of Class I, Class II and Class III Malocclusions were found to be 66.51%, 17.70%, 15.79% respectively. Among the small subsample of these candidates, male children with Class I, Class II and Class III Malocclusion were 43.80%, 12.27% and 7.40% respectively whereas female children were 22.07%, 10.93 %, 3.52 % respectively.

Conclusions

According to the 26 studies included in the systematic review, there were 72% of the candidates with malocclusion in Saudi Arabia. Prevalence of Class I, Class II and Class III malocclusion were 66.51%, 17.70%, and 15.79% respectively. In both male and female participants, the prevalence of Class I was the highest followed by class II and III malocclusion.

Prevalence of Occlusal Features and Their Relation to Sociodemographic Variables in Northwest Ethiopia: A Cross-Sectional Study

BACKGROUND

Malocclusion affects the chewing, dental aesthetics, jaw development, and overall attractiveness of individuals. The negative impact of malocclusion is high, particularly in adolescents who can be the target of teasing, intimidation, and name-calling. Even if, malocclusion is a common problem in developing countries, there was a paucity of data in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of malocclusion in northwest Ethiopia.

METHODS

This cross-sectional study was done at the University of Gondar comprehensive hospital from December 1, 2019, to October 30, 2020. Four hundred seventy-six study participants were selected using a systematic random sampling method. Data collection was done using a structured interviewer-administered questionnaire. Qualified dental professionals examined malocclusion traits according to the WHO oral health survey tool and evaluated for the presence of malocclusion in terms of angles classification, open bite, crossbite, spacing, and crowding. Data entry was done using Epi-Info 7, and analyzed by SPSS 26. Descriptive statistics and logistic regression was done to analyze the data.

RESULTS

A total of 476 subjects were included in the study with a mean age of 29.83 (SD±14.013). The prevalence of malocclusion was 55.9% (95% CI: 51.39-60.28). The common occlusal traits were class-I malocclusion with minor discrepancy (34.9%), anterior crowding (22.9%), and anterior open bite (21.6%). The prevalence of anterior crossbite, posterior crossbite, class-II, and class-III malocclusion was 5.9%, 3.8%, 10.9%, and 8.0%, respectively. Males (AOR=1.6, 95% CI: 1.11, 2.30), urban residents (AOR=1.64, 95% CI: 1.06, 2.56), monthly income of ≤2500 Ethiopian Birr (AOR=1.27, 95% CI: 1.02, 1.59) and mouth breathers (AOR=2.50, 95% CI: 1.72, 2.63) were significantly associated with malocclusion.

CONCLUSION

Significant amount of the study participants had malocclusion. Males, urban residents, low monthly income, and mouth breathing habits were independent factors for a malocclusion. Therefore, early attention to the development of the dentition and occlusion, and necessary functional correction during childhood are important to reduce its prevalence and lifelong adverse effect. Moreover, publicly financed orthodontic treatment should be scheduled, and supplied to individuals in desperate need of orthodontic care.

Nature and severity of dental malocclusion in children suffering from transfusion-dependent (-thalassemia major

Objective:

To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger’s Treatment Priority Index (TPI) and index of orthodontic treatment need (IOTN)-dental health component (DHC).

Methods:

A cross-sectional study was conducted on 200 transfusion-dependent children diagnosed with homozygous β-thalassemia and 200 healthy school children aged 11-17 years. The TPI and IOTN-DHC data was recorded for both groups. Total TPI score for each subject was calculated and graded according to malocclusion severity estimate (MSE). Independent sample t-test was used to compare mean TPI scores, overjet and overbite between thalassemic and healthy children. Chi-square test was used to compare the frequency of IOTN-DHC grades, Angle’s classification, and MSE grades between thalassemic and healthy children.

Results:

The most prevalent malocclusion was Class I in normal children (67.5%) and Class II in thalassemic children (59%). The mean overjet and overbite were significantly (p<0.001) greater in thalassemic children than in healthy children. Severe tooth displacements were 3.5 times greater in thalassemic children, compared to controls. A greater proportion of thalassemic children were in IOTN grades 3 and 4, compared to the controls (p<0.001). MSE grades 4 and 5 were significantly (p<0.001) more prevalent in thalassemic children, compared to the controls.

Conclusion:

There is a high prevalence of Angle’s Class II malocclusion in thalassemic children. Majority of these children are categorized in higher grades of IOTN-DHC and TPI-MSE, showing a great severity of malocclusion and high orthodontic treatment needs.

Assessment of mandibular characteristics in patients affected with β-thalassaemia major: A retrospective case-control study

OBJECTIVE

Thalassemia is the most common hereditary blood disorder across the world. This study aimed to identify some mandibular features of thalassaemic patients and compare them with unaffected counterparts.

MATERIAL AND METHODS

This retrospective case-control study was carried out on lateral cephalograms of 60 subjects (26 males, 34 females) with class II malocclusion and age range of 11 to 15 years. The control group consisted of 60 non-thalassaemic subjects with class II malocclusion and similar chronological age, gender and vertical facial dimension. Based on the Jarabak index, the case and control subjects were classified into hyperdivergent, normodivergent and hypodivergent growth patterns. Four linear (ramus height, ramus width, mandibular depth, and antegonial notch depth) and 3 angular (symphyseal angle, gonial angle, and mandibular arc angle) cephalometric parameters were measured to represent mandibular morphology. The data were analysed using Chi-square test and Student's t-test.

RESULTS

No significant difference was found in linear measurements between thalassaemic patients and controls. The symphysis angle was significantly greater and the mandibular arc angle was significantly smaller in the total thalassaemic sample than the control individuals (P<0.001 and P=0.004, respectively). The difference in symphysis angle was significant in both hyperdivergent and normodivergent subjects (P=0.004 and P=0.002, respectively), whereas the difference in mandibular arc angle was only significant in the normodivergent subgroup P=0.001).

CONCLUSIONS

The smaller mandibular arc angle in the thalassaemic sample suggests a more superior than posterior growth direction of condyles compared with healthy individuals. The difference in symphyseal angle represents inherent differences in chin morphology between thalassaemic subjects and controls.

The Adverse Impact of Thalassemia Major on Adolescents' Oral Health-related Quality of Life

BACKGROUND

Adolescents with beta-thalassemia major (βTM) had unfavorable quality of life (QOL).

OBJECTIVES

To assess oral health status of adolescents with βTM and its impact on their oral health-related QOL (OHRQoL).

SUBJECTS AND METHODS

Forty adolescents with βTM were recruited and compared with 40 age-matched and sex-matched healthy adolescents. Intraoral examination including dental caries assessment, oral hygiene index simplified (OHI-S), and Angle classification were performed. OHRQoL questionnaires were filled-out using child perception questionnaire-short form16.

RESULTS

Although the majority of adolescents with βTM had dental problems and convinced by their need for dental treatment, nearly half of them never brushed their teeth nor visited dental office. Patients showed higher frequency of class II malocclusion (P=0.017) and higher percentage of poor simplified debris index (DI-S) and OHI-S grade (P=0.008, 0.037, respectively). The median of DI-S and OHI-S were significantly higher in adolescents with βTM (P=0.009, 0.037, respectively). Adolescents with βTM had worse emotional well-being total score (P=0.049) than controls. Patients with poor oral hygiene had the worse total OHRQoL score (P=0.03). The total OHRQoL score showed significant positive correlation with oral hygiene; DI-S, calculus index-S, and OHI-S (P=0.028, 0.038, and 0.045, respectively).

CONCLUSION

βTM had a negative impact on the emotional well-being aspect.

Craniofacial Deformities in Patients With Beta-Thalassemia: Orthodontic Versus Surgical Correction-A Systematic Review

Rapid blood cell turnover and bone marrow expansion caused by beta-thalassemia (βT) result in craniofacial and dentoalveolar anomalies. This report presents a systematic review of the literature over the past 50 years on orthodontic and surgical considerations in the management of βT-affected patients. Seventeen publications encompassed 24 patients, 11 male individuals and 13 female individuals, 7 to 43 years of age. Eleven patients underwent only surgical treatment, eleven combined orthodontic-surgical treatment, and 2 orthodontic treatment. Surgical treatment primarily addressed typical maxillary overgrowth by maxillary reshaping, premaxillary segmental repositioning, or complete Le Fort I impaction and set back osteotomy. In severe maxilla-mandibular discrepancy and/or increased lower facial height, a bilateral sagittal split mandibular osteotomy is the treatment of choice. Although surgery involves risks of excessive bleeding, morbidity, and impaired nasal esthetics, little attention is given to the orthodontic modality. In conclusion, the current literature recommends early interceptive orthodontics aimed to decrease dentoskeletal deformities, severe malocclusion, and soft tissue imbalance. Treatment includes maxillo-mandibular orthopedic and functional manipulation with dentoalveolar treatment, which might either prevent orthosurgical procedures later or reduce its extent. This suggested a multidisciplinary approach comprising a hematologist, a pediatrician, a pediatric dentist, and an orthodontist, which might also significantly improve the patient's quality of life.

Evaluation of maxillary sinus volume and surface area in children with β-thalassaemia using cone beam computed tomography

OBJECTIVES

Among children with β-thalassaemia, skeletal changes and abnormalities, such as decreased volume or obliteration of the sinus, result primarily from hypertrophy and expansion of the erythroid marrow due to ineffective erythropoiesis. This study evaluated the volumes and surface areas of the maxillary sinuses of children with β-thalassaemia using cone beam computed tomography (CBCT), and compared these findings with corresponding measurements in age- and sex-matched control children.

METHODS

CBCT images were retrospectively evaluated for 16 children with β-thalassaemia, 19 children with a class I skeletal pattern (class I group), and 18 children with a class II skeletal pattern (class II group). After three-dimensional analyses and segmentation of each maxillary sinus, the volumes and surface areas were calculated.

RESULTS

The volumes and surface areas of the right (p > 0.05 and p > 0.05) and left maxillary sinuses (p > 0.05 and p > 0.05) and SNA angles (p > 0.05) were not significantly different among the groups. The ANB (p < 0.05) and SNGoMe (p < 0.05) angles were significantly greater and the SNB (p < 0.05) angle was significantly smaller in the class II and thalassaemia groups than in the class I group.

CONCLUSION

Children with thalassaemia tended to have lower maxillary sinus volumes and surface areas on both right and left sides, compared to those of children with class I and class II skeletal patterns; however, these differences were not statistically significant. In children with thalassaemia, a large intermaxillary discrepancy (ANB) indicated a tendency toward the class II skeletal pattern.

Medically compromised patients in orthodontic practice: Review of evidence and recommendations

INTRODUCTION

Due to advances in the field of medicine, early diagnosis and high-quality medical management has become available for medically compromised patients. This increases their life expectancy and improves their quality of life. Therefore, orthodontic treatment can be provided to these patients whose medical conditions are well controlled.

OBJECTIVE

This article will discuss some medical conditions that might be seen by orthodontists. Also, recommendations and modifications of the orthodontic treatment plan will be discussed thoroughly.

MATERIALS AND METHODS

A computerized electronic search of the literature was conducted in Google Scholar and PubMed and was limited to publications in English.

RESULTS

Orthodontic management was studied in cases of Infective endocarditis (IE), Thrombocytopenia, Hemophilia, Sickle cell anemia, Thalassemia, Diabetes mellitus (DM), Thyroid Disorders, Asthma, DiGeorge Syndrome, HIV/AIDS, Organ transplantation, Orthodontic management, Juvenile idiopathic arthritis (JIA), Seizure disorders, Autism Spectrum Disorder (ASD), Mood disorders, Schizophrenia and Eating disorders.

Global distribution of malocclusion traits: A systematic review

OBJECTIVE

Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions.

METHODS

An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016.

RESULTS

Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids.

CONCLUSION

Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.

Periodontal condition of patients with Thalassemia Major: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition.

MATERIALS & METHODS

MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment.

RESULTS

The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality".

CONCLUSION

Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.

Prevalence of Malocclusion among Male School Children in Riyadh City

BACKGROUND:

Malocclusion is defined as irregularity of the teeth or a molar relationship between the dental arches beyond the range of what is accepted as normal.

AIM:

To determine the prevalence of malocclusion among male school children aged 12-15 years old in Riyadh, Saudi Arabia.

MATERIALS AND METHODS:

Five hundred (500) school children in Riyadh city, Saudi Arabia with an age of 12-15 years participated in this study. The prevalence of malocclusion among the students was determined using a clinical examination form specially prepared for this study. The required information was collected from each subject, and descriptive statistics were performed.

RESULTS:

The Molar Class I relation involved the highest percentage of the sample (71.2%) while Class II relation involved only 23% which was four times of Class III (5.8%). The maxillary arch crowding was present in 23.2% of the sample which was double than that of spacing. Whereas, the mandibular arch crowding was present in 28% of the sample which was three times more than spacing (8.8%). The open bite was present in 4% of the sample while deep bite was present in 9.6%.

CONCLUSION:

The prevalence of malocclusion involved the highest percentage in Class I in comparison with other malocclusions.

Prevalence of malocclusion in primary dentition in mainland China, 1988-2017: a systematic review and meta-analysis

Malocclusion is a common oral disease affecting children with various reported prevalence rates. This meta-analysis aimed to determine the epidemiological characteristics of malocclusion among pre-schoolers in mainland China from 1988 to 2017. A total of 31 qualified papers describing 51,100 Chinese children aged 2–7 years were selected. The pooled malocclusion prevalence was 45.50% (95% confidence interval (CI): 38.08–52.81%) with 26.50% Class I (CI: 19.96–33.12%), 7.97% Class II (CI: 6.06–9.87%) and 12.60% Class III (CI: 9.45–15.68%) cases. The most common type of malocclusion was overbite (33.66%, CI: 27.66–39.67%), and the flush terminal type (47.10%, CI: 28.76–65.44%) was the most common in the terminal plane relationship. An increasing trend and wide variations across the country were observed. Additionally, there was no significant difference in malocclusion by gender (relative risk (RR) = 1.01, [0.96–1.06]) or urban/rural area (RR = 0.99, [0.82–1.20]). Although this study represents a narrow view of deciduous-dentition malocclusion in mainland China, the results provide sample evidence that can aid clinicians and policy makers towards early prevention and timely treatment.

Prevalence of Dental Malocclusions in Patients admitted to the Department of Orthodontics, School of Dentistry, Tabriz, in 2016

AIM

This study is aimed at investigating the prevalence of disorders among patients referred to Tabriz Dental School in 2016.

MATERIALS AND METHODS

This research was conducted in a cross-section method and taken from all patients admitted during this period. Classification of dental occlusion in patients was based on Angle's definition, skeletal classification was based on Steiner's analysis, and overjet and overbite values and other patient-related information were imported from the records in the extractive sector and in specific forms. After reviewing the data, the forms of individual patients were inputted into the computer and analyzed.

RESULTS

In terms of dental condition, the prevalence of malocclusion CL.I, malocclusion CL.II, and malocclusion CL.III was respectively, 50, 36.8, and 13.2%. In terms of overjet condition, 13.9% of patients had normal overjet, 67.1% had increased overjet, 8.9% had reduced overjet, and 10.1% had reversed overjet. In terms of overbite, 17.7% of patients had normal overbite, 53.2% had increased overbite, 8.9% had decreased overbite, 15.2% had open bite, and 5.1% had deep bite. Skeletally, 24.1% of patients had skeletal abnormalities CL.I, 62% had skeletal deformities CL.II, and 13.9% had skeletal CL.III.

CONCLUSION

The most common dental malocclusion among patients was related to CL.I and the most common skeletal malocclusion was related to CL.II, and malocclusions of CL.III had the least prevalence both dentally and skeletally. There was no significant relationship between dental and skeletal malocclusions and also between different malocclusions and gender.

CLINICAL SIGNIFICANCE

Knowledge of the prevalence of different types of dental and jaw anomalies is considered as the first step in the evaluation and treatment of these disorders. It is worth mentioning that the results of the study can be used in treatment planning required in the province and even in the country.

Sociodemographic profile and oral health status of thalassemic patients attending the National Thalassaemia Centre, Kurunegala, Sri Lanka

AIM

The aim of the present study was to investigate the sociodemographic profile and oral health status (Decayed, Missing, Filled Teeth [DMFT] and periodontal health) of thalassemic patients compared to healthy individuals.

METHODS

The data were collected by means of an interviewer-administered, pretested, and validated questionnaire, followed by oral examination. Patients attending the outpatient department, who were age and sex matched, but without any diagnosed or suspected long-term illnesses, were considered for the control group. Both groups were compared in terms of facial profile, skeletal pattern, facial angles, DMFT, and periodontal health (plaque index, bleeding on probing, and probing pocket depth).

RESULTS

The association of convex facial profile and class II skeletal pattern with Thalassemic status was statistically significant when compared to healthy individuals. Decayed, missing, and filled teeth in the permanent and deciduous dentition, plaque index, and probing pocket depths of the control group were significantly higher compared with the thalassemic group. Surprisingly, 67.8% of thalassemic patients did not show bleeding on probing.

CONCLUSION

Families of the thalassemic patients attending the National Thalassaemia Centre are from a low socioeconomic background. Their DMFT and periodontal health are significantly better than those of healthy individuals.

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.