Factors to consider when treatment planning for patients seeking comprehensive aesthetic dental treatment

Prevalence of dental midline shifting among 7- to 15-year-old children in Babylon/Iraq

OBJECTIVE

This study aimed to determine the prevalence of dental midline shifting in a group of children with mixed dentition aged 7-15 years in Babylon/Iraq and assess the association between different variables including gender, age stages, residency, and Angle's classes of malocclusions with midline shifting.

MATERIALS AND METHOD

A total of 300 dentate children aged 7-15 years (119 males and 131 females) were randomly chosen from children who visited the Department of Orthodontics, Pedodontics, and Prevention at the College of Dentistry/University of Babylon. The participants were from various environmental areas (162 urban and 88 rural area subjects). The dental midline shifting evaluation includes verifying the maxillary and mandibular dental midline positions with respect to the facial midline, taking philtrum as a guide. Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows was used for data analyses using Pearson's Chi-square tests. The significance level was set at P < 0.05.

RESULTS

More than half of the total sample had dental midline shifting (55.66%), which was relatively more prevalent in the mandible than in the maxilla. The prevalence of dental midline shifting was more common in females (31.3%), subjects over the age of 12 years (20%), and subjects from urban areas (37%). The midline deviation was more frequent in Angle's class I (34%) and class II (13%) malocclusion than in Angle's class III malocclusion (9%) with statistically significant differences (P = 0.028). 63.47% of the sample had midline shifts of 2 mm or more.

CONCLUSIONS

About half of the studied sample showed a maxillary-mandibular dental midline shift. The dental midline shift is more commonly noticed in females and children over 12 years old. A statistically significant difference was found between the shift of the dental midline and Angle's classes of malocclusions, with class I having the greatest midline shift.

Perception of laypersons, orthodontists, and oral and maxillofacial surgeons about the transverse occlusal plane

INTRODUCTION

Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study aimed to investigate the opinions of laypersons, orthodontists, and oral and maxillofacial surgeons about the impact of imbalanced IP and CL on facial attractiveness.

METHODS

We used a symmetrical face image as the reference. Then, using Photoshop software, we constructed the following 6 photographs: TOP roll relative to CL and IP (3° and 6°) with parallelism of CL and IP, CL roll relative to TOP and IP (3° and 6°) with parallelism of TOP and IP, TOP and CL roll relative to IP (3° and 6°). Consequently, the participants rated the photographs on the basis of their attractiveness. Kruskal-Wallis and Mann-Whitney U tests were used to compare the ratings.

RESULTS

One hundred thirty-one laypersons, 22 orthodontists, and 20 surgeons participated in this study. It was found that 51.1% of laypersons, 86.4% of orthodontists, and 70% of surgeons selected the reference photograph as the most beautiful, followed by the photograph with a 3° roll of CL relative to TOP, with parallelism of TOP and IP (29% of laypersons, 31.8% of orthodontists, and 35% of surgeons).

CONCLUSIONS

Most participants selected the reference photograph as the most beautiful and realized a roll in the horizontal planes up to 3°. The parallelism of the esthetic line of dentition relative to interpupillary is preferred over its parallelism relative to CL.

Impact of Malocclusions on the Oral Health-Related Quality of Life of Early Adolescents in Ndola, Zambia

The study aimed to assess the prevalence of malocclusions and its impact on oral health-related quality of life (OHRQoL) among early adolescents in Ndola, Zambia. It used a random sample of 384 primary school children aged 12–14 years. The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) was used to assess OHRQoL, and the Dental Aesthetic Index (DAI) was used to examine dentofacial anomalies. The chi-square test was used to study whether there was a statistically significant association between variables and multivariate logistic regression for the influence of sociodemographic and malocclusions on OHRQoL. Statistical significance was set at p < 0.05. Participants' sociodemographics were 53.6% female, 41.7% aged 13 years, and 43.5% from grade six. The overall reported impact on OHRQoL was 11.7%, which was significant (p < 0.001) by age and sex, and higher in females than males. The overall prevalence of malocclusions was 27.9%, which was significant (p=0.005) by sex, and higher in males than females. Children with malocclusions reported significant (p < 0.001) negative oral health impact compared to the children without malocclusions. Spacing, diastema, and crowding were most prevalent malocclusions that showed clear inverse association with OHRQoL. The study findings provide indications that malocclusions are negatively associated with OHRQoL among Zambian early adolescents.

Adults seeking orthodontic treatment: expectations, periodontal and TMD issues

The growth in adult orthodontics presents new challenges to both the general dental practitioner and the orthodontist. Although many of the main objectives of orthodontic treatment are similar for adults, young adults and children, adult patients frequently bring significant challenges in several areas not often seen in the younger patient group. In areas such as planning realistic treatment outcomes, it is paramount that the patient's expectations are identified, respected and managed where appropriate. The adult patient's dental health often dictates deviation from the ideal treatment plan and periodontal problems are a common example. Based on current evidence, this paper presents an overview of some of the difficulties in the management of these issues, as well as highlighting developments with regard to pain conditions and their relevance to orthodontic treatment and its effects on temporomandibular joint disorders (TMD) management.