Individual factors associated to malocclusion in adolescents

Orthodontic Treatment Need and Its Relation to Gender, Oral Hygiene, and Age Range in a Mexican Population

Introduction Malocclusion, a prevalent oral health concern, significantly impacts both functional abilities and psychosocial well-being. The Dental Aesthetic Index (DAI) is widely used to assess malocclusion severity and orthodontic treatment needs. This study aims to evaluate the prevalence of orthodontic treatment needs based on the DAI in a Mexican population, considering factors such as gender, oral hygiene, and age range. Materials and methods This retrospective observational study analyzed 639 patient records from the Orthodontics and Dentomaxillofacial Orthopedics postgraduate program at the Autonomous University of San Luis Potosí, San Luis Potosí, Mexico. The DAI was used to assess malocclusion severity, and patients were classified into four categories based on their scores. Data on gender, oral hygiene, and age were also collected and analyzed. Results The results showed no significant association between DAI levels and gender, oral hygiene, or age range. However, a significant association was found between missing teeth and higher DAI scores (OR = 8.9), maxillary irregularity (OR = 8.6), and open bite (OR = 4.9). The prevalence of severe malocclusion (DAI ≥ 36) was notably high, affecting over 50% of the study population. Discussion The findings align with previous studies that highlight the influence of structural irregularities such as open bite and maxillary irregularities on severe malocclusion. While no significant associations were found with gender, oral hygiene, or age, the high prevalence of severe malocclusion underscores the need for early orthodontic intervention in Mexican populations. Conclusion This study demonstrates a high prevalence of severe malocclusion in a Mexican population and highlights the importance of addressing structural dental irregularities to prevent long-term complications. These findings emphasize the need for accessible orthodontic care and early screening programs.

[Malocclusion in adolescents in the State of São Paulo: spatial and hierarchical analysis]

The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.

Impact of Dental Aesthetic Index characteristics on the severity levels of malocclusion in a non-White population

INTRODUCTION

This study evaluated the impact of the esthetic and occlusal characteristics of the Dental Aesthetic Index (DAI) on the need for orthodontic treatment in a non-White population.

METHODS

A cross-sectional study was conducted with 1296 non-White adolescents aged 12 years. DAI was the outcome variable (DAI 1 and 2 and DAI 3 and 4). The independent variables were categorized on the basis of the occlusal esthetic characteristics evaluated by DAI (tooth absence, crowding, spacing, midline diastema, maxillary misalignment, mandibular misalignment, maxillary anterior overjet, mandibular overjet, anterior open bite, and anteroposterior molar relationship). Simple logistic regression models were adjusted for the outcome, and the raw odds ratios were estimated. Variables with a P value of <0.20 for individual analyses were tested in a multiple logistic regression model, with P ≤0.05 remaining.

RESULTS

A total of 1296 adolescents (764 girls and 532 boys) were evaluated; 1067 (82.3%) had DAI 1 or 2 (minor to a moderate need for orthodontic treatment), and 229 (17.7%) had DAI 3 or 4 (defined need for orthodontic treatment). The results showed that adolescents with diastema, maxillary irregularity, mandibular irregularity, mandibular overjet, anterior open bite, and the altered molar relationship had 5.34, 2.36, 2.63, 3.56, 8.73, and 5.16 times more likelihood to have DAI 3 or 4 (P ≤0.05), respectively.

CONCLUSIONS

Diastema, maxillary and mandibular misalignment, mandibular overjet, anterior open bite, and anteroposterior molar relationship were the characteristics that influenced the determination of the need for orthodontic treatment in a non-White population using the DAI index.

Contextual and Individual Determinants of Anterior Open Bite in Adolescents

OBJECTIVE

Studying the broader determinants of anterior open bite (AOB) may guide more equitable policies.This study estimates the prevalence of AOB in Brazilian adolescents and its association with contextual and individual determinants.

METHODOLOGY

The data for dentofacial anomalies in 15- to 19-year-olds from the National Oral Health Survey SBBrasil 2010 were analysed (N = 4748). AOB was based on the Dental Aesthetic Index (AOB = 0; AOB > 0); the contextual variables were the Human Development Index (HDI) and the Gini Index (2010). The individual sociodemographic variables included sex (male, female), self-reported skin colour/race (white, black, brown, and indigenous + yellow), family income (≥4 minimum wage [MW]; 0-3 MW), and educational attainment (ideal, delayed). The individual clinical variables were decayed, missing, and filled teeth (DMFT) (0, ≥1), first permanent molar loss (0, ≤3, 4), and molar relationship (normal, half cusp, full cusp). Multilevel logistic regression models with random intercepts and fixed slopes were used to estimate odds ratios (ORs) and confidence intervals (95% CIs).

RESULTS

AOB prevalence in Brazil was 8.78% (95% CI, 6.85-11.20) at 15 to 19 years of age. The lowest prevalence was in São Luis (2.63%; 95% CI, 0.58-11.03) and the highest was in João Pessoa (29.85%; 95% CI, 15.93-48.85), both capitals of the northeast Brazilian region. A higher prevalence of AOB (OR, 1.71; 95% CI, 1.04-2.80) was observed in municipalities with a lower HDI. Adolescents who declared their skin colour black, with lower family income, with delayed education, with DMFT ≥ 1, who lost 4 permanent first molars, and who had a complete molar cusp relationship were more likely to have AOB.

CONCLUSIONS

AOB varied amongst Brazilian municipalities. The HDI plays an important role in the prevalence of AOB; individual social determinants have also been associated with AOB malocclusion in adolescents.

Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review

BACKGROUND

Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed.

SUMMARY

The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123-81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. Key Messages: The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.

The role of accelerated dental development on the occurrence of aberrant dental traits that indicate malocclusion

BACKGROUND

Timing of dental development might help orthodontists to optimize initiation of treatment and to prevent and intercept dental misalignment. This study examines the association between timing of dental development and aberrant dental traits such as crowding, impaction, and hypodontia.

METHODS

This study was performed using 4446 ten-year-old children from a multiethnic birth cohort, the Generation R Study. Dental development was defined using the Demirjian method. Crowding, impaction, and hypodontia were ascertained from 2D and 3D pictures and radiographs. We built three series of logistic regression models to test the associations of dental age with crowding, impaction, and hypodontia. Similar models were built to investigate the associations of the developmental stages of each left mandibular tooth with crowding, impaction, and hypodontia.

RESULTS

Inverse associations were found between every 1-year increase in dental age and the presence of crowding [odds ratio (OR) = 0.84, 95% confidence interval (CI): 0.79, 0.89], impaction of teeth (OR = 0.66, 95% CI: 0.52, 0.84), and hypodontia (OR = 0.52, 95% CI: 0.47, 0.56). Lower developmental stages of the second premolar were associated with the presence of crowding (OR = 0.90, 95% CI: 0.83, 0.98). Lower developmental stages of the second premolar (OR = 0.88, 95% CI: 0.79, 0.98), first molar (OR = 0.76, 95% CI: 0.65, 0.90), and the second molar (OR = 0.83, 95% CI: 0.73, 0.94) were associated with the presence of tooth impaction. Lower developmental stages of all mandibular teeth except the central incisor were associated with hypodontia (P < 0.05).

CONCLUSION

Accelerated dental development is associated with lower occurrence of crowding, impaction, and hypodontia.