Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept

A rapid identification method for soft tissue markers of dentofacial deformities based on heatmap regression

OBJECTIVE

The purpose of this study was to construct a facial deformity dataset and a network model based on heatmap regression for the recognition of facial soft tissue landmarks to provide a basis for clinicians to perform cephalometric analysis of soft tissue.

MATERIALS AND METHODS

A 34-point face marker detection model, the Back High-Resolution Network (BHR-Net), was constructed based on the heatmap regression algorithm, and a custom dataset of 1780 facial detection images for orthognathic surgery was collected. The mean normalized error (MNE) and 10% failure rate (FR10%) were used to evaluate the performance of BHR-Net, and a test set of 50 patients was used to verify the accuracy of the landmarks and their measurement indicators. The test results were subsequently validated in 30 patients.

RESULTS

Both the MNE and FR10% of BHR-Net were optimal compared with other models. In the test set (50 patients), the accuracy of the markers excluding the nose root was 86%, and the accuracy of the remaining markers reached 94%. In the model validation (30 patients), using the markers detected by BHR-Net, the diagnostic accuracy of doctors was 100% for Class II and III deformities, 100% for the oral angle plane, and 70% for maxillofacial asymmetric deformities.

CONCLUSIONS

BHR-Net, a network model based on heatmap regression, can be used to effectively identify landmarks in maxillofacial multipose images, providing a reliable way for clinicians to perform cephalometric measurements of soft tissue objectively and quickly.

Assessment of Relationship between Intelligence Quotient and Orthodontic Treatment Need

Objective

Low cognitive ability may reduce the ability to understand the importance of oral health and to perform the necessary practices to maintain proper oral hygiene. Early loss of primary teeth following high caries risk may lead to malocclusion of permanent dentition. This study aimed to evaluate the relationship between the cognitive levels of adolescents and their orthodontic treatment needs.

Material and Methods

Between January 2018 and May 2018, 200 adolescents aged 10 - 15 who applied to the Pediatric Dentistry Clinic of Marmara University and sought orthodontic treatment were invited to participate in the study. The orthodontic treatment needs of 150 adolescents who agreed to participate were evaluated with the Index of Orthodontic Treatment Need - Aesthetic Component and their cognitive levels were evaluated with the Raven Standard Progressive Matrices (SPM) Test. P-value < 0.05 was considered statistically significant.

Results

The mean age (± standard deviation) of 126 adolescents (77 females and 49 males) who completed the SPM test was 11.8 (± 1.3). There was no consistency between the intellectual level and the need for orthodontic treatment (Kappa value = 0.071, p-value = 0.081). There was no correlation between malocclusion severity and intelligence quotient scores of adolescents (ρ [rho] = -0.089, p = 0.322). According to Multiple logistic regression results, there was no difference between 'borderline need' (p = 0.059) and 'great need' (p = 0.881) from 'no need' for orthodontic treatment in adolescents with different intelligence quotients.

Conclusions

The results showed no evidence for an association between malocclusion and intelligence quotient.

A survey regarding orthodontic treatment among contemporary college freshmen in China

Background

A growing number of Chinese residents are seeking orthodontic treatment. The aim of the study was to investigate rates of orthodontic publicity, orthodontic treatment history and related factors among college freshmen in China, to preliminarily understand the current situation of orthodontic publicity and treatment in China, especially after the 2020s.

Methods

Referred to previous studies, a self-designed online questionnaire of Chinese college freshmen was conducted. The questionnaire was divided into two parts, after collecting basic information, we investigated orthodontic publicity rate and orthodontic treatment history with starting age, relapse phenomenon, satisfaction score and willingness to re-treatment. Factors hindering first-time and second-time treatment were also collected. The statistical analysis was performed using the Chi-square test, t-test, Kruskal–Wallis test and logistic regression analysis.

Results

The response rate was 100% and 3308 responses were included. The male to female ratio was 1524:1784 with a mean age of 18.43 years (SD 0.91 years). Statistically significant of economic administrative regions, age, major and orthodontics engagement of relatives or friends were found on prevalence and rate of orthodontic treatment (P < 0.05). Average opinion on orthodontic treatment was “satisfied” and most claimed a phenomenon of relapse (slight relapse: 38.22%, obvious relapse: 23.12%), where age, major and orthodontics engagement of relatives or friends showed statistically significant. Retreatment willingness was correlation with start age and relapse phenomenon. For those who refused first-time treatment, except for good tooth arrangement condition, pain, long-time span, and cost weighted, while for those who refused re-treatment, the fair of discomfort and long-time span ranked at the top.

Conclusions

In contemporary China, the prevalence and rate of orthodontic treatment had been greatly promoted. Earlier age for receiving orthodontic treatment was also discovered. Subjective factors regarding psychology, self-requirement affected the need of orthodontic treatment. Contemporary Chinese college freshmen had a high ability of judging dental alignment, while improve of overall orthodontic care level is still required.

The Attitudes of Children Undergoing Orthodontic Treatment toward Face Mask Wearing during the COVID-19 Pandemic: A Cross Sectional Study

During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children’ attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1—Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2—Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children.

Evaluation of the Effect of Surgical Extraction of an Impacted Mandibular Third Molar on the Periodontal Status of the Second Molar-Prospective Study

Dental injury to the second molar (SM) caused by the surgical extraction of the impacted third molar tends to be underestimated. The necessity of assessment of the impact of the removal of the wisdom tooth in the mandible on the second molar arose. The study group (n = 60) was the one with the second molar on the surgical side, and the control group (n = 60) was the one with the tooth on the opposite side of the alveolar arch. Before the surgery, the difficulty level was assessed according to the Pederson scale. The periodontal status of the SM was assessed by probing depth (PD), gingival index (GI), tooth mobility (TM) examination by the percussion method and resonance frequency. Measurements were taken before and after the surgery, 7 days and 8 weeks after the surgery. The study demonstrated the significant impact of the surgical removal of the wisdom tooth on the PD, GI and TM of the SM. The predicted degree of difficulty of the very difficult surgery had an influence on the increase in PD on the distal buccal and lingual surface of the SM, and on the GI in the proximity of the examined tooth. The results of the presented research confirm the necessity of the clinical assessment of the lower SM before and after the surgical removal of the impacted wisdom tooth in the mandible.

Changes in quality of life induced by tooth whitening are not influenced by global self-esteem: a randomized double-blind placebo-controlled trial

The purpose of this paper is to investigate which elements of tooth colour are most influenced by whitening and to identify the short-term changes in satisfaction with smile aesthetics and quality of life induced by tooth whitening and the role of global self-esteem. Sixty participants were randomly assigned to a treated or a placebo group (each group N = 30). Their anterior teeth were bleached with a photo-activated whitening gel, or subjected to a placebo. Lightness, chroma and the translucency of teeth were assessed before and 1 week after the procedure using a spectrophotometer. The Self-Esteem Scale, Psychosocial Impact of Dental Aesthetics Questionnaire, the Orofacial Aesthetic Scale and the Oral Health Impact Profile were administered to subjects. Changes in colour and chroma were greater in the treated than the placebo group (3.8 ± 1.5 vs. 1.7 ± 1.5 and - 3.2 ± 1.5 vs. 0.0 ± 1.1; p < 0.001). The treated group reported increased satisfaction with appearance and a decrease in psychological and social impacts (p < 0.05). In the placebo group there was no objective change in colour but the subjects reported an increase in satisfaction and dental self-confidence, as well as a decrease in psychological impact (p < 0.05). Self-esteem did not have a moderation nor a mediation effect. In conclusion, patients are not able to accurately detect the colour change induced by tooth whitening after 1 week, but they are also largely suggestible when evaluating the changes in quality of life. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem.ClinicalTrials.gov Identifier NCT03380702.

Difference and Commonness Among CLP, NON-CLP Patients and Their Parents Seeking for Orthodontic Treatment: A Questionnaire Applying Q Methodology to Investigate Motives

PURPOSE

Based on Q methodology, this study investigated the motivation of orthodontic treatment for patients and their parents. Through investigation, this paper attempts to explore the motivational factors of CLP and NON-CLP children and their parents, which are different or general.

PATIENTS AND METHODS

Q methodology involves 4 phases. (1) Interviews of CLP (N=5), NON-CLP (N=5) patients generated 30 statements (Q-set 1) and CLP (N=5), NON-CLP (N=5) patients' parents produced 36 statements (Q-set 2) about different reasons to pursue orthodontic care. (2) P-set: recruitment participants. The sample comprised 40 CLP patients (G1) and 40 NON-CLP patients (G2) aged 9-16 years, 40 CLP patients' parents (G3) and 40 NON-CLP patients' parents (G4) wanting their children to have orthodontic treatment. (3) Q-sort: 4 groups ranked statements in order of comparative significance using enforced distribution grids (G1, G2 ranked Q-set 1; G3, G4 ranked Q-set 2). (4) Analysis: using the PQMehtod 2.35 vision to analyze data.

RESULTS

Three factors in each group were identified as representing the most widespread views of the majority of the participants, described as G1: (1) aesthetics, (2) preparation for other oral treatments, (3) timely. G2: (1) admiration of others, aesthetics, (2) oral function, (3) oral hygiene and improvement of smile. G3: (1) worrying about the future of children, parents' responsibilities, children's feelings; (2) mental health, timely; (3) parents' responsibilities, ready for treatment. G4: (1) aesthetics, children's will; (2) future problems, timely; (3) timely, parents' responsibility and no need to worry about physical problems.

CONCLUSION

CLP and NON-CLP patients and parents have different orthodontic treatment motives, yet, they still shared 3 global motivation themes, respectively. Consideration of these motives may help clinicians develop their treatment discussions with patients and parents, which could consequently improve their cooperation and may achieve a more satisfactory outcome.

Common dental diseases in children and malocclusion

Malocclusion is a worldwide dental problem that influences the affected individuals to varying degrees. Many factors contribute to the anomaly in dentition, including hereditary and environmental aspects. Dental caries, pulpal and periapical lesions, dental trauma, abnormality of development, and oral habits are most common dental diseases in children that strongly relate to malocclusion. Management of oral health in the early childhood stage is carried out in clinic work of pediatric dentistry to minimize the unwanted effect of these diseases on dentition. This article highlights these diseases and their impacts on malocclusion in sequence. Prevention, treatment, and management of these conditions are also illustrated in order to achieve successful oral health for children and adolescents, even for their adult stage.

Effect of malocclusion on the self-esteem of adolescents

INTRODUCTION:

Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment.

OBJECTIVES:

This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships.

MATERIALS AND METHODS:

Adolescent students aged 12–19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN.

RESULTS:

The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference (P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem (P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem.

CONCLUSIONS:

The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects.

Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP.This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA.Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively.The MAD treatment resulted in a significant reduction in apnea-hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA.These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP.

Children's perceptions of smile esthetics and their influence on social judgment

OBJECTIVE

To define a threshold of acceptance of smile esthetics for children and adolescents.

MATERIALS AND METHODS

A systematic search in the medical literature (PubMed, PubMed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical Trials, Web of Knowledge, Scopus, Google Scholar, and LILACs) was performed to identify all peer-reviewed papers reporting data regarding the evaluation of children's and adolescents' perceptions of dental esthetic factors. The search was conducted using a research strategy based on keywords such as "children," "adolescents," "smile aesthetics perception," "smile aesthetics evaluation." Studies analyzing smile esthetics involving at least 10 observers younger than 18 years of age were selected.

RESULTS

Among the 1667 analyzed articles, five studies were selected for the final review process. No study included in the review analyzed perception of smile anomalies in a quantitative or qualitative way, thus no threshold was identified for smile features. Among the analyzed samples, unaltered smiles were always significantly associated with better evaluation scores when compared with altered smiles.

CONCLUSIONS

Smile esthetics influence social perception during childhood and adolescence. However, thresholds of smile esthetic acceptance in children and adolescents are still not available.

Orthodontic Treatment of Malocclusion and its Impact on Oral Health-Related Quality of Life

Objectives:

Malocclusion, though not life-threatening, has vast impact on individual’s social interactions and self-esteem. Therefore, the aim of the current study was to assess whether orthodontic treatment of adolescents with malocclusion had any association with their oral health-related quality of life (OHRQoL).

Methods:

The subjects for this study were recruited at a state-funded university clinic. Data were collected from 100 participants aged 17 to 21 with moderate to severe malocclusion. Experimental group comprised of 50 subjects who were in the retention phase of their orthodontic treatment and the control group comprised of 50 untreated subjects. The shortened version of the Oral Health Impacts Profile (OHIP-14) as used to assess the subjects’ oral health-related impact. T-test, Kruskal-Wallis, and Mann Whitney tests were used to analyze the data and p-value was set at P < 0.05.

Results:

In general, oral health-related quality of life of all subjects significantly improved after orthodontic treatment. (p<0.001) Subjects with moderate malocclusion showed better improvement than severe malocclusion subjects. (P<0.001)

Conclusion:

This study showed that oral health-related quality of life improves with the treatment of malocclusion.

Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives

OBJECTIVE

Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Untreated OSA may lead to a number of cardiovascular complications. Dentists may play an important role in OSA detection by conducting careful oral examinations. This study focused on the correlation of oral anatomical features in Thai patients who presented with OSA.

METHODS

We conducted a prospective comparative study at a sleep/hypertension clinic and a dental clinic at Khon Kaen University in Thailand. Patients with OSA were enrolled in the study, along with age-matched patients with non-OSA (controls). Baseline characteristics, clinical data, and oropharyngeal data of all patients were compared between the two groups. Oropharyngeal measurements included tongue size, torus mandibularis, Mallampati classification, palatal space, and lateral pharyngeal wall area. Multivariate logistic regression analysis was used to identify the factors associated with OSA.

RESULTS

During the study period, there were 156 patients who met the study criteria; 78 were patients with OSA and the other 78 were healthy control subjects. In the OSA group, there were 43 males with a mean age of 53 (standard deviation 12.29) years and a mean BMI of 30.86 kg/mm(2). There were 37 males in the control group with a mean age of 50 (standard deviation 12.04) years and a mean BMI of 24.03 kg/mm(2). According to multivariate logistic analysis, three factors were perfectly associated with OSA, including torus mandibularis class 6, narrow lateral pharyngeal wall, and Mallampati class 4. There were two other significant factors associated with having OSA, namely, BMI and Mallampati classification. The adjusted odds ratios (95% confidence interval) of these two factors were 1.445 (1.017, 2.052) and 5.040 (1.655, 15.358), respectively.

CONCLUSION

Dentists may play an important role in the detection of OSA in patients with high BMI through careful oropharyngeal examination in routine dental treatment. A large torus mandibularis, Mallampati class 4, and a narrow lateral pharyngeal wall are important anatomical risk factors for OSA.

Relationships among satisfaction, treatment motivation, and expectations in orthodontic patients: a prospective cohort study

BACKGROUND

Few research projects have looked at patient satisfaction with treatment outcome and factors contributing to satisfaction. The aim of this study was to examine treatment motivation and expectation associated with treatment-outcome satisfaction in a group of adolescent nonextraction orthodontic patients. We hypothesized that there would be significant correlations among treatment-outcome satisfaction, motivation, and expectations.

SUBJECTS AND METHODS

A sample of 120 patients who received orthodontic treatment at the Second Affiliated Hospital of Zhejiang University School of Medicine completed two questionnaires. Before treatment, questionnaire 1 was given to patients to assess treatment motivation and expectations. When treatment had been completed, questionnaire 2, concerning treatment satisfaction, was assessed. Spearman's rank correlation and regression analyses were used to assess the relationships among treatment satisfaction, expectations, and motivation.

RESULTS

A total of 110 patients completed the two questionnaires. There was a tendency toward significant correlations between treatment motivation and overall satisfaction with treatment (β-coefficient -0.264, 95% confidence interval -0.456 to 2.314; P<0.001). However, correlations among treatment motivation and satisfaction with changes made and satisfaction with one's appearance posttreatment were more fragmented. No relationship between treatment expectation and satisfaction was found (β-coefficient -0.126; 95% confidence interval -0.024 to 0.524; P>0.05).

CONCLUSION

Motivation was correlated with satisfaction with treatment outcome. Patients' expectations had no correlation with treatment satisfaction.

Preferences of color and lip position for facial attractiveness by laypersons and orthodontists

BACKGROUND

Previous studies have reported some evaluation methods about profiles, but so far, they have no consistent agreement on the esthetic profiles of color images. Thus, the aim of this study was to determine whether the judges have different preferences about the color of the photograph and lip position for esthetic profiles when comparing a Chinese boy and girl.

METHODS

The photographic records of a Chinese boy and girl with a good balanced profile were randomly selected. The images of the patients' profile were altered to produce silhouettes and black and white and color photographs (a total of six images). After evaluation by the judges, the best two photographs of the boy and girl were used to produce images of anterior-posterior lip positions with -6, -4, -2, 0, +2, +4, and +6 mm in relation to the esthetic plane, which was created by Ricketts. The judges were invited to enumerate the images in the order in which they considered the most attractive.

RESULTS

The chromophotograph was chosen as the best way to express the facial profile in both the boy and girl. The profiles with a deviation of -4 mm in the boy and a deviation of -2 mm in the girl from line E were considered as the most attractive, and the image with a deviation of +6 mm from the normal line E was considered the least attractive. There were statistically significant differences between the preferences of the profiles of the boy and girl; the same results were recorded in the variables educational background and clinic role of the judges.

CONCLUSION

The chromophotograph was considered as the best way to evaluate the esthetic profiles, and the judges preferred the boy with a concave profile than the concave profile of the girl.

Patients' acceptance of corticotomy-assisted orthodontics

OBJECTIVE

To study patients' acceptance of corticotomy-assisted orthodontics as a treatment option.

METHODS

Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown.

RESULTS

A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427).

CONCLUSION

The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient's level of education or sex.

Motivation of adult female patients seeking orthodontic treatment: an application of Q-methodology

BACKGROUND

Motivation is the impetus for patients to seek orthodontic treatment, affecting adherence, treatment outcomes, and satisfaction. The aim of this study was to assess the motivation of adult female patients seeking orthodontic treatment, and classify the patients according to their motivations.

METHODS

This study used Q-methodology as the main tool. Q-samples were collected and categorized (35 items). Forty-two adult female patients were interviewed before treatment as the P-sample, and their responses were categorized into the Q-methodology grid. Participants were asked to rank-order a set of 35 statements (Q-sample) from "agree most" to "disagree most" (Q-sorting). The finished Q-grids were analyzed using PQ method 2.35.

RESULTS

Four main factors were identified based on how adult female patients ranked statements: factor 1, patients who focus on their self-perception of their appearance; factor 2, patients who are concerned about the esthetics and function of their teeth; factor 3, patients who are easily influenced by others; factor 4, patients who want to improve their confidence and avoid negative thoughts caused by their teeth. The remaining patients who had other views did not match any of the above four groups.

CONCLUSION

The motivations of adult female patients seeking orthodontic treatment are complex. This study found that most adult female patients fell into one of four typical factor groups. Our findings may improve the adherence of adult female patients by developing a more ideal treatment program.

Malocclusion in elementary school children in beirut: severity and related social/behavioral factors

Aim. To assess severity of malocclusion in Lebanese elementary school children and the relationship between components of malocclusion and sociodemographic and behavioral factors. Methods. Dental screening was performed on 655 school children aged 6-11 from 2 public (PB) and 5 private (PV) schools in Beirut. A calibrated examiner recorded occlusion, overjet, overbite, posterior crossbite, midline diastema, and crowding. Another examiner determined the DMFT (Decayed/Missing/Filled Teeth) score. A questionnaire filled by the parents provided data on sociodemographic and behavioral factors. Multinomial, binomial, and multiple linear regressions tested the association of these factors with occlusal indices. Results. Malocclusion was more severe in PB students. Age and sucking habit were associated with various components of malocclusion. Crowding was more prevalent among males and significantly associated with the DMFT score. Income and educational level were significantly higher (P < 0.05) in PV pupils and deleterious habits were more frequent in PB children. Conclusions. Children of lower socioeconomic background had more severe malocclusions and poorer general dental health. Compared to Western and WHO norms, the findings prompt health policy suggestions to improve dental care of particularly public school children through regular screenings in schools, prevention methods when applicable, and cost effective practices through public and private enabling agencies.

Acute effects of single and multiple level thoracic manipulations on chronic mechanical neck pain: a randomized controlled trial

BACKGROUND

Thoracic spine manipulation has become a popular alternative to local cervical manipulative therapy for mechanical neck pain. This study investigated the acute effects of single-level and multiple-level thoracic manipulations on chronic mechanical neck pain (CMNP).

METHODS

Forty-eight patients with CMNP were randomly allocated to single-level thoracic manipulation (STM) at T6-T7 or multiple-level thoracic manipulation (MTM), or to a control group (prone lying). Cervical range of motion (CROM), visual analog scale (VAS), and the Thai version of the Neck Disability Index (NDI-TH) scores were measured at baseline, and at 24-hour and at 1-week follow-up.

RESULTS

At 24-hour and 1-week follow-up, neck disability and pain levels were significantly (P<0.05) improved in the STM and MTM groups compared with the control group. CROM in flexion and left lateral flexion were increased significantly (P<0.05) in the STM group when compared with the control group at 1-week follow-up. The CROM in right rotation was increased significantly after MTM compared to the control group (P<0.05) at 24-hour follow-up. There were no statistically significant differences in neck disability, pain level at rest, and CROM between the STM and MTM groups.

CONCLUSION

These results suggest that both single-level and multiple-level thoracic manipulation improve neck disability, pain levels, and CROM at 24-hour and 1-week follow-up in patients with CMNP.

A feasible method to improve adherence of Hawley retainer in adolescent orthodontic patients: a randomized controlled trial

BACKGROUND

Retention is an important component of orthodontic treatment; however, poor compliance with retainer use is often encountered, especially in adolescents. The purpose of this study was to prove the hypothesis that verbal instructions combined with images showing the severe consequences of poor compliance can increase retainer use.

METHODS

This study was a randomized controlled trial. The sample was recruited from Wenzhou, People's Republic of China, between February 2013 and May 2014, and 326 participants were randomized into three groups. Patients and parents in Group A (n=106) were given routine retainer wear instructions only; in Group B (n=111), images illustrating the severe consequences of poor compliance with Hawley retainer use were shown to patients, combined with routine instructions; and in Group C (n=109), images illustrating the severe consequences of poor compliance with Hawley retainer use were shown to patients and parents, combined with routine instructions. Three months after debonding, questionnaires were used to investigate daily wear time and the reasons for poor compliance. Differences in means between the groups were tested by one-way analysis of variance.

RESULTS

The mean daily wear time in Group C (15.09±4.13 hours) was significantly greater than in Group A (12.37±4.58 hours, P<0.01) or Group B (13.50±4.22 hours, P<0.05); the mean daily wear time in Group B was greater than in Group A, but was not significant (P=0.67). Reasons for nonusage were forgetting to wear the retainer (51%) and finding the retainer bothersome to frequently insert and remove (42%).

CONCLUSION

Verbal instructions combined with images showing the severe consequences of poor compliance can increase retainer use. Parents play an important role in compliance with retainer use in adolescent patients.

Quantification of wear-time adherence of removable appliances in young orthodontic patients in relation to their BMI: a preliminary study

PURPOSE

The relationship between unhealthy body mass index (BMI) and adherence to orthodontic treatment with removable appliances has not previously been evaluated.

OBJECTIVE

The aim of this study was to quantify the association between BMI and wear time of removable orthodontic appliances and to evaluate BMI changes during orthodontic treatment.

PATIENTS AND METHODS

Fifty-three normal-weight and 39 overweight/obese children and adolescents (7-15 years old) undergoing orthodontic treatment with removable appliances were enrolled into the study. BMI categories were determined using standardized age-specific and sex-specific BMI criteria, using data measured at the beginning of therapy and once during orthodontic treatment. Wear times of removable appliances were measured at 15-minute intervals over a period of 5 months using implanted microelectronic sensors. Median wear-time values were used in the analysis with the Mann-Whitney U-test used to test statistical differences between groups.

RESULTS

The median wear time of removable orthodontic appliances was 9.3 hours for normal-weight patients and 9.2 hours for overweight/obese patients. No statistically significant (P>0.05) or clinically relevant differences in usage or adherence were detected between normal-weight and overweight/obese patients. BMI did not influence wear time or behavior of removable orthodontic appliances by young patients. The majority of patients showed qualitative decreases in BMI during therapy.

CONCLUSION

The orthodontic treatment of young patients with removable devices does not require BMI-dependent changes in the treatment strategy. However, the use of removable appliances during meal times raises the possibility of reducing food intake, and in this way the orthodontist may have an active role to play in weight reduction.

Association of orthodontic treatment needs and oral health-related quality of life in Saudi children seeking orthodontic treatment

INTRODUCTION

The objective was to assess the effects of different orthodontic treatment needs on the oral health-related quality of life (OHRQoL) of Saudi children seeking orthodontic treatment as perceived by the children and their parents.

METHODS

A cross-sectional evaluation of orthodontic patients and their attending parents was conducted to assess the relationship between orthodontic treatment needs and the OHRQoL. The study sample comprised 120 young orthodontic patients (36 boys, 84 girls; age range, 12-15 years). Each participant was assessed for orthodontic treatment needs and OHRQoL using the Dental Health Component of the Index of Orthodontic Treatment Needs and the Michigan Oral Health-related Quality of Life Scales-Version C (child) and Version PG (parent/guardian), respectively.

RESULTS

Orthodontic treatment needs significantly affected mouth aching, chewing and biting, going to school, and playing. Higher income and borderline index of orthodontic treatment needs are significantly related to oral health impact on quality of life perceived by the child, while younger age and high school education are related to oral health impact on quality of life as perceived by the parent/guardians.

CONCLUSION

These findings emphasize the impact of malocclusion on OHRQoL in children.