Orthodontic treatment need and demand in Senegalese school children aged 12-13 years. An appraisal using IOTN and ICON

Comparison of treatment outcomes as assessed by 3 indexes in subjects with Class I malocclusion treated by 3 different methods: A cross-sectional study

INTRODUCTION

Various treatment modalities exist to improve and correct Class I malocclusion. This study was conducted to evaluate the outcomes of nonextraction (NE), premolar extraction (PME), and mandibular incisor extraction (MIE) treatment modalities in subjects presenting with Class I malocclusion.

METHODS

A cross-sectional study was conducted at a tertiary care hospital using pretreatment and posttreatment dental casts along with intraoral photographs of 90 orthodontic subjects. These subjects were divided equally into NE, PME, and MIE groups and scored using the Index of Orthodontic Treatment Need, Index of Complexity, Outcome, and Need (ICON), and peer assessment rating (PAR) indexes. Nonparametric tests were run to compare pretreatment and posttreatment scores and to evaluate the percentage and categorical changes for the treatment modalities. Pairwise comparisons were performed using the Mann-Whitney U test.

RESULTS

Statistically significant differences (P ≤0.001) were seen between the pretreatment and posttreatment scores for all modalities. Statistically significant improvements were seen between the 3 treatment modalities for the PAR (P = 0.010) and ICON (P = 0.003) indexes. Significant categorical improvements were found for the Aesthetic Component (AC) (P = 0.012) among the 3 groups. Pairwise comparison revealed significant differences between the NE and MIE groups (ICON, P = 0.001; AC, P = 0.018) and PME and MIE groups (PAR, P = 0.002; ICON, P = 0.007; AC, P = 0.007).

CONCLUSIONS

Posttreatment scores of all indexes were reduced, with significant differences found among the treatment modalities for all except the Dental Health Component index. The pairwise comparison revealed suboptimal occlusal results with the MIE group. Good occlusal and esthetic treatment outcomes were achieved with the PME and NE groups.

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain)

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010.

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

BACKGROUND

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

AIM

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Quality control in the orthodontic department of a Tertiary Military Dental Centre: A decade clinical audit

Background

The objective of the study was to analyze the quality control of the treatment within the orthodontic department by determining the workload, type of treatment, and quality of outcome.

Method

Two hundred eighty patients were selected from departmental archives, who underwent orthodontic treatment since January 2010 and assessed using index of complexity, outcome and treatment need. Descriptive statistics was performed by SPSS, version 21 (IBM, USA). Mann-Whitney U test was applied to assess the difference between complexity and improvement grade.

Result

Orthodontic treatment was provided to 56.43% of female and 43.57% male patients with a mean age of 16.91 years. Angle's class I type malocclusion was the highest with 35.71%. Preadjusted edgewise metal appliance with 95% dominated the mechanics. About 12.14% and 3.57% patients got benefited with myofunctional and orthopedic treatment, respectively. Ten percent of patients were treated with orthognathic surgery. The mean duration of treatment was 31.19 months with a range of minimum of 17 months to a maximum of 46 months. Among 87.14% patients treated by faculty, 47.95% had difficult complexity grading and 22.95% had very difficult complexity grading. Residents had provided treatment with 63.88% difficult and 19.44% very difficult grade. Mann-Whitney U test of overall complexity and improvement grade showed Z score of -9.25715 which was highly significant.

Conclusion

The present study concludes that fair quality control is being maintained by the department considering the number of patients, its severity, and excellent outcomes. However, being the premier institute of Indian Armed Forces, regular clinical audit should be conducted to fulfill demand and supply ratio in appropriation.

Comparison of perceptions on the dental aesthetics of different malocclusions between orthodontists and schoolchildren

OBJECTIVES

To compare perceptions on dental aesthetics of various malocclusions between schoolchildren and orthodontists with an orthodontic assessment of treatment needs.

METHODS

The prospective study was conducted between late March-December in 2017. A total of 32 orthodontists practicing in Shenyang, China and 116 schoolchildren (59 boys and 57 girls) aged 10-12 years (average= 11±0.60 years) from a 645 individual representing the population were selected via random sampling from a private primary school. Participants were questioned to assess 6 anterior dental photographs representing a variety degrees of aesthetic impairments, namely, reverse overjet (ROJ), anterior dental diastema and anterior open bite (OB) malocclusions.

RESULTS

Perceptions on dental aesthetics were identical among genders (p more than 0.05). Compared with the orthodontists, schoolchildren perceived significantly greater aesthetic impairment for severe anterior OB and severe ROJ, mild anterior OB malocclusions (p less than 0.01). Anterior dental diastemas were evaluated based on least aesthetic impairment and with no significant difference in perception between schoolchildren and orthodontists.

CONCLUSION

Schoolchildren perceived greater aesthetic impairment in severe anterior OB, severe ROJ, and mild anterior OB malocclusions than orthodontists. Median aesthetic components (AC) scores of schoolchildren for severe anterior OB and severe ROJ malocclusions corresponded with the category of "definite need" for treatment.

Prevalence of Need of Orthodontic Treatment in 7-16-Year-Old School Children in Udaipur City, India

Objective

The study aimed to estimate the need of orthodontic treatment in 7-16-year-old school children in Udaipur city, India.

Methods

This cross sectional study enrolled 1029 subjects (661 males and 368 females) belonging to Udaipur city, Rajasthan, India. Subjects who had not undergone orthodontic treatment were randomly selected. The need for orthodontic treatment was assessed using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN) by the same calibrated examiner. Collected data were quantitatively analyzed, and the difference pertaining to prevalence between males and females was measured using the chi-square test.

Results

A Grade 1 IOTN score was observed in 48.4% of the population. Grade 2 was observed in 22.9% of the population. A significant difference was noted for the prevalence of Grades 1, 2, and 3 between male and female children, with male children showing greater prevalence of malocclusion grades. Grades 4 and 5, which were noted less frequently, did not show a significant difference with respect to sex.

Conclusion

A higher percentage of the sample required moderate orthodontic treatment. This necessitates proper education and motivation to undergo orthodontic treatment.

Normative need for orthodontic treatment and perception of the need for such treatment among Brazilian adolescents

Objective:

The aim of the present study was to evaluate the normative need for orthodontic treatment and the perception of such need among students aged 11-14 years.

Methods:

A cross-sectional study was conducted with a sample of 346 students, randomly selected from public and private schools. The Dental Aesthetic Index (DAI) was used to evaluate the normative need for orthodontic treatment (NNOT). The perceived need for treatment among students was assessed by a previously validated questionnaire. Data was analyzed by Pearson’s Chi-squared test (α = 5%).

Results:

The prevalence of malocclusion and NNOT was 65.6%. Of the sample, 73.7% felt they needed treatment, 66.2% wanted orthodontic treatment and 62.7% were satisfied with their dental aesthetics. A statistically significant association was observed between NNOT and the perception of the need for treatment among the students (p < 0.001).

Conclusion:

The present study demonstrated a high prevalence of malocclusion, which was reflected in the high normative need for orthodontic treatment. The opinion of patients regarding their expectations of orthodontic treatment should be valued. The students perceived a need for orthodontic treatment.

Association between maternal education and malocclusion in Mongolian adolescents: a cross-sectional study

OBJECTIVE

Malocclusion is a highly prevalent condition, affecting 20-60% of adolescents worldwide. Although its treatment is often expensive and unaffordable for disadvantaged individuals, few studies have examined the relationship between malocclusion and socioeconomic status. We investigated the prevalence of malocclusion among Mongolian adolescents and its association with maternal education in a community-based sample in Mongolia.

DESIGN

Cross-sectional study.

SETTINGS

2 large secondary schools with different backgrounds in Ulaanbaatar, Mongolia.

PARTICIPANTS

Complete dental casts of 557 randomly recruited Mongolian schoolchildren aged 11-16 years were evaluated using the Dental Health Component of the Index of Orthodontic Treatment Need to dichotomise orthodontic treatment requirements. Exclusion criteria were the presence of orthodontic treatment history and absence of maternal educational status. Questionnaires were administered to caregivers to assess socioeconomic status. Poisson regression analysis was performed to examine the association between malocclusion and maternal educational status.

RESULTS

The prevalence of malocclusion requiring orthodontic treatment among all adolescents was 35.2% (95% CI 31.2 to 39.2). In the unadjusted analysis, the prevalence ratio (PR) for malocclusion was higher (PR=1.46; 95% CI 0.96 to 2.20) among adolescents of mothers with a high educational background than among those of mothers with a low educational background. After adjusting for covariates, the PR remained significantly higher (PR=1.72; 95% CI 1.06 to 2.82) among adolescents of mothers with a high educational background. Other socioeconomic status variables, including family income and the educational level of the father, showed no association with malocclusion.

CONCLUSIONS

These findings suggest that malocclusion requiring orthodontic treatment in adolescents is more prevalent among children of mothers with high levels of education. Further studies are needed to clarify the behavioural factors and environmental circumstance that contribute to this.

Association between normative and self-perceived orthodontic treatment need in a Lebanese population

The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150 subjects (81 males and 69 females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need.

The Need for Orthodontic Treatment among Vietnamese School Children and Young Adults

Objective. The aim of this study was to evaluate the need for orthodontic treatment among 12-year-old school children and 18-year-olds from Da Nang, Vietnam. Basic Research Design. A random representative sample of 200 12-year-old children from primary schools in Da Nang city was gathered. In addition, 200 18-year-old students were randomly selected from among the 4000 students studying at Da Nang University of Medical Technology and Pharmacy, Vietnam. All the subjects were evaluated according to Angle's molar relationship, the presence of malocclusion, and the components of the Index of Orthodontic Treatment Need (Dental Health Component, DHC, and Aesthetic Component, AC). Results. The DHC of index of orthodontic treatment need (IOTN) for 12-year-olds was in 60% of cases no or little, in 21% of cases moderate, and in 19% of cases definitive, while the prevalence of moderate and definitive need for treatment among the 18-year-olds was 24% and 30.5%, respectively. The prevalence of class III malocclusion, contact point displacement, and crossbite was higher in 18-year-olds than among the 12-year-olds, while the prevalence of increased overjet and increased overbite had decreased in 18-year-olds compared to the group of 12-year-olds. Conclusions. There is a strong need for orthodontic treatment in Vietnam's population. The need for orthodontic treatment was determined by contact point displacement, crossbite, increased overjet, and increased overbite.

Prevalence of malocclusion and orthodontic treatment need in schoolchildren - An epidemiological study

BACKGROUND

To ascertain the prevalence of malocclusion and orthodontic treatment need in schoolchildren dependent on armed forces personnel. To review the overall oral health using DMFT index and to evaluate any relation between increased DMFT index to existing orthodontic problems.

METHOD

Five schools were randomly selected among Army/KV/AF schools and a random sample of 1200 children aged 10-15 years old attending these schools dependant on armed forces personnel were selected. A survey form was filled up after the examination of children by the principal worker and need for orthodontic treatment was assessed using index for orthodontic treatment need (IOTN) and overall oral health status by DMFT index and totaled. Frontal intra oral photograph in centric occlusion were taken. Dental Health Component (DHC) of IOTN for all the patients was marked by one set of orthodontists. The most severe occlusal trait was identified by the examiner for any particular patient and the patient was then categorized according to this most severe trait. AC of the IOTN was assessed by second orthodontist, individual and a layperson.

RESULTS

It was observed that prevalence of malocclusion in the sample was 53.7%. 32.8% (239 males & 154 females) of samples are in need of orthodontic treatment. 55.1% of samples shown no caries risk, 38.1% had moderate caries risk and 6.8% had high caries risk.

CONCLUSION

Significant percentage of the samples are in need for orthodontic treatment. There is significant relation between higher DMFT index and orthodontic treatment need. It was found that IOTN is a reliable and user-friendly index, which can be used for orthodontic surveys.

Prevalence of malocclusions, oral habits and orthodontic treatment need in a 7- to 15-year-old schoolchildren population in Tirana

Background

The aim of present study was to determine the prevalence of malocclusions, oral habits and the need for orthodontic treatment in a sample of 7- to 15-year-old Albanese schoolchildren.

Methods

The final sample comprised 2,617 subjects (1,257 males and 1,360 females), all orthodontically untreated. Occlusal relationship and the functional analysis were recorded for all subjects. The prevalence rates for the dental health component of the index of orthodontic treatment need (IOTN) were calculated. Comparisons between genders were performed for the prevalence of malocclusions, oral habits and IOTN grades (chi-square tests).

Results

Class I, class II and class III malocclusions and asymmetries were observed in 40.4%, 29.2%, 3.2% and 27.1% of the sample, respectively. There were 2,108 subjects (80.6%) that showed oral habits, with females (82.1%) presenting with a greater prevalence rate than males (78.9%). The objective need for orthodontic treatment (grades 4 and 5 of IOTN) was registered in 1,077 subjects (41.2%). This prevalence rate is higher than those reported for other European countries. No significant differences between genders were found for the IOTN grades.

Conclusions

The findings of the present study revealed the need to improve public health plans for orthodontic prevention and screening and to organise the resources in this area in Albania.

Validity assessment and determination of the cutoff value for the Index of Complexity, Outcome and Need among 12-13 year-olds in Southern Chinese

To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12–13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98. The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12–13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need.

Self-Perception of Malocclusion Among Nigerian Adolescents Using The Aesthetic Component of The IOTN

Introduction:

The practice of orthodontics is very young in South-South Nigeria and there is need for base line data for informed planning. This study was carried out to investigate the self-perception of malocclusion among Nigerian school children aged 12 to 18 years in order to compare their perception with that of an orthodontist and also to determine the influence of gender and age on self-perception.

Materials and Methodology:

A total of 612 randomly selected schoolchildren comprising 299 (48.9%) males and 313 (51.1%) females with a mean age of 15 + 2.0 years were included in the study, the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was the instrument used to measure the perception of malocclusion by both the school children and the orthodontist.

Results:

Majority of the students (82.5%) rated their teeth towards the more attractive end of the scale (Grades 1-4). Although self - perception was not found to be related to gender, older children (16-18 years) had an increased level of perception of need. Males and older children were found to be more in need of treatment by the orthodontist.

Conclusions:

A significant difference was found between the orthodontist’s rating and the students’ ratings of the attractiveness of their occlusions. Age and gender were not found to influence self- perceived orthodontic treatment need. Therefore, for effective orthodontic care, self- perception and not only professional assessment must be taken into consideration when formulating treatment plans to ensure patient satisfaction.

Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region.

Perceptions of dental aesthetics of Class III and anterior open bite malocclusions: a comparison between 10- to 11-year-old schoolchildren and orthodontists

OBJECTIVE

To compare perceptions of dental aesthetics of Class III and anterior open bite (AOB) malocclusions between 10- to 11-year-old Birmingham schoolchildren and orthodontists.

MATERIALS AND METHODS

Thirty-one orthodontists practicing in Birmingham (UK) and 383 school children aged 10-11 years from a random and representative sample of seven primary schools in South Birmingham participated in the study. Participants were asked to assess five anterior photographs of the dentition representing varying degrees of aesthetic impairment of Class III and AOB malocclusions. Perceptions of dental aesthetics were determined using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN).

RESULTS

Perceptions of dental aesthetics were similar among males and females (P > .05). Both groups allocated the highest median AC score to the photo representing severe Class III malocclusion and the lowest to the photo representing mild Class III and AOB malocclusion. Differences in perceived dental aesthetics were significant for photos representing severe Class III and moderate AOB malocclusions, with orthodontists perceiving greater aesthetic impairment for severe Class III and schoolchildren for moderate AOB, respectively (P < .05).

CONCLUSIONS

Schoolchildren and orthodontists perceived Class III malocclusions to have greater aesthetic impairment compared to AOB malocclusions. Surprisingly, none of the median AC scores allocated to the five photos were in the "Definite need" for treatment category. The IOTN may not be sensitive to these types of malocclusions. This finding merits further investigation.

Orthodontic treatment need in a 12-year-old population in the Western Sahara

The aim of this study was to establish orthodontic treatment need according to the Dental Aesthetic Index (DAI) and Aesthetic Component (AC) and Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and to determine its association with gender among Saharan schoolchildren. The study was carried out in accordance with World Health Organization (WHO) recommendations for oral health surveys at 12 years of age. The sample comprised 248 Sahrawi children (135 girls and 113 boys) living in refugee camps in Tindouf, Algeria. None of the children had previously received any orthodontic treatment. A chi-square test was used to analyse the IOTN results by gender, and a Student's t-test was employed for the DAI results. The mean DAI was 23.32 with a standard deviation of 6.05, 4 percent with a very severe and 9.2 per cent with severe malocclusion. Orthodontic treatment need was 16.1 and 2.0 percent, respectively, according to grades 4 and 5 of the IOTN DHC, 13.7 percent according to the IOTN AC, and 28.6 percent according to the modified IOTN (IOTN DHC grades 4-5 and/or IOTN AC grades 8-10). There were no statistically significant differences by gender. The orthodontic treatment need of Western Saharan schoolchildren is similar to that reported by many recent studies in European and in Sub-Saharan countries.

[Reciprocal relationships between orthodontics and periodontics: relevance of a synergistic action]

The aim of this article is to review evidence on the reciprocal relationships between orthodontics and periodontics. Normal intra-arch and inter-arch relationships have long been considered as an anatomic prerequisite for the preservation of dental health and function. Certain malocclusion traits are associated with difficulties in maintaining good oral hygiene and as a consequence to poor periodontal condition. Therefore, proper alignment of the teeth provided by orthodontic treatment may promote good control of soft deposit and calculus and subsequent periodontal inflammation. The tendency of orthodontic appliances, particularly the brackets and bands to promote the accumulation of plaque and thus increasing the risk of developing localized periodontal disease must however be constantly emphasized. Periodontitis involves progressive loss of the alveolar bone around the teeth, pathological tooth migration and gingival recession with pathological tooth migration and gingival recession as a possible outcome. The effectiveness of orthodontics in conjunction with periodontics in the management of these esthetic and functional defects is highlighted in this review.