The prevalence of malocclusion traits in Saudi Arabia 2015–2019: An epidemiological cross sectional study

Prevalence of orthodontic treatment needs in permanent dentition in the population of Gulf Cooperation Council countries: A systematic review and meta-analysis of observational studies

The aim of this systematic review and meta-analysis was to comprehensively analyze the existing information on the prevalence of the need for orthodontic treatment in the permanent dentition stage among populations in Gulf Cooperation Council (GCC) countries. For observational studies in GCC countries, the key terms were electronically searched in Science Direct, PubMed, Embase, Cochrane Reviews, Google Scholar, and Sage databases (1990-2021). The bias risk for the selected studies was evaluated using the modified Strengthening the Reporting of Observational Studies in Epidemiology statement. Thirteen studies reported on the prevalence of orthodontic treatment needs among 33,134 children in GCC countries in permanent dentition with an age range of 11-19 years satisfied the inclusion criteria. Out of the 13 studies, 9 reported on the prevalence of malocclusion, 11 reported on the prevalence of occlusal traits, and 12 reported on the prevalence of orthodontic treatment needs as per the Dental Health Component (DHC) of Index of Orthodontic Treatment Need (IOTN), 4 reported as per both DHC and Aesthetic Component (AC) of IOTN, and 1 reported as per only AC of IOTN. Meta-analysis of the included studies indicated that the pooled malocclusion prevalence rate was 10.60% (confidence interval [CI] 95%: 0.093-0.076) with 8.58% Class I (CI 95%: 0.074-0.188), 2.09% Class II (CI 95%: 0.014-0.058), and 0.93% Class III (CI 95%: 0.005-0.018) malocclusions. The most prevalent type of occlusal trait was spacing (13.10%, CI 95%: 0.018-0.169), followed by crowding (4.96%, CI 95%: 0.017-0.091). The pooled prevalence of borderline and definite needs for orthodontic treatment based on DHC and AC of IOTN was 0.82% (CI 95%: 0.014-0.035), 1.13% (CI 95%: 0.011-0.091), 4.08% (CI 95%: 0.009-0.114), and 2.06% (CI 95%: 0.002-0.048), respectively. The findings were heterogeneous (P < 0.05). These findings indicated that the prevalence of malocclusion and orthodontic treatment needs was not high in the GCC population.

Towards Genetic Dissection of Skeletal Class III Malocclusion: A Review of Genetic Variations Underlying the Phenotype in Humans and Future Directions

INTRODUCTION

Skeletal abnormalities and malocclusions have varied features that impact populations globally, impairing aesthetics and lowering life quality. The prevalence of the Skeletal Class III disease is the lowest among all angle malocclusions, with varied prevalence across nations. Environmental, genetic, and societal factors play a role in its numerous etiologies. In this study, we conducted a thorough search across the published data relating to quantitative trait loci (QTL) and the genes associated with Class III progression in humans, discussed these findings and their limitations, and proposed future directions and strategies for studying this phenotype.

METHODS

An inclusive search of published papers in the PubMed and Google Scholar search engines using the following terms: 1. Human skeletal Class III; 2. Genetics of Human skeletal Class III; 3. QTL mapping and gene associated with human skeletal Class III; 4. enriched skeletal Class-III-malocclusion-associated pathways.

RESULTS

Our search has found 53 genes linked with skeletal Class III malocclusion reported in humans, genes associated with epigenetics and phenomena, and the top 20 enriched pathways associated with skeletal Class III malocclusion.

CONCLUSIONS

The human investigations yielded some contentious conclusions. We conducted a genome-wide association study (GWAS), an epigenetics-wide association study (EWAS), RNA-seq analysis, integrating GWAS and expression quantitative trait loci (eQTL), micro- and small-RNA, and long non-coding RNA analysis in tissues connected to skeletal Class III malocclusion phenotype in tissues connected with the skeletal phenotype. Finally, we invite regional, national, and international orthodontists and surgeons to join this effort by contributing human samples with skeletal Class III malocclusion following the accepted Helsinki ethical protocol to challenge these phenomena jointly.

Knowledge and Perception of Orthodontic Treatment among General and Non-Orthodontic Dental Specialists: A Comparative Study

The objective of this study is to discover any possible association of gender or practitioner classification with orthodontic knowledge and attitudes towards orthodontic treatment. Descriptive cross-sectional research was conducted on two groups of dentists in the Ha'il region of Saudi Arabia. Group I included general practitioners, while Group II had non-orthodontic specialists. The findings suggest a statistically significant (p < 0.05) difference between the knowledge and attitudes of general practitioners and non-orthodontic specialists. Independent two tailed t-scores for difference in Knowledge (t-score = 3.19919, p = 0.003) and Attitude (t-score = 2.16314, p = 0.048319), highlight significant disparities in the knowledge and attitudes of general practitioners and non-orthodontic specialists. However, no statistically significant difference was observed in terms of knowledge and attitudes based on gender differences. This study captures and highlights subtle information that is very significant in dealing with critically important orthodontics issues. The study suggests that it is possible that a non-orthodontic specialist may suggest an altogether different line of treatment with different consequences when compared to a general practitioner and vice versa. This may result in unwanted, permanent orthodontic effects, highlighting the significance of the early stage of orthodontic treatment awareness. This research reveals disparities between the perceptions of general practitioners and non-orthodontic specialists about the stage and relevance of orthodontic treatment. It is strongly advised to see an orthodontic expert rather than a general practitioner or non-orthodontic specialist for orthodontic issues.

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 anterior open bite in children and adolescents: a systematic review and meta-analysis

PURPOSE

Anterior open bite is defined by the lack of incisal contact between the teeth in centric relation. The aim of this study was to determine the prevalence of anterior open in children and adolescents.

METHODS

This systematic review included a search in the databases: PubMed, Scopus, Web of Science, LILACS, Google Scholar, and ProQuest. The acronym PECOS was considered: (P) children and adolescents, (E) presence of anterior open bite, (C) not applicable, (O) prevalence, and (S) observational studies. The risk of bias assessment was carried out using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The prevalence meta-analyses were performed using MedCalc^® software. The certainty of the evidence was determined with the GRADE approach.

RESULTS

26 studies were included. Eleven studies were judged at low, seven at moderate, and eight at high risk of bias. The overall prevalence of anterior open bite was 16.52% (95% CI 12.34-21.17) in children and adolescents. The prevalence was 19.38% (95% CI 13.77-25.69) in South America. The prevalence of anterior open bite was 22.67% (95% CI 16.56-29.43) among females and 16.99% (95% CI 11.77-22.94) among males. The prevalence of anterior open bite was 18.84% (95% CI 13.88-24.38) in the primary dentition, and 14.26% (95% CI 7.67-22.46) in the mixed dentition. The overall certainty of the evidence was very low.

CONCLUSION

The overall prevalence of anterior open bite was 16.52% in children and adolescents aged 2-16 years. Giving the limitations of a prevalence meta-analysis, the extrapolation of the results should be cautious.

REGISTRATION NUMBER

CRD42020183162, 10 July 2020.

Oral Impacts Experienced by Orthodontic Patients Undergoing Fixed or Removable Appliances Therapy in Saudi Arabia: A Cross-Sectional Study

PURPOSE

The objective of this study is to compare the orthodontic patient's experiences with removable and fixed orthodontic appliances on daily activities, food consumption, and oral symptoms in Riyadh city, Saudi Arabia.

METHODS

This was a cross-sectional observational study carried out among orthodontic patients. A total of 150 adult patients, including 118 in the fixed orthodontic appliance group and 32 in the removable (Invisalign) orthodontic group, who met the inclusion criteria completed a validated and self-administered questionnaire. In addition, the study participants reported their experience in terms of daily routine, food consumption, and oral symptoms one week after appliance activation. Data were analyzed using the chi-square test and Fisher's exact tests for the categorical variables. In addition, Mann-Whitney U, Kruskal-Wallis, and Spearman's tests were also applied to the data.

RESULTS

The fixed orthodontic patients compared to the removable orthodontic cases showed significantly higher difficulty in sleeping (1.28±1.10 vs 0.94±0.88, p=0.024), sores on the tongue (0.97±1.00 vs 0.56±0.76, p=0.042) and cheeks (1.20±1.11 vs 0.72±0.81, p=0.027), and the presence of food debris under the appliance (1.53±1.16 vs.1.00±0.95, p=0.021). Moreover, the oral health impact score showed a significant positive correlation with the duration of the orthodontic treatment (r=0.339, p<0.001) and pain intensity (r=0.309, p<0.001).

CONCLUSION

The fixed orthodontic treatment compared to removable orthodontic treatment resulted in more severe pain, sleeping difficulty, sores on the tongue and cheeks, and food impaction after one week of appliance activation.