The prevalence of malocclusion and orthodontic treatment need of school children in Northern Saudi Arabia

An epidemiological study on early orthodontic treatment need among eastern Saudi Arabian children in the mixed dentition stage

Estimation of early orthodontic treatment need among children is essential for planning orthodontic interventions in the mixed dentition stages thereby reducing the burden in a publicly funded healthcare system. The present study aimed to assess the early orthodontic treatment need among children with mixed dentition in the Eastern Saudi Arabia. A descriptive cross-sectional study was conducted among Saudi children visiting the outpatient clinics in a University dental setting, and data were collected based on Index for preventive and interceptive orthodontic need (IPION). Descriptive statistics, chi-square test and Fisher's exact test were used for data analysis with statistical significance set at p < 0.05. The category of 'no treatment need' accounted for 11.3% while 'moderate treatment need' and 'definite treatment need' categories accounted for 29.3% and 59.4% respectively. There was no statistical difference between males and females in the distribution of the three categories of treatment need (p = 0.513). This study demonstrated a very high need for early orthodontic treatment among Saudi children in the mixed dentition stage. Emphasis should be placed on increased awareness and benefits of seeking early orthodontic treatment involving preventive and interceptive procedures in the mixed dentition.

Correlation Between Horizontal and Vertical Skeletal Components in Dental Malocclusions Among the Jazan Population

INTRODUCTION

The dentoskeletal morphology of various malocclusions has been analyzed in cephalometric studies. It is important to understand the vertical and horizontal components of orthodontic treatment. To provide accurate treatment, an orthodontist needs to understand the facial types of an individual. This study aims to evaluate a correlation between vertical and horizontal components of skeletal and dental malocclusion by assessing cephalometric radiographs of the population of Jazan province.

METHODS

The cephalometric radiographs of 267 eligible participants were assessed digitally. Fourteen skeletal and dental parameters were used to evaluate the association. Reliability was checked with the intra-class coefficient. Statistical analyses included descriptive statistics and Spearman's rho test. Statistical significance was set at P ≤ 0.05.

RESULTS

Correlations were found between anterior facial height (AFH), posterior facial height (PFH), FH ratio (Jarabak ratio), upper incisor to NA (U1-NA), lower incisor to NB (L1-NB), and upper incisor to the palatal plane (U1/PP). In dental class I, AFH (N-Me) had a strong positive correlation with L1-NB (0.300), U1/PP (0.164), and L1/MP (0.215). In dental class II, AFH negatively correlated with U1-NA (-0.735) and positively correlated with L1-NB (0.292), L1/MP (0.085), and U1-NA. PFH (S-Go) positively correlated with L1-NB (0.525) in class I but negatively correlated in class II. However, a negative relation was observed between all the vertical and horizontal components in class III.

CONCLUSION

This study suggests potential associations between vertical and horizontal components in developing skeletal and dental discrepancies.

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.

Gender Dimorphism of Skeletal Measurements and Dental Angle Classification in Orthodontic Patients

AIM

The present study aimed to evaluate gender dimorphism of the skeletal and dental angles and measurements among different types of malocclusions in the Population of Jizan, Kingdom of Saudi Arabia (KSA).

MATERIALS AND METHODS

Cephalometric data were retrieved from the archived records of 272 dental patients, comprising 134 males and 138 females. Skeletal and dental malocclusions in both the sub-groups were digitally studied.

STATISTICAL ANALYSIS

The measurement reliability was assessed using the intra-class correlation coefficient (ICC). Non-parametric Mann-Whitney U tests were performed to evaluate the difference in skeletal and dental parameters between genders. The Chi-square test was done to determine the difference in malocclusion patterns amongst the gender.

RESULTS

Statistical significance was noted in dental malocclusion (p-value = 0.003) and facial height, with females having a steeper mandible plan than males. The Sella-nasion-Nasion-Vertical line angles were reported high in females with no statistical significance. Linear cephalometric values were measured higher in males than females, whereas angular values and facial height parameters were lower in females than male.

CONCLUSION

Within the limitation of this study, it could be concluded that there is a prominent difference measured in facial profiles of males and females with higher facial height in males. Clinical significance and limitations: These clinical outcomes will help orthodontists to analyze the accurate base angles and points to draft proper treatment plans considering the variation in the profile of males and females.

Prevalence of Orthodontic Malocclusions in Healthy Children and Adolescents: A Systematic Review

The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents. Methods: The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias. Results: The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively. Conclusions: There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.

A Nation-wide Prevalence of Malocclusion Traits in Saudi Arabia: A Systematic Review

Objectives

The aim of this article is to establish a comprehensive nation-wide prevalence of malocclusion traits on the sagittal, vertical, and transverse planes of space in Saudi Arabia.

Materials and Methods

A systematic search was conducted in three databases (Medline via PubMed, Embase, and Web of Science) and complemented with a manual search of Google Scholar and the reference list of included studies. Original studies of Saudi Arabian healthy individuals at any age were included. The quality and the risk of bias of the included studies were assessed using the Joanna Briggs Institute's appraisal tool. The data about the selected malocclusion traits on the sagittal, vertical, and transverse planes of space were extracted and pooled.

Results

Out of 7163 identified titles, 11 studies were finally included. The risk of bias was high in two studies, moderate in eight studies, and low in one study. The studied age groups were from early childhood to late adulthood, with a total sample size of 19,169 participants. The majority of the studies recruited their sample from school/public sources, whereas the remaining three studies recruited their sample from dental (non-orthodontic) clinics.

Conclusions

Within the limitations of this study, pooled prevalence of Angle's Class I molar relation in Saudi Arabia was similar to other populations but Angle's Class II and Class III molar relations were lower and higher, respectively. These differences could be attributed to population-related differences in craniofacial morphology. Teeth crowding, teeth spacing, and midline shift, along with increased overjet and overbite, were among the most common malocclusion traits occurring in Saudi Arabia.

Malocclusion and occlusal traits among dental and nursing students of Seven North-East states of India

BACKGROUND

Any irregularity of the teeth or a mal-relationship of the dental arches is known as malocclusion. Among all the oro-facial problems, tooth decay is considered the most prevalent one followed by periodontal disease and dental malocclusion. Dental malocclusion is not a life-threatening condition. However, it is closely related to an individual's self-esteem and psychosocial wellbeing. The prevalence of malocclusion varies among different ethnic groups, age-groups, and gender.

OBJECTIVES

This study was conducted with the objective to find out the prevalence of normal occlusal traits and to identify the proportion of different types of malocclusions among dental and nursing students of Seven North-Eastern states studying at a tertiary care Medical Institute.

METHODS AND MATERIALS

This cross-sectional study included 432 students with a mean age of 21.42 years, who satisfied the inclusion criteria. Inclusion criteria consisted of the presence of all permanent teeth with or without third molars. The oral cavity was examined using a sterile mouth mirror and flashlight followed by evaluation of all the occlusal relationships in centric occlusion position (COP). COP was achieved by asking the participant to swallow, and then to bite on his or her teeth together. The occlusion traits were assessed as normal occlusion or malocclusion using the first permanent molars as described by E.H. Angle and deviation from line of occlusion. Descriptive statistics like mean and proportions were calculated.

RESULTS

The prevalence of normal occlusal traits was 48.4%, and that of malocclusion was 51.6%. Class I malocclusion was most prevalent occlusal trait followed by Class II malocclusion and Class III malocclusion showed the least prevalence.

CONCLUSIONS

Class I malocclusion was most prevalent followed by Class II malocclusion and Class III malocclusion showed the least prevalence.

Orthodontic treatment need and occlusal traits in the early mixed dentition among 8-9-year old Saudi children

Purpose

The present study aimed to assess the prevalence of occlusal traits and to evaluate the orthodontic treatment need among children aged 8-9 years in Al Ahsa, Eastern region of Saudi Arabia.

Materials and methods

A descriptive cross-sectional study was conducted among 282 Saudi children who were randomly selected from those visiting dental outpatient clinics at the College of dentistry in King Faisal University, AlAhsa. All the children were evaluated using the DHC and AC components of Index of Orthodontic Treatment Need (IOTN). Descriptive statistics, chisquare test and Fisher's Exact test were used for data analysis with statistical significance set at p< 0.05.

Results

The most prevalent malocclusal trait was crowding (39.7%) followed by increased overjet (28.4%). About 30.9% and 17% of the children were in definite need for orthodontic treatment according to DHC and AC of IOTN, respectively. There was no statistical difference in the distribution of DHC (p=0.116) and AC (p=0.177) scores between the gender.

Conclusion

This study demonstrated high percentage of malocclusal traits and orthodontic treatment need in the mixed dentition period among 8-9-year-old children in the Eastern region. Emphasis should be placed on early orthodontic screening and treatment in the mixed dentition stage of dental development.

Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study

Aim and objective

This study aimed to determine the prevalence of missing first permanent molars (FPMs) in the 7–29-year-old selected population of Al Ahsa, Saudi Arabia.

Materials and methods

This study retrospectively analyzed 398 panoramic radiographs of patients aged from 7 to 29 years old for missing FPM. Patients were divided into two age-groups: 7–15 and 16–29 years old. Study variables including gender, age, missing FPM, dental arch, and right or left sides of the arch were recorded. The data were statistically analyzed using Chi-square tests.

Results

Of the total study sample, 23.1% of patients had only one missing FPM, 13.3% of patients had two, and 2.8% of them had three missing FPM teeth. No patient had four missing FPM teeth. A total of 60.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (17.4%) and the left mandibular quadrant showed a higher rate of missing FPM (21.9%). No statistically significant association was seen between the missing FPM and the gender or age-group (p > 0.05).

Conclusion

The high prevalence rates of missing FPM in the study population warrants attention. Further prospective studies are needed to comprehensively evaluate the effect of early loss of the FPM on space changes in the arch and subsequent reduction in complex orthodontic treatment needs.

How to cite this article

Almugla YM. Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study. Int J Clin Pediatr Dent 2021;14(2):269–272.

A Comparison of Craniofacial Characteristics between Two Different Adult Populations with Class II Malocclusion-A Cross-Sectional Retrospective Study

Simple Summary

One of the most common orthodontic problems, Class II malocclusion, may lead to an increased risk of dentoalveolar trauma, psychosocial issues, and a possible compromised quality of life. Oftentimes clinicians use normative standard values to which each patient is compared to identify deviations from the norm, in order to determine a patient-specific treatment plan. Large inter-individual and inter-ethnic variability, however, is sometimes not considered. In our study, we compared the cephalometric characteristics between two different ethnic groups (South Indian and Vietnamese) with the phenotype of Class II malocclusion in the hope of better understanding this variation and its implications in treatment planning to achieve satisfactory outcomes.

Abstract

The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.

Estimation of the prevalence of malocclusion on the basis of nationwide oral health examinations of pre-adolescent and adolescent students during 2012-2017

Objective

To investigate the prevalence of malocclusion with respect to grade, sex, and year among Korean pre-adolescent and adolescent students during 2012–2017.

Methods

A total of 165,996 students (first grade [E1, 6–7 years of age], fourth grade [E4, 9–10 years], seventh grade [M1, 12–13 years], and tenth grade [H1, 15–16 years]) were selected by stratified sampling method and underwent the nationwide oral health examination performed by the Ministry of Education, Republic of Korea. The malocclusion assessments based on dentists’ judgments were “no malocclusion,” “needs orthodontic treatment (N-OTx),” and “under orthodontic treatment (U-OTx).” The sum of N-OTx and U-OTx cases was determined as the number of students with malocclusion. After analyzing the prevalence of malocclusion according to grade, sex, and year-by-year differences, Pearson correlation analyses and two-way analyses of variance were performed.

Results

The prevalence of malocclusion was 18.7%, which increased with the grades (E1 [8.3%] < E4 [15.8%] < M1 [22.9%] < H1 [25.3%], p < 0.001). However, there was no significant difference in the prevalence of malocclusion in each grade group for the period (p > 0.05) without significant correlation (E1, ρ = 0.129; E4, ρ = –0.495; M1, ρ = 0.406; H1, ρ = –0.383; all p > 0.05). The prevalence of malocclusion within each grade group over the six-year period was more prominent in the female (p < 0.0001).

Conclusions

Further studies are necessary to modify the malocclusion assessment method to account for specific types of malocclusion in pre-adolescent and adolescent students.