Effect of malocclusion on the self-esteem of adolescents

Malocclusion among patients at Agartala, Tripura, India

Malocclusion is the mal-relationship of dental arches with or without an irregularity of the teeth. Therefore, it is of interest to estimate the rate of occurrence of malocclusion within the population of Agartala city, Tripura, India. The study included 850 individuals ranging from 16 to 24 years of age, which were categorized into five distinct classifications, namely normal occlusion, Angle's Class I malocclusion, Class II Division 1, Class II Division 2, and Class III malocclusion. Data shows that normal occlusal alignment was observed in 29.41% of the participants, whereas a majority of 70.59% exhibited various forms of malocclusion among this population.

Evaluating the influence of dental aesthetics on psychosocial well-being and self-esteem among students of the University of Novi Sad, Serbia: a cross-sectional study

BACKGROUND

A person's smile has been identified as one of the first observed facial characteristics. Even minor deviations from societal beauty standards, especially among younger individuals, can have a negative effect on their self-esteem. The aim of this research is to evaluate the self-perceived psychosocial impact of dental aesthetics and self-esteem among respondents and their association, as well as to determine the main factors contributing to dissatisfaction with dental appearance.

METHODS

This research was conducted as a cross-sectional study that surveyed students of the University of Novi Sad. Other Universities and private faculties were excluded from participation. Data collection used standardized questionnaires measuring the Psychosocial Impact of Dental Aesthetics (PIDAQ) and the Rosenberg Self-Esteem Scale (RSES). Questionnaire (an online GoogleForms) was sent to the students via official Facebook groups of the faculties, student's e-mails and Instagram profiles. Data analysis included descriptive statistics, Students T-test, ANOVA, multiple linear regression analysis and Spearman coefficient. To test internal consistency, Cronbach's alpha(α) was calculated for the questionnaire as a whole (0,761) and each used questionnaire (PIDAQ - 0.766; RSES - 0.765). Cronbach's alpha(α) was also calculated for each domain from PIDAQ (DSC-0.946; SI-0.882; PI-0.953; AC-0.916).

RESULTS

The study involved 410 participants, predominantly female (80%), aged between 21 and 23 (45.4%), primarily in ther first academic year (21.5%), and with a grade point average between 8.01 and 9.00 (42.4%). Data analysis has shown a statistically significant difference in the total PIDAQ score and SI subdomain in relation to the academic year (total PIDAQ p = 0.025; SI p = 0.000). In terms of self-esteem, results of multiple linear regression analysis showed that the academic year (95%CI: 0.410-1.837; p = 0.002) and the average point grade (95%CI: -0.025-1.600; p = 0.047) were significant predictors of greater self-esteem. The Spearman coefficient value (r=-0.316, p < 0.001) confirmed a statistically significant negative correlation between PIDAQ and self-esteem. Only 34% of respondents expressed satisfaction with their teeth. Dissatisfaction about the smile was primarily attributed to the arrangement and positioning of their teeth (32.2%). Financial constraints were identified as the main barrier for seeking interventions to improve smile satisfaction (39.5%).

CONCLUSION

Students experiencing a greater psychosocial impact of dental aesthetics tended to exhibit lower self-esteem.

Prevalence and factors influencing bullying among Egyptian schoolchildren

OBJECTIVE

To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the need for orthodontic treatment and socioeconomic status.

DESIGN

A cross-sectional study.

SETTING

Low, middle and high socioeconomic-class schools in the same educational district in Cairo, Egypt.

PARTICIPANTS

A total of 324 Egyptian schoolchildren aged 11-14 years.

METHODS

Validated questionnaires were used to assess self-reported bullying frequency and intensity, self-esteem and OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to assess the orthodontic treatment need and the participants' occlusion was classified according to the British Standard Incisors (BSI) classification.

RESULTS

Bullying was found to be prevalent in 61.7% of the sample. Regression analysis revealed that participants with a Class II division 1 incisor relationship had the highest odds ratio (OR) for predicting bullying (OR = 1.86, 95% confidence interval [CI] = 1.38-2.15). Being bullied was significantly associated with lower self-esteem (OR = 0.47, 95% CI = 0.13-0.78), worse OHRQoL (OR = 2.73, 95% CI = 1.95-3.15) and a high need for orthodontic treatment, as determined by the IOTN Dental Health Component score (OR = 1.33, 95% CI = 1.05-1.95) and IOTN Aesthetic Component score (OR = 1.52, 95% CI = 1.12-1.88). Moreover, participants in high and middle socioeconomic-class groups had a lower OR for predicting bullying than those in the low socioeconomic-class group (OR = 0.27, 95% CI = 0.13-0.54).

CONCLUSION

The bullying prevalence among Egyptian schoolchildren aged 11-14 years was very high. The prevalence of bullying was higher in schoolchildren with higher orthodontic treatment need and Class II division 1 incisor relationship. Bullying was correlated to poor self-esteem as well as poor OHRQoL. In addition, low socioeconomic status was found to be a potential predictor for bullying.

Evaluation of the mandibular condyles trabecular structure in patients with severe class III pattern: a computed tomography (CT) fractal analysis study

Class III malocclusion is a combination of dental and skeletal disorders that causes discrepancies in occlusion. Malocclusion can affect the structure of the Temporomandibular joint (TMJ) resulting in many problems, one of which is affecting the internal structure of the bone. This study aimed to examine the morphological features of class III patients' trabecular structure of the mandibular condyle in comparison with normal class I individuals using fractal analysis (FA). To study the internal structure of the mandibular condyle bone, Computed Tomography (CT) scans of 45 severe class III patients (age: 16-46) who were the candidates for orthognathic surgery were selected and matched by age and sex with 45 normal class I individuals. The trabecular bone structure of the left and right mandibular condyles in three CT planes of the study group and control group were evaluated employing the FA. The result of the present study indicated that the fractal dimensions (FD) values of class III patients were lower than those of the normal class I individuals in axial (class I: 1.31 ± 0.02, class III: 1.28 ± 0.02), sagittal (class I: 1.25 ± 0.03, class III: 1.19 ± 0.08), and coronal (class I: 1.5 ± 0.06, class III: 1.45 ± 0.07) planes (P < 0.001). There were no significant differences between the FD values of the males and females. The intra-group evaluation revealed that there was no correlation between age and FD values. No evidence of laterality was found regarding the FD values of the right and left condyles. Given the noticeable differences between the FD values, it can be implied that severe class III malocclusion may affect the trabecular pattern of the cancellous bone of the mandibular condyle compared to class I individuals. Therefore, due to the altered trabecular structure, clinicians should be cautious when planning treatments for these patients.

Implications of Post-Traumatic Treatment of Immature Maxillary Incisors

The aim of this review was to discuss traumatic dental injuries in view of their treatment implications to provide an evidence-based resource for clinicians when planning treatment for traumatised immature maxillary incisors. Dental trauma to immature maxillary incisors can result in various complications, such as critical fractures, resorptions, or ankylosis, and might lead to tooth loss. Traumatised teeth may exhibit various unaesthetic discolourations as a result of different dental trauma sequelae or materials used for treatment. All of the above can influence patients' social experience, including self-esteem, confidence, eating and speaking abilities, as well as proper development and growth of the jaw bones. Treatment of traumatised immature incisors should focus not only on the acute phase but on the long-term consequences. Any time gained with the tooth in the jaw bone, free of infection, is an achievement, as it allows normal growth and development. All these aspects are discussed in this narrative review, and an evidence-based summary resource is suggested for clinicians to use when planning treatment for traumatised immature maxillary incisors.

Parents' Awareness of Malocclusion and Orthodontic Consultation for Their Children: A Cross-Sectional Study

Parents' awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children's orthodontic treatment. This cross-sectional study aims to investigate parents' awareness of malocclusion and orthodontic consultation of their children and the influence of parents' demographics on their awareness level. An electronic survey collected information about participants' demographics and awareness about malocclusion and orthodontic consultation of children. A total of 473 parents living in Jeddah, Saudi Arabia, participated in the study. The average awareness level among parents was moderate (3.09 ± 1.4). Male gender and unemployment were associated with low orthodontic awareness levels relative to moderate awareness (OR = 3.3, 95% CI = 1.8-5.8 and OR = 2.1, 95% CI = 1.1-3.8, respectively). Former or current orthodontic treatment was associated with high awareness levels (OR = 3.9, 95% CI = 2.4-6.5). There is still a need to raise the awareness of Saudi parents about malocclusion and orthodontic consultations for their children. Orthodontic awareness-raising campaigns should be designed to include fathers and parents with low socioeconomic status. The findings of this study also suggest that orthodontists can enhance their patient's awareness of malocclusion and orthodontic consultation for their children.

Statistical Study on the Motivation of Patients in the Pediatric Dentistry

Our statistical study included 344 participants selected from the patients of the Pedodontics–Orthodontics Discipline of the Tîrgu-Mureş University of Medicine and Pharmacy. The patients’ age was between 6 and 18 years, with an average of 13.70 and a standard deviation of 4.62. The study participants were informed and agreed to complete two questionnaires of our conception regarding their health status, oral hygiene, and motivation for pedodontics or orthodontic treatment. The results of the two questionnaires were interpreted according to the gender and age of the patients. Data processing was performed with NCSS/PASS Dawson Edition statistical software, using the CHI2 test, considering a p of less than 0.05 as significant for comparative results. Results showed that girls were more motivated than boys in addressing pedodontic services due to dental, periodontal, and articular problems. Children, aged between 11 and 14 years, were less intrinsically motivated to solve oral health problems due to their low frequency. The intrinsic motivation for a more beautiful dentition was very strong, regardless of age and sex. Girls were more intrinsically motivated for orthodontic treatment than boys. There was a linear increase together in the age of those who wanted to improve their smile and facial appearance. Children between 11 and 14 years had the best self-perception of the appearance of their teeth, mouth, smile, and facial harmony. The strongest extrinsic motivation for orthodontic treatment came from parents or another doctor. The most important reason for orthodontics was dental malpositions, the last one was the improvement of masticatory efficiency. The extrinsic motivation from parents for orthodontics decreases linearly with age, along with the increase in motivation from the person with whom the participants relate emotionally and from the group of friends.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents

BACKGROUND

The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria.

METHODS

This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem.

RESULTS

A significant correlation was found between self-esteem and self-perceived smile (r = 0.294; P < 0.001) and dental aesthetics (r = 0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem.

CONCLUSIONS

The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

The development of a guide to borderline orthodontic need

Objective

To produce a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (dental health component DHC 3) and to compare views of different panels of judges on treatment need.

Materials and methods

Prospective, observational study. Photographs of one hundred subjects displaying borderline occlusal traits (DHC3) were collected. Three panels of judges consisting of 25 orthodontists, 25 dentists and 25 lay persons assessed photographs based on orthodontic treatment need on aesthetic grounds.

Results

Spearman’s correlation coefficient showed no statistical difference between the panels of judges (p < 0.001). The judges identified a ‘high need’ for treatment on aesthetic grounds for those with anterior open bites and reverse overjets. Kappa analysis showed moderate intra-rater agreement for the orthodontic and dental panels of judges (k = 0.47 and 0.45, respectively) and fair agreement (k = 0.26) for the lay panel, highlighting the intrinsic difficulty of assessing borderline malocclusions.

Conclusion

There was no statistical difference in the way the orthodontic, dental and lay panels of judges perceived treatment need for DHC 3 cases. Anterior open bites and reverse overjets were predominantly found to be in high need of treatment by all panels of judges. A ‘Guide to Borderline Orthodontic Need’ (GBON) is proposed consisting of 8 photographs of subjects with borderline occlusal traits (DHC3) determined unambiguously by lay, dental and orthodontic panels as either ‘needing’ or ‘not needing’ orthodontic treatment on aesthetic grounds. It is anticipated that this will assist users to make judgments on aesthetic grounds on the need for treatment in borderline cases.

Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria

BACKGROUND

This study determined the association between mental health and risky oral health and sexual health behaviours.

METHODS

A household cross-sectional survey was conducted in Ile-Ife, Nigeria between December 2019 and January 2020. Data were collected from 10 to 19-year-old on the sociodemographic profile (age, sex at birth and socioeconomic status); mental health problems (psychological distress, depressive symptoms and suicidal ideation); and mental (smoking habit, consumption of alcohol, use of psychoactive substances), sexual (history of vaginal or anal sexual intercourse; transactional sex, multiple sex partners, use of condom at last sexual intercourse) and oral (frequency of daily tooth brushing, daily frequency of consumption of refined carbohydrate in-between-meals, frequency of use of dental floss, history of dental service utilization in the last 12 months and dental anxiety) health risk factors. Binary logistic regression analysis was conducted to determine the association between risky oral (neglecting to brush twice daily and frequent consumption of refined carbohydrates in-between-meals), and sexual (neglecting to use condoms during the last sex act and having multiple sex partners) health behaviours as outcome variables, and mental health status as the explanatory variables. An ordinal logistic regression model was also developed where the outcome variable was the number of risky health behaviours. The models were adjusted for the socio-demographic variables and history of dental service utilisation in the last 12 months of the survey.

RESULTS

High psychological distress was significantly associated with lower odds of frequent consumption of refined carbohydrates in-between-meals (AOR = 0.32; 95%CI 0.23, 0.47), and having multiple sex partners (AOR = 0.10; 95%CI 0.02, 0.57); but higher odds of having a higher number of risky behaviours (AOR = 3.04; 95%CI 2.13, 4.33). Having depressive symptoms was significantly associated with higher odds of neglecting to use condom at the last sexual intercourse (AOR = 7.20; 95%CI 1.94, 26.76) and having multiple partners (AOR = 95.43; 95%CI 24.55, 370.90). Suicidal ideation was significantly associated with lower odds of neglecting to use condom at the last sexual intercourse (AOR = 0.00; 95%CI 0.00, 0.00) and having multiple sex partners (AOR = 0.00; 95%CI 0.00, 0.00).

CONCLUSION

The associations between psychological distress and oral and sexual health risk behaviours in adolescents seem complex and need to be studied further.

Is the adolescent's esthetic concern associated with anterior occlusal conditions or the malocclusion severity level?

OBJECTIVES

To assess the esthetic impact of anterior occlusal conditions and malocclusion severity levels.

MATERIALS AND METHODS

A population-based cross-sectional study of 700 adolescents aged 15 to 19 years was conducted. The Oral Aesthetic Subjective Impact Scale (OASIS) was used to evaluate the subjective esthetic impact of malocclusion. The Dental Aesthetic Index (DAI) criteria were used to diagnose the anterior occlusal characteristics in isolation and the severity levels of malocclusion. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).

RESULTS

Of the adolescents, 42% showed negative self-perception of malocclusion. In addition, 15.4% of adolescents had severe malocclusion (DAI 3) and 18.9% very severe malocclusion (DAI 4). Crowding and spacing were shown to be 2.90 (CI: 2.06-4.09) and 2.53 (CI: 1.65-3.86) times, respectively, more likely to cause a negative esthetic impact in adolescents (P < .05). In addition, adolescents with orthodontic treatment need (DAI 2, 3, and 4) were more likely to report a negative esthetic impact (P < .05).

CONCLUSIONS

Anterior crowding and spacing are the conditions that most influence the esthetic concern of adolescents. Adolescents with very severe malocclusion and higher orthodontic treatment need are more likely to report a negative esthetic impact.

Impact of Self-Perceived Dental Esthetic on Psycho-Social Well-Being and Dental Self Confidence: A Cross-Sectional Study Among Female Students in Riyadh City

PURPOSE

To assess the self-perceived psychological impact of dental aesthetics among female university students and its relationship to various sociodemographic factors.

PATIENTS AND METHODS

A cross-sectional study was conducted on a sample of 2400 female students from various departments of selected private and public universities in Riyadh City. Participants completed an Arabic translated version of the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) and a short demographic sheet. Descriptive statistics was used to describe the sample's sociodemographic characteristics as well as the mean PIDAQ scores. Bivariate analysis (ANOVA) and linear regression were used to investigate the impact of the sociodemographic factors on the mean PIDAQ scores.

RESULTS

The pilot test revealed the instruments' conceptual equivalence, semantic equivalence and ease of comprehension. Cronbach's alpha was 0.81, indicating good internal consistency. The total sample was 1845 with a mean age of 20.74 years. The total mean score for the (PIDAQ) was 58.10 (SD=11.41). Significant differences were detected between different university affiliation in the dental self-consciousness (<0.0001), social (<0.0001) and psychological impacts (0.0256) and the total PIDAQ scores (0.0024). Significant differences were also detected between different disciplines in the dental aesthetics (0.0110) and social (0.0195) domains as well as the total PIDAQ scores (0.0144). College level was also a significant factor where middle students were significantly impacted socially (0.0026) compared to junior level students. As for the impact of income, those with the highest income displayed greater social impact (0.0039), psychological impact (0.0046) and impact on aesthetic attitude (0.0037) when compared to students with lower income levels.

CONCLUSION

Dental aesthetics was found to affect the psychological well-being of the subjects. University affiliation, faculty affiliation, college level, and level of income were all factors that significantly affected self-perceived aesthetics and psychosocial well-being.

Is there a relationship between malocclusion and bullying? A systematic review

Background

Malocclusion is a highly prevalent public health problem, and several studies have shown its negative correlation with quality of life, self-esteem, and social perceptions. However, its association with bullying is still controversial.

Objectives

To evaluate the relationship between malocclusion and bullying in children and adolescents.

Search methods

The databases used for the electronic researches were PubMed, Scopus, Lilacs/BBO, Web of Science, and Cochrane Library. Grey literature was reviewed through Open Grey literature with no language or date restrictions. Selection criteria, based on the PECO strategy, were considered eligible observational studies that included schoolchildren or adolescents (P) with malocclusion (E), compared to those with normal occlusion (C), in which the relationship between malocclusion and bullying was determined (O).

Data collection and analysis

Risk of bias evaluation was made for the qualitative synthesis by the Fowkes and Fulton criteria. Data regarding the age of participants and types of malocclusion and of bullying were extracted among other reported data. The quality of the evidence analyzed was evaluated through the GRADE approach.

Results

From 2744 articles identified in databases, nine met the eligibility criteria and were included in present systematic review, of which two studies were judged with methodological soundness. The quality of the evidence was classified as very low due to very serious problems for “risk of bias” and “other considerations” and serious problems of “indirectness”. The age of participants ranged from 9 to 34 years considering a cohort study, with a bullying recalling perspective. Malocclusion was both evaluated by researchers and self-reported by participants addressing dentofacial characteristics mostly related to the incisors relationship. All studies evaluated the verbal type of bullying, while 3 also considered physical type. Both types were reported as related to malocclusion, although the results showed that extreme maxillary overjet (> 4 mm, > 6 mm, > 9 mm), extreme deep overbite, and having space between anterior teeth or missing teeth were the types of malocclusion with the strongest relations to bullying.

Conclusions

With very low certainty of evidence, the results of this systematic review suggest that conspicuous extreme malocclusion may be related to the occurrence of bullying among children and adolescents.

Effects of sodium chloride on the gene expression profile of periodontal ligament fibroblasts during tensile strain

Purpose

During orthodontic tooth movement, pressure and tension zones develop in the periodontal ligament, and periodontal ligament fibroblasts (PDLF) become exposed to mechanical strain. Enhanced salt (NaCl) concentrations are known to modulate responses of PDLF and immune cells to different stimuli like mechanical strain. Here, we investigated the impact of tensile strain on the gene expression profile of PDLF under normal (NS) and high salt (HS) conditions.

Methods

After preincubation under NS or HS (+40 mM NaCl in medium) conditions for 24 h, PDLF were stretched 16% for 48 h using custom-made spherical cap silicone stamps using an established and published setup. After determination of cell number and cytotoxicity, we analyzed expression of genes involved in extracellular matrix reorganization, angiogenesis, bone remodeling, and inflammation by quantitative real-time polymerase chain reaction (RT-qPCR).

Results

Tensile strain did not affect the expression of genes involved in angiogenesis or extracellular matrix reorganization by PDLF, which however modulate inflammatory responses and bone remodeling in reaction to 16% static tensile strain. Salt (NaCl) treatment triggered enhanced extracellular matrix formation, expression of cyclooxygenase 2 and bone metabolism in PDLF during tensile strain.

Conclusions

Salt (NaCl) consumption may influence orthodontic tooth movement and periodontal bone loss via modulation of extracellular matrix and bone metabolism. Excessive salt intake during orthodontic therapy may cause adverse effects regarding periodontal inflammation and bone resorption.

Impact of anterior occlusal conditions in the mixed dentition on oral health-related quality-of-life item levels

OBJECTIVES

To evaluate the impact of anterior occlusal conditions in the mixed dentition on item-level analysis of oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

A population-based cross-sectional study of 787 children aged 8 to 10 years was conducted. The Child Perceptions Questionnaire (CPQ8-10) was used to evaluate OHRQoL, and the analysis of item levels was performed on CPQ8-10 domains. Anterior occlusal characteristics were diagnosed according to the Dental Aesthetic Index criteria. Individual analyses were performed relating the outcome as independent variables. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).

RESULTS

No associations were found with regard to anterior occlusal characteristics (P < .001) after the variables of the previous determinants were adjusted for multivariate analysis. However, the following variables were significantly associated with negative impact on OHRQoL item levels: sex, in oral symptoms (OR = 1.42; CI, 1.07-1.89) and emotional well-being (OR = 1.34; CI, 1.00-1.79); race, in oral symptoms (OR = 1.48; CI, 1.10-1.98), emotional well-being (OR = 1.54; CI, 1.14-2.06), and social well-being (OR = 1.34; CI, 1.00-1.80); and family income in functional limitation (OR = 1.46; CI, 1.06-2.02), emotional well-being (OR = 1.71; CI, 1.21-2.42), and social well-being (OR = 1.59; CI, 1.14-2.21).

CONCLUSIONS

Anterior occlusal conditions did not affect the levels of OHRQoL items.

Psychological impact of orthodontic treatment on quality of life - A longitudinal study

OBJECTIVE

(1) To assess the psychosocial, functional and aesthetic changes in young adults pre- and post-orthodontic treatment. (2) To assess the changes in quality of life in individuals having malocclusion before and after orthodontic appliance therapy. (3) To evaluate the effect of severity of malocclusion pre- and post-orthodontic treatment on quality of life among males and females.

MATERIALS AND METHODS

This longitudinal study included a convenience sample of 18.1 to 25.3-year-old young adults (n=400). The self-perception of dental aesthetics pre- and post-treatment related to gender variations and severity of malocclusion (Angle's class I, II, III) were also assessed using the Psychosocial Impact of Dental Aesthetics Questionnaire with additions (PIDAQ) according to the needs of Indian ethnic group. Cronbach alpha of each domain at baseline score and Wilcoxon signed ranked test was carried out.

RESULTS

Statistically positive psychosocial impacts were observed after orthodontic treatment for the six PIDAQ domains (P<0.001 for all six domains). There was a similar influence of gender and severity on the improvement of scores over the period in all the domains though males showed the least psychological impact on matrimonial concerns both pre- and post-treatment. The severity of malocclusion showed a difference only in functional concerns. There was less improvement in class III malocclusion group as compared to class I and class II groups.

DISCUSSION

Orthodontic treatment has a positive psychological impact, as there was a significant improvement in self-esteem and social interaction of the individuals. Significant changes occurred in functional and aesthetic domain measures of quality of life in orthodontically treated cases. The severity of malocclusion has a negative impact on the quality of life and a significant improvement in the quality of life was observed before and after orthodontic treatment with no gender difference.