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PubMed1990

A longitudinal study on malocclusion in relation to signs and symptoms of cranio-mandibular disorders in children and adolescents.

Two-hundred-and-thirty-eight subjects in three different age-groups (7, 11, and 15 years) were followed over a period of 4-5 years in respect of morphological malocclusions, and signs and symptoms of functional disturbances. About half of the 7-year-olds had at least one of the morphological malocclusions registered while the corresponding figure was 38 per cent at the age of 20. Some subjects had received corrective orthodontic treatment. When compared with subjects without such treatment, there were no differences in prevalences of occlusal interferences, nor in signs or symptoms of craniomandibular disorders (CMD). The associations between CMD and different morphological malocclusions were low. Nevertheless, some malocclusions were found to be more important than others. In a long-term perspective cross-bite, both uni- and bilateral, anterior open bite, post-, and prenormal occlusion had some association with the development of CMD.

Adolescent↗

PubMed1992

Perception of malocclusion in 11-year-old children: a comparison between personal and parental awareness.

In orthodontic counselling an understanding of how individuals perceive their occlusal features is important to ensure effective communication and for provision of adequate advice on treatment need. The purpose of the present study was to assess personal and parental awareness of malocclusion in children, and to examine whether agreement existed between children and their parents on assessments of malocclusion traits. Of 104 randomly selected fourth-grade children 99 presented themselves at a public dental clinic. Ninety-three accompanying parents attended. Awareness was assessed by comparing the opinion of parents and children on the presence or absence of anterior malocclusion with direct measurements on dental study casts. The subjects' abilities to identify a polaroid of the child's dentition in a panel of 17 alternative photographs were also used as a measure of awareness. The findings revealed a moderate level of awareness among both the children and their parents. About half of the children and the parents identified the child's photograph on the first attempt. About three-quarters of the traits recorded as marked/severe malocclusion and about half of the mild/moderate traits were recognized. A significant association existed between the number of correct reports on traits given by the children and the parents. However, agreement across professional, child, and parental assessments varied for the different traits. The results indicated that the individual's comprehension of professional terms may be unclear and that professionally defined cut-off points often do not coincide with norms existing within the actual family unit.

Attitude to Health↗

PubMed1995

Cluster analysis application to Class I malocclusion.

The purpose of this study was to obtain Class I malocclusion statistical subtypes by applying cluster analysis techniques, to assess clinical and cephalometric characteristics from different clusters, and to analyse sex and age effects on grouping patterns. Four-hundred-and-sixteen Spanish patients (243 females, 173 males) with Class I osseous and dental malocclusion (4 degrees > ANB > 0 degrees) between 8 and 16 years of age, with no previous orthodontic treatment, were analysed. Cluster analysis was applied to the information provided by 20 variables both clinical and cephalometric (Ricketts' analysis) per patient. The grouped individuals were defined in a statistically significant manner by a greater lower incisive proclination, greater lower labial protrusion, less dental crowding, and less pogonion-NB distance. So, only the protrusive traits were statistically expressed in the cluster analysis. The grouping pattern in Class I malocclusion was shown in a more defined form at younger age levels and disappeared with age. The clustering pattern was very similar in Class I malocclusion males and females.

Adolescent↗

PubMed1999

Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the dental aesthetic index (DAI).

The aims of this study were to measure the distribution, prevalence and the severity of malocclusion and treatment need amongst randomly selected (n = 703) rural and urban Nigerian children aged 12-18 years (mean 14.0 +/- 1.84) using the dental aesthetic index (DAI), and to assess whether malocclusion was affected by age, gender and socio-economic background. Data were collected according to the method recommended by WHO. Most of the children (77.4 per cent) had a dental appearance which required no orthodontic treatment. Over 13 per cent fell into the group where treatment for malocclusion is considered to be 'elective'. However, a substantial proportion (9.2 per cent) of the population had severe to handicapping malocclusion where treatment is 'highly desirable' or 'mandatory'. There were no statistically significant differences (P > 0.05) in DAI scores between age groups, gender and socio-economic background. This study also found that Nigerian adolescents had better dental appearance and less orthodontic treatment need compared with the Caucasian and Oriental populations.

Adolescent↗

PubMed2003

Malocclusion and orthodontic treatment need of handicapped individuals in South Canara, India.

AIMS: To estimate the prevalence and the severity of malocclusion and treatment need for 329 handicapped individuals. SUBJECTS AND SETTING: 329 handicapped individuals aged 11-30 years, attending eight different nonresidential special schools of South Canara, India. METHOD: Examination and recording using the Dental Aesthetic Index (DAI). RESULTS: 53% had a dental appearance which required no orthodontic treatment, 24% had a definite malocclusion, where treatment was 'elective' and treatment for a further 12% was considered to be 'highly desirable'. The remaining subjects (11%) had a handicapping malocclusion where treatment was considered mandatory. CONCLUSIONS: The prevalence of definite and severe malocclusions was higher in the mentally subnormal individuals when compared to other handicapping conditions. Orthodontic services for the handicapped have generally been neglected.

Adolescent↗

PubMed2004

Smile aesthetics and malocclusion in UK teenage magazines assessed using the Index of Orthodontic Treatment Need (IOTN).

OBJECTIVE: There is a significant demand for orthodontic treatment within the UK from adolescent girls, a group known to be influenced by the media portrayal of body form and body image, which may extend to the presentation of malocclusions. This study examined the portrayal of malocclusion in a media type that targets teenage girls under 16 years of age. MATERIALS AND METHODS: A representative selection of 1 month's magazines targeting this group were investigated, and the frequency and severity of malocclusions displayed were assessed. Two calibrated examiners viewed all the smiles (on two occasions) using a modification of Index of Orthodontic Treatment Need (IOTN) and assigned an Aesthetic Component Score to each smile. RESULTS: It was found that the aesthetic score is low (less than 7) for the majority of models (92.8%) indicating no need or a borderline need for treatment. Only 7.2% of models exhibited a definite need for treatment. CONCLUSION: It appears that the portrayal of malocclusion in teenage magazines does not reflect the general treatment need of the adolescent population.

Adolescent↗

PubMed1992

Prevalence and severity of malocclusion in children with cleft lip and/or palate in Hong Kong.

The prevalence and severity of malocclusion among children with cleft lip and palate in Hong Kong has never been assessed or documented. A group of 20 children in the primary or early mixed dentition stages, with clefts of the lip and/or palate were assessed using the Occlusal Index. Results of this preliminary study showed that 92.3 percent of the male and 71.5 percent of the female subjects had severe malocclusion, which implied that comprehensive orthodontic treatment at a later stage would be needed. More than half (69.2% of the male, and 57.1% of the female subjects) had syndrome F, defined as mesial molar relationship, overjet, overbite, posterior crossbite, midline diastema, and midline deviation (Summers, 1966). Therefore malocclusion problems were shown to manifest early in patients with cleft lip and/or palate, and further that it is possible to assess malocclusion prevalence and severity in early stages of dental development.

Child↗

PubMed2002

Time dependent changes of variables associated with malocclusion in patients with Duchenne muscular dystrophy.

Time dependent changes of parameters associated with malocclusion in patients with Duchenne muscular dystrophy (DMD) were examined in four dental developmental stages in 34 patients. We adopted activities of daily living (ADL) score, dental arch, craniofacial morphology, and electromyograms of the masseter and temporalis muscle as parameters. A comparison was made with the results in DMD subjects to data from healthy subjects with normal occlusion reported in the literature. In DMD subjects, manifestations of open-bite were related to ADL score, sagittal shortening and transverse expansion of the dental arch and vertical overgrowth of the lower jaw. Posterior cross-bite malocclusion was associated with differences in the time dependent changes between the jaws in transverse expansion. The malocclusion in DMD subjects was also related to the time dependent disproportional changes in masticatory muscle function by EMG. Occlusal deviation in DMD subjects became apparent at the late mixed dentition and malocclusion became definitely manifest from early permanent dentition.

Activities of Daily Living↗

PubMed2001

A lip seal study of Japanese children with malocclusion.

The purpose of this study was to clarify the relationship between lip seal and malocclusion in Japanese children. Fifty-three patients aged 7 to 14 years (mean 10.24 +/- 1.93) were selected randomly, and compared with 20 subjects with normal occlusion aged 7 to 14 years (mean 10.50 +/- 2.56). The subjects were divided into a good lip seal group and poor lip seal group by observing the distance between the upper and lower lip at rest. The variables that were analyzed for morphological evaluation included model analysis and cephalometric analysis. Noted for functional evaluation were tongue position, the size of the tonsils and adenoids and the oral muscle force measured by button pulling. In the evaluation of the degree of lip seal, there was no statistical difference between subjects with malocclusion and those with normal occlusion. Within the group with malocclusions, however, there were significant differences in overbite (p < 0.01), overjet (p < 0.01), and oral muscle force by button pulling (p < 0.05) between the good lip seal and poor lip seal groups. These results suggest that there is a need not only to correct malocclusion but also to be aware of lip sealing so that it may be improved in Japanese children.

Adolescent↗

PubMed2002

Lip seal study of Japanese adults with malocclusion.

The purpose of this study to clarify the factors an effecting lip seal in Japanese adults with malocclusion. Sixty-three malocclusion patients aged 20 to 27 years were randomly selected and compared with fourteen normal occlusion controls aged 22 to 26 years old. The subjects were divided into a good seal group and a poor lip seal group by observing the distance between the upper and lower lip at rest. Results of this adult study were as follows; There were no poor lip seals in normal occlusion subjects. Significant differences were observed for tongue thrust (p < 0.05) and mouth breathing (p < 0.05) between the good lip seal group and poor lip seal group of malocclusion subjects. Adults with poor lip seal should be treated for their malocclusion prior to be other functional approaches to improving their lip seal.

Adult↗

PubMedDate not supplied

Soft tissue thin-plate spline analysis of pre-pubertal Korean and European-Americans with untreated Angle's Class III malocclusions.

The purpose of this study was to assess soft tissue facial matrices in subjects of diverse ethnic origins with underlying dentoskeletal malocclusions. Pre-treatment lateral cephalographs of 71 Korean and 70 European-American children aged between 5 and 11 years with Angle's Class III malocclusions were traced, and 12 homologous, soft tissue landmarks digitized. Comparing mean Korean and European-American Class III soft tissue profiles, Procrustes analysis established statistical difference (P < 0.001) between the configurations, and this difference was also true at all seven age groups tested (P < 0.001). Comparing the overall European-American and Korean transformation, thin-plate spline analysis indicated that both affine and non-affine transformations contribute towards the total spline (deformation) of the averaged Class III soft tissue configurations. For non-affine transformations, partial warp (PW) 8 had the highest magnitude, indicating large-scale deformations visualized as labio-mental protrusion, predominantly. In addition, PW9, PW4, and PW5 also had high magnitudes, demonstrating labio-mental vertical compression and antero-posterior compression of the lower labio-mental soft tissues. Thus, Korean children with Class III malocclusions demonstrate antero-posterior and vertical deformations of the labio-mental soft tissue complex with respect to their European-American counterparts. Morphological heterogeneity of the soft tissue integument in subjects of diverse ethnic origin may obscure the underlying skeletal morphology, but the soft tissue integument appears to have minimal ontogenetic association with Class III malocclusions.

Cephalometry↗

PubMedDate not supplied

Association of functional malocclusion with temporomandibular disorders in orthodontic patients prior to treatment.

The purpose of this study was to investigate the role of functional malocclusion in temporomandibular disorders (TMD) in untreated orthodontic patients. A total of 508 orthodontic patients were enrolled. All patients were evaluated for the presence of various types of functional malocclusion and clinical signs of TMD before treatment. The chi-square test was used to evaluate the association of functional malocclusion and TMD. The frequencies of TMD were 44.2% in patients with retruded position (RP) interference and 38.1% in those without such interference (p > 0.05). The frequency of TMD in patients with protrusive interference was greater than those without (32.2% vs. 18.4%; p < 0.005). Patients with balancing interference had a significantly higher frequency of TMD than those without (49.2% vs. 23.9%; p < 0.0001). We thus conclude that patients with functional malocclusion of balancing or protrusive interference type have an increased risk for developing TMD.

Adolescent↗

PubMedDate not supplied

Early treatment mechanics of the Class II division 2 malocclusion.

A most common type of early malocclusion that the pediatric dentist comes in contact with daily is the developing Class II Division 2 malocclusion (Fig 1-a,b). It is the malocclusion that the parents of the children we serve bring to our attention. Parental concern is the early crowding that develops in the anterior of the lower arch with risk of periodontal involvement. This malocclusion is readily amenable to interception at age 7 or 8 and can proceed with a protocol of defined objectives and predictable outcomes (Fig 2). With efficient and effective utility arch wire (UAW) mechanics a state of normalcy can be achieved within six to eight months of treatment.

Child↗

PubMed1999

Prevalence of malocclusion in a sample of Lebanese schoolchildren: an epidemiological study.

The study aimed to provide oral health planners in Lebanon with information on the prevalence of malocclusion in schoolchildren in an attempt to define the target population for orthodontic services in the future. A total of 851 schoolchildren (446 males and 405 females) aged 9-15 years were examined for malocclusion using Angle's classification. In all, 59.5% of the sample had malocclusions, 35.5% of which were of dental origin and 24% had skeletal discrepancy (19% Class II and 5% Class III malocclusions). A statistically significant difference was found between males and females. The findings are compared with those of studies of other ethnic groups and suggestions for future epidemiological research are presented.

Adolescent↗

PubMedDate not supplied

Midfacial morphology of Koreans with class III malocclusions investigated with finite-element scaling analysis.

The spheno-ethmoidal model of midfacial retrognathia suggests that deficient chondrocytic proliferation in the anterior cranial base is associated with inadequate anterior translation of the midfacial complex resulting, for example, in Class III malocclusions. The purpose of this study was to determine whether the morphology of the midface differed in subjects of diverse ethnic origin exhibiting features associated with Class III malocclusions. Lateral cephalographs of 142 children of Korean or European American descent aged between 5 and 11 years were compared. The cephalographs were traced and subdivided into seven age- and sex-matched groups. Average geometries, scaled to an equivalent size, were generated using Procrustes superimposition and subjected to analysis of variance (ANOVA). Graphical analysis using a color-coded finite-element scaling analysis (FESA) program was used to localize differences in morphology. Results indicated that the mean Korean and European American midfacial configurations differed statistically (P < 0.01), and this difference was maintained at most, but not all, age-wise comparisons. Comparing Korean and European American Class III midfacial configurations for local size-change, FESA analysis revealed that while local increases in size were apparent in the posterior palatal regions, the Korean anterior nasal spine regions were generally smaller. For shape-change, the Korean and European American midfacial configurations were predominantly isotropic. Therefore, heterogeneity in appearance may be influenced by morphological variation of the midfacial complex in subjects of diverse ethnic origin, but features of the anterior cranial base may contribute also to the prevalence and severity of Class III malocclusions in Koreans. Moreover, perturbations in endochondral mechanisms of cranio-mandibular growth, and not maxillary intramembranous methods, may be implicated in the etiology of Class III malocclusions in South East Asians.

Age Factors↗

PubMed2001

Classification of Angle Class III malocclusion and its treatment modalities.

To obtain the best results in the treatment of patients with Angle Class III malocclusion, the etiologies of the malocclusion should first be clarified, and then an appropriate treatment modality should be decided. Angle Class III malocclusions in 120 subjects who had orthognathic surgery were analyzed with cephalometrics and facial photos and classified into 3 categories based on the abnormalities of the maxilla. Type A is true mandibular prognathism, which means that the maxilla is normal but the mandible is overgrown. Type B is characteristic of the overgrown maxilla and mandible with anterior crossbite. Type C indicates a hypoplastic maxilla with anterior crossbite. Treatment modalities should be differentially decided according to this new classification of Angle Class III malocclusions.

Adolescent↗

PubMed2000

[The influence of malocclusion on self-esteem and personality of college student].

OBJECTIVE: To study the relationship among the different malocclusions and self-esteem and personality. METHODS: Two hundred and forty college students with normal occlusion and different types of malocclusion were classified into four groups(class I, class II, class III and normal) by Angle's classification, Sixty students in each group. The first three groups had been divided into three subgroups respectively by IOTN: mild, moderate and severe, twenty students in each subgroup. Each subject was assessed by using the body-esteem scale (BES) and the Eysenck personality questionnaire (EPQ). RESULTS: (1) the mean score on facial appearance subscale in BES of the normal group is significantly higher than that of moderate and severe subgroups in class II and class III groups; (2) the mean T score on E subscale in EPQ of the normal group is significantly higher than that of severe subgroups in class II and class III groups, and the mean T score on N subscale in EPQ of the normal group is significantly lower than that of severe subgroups in class II and class III groups; (3) There is a positive correlation between the mean score on facial appearance subscale in BES and the mean T score on E subscale in EPQ and a negative correlation between the mean score on facial appearance subscale in BES and the mean T score on N subscale in EPQ. CONCLUSIONS: (1) The students with moderate and severe class II and class III malocclusion have lower self esteem about their facial appearance than normal students; (2) The trends of introverstion and astatic emotion are higher in students with severe class II and class III malocclusion than in normal students; (3) The higher self esteem about his (or her) facial appearance, the higher trends of extroversion and statical emotion he(or she) has; the lower self-esteem about his (or her) facial appearance, the higher trends of introversion and astatic emotion he (or she) has.

Adult↗

PubMed2002

[Combined rapid palatal expansion (RPE), edgewise technique and protraction headgear in correction of skeletal Class III malocclusion].

OBJECTIVE: The skeletal Class III malocclusion often occurs in ethnic Asia population, and it is difficult to obtain an ideal results if only treated with protraction headgear (PH). However, the combined rapid palatal expansion (RPE), Edgewise Technique and PH can reach it, so the authors investigated the methods and characteristics of combined RPE, Edgewise Technique and PH in the treatment of skeletal Class III malocclusion. METHODS: Fifteen patients, aged 8.5-12 years, including six males and 9 females, with skeletal Class III malocclusion and maxillary retrusion were selected for this study. Radiographs of left hand and wrist showed that all patients were at the pre-pubertal stage. The duration of treatment was nine months on average. RESULTS: The SNA and A-ptm increased with a mean of cephalometric analysis, which showed significant difference (P < 0.05). CONCLUSION: Obvious skeletal and profile changes can be achieved with combined RPE, Edgewise Technique and PH in the treatment of early skeletal Class III malocclusion.

Child↗