[Urgency of interceptive orthodontics].
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OBJECTIVE: Early recognition of developing malocclusions and the potential for uncomplicated orthodontic treatment procedures can minimize or eliminate future costly treatment. This study was designed to assess the potential for this approach in children living in a limited-income environment. A modified index for preventive and interceptive orthodontic needs (IPION) was used to determine the need for such treatment in schoolchildren aged 6 and 9 years. METHODS: Two calibrated examiners examined each child independently and assessed several components of his or her occlusion, including molar relationship, crossbite, open bite, overbite and overjet. Dental variables such as presence of caries and early loss of teeth were also noted. Informed consent was obtained and all children present at school on the day of the field study were included. A total of 395 children were divided into 2 groups, aged 6 and 9 years. RESULTS: A high prevalence of caries in the deciduous dentition (30.4% for 6 year olds; 20.6% for 9 year olds) and early loss of primary teeth (11.9% for 6 year olds; 29.4% for 9 year olds) was observed. A large percentage of children had crossbite in the anterior or posterior segments, or both. Open bites were also a common finding. Future orthodontic problems were identified in 28% of this population by using the modified IPION. No statistically significant differences (p > 0.05) were found between sexes or age groups using the chi2 test. CONCLUSIONS: Most of the developing malocclusions identified in this study would be amenable to interceptive orthodontics, consisting of space maintenance, crossbite correction and arch expansion.
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Orthodontic unit, University College Hospital, Ibadan is young and in need of baseline data for effective planning. The main aim of this study was to determine the nature of orthodontic demands in the unit that could benefit from preventive and interceptive treatment so as to enhance treatment planning, teaching and further research. Consecutive patients who presented for treatment in the Unit between May 1997 and November 1999 were included in the study. The patients aged 5-19 years with mean age of 8.8 +/- 0.82 years. One hundred and twenty-one (60.5%) of the orthodontic cases that presented for treatment needed one form of preventive and interceptive treatment or the other such as extraction of retained primary teeth, use of upper removable orthodontic appliances to correct teeth in cross bite, extraction of erupted supernumerary teeth and fabrication of oral habit breaking appliances such as goal post appliance. Ninety-three (76.9%) of these children had retained primary anterior teeth while 9.1% had proclination of maxillary anterior teeth with moderate spacing. Based on dental history and clinical examination, nine (7.4%) children were involved with oral habits, seven (5.8%) and one (0.8%) had anterior crossbite and supernumerary teeth, respectively. The remaining 39.5% needed full-blown orthodontic treatments. No sex predilection was found in relation to the various needs (P > 0.05). We suggest a need for more emphasis on preventive and interceptive orthodontic treatment in our environment due to the relatively high prevalence ofthese presenting needs.
There is a growing emphasis world-wide for early orthodontic treatment but in Nigeria there is very little information regarding the occlusal development in pre-school children reported. The need for preventive and interceptive intervention for malocclusion was studied in a sample of 563 Nigerian children (289 boys and 274 girls) aged 3-5 years. Orthodontic intervention was estimated to be needed in 12.8% of the children due to cross bite of the anterior or lateral segments. Education was needed in 12.5% of the children in cases of digit sucking, lip sucking and tongue thrusting. Extraction was indicated in 0.4% of children in cases of retained primary incisors causing displacement of the erupting successors. The need for further follow-up of occlusal development was noted in 1.4% of the children due to double primary teeth (0.4%), numerical variation of primary teeth (0.4%), crown dilaceration of a tooth (0.2%) and true class III skeletal malocclusion (0.4%).
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