Impact of malocclusion on oral health-related quality of life: insights from children with and without hypodontia

OBJECTIVE

To assess the impact of malocclusion on oral health-related quality of life (OHRQoL) and to compare the impact of malocclusion in children with and without hypodontia.

METHODS

Children aged 10-16 years with ≥ 5 missing teeth and without hypodontia completed the Malocclusion Impact Questionnaire (MIQ) to assess the impact of malocclusion on OHRQoL. The Child Perception Questionnaire 11-14 years short form (CPQ11-14-ISF16) was used to verify the validity of the MIQ. Demographic and orthodontic data were collected. Internal consistency and validity of the MIQ were analyzed. MIQ scores were compared using an independent t‑test. Regression analysis was performed to identify predictors of the MIQ score.

RESULTS

A total of 92 participants completed the MIQ, and 52 participants the CPQ11-14-ISF16. The MIQ showed excellent internal consistency (Cronbach's α 0.89) and good criterion validity with CPQ11-14-ISF16 (r = 0.58). No significant difference in the impact of malocclusion on OHRQoL between the groups (p = 0.15) was found. Age (p < 0.05), sex (p < 0.001), and general appearance (p < 0.001) significantly predicted OHRQoL scores in the regression analysis. Multilevel analysis showed that the group and age effects were nonsignificant and that sex and general appearance were predictive for the MIQ score.

CONCLUSION

This study suggests that the MIQ is a useful tool to assess the impact of malocclusion on OHRQoL in the orthodontic field. Differences in the impact of malocclusion on OHRQoL between children with and without hypodontia of ≥ 5 teeth were limited. It may be beneficial delaying treatment until the patient expresses a subjective treatment need which may reduce overtreatment of children with hypodontia.

Possible role of superoxide dismutase 3 in hypoxia-induced developmental defects in murine molars

OBJECTIVES

To investigate the effects of hypoxia on tooth germ development in mice and explore the underlying mechanisms.

METHODS

Tooth germs were extracted from E14.5 mouse embryos and divided into the control and hypoxia groups for organ culture. The hypoxia group was exposed to hypoxia (0% oxygen) for 3 h, followed by normoxia for 21 h. After 2 or 7 days, samples were collected for morphometric analysis, reverse transcription-quantitative polymerase chain reaction, immunohistochemistry (IHC), and immunofluorescent staining (IF). Additionally, superoxide dismutase 3 (SOD3) expression patterns in mandibular molar tooth germs from C57BL/6 mouse embryos were analyzed using IHC. The SOD inhibitor sodium N, N-diethyldithiocarbamate trihydrate (DETC; 400 μM) was applied under normoxia for 3 days, followed by morphometry, IHC, and IF.

RESULTS

After 7 days, the hypoxia group exhibited significantly smaller tooth size, fewer cusps, reduced cell proliferation, and increased apoptosis in the epithelium compared to the control group. Sod3 mRNA expression was higher than other Sod family member expressions in the control group. In the hypoxia group, Sod3 mRNA and SOD3 protein expression were significantly decreased, whereas hypoxia-inducible factor-1 expression and reactive oxygen species levels were increased. SOD3 was primarily expressed in the dental epithelium from E12.5 to E17.5. DETC impaired tooth germ development in the control group, resulting in a phenotype similar to that of the hypoxia group, and significantly reduced amelogenin and msh homeobox 2 expression in the epithelium.

CONCLUSIONS

Hypoxia impairs tooth germ development. SOD3 probably plays a protective role during this process.

The impact of orthodontic treatment on a young person's quality of life, esthetics, and self-esteem in hypodontia: A longitudinal study

INTRODUCTION

This research aimed to evaluate the impact of orthodontic treatment on a young person's oral health-related quality of life, self-esteem, and esthetics concerning hypodontia.

METHODS

A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. Forty-one participants (42%) originally planned to have space closure and the remainder space opening, with subsequent prosthetic replacement. The following questionnaires were completed before and after orthodontic treatment: the child perception questionnaire, Bristol condition-specific questionnaire for hypodontia (BCSQ), the child health questionnaire, and the Oral Aesthetic Subjective Impact Scale (OASIS). The Wilcoxon and matched pairs t tests approach was applied to compare before and after orthodontic treatment for significant testing (P <0.05).

RESULTS

Fifteen participants were lost to follow-up, resulting in 82 participants completing orthodontic treatment, with an average age of 13.8 ± 1.71 years. A total of 282 teeth were missing in the sample. Treatment resulted in significantly lower indexes (P <0.001) to overall BCSQ, OASIS, appearance, and how others would treat them. In comparing the 2 subgroups, those treated with space closure had significantly reduced functional limitations (child perception questionnaire), appearance concerns, self-esteem (child health questionnaire), OASIS, and overall BCSQ scores.

CONCLUSIONS

Orthodontic treatment in participants with hypodontia appears to significantly impact a range of psychological and esthetic scales. In particular, space closure appears to significantly improve the quality of life of participants compared with those undergoing space opening.

Mesiodistal angulation and developmental stages of unerupted mandibular second premolars in nonsyndromic oligodontia

INTRODUCTION

Oligodontia is a serious developmental dental anomaly that requires long-term multidisciplinary treatment, but its clinical characteristics are not well understood because it is rare. This study evaluated the mesiodistal angulation and developmental stages of unerupted mandibular second premolars (MnP2s) in orthodontic patients with nonsyndromic oligodontia.

METHODS

Thirty-seven patients with oligodontia with at least 1 unerupted MnP2 in Demirjian's developmental stages between D and G were selected. Age- and sex-matched patients without tooth agenesis, excluding third molars, were selected as the control group. Mesiodistal angulation between the long axis of the available MnP2 and the mandibular plane was measured on panoramic radiographs.

RESULTS

The MnP2 was significantly more distally angulated in the oligodontia group than in the control group. The developmental stage of the MnP2 in the oligodontia group was significantly delayed (1.04 ± 0.26 years; 95% confidence interval, 0.53-1.55 years). No correlation between the mesiodistal angulation and the developmental stage of the MnP2 was found in both groups.

CONCLUSIONS

Significant distal angulation and delayed developmental stages of MnP2s were found in patients with nonsyndromic oligodontia compared with age- and sex-matched patients without agenesis of permanent teeth, excluding third molars. However, no significant correlation was found between them. Regardless of the severity of the distal angulation of MnP2, observing delayed dental development in each patient is important.

Pre-implant and implant management of oligodontia patients: A 10-year retrospective study

INTRODUCTION

the aim of this study was to report and assess the management and implant rehabilitation of oligodontia patients since its recognition in 2012 by french authorities in the nomenclature.

MATERIAL AND METHODS

we conducted a retrospective study in the Maxillofacial Surgery and Stomatology Department of the Lille University Hospital between January 2012 and May 2022. Patients had to present an oligodontia recognized under the ALD31 in adulthood, and to have benefited from a pre-implant/implant surgical treatment in the unit.

RESULTS

a total of 106 patients were included in the study. The mean number of agenesis was 12 per patient. The most missing teeth are the ones at the end of the series. After a pre-implant surgery phase including orthognathic surgery and/or bone grafting, 97 patients benefited from implant placements. The mean age for this phase was 19.38. A total of 688 implants were placed. The median number of implants placed was 6 per patient and 5 patients presented implant failures after or during the osseointegration phase (16 implants lost). The implant success rate was 97.6%. 78 patients benefited from rehabilitations by fixed implant-supported prostheses and 3 by implant-supported mandibular removable prostheses.

DISCUSSION

The described care pathway seems to us adapted to the patients followed in our department, with good functional and esthetic results. It would be necessary to evaluate on a national scale to adapt the management process.

Dental management of a pediatric patient with progressive familial intrahepatic cholestasis having dental anomalies: a case report and brief review of the literature

BACKGROUND

Progressive familial intrahepatic cholestasis is a heterogeneous group of disorders, leading to intrahepatic cholestasis, with the possibility of chronic liver failure and biliary cirrhosis. Oligodontia is either the manifestation of a specific syndrome or is non-syndromic. To the best of our knowledge, this is the first case report of type 3 progressive familial intrahepatic cholestasis and concurrent oligodontia, craniosynostosis, dens in dente, taurodontism, and delayed permanent dentition in the medical and dental literature.

CASE PRESENTATION

We present the dental and medical histories and comprehensive dental management of a girl with type 3 progressive familial intrahepatic cholestasis and several dental anomalies, who was referred to a dental clinic due to severe dental caries and pain.

CONCLUSION

Our findings suggest that PFIC with manifestations as oligodontia, craniosynostosis, dens in dente, taurodontism, and delayed permanent dentition, might indicate an unknown syndrome; otherwise, the craniofacial anomalies are the manifestations of an independent disease coinciding with PFIC. Moreover, our case is a good example of the importance of timely medical and dental care in confining further health-related complications. The patient was able to ingest without any pain or discomfort after receiving proper dental management.

Primary Teeth Supported Fixed Prosthesis—A Predictable Treatment Alternative

Background: Individuals with tooth agenesis often present a significant clinical challenge for dental practitioners. This retrospective study evaluated clinical and radiological long-term functional and esthetic outcomes following restoration using primary teeth to support fixed all-ceramic prosthesis in patients with teeth agenesis. Methods: Patients with teeth agenesis and at least one year follow-up were included. Examinations included panoramic X-ray, clinical examination and family history records. Only primary teeth without permanent teeth underneath were chosen. All ceramic fixed restorations were used. All data were collected from patient files. Outcome parameters included: restoration parameters (restoration survival, restoration fractures, restoration detachment, restoration replacement, and secondary caries), plaque index, and gingival index. Results: The study included 58 porcelain restorations inserted in 25 individuals; mean age 12 ± 2.1 years (range 10–19 years); mean number of missing teeth 12.3 ± 9 (range 6–12). Mean follow-up 48 ± 6 months (range 12–60 months). All restorations survived up to last follow-up, rendering a survival rate of 100%. Restorations outcome—porcelain chipping (9%), detachment (2%), no restoration replacement nor secondary caries, mean gingival index—0.7 ± 0.5 and mean plaque index—0.9 ± 0.3. Conclusions: In tooth agenesis, restoration using primary teeth to support fixed all-ceramic prosthesis is a viable treatment alternative.

Parental perception on oral health-related quality of life and dental features of ectodermal dysplasia and isolated hypodontia in children

Background

Children missing 6 or more permanent teeth often present with complex dental care needs and significant impacts on their oral health related quality of life (OHRQoL). The most important facet in the overall care for these children is the child’s own experience, but parents primarily make the decisions regarding their child’s dental management. Understanding the parental perspective could have a positive impact on planning and provision of care for these patient groups in the future. The study compared the parental perspectives on OHRQoL impact and dental experience for children with ectodermal dysplasia (ED), severe isolated hypodontia (IH), and matched controls following assessment of their dental features.

Design

A cross-sectional study of 172 children (mean age: 12.4 years old) was conducted; 86 with severe hypodontia (≥ 6 missing teeth; ED: 29; IH: 57) and 86 age and gender matched controls. The Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS) and a supplemental questionnaire were used to gather information on parental perceptions of OHRQoL and dental experiences, respectively. Clinical examinations were used to assess and compare the dental features between children with ED, IH and their respective controls.

Results

Higher scores (p < 0.05) were found in P-CPQ and FIS scores between the children with ED, IH and their respective controls. P-CPQ scores for males with ED had a moderate correlation with functional limitations (R_s = 0.576; p = 0.001*), oral symptoms (R_s = 0.444; p = 0.016*) and overall QoL (R_s = 0.499; p = 0.006*). The ED group reported earlier awareness of issues, the youngest attendance (3.24 years) and highest perceived number of appointments (“20 or more”; 58.6%). The mean number of missing teeth in the ED group was almost twice that of the IH group (ED: 20.17; IH: 10.68) and the median number of missing teeth (Radiographically: ED = 21; IH = 9; Clinically: ED = 11; IH = 6), was significantly greater in the ED group when compared to the IH group (p < 0.001*).

Conclusion

Parents of children with ED and IH perceive a greater impact on QoL, for both the child and their family. Children with ED need earlier intervention and more extensive treatment than children with IH and their controls.

Staged autogenous calvarial bone grafting and dental implants placement in the management of oligodontia: a retrospective study of 20 patients over a 12-year period

Oligodontia demands multidisciplinary management due to its repercussions on dentofacial growth. To place implants to realize implant-borne fixed denture, preimplant surgery may be necessary if bone volumes are insufficient. Our aim was to assess bone increase following autogenic bone grafting and to discuss prosthetic options. Twenty patients followed for oligodontia, who underwent bone grafting, were treated from 2008 to 2019. Transversal and vertical bone levels were measured pre- and postoperatively to assess alveolar ridge augmentation. Mean horizontal grafting increase was 4.60 mm [standard deviation (SD) 0.79 mm], mean sinus lift increase was 9.95 mm (SD 2.35 mm). Mean implants placed per patient was 9, mean implants placed on grafted site was 5 per patient. Overall implant survival rate was 100%. All patients benefited from prosthetic procedures when it was planned to perform implant-borne fixed dentures. Within the framework of a complete treatment plan (involving paediatric dentistry, dentofacial orthopaedics, oral and maxillofacial surgery, and prosthodontics), autologous bone grafting combined or not with orthognathic surgery is fully adapted to patients with oligodontia. It allows reconstruction of favourable bone volumes for placement of implants to realize implant-borne fixed dentures, with high implant survival rates and great improvements to quality of life.