Dental anomalies in different growth and skeletal malocclusion patterns

Orthodontic diagnosis rates based on panoramic radiographs in children aged 6-8 years: A retrospective study

Objective

This study aimed to retrospectively analyze the prevalence of orthodontic problems and the proportion of patients who underwent orthodontic diagnosis among children aged 6 (n = 300), 7 (n = 400), and 8 (n = 400) years who had undergone panoramic radiography.

Methods

Children were divided into five groups according to their chief complaint and consultation: conservative dentistry, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics). Chief complaints investigated included first molar eruption, lack of space for incisor eruption, frequency of eruption problems, lack of space, impaction, supernumerary teeth (SNT), missing teeth, and ectropion eruption. The number of patients whose chief complaint was not related to orthodontics but had dental problems requiring orthodontic treatment was counted. The proportion of patients with orthodontic problems who received an orthodontic diagnosis was also examined.

Results

Dental trauma and SNT were the most frequent chief complaints among the children. The proportion of patients with orthodontic problems increased with age. However, the orthodontic diagnosis rates based on panoramic radiographs among children aged 6, 7, 8 years were only 1.5% (6 years) and 23% (7 and 8 years).

Conclusions

Accurate information should be provided to patient caregivers to correct misconceptions regarding the appropriateness of delaying orthodontic examination until permanent dentition is established.

The Prevalence and Association of Non-metric Dental Traits With Dentoskeletal Malocclusion and ABO Blood Groups in the Maharashtrian Population

Introduction Non-metric dental traits (NMDTs) are a fundamental data source in forensic dentistry. Nevertheless, the insufficiency of data regarding the occurrence of these traits has instigated the present research endeavor aimed at ascertaining the prevalence, sexual dimorphism, and extent of inter-trait correlations within the Maharashtrian population of India. The secondary objective was to determine the correlations between NMDTs, dentoskeletal malocclusion, and ABO blood groups. Materials and methods This prospective, observational study included 528 individuals aged 18-30 years with dentoskeletal Class I, II, and III malocclusions. NMDTs such as the presence of Cusp of Carabelli (CoC) on the upper first molars, hypocone on the upper second molars, and tri- or bicuspid lower second premolars were observed on the dental casts of all individuals. The dental relationship was assessed clinically according to Angle's system for the classification of malocclusion. The skeletal relationship was assessed using lateral cephalograms of the individuals. ABO blood groups were obtained from their medical records. The Chi-square test of independence was used to assess the associations between various variables. The correlation between each measurement was determined using Spearman's correlation test. Multivariate analysis enabled the identification of parameters that exhibited independent associations with NMDTs. A multinomial logistic regression model was constructed using NMDTs as the outcome variable. Results The mean age of males was 20.82 ± 1.71 years and 21.15 ± 1.76 years was in females. NMDTs were predominantly seen in females (n=394, 75%), with Class II dentoskeletal malocclusion (n=265, 50%) and B blood group ((n=199, 38%). All traits showed bilateral predominance. A statistically significant association was found between CoC, dentoskeletal malocclusion, hypocone, and tricuspid lower second premolars (p <0.05). All NMDTs showed a negative correlation with sex, a positive correlation between age and the presence of hypocones and CoC, a negative correlation between age and tricuspid lower second premolars, a strong positive correlation with dentoskeletal malocclusion, and a weak positive correlation with ABO blood groups. Multinomial logistic regression model analysis revealed that none of the independent variables were statistically significant predictors of the presence of CoC and tricuspid lower second premolars, while dentoskeletal malocclusion and sex were significant predictors of the presence of the hypocone trait. Conclusion NMDTs showed a female predilection with bilateral predominance. A significant association was observed between these traits and dentoskeletal malocclusions. The most commonly observed NMDT was the presence of a hypocone on the upper second molars, followed by the tricuspid lower second premolars and the CoC.

Prescription of panoramic radiographs in children using age-based prevalence of dental anomalies and pathologies

BACKGROUND

Panoramic radiographs (PRs) are used in the detection and diagnosis of developmental dental anomalies and pathologies (DDAPs) in children.

AIM

The primary objective of this observational cohort study was to evaluate the age-based prevalence of DDAP on PRs, whereas the secondary objective was to determine a threshold age for the detection of DDAP to provide supportive evidence for the prescription of PR in paediatric dental practice.

DESIGN

The study examined diagnostic PRs from 581 subjects aged 6 to 19 years. All PRs were reviewed by experienced, calibrated, masked examiners for the identification or presence of anomalies in size, shape, position, structure, and other developmental anomalies and pathologies (ODAP) of the face-neck region in a standardized condition. The data were statistically analyzed for interpretation.

RESULTS

Overall, 74% (n = 411) of the cohort had at least one anomaly (shape anomaly: 12%, number anomaly: 17%, positional anomaly: 28%, structural anomaly: 0%, and ODAP: 63%). The optimal Youden index cutoff for any anomaly was 9 years. Twelve and 15 years also showed predictive ability.

CONCLUSION

The results suggest that PRs should be prescribed at ages 9, 12, and 15 years for the diagnosis of DDAP.

Evaluation of Twenty Non-Metric Dental Crown Traits in Different Types of Malocclusions in a Sample from India, New Delhi Population

Background

Dental phenotype shows variation in the form of various metric and non-metric traits, primarily due to gene-environment interplay. It gives an insight into the evolutionary trends, ancestry, and food habits. Recently, it has been explored for genetic affinity with several growth anomalies and development of craniofacial skeleton which is also responsible for dental and skeletal malocclusions.

Objectives

the current study aims to investigate the non-metric dental crown traits (NDCTs) using Arizona State University Dental Anthropology system (ASUDAS) in different types of malocclusions in Delhi, National Capital Region (NCR) population.

Materials and methods

The study design was observational and retrospective. The total sample comprised of 240 pairs of dental casts divided into four equal groups of 60 subjects each (30 male and 30 female), based on malocclusion. The four groups of malocclusions were: Angle's Class I, Class II division 1, Class II division 2, Class III. The investigator was blinded for patient ID and sex before recording the data. The data for cast were recorded by three observers independently in a modified malocclusion- non-metric dental crown traits (M-NDCT) anthropological variants chart and statistically analyzed for association with different malocclusions and sex.

Results

Significant differences were found in the expression of several NDCTs (both in presence and scoring) in different malocclusions. Class I malocclusion showed a predominantly winging, shoveling -upper central and lateral incisor, protostylid, hypoconulid absence in lower second molar, and cusp number. Class II malocclusion showed a double shoveling, interrupted groove, tuberculum dentale, canine mesial ridge, premolar accessory cusp, Carabelli's trait, lingual cusp variation, and seventh cusp in the lower left first molar. Class III malocclusion showed the absence of hypocone in upper second molar, deflecting wrinkle, distal trigonid crest, and Y groove in left lower second molar (26.7%). Besides, sexual dimorphism was seen in shoveling -upper central and lateral incisor, canine mesial ridge, Carabelli's trait, 3-cusp in upper second molar, and cusp number.

Conclusions

Significant association was found between non-metric dental traits and malocclusions (Class I, Class division 1, Class II division 2, and Class III). Significant sex-linked differences were also found. Further studies can be performed at multicenter pan-India level with a standard robust protocol and a large sample.

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits

INTRODUCTION

Despite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns.

METHODS

This epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05).

RESULTS

Prevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables 'sagittal skeletal relationships, vertical growth patterns, PP, and APAD' showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities.

CONCLUSIONS

STB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

Comparison of the posterior teeth angulations in orthodontic patients with different facial growth patterns

Background

Dental relationships can be affected according to the pattern of facial growth. Thus, the aim of this study was to compare the angulations of posterior teeth in patients with different patterns of facial growth.

Material and Methods

A total of 412 lateral head radiographs were included. The facial skeletal growth pattern was evaluated with the Björk-Jarabak analysis. For the angular measurements of the posterior teeth, the apex-cusp inclination of the premolars and the long axes of the molars were considered, with respect to the occlusal, palatal and mandibular plane. The intraclass correlation coefficient (ICC) was used to evaluate the intra-examiner concordance. One way ANOVA was used to compare the values between the patterns of facial growth. A significance level was set at 0.05.

Results

A high intra-examiner correlation was observed (0.75). Subjects with horizontal and normal growth presented significantly different angulations for the first and second premolars in relation to the palatal plane than the vertical growth (p<0.05). Subjects with horizontal growth pattern showed greater angulation of the teeth with respect to the occlusal plane than the other groups (p<0.05). The angulations of all mandibular teeth related to the mandibular plane were significantly higher for the group with horizontal growth (p<0.05).

Conclusions

The first and second premolars presented greater angulations in subjects with horizontal and normal growth than in those with vertical growth. The angulations of all mandibular teeth were significantly higher in the horizontal growth according to the mandibular plane. Key words:Facial growth pattern, posterior tooth, occlusal plane, palatal plane, mandibular plane.

Association between Eruption Sequence of Posterior Teeth, Dental Crowding, Arch Dimensions, Incisor Inclination, and Skeletal Growth Pattern

Background: We conducted research to investigate the effects of the eruption sequence of posterior teeth, arch dimensions, and incisor inclination on dental crowding. Material and Methods: A cross-sectional analytic study was performed on 100 patients (54 boys and 46 girls; mean ages: 11.69 and 11.16 years, respectively). Seq1 (canine-3-/second premolar-5-) or Seq2 (5/3) eruption sequences were recorded in maxilla, and Seq3 (canine-3-/first premolar-4-) or Seq4 (4/3) eruption sequences in mandible; tooth size, available space, tooth size-arch length discrepancy (TS-ALD), arch lengths, incisor inclination and distance, and skeletal relationship were noted. Results: The most common eruption sequences in the maxilla and mandible were Seq1 (50.6%), and Seq3 (52.1%), respectively. In the maxilla, posterior tooth sizes were larger in crowded cases. In the mandible, anterior and posterior tooth sizes were larger in crowded patients. No relationship between incisor variables and the maxillo-mandibular relationship and dental crowding was found. A negative correlation between inferior TS-ALD and the mandibular plane was found. Conclusions: Seq1 and Seq 2 in the maxilla and Seq 3 and Seq 4 in the mandible were equally prevalent. An eruption sequence of 3–5 in the maxilla and 3–4 in the mandible is more likely to cause crowding.

Dental anomalies in an Albanian orthodontic sample: a retrospective study

BACKGROUND

To evaluate the prevalence and the distribution of dental anomalies in an Albanian orthodontic sample.

METHODS

For this retrospective study, a sample of panoramic radiographs (PR) of n. 779 (456 F and 323 M, mean age of 15.1 ± 5.5 years) Albanian subjects with no genetic syndromes or craniofacial malformations (e.g., cleft lip/palate), history of extraction, trauma or previous orthodontic treatment drawn from the archives of the University Dental Clinic Our Lady of Good Counsel, was examined. The inclusion criteria were: subjects from 8 to 30 years of age, good quality of PRs in order to allow the assessment of crown and root development. For different dental anomalies, both the prevalence and the association were evaluated by using Chi-square test (p < 0.05).

RESULTS

24.4% of the sample had at least one dental anomaly and 4.6% had more than one. The following dental anomalies were most prevalent: hypodontia (9.8%), dental impaction (7.6%), and ectopic eruption (5.3%). No statistically significant correlation was found between males and females (p > 0.05).

CONCLUSIONS

The most common anomalies in this group are found to be those of number and position, and only radiological investigations can reveal either of these anomalies. Early diagnosis of dental anomalies can contribute to prevent their complications and to establish the most suitable therapy to achieve a functional occlusion.

Cone-Beam Computed Tomography Analysis on the Relationship between the Mandibular Third Molar and the Position of the Mandibular Canal in Koreans from the Yanbian Area and the Han People

OBJECTIVE

To analyze differences in the positional relationships between the mandibular third molar (MTM) and the mandibular canal in Korean and Han patients using cone-beam computed tomography (CBCT) and to provide a basis for preoperative risk assessments.

MATERIALS AND METHODS

The CBCT imaging data of 260 Korean and Han patients were collected. The patients' genders, ages, impaction types and depths, relative positions between the MTMs and the mandibular nerve canals, and the shortest distances and shapes at the root tips and cortical bones were all recorded and analyzed. All data were compared using the nonparametric test, ordered logistic regression analysis, a chi-square test, and Fisher's exact test.

RESULTS

The relationship between the mandibular canal and the relative position of the MTM differed between Korean and Han patients, mainly in the different types of impactions, and the difference was statistically significant (P < 0.05). The shortest distance between the mesioangular and horizontally impacted mandibular canals and the buccal side of the MTM in Korean patients was less than in Han patients, and the difference was statistically significant (P < 0.05). For horizontal impactions, the probability of cortical bone interruption was 1.980 times greater in Korean patients than in Han patients, and the difference was statistically significant (P < 0.05). The significance threshold was set at 0.05.

CONCLUSION

There are some differences in the positional relationship between the mandibular canal in the MTM region and the rate of cortical bone disruption between Koreans from the Yanbian area and the Hans. This should gain clinical attention.

COMPARATIVE STUDY OF BIOTOLERANCE CHARACTERISTICS OF DIFFERENT GELS COMPOSED OF BENZYDAMINE AND FLAVONOIDS THAT WERE DEVELOPED FOR TREATMENT OF PERIODONTAL DISEASES IN ORTHODONTIC PATIENTS

OBJECTIVE

The aim: Different gels composed of benzydamine and flavonoids that were developed for treatment of periodontal diseases in the orthodontic patients will be compared regarding their effects on survival of mammalian cells of various tissue origin and their DNA intactness.

PATIENTS AND METHODS

Materials and methods: Effect of different variants of patented gel composition «Benzidaflaziverdine» including a gel base and «Proteflazid®» containing flavonoids and benzydamine hydrochloride in powder form («T-Sept®») towards survival (MTT) of murine BALB-3T3 fibroblasts, J774.2 macrophages, human HaCaT keratinocytes was studied. Their effect on nativity of DNA of J774.2 macrophages was evaluated using DNA-comet assay.

RESULTS

Results: Three gel compositions were used. Sample 1 was prepared on gel basis including benzydamine in liquid form and demonstrated inhibitory effect towards pseudonormal murine BALB-3T3 fibroblasts and murine J774.2 macrophages, however, normal human НаСаТ keratinocytes were resistant to its action. Sample 2 included BH in powder form and it did not affect significantly НаСаТ keratinocytes аnd BALB-3T3 fibroblasts, but it suppressed J774.2 macrophages. Sample 3 («Benzidaflaziverdine») was developed and patented by us as a gel composed of benzydamine in powder form and flavonoid drops «Proteflazid®». It did not suppress tested mammalian cells and was not genotoxic (measured as % of DNA in comet tail and Olive Tail Moment) for murine J774.2 macrophages.

CONCLUSION

Conclusions: Inclusion of flavonoids in gel composition «Benzidaflaziverdine» blocked cytotoxic and genotoxic actions of benzydamine. Developed gel com¬position might be efficient in clinical periodontology, in particular, for treatment of periodontal diseases in orthodontic patients.

Association between Hypodontia and Angle’s Malocclusions among Orthodontic Patients in Kathmandu, Nepal

Background. Disturbances during the early tooth development stages may result in the congenital absence of teeth. The purpose of this study was to assess the relationship between hypodontia and Angle’s malocclusions. Materials and Methods. The sample comprised 601 orthodontic patients’ pretreatment records (242 men and 259 women), selected from the achieved orthodontic records. Developmental anomalies of teeth affecting the number were examined on dental panoramic radiographs. Based on Angle’s classification, pretreatment dental casts were assessed and classified into different classes of malocclusion. The relationship between hypodontia and different classes of malocclusion was evaluated using the chi-square test. Results. The prevalence of tooth agenesis was 7.48%, that is, 45 out of 601 samples. There were a total of 72 (0.42%) missing teeth, excluding the third molars. The most frequent missing tooth was the maxillary lateral incisor (35, 48.61%), followed by the mandibular lateral incisor (14, 19.44%), the mandibular central incisor (6, 8.33%), the mandibular second premolar (5, 6.294%), and the maxillary second premolar (4, 5.55%). Hypodontia was more common in the upper jaw. Although hypodontia was mostly seen in Class I malocclusion patients (7.87%), followed by Class II malocclusion patients (6.99%) and least in Class III malocclusion patients. However, there was no significant difference in hypodontia among different classes of malocclusions (p = 0.352). Conclusion. The most frequently missing tooth was the maxillary lateral incisor, followed by lateral and central mandibular incisors and mandibular second premolars, while excluding the third molars. The present study did not find any association between various types of malocclusions and hypodontia.

Associations between 44 nonmetric permanent dental traits or anomalies with skeletal sagittal malocclusions and sex, besides correlations across the variations or abnormalities

Introduction

Nonmetric dental traits and the shape, size, or number of dental anomalies are essential to various dental fields such as orthodontics, dental anatomy, anthropology, pathology, and forensic dentistry. Nonetheless, many are not well assessed worldwide. Moreover, most studies are limited to a few nonmetric traits. Therefore, we aimed to examine several nonmetric dental traits/anomalies.

Methods

In this cross-sectional epidemiological study, ~ 9000 permanent teeth of 331 non-syndromic orthodontic patients (radiographs and dental casts) with fully erupted permanent dentitions (except the third molars and some cases of a few teeth missing or excluded) were evaluated by two observers, each twice, in search for 62 nonmetric traits/shape-number-size anomalies. The traits/anomalies of interest were supernumerary, microdontia, peg-shaped lateral, shovelings, talon cusps, Carabelli cusps, fifth/sixth/seventh cusps on the molars, hypocone/hypoconulid absence, protostylid, deflecting wrinkle‏s, canine mesial ridge, distal trigonid crest, canine distal accessory ridge, accessory cusps in the mesial/distal marginal ridges, mesial/distal accessory ridges, and accessory cusps in the lingual of the mandibular premolars and second molars). Data, at both patient/quarter levels, were analyzed regarding the associated factors (skeletal Angle classes, crowding, sex, and sides) as well as the correlations among traits, using the chi-square test and Spearman correlation coefficient (α = 0.05).

Results

Prevalence rates of 44 traits/anomalies were reported (18 out of the 62 searched traits/anomalies were not found [prevalence = 0%]). Microdontia and accessory cusps on the marginal ridge of the second mandibular molars were significantly more common in women (P < 0.05). Canine talon cusp and distal trigonid crest of the second mandibular molars were more prevalent in men (P < 0.05). Shoveling, canine talon cusp, canine distal accessory ridge, and accessory cusp in the first premolar might be more prevalent in skeletal Angle class II; whereas, accessory cusp in the mesial marginal ridge of the second premolar might be rather more prevalent in skeletal Angle class I (P < 0.05). Few dental traits were positively and moderately or strongly correlated with each other (Spearman Rho ≥ 0.4, P < 0.0005).

Conclusions

Sex dimorphism was uncommon in nonmetric dental traits/anomalies. Skeletal malocclusions may be associated with a few dental abnormalities or variations.

The effect of combined maxillary pad movable appliance and FR-III functional appliance in the treatment of skeletal Class III malocclusion of deciduous teeth

Background

To evaluate the therapeutic effect of maxillary pad movable appliance combined with FR-III functional appliance in treating skeletal Class III malocclusion of deciduous teeth and provide a reference for optimizing clinical treatment methods.

Methods

A total of 30 pediatric patients were randomly selected between April 2012 and April 2019. They were in stage IIA osseous skeletal Class III malocclusion, treated with maxillary pad movable appliance to relieve the reverse, combined with FR-III functional appliance to maintain a median relationship to stage IIIA. A self-control study of children before and after treatment was used, and paired t-test was used to evaluate the changes in the measurement indexes of the IIA and IIIA stage X-rays and changes in the bone and soft tissue profiles.

Results

After 3 years of treatment, SNA, ANB, and NA-PA in the sagittal osteofacial index of the jawbones increased, SNB decreased, and the Y-axis angle in the vertical index of the jawbones increased. U1-SN, U1-NA, U1-NA distance, L1-MP, L1-NB, and L1-NB distance in the index of labial inclination of upper and lower central incisors increased, while U1-L1 decreased. The sagittal anomalies of the jawbones were improved, and there were significant differences before and after treatment (P < 0.05). FCA, ULP, and UL-EP increased, soft-tissue facial prominence and facial height increased, and the relationship between the upper lip and the aesthetic plane was harmonious. None of the 30 children with skeletal Class III malocclusion in the deciduous stage experienced recurrence in stage IIIA.

Conclusions

Combined treatment with the maxillary pad movable appliance and the FR-III functional appliance is suitable for children with skeletal Class III malocclusion in the deciduous stage.

A Comparative Analysis of Dental Measurements in Physical and Digital Orthodontic Case Study Models

Background and Objectives: Study models are essential tools used in the dental teaching process. The aim of the present study was to compare the values obtained by manual and digital orthodontic measurements on physical and digital case study models. Materials and Methods: The physical experimental models were obtained by traditional pouring (improved stone-type IV gypsum products) and by additive manufacturing (resins). The digital experimental models were created by scanning the physical ones, using a white light-emitting diode (LED) source and an L-shaped dental scanner—Swing DOF (DOF, Seoul, Korea). The physical study models were first measured using a digital caliper, and then, they were scanned and evaluated using the DentalCad 3.0 Galway software (exocad GmbH, Darmstadt, Germany). The Pont, Linder−Harth, and Bolton indices, which are used in orthodontics for training students, were derived using the available data. Results: When comparing the linear measurement mean ranks taken on physical study models to those of digital models, no statistically significant differences (p > 0.05) were found. A similar result was also shown when the dentoalveolar growth indicators were analyzed. Conclusions: It can be concluded that dental study models made by direct light processing (DLP) and pouring type IV class gypsum are both acceptable for orthodontic teaching purposes.

Prevalence of dental anomalies in different facial patterns and malocclusions in an Iranian population

Objective

This study aimed to evaluate the prevalence and association of dental anomalies with different types of malocclusions and facial patterns.

Methods

In this cross-sectional study, the records of patients referred to the Orthodontics Department at 12-20 years of age were collected. The patients were classified into four types of malocclusion: Cl I, Cl II div 1, Cl II div 2, and Cl III, and three types of facial patterns: normal, long, and short. Fifteen dental anomalies were searched within the documents. The statistical analysis of data was performed with chi-squared and Fisher's exact test.

Results

Among 602 patients evaluated in this study, 28.6% were males, and 71.4% were females. The prevalence of Cl I, Cl II div1, Cl II div 2, and Cl III was 58.3%, 28.7%, 5.5%, and 7.5%, respectively. The normal facial pattern was most prevalent (47.2%), followed by the long facial pattern (41.4%) and short facial pattern (11.5%); 60.7% of the study population had at least one dental anomaly. Dilaceration was the most common anomaly (27.7%), followed by impaction (21.8%) and hypodontia (18.9%). Most dental anomalies were found in females, Cl II malocclusion, and long face samples. A statistically significant association was found between transposition and male gender (P = 0.006) and between short roots and Cl II malocclusion (P = 0.047). No significant association was found between dental anomalies and facial patterns.

Conclusion

Significant associations were reported between transposition and male gender and between short roots and Cl II malocclusion. In our population, dilaceration was the most common dental anomaly.

Common dental anomalies in Korean orthodontic patients: An update

Objective

The aim of this study was 1) to investigate the prevalence and pattern of dental anomalies (DAs), 2) to compare DAs according to the type of malocclusion, and 3) to investigate the correlation between tooth impaction and other DAs in the Korean orthodontic population.

Methods

A total of 3,240 orthodontic patients were classified as Class I, Class II, or Class III malocclusion groups. The presence and location of common DAs, including impaction, microdontia, agenesis, supernumerary tooth, transposition, and fusion, were identified by examining diagnostic records. Furthermore, samples were classified as Group 1 without impaction or Group 2 with impaction. The prevalence of other DAs concurrent with impaction was investigated and compared to Group 1.

Results

Impaction was the most prevalent DA, followed by microdontia, agenesis, and supernumerary. Class I and Class III groups showed the same order of prevalence, but agenesis was more frequent than microdontia in the Class II group. The prevalence of the four DAs was lowest in the Class III group. Overall, 8.6% of patients were classified into Group 2. The incidence of DAs other than impaction and the prevalence of multiple concurrent DAs were significantly higher in Group 2. Impaction showed a significant relationship with supernumerary tooth, transposition, and fusion.

Conclusions

The prevalence and pattern of DAs varied depending on the type of malocclusion. As there was a higher risk of other DAs in patients with impacted teeth, early detection of the impacted tooth and a detailed diagnosis of other possible DAs may be essential.

Sleep disordered breathing and oral health-related quality of life in children with different skeletal malocclusions

OBJECTIVE

To evaluate the relationship among different skeletal malocclusion patterns, sleep-disordered breathing (SDB) and children's oral health-related quality of life (OHRQoL).

METHODS

Two hundred-five patients were divided into three groups, considering skeletal malocclusion. Parents completed the Pediatric Sleep Questionnaire (PSQ) on behalf of the patients, who completed the 14-question version of the Oral Health Impact Profile (OHIP-14).

RESULTS

SDB was observed in 10.7% of children. The overall prevalence of snoring, difficulty breathing during sleeping, mouth breathing, and dry mouth on awakening was 8.78%, 7.31%, 36.09%, and 37.07%, respectively. However, there was no significant difference in OHIP-14 parameters among the skeletal groups. A positive correlation was found between OHIP-14 and PSQ and was significant in Class I and III.

CONCLUSION

Although there was no significant difference, SDB risk and sleep quality were found as most to least problematic, in the following sequential order: Class II > Class III > Class I.

Number of Teeth Is Related to Craniofacial Morphology in Humans

Simple Summary

In modern humans, congenital absence of one or more permanent teeth has a prevalence of 22.6% when considering the third molars and of 6.4% when not. Its high prevalence, in conjunction with evolutionary findings pinpointing to a steady reduction in teeth number, raises the question whether the congenital absence of teeth in modern humans is an evolutionary trend rather than an anomaly. Previous studies have shown that modern humans with less teeth also have smaller faces; however, the association between teeth number and craniofacial morphology remains unclear. Here, we show that less teeth are associated with a flatter profile and a decreased facial height. These findings support the claim of a broader relationship between number of teeth and overall craniofacial development and have evolutionary implications, since face reduction comprises also an evolutionary trend in humans.

Abstract

One of the most common dental anomalies in humans is the congenital absence of teeth, referred to as tooth agenesis. The association of tooth agenesis to craniofacial morphology has been previously investigated but remains unclear. We investigated this association by applying geometric morphometric methods in a large sample of modern humans. In line with previous studies, we report here that a reduced teeth number is linked to a less convex profile, as well as to a shorter face. The effects were similar for males and females; they increased as the severity of the tooth agenesis increased and remained unaltered by the inclusion of third molars and of allometry in the analysis. Furthermore, in cases with tooth agenesis only in the maxilla, there was no detectable effect in mandibular shape, whereas maxillary shape was affected independently of the location of missing teeth. The robustness of the present sample along with the shape analysis and the statistical approach applied, allowed for thorough testing of various contributing factors regarding the presence but also the magnitude of effects. The present findings suggest a relationship between number of teeth and overall craniofacial development and have evolutionary implications.

Comparative Study of Malocclusions between Cancer Patients and Healthy Peers

Background. There is lack of data related to dental occlusion among children cured from cancer. The aim of our study was to compare the prevalence of malocclusion in cancer survivors and in healthy peers. Methods. A cross-sectional study was conducted on 225 children aged between 4 and 18 years, including 75 cancer survivors, and 150 sex and age-matched controls. All patients were orthodontically examined and malocclusion traits were recorded. In the cancer group, 75 panoramic radiographs were used to evaluate the prevalence of dental anomalies and dental age using the Demirjian scale. Data were analyzed by univariate statistical analysis with p-values p < 0.05 considered as statistically significant. Results. Malocclusion was found in 49 (65.33%) cancer survivors and 99 (65.56%) controls (p > 0.05). The cancer group demonstrated significantly higher likelihood of crossbite (p < 0.01) and malalignment of teeth (p = 0.031). The healthy controls were more likely to demonstrate open bite (p = 0.038). Cancer patients with posterior crossbite (p = 0.023) or dental malalignment had a more advanced dental age (p = 0.022). Survivors with crossbite had more teeth with short roots (p = 0.016). Those who were older when they started their cancer therapy were more likely to suffer from tooth disturbances (p = 0.019). Conclusion. Oncological treatment can alter the development of occlusion in cancer patients.

Elastodontic Therapy of Hyperdivergent Class II Patients Using AMCOP® Devices: A Retrospective Study

Background: The management of a hyperdivergent growth pattern is one of the most challenging in orthodontics and different treatments are advocated. The present study analyses the effectiveness of elastodontic therapy with AMCOP® devices in treating children with hyperdivergent class II malocclusion and the effect on the upper airway patency. Methods: The study group included 21 patients (10 males and 11 females, mean age 8.22 ± 1.17 years) with a hyperdivergent growth and a class II malocclusion treated with AMCOP® devices. Cephalometric analysis was performed before treatment (T0) and after treatment (T1). Results: After treatment, the cephalometric analysis revealed a correction of the class II malocclusion and a modification of the growth pattern with a divergence reduction. The improvement of the upper airway space was also observed. Conclusion: The elastodontic therapy effectively corrected hyperdivergent class II malocclusion in growing patients over a short period.

Impact of primary dentition malocclusion on the oral health-related quality of life in preschoolers

BACKGROUND

Malocclusion is a condition frequently seen in primary dentition due to the interaction of environmental, genetic and behavioural factors. The occurrence of some types of malocclusions can have an impact on oral health-related quality of life in children. Hence, the present study aimed to verify the impact of primary dentition malocclusion on oral health-related quality of life in preschool children.

METHODS

A population-based cross-sectional study was conducted in Florianopolis, Brazil, with a representative sample of 1050 preschoolers aged between 2 and 5 years, randomly selected. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale and also to a questionnaire on socio-economic indicators. Data obtained from the questionnaire were obtained by item response theory based on model of gradual response. The malocclusion assessed was: anterior open bite, increased overjet and posterior crossbite. Poisson regression model was employed for multivariate analysis (P < 0.05).

RESULTS

Malocclusion was observed in 36.7% of the children. Of these, 11.4% were anterior open bite, 67.2% were increased overjet, and 21.4% were posterior crossbite. Malocclusion's impact on oral health-related quality of life was 28.6%. In children aged 4-5 years, the prevalence of malocclusion's impact on quality of life was 49.5% higher than in children aged 2-3 years. Statistical analysis showed that preschool children with malocclusion showed no significant impact on quality of life.

CONCLUSIONS

The findings of the present study indicate that the occurrence of primary dentition malocclusion has no impact on the quality of life of children aged 2-5 years.

Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review

The World Health Organization (WHO) considers malocclusion one of the most important oral health problems, after caries and periodontal disease. Its prevalence is highly variable and is estimated to be between 39% and 93% in children and adolescents. Due to the importance of malocclusions in dentistry, the aim of our review is to assess the frequency of malocclusions among different geographical regions. A literature research was performed through the Pubmed, Medline, Scopus, Web of Science, LILACS, Open Grey and Cochrane Library databases. The “PRISMA” guidelines were used for the following review. Fourteen studies were analysed for this review. Class I was found most frequently, followed by class II and finally class III. Considering the other anomalies, crowding was one of the most frequent with a prevalence of up to 84%, followed by spacing, which reached a frequency of 60%. Prevalence of crossbite and openbite was quite variable, while the evaluation of deepbite revealed more uniform values. The prevalence varied widely for most of the types of malocclusion in relation to the different populations, which suggests a role of genetics and environmental influences, typical of each population in determining dental problems.

The effects of bracketless invisible orthodontics on the PLI, SBI, SPD, and GI and on the satisfaction levels in children with malocclusions

OBJECTIVE

The purpose of this study was to investigate the effects of bracketless invisible orthodontics on the plaque index (PLI), the sulcus bleeding index (SBI), the gingival sulcus probing depth (SPD), and the gingival index (GI) in children with malocclusions and on their families' satisfaction with the orthodontic treatment.

METHODS

The baseline data of 113 children with malocclusions were retrospectively collected and divided into two groups according to the orthodontic mode each child underwent. Group A was treated with traditional fixed braces, and Group B was treated with bracketless invisible orthodontics. The clinical efficacy, the satisfaction, the PLI, the SBI, the SPD, and the GI, the tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the interleukin-2 (IL-2) levels, the occurrence of adverse reactions, the COHIP (oral health-related quality of life scale, Chinese Version), and the changes in oral chewing function were compared between the two groups.

RESULTS

The total effective rate in group B was 96.49%, higher than the 69.64% in group A (P<0.05). The total satisfaction rate in group B was 98.25%, higher than the 69.64% in group A (P<0.05). Compared with group A, group B had higher PLI, SBI, SPD, and GI levels after the treatment (P<0.05), lower of TNF-α and IL-6 levels, and higher IL-2 levels (P<0.05). The quality of life and the chewing function scores in group B were higher than they were in group A (P<0.05). The incidence rate of adverse events in group B was 5.26%, lower than the 17.86% in group A (P<0.05).

CONCLUSION

The efficacy of bracketless invisible orthodontic treatment in children with malocclusions is higher than it is using traditional fixed orthodontic treatment, as it helps improve their chewing function, periodontal health, and quality of life, and helps reduce the inflammatory factor levels and improves their satisfaction with the orthodontic treatment.

Classification and Morphological Analysis of the Hard Palate in Cone-Beam Computed Tomography Scans: A Retrospective Study

PURPOSE

As the hard palate is a central structure of the skull and is involved in orthodontic and surgical procedures, it would be of interest to study the morphological aspects of this bone and its possible variations as per different patterns of skeletal development. Thus, this study aimed to develop a classification for the different morphological characteristics of the hard palate and to evaluate the relationship between these characteristics and the different skeletal patterns, using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

This retrospective and cross-sectional study used CBCT scans of patients seen from January 2014 to December 2016. Carestream Dental 3D Imaging software was applied to classify each patient according to vertical and sagittal skeletal patterns, and to evaluate the 3 morphological characteristics of the hard palate: depth (flat, regular, or deep), inclination (superior, parallel, or inferior), and presence of a bony projection (S-shaped). χ² and Fisher's exact tests evaluated the relationship between the hard palate characteristics and the different skeletal patterns.

RESULTS

A total of 298 CBCT scans (144 males and 154 females) were evaluated. The depth of the hard palate was significantly related to both skeletal patterns in males (P < .05), with Class II and dolichocephalics presenting a greater amount of deep palates, while classes I and III and brachycephalics had a greater amount of regular palates. The inclination of the hard palate was significantly associated with the facial type in females (P < .05), with brachycephalics and mesocephalics presenting a greater amount of parallel palates, whereas dolichocephalics had a greater number of inferiorly inclined palates. Regarding the presence of the S-shape in the hard palate, there was a greater number of this projection in Class II males and brachycephalic females.

CONCLUSIONS

A morphological classification for the hard palate was developed. The morphology of the hard palate varied among the different skeletal patterns.

IRF6, MSX1, TGFA, dental anomalies, and skeletal malocclusion

OBJECTIVE

Verify the presence of association between four variables-transforming growth factor α (TGFA; C/T rs1523305), interferon regulatory factor 6 (IRF6; A/C rs2013162), muscle segment homeobox 1 (MSX1; A/G rs12532), and dental anomalies-with skeletal malocclusion by comparing these four variables with Angle Classes I, II, and III, and normal, hyperdivergent, and hypodivergent growth patterns.

METHODS

A total of 505 orthodontic records of patients older than 8 years were evaluated. The sample consisted of 285 (56.4 per cent) females, 220 (43.6 per cent) males, 304 (60.2 per cent) Whites (the rest were mixed Blacks with Whites), with a mean age of 20.28 (±10.35) years (ranging from 8 to 25 years). Eight cephalometric points, which served as the anatomical framework for obtaining angles and cephalometric measurements, were used for skeletal characterization using the Dolphin Software. Samples of saliva were collected and the DNA was extracted, diluted and quantified. Markers in TGFA, IRF6, and MSX1 were used and genotypes were obtained using TaqMan chemistry. Odds ratio (OR) and 95 per cent confidence interval (CI) calculations, chi-square, Fisher's Exact, Mann-Whitney, and correlation coefficient tests (significance level: 95 per cent) were performed. Bonferroni correction was applied and an alpha of 0.0006 was considered statistically significant.

RESULTS

There was no statistically significant associations between markers in TGFA or IRF6 with skeletal malocclusions. Tooth agenesis was associated with facial convexity (P < 0.001). MSX1 was associated with Class II skeletal malocclusion (P = 0.0001, OR = 0.6, CI = 0.46-0.78).

CONCLUSION

Individuals with tooth agenesis were more likely to have a convex face. MSX1 was associated with Class II skeletal malocclusion.

Prevalence and patterns of tooth agenesis among malocclusion classes in a Japanese orthodontic population

The purpose of the present study was to assess, in detail, the association between tooth agenesis (TA) and various sagittal skeletal malocclusion groups in a Japanese orthodontic population. One thousand and twenty patients were divided into skeletal Class I, II, or III malocclusion groups using the A point, nasion, and B point angle. TA was identified in each group using panoramic radiographs. Patients with class III malocclusion exhibited a significantly higher prevalence of third molar (M3) agenesis, bilateral and overall agenesis of the maxillary M3s than those patients with a class II malocclusion. Those with a Class II malocclusion demonstrated a significantly lower prevalence of overall agenesis of the mandibular M3s than those with class I or III malocclusions. There were no significant differences in the prevalence of agenesis of teeth other than the M3s between the skeletal malocclusion groups. In each group, there was significantly more M3 agenesis present in the maxilla than in the mandible, and agenesis of the incisors and second premolars was found more often in the mandible than in the maxilla. Sagittal jaw relationships were significantly associated with M3 agenesis but were not associated with agenesis of the maxillary and mandibular incisors and second premolars.