Prevalence of malocclusion and its relationship with dental caries in a sample of Pakistani school children

Malocclusion is one of the most prevalent dental problems observed in children which may cause oral health problems, loss of function and psychosocial problems related to impaired dentofacial aesthetics. Malocclusion and dental caries have a negative impact on Oral Health Related Quality of Life [OHRQoL]. The objective of the study was to assess the prevalence of malocclusion and dental caries in school children, using Index Of Orthodontic Treatment Need [Dental Health Component] IOTN [DHC] and Decayed, Missing, Filled,Teeth [DMFT] score.Also to evaluate any relationship between malocclusion/ orthodontic treatment need and dental caries. A cross-sectional study was conducted among 574 school children aged 11 to 16 years having permanent dentition, no history of orthodontic treatment and no dental anomalies. Each student's number of DMFT was computed and the IOTN [DHC] was recorded based on contact point displacement only. Results of the current study which comprised of 574 school children, with 320 males and 254 females, exhibited a mean IOTN grade of 2.4 +/- 1.016 and a mean DMFT score of 2.57 +/- 2.7. The prevalence of malocclusion was found to be 75.6% while the prevalence of dental caries was 64.6%. The Pearson correlation coefficient found a significant correlation between IOTN and DMFT scores. The brushing frequency and gender did not correlate with DMFT scores, while sugar intake, age and SES had a significant correlation with DMFT. Taking IOTN into consideration, age and diet showed no correlation with it, whereas gender and Socio Economic Status [SES] status displayed a significant correlation with IOTN grades. The current study yielded a significant correlation between malocclusion and dental caries. Healthy diet and proper brushing technique are important to maintain a healthy dentition, despite the presence of malocclusion

Comparison of research diagnostic criteria with magnetic resonance imaging in patients with myofascial pain

Temporomandibular disorders affect a considerable percentage of population. Myofascial pain is the most common of temporomandibular pain due to occlusal disharmony, jaw clenching, anxiety and other factors. The objective of this study was to compare the research diagnostic criteria for temporomandibular disorders with magnetic resonance imaging to determine validity for correct clinical diagnosis of patients having myofascial pain. The diagnoses from the clinical examination of 54 joints in 27 patients were compared with magnetic resonance imaging diagnoses. The readers of magnetic resonance images were blinded to the clinical diagnoses. Comparative cross sectional study was undertaken. 38 joints [70.4%] were clinically diagnosed with myofascial pain whereas 29 joints [53.7%] were shown to have myofascial pain by MRI examination. The results of our study showed that clinical diagnosis according to research diagnostic criteria for temporomandibular disorders is insufficiently reliable for diagnostic accuracy in comparison with magnetic resonance imaging, a gold standard. The kappa value for the agreement between clinical and magnetic resonance imaging diagnoses was 0.045. Kappa statistics measures the agreement in excess of chance with kappa values ranging between 0 and 1; values lower than 0.4 are considered to have poor agreement and 1.0 represents perfect agreement

Effects of noise pollution on dental patients satisfaction level

Effects of the noises produced in the dental setup is a cause of various health related issues as well as dental anxiety to the patients, leading to [dental drop-out] i.e., patients refusing to undergo further dental treatment or ignoring follow up appointments. One hundred sixty-eight patients were treated for identical dental restorations in posterior teeth by 3 dentists, once in a Noisy Surgery and once in a Noise-Reduced Surgery. Questionnaires were filled by the patients after each procedure to assess the satisfaction level of the patients and plan of recall visit. After treatment in the Noisy Surgery 27.4% patients rated the experience as [Bad] or [Very Bad] and 11.9% patients did not want to visit for dental treatment again. After treatment in the Non-Noisy Surgery only 7.0% rated the experience as [Bad] or [Very Bad] and 2.4% patients did not want to visit for dental treatment again. The results of this study showed that patients treated in a noise-reduced environment show a greater satisfaction level and are more likely to visit for a dental treatment in future, as compared to those treated in a noisy environment

Malocclusion and its relationship with dental caries in a sample of Pakistani school children

Malocclusion is one of the most prevalent dental problems observed in children which may cause oral health problems, loss of function and psychosocial problems related to impaired dentofacial aesthetics. Malocclusion and dental caries have a negative impact on Oral Health Related Quality of Life [OHRQoL]. The objective of the study was to assess the prevalence of malocclusion and dental caries in school children, using Index Of Orthodontic Treatment Need [Dental Health Component] IOTN [DHC] and Decayed, Missing, Filled,Teeth [DMFT] score. Also to evaluate any relationship between malocclusion/ orthodontic treatment need and dental caries. A cross-sectional study was conducted among 574 school children aged 11 to 16 years having permanent dentition, no history of orthodontic treatment and no dental anomalies. Each student's number of DMFT was computed and the IOTN [DHC] was recorded based on contact point displacement only. Results of the current study which comprised of 574 school children, with 320 males and 254 females, exhibited a mean IOTN grade of 2.4 +/- 1.016 and a mean DMFT score of 2.57 +/- 2.7. The prevalence of malocclusion was found to be 75.6% while the prevalence of dental caries was 64.6%. The Pearson correlation coefficient found a significant correlation between IOTN and DMFT scores. The brushing frequency and gender did not correlate with DMFT scores, while sugar intake, age and SES had a significant correlation with DMFT. Taking IOTN into consideration, age and diet showed no correlation with it, whereas gender and Socio Economic Status [SES] status displayed a significant correlation with IOTN grades. The current study yielded a significant correlation between malocclusion and dental caries. Healthy diet and proper brushing technique are important to maintain a healthy dentition, despite the presence of malocclusion

Comparative study of efficacy of formocresol and calcium hydroxide pulpotomy in primary molars

Comparative study of formocresol and calcium hydroxide pulpotomy procedure has a particular importance in this part of the subcontinent where low socioeconomic status is debilitating and does not allow many persons to undergo an expensive therapy like Mineral Trioxide Aggregate therapy, laser therapy and electro cauterization modality of pulpotomy. The purpose of this study was to compare the efficacy of two different vital pulp therapy techniques both clinically and radiographically in cariously exposed primary molars, utilizing calcium hydroxide and formocresol as the material for pulpotomy. It was a Quasi-experimental study. The sampling technique was a non-randomized convenience sampling. The study was conducted and completed in one year 28, Military Dental Centre, La-hore. The study was carried out using clinical and radiological criteria of follow up for evaluating the success of the two techniques by selecting 60 subjects, all Pakistanis. The sample comprised of subjects within 4 to 6 years age bracket selected alternatively according to gender. Formocresol and Calcium hydroxide pulpotomy was performed after amputation and proper hemostasis of the coronal pulp chamber and the selected patients were divided into two groups. The patients selected for formocresol pulpotomy were placed in Group F and the patients for calcium hydroxide pulpotomy were placed in Group C. Follow up of the cases were performed at 03 months, 06 months and 01 year period and the results in terms of success and failure were recorded in the stipulated data form and analyzed by SPSS version 17 for Windows. Sixty cariously exposed primary molars required vital pulp therapy. Thirty primary molars [50%] in Group F and thirty primary molars [50%] in Group C. 27 teeth [90%] treated with formocresol and 17 teeth [56.7%] with calcium hydroxide were classed as clinically and radiographically successful at the end of one year. The results showed a significant difference in the efficacy of the two groups [p= 0.004]. It was concluded that there was a significant difference in the efficacy of the two medicaments projecting higher rate of success with formocresol as compared to calcium hydroxide both clinically and radiographically

Frequency of simultaneous presence of dental caries in mandibular first permanent molar and its antimere in children of Lahore Cantt

The study was a cross sectional observational study undertaken to evaluate the frequency of dental caries in mandibular first molar and its antimere in the opposite mandibular quadrant in eight to ten years old children seen at 28 Military Dental Centre. The study involved 100 male and 100 female children of age 6-10 Years. 80[80%] males exhibited evidence of simultaneous presence of dental caries in mandibular first permanent molar and its antimere while 20[20%] males did not show any evidence. 85[85%] females exhibited evidence of simultaneous presence of dental caries in mandibular first permanent molar and its antimere while 15[15%] females did not show any evidence. Dental caries is frequently observed in the antimere of mandibular permanent first molar when the dental caries involves mandibular permanent first molar

Relationship between dental arch widths and mandibular plane angle in untreated adults with skeletal class II malocclusion

To investigate the arch width in untreated Class II subjects with average and high mandibular plane angles. Cross sectional comparative study. The study was conducted in the orthodontics department of Armed forces institute of Dentistry Rawalpindi from Sep 2008 to March 2009. Pretreatment dental casts and cephalograms of skeletal class II patients with complete set of permanent dentition except third molars reporting to the OPD of Orthodontic department were selected. Records of 60 patients [30 high angle, 30 normal angle] were randomly selected out of the 240 records studied. Intermolar and intercanine widths were measured in millimeters using digital calipers. Mandibular plane angle was measured from cephalometric tracings using the SN Mandibular plane [CoGn SN] angle as used in Steiner's analysis. The mean intermolar width for the normal angle group was 49.18 +/- 2.69 mm and 48.56 +/- 4.44mm for the high angle group. The mean intercanine width for the normal angle group was 34.41 +/- 2.33mm and for the high angle group it was 33.13 +/- 2.60mm. Independent t test failed to show any significant [p > 0.05] difference in the IMW between normal and high angle patients. However a significant [p < 0.05] difference was observed in the intercanine width of the normal and high angle groups. In our study there was no significant difference of intermolar width whereas significant difference of intercanine width was found between normal and high angle cases

Root resorption of permanent incisors during three months of active orthodontic treatment

Root resorption is one of the most common and undesirable sequelea of orthodontic treatment. The aim of this study was to evaluate the amount of root resorption in permanent incisors during 3 month active period of fixed orthodontic appliance therapy using periapical radiographs. Periapical radiographs of a total of 138 permanent teeth [n=138, mandibular n1=52, maxillary n2=86] were evaluated for root resorption. All patients were treated with 3M MBT multibonded, pre-adjusted appliances with 0.022 inch slots. Initial levelling and alignment was achieved with 0.0175 inch co-axial wires. All four incisors [maxillary and mandibular] were measured for any change in root length. The change in root length between T[o] [pre-treatment] and T1 [post-treatment] was measured in millimetres and expressed in terms of percentage of original root length. The mean pre treatment [T[o]] root length for the maxillary teeth [n1=62] was 19.27 +/- 2.86 mm and 20.01 +/- 2.57 mm for the mandibular teeth [n2=31]. The post-treatment [T[1]] root length for the maxillary teeth was 18.96 +/- 2.85 mm and 19.49 +/- 2.4 mm for the mandibular teeth showing a mean resorption of 0.31 mm and 0.52 mm for the maxillary and mandibular teeth respectively. Root resorption was strongly correlated with active orthodontic appliance therapy with maxillary and mandibular incisors being most susceptible. It was found that root resorption can be detected even in the early levelling and alignment stages of orthodontic treatment

Comparison of upper and lower pharyngeal airway space in class II high and low angle cases

Normal airway is one of the important factors for the normal growth of the craniofacial structures. Skeletal features such as retrusion of the maxilla and mandible and vertical maxillary excess in hyperdivergent patients may lead to narrower anteroposterior dimensions of the airway. The purpose of this study was to compare the widths of the upper and lower pharyngeal airways in Class II malocclusion patients with low and high vertical growth patterns. The sample comprised sixty five class II subjects divided into 2 groups: thirty three Class II high angle and thirty two Class II low angle. The upper and lower pharyngeal airways were assessed according to McNamara's airways analysis. Independent t-test was used to compare upper and lower airway space in Class II high and low growth patterns. Independent t-test showed a statistically significant difference [p < 0.05] in upper and lower airway space between the two groups, showing that in class II high angle cases, both upper and lower airway space is narrow than in low angle cases. Subjects with Class II malocclusions and vertical growth patterns have significantly narrower upper and lower pharyngeal airways than those with Class II malocclusions and horizontal growth patterns. Narrow pharyngeal airway is one of the predisposing factors for mouth breathing and Obstructive sleep apnoea [OSA]

Correlation of upper airway space and maxillary intermolar width

To access the relation between upper airway space and maxillary intermolar width. A descriptive study. The study was carried out at the orthodontics department of Armed Forces Institute of Dentistry Rawalpindi. The study was conducted at orthodontics department, Armed Forces Institute of Dentistry. Study casts and lateral cephalograms of 12 to 14 years old skeletal Class II patients with no previous history of orthodontic treatment or air way related surgery were included in the study. Upper airway space was measured on the cephalograms as described by McNamara Jr. Maxillary inter molar width was measured on the corresponding study casts using a digital caliper. Pearson's correlation i.e r=0.18 showed a direct [r = 0.21] but insignificant [P > 0.05] correlation between upper airway space and maxillary intermolar width. This study failed to show any correlation between maxillary intermolar width and upper airway space, as has been postulated by some researchers

Evaluation of tooth size discrepancy in different malocclusion groups

Orthodontic diagnosis and treatment planning requires the patient's thorough history, extra and intra oral examination, analysis of diagnostic records comprising of orthodontic photographs, necessary radiographs and properly trimmed study casts. Tooth-size is the sum of mesio distal widths of the maxillary and mandibular teeth. For ideal occlusion, teeth in both arches should be proportional in size. If larger teeth in one jaw are occluded with smaller teeth in the other jaw, ideal occlusion is not achieved. Tooth size analysis was presented by Bolton in 1958. The ratio for anterior segment was derived to be 77.2 +/- 0.22% and 91.3 +/- 0.26% for the whole arch. A quantitative study was carried out at the Armed Forces Institute of Dentistry [AFID], Rawalpindi, Pakistan, a tertiary care facility. Cross sectional data was gathered from the study casts of patients undergoing orthodontic treatment at AFID, after obtaining informed written consent from them. 135 out of 200 study casts were filtered based upon the inclusion and exclusion criteria. ANB angle and witt's appraisal were traced on corresponding lateral cephalograms. The mesio distal widths of all maxillary and mandibular teeth from right first molar to left first molar were calibrated with the use of a manual caliper. The readings were then used to compute the anterior and total Bolton ratios. Significantly higher mean anterior tooth ratios were found for Class II [p<0.01] patients. All other ratios were within close range of Bolton's norms. Skeletal Class II patients showed a tendency towards higher mesiodistal widths of teeth in the mandibular anterior region

Periodontal evaluation of AFID cadets in lower anterior crowding

The objective of this study was to analyze the correlation between lower anterior teeth crowding and the periodontal status among cadets of Armed Forces Institute of Dentistry. The investigation of this relationship was done on 60 cadets. 30 subjects each represented the experimental and the control sample, with an age range between 19-24 years. Plaque Index [PI] of lower six anterior teeth was used for assessment of periodontal status. Irregularity index [II] was used to calibrate the amount of lower anterior crowding. A number of statistical tests were performed to analyze the data. The labial and lingual surfaces of teeth examined presented with plaque accumulation, that increased with the severity of lower anterior teeth crowding and was seen more lingually than labially. So a significant relation was observed between periodontal indices and lower anterior crowding [P - value < 0.001]. On comparison between control group and experimental group, the labial and lingual surfaces of lower anterior teeth of control group showed less amount of plaque. Therefore a highly significant difference between the two group samples was present. Thus, the present study showed that lower anterior teeth crowding has a deleterious effect on the periodontal health of the teeth when measured by plaque index