Orthodontic Treatment Need among Nepalese High School Students

Abstract Objective: To assess the need for orthodontic treatment among Nepalese high school students. Material and Methods: This is a quantitative, cross-sectional descriptive study. The sample comprises 938 children (537 males and 401 females) with an age group above 14 years. The subjects were selected voluntarily from seven different schools of Kathmandu valley using a multistage sampling technique. The Index of Orthodontic Treatment Need comprises two components: Dental Health Component (DHC) and Aesthetic Component (AC). Two trained and calibrated examiners performed the oral examination. Results: On analysis of the DHC component, it was found that 21% had no need, 18.1% had mild/little need, 24.3% had moderate/borderline need, 35.8% had severe need, and 0.7% had extreme treatment need. Similarly on analysis of AC component, it was found that 33% were AC-1, 30.8% were AC-2, 7.2% were AC-3, 8.2% were AC-4, 2.1% were AC-5, 3.6% were AC-6, 1.8% were AC-7, 7.4% were AC-8, 1.8% were AC-9, and 3.9% were AC-10. Conclusion: The Index of Orthodontic Treatment Need can be used as a tool for planning dental health resources and prioritizing the treatment need of different populations (AU).

Correlation of the need for orthodontic treatment between the self-perception of chilean adolescents aged 14 to 18 years and the dentist's diagnosis / Correlación de la necesidad de tratamiento ortodóncico entre la autopercepción de adolescentes chilenos de 14 a 18 años con la observación del odontólogo

Background: To correlate the need for orthodontic treatment between the self-perception of Chilean adolescents from 14 to 18 years old with the observation of a dentist using the same assessment scale, as well as to determine if covariates such as gender, age and type of school influence the self-perception of the adolescent and the examiner. Material and Methods: Cross-sectional descriptive study of adolescents aged 14 to 18 years from public, subsidized and private schools in Temuco, Chile. The probability sample is stratified by course, from first to fourth year, a total of 414 students participated, according to the eligibility criteria. The photographic score of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used. The statistical analysis of the data was performed with the SPSS Statistics program v.23. Results: 94.9% of the adolescents perceived themselves as having good aesthetics. The examiner considered that 77% presented this condition, p<0.00. Males perceived themselves better than females. At age 15, 1.7% of students considered themselves to have poor aesthetics, p<0.01. From the examiner's perspective, aesthetics are related to type of school, p<0.00. Conclusion: Adolescents perceive themselves better aesthetically than do the evaluators. The school type factor, according to the IOTN-AC examiner, shows a higher proportion of students with no need for orthodontic treatment in private schools, and a threshold need in municipal and subsidized institutions.

Correlacionar la necesidad de tratamiento ortodóncico, entre la autopercepción de adolescentes con el diagnóstico de un evaluador odontólogo, utilizando la misma escala de valoración, así también determinar si las variables como el género, la edad y la dependencia educacional influyen en la autopercepción del adolescente y la observación del examinador. Material y Métodos: Estudio descriptivo de corte transversal, en adolescentes de 14 a 18 años de escuelas públicas, subvencionadas y privadas de Temuco-Chile. Muestreo probabilístico estratificado por cursos, de primero a cuarto medio con una muestra de 414 estudiantes, según los criterios de elegibilidad. Se utilizó el score fotográfico del componente estético (AC) del Índice de Necesidad de Tratamiento de Ortodoncia (INTO). El análisis estadístico de los datos fue realizado con el programa SPSS Statistics v.23. Resultados: El 94,9% de los adolescentes se autoperciben con una buena estética, el examinador considera que un 77% presenta esta condición, p<0,00. Los varones se perciben mejor que las damas. Los adolescentes de 15 años un 1,7% considera tener mala estética, p<0,01. Desde la perspectiva del examinador la estética se relaciona con la dependencia educacional, <0,01. Conclusión: Los adolescentes se autoperciben mejor estéticamente que lo diagnosticado por evaluadores odontólogos. El factor dependencia educacional según INTO-AC examinador, muestra mayor proporción de estudiantes sin necesidad de tratamiento ortodóncico en los establecimientos privados, y necesidad límite en los públicos y subvencionados.

Nature and severity of dental malocclusion in children suffering from transfusion-dependent (-thalassemia major

ABSTRACT Objective: To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger's Treatment Priority Index (TPI) and index of orthodontic treatment need (IOTN)-dental health component (DHC). Methods: A cross-sectional study was conducted on 200 transfusion-dependent children diagnosed with homozygous β-thalassemia and 200 healthy school children aged 11-17 years. The TPI and IOTN-DHC data was recorded for both groups. Total TPI score for each subject was calculated and graded according to malocclusion severity estimate (MSE). Independent sample t-test was used to compare mean TPI scores, overjet and overbite between thalassemic and healthy children. Chi-square test was used to compare the frequency of IOTN-DHC grades, Angle's classification, and MSE grades between thalassemic and healthy children. Results: The most prevalent malocclusion was Class I in normal children (67.5%) and Class II in thalassemic children (59%). The mean overjet and overbite were significantly (p<0.001) greater in thalassemic children than in healthy children. Severe tooth displacements were 3.5 times greater in thalassemic children, compared to controls. A greater proportion of thalassemic children were in IOTN grades 3 and 4, compared to the controls (p<0.001). MSE grades 4 and 5 were significantly (p<0.001) more prevalent in thalassemic children, compared to the controls. Conclusion: There is a high prevalence of Angle's Class II malocclusion in thalassemic children. Majority of these children are categorized in higher grades of IOTN-DHC and TPI-MSE, showing a great severity of malocclusion and high orthodontic treatment needs.

RESUMO Objetivo: Avaliar a prevalência e gravidade da má oclusão em crianças que sofrem de beta-talassemia e mensurar a necessidade de tratamento ortodôntico usando o Índice de Prioridade de Tratamento (IPT) de Grainger e o Índice de Necessidade de Tratamento Ortodôntico (Index of Orthodontic Treatment Need - IOTN) - Componente de Saúde Dental (Dental Health Component - DHC). Métodos: Um estudo transversal foi conduzido com 200 crianças com diagnóstico de beta-talassemia homozigótica dependentes de transfusão e 200 crianças saudáveis em idade escolar, entre 11 e 17 anos. Os dados do IPT e do IOTN-DHC foram documentados para ambos os grupos. A pontuação total do IPT para cada sujeito foi calculada e classificada de acordo com a Estimativa de Severidade da Má oclusão (ESM). O teste t para amostras independentes foi usado para comparar os escores médios de IPT, sobressaliência e sobremordida, entre as crianças saudáveis e as com talassemia. O teste qui-quadrado foi usado para comparar a frequência dos escores do IOTN-DHC, a classificação de Angle e os escores do ESM entre crianças com beta-talassemia e crianças saudáveis. Resultados: A má oclusão mais prevalente foi a Classe I em crianças normais (67,5%) e a Classe II em crianças com beta-talassemia (59%). Os valores médios de sobressaliência e a sobremordida foram significativamente (p< 0,001) maiores em crianças com beta-talassemia do que em crianças saudáveis. Os deslocamentos dentários graves foram 3,5 vezes maiores em crianças com beta-talassemia em comparação com os controles. Uma proporção maior de crianças com beta-talassemia estava nos escores 3 e 4 do IOTN em comparação com os controles (p <0,001). Os escores 4 e 5 de ESM foram significativamente (p< 0,001) mais prevalentes em crianças com beta-talassemia em comparação com os controles. Conclusão: Há uma alta prevalência de má oclusão de Classe II de Angle em crianças com beta-talassemia. A maioria dessas crianças é categorizada em escores superiores de IOTN-DHC e IPT-ESM, mostrando uma grande gravidade de má oclusão e alta necessidade de tratamento ortodôntico.

Correlation between social psychology and personality characteristics and treatment options for adult patients with skeletal malocclusion / 华西口腔医学杂志

OBJECTIVE@#This study aims to explore factors affecting the dental aesthetic social psychology of patients with skeletal malocclusion and to measure the relationship between the objective orthodontic requirements and the subjective treatment requirements of patients. This work provides a reference for doctors to measure patients' orthodontic treatment needs.@*METHODS@#Adult patients with skeletal malocclusion were chosen as the research object. Questionnaire survey was used to analyze factors influencing the psychosocial impact of dental aesthetics questionnaire (PIDAQ), index of orthodontic treatment need (IOTN), and Eysenck personality questionnaire-revised short scale for Chinese (EPQ-RSC). The relationship among PIDAQ, IOTN, EPQ-RSC, and treatment options was also evaluated.@*RESULTS@#Seventy-two valid questionnaires were collected from adult patients with skeletal malocclusion. 1) The PIDAQ scores significantly differed among different occupations (P0.05). People with low educational level were more likely to receive surgery if their psychosocial impacts of dental aes-thetics were serious. 5) The score of psychoticism scale of EPQ-RSC and the educa-tional level had a mutual influence on the PIDAQ score (P<0.01). Moreover, the neuroticism scale and AC self-assessment scores had a mutual influence on the PIDAQ score (P<0.05). However, this study did not find a correlation between personality traits and treatment options.@*CONCLUSIONS@#Many factors, such as personal natural conditions, subjective aesthetic evaluation of teeth, and psychosocial impacts of dental aesthetics, affect patients' treatment options. Personality characteristics can play a certain role in dental aesthetics social psychology.

Association Between Psychosocial Status and Orthodontic Treatment Needs in Indonesian High School Students

Abstract Objective: To determine whether psychosocial status is associated with orthodontic treatment needs in high school students using the Psychosocial Impact of the Dental Aesthetic Questionnaire (PIDAQ) and the Index of Orthodontic Need (IOTN). Material and Methods: This cross-sectional study comprised 95 adolescents, both genders, aged 15-17 years old. PIDAQ was used to assess psychosocial status. The IOTN Aesthetic Component (IOTN-AC) and the IOTN Dental Health Component (DHC) was used to assess treatment needs. Examination of the oral cavity was carried out with the help of the IOTN ruler by observing the MOCDO components: missing teeth, overjet, crossbite, displacement, and overbite. The Chi-square test was used to determine the association of psychosocial status and orthodontic treatment need. The reliability test was carried out by using Cronbach's Alpha test (0.978). Results: There was an association between psychosocial status and orthodontic treatment need based on the IOTN-AC (p=0.001) and between psychosocial status and orthodontic treatment need based on the IOTN-DHC (p=0.140). Conclusion: There is an association between psychosocial status based on the PIDAQ and subjective orthodontic treatment need based on the IOTN-AC, but there is no association between psychosocial status based on the PIDAQ and objective orthodontic treatment need based on the IOTN-DHC in students of SMAN 27 Jakarta.

Influence of social capital on self-perception related to orthodontic treatment need

Aim: To evaluate the influence of social capital on self-perception related to orthodontic treatment need. Methods: A cross-sectional study was conducted with a sample of 578 11-16 years-old adolescents from a city in southern Brazil. Social capital was evaluated using the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Index of Orthodontic Treatment Need (IOTN) assessed malocclusion and self-perception related to orthodontic treatment need. Sociodemographic aspects of adolescents were also evaluated. Individual analyses were performed, relating the study variables to the outcome, estimating the odds ratio with the respective confidence intervals of 95%. The variables with p<0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p<0.10 remained in the model. Results: Social capital did not influence the self-perception related to orthodontic treatment need. Adolescents with high orthodontic needs were 5.35 (CI 95%: 2.68 to 10.65) times more likely to perceived orthodontic treatment need (p <0.05). Crowding and dental absence were associated with self-perception related to orthodontic treatment need (p <0.05). Conclusions: Social capital did not influence the self-perception related to orthodontic treatment need

Correlation between self-perception of need for orthodontic treatment in pregnant women and the perception of oral health professionals

Objective: to determine the correlation between the self-perception of need for orthodontic treatment in pregnant women and the perception of oral health professionals. material and methods: a cross-sectional study was conducted with a sample of 30 pregnant women, whose self-perception of the need for orthodontic treatment was assessed through the aesthetic component of the Index of orthodontic treatment need (IOTN). a panel of oral health professionals (OHP) composed by a dental surgeon and an orthodontist also evaluated the aesthetic perception for each pregnant woman, independently, using the same method. the correlation between the IOTN scores was evaluated using the Spearman's rank correlation coefficient and the resulting correlations were compared by the Eid-Gollwitzer-Schnmidt significance of correlations test. results: a moderate-positive, statistically significant correlation was found between the IOTN of the pregnant women and those of the dental surgeon (0.507, p=0.004) and of the orthodontist (0.451, p=0.013). between the dental surgeon and the orthodontist, the correlation was very high-positive and statistically significant (0.957, p<0.001). the OHP panel reported greater correlation than those involving the pregnant women (p<0.001). conclusion: the perception of pregnant women of the need for orthodontic treatment increased moderately similar to the perception of the OHP. the pregnant women showed less consistency in their perception than the OHP, demonstrating low awareness of need for orthodontic treatment by pregnant women.

AVALIAÇÃO OBJETIVA E SUBJETIVA DA NECESSIDADE DE TRATAMENTO ORTODÔNTICO DO ADOLESCENTE E SEU IMPACTO SOBRE A AUTOESTIMA / OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT'S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM

RESUMO Objetivo: Verificar a presença de associação entre a avaliação objetiva e subjetiva da necessidade de tratamento ortodôntico em adolescentes e seu impacto na autoestima. Métodos: Estudo transversal com adolescentes de 10 a 17 anos da cidade de Sri Ganganagar, Rajastão, Índia. Foi utilizado o Índice de Ortodontia de Saúde Dental (IOTN) para avaliar de modo objetivo a necessidade de tratamento (DHC) e o componente estético desse índice (AC) para a avaliação subjetiva. Os estudantes selecionados foram também avaliados quanto a traumatismos dentários, perda dentária e cárie dentária. Aplicou-se a escala de autoestima de Rosenberg para determinar o nível de autoestima dos estudantes. Os dados foram analisados por regressão linear múltipla, testando a associação individual das diferentes variáveis clínicas independentemente da autoestima dos adolescentes, de acordo com o escore da escala de Rosenberg. Resultados: Entre 1.140 adolescentes estudados, a prevalência da necessidade de tratamento ortodôntico avaliado de modo objetivo pelo IOTN-DHC ocorreu em 56,9% dos indivíduos. A avaliação subjetiva do adolescente (IOTN-AC) revelou prevalência de necessidade de tratamento de 53,3%. A análise multivariada mostrou que, além de todos os problemas dentários, o componente objetivo (IOTN-DHC), seguido do componente estético subjetivo (IOTN-AC), teve maior impacto na autoestima dos estudantes analisados. Conclusões: A insatisfação com a aparência dental é um forte preditor de baixa autoestima na adolescência.

ABSTRACT Objective: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Methods: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Results: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Conclusions: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence.

Autopercepção da criança e do adolescente em relação à má oclusão e sua motivação para o tratamento ortodôntico / Child/adolescent's self-perception of malocclusion and motivation for orthodontic treatment

Objetivo: Comparar a autopercepção da criança e do adolescente em relação à má oclusão e sua motivação ao tratamento ortodôntico. Material e métodos: A amostra de 216 jovens foi dividida em dois grupos: Grupo 1 (136 crianças com idade entre 8 e 10,9 anos) e Grupo 2 (80 adolescentes de 11 a 14 anos de idade). A autopercepção e o nível de necessidade de tratamento foram avaliados por meio do Componente Estético (AC) e do Componente de Saúde Dentária (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN). A motivação para o tratamento ortodôntico foi avaliada por meio de questionários. Os dados foram analisados estatisticamente por meio dos testes Qui-quadrado e Mann-Whitney. Resultados: As crianças apresentaram um escore de IOTN-AC estatisticamente maior do que o dos adolescentes. A oclusão foi avaliada pelo IOTN-DHC e mostrou que a maioria dos jovens apresentou necessidade definida de tratamento ortodôntico no Grupo 1 (55%) e no Grupo 2 (43%). As principais razões citadas pelos grupos avaliados para justificar o uso do aparelho foram: "Acho bonito usar aparelho" e "Meus pais acham importante usar aparelho". Conclusão: As crianças foram mais críticas com a autoimagem que os adolescentes e a motivação para tratamento estava relacionada à estética e à opinião dos pais.(AU)

Objective: To compare child and adolescent's self-perception of malocclusion and their motivation for orthodontic treatment. Material and methods: A sample of 216 individuals was divided into two groups: Group 1 (136 children aged from 8 to 10.9 years) and Group 2 (80 adolescents aged from 11 to 14 years). Self-perception and treatment need level were evaluated using Aesthetic Component (AC) and Dental Health Component (DHC) of the Orthodontic Treatment Need Index (IOTN). Motivation for orthodontic treatment was evaluated through questionnaires. Data were statistically analyzed through Chi-square and Mann-Whitney tests. Results: Child group presented an IOTN-AC score statistically higher than the adolescents. Occlusion was assessed by IOTN-DHC and showed that the majority of the children presented definitive orthodontic treatment need in Group 1 (55%) and Group 2 (43%). The main reasons mentioned by both groups to justify the orthodontic appliance use were: "I think it is beautiful to wear orthodontic appliance" and "My parents think it is important to use orthodontic appliance". Conclusion: Children were more critical about their self-perception than adolescents, and the motivation for orthodontic treatment was related to aesthetics and parents' opinions.(AU)

The prevalence of malocclusion and orthodontic treatment needs in school going children of Nalagarh, Himachal Pradesh, India.

Objective: The aim of this study was to determine the prevalence of malocclusion and orthodontic treatment need in 13–18‑year‑old schoolchildren of Nalagarh, Himachal Pradesh, India using the Index of Orthodontic Treatment need (IOTN) and to analyze the treatment needs between males and females and correlation between the esthetic component (AC) and dental health component (DHC) of IOTN. Subjects and Methods: The sample comprised 2000 school children (1125 females and 875 males) who had not undergone orthodontic treatment. No radiographs, study casts, were used; IOTN was calculated from clinical examination. Results: DHC results showed that little need for orthodontic treatment was found in 31.6% and moderate need in 30.85%. A great need was estimated at 37.55%. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by increased overjet, impeded eruption of teeth, and anterior or posterior cross bite. AC results showed that little need for orthodontic treatment was in 86.15%, moderate need in 8.90%, and great need in 4.95%. Limitations: Index does not consider midline discrepancy, soft tissue abnormalities, and AC does not include Class III and Class II div 2 malocclusion photographs. Conclusions: There seems a discrepancy in the proportion of children needing orthodontic treatment on esthetic and dental health grounds. This study provides baseline data on the need and demand for orthodontic treatment among the sample which is important for planning public orthodontic and dental services.

Orthodontic treatment outcomes obtained by application of a finishing protocol

ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS) of the American Board of Orthodontics (ABO). Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG) consisted of 17 patients (19.88 ± 4.4 years old) treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old) selected by stratified randomization without finishing intervention (CG). Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048), respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8) (p = 0.009) and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6) (p = 0.007). Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8) (p = 0.62) and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9) (p = 0.65). Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system.

RESUMO Objetivo: avaliar os resultados da implementação de um protocolo de finalização em pacientes tratados no programa de pós-graduação em Ortodontia da Universidad de Antioquia. A avaliação foi conduzida utilizando-se os critérios definidos pelo Objective Grading System (OGS) do American Board of Orthodontics (ABO). Métodos: modelos de gesso e radiografias panorâmicas de 34 pacientes foram avaliados. O grupo experimental (GE) consistiu de 17 pacientes (idade média = 19,88 ± 4,4 anos) submetidos a um protocolo de finalização que incluiu o treinamento para a etapa de finalização, a aplicação de um guia de finalização, o reposicionamento de braquetes e o acompanhamento dos pacientes. Os resultados obtidos para o GE foram comparados aos resultados de um grupo controle (GC), não submetido à etapa de finalização, composto por 17 pacientes (idade média = 21,88 ± 7,0 anos) selecionados por um método de amostragem aleatória estratificada. Resultados: os escores do GC e do GE foram de 38,00 ± 9,0 e 31,41 ± 9,6 (p = 0,048), respectivamente. Houve melhora significativa no escore do grupo GE, principalmente com relação às cristas marginais (GC = 5,59 ± 2,2; GE = 3,65 ± 1,8) (p = 0,009) e à angulação da raiz (GC = 7,59 ± 2,8; GE = 4,88 ± 2,6) (p = 0,007). Os critérios que não apresentaram melhora, mas obtiveram os escores mais altos, foram: alinhamento (GC = 6,35 ± 2,7; GE = 6,82 ± 2,8) (p = 0,62) e vestibularização (GC = 3,6 ± 5,88; GE = 5,29 ± 3,9) (p = 0,65). Conclusões: a implementação de um protocolo padronizado de finalização contribuiu para melhorar o desempenho clínico dos alunos em um programa de pós-graduação em Ortodontia, conforme demonstram os resultados oclusais. Maior ênfase deveria ser dada à fase de finalização, para se obter escores mais baixos no OGS do ABO.

Psychosocial impact of dental aesthetics among sudanesehigh school students / Impacto psicossocial da estética dental entre estudantes de ensino médio sudaneses

Dental aesthetics essential part of facial attractiveness, plays a vital role in the social as wellas the psychological well being of individuals. This study aimed to assess the level of dental aestheticsby the self-rated Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and the psychosocial impact of dental aesthetics using the ‘Psychosocial Impact of Dental Aesthetics Questionnaire’ (PIDAQ). Material and methods: A total of 192 high school students (13-16 yearsold), genders equally participated in the study and completed a modified version of the ‘Psychosocial Impact of Dental Aesthetics Questionnaire’ (PIDAQ). Dental aesthetics were assessed by the IOTN Aesthetic Component (self-rated IOTN-AC). The data was processed and analyzed using computer soft ware program “SPSS” (Statistical Package for Social Sciences) version 17. T-test has been used, P-valueof less than 0.05 was considered as significance. Results: All the variables of the PIDAQ showed a significant difference with the groups of the IOTN-AC(P-value < 0.05). Inter-gender significant difference was found among the students. Conclusion: Self perceived dental aesthetics has a strong influence on the psychological as well as the social well beingof individuals. There fore self-perception of dental aesthetics maybe an important key in deciding the orthodontic treatment need...

A estética dental é parte essencial da atratividade facial e desempenha um papel vital na vida social, bem como no bem-estar psicológico dos indivíduos. Este estudo teve como objetivo avaliar o nível de estética dental pela auto-avaliação do Componente Estético (CE) do Índice de Necessidade de Tratamento Ortodôntico (INTO) e o impacto psicossocial da estética dental utilizando o Questionário de Impacto Psicossocial da Estética Dental. Material e Métodos: um total de 192 estudantes do ensino médio(13-16 anos), distribuídos igualmente entre os sexos, participaram do estudo. Os estudantes responderam uma versão modificada do Questionário de Impacto Psicossocial da Estética Dental. A estética dental foi avaliada pelo Componente Estético do Índice de Necessidade de Tratamento Ortodôntico (autoavaliação). Os dados foram processados e analisados utilizando software”SPSS” (Statistical Package for Social Sciences) versão 17. O Teste t foi utilizado, com nível de significância de 5%. Resultados: todas as variáveis do questionário de impacto psicossocial mostraram uma diferença significativa com os grupos da avaliação do Componente estético (p < 0,05). Também foi encontrada uma diferença significativa entre os sexos. Conclusão: a auto-percepção da estética dental tem uma forte influência sobre a percepção psicológica, bem como com o bem-estar social dos indivíduos. Portanto a auto-percepção da estética dental talvez seja uma chave importante na decisão sobre a necessidade de tratamento ortodôntico...

Self-perceived need for dental treatment and related factors. A cross-sectional population-based study

Abstract This study compared adolescents' self-perceived need for orthodontic treatment with the normative need for such treatment and investigated associations between socioeconomic and demographic variables and self-perceptions of dental malocclusion. This cross-sectional study involved 1015 schoolchildren aged 12-15 years in São Luís, Maranhão, Brazil. The following data were collected using a questionnaire and an orthodontic examination card: demographic and identifying data, socioeconomic data, educational levels of family, household income, economic classification criteria, and self-reported skin color behavioral data, and oral health data. Normative occlusal condition was examined using the Angle classification and Dental Aesthetic Index (DAI). Data were analyzed using the chi-squared test (to analyze differences in the frequency distribuition of qualitative variables) and Poisson regression (to stimate associations between the perceived need of orthodontic treatment and study covariates), with a 5% significance level. Schoolchildren's self-perceived need for orthodontic treatment was associated with sex (p = 0.022) and the normative need for treatment (p = 0.004). Among socioeconomic, demographic, and oral health variables, only sex [prevalence ratio (PR) = 1.15; 95% confidence interval (95%CI) = 1.04-1.28; p = 0.009] and the normative need for orthodontic treatment (PR = 1.19; 95%CI = 1.08-1.32; p < 0.001) were associated with the perception of malocclusion, with female adolescents reporting a greater need for orthodontic treatment. Female adolescents seems to be more sensitive to oral health problems. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment and the Angle classification might overestimate the orthodontic treatment need.

Avaliação dos índices DAI e IOTN como Indicadores de complexidade e necessidade de tratamento ortodôntico / Assessment of DAI and IOTN indexes as indicators of orthodontic treatment complexity and need

O objetivo deste estudo foi determinar a complexidade e necessidade de tratamento ortodôntico através dos Índices DAI e IOTN (DHC) e avaliar as características da oclusão que apresentam relação estatística significativa com os índices, buscando inferir qual índice apresenta-se como a melhor ferramenta para a seleção de pacientes visando à assistência ortodôntica em saúde coletiva. A amostra deste estudo foi composta de 80 modelos de estudo de pacientes que buscaram tratamento ortodôntico. Foram utilizados protocolos internacionalmente reconhecidos para determinação dos índices e um examinador, devidamente calibrado, mediu os modelos segundo os critérios. Os resultados mostraram que mais de 50% dos casos necessitam de tratamento ortodôntico obrigatório de acordo com os índices. As características oclusais mais prevalentes nesta pesquisa foram: apinhamento anterior (47,5%), apinhamento maxilar (<2mm/51,25%), espaçamento segmento anterior (25%) e diastema mediano (<2mm/62,5%) no índice DAI; overjetmaxilar (< 4mm/31,25%) e overjetmandibular estavam presentes (38,75%) no índice IOTN (DHC). De acordo com os critérios avaliados pode-se concluir que os índices avaliados selecionam pacientes indicados para o tratamento ortodôntico com base nos critérios a que se propõem. O DAI é um indicador de necessidade de tratamento que toma como base características estéticas da dentição humana, enquanto o IOTN é um indicador associado às características potencialmente nocivas ao sistema estomatognático. Considerando a perspectiva de seleção de pacientes para tratamento ortodôntico em saúde pública, o IOTN apresenta-se como a ferramenta mais viável, pois seleciona pacientes com condições oclusais mais graves, as quais prioritariamente deveriam ser tratadas...

The aim of this study was to determine the complexity and orthodontic treatment need through DAI and IOTN (DHC) Indexes and testocclusion characteristics that show a significant relationship according to indexes, seeking to infer which of these indexes represented the best tool of patient selection for orthodontic care in public health. The sample of this study was composed of 80 study models of patients, who sought orthodontic treatment. To collect data internationally recognized protocols were used to determine the indexes and an examiner, calibrated for both indexes, measured the models according to the criteria. Results showed that over 50% of cases require orthodontic treatment according to the indexes. The most prevalent occlusal characteristics in this study were anterior crowding (47.5%), mandibular crowding (< 2mm / 51.25% ), anterior segment spacing ( 25%) and midline diastema (<2mm / 62.5 %) in DAI index; maxillary overjet (<4mm/ 31.25% ) and mandibular overjet were present(38.75% ) in IOTN index(DHC). According to the criteria assessed, it is concluded that the indexes assessed select patients referred for orthodontic treatment based on the criteria they propose. DAI is an indicator of treatment need that takes as its basishuman dentition aesthetic characteristics, while IOTN is an indicator associated with potentially harmful characteristics to the stomatognathic system. Considering the patient selection perspective for orthodontic treatment in public health, IOTN presents itself as the most viable tool for selecting patients with more severe occlusal conditions, which should be primarily treated...

Validación interna de modelo predictivo creado mediante nueva metodología aplicable en la atención primaria de salud / Internal validation of a predictive model created through a new methodology applicable in primary health care

Introducción: los modelos predictivos sirven de apoyo a la toma de decisiones en salud pública. Como parte del desarrollo de estos modelos, se debe contar con alguna forma de validación interna que permita cuantificar el optimismo en su desempeño predictivo. Para esta validación, se utiliza el mismo grupo de estudio empleado para su desarrollo y los resultados son reproducibles a la población subyacente. Objetivo: validar un índice de necesidad de tratamiento ortodóntico, creado mediante una metodología que utiliza, para construir el modelo multivariante, los valores del estadígrafo V de Cramer de cada predictor. Métodos: el modelo creado con la muestra de entrenamiento, se aplicó a 181 estudiantes de una escuela primaria de Santa Clara y se calcularon medidas del desempeño discriminatorio; estas fueron: área bajo la curva Receiver Operating Characteristic y parámetros calculados a partir de las matrices de confusión. Fueron comparados los modelos obtenidos mediante el nuevo método y la regresión logística. Resultados: el nuevo modelo superó en todos los parámetros calculados a la regresión logística, con valores de sensibilidad, especificidad y validez de 79,3 %, 84,3 % y 81,2 %, respectivamente. El área bajo la curva fue de 0,886. Conclusiones: estos resultados avalan el índice obtenido mediante V de Cramer, para su utilización en la población diana subyacente. La facilidad de cálculo y comprensión de esta metodología son argumentos a favor de su uso por decisores del sector en la atención primaria de salud.

Introduction: predictive models are support tools when it comes to decision making in public health. We should count on a specific form of internal validation, as a part of the development of these models, which allows us to quantify any optimism in their predictive performance. For this validation, the same group of study employed for its performance is used, and results are reproducible to the underlying population.Objective: to validate an index of orthodontic treatment need, created by means of a methodology, that uses the values of Cramer's V of each predictor in order to build the multivariate model. Methods: the model created with the training sample was applied to 181 students from a primary school of Santa Clara, and measures of discriminatory performance were calculated, such as, area under the receiver operating characteristic curve, as well as, parameters were calculated from the confusion matrices. Models obtained by means of the new method and the logistic regression were also compared. Results: the new model exceeds logistic regression in all calculated parameters with values of sensitivity, specificity and validity of 79,3 %, 84,3 % and 81,2 %, respectively. Area under the curve was of 0,886. Conclusions: these results support the obtained index through Cramer ` V in order to be used in the underlying target population. The easiness of calculation and comprehension of this methodology are arguments in favor of its use for health decision - makers in primary care.

Avaliação da severidade das más oclusões em indivíduos com má oclusão de Classe II 1ª Divisão tratados com o aparelho extrabucal modificado de Thurow / Evaluation of malocclusion severity using the modified Thurow extraoral appliance in subjects with Class II division 1 malocclusion

Os índices normativos são ferramentas de diagnóstico e de avaliação terapêutica muito importantes, pois possuem grande valia para o planejamento ortodôntico e a compreensão dos resultados obtidos. Dentre os índices validados, o Dental Aesthetic Index (DAI) pode avaliar a necessidade de tratamento ortodôntico e seus resultados, o qual aborda componentes estéticos e da oclusão dentária. Os indivíduos com má oclusão de Classe II, 1ª divisão, em crescimento, ocupam o primeiro lugar em busca do tratamento ortodôntico-ortopédico, parte com protrusão maxilar. O aparelho extraoral tem mostrado, ao longo dos anos, uma boa opção devido à possibilidade de promover alterações esqueléticas corrigindo o posicionamento da maxila, como o aparelho de Thurow modificado. Este estudo retrospectivo avaliou, por meio do Índice Dental Estético, as mudanças oclusais em 15 casos tratados por meio do aparelho de Thurow modificado. Houve uma diminuição significativa da severidade da má oclusão com a redução do escore DAI 4 de 87% para 0% do total de casos tratados. Conclui-se que o aparelho modificado de Thurow é eficiente no tratamento da má oclusão de Classe II, 1ª divisão, principalmente pela redução do overjet e melhoria da relação molar.

Normative indexes are very important diagnostic and therapeutic evaluation tools, since they have great value in orthodontic planning and understanding of orthodontic treatment results. Among the validated indexes, Dental Aesthetic Index (DAI) can evaluate the need for orthodontic treatment and its results, using occlusal and aesthetic components. Class II division 1 malocclusion cases, in growing patients, are the first in search for orthopedic-orthodontic treatment, of them with maxillary protrusion. Over the years the extraoral appliance has proved to be a good option due to the possibility of promoting skeletal changes by correcting the positioning of the bone bases, likewise, the Modified Thurow Extraoral Appliance. This retrospective study has evaluated, through the Dental Aesthetic Index, occlusal modifications in 15 cases treated with modified Thurow’s appliance. There was a significant reduction in malocclusion severity, with a modification of DAI score reducing from 87% to 0% of DAI score 4. It was concluded that modified Thurow’s appliance is efficient in Class II division 1 malocclusion, mainly in overjet reduction and improvement of molar relationship.

Trauma dentário como fator de inversão na erupção dentária e dilaceração radicular – relato de caso / Dental trauma as an inversion factor in tooth eruption and root laceration – case report

O objetivo do presente trabalho foi relatar um caso clínico de dilaceração e inversão dentária após trauma dentário. Nos primeiros estágios de desenvolvimento, o germe do incisivo superior permanente se encontra situado palatalmente e superiormente ao ápice do incisivo central decíduo. Gradualmente, o sucessor permanente muda em direção labial. Nesse momento a coroa do dente permanente avizinha da raiz do sucessor, iniciando o processo de reabsorção do dente decíduo. Por razões desta estreita relação entre o germe do dente permanente e o ápice do incisivo decíduo, acredita-se que um trauma agudo ao antecessor decíduo pode causar a dilaceração do eixo longitudinal do sucessor permanente. Clinicamente, a dilaceração pode ser revelada por meio de palpação alta no sulco labial e/ou no palato duro, enquanto que o exame radiográfico é característico e decisivo para o diagnóstico. A abordagem terapêutica de incisivo central superior tem de ser cuidadosamente planejada e precisa da cooperação de várias especialidades para alcançar o objetivo. A extração do incisivo dilacerado é uma prática comum, mas compromete o paciente com um extenso tratamento reabilitador no futuro...

The objective of this study was to present a case report of a dilacerated and inverted tooth after dental trauma. In the early stages of development, the germ of the permanent incisor is situated palatally and above the apex of the deciduous central incisor. Gradually the permanent successor changes in labial direction, at that time the permanent tooth crown approaches to the successor tooth root, starting the process of resorption in deciduous teeth. Due to this proximal relation between the germ of the permanent tooth and the apex of the deciduous incisors, it is believed that an acute trauma to the deciduous predecessor may cause dilaceration of the longitudinal axis of the permanent successor. Clinically, the dilaceration can be revealed by palpation in the labial sulcus and/or the hard palate, and radiographic examination is determinant for a final diagnosis. The treatment of the dilacerated central incisor has to be carefully planned and requires the cooperation of various specialties. The dilacerated incisor extraction is a common practice that may compromise patients’ life requiring an extensive rehabilitation treatment in the future...

Resultado de Tratamientos Ortodóncicos y su Relación con la Complejidad de la Maloclusión / Outcome of Orthodontic Treatments and its Relationship to Malocclusion Complexity

Este estudio descriptivo evalúa los resultados clínicos estáticos de los tratamientos finalizados en el Posgrado de Ortodoncia de la Universidad de Antioquia durante el periodo 2010-2011 y su relación con la complejidad inicial y otros factores administrativos. A los pacientes terminados se les realizó un seguimiento documental de la historia clínica para determinar el grado de compromiso inicial y se evaluaron, con los parámetros del Objective Grading System (OGS) del American Board of Orthodontic (ABO), los modelos y las radiografías panorámicas finales. De 99 pacientes que terminaron el tratamiento, 40 cumplieron los criterios de inclusión. El 80% de los pacientes que terminaron el tratamiento tenían maloclusión comprometida o altamente comprometida al iniciar. El puntaje OGS del ABO encontrado fue en promedio de 31,7(±8,5) puntos y el 50% de los casos pasaban los criterios del OGS. El tiempo de duración del tratamiento (55±22,25 meses) y el número de citas promedio para terminar el tratamiento (37,3±11,4) aumentan según la complejidad de la maloclusión inicial. El grado de maloclusión inicial tuvo relación estadísticamente significativa con los puntajes de OGS (p=0,018), mientras que otras variables administrativas y clínicas no afectaron los resultados. Los valores finales del OGS encontrados no son los ideales y son afectados por el compromiso de la maloclusión.

This descriptive study assessed the clinical static results of the treatment finished in the orthodontic graduate clinics of the University of Antioquia during the years 2010-2011, and its relationships with initial malocclusion complexity and some administrative factors. The records and complete medical histories of the patients were reviewed to determine the degree of initial malocclusion commitment and the final panoramic radiography and plasters were evaluated applying the Objective Grading System (OGS) proposed by the American Board of Orthodontic (ABO). Of 99 patients who completed treatment, 40 met the inclusion criteria. 80% of patients, who completed treatment, started with committed or highly committed malocclusion. The ABO OGS score found an average of 31.7 (±8.5) and 50% of the cases approved OGS criteria. The duration of treatment (55±22.25 months) and the average number of appointments to complete treatment (37.3±11.4) increased with the complexity of the initial malocclusion. The degree of initial malocclusion had statistically significant relationship with OGS scores (p=0.018), while other administrative and clinical variables did not affect the results. The final values of OGS found are not ideal and are affected by the complexity of the initial malocclusion.

Orthodontic manpower requirements of Trinidad and Tobago / Necesidades de personal de ortodoncia en Trinidad y Tobago

OBJECTIVE: A study was done to estimate the orthodontic manpower requirements of Trinidad and Tobago. METHODS: A questionnaire was administered via e-mail to 9 of 11 orthodontists. Information from a population census, a report on the orthodontic treatment needs of children in Trinidad and Tobago and this questionnaire were used to calculate the number of orthodontists and chairside orthodontic assistants needed in Trinidad and Tobago. RESULTS: On average, 50 per cent of the 289 patients treated by each orthodontist in Trinidad and Tobago annually are children. Approximately, 13 360patients can be expected to demand orthodontic treatment every year in this country. The number of orthodontists and chairside assistants required to treat these patients was estimated to be 44 and 154, respectively. CONCLUSIONS: Currently, Trinidad and Tobago only has a quarter of the number of orthodontists and orthodontic chairside assistants required to treat the number of patients in need. As the demand is relatively high in Trinidad and Tobago and the number of orthodontists has increased slowly and inadequately for the past decade, the orthodontists are likely to remain adequately employed and happy with their job unlike dentists who are currently in private practice for less than a year.

OBJETIVO: Se realizó un estudio con el propósito de calcular la necesidad de personal para el trabajo de ortodoncia en Trinidad y Tobago. MÉTODOS: Se administró una encuesta via correo electrónico a 9 de 11 ortodoncistas. La información de un censo de población, un reporte sobre las necesidades de tratamiento ortodóncico de los niños en Trinidad y Tobago, así como esta encuesta, se usaron para calcular el número de ortodoncistas y asistentes dentales de ortodoncia necesitados en Trinidad y Tobago. RESULTADOS: Como promedio, el 50 por ciento de los 289 pacientes tratados anualmente por cada ortodoncista en Trinidad y Tobago son niños. Puede esperarse que aproximadamente 13360pacientes pidan tratamiento de ortodoncia todos los años en este país. Estimados indicaron que el número de ortodoncistas y asistentes ortodoncistas requeridos para tratar a estos pacientes es 44 y 154, respectivamente. CONCLUSIONES: Actualmente, Trinidad y Tobago sólo tiene un cuarto del número de ortodoncistas y asistentes de ortodoncia requeridos para tratar al número de pacientes con necesidades. Como que la demanda es relativamente alta en Trinidad y Tobago y el número de ortodoncistas ha aumentado lenta e inadecuadamente en los últimos diez años, es probable que los ortodoncistas permanezcan adecuadamente empleados y felices con su trabajo, a diferencia de los dentistas que están actualmente en la práctica privada por menos de un año.