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.

Global distribution of malocclusion traits: A systematic review

Abstract Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.

Resumo Objetivo: considerando-se que os estudos disponíveis sobre a prevalência das más oclusões são de base local ou nacional, esse estudo teve como objetivo reunir dados para determinar a distribuição dos tipos de má oclusão em uma escala global, nas dentições permanente e mista. Métodos: foi realizada uma busca eletrônica através das ferramentas de pesquisa do PubMed, Embase e Google Acadêmico, para reunir estudos publicados até dezembro de 2016 sobre a prevalência das más oclusões, tanto na dentição permanente quanto na dentição mista. Resultados: dos 2.977 estudos encontrados, 53 foram analisados. Na dentição permanente, a distribuição mundial das más oclusões de Classe I, II e III foi, respectivamente, de 74,7% [31 - 97%], 19,56% [2 - 63%] e 5,93% [1 - 20%]. Na dentição mista, a distribuição dessas más oclusões foi de 73% [40 - 96%], 23% [2 - 58%] e 4% [0,7 - 13%]. Em relação às más oclusões verticais, observou-se prevalência de 21,98% de sobremordida profunda e 4,93% de mordida aberta. A mordida cruzada posterior afetou 9,39% da amostra. Os africanos mostraram a maior prevalência de Classe I e mordida aberta na dentição permanente (89% e 8%, respectivamente) e na dentição mista (93% e 10% respectivamente), enquanto os caucasianos apresentaram a maior prevalência de Classe II na dentição permanente (23%) e na dentição mista (26%). A má oclusão de Classe III na dentição mista foi mais prevalente entre xantodermas. Conclusão: mundialmente, nas dentições mista e permanente, as más oclusões de Classe I de Angle são mais prevalentes do que as de Classe II, especificamente entre os africanos; a menos prevalente foi a Classe III, ainda que mais prevalente entre os xantodermas na dentição mista. Na dimensão vertical, as mordidas abertas foram mais prevalentes entre xantodermas na dentição mista. A mordida cruzada posterior apresentou maior prevalência na dentição permanente na Europa.

Impacto del perfil facial en la apreciación de la personalidad / Impact of facial profile on personality assessment

Objetivo: determinar el impacto de los perfiles faciales y analizar si contribuyen a calificar a una persona de agradable, positiva, negativa, simpática, exitosa, alegre o amargada. Materiales y métodos: se modificó la fotografía de una paciente a fin de obtener cinco tipos de perfiles faciales, los cuales fueron evaluados mediante la escala de Likert por estudiantes de odontología, Los resultados fueron volcados en tablas con el programa Excel (Microsoft) y analizados mediante la prueba de ANOVA. Resultados: losperfiles de clase III fueron asociados a personas amargadas, menos exitosas, poco simpáticas y negativas. Los perfiles de clase II, a personas agradables, simpáticas, alegres y positivas. Los perfiles de clase I, a personas exitosas. Conclusiones: el perfil facial influye en la percepción de las personas. El perfil de clase III es asociado a valores socialmente negativos.

Management of Class II Malocclusion with Modification in Forsus Fatigue Resistance Device: A Case Report.

Management of class II malocclusion in adolescents by growth modulation is one of the most difficult and commonly encountered scenario in clinical orthodontics. Noncompliance has been a major concern for orthodontists. This case report describes the management of class II malocclusion in young adult with Forsus fatigue resistance device (3M Unitek, 2724 S., Peck Road, Monrovia, CA 91096; www.3Munitek.com), a fixed functional appliance, that is now most widely used for correction of Class II malocclusion. A common problem with this appliance is frequent debonding of mandibular canine brackets. The present article also describes a simple, chairside fabrication of acrylic button that will ensure prevention of debonding of brackets. This case report illustrates that functional appliances even today have a significant role in growth modulation that further minimizes the necessity of extraction of permanent teeth and orthognathic surgery.

Two Phase Orthodontic Treatment: A Case Report.

Myofunctional appliances become active through muscular forces that bring about the dentoalveolar and skeletal changes. Functional appliances can be both removable or fixed. Twin block appliance given by William Clark is one of the most popular functional appliance owing to its ease of fabrication for the orthodontist and its ease of wear for the patient. It is known to bring about both skeletal and dental changes and has been used extensively in Class II growing patients. This was a case report of a 12-year-old patient treated in two phases, first the functional phase using the twin block, followed by the second phase of fixed orthodontic appliance.

Cervical vertebral anomalies in skeletal malocclusions: A cross-sectional study on orthodontic patients at the Aga Khan University Hospital, Pakistan.

Introduction: Morphological deviations of the cervical vertebral column have been described in relation to craniofacial aberrations and syndromes. Furthermore, it has recently been shown that abnormal morphology of upper cervical vertebrae is associated with malformation of the jaws and occlusion. Accordingly, it is relevant to focus on similar associations in patients with skeletal malocclusions. Therefore, the objectives of this study are to: • Identify the anomalies of the cervical column in patients with skeletal malocclusions • Determine the association between cervical vertebral anomalies and skeletal malocclusions. Materials and Methods: This cross‑sectional study was conducted on a total of 90 subjects at the Aga Khan University Hospital, Pakistan. The inclusion criteria were: (1) Pakistani origin; (2) standardized pretreatment profile radiograph with first six cervical vertebrae visible; and (3) accessibility of the second‑profile radiograph (mid‑ or posttreatment). The exclusion criteria were: (1) A prior history of orthodontic treatment; (2) any craniofacial anomaly; and (3) systemic muscle or joint disorder. Lateral cephalograms of all subjects (n = 90) were traced by the principal investigator and sagittal jaw relationship was assessed. A total of 30 subjects each with skeletal Class I, Class II, and Class III malocclusions were selected and the cervical vertebral anomalies were observed on their cephalometric radiographs. The frequencies of cervical vertebral anomalies according to skeletal malocclusion categories and gender were analyzed with the Chi‑square test, whereas association of cervical vertebral anomalies with skeletal malocclusions was assessed with logistic regression analysis. The level of significance (P ≤ 0.05) was used for the statistical tests. Results: Most common anomaly observed in the three groups was fusion between C2 and C3 (P = 0.006). This anomaly was found in 20% of subjects with skeletal Class I, 50% of subjects with skeletal Class II and 53.3% with skeletal Class III malocclusions. The highest frequencies of partial cleft at the level of C1 and occipitalization were observed in subjects with skeletal Class II and III malocclusions, respectively. However, none of the subjects showed fusion between C1 and C2 or dehiscence. No statistically significant gender difference was found in the occurrence of morphological deviations of the cervical column. The association of cervical vertebral anomaly was found to be the highest with skeletal Class III and lowest with skeletal Class I malocclusions. Conclusion: Fusion between C2 and C3 seems to be the most commonly occurring anomaly. This anomaly seems to be more often associated with skeletal Class III than skeletal Class I or Class II malocclusions.

Tratamento precoce de más-oclusões esqueléticas de Classe II - comparação de três aparelhos ortopédicos funcionais: Bionator, Klammt, SN1 / Early treatment of skeletal Class II malocclusions – comparison of three functional appliances: Bionator, Klammt, SN1

Objetivo: comparar no plano sagital os efeitos esqueléticos e dentoalveolares para a maxila e mandíbula, como consequência do uso dos aparelhos Bionator, Klammt e SN1 no tratamento de más-oclusões esqueléticas Classe II. Material e métodos: foi realizado um estudo prospectivo de 21 crianças com má-oclusão esquelética de Classe II, tratadas com Bionator, Klammt ou SN1. Compararam-se mudanças no componente maxilar, mandibular e dentoalveolar através de medições e ângulos cefalométricos no plano sagital. Contrastaram-se as médias de longitudes e ângulos entre T1 e T2 pelas análises t student e wilcononox. Mediante Anova, foi contrastada a porcentagem da mudança nas medidas de interesse para os três grupos. Resultados: foram avaliadas 42 radiografias cefalométricas laterais (21 iniciais T1, 21 finais T2). Entre os participantes, 62% eram meninos e 38% eram meninas. A média das idades para início do tratamento foi 9,5 ± 1,2 anos. O SN1 apresentou a maior média de mudança na longitude mandibular Co-Pg (6,69 ± 3,3) e Co-B (6,59 ± 1,42). Encontrou-se a maior média de mudança relativa na altura do ramo mandibular no Bionator (9,52 ± 7,21). As mudanças dentoalveolares foram clinicamente relevantes para os três aparelhos. Conclusão: os aparelhos ortopédicos maxilares estimulam o crescimento mandibular sagital e vertical, controlam a posição sagital da maxila e geram mudanças dentoalveolares favoráveis para a correção de más-oclusões de Classe II.

Objective: comparing in the sagittal plane the skeletal and dento alveolar effects for the maxilla and the mandible as a result of the use of Bionator, Klammt and SN1 as a treatment of malocclusions class II skeletal. Material and Methods: a prospective study was realized on 21 boys and girls with skeletal Class II malocclusion under treatment with Bionator, Klammt or SN1, in which compare the changes in the maxillary, mandibular and dento-alveolar component by means of measurements and cephalometric angles in the sagittal plane. The averages of lengths and angles between T1y T2 was compare by t-student and wilcoxon tests. By Anova tests, contrasted the percentage of change in the measures of importance for the three groups. Results: 42 lateral skull radiographs were evaluated (21 initial-T1, 21 final-T2). 62% of participants were male and 38% were women. The average age for onset of treatment was 9.5 ± 1.2. The SN1 presented the highest average percent of change of the Co-Pg mandibular length (6.69 ± 3.3), Co-B (6.59 ± 1.42). A higher average relative change in the height of the ramus was found in Bionator (9.52 ± 7.21). Dento alveolar changes were clinically relevant for all three devices. Conclusion: orthopedic appliances stimulate mandibular sagittal and vertical growth, control the sagittal position of the maxilla, and generate favorable dento alveolar changes to correct class II malocclusions.

Proporción divina en pacientes con síndrome de clase II división 1 / Divine proportion in patients with Class II Division I Syndrome

La belleza y la armonía facial desempeñan una función decisiva en las relaciones sociales del hombre. La afectación estética es el principal motivo de consulta de los pacientes de Ortodoncia. La Proporción Divina está siendo estudiada cada día más, con fines diagnósticos y terapéuticos relacionados con la estética facial. Con el objetivo de evaluar el comportamiento de la Proporción Divina en mediciones faciales en pacientes con Síndrome de Clase II división 1 y su relación con el sexo se realizó un estudio descriptivo transversal durante los años 2008-2010 en el Departamento de Ortodoncia de la Facultad de Estomatología de la Habana. La muestra estuvo formada por 30 pacientes que cumplieron con los criterios de inclusión y se estudiaron las mediciones faciales mediante fotografías de frente y perfil. El estudio arrojó que los mayores porcentajes se encontraron en los pares que relacionaban la distancia entre el canto lateral de los ojos y el margen lateral de la nariz (66,7 por ciento); la base del tragus y el canto lateral del ojo y de este a la punta de la nariz (66,7 por ciento); de trichion al ala de la nariz y de esta al mentón (63,3 por ciento). Pocos pacientes mostraron la Proporción Divina en las mediciones faciales estudiadas, sin diferencias significativas en su comportamiento en relación con el sexo(AU)

The beauty and the facial harmony have a decisive function in social relationships of man. The esthetic affection is the leading cause of consultation of patients to Orthodontics. Divine Proportion is being more and more studied having diagnostic and therapeutical aims related to the facial aesthetics. To assess the behavior of Divine Proportion in facial measurements in patients presenting with Class II Division I syndrome and its relation to sex a cross-sectional and descriptive study was conducted for 2008-2010 in the Orthodontics Department of the Stomatology Faculty of La Habana. The sample included 30 patients who fulfilled the inclusion criteria studying the facial measurements by frontal and in profile photos. Study demonstrated that the greater percentages were in the pairs related to the distance between the lateral edge of eyes and the lateral margin of the nose (66.7 percent); the tragus basement ahd the lateral side of eye and from this one to nose tip and from this one to chin (63.3 percent). Few patients showed the Divine Proportion in the study facial measurements without significant differences in its behavior in relation to sex(AU)

Prevalence of dental ailments in 6-12 years old schoolchildren of Peshawar district

The aim of the present study was to report the prevalence of dental ailments among Peshawar Schoolchildren. Subjects aged 6-12 [n=967] were randomly selected from school children in Peshawar district. They were clinically examined by 4 trained and calibrated House Surgeons dental ailments using criteria described by World Health Organization. Dental caries was recorded in 45.6% of the children. The overall mean DMFT score was 1.13 + 0.247. Caries was significantly more severe in females as compared to males [p<0.05]. Gum bleeding was also significantly more prevalent but there is no significant difference as far as gender was concerned. Class II malocclusion and anterior crowding were more prevalent in females compared to male children. The prevalence of dental fluorosis was 0.3%. The prevalence of dental diseases was generally low among the study population. Caries experience was significantly low in District Peshawar compared to Pakistan national Mean DMFT = 1.39, the Decay - component being the major contributor to this recorded DMFT

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. Em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Prevalência de má oclusão em crianças entre 6 e 10 anos: um panorama brasileiro / An overview of the prevalence of malocclusion in 6 to 10-year old children in Brazil

OBJETIVO: estabelecer um panorama da ocorrência de más oclusões em crianças brasileiras de 6 a 10 anos de idade, além de duas situações clínicas frequentemente associadas a elas, a cárie e a perda prematura de dentes decíduos. MÉTODOS: a amostra selecionada foi aleatória e intencional, tendo-se avaliado 4.776 crianças. A coleta dos dados foi realizada por meio de exame clínico e anamnese, como parte da campanha "Prevenir é melhor que tratar", conduzida em 18 estados brasileiros e no Distrito Federal, com a participação de ortodontistas filiados à Associação Brasileira de Ortodontia e Ortopedia Facial (ABOR). RESULTADOS E CONCLUSÕES: verificou-se que apenas 14,83 por cento das crianças eram portadoras de oclusão normal, enquanto 85,17 por cento possuíam algum tipo de alteração oclusal - sendo 57,24 por cento portadoras de má oclusão de Classe I; 21,73 por cento, de Classe II e 6,2 por cento, de Classe III. Observou-se, também, a ocorrência de mordida cruzada em 19,58 por cento das crianças, sendo 10,41 por cento, na região anterior e 9,17 por cento na posterior; de sobremordida profunda em 18,09 por cento; e de mordida aberta em 15,85 por cento. Cárie e/ou perdas dentárias estavam presentes em 52,97 por cento das crianças. Além disso, verificou-se a possibilidade de intervenção ortodôntica preventiva em 72,34 por cento das crianças examinadas, e interceptora em 60,86 por cento. Sendo assim, destaca-se que a presença, nos postos públicos de saúde, de um especialista em Ortodontia, com qualificação que atenda aos padrões estabelecidos pela ABOR e pela World Federation of Orthodontists (WFO), pode beneficiar sobremaneira as crianças carentes brasileiras.

OBJECTIVES: To provide an overview of the malocclusions present in Brazilian children aged 6 to 10 years, and present two clinical situations often associated with these malocclusions, i.e., caries and premature loss of deciduous teeth. METHODS: A sample comprised of 4776 randomly and intentionally selected children was evaluated. Data collection was performed by clinical examination and history taking (anamnesis) as part of the campaign "Preventing is better than treating" conducted in 18 Brazilian states and the Federal District involving orthodontists affiliated with the Brazilian Association of Orthodontics and Facial Orthopedics (ABOR). RESULTS AND CONCLUSIONS: It was noted that only 14.83 percent of the children had normal occlusion while 85.17 percent had some sort of altered occlusion, with 57.24 percent presenting with Class I malocclusion, 21.73 percent, Class II, and 6.2 percent, Class III. Crossbite was also found in 19.58 percent of the children, with 10.41 percent in the anterior and 9.17 percent in the posterior region. Deep overbite was found in 18.09 percent and open bite, in 15.85 percent of the sample. Caries and/or tooth loss were present in 52.97 percent of the children. Moreover, the need for preventive orthodontics was observed in 72.34 percent of the children, and for interceptive orthodontics, in 60.86 percent. It should therefore be emphasized that the presence of specialists in orthodontics-duly qualified to meet the standards established by ABOR and the World Federation of Orthodontists (WFO)-in attendance at public health clinics, can greatly benefit underprivileged Brazilian children.

Prevalence of malocclusions in school-age children attending the orthodontics department of Shiraz University of Medical Sciences

To provide quantitative data about the prevalence of malocclusions in the Shiraz orthodontic population, we studied the records of 700 patients [391 girls and 309 boys] aged 6-14 years attending the undergraduate Department of Orthodontics at Shiraz University of Medical Sciences. The prevalence of Angle class I, II and III malocclusion of first molars was 52.0%, 32.6% and 12.3% respectively. Skeletal class I, II and III malocclusion was found in 18.0%, 70.0% and 12.0% respectively. There were no significant differences between the sexes in the prevalence of different types of skeletal malocclusion. Children with class III were significantly younger [mean age 8.9 years] than those with class I [9.6 years] or class II [9.7 years] malocclusions. Orthodontics students need more education and training in the management of class II malocclusion to improve the overall quality of care for patients

Frequency of class-III malocclusion reported in dental OPD, Karachi medical dental college

To determine the frequency of Class-III malocclusion reported Orthodontic department in Karachi Medical Dental College, Pakistan. It was a cross sectional study of orthodontic patients. With convenience sampling a total of 384 patients [267 girls, 117 boys] referred to the Department of Orthodontics, Karachi Medical Dental College, were evaluated in this study. The mean age of the patients was 11.86 +/- 3.16 years. There malocclusion were classified from I, II [Div-1 and Div-2 with sub division right and left], and III, and recorded according to angle classifications. Class-III malocclusion was the least common malocclusion present in the major category of malocclusion and found 8.1% of the samples. Class-III malocclusion requires very early treatment then class-II and Class I malocclusion and has totally reverse treatment philosophy. Having the lower frequency of Class-III malocclusion in the population makes doctor to focus more in later age group and puts less burden on health resources as more patients of Class-II and I can be treated using the same resources. The type of malocclusion, also an important factor that affects a patient's motivation to seek treatment

Association between symptoms of temporomandibular disorders and gender, morphological occlusion, and psychological factors in a group of university students.

Aim: The purpose of this study was to find out the prevalence of temporomandibular disorder (TMD) in a sample of university students and its relationship to gender, occlusion, and psychological factors. Materials and Methods: The sample comprised 196 subjects, aged 18-25 years. The TMD degree was evaluated using an anamnestic questionnaire. Morphologic occlusion was evaluated according to Angle classification (classes I, II, and III). The Hospital Anxiety and Depression Scale (HADS), a 14-item self-administered rating scale developed specifically to identify anxiety and depression in nonpsychiatric medical outpatients, was used to assess the levels of anxiety (HADSa) and depression (HADSd). Statistical Analysis: The incidence of TMD level, malocclusion, anxiety, and depression in both genders was calculated as percentages. Association between TMD degree and occlusion, HADSa, and HADSd was tested using the Chi-square test. Results: According to our results, 50% of the subjects had TMD, but it was of moderate or severe degree in only 9.18% of them. No statistically significant association could be found between TMD and gender or occlusion. TMD was found to have statistically significant association with HADSa but not with HADSd. Conclusion : A high prevalence of TMD was found in this student population; however, most of the cases could be classified as mild. Of the variables studied, only HADSa had a statistically significant association with TMD.

[ dentoskeletal effect of mandibular tongue guard in Cl II/I malocclusion]

The prevalence of Cl II malocclusion with tongue thrust and open bite is high. The pressure of the tongue during swallowing and its physiological activity could be transferred to the maxillary complex by the tongue crib and might advance the maxilla to an unfavorable position. This study aimed to evaluate the dentoskeletal change in the Cl II division 1 patients with anterior tongue thrust and mandibular deficiency treated by mandibular tongue guard, from a private office and orthodontic department of Azad University in Tehran. The sample consisted of 23 patients, [14 females aged 8 years and 9 months and 9 males aged 10 years and 6 months], with Cl II div 1 malocclusion in late mixed dentition with anterior tongue thrust. The patients were treated by mandibular tongue guard. Lateral Cephalograms were obtained and traced before and after treatment and certain angular and linear variables were measured. The pretreatment and post treatment measurements were compared using Paired t test to evaluate the significance of the results. The findings indicated that SNB, facial angle, the distance between B and Pogonion to the reference line and Interincisal angle were significantly increased [P<0.05]. The changes were mainly caused by mandibular growth, were observed after treatment by mandibular tongue guard. Decrease of IMPA, 1-SN, ANB, Wits were significant [P<0.05]. The changes of Jarabak index, SN-MP, SNA, Y-axis were not significant. In Cl II div 1 patients with mandibular deficiency combined with tongue thrust, mandibular tongue guard caused slight increase in mandibular growth

Importancia de la evaluación y clasificación del frenillo lingual / The importance of evaluation and classification of lingual frenum

El propósito de esta investigación surge a partir de la observación, cada vez más frecuente, de pacientes con maloclusiones, cuya causa principal es la anquiloglosia parcial o total. El objetivo fue determinar la cantidad de pacientes con maloclusión que presentaban anquiloglosia sobre una muestra de 282 pacientes de ambos sexos, correspondientes a las tres denticiones, quienes durante el período de un año (noviembre 2003-2004) concurrieron espontáneamente a la Facultad de Odontología de la UNC. En primer término, se evaluó la presencia de anquiloglosia, su frecuencia, y la maloclusión más frecuente en los pacientes con y sin anquiloglosia. Para categorizar los distintos tipos y grados de anquiloglosia, se aplicaron dos métodos de evaluación, considerándose 0 la norma en ambos grupos: (1) grado de movilidad lingual grados 0, 1, 2, 3, 4 (G), referido a la ubicación de la punta de la lengua y su relación con el paladar duro, por detrás de los incisivos superiores, estando el paciente en apertura bucal máxima (ABM); (2) longitud del frenillo lingual tipo 0, I, II, III, IV, medido con calibre de Boley, desde la inserción del frenillo hasta la punta de la lengua, considerándose clínicamente aceptable la lengua libre mayor de 16 mm. Los resultados obtenidos fueron: sobre 282 pacientes con maloclusión, 153 presentaron anquiloglosia, en los cuales la maloclusión más frecuente fue la Clase II, con 43,14 por ciento (n=66), siendo el grado de movilidad lingual G2 (n=92) con 60.13 por ciento y la longitud del frenillo lingual, Tipo II (n=65) con 42,50 por ciento, las más frecuentes.

Prevalencia de maloclusiones dentales en un grupo de adolescentes mexicanos y su relación con la edad y el género / Prevalence of dental malocclusions in a group of Mexican adolescents and its relationship with age and gender

Objetivos. Evaluar la frecuencia y distribución del tipo de oclusión dental en adolescentes mexicanos y medir su posible dependencia con la edad y el género. Material y métodos: Estudio epidemiológico descriptivo, transversal y prolectivo en el cual se examinaron a 675 adolescentes, previa calibración de examinadores (Cr=88 por ciento, Ca=90 por ciento, K=0,89). Para evaluar el tipo de oclusión se tomaron en cuenta los criterios establecidos por Angle y por Dewey-Anderson. Resultados. La tasa de prevalencia por maloclusiones fue de 94:100 /adolescentes resultando la Clase I de Angle la más frecuente(72,8 por ciento), resultando cinco y siete veces mayor que las Clases II y III, con una estimación al nivel poblacional entre 69 por ciento y 76 por ciento (IC95 por ciento=69,54-76,24). La maloclusión Clase I, tipo 1, fue la más frecuente, considerando la clasificación de Dewey-Anderson(58.3 por ciento). La prevalencia por edad resultó no ser estadísticamente significativa (X20,95 g.l. 12=20,314, p=0,610), lo que no sucedió al llevar a cabo este mismo análisis por género (X20,95, g.l.4=17,851 p=0.001). Conclusiones. La alta prevalencia de maloclusiones Clase I de Angle y el tipo 1 de acuerdo a Dewey-Anderson probablemente se desarrollaron por el inadecuado crecimiento de los maxilares y por la deficiente función masticatoria. No se encontraron diferencias significativas por edad, lo que no sucedió por género, mostrándose un riesgo mayor para el femenino. Debido a que la mayoría de los casos de maloclusión observados fueron Clase I, caracterizados en su mayoría por desplazamientos dentarios, su pronóstico es favorable, ya que pueden ser corregidas a partir de terapéuticas ortodónticas de baja complejidad y de menor costo.

Objective. Frequency and distribution of type of dental occlusion was assessed in Mexican adolescents and their possible dependence with age and gender.Material and methods. This study was carried out on 675 Mexican adolescents (aged 12-15 years) to assess both qualitatively and quantitatively certain dental occlusal features by Angle and Dewey-Anderson criteria, previous calibration of examiners (Cr=88%, Ca=90%, K=0,89). Results. The population was found to have a high prevalence of Class I malocclusions compared with Class II and III (CI95%=69,5 to 76,2). Malocclusion Dewey-Anderson Class I, type 1 was the most frequent (58.3%). No statistically significant differences were observed for age (X20,95 g.l. 12 =20,314, p=0,610), however a statistically significant difference can be observed by gender (X20,95, g.l.4=17,851 p=0.001).Conclusions. The high prevalence of dental malocclusion Class I type 1 were probably developed by the inadequate growth of the maxillary ones and for the faulty masticator function. It was statistically significant differences for gender being shown a bigger risk for women. The most cases observed were Class I malocclusion, characterized in their majority by dental displacements and they can be corrected by low complexity orthodontic therapeutic and a smaller cost.

Frecuencia de maloclusiones y su asociación con hábitos perniciosos en una población de niños mexicanos de 6 a 12 años de edad / Frequency of malocclusions and its association with pernicious habits in a 6- to 12- year-old Mexican children population

Se examinaron 135 niños mexicanos con dentición mixta en edades de 6 a 12 años, con el fin de evaluar la frecuencia de maloclusión y su posible asociación con hábitos orales perniciosos, manifestándose una predisposición hacia la clase I relación molar para el sexo femino con un 71 por cento con respecto a otro tipo de maloclusión, se encontró desviación de la línea media 10 por ciento y apiñamiento 10 por ciento. Asimismo, para hábitos bucales perniciosos encontramos onicofagia con un 41 por ciento para la clase I, afectando a niños de 11 años con preferencia por el sexo femenino con p = 0.021, respiración bucal 20 por ciento y empuje lingual 14 por ciento

Medidas radiográficas y corporales para diagnosticar relaciones de clase II utilizando análisis estadístico multivariado / Radiographic and body measurements to diagnose class II relationships using a multivariate statistical analysis

Para el diagnóstico en ortodoncia se han utilizado más de 40 variables dependiendo de los autores. De ellas, algunas aportan información para realizar el diagnóstico de las relaciones de clase II. Cuando se tienen tantas variables es necesario utilizar un método que permita identificar las más representativas y eliminar las redundantes. Para el logro de este objetivo se utilizó el análisis estadístico multivariado (análisis de componentes principales, análisis de factor, análisis de agrupamiento y análisis discriminante), con el cual se identificaron las variables: ángulo de Lande, ánguilo de la convexidad y la distancia del punto A a la perpendicular de FH; igualmente, se identificaron los subgrupos y los factores (constructor) por género; por último, se obtuvo la función discriminante para identificar las relaciones clase II. Con el análisis multivariado se logró reducir el número de variables utilizadas para el diagnóstico.