Cleft Care in a Developing Country: An Assessment of Knowledge and Attitudes of Patients/Parents of Children With an Orofacial Cleft to Orthodontic Treatment.

OBJECTIVE: To assess the knowledge, awareness and attitude to orthodontic treatment of patients and parents of children with orofacial clefts, receiving comprehensive cleft care treatment. DESIGN: Cross-sectional survey. SETTING: A major tertiary health care facility in Nigeria, the Lagos University Teaching Hospital, Idi-araba, Lagos. PARTICIPANTS: Patients and parents of children with orofacial clefts receiving comprehnsive cleft care. INTERVENTION: Patients and parents of children with orofacial clefts were asked to complete the survey. Interviewer-administered questionnaires were used. RESULTS: A total of 123 patients participated in the study, 55.3% (68) were females and 44.7% (55) were males. The majority (85.3%, 114) of patients were children aged between 0 and 5 years, while only 7.3% (9) were adults, aged 18 years and above. About one-third (41) of the respondents indicated that they felt "their teeth was not straight." Although 43.9% (54) reported that they knew that braces could be used to straighten teeth, only 13.8% of the respondents knew who an orthodontist was. Eighty percent (99) indicated that they would be willing to undergo treatment to straighten their teeth or their children/wards' teeth. CONCLUSION: The majority of parents of children with clefts and adult patients attending the institution's cleft clinic had limited knowledge of orthodontics and the orthodontic care required for patients with clefts, although they had a positive attitude toward orthodontic treatment. These findings will guide the center in planning patient-centered orthodontic care for patients with clefts while also highlighting areas of importance for patient counseling and education in the orthodontic care for these patients.

Perception of dental midline deviation amongst dental professionals and lay people

Objective: This study was conducted to evaluate the perception of midline coincidence as a determining factor in smile aesthetics. Methods: A single of a female smile was intentionally altered with a software program (Adobe Photoshop, CS5. 1990-2010, Adobe system incorporated). The alteration involved shifting the upper midline by 0.5mm to the left in four variations. These altered images were then rated by two groups, 30 in each group, the professionals and the lay persons using a visual analogue scale. Results: There was a statistically significant difference between the professionals and the laypeople in the perception of midline coincidence as a factor in assessing smile aesthetics, (p=0.038, T=2.1). Conclusion: The orthodontists, general dentists, other professionals and the laypersons detected specific dental aesthetic discrepancies at varying levels of deviation

Malocclusion and early orthodontic treatment requirements in the mixed dentitions of a population of Nigerian children.

INTRODUCTION: The aims of this study were to establish the prevalence of dental features that indicate a need for early intervention and to ascertain the prevalence of different methods of early treatment among a population of Nigerian children in mixed dentition. METHODS: Occlusal relationships were evaluated in 101 children in mixed dentition between the ages of 6 and 12 years who presented at the Orthodontic Unit, Department of Child Dental Health, Lagos University Teaching Hospital over a 2 years period. The need for different modes of early orthodontic treatment was also recorded. RESULTS: Anterior tooth rotations (61.4%) and increased overjet (44.6%) were the most prevalent occlusal anomalies. Others included deep bite (31.7%), reverse overjet (13.9%), and anterior open bite (14.8%). Severe maxillary spacing and crowding were exhibited in 12.0% and 5.0%, respectively. About a third (35.7%) of the subjects presented with crossbite while lip incompetence was observed in 43.6% of the subjects. About 44% of the subjects also presented with various oral habits with digit (15.8%) and lip sucking (9.9%) being the most prevalent. Subjects were recommended for treatment with 2 by 4 fixed orthodontic appliances (22.3%), habit breakers (20.7%), removable orthodontic appliances (16.5%), and extractions (15.7%). CONCLUSIONS: Increased overjet and anterior tooth rotation were the majority of occlusal anomalies seen, which are not only esthetically displeasing but may also cause an increased susceptibility to trauma to these teeth. Treatment options varied from extractions only to the use of appliance therapy.

Use of Twin Block of Clark in management of Angle's Class II Division I malocclusion. Case report.

A case report on the orthodontic management of a 10-year-old female patient with Angle's Class II Division I malocclusion, 12 mm overjet, incompetent lips, a deep bite and a lower midline shift to the right using the Twin Block of Clark is presented. Treatment objectives included reduction of the overjet and overbite, obtaining a Class I molar and canine relationship, and improving the patient's profile. After a thorough patient assessment, a two-phase orthodontic treatment plan was chosen with myofunctional therapy using the Twin Block constituting the first phase of treatment. Second phase of treatment was to be carried out using a preadjusted edgewise appliance system. Active treatment with the Twin Block lasted for nine months. Patient's compliance with the appliance was good, and an overjet reduction to 4.5 mm was achieved with an improvement in facial profile after the first phase of treatment. The Twin Block of Clark is a very good treatment alternative in managing selected cases of Angle's Class II Division I malocclusion.

Lip dimensions of an adult Nigerian population with normal occlusion.

INTRODUCTION: The soft tissue paradigm is placing greater emphasis on the importance of the soft tissue profile to orthodontic treatment planning. The purpose of this study was to determine the lip dimensions of a Nigerian adult population; compare the male and female values and to compare the values obtained for Nigerians with those reported for other population. METHODOLOGY: Lateral cephalometric radiographs of 100 students (44 males and 56 females) of the College of Medicine, University of Lagos, aged 18 to 25 years were taken. Selected subjects were of Nigerian ancestry with normal occlusion and a harmonious facial appearance. The radiographs were manually traced and the upper and lower lip length and thickness of each subject was measured. Statistical analysis was carried out using SPSS, while the male and female values were compared using student's t-tests. RESULTS: Mean values for the lip dimensions were computed for the entire sample. Marked sexual dimorphism was observed with the males having thicker and longer upper and lower lips than the females. The Nigerian sample also had a longer upper lip and a thicker and shorter lower lip than that reported for Caucasians. However, both population had a similar upper lip thickness. CONCLUSION: Cephalometric norms were developed for the lip dimensions of a Nigerian population. Marked sexual dimorphism was observed in the Nigerian population studied with the males having longer and thicker lips than the females. The lip dimensions of the Nigerian population studied differed from that reported for Caucasians and other racial groups.

Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria.

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region.