Are changes in malocclusion associated with adulthood psychosocial well-being?

INTRODUCTION: The purpose of this study was to investigate the longitudinal psychosocial effects of changes in malocclusion from adolescence to adulthood on oral health-related quality of life (OHRQOL), self-rated dental appearance, and overall life satisfaction. METHODS: The Dunedin Multidisciplinary Health and Development Study is a longitudinal birth cohort study of 1037 children born at Queen Mary Hospital, Dunedin, New Zealand, between April 1, 1972 and March 31, 1973. Data on their health and development, including dental examinations, has since been collected periodically. Malocclusion severity was measured using the Dental Aesthetic Index in participants aged 15 and 45 years (data collected at age 18 years was supplemented for data missing at age 15 years). Other data collected included clinically assessed oral health (dental caries and periodontal disease experience) and self-rated dental appearance, OHRQOL, life satisfaction, and personality traits. RESULTS: Malocclusion data were available for 868 participants in adolescence and 834 aged 45 years. For those with a severe handicapping malocclusion at 15 years old, 46.6% who received orthodontic treatment transitioned to a resolved (ie, mild-moderate) malocclusion when aged 45 years, whereas only 16.2% of those who did not receive orthodontic treatment made that transition. A transition to a worse malocclusion was associated with impacts on OHRQOL when aged 45 years in the subdomains of functional limitation, psychological discomfort, and physical disability as well as worse self-ratings of dental appearance, and these findings were held after adjusting for potential confounders. Malocclusion was not associated with overall life satisfaction. CONCLUSIONS: Maintenance of acceptable occlusion after orthodontic treatment requires a strong emphasis on achieving and maintaining excellent dental health and avoiding chronic oral conditions such as dental caries and tooth loss. The long-term benefits of orthodontic treatment may diminish by midlife unless good dental health is maintained. Orthodontists have the responsibility to raise awareness among their patients on how to maintain good oral health after orthodontic treatment.

Changes in incisor relationship over the life course - Findings from a cohort study.

OBJECTIVE: The aim of this longitudinal cohort study was to investigate the changes in incisor relationship over three decades from adolescence to mid-adulthood. MATERIALS AND METHODS: The sample included 1,037 children (48.4% female) born between April 1972 and March 1973 from the longitudinal birth cohort Dunedin Multidisciplinary Health and Development Study. Overjet and overbite values were assessed at age 15 and 45 years and entered in a regression model as outcome variables. Baseline occlusal variables, sex, history of orthodontic treatment, periodontal data recorded at age 38, and self-reported oral parafunction and orthodontic treatment history recorded at age 45 were entered as covariates in the regression analysis. RESULTS: Regression modelling showed that overjet/overbite category (high or low) at age 15 tends to predict overjet/overbite category at age 45, with overjet become slightly larger (around +0.5 mm) and overbite slightly lower (-0.5 mm) over time. Study members with self-reported tooth clenching had a slighter greater overbite (+0.3 mm) at age 45 than those who did not. Additionally, those with signs of periodontal disease at age 38 had a slightly larger overjet (+0.5 mm) at age 45 than those without disease. Sex differences were demonstrated with females having 0.6 mm larger overjet, and 0.4 mm overbite at age 45. CONCLUSIONS: Overall, overjet values tend to be higher during mid-adulthood than during adolescence, while the converse is true for overbite. There appears to be a degree of sexual dimorphism in overjet and overbite values later in life. CLINICAL SIGNIFICANCE: Incisor relationships change during the life course and are related to ageing, sex, periodontal health, and parafunctional habits. Clinicians and educators should be aware of these changes when making treatment decisions that alter incisor relationship.

Temporomandibular condylar morphology in diverse maxillary-mandibular skeletal patterns: A 3-dimensional cone-beam computed tomography study.

BACKGROUND: The authors evaluated the morphology and symmetry of the temporomandibular joint in participants with normodivergent and hyperdivergent skeletal class I, II, and III patterns. METHODS: A total of 80 participants were divided into 4 groups on the basis of their sagittal and vertical skeletal patterns. Cone-beam computed tomographic images were used to evaluate the condyle-fossa relationship and the morphology and symmetry of the mandibular condyle. One-way analysis of variance and Tukey post hoc tests were used to compare the mean values among the different groups. RESULTS: Participants with class II hyperdivergent patterns had the smallest anteroposterior (mean [standard deviation {SD}], 4.4 [1.6] millimeters) and mediolateral (10.5 [3.0] mm) condylar process widths among all 4 groups. The mean (SD) axial condylar angle was flatter in patients with class III hyperdivergent patterns (19.8° [5.1°]) compared with the other groups. The mean (SD) anteroposterior differences of the condylar processes (2.9 [1.4] mm) in patients with class III hyperdivergent patterns were the greatest in all 4 groups. CONCLUSION: Participants in the group with class II hyperdivergent patterns have a smaller and narrower condyle compared with the other groups measured. Asymmetry was found among all groups, with participants with skeletal class III patterns having the most asymmetry. The most common condylar morphology in all groups examined was convex. PRACTICAL IMPLICATIONS: These results support the concept that morphology and symmetry of the temporomandibular joint varies in different skeletal patterns, presumably as an adaptive response to functional demands.