Orthodontic anomalies and malocclusions in Late Antique and Early Mediaeval period in Croatia.

OBJECTIVE: Malocclusions are relative infrequently analysed in bioarchaeological investigations and if investigated the samples are very small. This research provides analysis of orthodontic anomalies of even 1118 individuals from the Late Antique (LA) and Early Mediaeval (EM) period. Aims were to describe the prevalence of orthodontic anomalies in this historical period and to analyse which orthodontic anomalies are best suitable for bioarchaeological investigations. METHODS: 1118 skulls were examined for anomalies of tooth number, tooth displacement (rotation, malposition, diastema and crowding) as well as for malocclusions. RESULTS: The prevalence of hypodontia in the LA was 41.02% and 30.61% in the EM sample. Tooth displacement was noticed in 15.63% individuals from the LA and in 12.42% individuals from EM. About 26% of the LA sample and 7.19% of the EM sample were affected with tooth crowding and the difference was statistically significant. CONCLUSION: Orthodontic anomalies affecting only one tooth or group of teeth are more suitable for examination in bioarchaeological investigations than orthodontic features requiring presence of both jaws and all or almost all teeth. Clinical investigation protocols and methodology should be adopted for bioarchaeological researches and international standards and recommendations should be established for this kind of investigation on skeletal remains.

Esthetic rehabilitation of complicated crown fractures utilizing rapid orthodontic extrusion and two different restoration modalities.

This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.

Perception of orthodontic treatment need in children and adolescents.

SUMMARY: Patients' and parents' perception of malocclusion are important in determining orthodontic treatment demand, motivation, and cooperation. The aim of this study was to investigate differences in perception of treatment need in currently orthodontically treated, previously treated, and untreated subjects. The sample comprised 3196 children and adolescents (1593 males and 1603 females) aged 8-19 years (mean age 13.0 +/- 3.6 years) from 24 randomly selected public schools in Zagreb, Croatia. Objective treatment need was assessed clinically using the Dental Aesthetic Index (DAI). Subjective treatment need was estimated separately by an orthodontic resident, the child/adolescent and his/her parent using the Standardized Continuum of Aesthetic Need (SCAN) procedure. The children/adolescents completed a questionnaire that had five questions with five-point Likert-type scale answers concerning satisfaction with dental appearance, importance of teeth for facial appearance, and malocclusion-related quality of life. Spearman correlation and logistic regression were used for statistical analysis. Associations between objective and subjective orthodontic treatment need were weak but statistically significant (Rho from 0.20 to 0.50; P < 0.05). Malocclusion-related quality of life was poorly associated with treatment need. Satisfaction with tooth appearance showed the most frequent statistically significant correlation (Rho from -0.14 to -0.35; P < 0.05), while importance of aligned teeth for facial appearance and social contacts had the weakest correlation with treatment need. Perception of treatment need was greater in previously treated subjects. Parents' perception had a low predictive value. The findings of this study show that malocclusion has more impact on emotional well-being than on function or social contacts.

Tooth size discrepancy in orthodontic patients among different malocclusion groups.

An appropriate relationship of the mesiodistal (MD) widths of the maxillary and mandibular teeth favours optimal post-treatment results. The aims of this study were to determine whether there is a difference in the incidence of tooth size discrepancies among different skeletal malocclusion groups and if gender dimorphism exists. The dental casts and lateral cephalometric radiographs of 301 Croatian subjects (127 males and 174 females, mean age 16.86 +/- 2.93 years) were selected from a larger sample of records of the archives of the Orthodontic Department, School of Dental Medicine, University of Zagreb, Croatia. The subjects were from malocclusion groups according to Angle classification, with the corresponding skeletal characteristics. The MD dimensions of all teeth from first molar to first molar were measured on the dental casts using digital callipers. Statistical analysis was undertaken using Kolmogorov-Smirnov, t, and Scheffé's tests and one-way analysis of variance. A statistically significant gender difference was found in anterior ratio (P = 0.017). A significant difference in the overall and posterior ratio was observed between Class II and Class III subjects. There was a tendency for mandibular tooth size excess in subjects with an Angle Class III malocclusion and for maxillary tooth size excess in those with an Angle Class II malocclusion. The percentage of subjects more than 2 standard deviations from Bolton's means for anterior and overall ratios was 16.28 and 4.32, respectively.

Relations between anterior permanent teeth, dental arches and hard palate.

The width and length of the anterior teeth, the dimensions of the frontal dental arches and the dimensions of the hard palate were measured (24 men and 56 women, age range of 18-30 years). The results showed gender-related dimorphism only for the cervical width of the maxillary canine, which were wider in men, p < 0.05. The width-to-length ratios of the maxillary frontal teeth varied from 0.82 to 0.91. The tooth-to-tooth width ratios among different maxillary frontal teeth varied from 0.78 to 0.91. The sum of all anterior maxillary teeth widths was equal to the hamular width and to the distal maxillary arch width (p > 0.05), meaning that the sum of the frontal artificial teeth width may be selected upon the measurement of the hamular width on the hard palate. The ratios between the maxillary and the mandibular frontal dental arch dimensions are representative values for the skeletal class I.