Changes in lateral standing posture following orthognathic surgery: a cohort study.

Altering neuromuscular and musculoskeletal relationships also affects standing body posture, particularly in the head and neck areas. This prospective cohort study assessed the effects of orthognathic surgery on head posture in the lateral standing view. Thirty-one patients who underwent single-jaw orthognathic mandibular surgery were included. The patients underwent cephalometric and photographic evaluations of their habitual posture before and 6 months after surgery. The craniovertebral angle and Frankfort angle were determined and measured using MB-Ruler software. Mandibular positional changes were also measured by superimposing lateral cephalograms and recording changes in the menton point. All data were analysed by paired t-test. The craniovertebral angle increased significantly in patients with Class II malocclusion (P = 0.001) and decreased significantly in Class III patients (P = 0.004). Furthermore, the Frankfort angle was significantly increased in both Class II (P = 0.005) and Class III (P = 0.012) patients. The tendency towards forward head posture decreased in Class II patients, and the neck posture improved. Conversely, a slight but significant tendency towards a forward head posture was observed in Class III patients after surgery. Furthermore, the natural head position changed in both study groups, leading to a more upright head posture.

Evaluating malocclusion patterns in children with autism spectrum disorder using the index of complexity, outcome and need: a cross-sectional study.

BACKGROUND: The purpose of this study was to evaluate the complexity of malocclusion and existing patterns in children with autism spectrum disorders (ASD) using the index of complexity, outcome and need (ICON). METHODS: This cross-sectional study included children diagnosed with ASD, aged 9-15 years. A group of healthy children with the same demographic characteristics was randomly selected as the control group. Malocclusion was assessed according to ICON scoring protocol. The following parameters were recorded: dental aesthetics, upper arch crowding/spacing, presence of crossbite, anterior-vertical relationship (open and deep bite) and buccal segment anterior-posterior relationship. Finally, an overall ICON score was derived and reported for each patient. Descriptive analysis was performed for all investigated variables. Significance level was set at p < 0.05. RESULTS: A total of 324 children, divided into ASD (162) and control (162) groups, comprised the study population. Our results demonstrated that the average overall ICON score was significantly higher in the ASD group compared to the control group (38.77 vs. 27.43, p < 0.001). ASD children also obtained significantly higher scores regarding the dental aesthetics component (3.84 vs 2.78, p < 0.001). Study groups were significantly different in terms of the prevalence of incisor overbite and open bite (p = 0.002 and p < 0.001, respectively). Patients in the ASD group showed a higher prevalence of Class II and Class III malocclusions (p < 0.001). CONCLUSION: ASD children obtained significantly higher overall ICON scores, indicating more complex and severe malocclusions. These children also exhibited a greater tendency towards Class II and III malocclusions.

Differential outcomes of jaw bone position after surgical-orthodontic treatment in three types of skeletal Class III asymmetry patients.

BACKGROUND/PURPOSE: Facial asymmetry is common in Class III patients requiring orthognathic surgery. This study aimed to analyze jaw bone position after surgical-orthodontic treatment in three types of skeletal Class III asymmetry patients. METHODS: The retrospective study included 30 Class III patients who underwent surgical-orthodontic treatment comprising LeFort I osteotomy and bilateral sagittal split osteotomy (BSSO) without genioplasty. Cone-beam computed tomography (CBCT) images obtained before surgery (T1) and after post-surgical orthodontic treatment (T2) were superimposed with voxel-based registration. Patients were classified into three groups based on T1 CBCT scans. Groups 1 and 2 exhibited menton and ramus deviated to the same side. Menton deviation was larger than ramus width asymmetry in group 1, while the reverse was true for group 2. Group 3 had menton deviation contralateral to the side with greater ramus width. RESULTS: Menton deviation after treatment was improved in all groups. Ramus width asymmetry and coronal ramus angle difference decreased in groups 1 and 2. Neither improvement nor deterioration of ramus width asymmetry was noted for group 3. Comparing to groups 1 and 2, group 3 had greater roll and yaw rotations of distal segment, more upward pitch of proximal segment on chin deviation side, and largest inward yaw as well as backward translation of proximal segment on non-deviation side. CONCLUSION: The positional changes of osteotomy segments differed among three types of mandibular asymmetry. Special attention should be given to the atypical mandibular asymmetry with mandibular body and ramus deviating to opposite directions during surgical correction of jaw deflection.

The Influence of the Tongue on the Development of Dental Malocclusion.

The tongue supports the upper dental arch and encourages healthy dental arch development when it rests against the roof of the mouth. On the other hand, over time, malocclusion can result from incorrect tongue position, such as lying low in the mouth or thrusting forward during swallowing or speaking. As a muscular organ, the tongue applies forces to the jaws and teeth that may help with malocclusion or hinder it from aligning properly. The dentition and jaws grow and align according to the way the tongue, teeth, and surrounding structures interact. The tongue's morphogenetic function includes forming the arches and having an important impact on the maxillary complex's development. The tongue frequently assumes a balancing and compensatory function in subsequent phases, functioning more or less like a natural orthodontic bite. In adults, the tongue is able to compensate for problems like open bites, teeth that are out of alignment, or differences in the occlusal and sagittal planes of the spine. In this context, the tongue's ability to sustain occlusion during malocclusion can be considered a compensatory response. This is comparable to how lingual dysfunction may contribute to malocclusion or act as a potential source of recurring orthodontic instability. In order to diagnose and treat orthodontic issues, dental professionals must know the connection between tongue position and dental malocclusion. Malocclusion can be prevented or minimized with early intervention, such as myofunctional therapy to correct tongue position and habits, improving dental health and well-being overall.

Mapping the evolving trend of research on Class III malocclusion: a bibliometric analysis.

OBJECTIVES: This study aimed to provide visualized knowledge maps to show the evolving trends and key focal points of Class III malocclusion research through a comprehensive bibliometric analysis. MATERIALS AND METHODS: Class III malocclusion research published between 2000 and 2023 was retrieved from the Web of Science Core Collection. VOSviewer was utilized to count the citation and publication number of authors, institutions, countries and journals. Co-occurrence, co-citation, and cluster analyses and burst detection were conducted using CiteSpace. RESULTS: A total of 3,682 publications on Class III malocclusion were included in the bibliometric analysis. During 2000-2023, both the annual publication count and citation frequency exhibited a gradual upward trajectory, with a noticeable surge in recent years. In terms of production and citation counts of Class III malocclusion research, the core journal is the American Journal of Orthodontics and Dentofacial Orthopedics. Furthermore, apart from the primary keyword 'Class III malocclusion', 'orthognathic surgery' was identified as keyword with the most frequency. The cluster analysis of cited references reveals that the research focal points have shifted to 'skeletal anchorage' and 'surgery-first approach'. Furthermore, the burst detection identified 'quality of life' as a potential research hotspot since it has recently gained increasing scholarly attention. CONCLUSIONS: The current study provides scholars with the knowledge maps of evolving trends and prominent topics of Class III malocclusion research and a summary of research progress on various priorities during different periods. These findings are expected to provide a valuable guidance to facilitate the future research on Class III malocclusion.

Prevalence of Malocclusion Traits in Primary Dentition, 2010-2024: A Systematic Review.

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle-Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries.

Predicting Outcome in Clear Aligner Treatment: A Machine Learning Analysis.

Background/Objectives: Machine learning (ML) models predicting the risk of refinement (i.e., a subsequent course of treatment being necessary) in clear aligner therapy (CAT) were developed and evaluated. Methods: An anonymized sample of 9942 CAT patients (70.6% females, 29.4% males, age range 18-64 years, median 30.5 years), as provided by DrSmile, a large European CAT provider based in Berlin, Germany, was used. Three different ML methods were employed: (1) logistic regression with L1 regularization, (2) extreme gradient boosting (XGBoost), and (3) support vector classification with a radial basis function kernel. In total, 74 factors were selected as predictors for these methods and are consistent with clinical reasoning. Results: On a held-out test set with a true-positive rate of 0.58, the logistic regression model has an area under the ROC curve (AUC) of 0.67, an average precision (AP) of 0.73, and Brier loss of 0.22; the XGBoost model has an AUC of 0.67, an AP of 0.74, and Brier loss of 0.22; and the support vector model has a recall of 0.61 and a precision of 0.64. The logistic regression and XGBoost models identify predictors influencing refinement risk, including patient compliance, interproximal enamel reduction (IPR) and certain planned tooth movements, for example, lingual translation of maxillary incisors being associated with the lowest risk of refinement and rotation of mandibular incisors with the highest risk. Conclusions: These findings suggest moderate, well-calibrated predictive accuracy with both regularized logistic regression and XGBoost and underscore the influence the identified factors have on the risk of refinement in CAT, emphasizing their importance in the careful planning of orthodontic treatment and the potential for shorter treatment times, less patient discomfort, and fewer clinic visits. Identification of at-risk individuals could support tailored clinical decision-making and enable targeted interventions.

Assessment of the Relationship between Antero-Posterior Dental Malocclusions, Body Posture Abnormalities and Selected Static Foot Parameters in Adults.

Objectives: This study aimed to find if a relationship exists between antero-posterior malocclusions and the level of musculoskeletal disorders in adults, including body posture and static foot analysis. Methods: In all, 420 participants were recruited through convenience sampling (Kraków University students and patients of a local dentist's practice). Following general medical interviews, dental examinations and consideration of inclusion and exclusion criteria, 90 healthy volunteers (ages 19-35) were enrolled and assigned to three groups (n = 30) based on occlusion type (Angle's molar Class I, II or III). The research procedure involved occlusion and temporomandibular disorder assessment conducted by a dental specialist. Comprehensive morphological measurements of body asymmetry were performed using the Videography 2D package and FreeSTEP software, which calculated the parameters determined from anterior, posterior and lateral projection photos. Foot loading distribution was analyzed using the FreeMED baropodometric platform. Results: Significant differences were demonstrated in the positioning of the head, cervical and lumbar spine in the sagittal plane among individuals with the analyzed occlusal classes (p < 0.05). Individuals with Angle's Class II exhibited significantly greater forward head positions and greater depths of cervical and lumbar lordosis compared with individuals with Class III or Class I. Those with overbites had higher forefoot loading. The Class III individuals exhibited greater L-R displacement, indicating a larger angle of displacement of the centers of the right and left feet relative to the lower edge of the measurement platform, suggesting pelvic rotation. Conclusions: An inclination for concurrent occurrences of malocclusions and posture deviations in the sagittal plane was observed. An interdisciplinary approach involving dentistry and physiotherapy specialists which utilizes tools for comprehensive posture assessment is crucial for diagnosing and treating such conditions.

Class III Camouflage Orthodontic Treatment in Adult Patient with Anterior Crossbite and Abnormal Functional Shift: A Case Report.

Skeletal Class III malocclusion is a complex malformation with a prevalence of 81.6% in Airlangga University Dental Hospital, distributed in patients aged 15-45 years old. Camouflage treatment of skeletal Class III malocclusion improves prognosis with a mild-to-moderate shift. This study aimed to discuss orthodontic camouflage as an option for adult patients with Class III malocclusion, emphasizing its indications, implications, and expected results. This report presents the case of a 17-year-old male patient with poor facial aesthetics associated with protruded chin, abnormal functional shift, and temporomandibular joint pain. The facial profile was concave with lower anterior multiple diastemas, mandibular lip protrusion, mandibular displacement, and anterior crossbite. This case was treated by camouflage therapy using straight wire appliance system combined with elastic class III. After 24 months of treatment during the pandemic, the mandibular displacement and the crossbite were corrected, the teeth were arched, the anterior crossbite fixed, and the profile became convex. Camouflage orthodontic treatment can be an effective management option to achieve functional occlusion, stability, and a satisfactory aesthetic impression in adult patients with mild to moderate skeletal Class III deformities, anterior cross bite, and functional shift.

Comparison of Speech Defects in Different Types of Malocclusion.

Introduction Speech has a great impact on human evolution, allowing for the widespread knowledge and advancement of tools. Difficulty in pronouncing one or more sounds is the most common speech impairment. Speech defects are more commonly associated with class III malocclusion patients (difficulty in pronouncing 's' and 't' sounds), the second in line is class II malocclusion (difficulty in pronouncing 's' and 'z' sounds), and speech distortions are least affected in class I malocclusion (difficulty in pronouncing 's' and 'Sh'). Most patients with dentofacial disharmonies and speech distortions need orthodontic care and orthognathic surgery to resolve their issues with mastication, aesthetics, and speech. Aims and objectives To compare and assess speech difficulties in different types of malocclusion. Materials and methods The study was conducted over 160 subjects for three and half months. All of them were evaluated for speech defects before they received orthodontic treatment. The main basis of this study is according to Angle's classification of malocclusion. The subjects were segregated according to Angle's classification of malocclusion. Malocclusion traits that are included in this study are Angle's class I, Angle's class II division I and division II, and Angle's class III. Results According to the results, out of 160 subjects, labio-dental speech defects are observed in 8% where n=13 of the study participants, linguodental speech defects are observed in 2% where n=3, lingua-alveolar speech defects are present in 54% where n=86, and bilabial speech defects are observed in 2% where n=3 of the study participants. Here 'n' represents the frequency of the subjects. Severe speech defects are seen in Angle's class III malocclusion. Results according to the type of malocclusion include: labio-dental speech defects are seen in 37.5% in class I, 25% in class II division I, 0% in class II division II, and 37.5% in class III. Linguodental speech defects are seen in class III malocclusion subjects only. Lingua-alveolar sounds are seen in 27.8% of class I, 29.6% of class II division I, 1.9% of class II division II, and 40.7% of class III. Bilabial speech defects are only seen in class II division I subjects. According to the results, only lingua-alveolar speech defects are statistically significant, and more severe speech defects were observed in class III malocclusion. Conclusion Speech plays an important role in affecting the quality of life of people. Different types of malocclusion traits are associated with different types of speech defects.

Non-extraction Approach in a Borderline Case of a Growing Patient: A Case Report.

This case presents the effective non-extraction orthodontic treatment of a 13-year-old boy with crowding in both upper and lower arches and deep bite. The patient's chief complaint was irregularly placed maxillary anterior teeth. The active treatment duration lasted for 10 months, which resulted in the successful alleviation of arch crowding and correction of the deep bite without the extraction of any sound erupted tooth. Posttreatment, all of the patient's chief complaints were relieved. Essix retainers were fitted post-debonding, with instructions for the patient to wear them for the subsequent year to maintain the achieved results. This case highlights the efficacy of non-extraction orthodontic strategies in addressing crowding and deep bite issues, drawing the importance of individualized treatment plans to achieve optimal outcomes.

Craniosynostosis: orofacial and oral health perspectives with masticatory insights.

BACKGROUND: Craniosynostosis (CS), premature fusion of one or more cranial sutures, leads to abnormal skull development, impacting both facial esthetics and oral function. This study aimed to evaluate the specific orofacial and oral health characteristics, including masticatory performance, in Thai patients with CS. METHODS: A comparative study was conducted with Thai CS patients aged 6-17 years and a control group of healthy individuals with similar age distribution. Assessments included craniofacial morphology, oral health status, and masticatory performance. Intergroup comparisons utilized appropriate statistical tests. RESULTS: The study included 24 CS patients with a mean age of 10.11 ± 2.98 years and 30 controls. CS patients exhibited a significantly higher prevalence of various oral conditions compared to controls: cleft palate (20.8%), anterior open bite (41.7%), anterior crossbite (54.2%), posterior crossbite (50%), combined anterior-posterior crossbite (45.8%), dental crowding in both maxilla and mandible (50% and 45.8% respectively), congenitally missing teeth (50%), supernumerary teeth (12.5%), and eruption failure (54.2%). Furthermore, CS patients exhibited significantly higher caries prevalence and susceptibility, alongside poorer oral hygiene, compared to controls. Regarding jaw relationships, CS patients exhibited a significantly higher proportion of Angle's Class III malocclusion (50%) compared to the control group, where Class I malocclusion was predominant (50%). Masticatory performance, assessed using the two-color gum mixing ability test, showed significantly higher hue variance in CS patients (0.12 ± 0.07) compared to the control group, indicating reduced chewing performance. CONCLUSION: This study underscores the significant orofacial and oral health challenges faced by children with CS, including a high prevalence of malocclusions, dental anomalies, elevated caries experience, and compromised masticatory function. These findings emphasize the importance of tailored interventions and comprehensive oral healthcare strategies to address the unique needs of this population and improve their overall quality of life.

Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court.

Purpose: Ponticulus posticus (PP) is a bony protrusion located between the posterior portion of the superior articular process and the posterolateral portion of a posterior arch of the atlas vertebrae in the cervical spine. The aim of this study is to verify the presence of different types of PP in a Southern Italian pre-orthodontic cohort to understand its correlation with skeletal class and maturity. Methods: A case-control retrospective study was conducted, utilizing 212 latero-lateral telecranium radiographs to analyze skeletal maturity according to the cervical vertebral maturation method, the Angle's classification of malocclusion (I, II, or III), and the presence or absence of the PP, whether complete (c-PP) or partial (p-PP). A total of 212 lateral cephalograms were analyzed. Results: Of the 72 male patients, 67 (93%) exhibited PP, and 116 (88%) were PP. The chi-square value was 0.001, while Cramer's V was 0.270, indicating a significant correlation between age groups and PP presence, and a very strong association overall. Out of the 41 complete PP cases, class I was notably more prevalent than classes II and III. Conclusion: Orthodontists should carefully consider PP when assessing and treating individuals with or without skeletal discrepancies and dental anomalies.

Validity of digital analysis versus manual analysis on orthodontic casts.

BACKGROUND: As artificial intelligence within digital processes continues to advance and replace conventional manual workflows, it is crucial that digital data are consistent with analog data. The aim was to evaluate the validity and time efficiency of digital cast analysis on digital models in comparison with the manual, gold standard, cast analysis on plaster models. METHODS: Cast analysis was performed on 30 patients in three various methods: manually measured variables on plaster models (MP), manually measured variables on digital three-dimensional models (MD), and automatically measured variables on digital three-dimensional models (AD) on digital models. Digital cast analysis was performed in CS Model+. Analyses included metrical and categorical variables and the required work time. Measurements in MD and AD were validated to MP. Validity of the metrical variables was analyzed with Bland-Altman, Dahlberg's formula, and paired sample t test. Categorical variables were validated by Cohen's Kappa. Work time was analyzed with Wilcoxon signed-rank test. RESULTS: Metrical variables had measurement errors ranging 0.4 to 1.4 mm between MP-MD, and 0.6 to 3.2 mm between MP-AD. Observations of categorical variables had a moderate to strong (0.65 to 0.9) level of agreement between MP-MD, and a weak to moderate (0.4 to 0.68) level of agreement between MP-AD. Data for dental stage, vertical, and transversal relation was not provided in AD. Cast analysis was performed quicker digitally, P ≤ 0.05. CONCLUSIONS: Digital cast analysis is consistent with manual cast analysis for metrical variables. Analyses of categorical variables show a weak level of agreement with automatic digital analysis, such as space conditions and midline assessments. Digital cast analysis optimizes time compared with manual cast analysis, with automatic analysis being the fastest.

Combined Periodontal-Orthodontic Treatment with Periodontal Corticotomy Regenerative Surgery in an Adult Patient Suffering from Periodontitis and Skeletal Class II Malocclusion: A Case Report with 5-Year Longitudinal Observation.

A thick periodontal phenotype with thick gingiva and alveolar bone volume is required for safe orthodontic tooth movement and long-term stability. A high incidence of dehiscence and fenestration in the labial aspect of mandibular anterior teeth may limit the correction of deformity and orthodontic treatment, especially when the lower anterior teeth are needed to have a large range of movement. This study reports a combination of periodontal therapy and orthodontic therapy with periodontal corticotomy regenerative surgery (PCRS) in a 25-year-old patient suffering from skeletal Class II malocclusion and periodontitis. The patient received periodontal therapy 5 years ago and commenced orthodontic treatment 4.5 years ago. During the 4 years of follow-up for PCRS, the clinical and radiographic evaluations revealed significant improvements in the periodontal phenotype of the mandibular anterior region. The periodontal phenotypes in the mandibular incisors region were all modified from thin to thick. Supplementing orthodontic treatment with labial PCRS could be a promising treatment strategy to maintain long-term periodontal health in adult patients with alveolar deficiency and thin gingiva tissue.

Digital versus Manual Tracing in Cephalometric Analysis: A Systematic Review and Meta-Analysis.

Background: Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the findings from the earlier studies and determine the potential advantages and limitations of each method. The present systematic review aimed to compare the accuracy of digital and manual tracing in cephalometric analysis for the identification of skeletal and dental landmarks. Methods: A systematic search was performed using the keywords "Digital" AND "Manual" AND "Cephalometry" to identify relevant studies published in the English language in the past decade. The electronic data resources consulted for the elaborate search included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PsycINFO, Scopus, ERIC, and ScienceDirect with controlled vocabulary and free text terms. Results: A total of n = 20 studies were identified that fulfilled the inclusion and exclusion criteria within the timeframe of 2013 to 2023. The data extracted from the included articles and corresponding meta-analyses are presented in the text. Conclusions: The findings of the present systematic review and meta-analysis revealed trends suggesting that digital tracing may offer reliable measurements for specific cephalometric parameters efficiently and accurately. Orthodontists must consider the potential benefits of digital cephalometry, including time-saving and user-friendliness.

Floating-Harbor Syndrome: A Systematic Literature Review and Case Report.

Floating-Harbor syndrome (FHS) is an extremely rare genetic disorder connected with a distinctive facial appearance, various skeletal malformations, delayed bone age, and expressive language delays. It is caused by heterozygous mutations in the Snf2-related CREBBP activator protein (SRCAP) gene. The aim of this paper is to describe the case of a 14-year-old male with FHS, referring to a review of the literature, and to collect all reported symptoms. In addition, the orthodontic treatment of the patient is described. For this, the electronic databases PubMed and Scopus were searched using the keyword "Floating-Harbor syndrome". Similar to previous cases in the literature, the patient presented with short stature; a triangular face with a large bulbous nose; deep-set eyes and narrow eyelid gaps; a wide mouth with a thin vermilion border of the upper lip; and dorsally rotated, small ears. They also presented some less-described symptoms, such as macrodontia and micrognathia. Moreover, mild mental retardation, microcephaly, and delayed psychomotor development were found. On the basis of an extraoral, intraoral examination, X-rays, and CBCT, he was diagnosed with overbite, canine class I and angle class III, on both sides. To the best of our knowledge, orthodontic treatment of this disease has not been assessed in detail so far, so this is the first case.

The Correlation between Malocclusion and Body Posture and Cervical Vertebral, Podal System, and Gait Parameters in Children: A Systematic Review.

Background: This study investigates the relationship between malocclusion and body posture, head posture, podal system, and gait parameters in children. Methods: A systematic review of observational studies from 2010 to 2023 was conducted and 24 cross-sectional studies involving 6199 participants were identified. These studies were categorized into those dealing with body posture (10 studies, 3601 participants), cervical vertebral column and head posture (6 studies, 644 participants), the podal system (5 studies, 1118 participants), and gait (3 studies, 836 participants). Results: Evidence suggests a significant association between malocclusion and body posture, balance, podal system, and gait parameters. Notably, eight studies found a significant relationship between malocclusion and body posture, while five studies identified this relationship with the cervical vertebral column and head posture, five with the podal system, and three with gait parameters. Conclusions: Overall, the quality of evidence was strong for the association between malocclusion and body posture and the podal system and moderate for head posture and gait parameters. These findings offer insights for therapists to design interventions tailored to children with malocclusion based on considerations of body posture, head posture, podal system, and gait parameters, though further longitudinal cohort studies are needed for better predictive understanding.

Investigation of Malocclusion and Associated Factors in Preschoolers: A Cross-Sectional Questionnaire Study.

This study aims to describe the prevalence of malocclusion and identify associated factors in preschool children. Completed in 2022-2023, this cross-sectional study included 523 children aged 26 to 80 months in municipal schools in Salvador. An oral examination was carried out on the children, and a questionnaire was self-administered by the parents. Descriptive analyses and multivariate logistic regression (the backward method, p-value ≤ 0.05, 95% CI) were conducted. The majority of children were female (51.82%), over 54 months old (52.2%), Black or mixed race (90.63%), and not affected by COVID-19 (92.35%). The prevalence of malocclusion was 43.21%, with open bite as the most common condition. There was a significant association between malocclusion and screen time (OR: 1.34; p: 0.116; CI: 1.0-1.94), physical/psychological aggression (OR: 2.55; p: 0.031; CI: 1.0-5.98), consumption of ultra-processed foods (OR: 1.77; p: 0.003; CI: 1.22-2.57), digital suction (OR: 3.1; p: 0.001; CI: 1.56-6.16), and the habit of biting objects (OR: 1.56; p: 0.121; CI: 1.0-2.73). The promotion of comprehensive health in early childhood and psychosocial interventions are recommended, aiming to reduce screen time, aggression, consumption of ultra-processed foods, thumb sucking, and the habit of biting objects to prevent malocclusion.

Positional, morphologic, and volumetric differences in TMJ in unilateral posterior crossbites and controls: A retrospective CBCT study.

OBJECTIVES: The objective of this study was to evaluate if there are any morphologic, positional, and volumetric differences in the temporomandibular joint (TMJ) of patients with unilateral posterior crossbite (UPC) compared to controls. Another objective was to analyse the discrepancy in the TMJ between the crossbite versus non-crossbite side in UPC versus right and left sides in controls. Additionally, this study aimed to evaluate the differences in the bone density at the masseteric insertion site at the angle of mandible in the UPC group and control group. MATERIAL AND METHODS: One hundred and thirty-two CBCTs were analysed with 66 patients in UPC group and 66 patients in control group (non-crossbite). Temporomandibular joint spaces - Anterior joint space (AJS), Superior joint space (SJS), Posterior joint space (PJS), Medial joint space (MJS), Middle joint space (MiJS), and Lateral joint space (LJS) were measured. Additionally, bone density at angle of mandible and volume of mandibular condyle were evaluated. The measurements were compared between the groups as well as between the crossbite and non-crossbite sides within the UPC group and between right and left sides within the control group. Furthermore, the associations between UPC and changes in TMJ regarding joint space availability, bone density, condylar head volume, and the effects of sex and age were evaluated using regression analysis. RESULTS: It was observed that UPC group showed a greater condylar volume, than the control group. Additionally, a larger mean discrepancy was observed between the crossbite side and non-crossbite side within the UPC group concerning condylar volume than controls. Concerning age, condylar volume was observed to be larger in adults than children. Adults showed significantly greater bone density and condylar volume than adolescents. Concerning sex, it was observed that males showed a larger SJS (right), MiJS, LJS, and bone density at the mandibular angle than females. CONCLUSION: There is a difference in the TMJ parameters particularly condylar volume in patients with UPC compared to controls.