An Evaluation of Knowledge, Attitude, and Practice of Accelerated Orthodontics amongst Orthodontists.

BACKGROUND: Accelerated orthodontic teeth movement are procedures carried out to increase the rate of tooth movement thereby reducing treatment time. There are numerous techniques currently available to accelerate orthodontic treatment time, but evidence is still needed to determine the degree to which orthodontists accept and practice accelerated orthodontics. The present study is aimed at assessing the knowledge of Orthodontists on the practice of accelerated orthodontics; as well as their willingness to adopt it as a treatment option for their patients. METHODOLOGY: Ethical approval was obtained before the commencement of the study. The study population comprised all orthodontists practicing in Nigeria. Questionnaires were administered physically to the orthodontists at their annual general meeting. E-mails were further used to distribute the questionnaire to the orthodontists who were absent from the annual meeting. The questionnaire obtained information on respondents' biodata, knowledge, attitude, and practice of accelerated orthodontic treatment procedures.Statistical analysis was performed using IBM SPSS software version 27. The level of significance was 0.05 for all statistical analysis. RESULTS: The study participants comprised 60 respondents, with a mean age of 34.18 years and a male-to-female ratio of 1.3:1. A Majority of them were satisfied with treatment time/duration (61.7%), they had a good knowledge of accelerated orthodontics (83.3%) with piezocision (75%) and micro-osteoperforation (63.3%) being the most popular. All orthodontists were interested in accelerated orthodontics, if it offered up to 30% reduction in treatment time. Major limitations to the practice included unavailability of technique materials (50%), insufficient knowledge (41.7%) and cost (35%). CONCLUSION: Most orthodontists did not routinely practice accelerated orthodontics despite adequate knowledge. They were willing to offer accelerated orthodontic treatment (AOT) if patients were willing to pay an additional fee. The less invasive methods were more accepted.

CONTEXTE: Les mouvements dentaires orthodontiques accélérés sont des procédures réalisées pour augmenter la vitesse de déplacement des dents, réduisant ainsi le temps de traitement. Il existe de nombreuses techniques actuellement disponibles pour accélérer le temps de traitement orthodontique, mais des preuves sont encore nécessaires pour déterminer dans quelle mesure les orthodontistes acceptent et pratiquent l'orthodontie accélérée. La présente étude vise à évaluer les connaissances des orthodontistes sur la pratique de l'orthodontie accélérée, ainsi que leur volonté de l'adopter comme option de traitement pour leurs patients. MÉTHODOLOGIE: L'approbation éthique a été obtenue avant le début de l'étude. La population étudiée comprenait tous les orthodontistes exerçant au Nigeria. Des questionnaires ont été administrés physiquement aux orthodontistes lors de leur assemblée générale annuelle. Des courriels ont ensuite été utilisés pour distribuer le questionnaire aux orthodontistes absents de l'assemblée annuelle. Le questionnaire a recueilli des informations sur les données biographiques des répondants, ainsi que sur leurs connaissances, attitudes et pratiques en matière de traitement orthodontique accéléré. L'analyse statistique a été réalisée à l'aide du logiciel IBM SPSS version 27. Le niveau de signification était de 0,05 pour toutes les analyses statistiques. RÉSULTATS: Les participants à l'étude étaient au nombre de 60, avec un âge moyen de 34,18 ans et un ratio hommes-femmes de 1,3:1. La majorité d'entre eux étaient satisfaits du temps/durée du traitement (61,7 %), ils avaient de bonnes connaissances en orthodontie accélérée (83,3 %) avec la piezocision (75 %) et la micro-ostéoperforation (63,3 %) étant les plus populaires. Tous les orthodontistes étaient intéressés par l'orthodontie accélérée, si elle offrait une réduction allant jusqu'à 30 % du temps de traitement. Les principales limitations à la pratique comprenaient l'indisponibilité des matériaux de technique (50 %), le manque de connaissances (41,7 %) et le coût (35 %). CONCLUSION: La plupart des orthodontistes ne pratiquaient pas systématiquement l'orthodontie accélérée malgré des connaissances adéquates. Ils étaient prêts à proposer un traitement orthodontique accéléré (TOA) si les patients étaient prêts à payer des frais supplémentaires. Les méthodes moins invasives étaient plus acceptées. MOTS-CLÉS: Orthodontie accélérée, orthodontiste, temps de traitement, piezocision.

Craniofacial orthodontics and postgraduate orthodontic training in Nigeria.

INTRODUCTION: Craniofacial orthodontics has been shown to be a critical component of the care of patients with craniofacial anomalies such as cleft lip and palate. Thus, the purpose of this study was to assess the perceptions and clinical experience in cleft and craniofacial care, of orthodontic residents in Nigeria. METHODOLOGY: Questionnaires were sent out to orthodontic residents in the six Postgraduate Orthodontic Training Centers in the country at that time. The questionnaires were self-administered and covered areas in beliefs in cleft care and the clinical experience and challenges faced by the residents in the provision of craniofacial orthodontic care at their various institutions. RESULTS: Thirty-three respondents returned completed questionnaires, with a response rate of 97%. All the respondents believed that residents should be involved in cleft and craniofacial care. Postnatal counseling was the clinical procedure in which the residents reported the highest level of clinical experience (47.4%). The least clinical experience was recorded in pre-bone graft orthodontics (7.4%) and orthodontic preparation for orthognathic surgery (5.5%). Some of the challenges highlighted by the residents were low patients turn out for orthodontic care and the absence of multidisciplinary treatment for craniofacial patients in their centers. CONCLUSION: Orthodontic residents in Nigeria believe that they should be involved in the management of patients with craniofacial anomalies and cleft lip and palate. However, majority of the residents have limited clinical experience in the management of these patients. A lot more needs to be done, to expose orthodontic residents in training, to all aspects of the orthodontic and multidisciplinary team care required for the cleft/craniofacial patient.

Holdaway's analysis of the nose prominence of an adult Nigerian population.

BACKGROUND: Facial beauty is a function of harmonious balance among all parts of the face, and the nose plays a dominant role in this because of its location exactly in the middle of the face. Therefore, an evaluation of the nasal form and its position relative to other facial structures should play an important part in the assessment of patients before orthognathic surgery, rhinoplasty or orthodontics. AIM: The aim was to establish normative values for the nose prominence of an adult Nigerian population using Holdaway's soft tissue cephalometric analysis. METHODOLOGY: Lateral cephalometric radiographs of 100 adults aged 18-25 years, with normal occlusion and a harmonious facial appearance were analyzed. The nose prominence was assessed using Holdaway's analysis. Twenty radiographs randomly selected, were retraced to assess for errors. Data analysis included descriptive statistics, Student's t-tests and analysis of variance using the Statistical Package for Social Sciences. RESULTS: The mean value recorded for the nose prominence of the study population was 3.49 mm (standard deviation [SD], 3.26 mm), with a range of -5.0 mm to 15.0 mm. Mean values obtained for females were 3.73 mm (SD, 2.88 mm) and males 3.19 mm (SD, 3.70 mm). No statistically significant gender difference was observed (P>0.05). In addition, no significant difference was observed between the nose prominence values recorded for different age-groups (P>0.05). CONCLUSION: Normative values were established for the nose prominence of an adult Nigerian population. The values obtained for Nigerians in this study are comparatively lower than that reported for other populations. These values would aid in treatment planning for orthognathic surgery, rhinoplasty and orthodontics in Nigerians.

Metric analysis of the hard palate in children with digit sucking habits.

BACKGROUND: The effects of digit sucking on dentofacial structures has been widely studied, but its relationship with the function and/or shape of the palate has been negleted. A clinical observation of high palatal vault has been reportedly associated with digit sucking. However, the description has been made on the basis of subjective clinical observation rather than actual measurements. The aim of this study is to assess the effects of digit sucking habits on palatal dimensions of children with digit sucking habit; and compare the findings obtained to a control population. METHOD: Cross-sectional sucking behaviour data was collected on 250 school children aged 3 to 5 years using questionnaires completed by parents. Parameters including palatal widths, depth and heights were measured directly from the maxillary casts obtained from the children and palatal index was calculated. All values were compared using t-test. RESULTS: Significant differences were seen in palatal depth, palatal width, palatal height and palatal index at the level of the maxillary primary first and second molars. No significant difference was observed for palatal index at the level of the maxillary primary canine. CONCLUSIONS: It was concluded that digit sucking may cause changes in palatal dimensions.

Self-Perception of Malocclusion Among Nigerian Adolescents Using The Aesthetic Component of The IOTN.

INTRODUCTION: The practice of orthodontics is very young in South-South Nigeria and there is need for base line data for informed planning. This study was carried out to investigate the self-perception of malocclusion among Nigerian school children aged 12 to 18 years in order to compare their perception with that of an orthodontist and also to determine the influence of gender and age on self-perception. MATERIALS AND METHODOLOGY: A total of 612 randomly selected schoolchildren comprising 299 (48.9%) males and 313 (51.1%) females with a mean age of 15 + 2.0 years were included in the study, the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was the instrument used to measure the perception of malocclusion by both the school children and the orthodontist. RESULTS: Majority of the students (82.5%) rated their teeth towards the more attractive end of the scale (Grades 1-4). Although self - perception was not found to be related to gender, older children (16-18 years) had an increased level of perception of need. Males and older children were found to be more in need of treatment by the orthodontist. CONCLUSIONS: A significant difference was found between the orthodontist's rating and the students' ratings of the attractiveness of their occlusions. Age and gender were not found to influence self- perceived orthodontic treatment need. Therefore, for effective orthodontic care, self- perception and not only professional assessment must be taken into consideration when formulating treatment plans to ensure patient satisfaction.

A clinical review of crossbite in an orthodontic population.

BACKGROUND: Crossbite is a common occlusal anomaly. It may occur either anteriorly or posteriorly and may be either dental or skeletal in origin. OBJECTIVE: To determine the pattern and frequency of crossbite occurrence in an orthodontic population. METHODS: This was a retrospective study of 633 patients, 288 males (45.5%) and 345 (54.5%) attending a Lagos orthodontic clinic over a five-year period. Information obtained on each patient included age, sex and occlusal variables such as overjet, overbite and tooth-bone ratio. RESULTS: Out of the 633 patients seen 189 (29.9%) were recorded to have at least one tooth in crossbite. Anterior crossbite occurred in 125 (66.1%) of the affected patients while posterior crossbite was recorded in 37 (19.6%). Patients presenting with anterior and posterior crossbite constituted 27 (14.3%) of patients. Unilateral crossbite was slightly more frequently than bilateral crossbite. A total of 445 teeth were recorded in crossbite with the permanent maxillary lateral incisor being the most frequently affected tooth constituting 33.9% of the teeth in crossbite. The number of teeth in crossbite per patient ranged from 1 to 8, a single tooth in crossbite being most commonly occurring. Crossbite was most frequently seen in patients presenting with Class I malocclusion. CONCLUSION: Crossbite was a frequently occurring anomaly in the Lagos population, with anterior crossbite being more common. There appear to be gender or age difference in occurrence of crossbite in our population.

Effects of digit sucking on dental arch dimensions in the primary dentition.

The purpose of this study was to assess the effects of the duration and type of digit sucking habits (thumb or finger) on the dental arch dimensions of children with digit sucking habit; and compare the findings with children without the habit. A cross-sectional sucking behaviour data was collected on 250 school children aged 3 to 5 years using questionnaires completed by parents. Dental arch parameters including arch widths and arch depths were measured directly from the models obtained from the children and compared using t-test and ANOVA. The results indicated reduced maxillary arch widths (P < 0.001), increased maxillary arch depths (P = 0.009), reduced mandibular canine arch depth (P = 0.004) in those with digit sucking habits compared with the controls. Thumb sucking showed a significant reduction in intercanine widths and mandibular molar arch depth when compared with finger sucking. There was no statistically significant association between duration of digit habits and changes in dental arch depths. In addition, some changes in the dental arch parameters persisted well beyond the cessation of the digit habit. The results suggest a need for recommendations for discontinuing these habits that will be optimal in preventing digit sucking related malocclusion.

Oral habits, prevalence and effects on occlusion of 4-15 year old school children in Lagos, Nigeria.

AIM: To determine the prevalence of oral habits and assess the effects of these habits on the occlusion in a group of Nigerian schoolchildren. METHOD: A cross-sectional study of 928 children aged 4-15 years from Eti -Osa local government area in Lagos, Nigeria. The sample population was selected from 2 private and 3 public schools. RESULTS: Three hundred and sixteen children (34.1%) of total children examined, exhibited one form of oral habit or another. The most common habit observed was digit sucking which was observed in 17% of the children. Increased overjet was observed in 33% of the habit children. This was significantly higher than findings in children without the habit who recorded an increased overjet of 25.3%. Anterior open bite was observed in 12.5% of habit children and 3.1% of non-habit children. Statistically significant differences in the occurrence of upper incisor proclination, lower incisor retroclination and lip incompetence were also observed occurring more frequently in the oral habit group. Posterior crossbite was observed in 1.9% of the habit group and 1.5% of the non-habit group. This difference was not statistically significant. CONCLUSION: This study shows an increased prevalence of oral habits when compared to previous studies in this region. Increased overjet and anterior open bite were the most commonly occurring occlusal anomalies associated with oral habits. There is a need to reduce the occurrence of permanent occlusal deformation due to the persistent form of these habits through dental health education among Nigerian children.

Dental Spacing in Primary Dentition of Nigerian Children and its Relationship to Arch and Crown Dimensions

Objectives: The aims of this study were to compare mesiodistal and buccolingual crown widths; as well as dental arch dimensions between children with spaced and normal dental arches; and to determine which of the parameters mostly influence dental spacing. Methods: Crown and dental arch dimensions of dental casts of 125 children; grouped into spaced and normal primary dental arches; based on the tooth size-arch length discrepancy; were measured using electronic digital caliper. The data were statistically analyzed using t-test and stepwise multiple regression analysis. Results: Maxillary and mandibular spaced arches had statistically significant larger intercanine widths than the normal arches. The total mesiodistal tooth size in both arches; and mean buccolingual width of the mandibular first and second primary molars of the spaced arches were significantly smaller than those of the normal arches. However; there were no significant differences between spaced and normal arches in arch length; arch depth and intermolar arch width. The most important predictor of spacing in both arches is the intercanine width; followed by total mesiodistal tooth size. Conclusions: The parameter that mostly influences dental spacing is the intercanine width

The Prevalence of Oral Habits Among 4 to 15 year Old School Children in Lagos

Objective: To provide information regarding the prevalence of oral habits among a group of Nigerian children. Study Design : This is cross-sectional study of 928 children; 431 males and 497 females aged 4 to 15 years from both rural and urban areas of Lagos State in Nigeria. Habits assessed included digit; lip and tongue habits. Results: Thirty four point one per cent of the children examined presented with an oral habit. Of these; digit sucking was the most frequently occurring; seen in 50 of the children with oral habits. Tongue and lip habits occurred in 27 and 23 of children respectively. There was observed a steady decrease in oral habits with an increase in age. The prevalence being highest among 4 to 5 year olds (44.2) and gradually decreasing to 11.8 among the 14 to 15 year age group. Oral habits were found to be slightly more common among males than females; though this finding was not significant. Socio-economic status (SES) was found to have a significant effect on the occurrence of oral habits. Forty eight per cent of all children of high SES engaged in an oral habit; whereas this was observed in only 24.4of all children of low SES. Conclusion : The findings of this study indicate that there is an increased prevalence of oral habits among children in the population in recent times. The occurrence of these habits is more frequently seen in children from families of high socio-economic status

Occlusal features of sickle cell anaemia patients in Lagos, Nigeria.

One hundred and four sickle cell anaemia patients aged 10-45 years and attending the out patients' clinic of the Lagos University Teaching Hospital as part of a routine check-up were seen. They were in a steady state of health. By means of a structured questionnaire the Biodata of each consecutive eligible patient was obtained and physical examination was carried out. Oral examination was done with emphasis on occlusal variables including Angle's Classification of occlusion, overjet, overbite, tooth: bone ratio, lip competence and skeletal pattern. Results showed that the majority of the patients 92 (88.5%) seen presented with Angle's Class 1 malocclusion. Increased overjet was observed in 50 (48.2%) of the sample population while an overbite depth of 2 was most frequently seen in these patients. Spacing in the anterior segment of the upper and lower arches was a fairly common occurrence, occurring in 51 (49.0%) and 39 (30.8%) of the patients seen respectively. Normal dental base relationship (Skeletal 1) was observed in 72 (69.2%) while lip incompetence was seen in 41 (39.4%) of the patients examined. Occlusal anomalies vary from mild to severe and may be attributable to hyperplastic maxillary bone and the resultant skeletal discrepancy.

The digit sucking habit and related factors: observations from a child dental health clinic in Nigeria.

An increased prevalence of the digit sucking habit among Nigerian children has been reported. Certain factors are believed to influence its occurrence. This study was carried out to assess these factors and determine possible correlation with the onset and persistence of the habit. The sample population consisted of 81 children--52 females and 29 males aged 3-16 years who were still actively digit sucking. Findings in this group were compared with a control group made up of 80 children aged 2-16 years who were not digit suckers and had no history of the habit. Results showed no correlation between mode of infant feeding and the digit sucking habit. The duration of breast-feeding was found to have a significant effect on the habit. About 79% of non-suckers had been breast-fed for more than 6 months while only 43.2% of digit suckers were breast-fed for the same duration. The digit sucking habit was observed more frequently in children with mothers in high cadre occupations (53.1%) compared to non-suckers (23.8%). More digit suckers (22.2%) than non-suckers (12.5%) were reported to have a history of pacifier use. Neither family size nor position of the child in the family had a significant effect on the occurrence of the habit. In addition, 48.1% of the sample population had siblings with the same habit compared to 16.2% of the controls. The identification of significant factors may be useful in targeting interventions in order to prevent consequences of the prolonged habit.

Dentofacial anomalies related to the digit sucking habit.

Digit (thumb or finger) sucking is the most common oral habit, frequently seen among young children. With an increase in the prevalence of the oral habit in Nigeria in recent years there should be an expected increase in the dentofacial effects of the habit. In this study 81 children, 29 males and 52 females aged 3-16 years were examined. Each child was still actively engaged in the digit sucking habit. Subjects were divided into 3 age groups--3-6 years, 7-10 years and 11 years and above. The dentofacial effects of the habit on each subject were assessed. Increased overjet was observed in 63-705 of the children in the different age groups while the occurrence of anterior open bite ranged from 33.3% to 80% declining in frequency with increase in age. Unilateral posterior crossbite was observed in 8.65 of children while no case of bilateral crossbite was observed. Lip incompetence occurred in 51.8% of children examined, occurring most frequently in the oldest age group. Class 2 skeletal pattern was observed in 22.2% of the sample population. Results show that malocclusion is a frequent result of digit sucking especially when prolonged. There is a need to increase social awareness of the detrimental effects of this habit and if necessary offer alternative non-nutritive sucking methods.

The prevalence of malocclusion among a population of northern Nigeria school children.

An epidemiological survey of 1,028 children, 544 females (52.9%) and 484 males (47.1%) was carried out in Kaduna Nigeria to assess the prevalence of malocclusion in the Northern part of Nigeria. The sample population aged 11-18 years were of Northern Nigeria origin and none had received previous orthodontic treatment. From the results, normal occlusion was seen in 12.2% children, Angle's Class I malocclusion in 84.0%, 1.7% had Angle's Class II while Angle's III was observed in 2.0%. No case of Angle's Class II div 2 was seen. A reduction in the prevalence of Angle's Class II div I was seen to occur with increasing age while an increase in Angle's III malocclusion was noted in the 17-18 years age group. Spacing of the upper anterior segment was observed to occur in 45.9% of children examined while spacing of the lower anterior segment was seen in 30%. Crowding of these segments occurred in 21.6% and 36.3% respectively of the sample population. Using Jackson's method (1962) Overbite I was found to occur in 69.5% of the children examined. Deep bite (Overbite 3) occurred in only 1.6% of those examined. An overjet values of 2-4 mm was the most prevalent occurring in 70.8% of the children. A low prevalence of bimaxilliary proclination was observed (3.7%).