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International Journal of Environmental... Jun 2022The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and... (Review)
Review
UNLABELLED
The purpose of this study was to systematically review the literature regarding the prevalence of malocclusion and different orthodontic features in children and adolescents.
METHODS
The digital databases PubMed, Cochrane, Embase, Open Grey, and Web of Science were searched from inception to November 2021. Epidemiological studies, randomized controlled trials, clinical trials, and comparative studies involving subjects ≤ 18 years old and focusing on the prevalence of malocclusion and different orthodontic features were selected. Articles written in English, Dutch, French, German, Spanish, and Portuguese were included. Three authors independently assessed the eligibility, extracted the data from, and ascertained the quality of the studies. Since all of the included articles were non-randomized, the MINORS tool was used to score the risk of bias.
RESULTS
The initial electronic database search identified a total of 6775 articles. After the removal of duplicates, 4646 articles were screened using the title and abstract. A total of 415 full-text articles were assessed, and 123 articles were finally included for qualitative analysis. The range of prevalence of Angle Class I, Class II, and Class III malocclusion was very large, with a mean prevalence of 51.9% (SD 20.7), 23.8% (SD 14.6), and 6.5% (SD 6.5), respectively. As for the prevalence of overjet, reversed overjet, overbite, and open bite, no means were calculated due to the large variation in the definitions, measurements, methodologies, and cut-off points among the studies. The prevalence of anterior crossbite, posterior crossbite, and crossbite with functional shift were 7.8% (SD 6.5), 9.0% (SD 7.34), and 12.2% (SD 7.8), respectively. The prevalence of hypodontia and hyperdontia were reported to be 6.8% (SD 4.2) and 1.8% (SD 1.3), respectively. For impacted teeth, ectopic eruption, and transposition, means of 4.9% (SD 3.7), 5.4% (SD 3.8), and 0.5% (SD 0.5) were found, respectively.
CONCLUSIONS
There is an urgent need to clearly define orthodontic features and malocclusion traits as well as to reach consensus on the protocols used to quantify them. The large variety in methodological approaches found in the literature makes the data regarding prevalence of malocclusion unreliable.
Topics: Adolescent; Child; Humans; Malocclusion; Malocclusion, Angle Class II; Orthodontics, Corrective; Overbite; Prevalence
PubMed: 35742703
DOI: 10.3390/ijerph19127446 -
European Journal of Paediatric Dentistry Jun 2020The aim of this review is to quantify the prevalence and type of malocclusion among children and adolescents during the different stages of dentition worldwide. (Meta-Analysis)
Meta-Analysis
AIM
The aim of this review is to quantify the prevalence and type of malocclusion among children and adolescents during the different stages of dentition worldwide.
MATERIALS AND METHODS
Recent studies (from 2009 to 2019), published in Medline, Web of Science and Embase and orthodontic text-books have been comprehensively reviewed herein. The methodological quality of the included studies was assessed using STROBE criteria.
RESULTS
After screening 450 records and analysing 284 relevant full-text publications, 77 studies were included in this review. A good degree of evidence was obtained due to the medium-high methodological quality level of included studies. The worldwide prevalence of malocclusion was 56% (95% CI: 11-99), without differences in gender. The highest prevalence was in Africa (81%) and Europe (72%), followed by America (53%) and Asia (48%). The malocclusion prevalence score did not change from primary to permanent dentition with a common score of 54%. Malocclusion traits such as Angle's classes, overjet, overbite, and asymmetrical midline shift essentially did not change their prevalence during different dentitions. Conversely, traits such as cross-bite and diastema reduced their prevalence during permanent dentition, while scissor-bite and dental crowding increased their scores.
CONCLUSION
The worldwide high prevalence of malocclusion and its early onset during childhood should induce policymakers as well as paediatric physicians and dentists to devise policies and adopt clinical strategies for preventing malocclusion since younger children's ages.
Topics: Adolescent; Child; Dentition; Europe; Humans; Malocclusion; Overbite; Prevalence
PubMed: 32567942
DOI: 10.23804/ejpd.2020.21.02.05 -
The Angle Orthodontist Mar 2022To compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances.
MATERIALS AND METHODS
This randomized controlled trial included 66 patients, 32 aligners, and 34 fixed-appliance patients. The median ages of the aligner and braces patients were 26.7 (interquartile range [IQR]: 9.8) and 25.9 (IQR: 16.6) years, respectively. Pretreatment occlusion was assessed using the ABO Discrepancy Index. Posttreatment (T1) and 6-month retention (T2) occlusions were quantified using the ABO Objective Grading System (OGS) scores.
RESULTS
The braces group finished treatment significantly (P < .001) earlier (0.4 years) than the aligner group. The median DI scores for the aligner and braces groups were 4.5 and 7.0, respectively, which was a statistically significant (P = .015), but clinically insignificant, difference. There were no statistically significant between-group differences for the total OGS scores or any of the individual component scores at debond (T1) or after 6 months of retention (T2). During the posttreatment period, alignment and overjet worsened significantly in the aligner group, while buccolingual inclinations and occlusal relations improved. Over the same period, alignment worsened in the braces group and buccolingual inclinations improved. There was no statistically significant between-group difference in posttreatment changes of the total OGS scores.
CONCLUSIONS
While patients with simple malocclusions require 4.8 months longer treatment times with aligners than traditional braces, the treatment and 6-month posttreatment occlusal outcomes are similar.
Topics: Child; Humans; Malocclusion; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Orthodontic Brackets; Overbite
PubMed: 35168256
DOI: 10.2319/032921-246.1 -
International Orthodontics Jun 2023In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the... (Review)
Review
INTRODUCTION
In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the results predicted and those obtained clinically to be considered an effective treatment. Therefore, this scoping review aimed to identify the orthodontic literature concerning the effectiveness and predictability of CA treatments.
METHODS
A systematic computerized search was performed in 3 databases: PubMed, Scopus, and Embase. Inclusion criteria selected observational and clinical studies performed in at least 10 adult orthodontic patients, whose results of CA treatment's effectiveness and/or predictability were assessed.
RESULTS
The 3 database computerized searches resulted in 1,553 articles, and 169 full texts were considered potentially relevant. After applying the eligibility criteria, 33 studies were included. Most studies (76%) were designed as cohort studies and have been published in the last 5 years (79%). The majority included only non-extraction treatments (73%), and 79% reported results achieved with the Invisalign® system. The most predictable movement was the buccolingual tipping, while the least predictable movements were rotation, intrusion, and extrusion. Aligner treatment was effective for mild to moderate crowding resolution, and the success of overbite correction still seems to be limited.
CONCLUSIONS
The studies have demonstrated improvement of initial malocclusion through CA treatments. Still, predictability degree is overestimated and does not accurately reflect the occlusion immediately at the end of treatment. In future studies, there should be an effort to broaden the utilization of alternative aligner systems beyond Invisalign® and broadly disseminate their outcomes to strengthen clear aligners evidence base.
Topics: Humans; Adult; Malocclusion; Malocclusion, Angle Class II; Orthodontic Appliances, Removable; Treatment Outcome; Overbite
PubMed: 37086643
DOI: 10.1016/j.ortho.2023.100755 -
The Cochrane Database of Systematic... Oct 2017A Class II division 2 malocclusion is characterised by upper front teeth that are retroclined (tilted toward the roof of the mouth) and an increased overbite (deep... (Review)
Review
BACKGROUND
A Class II division 2 malocclusion is characterised by upper front teeth that are retroclined (tilted toward the roof of the mouth) and an increased overbite (deep overbite), which can cause oral problems and may affect appearance.This problem can be corrected by the use of special dental braces (functional appliances) that move the upper front teeth forward and change the growth of the upper or lower jaws, or both. Most types of functional appliances braces are removeable and this treatment approach does not usually require extraction of any permanent teeth. Additional treatment with fixed braces may be necessary to ensure the best result.An alternative approach is to provide space for the correction of the front teeth by moving the molar teeth backwards. This is done by applying a force to the teeth from the back of the head using a head brace (headgear) and transmitting this force to part of a fixed or removable dental brace that is attached to the back teeth. The treatment may be carried out with or without extraction of permanent teeth.If headgear use is not feasible, the back teeth may be held in place by bands connected to a fixed bar placed across the roof of the mouth or in contact with the front of the roof of the mouth. This treatment usually requires two permanent teeth to be taken out (one on each side).
OBJECTIVES
To establish whether orthodontic treatment that does not involve extraction of permanent teeth produces a result that is any different from no orthodontic treatment or orthodontic treatment involving extraction of permanent teeth, in children with a Class II division 2 malocclusion.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (to 10 January 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 11), MEDLINE Ovid (1946 to 10 January 2017), and Embase Ovid (1980 to 10 January 2017). To identify any unpublished or ongoing trials, the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform (apps.who.int/trialsearch) were searched. We also contacted international researchers who were likely to be involved in any Class II division 2 clinical trials.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of orthodontic treatments to correct deep bite and retroclined upper front teeth in children.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened the search results to find eligible studies, and would have extracted data and assessed the risk of bias from any included trials. We had planned to use random-effects meta-analysis; to express effect estimates as mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with 95% confidence intervals; and to investigate any clinical or methodological heterogeneity.
MAIN RESULTS
We did not identify any RCTs or CCTs that assessed the treatment of Class II division 2 malocclusion in children.
AUTHORS' CONCLUSIONS
It is not possible to provide any evidence-based guidance to recommend or discourage any type of orthodontic treatment to correct Class II division 2 malocclusion in children. Trials should be conducted to evaluate the best management of Class II division 2 malocclusion.
Topics: Child; Humans; Malocclusion, Angle Class II; Orthodontic Appliances, Functional; Orthodontics, Corrective; Overbite
PubMed: 28968484
DOI: 10.1002/14651858.CD005972.pub3 -
American Journal of Orthodontics and... Nov 2023Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as...
INTRODUCTION
Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as occlusal bite-blocks, limiting extrusion of the posterior teeth or possibly even intruding posterior teeth. This proposal, however, remains relatively unsubstantiated. The objective of this study was to investigate and determine the accuracy of Invisalign treatment in correcting anterior open bite by comparing the predicted outcome from ClinCheck to the achieved outcome for the initial aligner sequence.
METHODS
A retrospective study used pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 76 adult patients from private specialist orthodontic practices. Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners. Geomagic Control X software was used to measure overbite and overjet in the pretreatment, posttreatment, and predicted outcomes stereolithography files for each patient.
RESULTS
Approximately 66.2% of the programmed open bite closure was expressed compared with the prescribed ClinCheck outcome. The use of posterior occlusal bite-blocks and prescribed movement of teeth via anterior extrusion, posterior intrusion, or a combination of the 2 made no difference to the efficacy of open bite closure. Two-week aligner changes resulted in 0.49 mm more bite closure on average.
CONCLUSIONS
The prescribed bite closure in ClinCheck software overestimates the bite closure that is clinically achieved.
Topics: Adult; Humans; Open Bite; Retrospective Studies; Malocclusion; Orthodontic Appliances, Removable; Malocclusion, Angle Class II; Tooth Movement Techniques; Overbite
PubMed: 37330726
DOI: 10.1016/j.ajodo.2023.04.017 -
Progress in Orthodontics Dec 2022The purpose was to determine the predictability of tooth movements through clear aligner among premolar extraction patients and to explore the effects of various factors...
BACKGROUND
The purpose was to determine the predictability of tooth movements through clear aligner among premolar extraction patients and to explore the effects of various factors on tooth movements.
METHODS
A total of 31 extraction patients (10 males and 20 females; age 14-44) receiving clear aligner treatment (Invisalign) were enrolled in this study. The actual post-treatment models and pre-treatment models were superimposed using the palatal area as a reference and registered with virtual post-treatment models. A paired t test was used to compare the differences between actual and designed tooth movements of maxillary first molars, canines, and central incisors. A multivariate linear mixed model was performed to examine the influence of variables on actual tooth movements.
RESULTS
Compared to the designed tooth movements, the following undesirable tooth movements occurred: mesial movement (2.2 mm), mesial tipping (5.4°), and intrusion (0.45 mm) of first molars; distal tipping (11.0°), lingual tipping (4.4°), and distal rotation of canines (4.9°); lingual tipping (10.6°) and extrusion (1.5 mm) of incisors. Age, crowding, mini-implant, overbite, and attachments have differential effects on actual tooth movements. Moreover, vertical rectangular attachments on canines are beneficial in achieving more predictable canine and incisor tooth movements over optimized attachments. Lingual tipping and extrusion of incisors were significantly influenced by the interaction effects between incisor power ridge and different canine attachments (p < 0.05).
CONCLUSIONS
Incisors, canines, and first molars are subject to unwanted tooth movements with clear aligners among premolar extraction patients. Age, crowding, mini-implant, overbite, and attachments influence actual tooth movements. Moreover, vertical rectangular attachments on canines are beneficial in achieving more predictable incisor tooth movements over optimized canine attachments.
Topics: Male; Female; Humans; Bicuspid; Overbite; Tooth Movement Techniques; Malocclusion; Orthodontic Appliances, Removable; Malocclusion, Angle Class II; Multivariate Analysis
PubMed: 36581703
DOI: 10.1186/s40510-022-00447-y -
American Journal of Orthodontics and... Apr 2016A man, aged 28 years 9 months, came for an orthodontic consultation for a skeletal Class III malocclusion (ANB angle, -3°) with a modest asymmetric Class II and...
A man, aged 28 years 9 months, came for an orthodontic consultation for a skeletal Class III malocclusion (ANB angle, -3°) with a modest asymmetric Class II and Class III molar relationship, complicated by an anterior crossbite, a deepbite, and 12 mm of asymmetric maxillary crowding. Despite the severity of the malocclusion (Discrepancy Index, 37), the patient desired noninvasive camouflage treatment. The 3-Ring diagnosis showed that treatment without extractions or orthognathic surgery was a viable approach. Arch length analysis indicated that differential interproximal enamel reduction could resolve the crowding and midline discrepancy, but a miniscrew in the infrazygomatic crest was needed to retract the right buccal segment. The patient accepted the complex, staged treatment plan with the understanding that it would require about 3.5 years. Fixed appliance treatment with passive self-ligating brackets, early light short elastics, bite turbos, interproximal enamel reduction, and infrazygomatic crest retraction opened the vertical dimension of the occlusion, improved the ANB angle by 2°, and achieved excellent alignment, as evidenced by a Cast Radiograph Evaluation score of 28 and a Pink and White dental esthetic score of 3.
Topics: Adult; Cephalometry; Enamel Microabrasion; Esthetics, Dental; Humans; Male; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Appliances; Orthodontic Retainers; Overbite; Patient Care Planning; Tooth Movement Techniques; Treatment Outcome; Vertical Dimension
PubMed: 27021460
DOI: 10.1016/j.ajodo.2015.04.042 -
Dental Press Journal of Orthodontics 2020Anterior crossbite (AC) is defined as a reverse sagittal relationship between maxillary and mandibular incisors. According to an evidence-based orthodontic triage, the...
INTRODUCTION
Anterior crossbite (AC) is defined as a reverse sagittal relationship between maxillary and mandibular incisors. According to an evidence-based orthodontic triage, the treatment need of AC is indicated if any occlusal interference is forcing the mandible towards a Class III growth pattern. Removable and fixed appliances have been suggested to correct AC.
OBJECTIVE
The present report aims at presenting the benefits of an alternative therapy for the early treatment of anterior crossbite using clear aligners.
METHODS
Two cases of anterior crossbite corrected using clear aligners in 8-years-old children are presented.
RESULTS
In both cases, AC was successfully corrected within 5 months. At the end of the treatment, overjet and overbite were corrected. No major discomfort or speech impairment was noticed by the parents.
CONCLUSIONS
Due to the perceived shortcomings of alternative approaches, the use of clear aligners for correcting AC in mixed dentition should be considered as a comfortable and well tolerated appliance for young patients.
Topics: Child; Dentition, Mixed; Humans; Malocclusion; Malocclusion, Angle Class II; Orthodontic Appliances, Removable; Overbite
PubMed: 32965385
DOI: 10.1590/2177-6709.25.4.033-043.oar -
The Angle Orthodontist Jan 2022To compare deep overbite treatment using 0.016 × 0.022 nickel-titanium lower reverse curve of Spee archwire (LRCA) or metal anterior bite turbos (ABTs). (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare deep overbite treatment using 0.016 × 0.022 nickel-titanium lower reverse curve of Spee archwire (LRCA) or metal anterior bite turbos (ABTs).
MATERIALS AND METHODS
48 patients with deep overbite malocclusion were randomly allocated into two groups. Group I (age = 18.4 ± 2.8 years, overbite = 5.8 ± 0.6 mm) was treated with LRCA, while Group II (age = 18.2 ± 3.1 years, overbite = 5.2 ± 0.4 mm) was treated with ABTs bonded to the palatal surface of the upper central incisors. Two cephalograms were taken for each patient, at post-alignment stage (T1) and post-leveling stage (T2). The primary outcomes were the anteroposterior and vertical changes of the lower teeth. The secondary outcomes were the effect on upper incisor inclination and the vertical linear changes of upper teeth, to assess the sagittal and vertical skeletal changes, and to compare the duration of overbite correction.
RESULTS
42 of the 48 patients recruited completed the study (21 in each group). At T2, the lower incisors proclined more in Group I (P ≤ .001). Both lower second molars (P ≤ .001) and lower first molars (P = .001) tipped more distally, while the lower first premolar tipped more mesially, in Group I (P < .05). All cusps of both lower molars showed more extrusion in Group II (P < .05) except for the mesial cusp of lower second molars (P = .095). The duration of overbite correction was shorter using the ABTs by 1.7 months (4.85 ± 1.56 and 3.15 ± 0.93 months for Group I and Group II, respectively).
CONCLUSIONS
LRCA causes lower incisor proclination with distal tipping of lower molars, while ABTs result in lower posterior tooth extrusion.
Topics: Adolescent; Adult; Cephalometry; Humans; Incisor; Malocclusion, Angle Class II; Mandible; Overbite; Tooth Movement Techniques; Young Adult
PubMed: 34329389
DOI: 10.2319/020921-117.1