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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 -
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 -
Journal of Clinical Medicine Nov 2022Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in... (Review)
Review
Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in adolescent Class II malocclusion. Methods: Five databases; unpublished literature; and reference lists were last searched in August 2022. Randomized clinical trials and observational studies of at least 10 Class II growing patients that assessed dentoskeletal effects through cephalometric/CBCT superimpositions were eligible. The included studies quality was assessed with the RoB 2 and ROBINS-I tools. A random-effects model meta-analysis was performed. Heterogeneity was explored with subgroup and sensitivity analyses. Results: Among nine studies (298 patients); two-to-three studies were included in each meta-analysis. Less post-treatment upper incisor retroclination (<2) and no overbite; overjet; SNA; SNB; and lower incisor inclination differences were found between Herbst/Forsus and Class II elastics. No differences in maxilla; condyle; glenoid fossa; and most mandibular changes were found between Herbst and Class II elastics; except for a greater 1.5 mm increase in mandibular length and right mandibular ramus height (1.6 mm) with Herbst. Conclusions: Herbst and Class II elastics corrected the molar relationship; but Herbst moved the lower molars more mesially. Apart from an additional mandibular length increase; no other dental and anteroposterior skeletal difference was found. Forsus was more effective in molar correction; overjet reduction; and upper incisor control than Class II elastics. Trial registration number OSF: 10.17605/OSF.IO/8TK3R.
PubMed: 36498570
DOI: 10.3390/jcm11236995 -
Journal of Clinical and Experimental... Jul 2021There are no studies that have systematically reviewed randomized control trials and/or prospective cohort studies that have assessed the significance of temporary... (Review)
Review
BACKGROUND
There are no studies that have systematically reviewed randomized control trials and/or prospective cohort studies that have assessed the significance of temporary skeletal mini-screw anchorage devices (TSAD) for the correction of gummy-smile. The aim of the present systematic review was to assess the significance of non-surgical correction of gummy smile using TSAD.
MATERIAL AND METHODS
The addressed focused question was "Are temporary skeletal mini-screw anchorage devices effective for the correction of gummy smile?" Indexed databases were searched up to and including May 2020. Different combinations of the following key-indexing terms were used: anchorage; gummy smile, mini-screw; orthodontic; and vertical maxillary excess. The literature search was performed without time and language barriers. Randomized clinical trials and prospective cohort studies that addressed the focused questions were included. Risk of bias was assessed using the Downs and Black and Cochran collaboration tools. Letters to the Editor, commentaries, case-reports/series and articles published in non-indexed databases were excluded.
RESULTS
The initial search yielded 2118 studies out of which, four studies met the inclusion criteria and were processed for data extraction. All studies had a prospective research design. One study was a clinical trial and 3 had a non-randomized design. Results of the clinical trial showed no statistically significant difference in the extent of intrusion between the test- and control-groups. The non-randomized studies showed that TSAD are useful in reducing deep overbite. All studies had a high risk of bias.
CONCLUSIONS
The TSAD are an effective and practical option in facilitating reduction of excessive gingival display or gummy-smile. However, further long-term follow-up, well-designed and power-adjusted clinical trials are warranted in this regard. Anchorage, Excessive gingival display, Gummy-smile, Mini-screw.
PubMed: 34306536
DOI: 10.4317/jced.58242 -
Medicine and Pharmacy Reports Apr 2022Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among...
BACKGROUND AND AIM
Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible.
METHODS
Pre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age = 10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test.
RESULTS
The cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). "Headgear effect" on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship were achieved in the Twin Block group. However, no significant changes appeared in the control group.
CONCLUSION
The results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.
PubMed: 35721032
DOI: 10.15386/mpr-1989 -
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 -
Progress in Orthodontics Aug 2020To evaluate the dental and skeletal effects that occur in the correction of anterior open bite with clear aligners.
OBJECTIVES
To evaluate the dental and skeletal effects that occur in the correction of anterior open bite with clear aligners.
MATERIALS AND METHOD
In this single-center retrospective study, the mechanism of anterior open bite closure using clear aligners (Invisalign, Align Technology, Santa Clara, CA, USA) was evaluated by cephalometric superimposition based on records of patients consecutively treated by a single, experienced Invisalign provider. Inclusion criteria consisted of anterior open bite (overbite < 0.5 mm), adult patients (18+) at the beginning of treatment, consecutive records, and good quality pre- and post-treatment records, where the required landmarks were clearly visible.
RESULTS
A total of 45 patients were included for data analysis with a mean age of 30.73 ± 8.0 years and initial open bite of - 1.21 ± 1.15 mm. During treatment, the upper incisors showed significant (p < 0.05) retraction [U1-SN'(°) = - 10.91 ± 6.95°], [U1-SN'(mm) = - 2.57 ± 1.75 mm] and extrusion [U1-SN'(mm) = 1.45 ± 0.89 mm]. The lower incisors also showed significant retraction [IMPA(°) = - 3.73 ± 4.91°), (ΔL1-MP' (mm) = - 1.08 ± 1.59] and extrusion (ΔL1-MP'(mm) = 0.53 ± 0.74). Regarding molar position, no significant changes were noted in the anteroposterior position of the upper [ΔU6-SN'(mm) = 0.01 ± 1.08 mm] and lower molar [ΔL6-MP'(mm) = 0.03 ± 0.87 mm]; however, there was a statistically significant intrusion of the upper [ΔU6-SN'(mm) = - 0.47 ± 0.59 mm] and lower molar [ΔL6-MP'(mm) = - 0.39 ± 0.76 mm].
CONCLUSION
Open bite closure with clear aligners occurred due to a combination of maxillary and mandibular incisor extrusion and maxillary and mandibular molar intrusion, with slight mandibular auto rotation. Significant retraction of maxillary and mandibular incisors was also observed with treatment. Clear aligners are effective in reducing/controlling the vertical dimension in open bite patients.
Topics: Adult; Cephalometry; Humans; Malocclusion, Angle Class II; Open Bite; Orthodontic Appliances, Removable; Retrospective Studies; Tooth Movement Techniques; Young Adult
PubMed: 32830306
DOI: 10.1186/s40510-020-00325-5