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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 -
The association of overjet size and traumatic dental injuries-A systematic review and meta-analysis.Dental Traumatology : Official... Oct 2019Traumatic dental injuries are one of the most prevalent diseases globally, impacting people of different ages and socio-economic statuses. As disease prevention is... (Meta-Analysis)
Meta-Analysis
BACKGROUND/AIMS
Traumatic dental injuries are one of the most prevalent diseases globally, impacting people of different ages and socio-economic statuses. As disease prevention is preferable to management, understanding when an individual's overjet is prone to dental trauma helps identify at-risk patients, so to institute preventive strategies. The aim of this study was to identify the different overjet sizes that present an increased risk for developing dental trauma across different ages and dentition stages.
METHODS
The title and protocol were registered and published a priori with the Joanna Briggs Institute (JBI) and PROSPERO (CRD42017060907) and followed the JBI methodology of systematic reviews of association (etiology). A three-step search strategy was performed, including electronic searches of gray literature and four databases. Studies of healthy human participants of any age and in any dental dentition stage were considered for inclusion. Only high methodological quality studies with low risk of bias were included. Where possible, meta-analyses were performed using the random-effects model, supplemented with the fixed-effects model in situations where statistical heterogeneity was ≤50%, assessed using the I statistic.
RESULTS
The study identified 3718 articles, 41 were included. An increased overjet was significantly associated with higher odds of developing trauma in all dentition stages and age groups. Children 0-6 years with an overjet ≥3mm have an odds of 3.37 (95%CI, 1.36-8.38, P = 0.009) for trauma. Children in the mixed and secondary dentition with an overjet >5mm have an odds of 2.43 (95%CI, 1.34-4.42, P = 0.004). Twelve-year-old children with an overjet >5mm have an odds of 1.81 (95%CI, 1.44-2.27, P < 0.0001).
CONCLUSIONS
The results confirm the association between increased overjet and dental trauma. A child in the primary dentition could be considered as having an overjet at risk for trauma when it is ≥3mm. In the early secondary dentition, the threshold for trauma is an overjet ≥5mm.
Topics: Child; Dentition, Permanent; Humans; Malocclusion, Angle Class II; Overbite; Tooth Injuries; Tooth, Deciduous
PubMed: 31062510
DOI: 10.1111/edt.12481 -
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 -
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 -
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 -
JBI Database of Systematic Reviews and... Jul 2018The objective of this review of association (etiology) is to identify the relationship between different overjet measurements and developing a traumatic dental injury...
The objective of this review of association (etiology) is to identify the relationship between different overjet measurements and developing a traumatic dental injury (TDI) across different dentition stages. Specifically, the review will elucidate the critical level, in millimetres, at which an overjet will place an individual at an increased risk of developing a TDI within each specific dentition stage. The specific review questions are.
Topics: Humans; Overbite; Prevalence; Risk Factors; Tooth Injuries; Systematic Reviews as Topic
PubMed: 29995712
DOI: 10.11124/JBISRIR-2017-003599 -
Evidence-based Dentistry Jun 2015Medline/PubMed, SCOPUS and Google Scholar.
DATA SOURCES
Medline/PubMed, SCOPUS and Google Scholar.
DATA EXTRACTION AND SYNTHESIS
Studies were split according to the type of teeth and the overjet threshold used, thus obtaining three subsets; primary teeth - overjet threshold 3-4 mm; permanent teeth - overjet threshold 3-4 mm and permanent teeth - overjet threshold 6 ± 1 mm. Pooled odds ratios for TDI were estimated for each dataset.
RESULTS
Fifty-four studies were included involving patients from five continents. The adjusted pooled odds ratios were 2.31 (95%CI; 1.01-5.27) for primary teeth with 3-4 mm overjet; 2.01 (95%CI; 1.39-2.91) for permanent teeth with 3-4 mm overjet and 2.24 (95%CI; 1.56-3.21) for permanent teeth with 6 ± 1 mm overjet.
CONCLUSIONS
The present meta-analysis of observational studies showed that large overjet may double or even triple the risk for TDI to anterior primary and permanent teeth and that, at global level, large overjet is partly responsible for 100-300 million TDIs.
Topics: Cuspid; Dentition, Permanent; Humans; Overbite; Tooth Injuries; Tooth, Deciduous
PubMed: 26114792
DOI: 10.1038/sj.ebd.6401099 -
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 Journal of Clinical Pediatric... 2019. The objective of this retrospective chart review study was twofold. The first was to determine whether there is a correlation between the degree of overjet and the...
. The objective of this retrospective chart review study was twofold. The first was to determine whether there is a correlation between the degree of overjet and the type of anterior traumatic dental injury (ATDI) in the mixed dentition. The second was to assess whether the decision to not treat young patients with prominent upper front teeth for trauma prevention resulted in a greater number of ATDI's in patients of record from a single-center. . The authors conducted a retrospective chart review of patients presenting to the Boston Children's Hospital (BCH) Emergency Department with an ATDI in the mixed dentition between October 2011 and March 2016. . Patients with an overjet less than or equal to 4 millimeters experienced all types of ATDI with greater frequency than those patients with an overjet greater than 4 mm. . Our experience at BCH described in this study has led us to believe that a patient's risk of suffering an ATDI has more to do with the type of activities they participate in rather than the degree of their overjet.
Topics: Child; Dentition, Mixed; Humans; Malocclusion; Overbite; Retrospective Studies
PubMed: 31560595
DOI: 10.17796/1053-4625-43.5.11 -
The Angle Orthodontist Mar 2020To evaluate systematically the effectiveness of miniscrew-supported maxillary incisor intrusion compared with other nonsurgical intrusive mechanics for deep-bite... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate systematically the effectiveness of miniscrew-supported maxillary incisor intrusion compared with other nonsurgical intrusive mechanics for deep-bite correction.
MATERIALS AND METHODS
Unrestricted electronic searches in Embase, Web of Science, MEDLINE, LILACS, and Cochrane's CENTRAL as well as manual searches were conducted up to August 2019. Only randomized clinical trials (RCTs) were included. Study selection, data extraction, and bias assessment were done by two independent reviewers. The Cochrane risk-of-bias tool was used, and the quality of evidence was graded using the GRADE approach. A random-effects meta-analysis of continuous data, with its 95% confidence intervals (CIs), was used.
RESULTS
Seven RCTs were included in the quantitative synthesis, and the overall quality of evidence was very low to low. When compared with intrusion arches, miniscrews resulted in a more efficient deep-bite reduction with a standardized mean difference (SMD) of -0.48 (95% CI, -0.89 to -0.07). When miniscrews were used, a statistically significant difference was observed favoring less maxillary molar extrusion (SMD, -0.86; 95% CI, -1.46 to -0.27) and more incisor intrusion as measured from centroid to palatal plane (SMD, -0.95; 95% CI, -1.41 to -0.49). Results also showed a statistically nonsignificant difference regarding the amount of resultant root resorption between miniscrews and intrusion arches.
CONCLUSIONS
There is weak evidence indicating efficient deep-bite correction using miniscrews. Root resorption seems to be an associated adverse effect that occurs regardless of the intrusive mechanics used. These conclusions should be viewed with great caution as further well-designed long-term research is recommended.
Topics: Bone Screws; Humans; Incisor; Orthodontic Anchorage Procedures; Overbite; Tooth Movement Techniques
PubMed: 31816252
DOI: 10.2319/061119-400.1