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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 -
Clinical Oral Investigations Mar 2022To investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite... (Review)
Review
OBJECTIVE
To investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children.
MATERIALS AND METHODS
Systematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively.
RESULTS
The searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function.
CONCLUSIONS
Based on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general.
CLINICAL RELEVANCE
Comprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.
Topics: Bite Force; Child; Electromyography; Humans; Malocclusion; Masseter Muscle; Mastication; Masticatory Muscles
PubMed: 34985577
DOI: 10.1007/s00784-021-04356-y -
Dental Press Journal of Orthodontics 2018Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of...
OBJECTIVE
Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions.
METHODS
An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016.
RESULTS
Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids.
CONCLUSION
Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.
Topics: Databases, Factual; Dental Occlusion, Traumatic; Dentition, Mixed; Dentition, Permanent; Female; Geography; Global Health; Humans; Male; Malocclusion; Malocclusion, Angle Class I; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Open Bite; Population; Prevalence; Race Factors
PubMed: 30672991
DOI: 10.1590/2177-6709.23.6.40.e1-10.onl -
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 -
Nutrients Nov 2020The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of...
BACKGROUND
The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of malocclusions.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines were used to perform the present review. The following electronic databases were searched: Pubmed, Evidence-Based Medicine Reviews (EBMR), Embase, Cochrane Library, Medline, Web of Science and Ovid.
RESULTS
A primary research found a total of 279 articles. Two more papers were also considered from the gray literature. Two hundred sixty-three articles were excluded as they were deemed irrelevant on the basis of: duplicates, title, abstract, methods and/or irrelevant contents. Eighteen papers were selected and included in the qualitative analysis.
CONCLUSIONS
breastfeeding is a positive factor that seems to reduce the incidence of posterior crossbite, skeletal class II and distoclusion in primary and mixed dentition. A sort of positive relationship between months of breastfeeding and risk reduction seems to exist. More longitudinal research is needed to avoid bias in the results, with data collected prospectively on the months of exclusive breastfeeding, by means of specific questionnaires and successive clinical evaluation of the occlusal condition at the primary dentition, mixed dentition and permanent dentition stages.
Topics: Bottle Feeding; Breast Feeding; Databases, Factual; Dentition; Evaluation Studies as Topic; Humans; Malocclusion; Meta-Analysis as Topic; Randomized Controlled Trials as Topic
PubMed: 33265907
DOI: 10.3390/nu12123688 -
The Angle Orthodontist Sep 2015To assess the scientific evidence related to the efficacy of clear aligner treatment (CAT) in controlling orthodontic tooth movement. (Review)
Review
OBJECTIVE
To assess the scientific evidence related to the efficacy of clear aligner treatment (CAT) in controlling orthodontic tooth movement.
MATERIALS AND METHODS
PubMed, PMC, NLM, Embase, Cochrane Central Register of Controlled Clinical Trials, Web of Knowledge, Scopus, Google Scholar, and LILACs were searched from January 2000 to June 2014 to identify all peer-reviewed articles potentially relevant to the review. Methodological shortcomings were highlighted and the quality of the studies was ranked using the Cochrane Tool for Risk of Bias Assessment.
RESULTS
Eleven relevant articles were selected (two Randomized Clinical Trials (RCT), five prospective non-randomized, four retrospective non-randomized), and the risk of bias was moderate for six studies and unclear for the others. The amount of mean intrusion reported was 0.72 mm. Extrusion was the most difficult movement to control (30% of accuracy), followed by rotation. Upper molar distalization revealed the highest predictability (88%) when a bodily movement of at least 1.5 mm was prescribed. A decrease of the Little's Index (mandibular arch: 5 mm; maxillary arch: 4 mm) was observed in aligning arches.
CONCLUSIONS
CAT aligns and levels the arches; it is effective in controlling anterior intrusion but not anterior extrusion; it is effective in controlling posterior buccolingual inclination but not anterior buccolingual inclination; it is effective in controlling upper molar bodily movements of about 1.5 mm; and it is not effective in controlling rotation of rounded teeth in particular. However, the results of this review should be interpreted with caution because of the number, quality, and heterogeneity of the studies.
Topics: Humans; Malocclusion; Orthodontic Appliance Design; Prospective Studies; Retrospective Studies; Tooth Movement Techniques
PubMed: 25412265
DOI: 10.2319/061614-436.1 -
Clinical Oral Investigations Nov 2022This systematic review evaluated the available evidence regarding the skeletal, dentoalveolar, and soft tissue effects of orthodontic camouflage (OC) versus... (Review)
Review
OBJECTIVE
This systematic review evaluated the available evidence regarding the skeletal, dentoalveolar, and soft tissue effects of orthodontic camouflage (OC) versus orthodontic-orthognathic surgical (OOS) treatment in borderline class III malocclusion patients.
METHODS
Eligibility criteria. The included studies were clinical trials and/or follow-up observational studies (retrospective and prospective). Information sources. PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS were searched up to October 2021. Risk of bias. Downs and Black quality assessment checklist was used. Synthesis of results. The outcomes were the skeletal, dentoalveolar, and soft tissue changes obtained from pre- and post-cephalometric measurements.
RESULTS
Included studies. Out of 2089 retrieved articles, 6 were eligible and thus included in the subsequent analyses. Their overall risk of bias was moderate. Outcome results. The results are presented as pre- and post-treatment values or mean changes in both groups. Two studies reported significant retrusion of the maxillary and mandibular bases in OC, in contrast to significant maxillary protrusion and mandibular retrusion with increased ANB angle in OOS. Regarding the vertical jaw relation, one study reported a significant decrease in mandibular plane inclination in OC and a significant increase in OOS. Most of the included studies reported a significant proclination in the maxillary incisors in both groups. Three studies reported a significant proclination of the mandibular incisors in OOS, while four studies reported retroclination in OC.
CONCLUSION
Interpretation. The OSS has a protrusive effect on the maxillary base, retrusive effect on the mandibular base, and thus improvement in the sagittal relationship accompanied with a clockwise rotational effect on the mandibular plane. The OC has more proclination effect on the maxillary incisors and retroclination effect on the mandibular incisors compared to OOS. Limitation. Meta-analysis was not possible due to considerable variations among the included studies. Owing to the fact that some important data in the included studies were missing, conducting further studies with more standardized methodologies is highly urgent. Registration. The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199591).
CLINICAL RELEVANCE
The common features including skeletal, dental, and soft tissue characteristics of borderline class III malocclusion cases make it more difficult to select the most appropriate treatment modality that can be either OC or OOS. The availability of high-level evidence-systematic reviews-makes the clinical decision much more clear and based on scientific basis rather than personal preference.
Topics: Humans; Retrospective Studies; Malocclusion, Angle Class III; Orthognathic Surgical Procedures; Cephalometry; Maxilla; Mandible; Malocclusion, Angle Class II
PubMed: 36098813
DOI: 10.1007/s00784-022-04685-6 -
The Angle Orthodontist May 2007The aim of this systematic literature review was to evaluate associations between different malocclusions, orthodontic treatment, and signs and symptoms of... (Review)
Review
OBJECTIVE
The aim of this systematic literature review was to evaluate associations between different malocclusions, orthodontic treatment, and signs and symptoms of temporomandibular disorders (TMD).
MATERIALS AND METHODS
This review was part of a project at the Swedish Council on Technology Assessment in Health Care focusing on malocclusion and orthodontic treatment from a health perspective. As a first step, the literature was searched in the Medline and Cochrane Library databases from 1966 to May 2003. A later update was made in January 2005. Human studies in English or in Scandinavian languages were included.
RESULTS
Associations between certain malocclusions and TMD were found in some studies, whereas the majority of the reviewed articles failed to identify significant and clinically important associations. TMD could not be correlated to any specific type of malocclusion, and there was no support for the belief that orthodontic treatment may cause TMD. Obvious individual variations in signs and symptoms of TMD over time according to some longitudinal studies further emphasized the difficulty in establishing malocclusion as a significant risk factor for TMD. A considerable reduction in signs and symptoms of TMD between the teenage period and young adulthood has been shown in some recent longitudinal studies.
CONCLUSIONS
Associations between specific types of malocclusions and development of significant signs and symptoms of TMD could not be verified. There is still a need for longitudinal studies.
Topics: Humans; Malocclusion; Orthodontics, Corrective; Temporomandibular Joint Disorders
PubMed: 17465668
DOI: 10.2319/0003-3219(2007)077[0542:TIRTMA]2.0.CO;2 -
The Cochrane Database of Systematic... Dec 2021A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. The prevalence of posterior crossbite is around 4% and 17% of children and... (Review)
Review
BACKGROUND
A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. The prevalence of posterior crossbite is around 4% and 17% of children and adolescents in Europe and America, respectively. Several treatments have been recommended to correct this problem, which is related to such dental issues as tooth attrition, abnormal development of the jaws, joint problems, and imbalanced facial appearance. Treatments involve expanding the upper jaw with an orthodontic appliance, which can be fixed (e.g. quad-helix) or removable (e.g. expansion plate). This is the third update of a Cochrane review first published in 2001.
OBJECTIVES
To assess the effects of different orthodontic treatments for posterior crossbites.
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched four bibliographic databases up to 8 April 2021 and used additional search methods to identify published, unpublished and ongoing studies.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults.
DATA COLLECTION AND ANALYSIS
Two review authors, independently and in duplicate, screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. A third review author participated to resolve disagreements. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous data (event), unless there were zero values in trial arms, in which case we used odds ratios (ORs). We used mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models. We used the GRADE approach to assess the certainty of the evidence for the main outcomes.
MAIN RESULTS
We included 31 studies that randomised approximately 1410 participants. Eight studies were at low risk of bias, 15 were at high risk of bias, and eight were unclear. Intervention versus observation For children (age 7 to 11 years), quad-helix was beneficial for posterior crossbite correction compared to observation (OR 50.59, 95% CI 26.77 to 95.60; 3 studies, 149 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 4.71 mm, 95% CI 4.31 to 5.10; 3 studies, 146 participants; moderate-certainty evidence). For children, expansion plates were also beneficial for posterior crossbite correction compared to observation (OR 25.26, 95% CI 13.08 to 48.77; 3 studies, 148 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 3.30 mm, 95% CI 2.88 to 3.73; 3 studies, 145 participants, 3 studies; moderate-certainty evidence). In addition, expansion plates resulted in higher inter-canine distances (MD 2.59 mm, 95% CI 2.18 to 3.01; 3 studies, 145 participants; moderate-certainty evidence). The use of Hyrax is probably effective for correcting posterior crossbite compared to observation (OR 48.02, 95% CI 21.58 to 106.87; 93 participants, 3 studies; moderate-certainty evidence). Two of the studies focused on adolescents (age 12 to 16 years) and found that Hyrax increased the inter-molar distance compared with observation (MD 5.80, 95% CI 5.15 to 6.45; 2 studies, 72 participants; moderate-certainty evidence). Intervention A versus intervention B When comparing quad-helix with expansion plates in children, quad-helix was more effective for posterior crossbite correction (RR 1.29, 95% CI 1.13 to 1.46; 3 studies, 151 participants; moderate-certainty evidence), final inter-molar distance (MD 1.48 mm, 95% CI 0.91 mm to 2.04 mm; 3 studies, 151 participants; high-certainty evidence), inter-canine distance (0.59 mm higher (95% CI 0.09 mm to 1.08 mm; 3 studies, 151 participants; low-certainty evidence) and length of treatment (MD -3.15 months, 95% CI -4.04 to -2.25; 3 studies, 148 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and Haas for posterior crossbite correction (RR 1.05, 95% CI 0.94 to 1.18; 3 studies, 83 participants; moderate-certainty evidence) or inter-molar distance (MD -0.15 mm, 95% CI -0.86 mm to 0.56 mm; 2 studies of adolescents, 46 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and tooth-bone-borne expansion for crossbite correction (RR 1.02, 95% CI 0.92 to 1.12; I² = 0%; 3 studies, 120 participants; low-certainty evidence) or inter-molar distance (MD -0.66 mm, 95% CI -1.36 mm to 0.04 mm; I² = 0%; 2 studies, 65 participants; low-certainty evidence). There was no evidence of a difference between Hyrax with bone-borne expansion for posterior crossbite correction (RR 1.00, 95% CI 0.94 to 1.07; I² = 0%; 2 studies of adolescents, 81 participants; low-certainty evidence) or inter-molar distance (MD -0.14 mm, 95% CI -0.85 mm to 0.57 mm; I² = 0%; 2 studies, 81 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: For children in the early mixed dentition stage (age 7 to 11 years old), quad-helix and expansion plates are more beneficial than no treatment for correcting posterior crossbites. Expansion plates also increase the inter-canine distance. Quad-helix is more effective than expansion plates for correcting posterior crossbite and increasing inter-molar distance. Treatment duration is shorter with quad-helix than expansion plates. For adolescents in permanent dentition (age 12 to 16 years old), Hyrax and Haas are similar for posterior crossbite correction and increasing the inter-molar distance. The remaining evidence was insufficient to draw any robust conclusions for the efficacy of posterior crossbite correction.
Topics: Adolescent; Bias; Child; Dental Care; Dentition, Permanent; Europe; Humans; Malocclusion
PubMed: 34951927
DOI: 10.1002/14651858.CD000979.pub3 -
Progress in Orthodontics Dec 2016The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on... (Review)
Review
BACKGROUND
The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on treatments of anterior open bite in the mixed dentition in order to assess the effectiveness of the early treatment in reducing open bite, the most efficacious treatment strategy and the stability of the results.
MATERIALS AND METHODS
A literature survey was done on November 15, 2015, by means of appropriate Medical Subject Headings (MeSH) using the following databases: PubMed, EMBASE, Cochrane Library, LILACS, VHL, and WEB OF SCIENCE. Randomized clinical trials and studies with a control group (treated or untreated) were then selected by two authors. Trials including patients with syndromes or in the permanent dentition and studies concerning treatment with extractions, full-fixed appliances, or surgery were not considered. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion.
RESULTS
Two thousand five hundred sixty-nine studies about open bite were available; the search strategy selected 240 of them. Twenty-four articles have been judged suitably for the final review, and their relevant data were analyzed.
DISCUSSION
Although this review confirms the effectiveness of early treatment of open bite, particularly when no-compliance strategies are employed, meta-analysis was unfeasible due to lack of standardization, important methodological limitations, and shortcomings of the studies.
CONCLUSIONS
A more robust approach to trial design in terms of methodology and error analysis is needed. Besides, more studies with longer periods of follow-up are required.
Topics: Dentition, Mixed; Dentition, Permanent; Humans; Malocclusion; Meta-Analysis as Topic; Open Bite; Orthodontic Appliances; Orthodontic Appliances, Functional; Orthodontic Appliances, Removable; Orthodontics, Corrective; Orthopedic Procedures; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 27615261
DOI: 10.1186/s40510-016-0142-0