Comparison of three orthodontic bonding systems in white spot lesion development: a randomized clinical trial.

OBJECTIVES: To compare the development of white spot lesions (WSLs) during fixed orthodontic therapy among a conventional three-step bonding system, a self-etching primer bonding system, and a one-step adhesive bonding system. MATERIALS AND METHODS: Seventy-five patients were randomly allocated into three groups (group 1, conventional bonding system, n = 25; group 2, self-etch primer, n = 25; group 3, primer mixed with adhesive composite, n = 25). Quantitative light-induced fluorescence (QLF) was used to assess WSL parameters. Images were captured and then analyzed before treatment and at 2 months and 4 months after bond up. Lesion area (pixels), mean fluorescence loss (ΔF), and the number of newly developed WSLs were compared within and among the three groups. The significance level was P ≤ .05. RESULTS: The mean increase in lesion area was 31.3 ± 2.8 pixels, 38.4 ± 4.3 pixels, and 119.5 ± 5.3 pixels for groups 1, 2, and 3, respectively (P ≤ .001). For ΔF, the loss was 3.3% ± 0.3%, 4.4% ± 0.2%, and 6.6% ± 0.2% for groups 1, 2, and 3, respectively. These changes were significantly different (P ≤ .01 to P ≤ .001). The incidence of newly developed lesions was 9.5 WSLs in group 1, 10 WSLs in group 2, and 15.9 WSLs in group 3. CONCLUSIONS: The lack of primer contributed to the development of a larger number of and more severe WSLs.

Cranial base measurements in different anteroposterior skeletal relationships using Bjork-Jarabak analysis.

OBJECTIVES: To assess the linear and angular cranial base measurements (Bjork polygon) in different anteroposterior (AP) skeletal relationships using Bjork-Jarabak analysis. MATERIALS AND METHODS: Pretreatment lateral cephalograms of 288 (146 women, 142 men, mean ages 21.24 ± 2.72 years and 22.94 ± 3.28 years, respectively) adult patients were divided into Class I, II, and III skeletal relationships according to their ANB angle. Linear and angular measurements of Bjork polygon were measured and compared among different skeletal relationships. Analysis of variance was performed to detect the differences among groups. Independent-sample t-test was used to detect differences between men and women. RESULTS: The Class II skeletal relationship has a significantly larger saddle angle than Class III does (P < .05), whereas Class III has a significantly larger gonial angle than Class II does (P < .05). The articular angle and sum of Bjork polygon angles were not significantly different among groups (P > .05). Anterior (N-S) and posterior (S-Ar) cranial base lengths were similar in the different AP skeletal relationships (P > .05). The ramal height and body of the mandible length were significantly larger in Class III compared with Class I and II (P < .05). Women had a significantly larger articular angle than men did (P < .05), although men had significantly larger linear measurements of Bjork polygon than women did (P < .05). CONCLUSIONS: The Class III skeletal relationship has a smaller saddle angle and larger mandibular length and gonial angle. Men have a larger cranial base and mandibular linear measurements and a smaller articular angle compared with women.

Patients' perceptions of orthodontic treatment experiences during COVID-19: a cross-sectional study.

BACKGROUND: COVID-19 has impacted the care of patients undergoing orthodontic treatment. We aimed to provide an overall view of patients' perspectives, concerns, and expectations towards their treatment throughout the clinic lockdown during the pandemic; and to assess patients' levels of mental distress and its association with their confidence in resuming care. METHODS: An anonymous, validated, in-person paper questionnaire was distributed to adult orthodontic patients' post-lockdown at an academic institution. The survey focused on the clinical aspects and patients' perspectives regarding orthodontic treatment during the pandemic. The Kessler Mental Distress Scale (K10) was used to evaluate their psychological status. Survey responses were descriptively summarized and confidence in resuming care was compared between normal patients and patients with mental distress using Mann-Whitney tests. RESULTS: One hundred fifty-four patients were surveyed from July to October 2020. Mean age of the participants was 29.30 (SD = 12.01) years and 62% were females. Emergencies during the closure (21%, 32/154) involved primarily irritation with protruding wires. Patients were neutral regarding tele-dentistry and preferred their current fixed appliances over clear aligners. Upon resuming care, 80.51% were extremely pleased with the restrictive protocols and with high level of confidence in resuming treatment. The average level of anxiety was low, and a modest association was found between mental distress and reduced confidence in resuming treatment. CONCLUSIONS: Few numbers of minor emergencies occurred during the clinic closure. Despite the rising interest in tele-dentistry, patients were neutral on considering this option to monitor treatment and were content with fixed appliances. Patients had high confidence levels to resume their care based on the protocols established upon reopening. The association of mental distress and confidence in resuming care is suggestive and needs further investigation.

Enamel demineralization during clear aligner orthodontic treatment compared with fixed appliance therapy, evaluated with quantitative light-induced fluorescence: A randomized clinical trial.

INTRODUCTION: The objective of this prospective randomized clinical trial was to investigate the relationship between clear aligner (CA) therapy and the development of white spot lesions and compare it with orthodontic fixed appliance (FA) therapy. METHODS: This was a prospective randomized clinical trial. The setting was the postgraduate orthodontic clinic at Jordan University of Science and Technology. A total of 49 patients (39 female, 10 male; mean age ± standard deviation, 21.25 ± 3 years) who required orthodontic treatment with either FAs or CAs were randomly allocated into 1 of 2 study groups. Eligibility criteria included healthy patients of both sexes (age range 17-24 years), Class I malocclusion with mild-to-moderate crowding (≤5 mm), nonextraction treatment plan, and optimum oral hygiene before treatment as determined by clinical examination. The participants were randomly assigned to a study group according to a simple randomization method using a coin toss by the patient; the text or tail side of the coin indicated treatment with CA (group 1), and the head side of the coin indicated orthodontic treatment with FA (group 2). Blinding was applicable for outcome assessment only. CA therapy was performed for group 1 and FA for group 2. Quantitative light-induced fluorescence (QLF) images were taken before treatment (T0) and 3 months later (T1). The QLF images were then analyzed to assess the research outcomes. The main outcome was the mean amount of fluorescence loss (ΔF). Number of newly developed lesions, deepest point in the lesion (ΔFMax), lesion area (pixels), and plaque surface area (ΔR30) were measured as secondary outcomes. Descriptive statistics and comparison within and between groups were calculated. RESULTS: In total, 42 of the 49 participants recruited completed the study (19 in the CA group and 23 in the FA group). The mean amount of fluorescence loss was 0.4% for the CA group (P = 0.283) and 1.2% for the FA group (P = 0.013). The difference between the 2 groups was significant (confidence interval [CI], -1.8 to -0.4; P = 0.002). The mean increase in lesion area was 82.2 pixels for the CA group (P <0.001) and 9.3 pixels for the FA group (P = 0.225). The difference between the 2 groups was significant (CI, -117 to -75.0; P <0.001). ΔR30 was 1.2% for the CA group and 10.9% for the FA group (CI, 6.847-12.479; P <0.001). The number of newly developed lesions in the CA group was 6 lesions/patient and 8.25 in the FA group (P = 0.039). No serious harm on the oral health of the participants in the 2 study groups was observed other than mild gingivitis associated with plaque accumulation. No serious harm was reported by any of the participants. CONCLUSIONS: Orthodontic treatment with CAs and FAs caused enamel demineralization. The CA group developed larger but shallower white spot lesions, whereas the FA group developed more new lesions with greater severity, but they were smaller in area. More plaque accumulation was found in the FA group compared with the CA group. REGISTRATION: NCT04107012. PROTOCOL: The protocol was published after trial commencement.

Effect of different acid etchants on the remineralization process of white-spot lesions: An in vitro study.

PURPOSE: To investigate the effect of acid etchants with different low concentrations on remineralization of white spot lesion (WSL). METHODS: WSL were prepared on buccal surfaces of 100 intact premolars using the methyl cellulose gel/lactic acid method. The samples were then placed in a remineralizing solution in addition to fluoride application twice daily for 5 minutes. The changes were quantified weekly using the Quantitative Light-induced Fluorescence (QLF) system. When changes in fluorescence radiance approached zero, each sample was etched with one of the following acids; 5% phosphoric acid, 10% phosphoric acid, 5% polyacrylic acid or 10% polyacrylic acid for 15 seconds, washed, dried, and placed again in the remineralizing solution. Two samples were randomly selected from each group for transverse microradiography (TMR) and scanning electron microscopy (SEM) analysis. RESULTS: The 10% polyacrylic acid group showed the most significant improvement in fluorescence gain over the second phase of remineralization. It also showed partial loss of surface minerals without affecting enamel thickness as the phosphoric acid did. Additionally, 10% polyacrylic acid created the largest number of pores and smallest in size when compared to phosphoric acid, thus enhancing remineralization more efficiently than phosphoric acid without compromising the enamel outermost layer. CLINICAL SIGNIFICANCE: The findings of this study may improve the remineralization of WSL from the bottom of the lesion instead of precipitation on the outermost layer of the lesion leaving a better quality of enamel. 10% polyacrylic acid enhanced remineralization more efficiently than phosphoric acid without compromising the enamel outermost layer.

Effect of application sequence of fluoride and CPP-ACP on remineralization of white spot lesions in primary teeth: An in-vitro study.

OBJECTIVE: To explore how application sequence of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride influences remineralization of enamel white spot lesions (WSL) in primary teeth. DESIGN: In this in-vitro study, artificial WSLs were created in 130 primary teeth. Teeth were divided into 4 groups (n=27) and a control group (n=22) and exposed to one of the following remineralization regimens for 10 weeks: Group-1; 500ppm fluoride dentifrice; Group-2; 10% w/v CPP-ACP; Group-3; fluoride applied first, then CPP-ACP; Group-4; CPP-ACP applied first, then fluoride, and Group-5 was control. All groups were kept in a remineralizing solution. Mineral changes (ΔF) were quantified weekly using quantitative light-induced fluorescence. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0). RESULTS: Remineralization occurred in all groups to different degrees; changes from baseline were significant in groups 1-4 (P≤0.05). Group-4 showed the earliest significant remineralization (after 2 weeks) among groups, (P<0.001). Group-4 showed maximum changes in ΔF among groups; however, only differences with Groups 1 and 5 were significant (P<0.05 and P<0.01, respectively). Group-3 showed better remineralization than Groups 1, 2 and 5; however, the difference was only significant with Group-5 (P<0.001). There were no significant differences between Group 1and 2, however, only Group 2 showed better remineralization than Group 5, (P<0.01). CONCLUSION: Combined treatment with CPP-ACP followed by fluoride exhibited the best remineralization of white spot lesions in primary teeth in this study. Combined treatment with fluoride followed by CPP-ACP showed a tendency towards better remineralization than fluoride or CPP-ACP alone.

Force degradation of orthodontic latex elastics: An in-vivo study.

INTRODUCTION: Our objectives were to assess the force degradation of orthodontic latex elastics over 48 hours in vivo and to study the relationship between the amount of mouth opening and the degree of force decay. METHODS: Fifty-two orthodontic patients wearing fixed appliances using Class II elastics were asked to wear premeasured-force 3/16-in heavy and medium intermaxillary elastics. The force amounts were measured and compared at different time intervals. RESULTS: Fifty percent of the force was lost after 3.9 hours for the medium elastics and after 4.9 hours for the heavy elastics. A continuous significant force drop in all elastics was seen at all time intervals (P <0.05, P <0.001). There was greater force loss in the heavy elastics compared with the medium elastics in vivo at all time intervals (P <0.001); the rates of force loss, however, were similar. CONCLUSIONS: Fifty percent of force degradation occurred in the first 4 to 5 hours. Because of breakage and for oral hygiene purposes, orthodontic elastics should be changed daily; otherwise, elastics can be used for 48 hours. Force decay of the elastics was correlated to the lateral distance between the maxillary canine and the mandibular first molar in occlusion.

Occlusal bite force change after orthodontic treatment with Andresen functional appliance.

OBJECTIVES: The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. MATERIALS AND METHODS: OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. RESULTS: No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P < 0.001), 58.5±13.0 N in AOBF (P < 0.001), and 69.3±11.6 N IOBF (P < 0.001). CONCLUSIONS: Treatment with functional appliance caused a significant reduction in OBF immediately after treatment.

Long-term clinical effect of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial.

Mechanical removal of microbial biofilm dental plaque from tooth surfaces is important for treatment of periodontal diseases. However, the effectiveness of conventional scaling and root planing (SRP) is affected by the local conditions and residual bacteria which may affect the healing process. We performed a randomized clinical trial to test our hypothesis that adjunctive antimicrobial photodynamic therapy (aPDT) plus SRP has significant effect compared with SRP alone, which can last for 1 year. The study included 136 sites in 16 patients with previously untreated chronic periodontitis, at least one premolar and one molar in every quadrant (minimum, four teeth/quadrant) and at least one tooth with attachment loss of ≥4 mm in every quadrant. In all patients, two randomly assigned quadrants were treated with SRP and the other two were treated with SRP + aPDT. The clinical parameters of probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL) were evaluated at baseline and after 3, 6, and 12 months. There were no significant differences between the two groups at baseline. PPD and BOP showed significant reduction, and CAL showed significant gain from baseline for all three time points in both groups. In addition, there were significantly greater reduction and gain for SRP + aPDT than for SRP at all three time points. No adverse effects of aPDT were observed. These data demonstrate significant improvement in all evaluated clinical parameters for at least 1 year and suggest that aPDT as an adjunctive therapy to SRP represents a promising therapeutic concept for persistent periodontitis.

Mandibular symphysis morphology and dimensions in different anteroposterior jaw relationships.

OBJECTIVE: To assess the morphology and dimensions of mandibular symphysis (MS) in different anteroposterior jaw relationships and to investigate whether craniofacial parameters have any correlation with its shape and/or dimensions. MATERIALS AND METHODS: Lateral cephalograms of subjects with Class I, Class II, and Class III skeletal relationships were traced. Several craniofacial and MS parameters were measured. MS parameters were compared between the three groups using analysis of variance and were correlated with the craniofacial parameters using the Pearson correlation coefficient. RESULTS: Larger angle of concavity of the chin, more inclination of the alveolar bone toward the mandibular plane, and larger MS dimensions and area (P < .001) were found with a Class III skeletal relationship compared to Class I and Class II relationships. The Pearson correlation coefficient between Id-Me and AFH was r  =  0.83 and between Id-Me and LAFH it was r  =  0.81. CONCLUSIONS: The dimensions and configuration of MS in the Class III relationship were different than those in Class I and Class II relationships; the alveolar part of MS compensated for the skeletal relationship in the Class III pattern. MS dimensions were strongly correlated to anterior facial dimensions.

Effect of fixed orthodontic appliances bonded with different etching techniques on tooth color: a prospective clinical study.

INTRODUCTION: For most orthodontic patients, esthetic concerns are as important as functional demands. The purpose of this study was to assess the effect of self-etching primer and conventional acid etching on tooth color after orthodontic treatment. METHODS: A total of 34 patients were enrolled in a clinical trial and divided into 2 groups based on age: adolescents (≤17 years) and adults (>17 years). Tooth color of all maxillary and mandibular anterior teeth was measured before bonding and after debonding using a spectrophotometer (Vita Easyshade Compact; Vita Zahnfabrik, Bad Säckingen, Germany). Two types of etching techniques were used for orthodontic bonding, self-etching primer and conventional acid etching, in a randomized split-mouth design. Tooth color measurements were done according to the system of the Commission Internationale de l'Eclairage (lightness, red/green, and yellow/blue). The corresponding tooth color differences between pretreatment and posttreatment, etching groups, sexes, and age groups were calculated. RESULTS: Tooth color was significantly changed in all (L, a, b) color parameters (P <0.05). The lightness value decreased by 2.16 units, and the red/green and yellow/blue values increased by 0.32 and 1.78, respectively. The average tooth color difference after orthodontic treatment was 2.85 units. No significant difference was found between self-etching primer and conventional acid etching in their effects on tooth color (P >0.05). Men and adolescents had more color change than did girls and adults (P <0.05). CONCLUSIONS: Fixed orthodontic appliances caused tooth color changes; self-etching primer and conventional acid etching had similar effects on tooth color; men and adolescents had greater color changes than did girls and adults.

Dental age assessment in patients with maxillary canine displacement.

INTRODUCTION: The aims of this study were to investigate the relationship between dental age and maxillary canine displacement with 2 methods, to study differences in dental development between the displaced and nondisplaced sides, and to investigate sex differences in dental development in the studied groups. METHODS: Two hundred forty subjects were recruited for this study. They were divided into 2 groups: the palatally displaced canine group (87 girls, 33 boys) and the buccally displaced canine group (81 girls, 39 boys). Dental ages were assessed by using the 2 methods. RESULTS: Delayed dental development was associated with subjects with palatally displaced canines only, whereas those with buccally displaced canines had comparable dental development to that of the control group. Sex differences in the 3 groups were found; girls had more pronounced delayed dental development in all groups according to both methods. With unilateral palatally displaced canines, the displacement side showed delayed dental development compared with the side of nondisplacement (P = 0.002). The development rates of the displaced and nondisplaced sides were comparable in the subjects with unilateral buccally displaced canines. CONCLUSIONS: Palatal and buccal canine displacements are 2 distinct entities; delayed dental development plays a role in the etiology of palatal canine displacement, but not in buccal canine displacement.

Skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances and lower premolar extractions.

BACKGROUND: Mild Class III malocciusions can be treated by upper incisor proclination and lower incisor retroclination following extraction of the lower first premolars. AIMS: To compare the skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances, Class III traction and lower first premolar extractions with the changes in a group of untreated Class III patients. METHODS: The Treatment group consisted of 30 Class III patients (Mean age 13.69 +/- 1.48 years) who were treated by upper and lower fixed appliances, Class III intermaxillary traction and lower first premolar extractions for 2.88 +/- 1.12 years. The Control group consisted of 20 untreated Class III patients (Mean age 13.51 +/- 0.95) matched for age and gender. The T1 to T2 changes in the treated and untreated groups were compared using a paired t-test while differences between the two groups were compared with an independent t-test. RESULTS: During treatment, the upper incisors were proclined about 1 degree and the lower incisors were retroclined 8 degrees. Small, but statistically significant changes in SNB, Wits and the overlying soft tissues accompanied the changes in incisor inclination. At the end of treatment a positive overbite and overjet were achieved. The increase in lower facial height in the Treatment group was comparable with the change in the Control group. CONCLUSIONS: A range of mild to moderate Class III malocclusions can be treated by dentoalveolar compensation.

Perception of facial profile attractiveness of different antero-posterior and vertical proportions.

This study investigated the influence of changing the antero-posterior (AP) and vertical proportions of the lower face on the rankings of facial attractiveness. Four hundred and fifty-four (219 males and 235 females) native Jordanians of various ages and professions rated the attractiveness of a sequence of antero-posteriorly and vertically altered male and female profile images. Attractiveness ranking scores were obtained from the visual assessment of these digitally altered male and female profile images that represented a range of AP and vertical lower facial proportions. The mean and standard deviation (SD) for the rank scores were calculated. Statistical analyses were employed for comparison between the different age groups, genders, and professions. A Class I male profile with a normal lower face height and Class I female profile with a reduced lower face height were ranked as the most attractive. Class II male and female profiles with increased lower face heights were ranked as least attractive. As the vertical and AP dimensions diverged from normal, attractiveness decreased. Images with Class II profile features and increased lower face heights were considered less attractive than corresponding images with Class III profile features and reduced lower face heights. Gender had a limited influence on the perception of attractiveness. A significant difference was found between dentists and lay people in the perception of profile attractiveness.

Anteroposterior and vertical components of class II division 1 and division 2 malocclusion.

OBJECTIVE: To describe and analyze the skeletal and dental characteristics associated with Class II division 1 (Class II/1) and Class II division 2 (Class II/2) malocclusions in the anteroposterior and vertical dimensions. MATERIALS AND METHODS: A total of 551 lateral cephalograms were used; 293 films of Class II/1 and 258 films of Class II/2 malocclusions. Lateral cephalographs were traced and analyzed. Parameters for both malocclusions were compared with each other and with the norms calculated for the Jordanian population in another study. RESULTS: The maxilla was prognathic in both malocclusions. The mandible was retrognathic in Class II/1 and orthognathic in Class II/2. Vertically, LAFH was significantly reduced in patients with Class II/2 compared with subjects with Class II/1 who exhibited a significantly increased LAFH. In Class II/1, the lower incisors were proclined and the interincisal angle was reduced, while in Class II/2 the lower incisors were at a normal inclination and the interincisal angle was significantly increased. CONCLUSIONS: Class II/2 may be considered as a separate entity which differs in almost all skeletal and dental features from Class I and Class II/1. A Class II skeletal pattern and reduced interincisal angle were common features of Class II/1 malocclusion, while a Class II skeletal pattern, increased interincisal angle, and skeletal deep bite were common features of Class II/2 malocclusion.

Tooth size discrepancies and arch parameters among different malocclusions in a Jordanian sample.

The objectives of this study were to determine the mean mesiodistal tooth width of the dentition, Bolton anterior and overall ratios, arch length, and arch width in the different malocclusions in a Jordanian sample. The mesiodistal tooth width, arch width, and length were measured on a total of 140 orthodontic models of school students aged 13-15 years of different occlusal relationships (Class I, Class II division 1, Class II division 2, and Class III malocclusions). Anterior and overall Bolton ratios were calculated. The mean and standard deviation were calculated. Student's t-test and analysis of variance were used for the statistical analysis. The results show that (1) females have smaller teeth than males; (2) Class III malocclusion showed larger teeth than the rest of the other occlusal categories; (3) no statistically significant differences were found in Bolton ratios between the different malocclusions; (4) Class II division 1 showed the narrowest maxillary arch compared with the other types of malocclusion; (5) the mandibular intercanine width was significantly larger in Class III group than in Class II division 1 and Class II division 2 groups; (6) the maxillary arch was significantly longer in Class II division 1 than in Class II division 2; and (7) the mandibular arch of both Class II categories was significantly shorter than Class III malocclusion group. In conclusion, tooth size differences were found between right and left sides, between females and males, and between the different malocclusions. Arch width and length also showed differences among the different malocclusions.

Prevalence of malocclusion in 13-15 year-old North Jordanian school children.

OBJECTIVES: This study was carried out to determine the prevalence of malocclusion in 13-15-year-old North Jordanian schoolchildren. METHODS: One thousand and three children aged 13-15 years (619 females, 384 males) were examined using Björk et al. (1964) registration method. A full clinical examination was carried out in the school premises using a mouth mirror under natural lighting. Alginate impressions were then taken for each student together with a wax bite. The impressions were poured the same day by an orthodontic technician. Peri-apical radiographs were taken for the students when hypodontia was suspected. RESULTS: Overall, the prevalence of malocclusion was 92%. Class II and III molars were found in 18.8% and 1.4% of the sample respectively. The malocclusion traits detected were crowding (50.4%), midline shift (31.7%), spaced dentition (26.7%), increased overjet (24.7%), deepbite (16.9%), crossbite (6.8), abnormal tooth form (7.7%), median diastema (6.9%), missing teeth (6%), ectopic canines (5.9%), inverted incisors (5.2%), high frenal attachment (3.9%), openbite (2.9%), tooth impaction (1.8%), reversed overjet (1.9%), scissorbite 0.3%. There was no statistically significant difference between males and females in the overall prevalence of malocclusion and the occlusal traits investigated. However, some dental anomalies showed significant differences. CONCLUSIONS: Prevalence of malocclusion among north Jordanians is comparable with other populations.

Self-perception of malocclusion among north Jordanian school children.

This study was undertaken to assess the factors affecting self-perception and the demand for orthodontic treatment among north Jordanian school children. In total, 1404 students randomly selected to represent five geographical areas of northern Jordan were examined. The students were further subgrouped according to gender (858 females, 546 males), age (985 13 year olds, 419 17 year olds) and rural/urban place of residence (212 rural, 1192 urban). The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used as an assessment measure of the need for orthodontic treatment. The self-perception of malocclusion was evaluated by asking each student to identify which photograph on the AC scale most closely matched the appearance of their anterior teeth. The demand for orthodontic treatment was measured by asking the students: "Do you feel it is necessary to have your teeth straightened by an orthodontist?" Differences between the self-perception of malocclusion among the different groups were tested using the chi-squared test.The results showed that the majority of students rated their dentition from grades 1 to 4, with a tendency for the females and older school children to score their teeth as more attractive than males and younger children (P < 0.05, P < 0.001, respectively). Rural and urban school children did not differ in the perception of their own dentition. The self-perception scores of subjects within the no aesthetic need, borderline need and definite need groups differed significantly (P < 0.001). The subjects who reported a definite need perceived their teeth to be worse than the other two groups. The demand for orthodontic treatment was found to be affected by gender (P < 0.01) and rural/urban areas of living (P < 0.05).

Attractiveness ratings of anterior open bites and reverse overjets using the aesthetic component of the Index of Orthodontic Treatment Need.

This study was carried out to determine the level of attractiveness of anterior open bites (AOB) and reverse overjets of varying severity. A sample of 180 non-dental students (101 females and 79 males; average age 20 +/- 0.75 years) and 45 dental professionals (12 females and 33 males; average age 35.5 +/- 5.07 years) was asked to complete a questionnaire to rate the level of attractiveness of AOB and reverse overjets of varying severity using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Photographs of mild and severe AOB and reverse overjets were projected onto a white screen in a lecture theatre (15 seconds each with a 5 second interval between images). The participants were asked to record the AC grade at which they thought the projected picture of the AOB or reverse overjets had similar attractiveness. Dental awareness of non-dental students was determined by asking them their opinion on how important it was to have straight teeth (very unimportant, unimportant, important, very important), about their personal or close family members' orthodontic experiences and if they thought they were in need of any orthodontic treatment. A chi-square test was applied to record any differences between sexes and between the different groups. Backward stepwise linear regression analysis was used to determine the relationship between the students' ratings of the photographs and their dental awareness. The majority of non-dental students rated a mild AOB (93 per cent) and mild reverse overjet (96 per cent) to be aesthetically acceptable. A mild AOB and mild reverse overjet were found to be acceptable by 40 and 58 per cent of dental professionals, respectively. The differences in the ratings between dental professionals and non-dental students were significant at P < 0.001.A severe AOB was considered unattractive by both students and dental professionals. However, dental professionals rated it at the more unattractive end of the scale (P < 0.001). A severe reverse overjet was rated by the majority of the subjects as aesthetically unacceptable (85 per cent of the non-dental students and 78 per cent of the dental professionals).

Orthodontic treatment need and demand in 12-14-year-old north Jordanian school children.

This study was undertaken to assess the need and demand for orthodontic treatment among 12-14-year-old north Jordanian school children. In total, 1002 students randomly selected to represent five geographical areas of Irbid were examined. The examinations were carried out twice, first on the pupils in the school premises and then using study models taken from each student. The dental health (DHC) and aesthetic (AC) components of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment. The demand for orthodontic treatment was measured by asking the students 'if it was necessary, would they like to have their teeth straightened by an orthodontist'. The results showed that approximately one-third (34 per cent) of the children examined had a definite need for orthodontic treatment. Within this group, 73.5 per cent were in need of orthodontic treatment according to the DHC, 23.5 per cent had both DHC and AC great need scores, and 3 per cent were in need according to the AC only. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by impeded eruption of teeth, hypoplasia of a single tooth and increased overjet of more than 6 mm but less than or equal to 9 mm. The demand for orthodontic treatment among the students was 49 per cent. Approximately half of them (54 per cent) had a definite need for orthodontic treatment. This study provides baseline data on the need and demand for orthodontic treatment among a Jordanian population, which is important for planning public orthodontic and dental services.