Preventive and interceptive orthodontic needs among Syrian children.

BACKGROUND: Preventing or intercepting a developing malocclusion in a public health program requires identifying or measuring the degree of malocclusion. The present study aimed to quantify the proportion of Syrian children in Damascus who would benefit from preventive and interceptive orthodontic treatment. MATERIALS AND METHODS: In total, 1096 children (431 boys and 665 girls) of grade 1 up to grade 3 from 16 government elementary schools in Damascus city were evaluated using the index for preventive and interceptive orthodontic need (IPION). On the basis of IPION, the overall scores of children were distributed into three groups - no treatment need, moderate treatment need, and definite treatment need. According to dental development, children were divided into two groups - IPION-6 and IPION-9. RESULTS: Of the enrolled children, 15.4% showed no treatment need, 26.7% showed moderate treatment need, and 57.9% showed definite treatment need. Comparison between male and female children indicated no significant effect on the overall treatment need distribution (P=0.439). The IPION groups had a significant effect on treatment distribution (6 vs. 9, P=0.038); the IPION-9 scores were significantly higher than the IPION-6 scores. CONCLUSION AND RECOMMENDATIONS: The prevalence of preventive and interceptive orthodontic needs is unsatisfactorily high in Syrian children, which emphasizes the importance of including preventive and interceptive orthodontic treatment in the local dental healthcare program.

2013 survey of Australian orthodontists' procedures.

AIM: This survey of Australian orthodontists was conducted to assess treatment preferences. METHODS: Email invitations to participate in an online survey were sent to a total of 433 Australian Society of Orthodontists (ASO) members and 158 replies were received (36% response). RESULTS: For Class II treatment, most practitioners preferred to wait and treat later but when early treatment was performed, the Twin Block was the most popular appliance. For fixed appliance treatment, the 0.022 inch slot was the most commonly used (73%) and the median treatment time was 20 months. The median extraction rate was 23% which was similar to that reported in a 2008 USA survey. Sequential plastic aligners were used by 73% of respondents and Temporary Skeletal Anchorage Devices were used by 77%. The most common research question clinicians would like answered related to retention. CONCLUSION: The responses were similar Australia-wide but some areas of difference were revealed and discussed.

Need for preventive/interceptive orthodontic treatment among 7-10-year-old children in Ibadan, Nigeria: an epidemiological survey.

The aim of this epidemiological survey was to assess the level of needs for preventive/interceptive orthodontics among 7-10-year-old children in Ibadan, Nigeria, which is the second vigilance period in the study of developing occlusions. The sample consisted of 493 school children--237 (48.1%) boys and 256 (51.9%) girls randomly selected from various schools and different socio-economic groups. They were all examined in their school environments under natural illumination and the findings entered into a pre-structured form. The study revealed that about 27% of the children had need for one form of preventive/interceptive orthodontic treatment or the other with some having multiple needs. Some of the needs detected were as follows: prolonged retention of primary teeth (6.9%), cross bite (10.3%), early loss of primary teeth (4.3%), oral habits (7.3%), over jet of more than 6mm (4.9%), carious lesions (14.8%) crowding (18.9%) and clinically missing upper lateral incisors (3.7%). The relationship between observed occlusal discrepancies and oral habits was found very statistically significant (p=0.001). No gender differences were noted among the children with preventive/interceptive needs (p>0.05). Children from the working class accounted for 55.2% of the study sample, while 44.8% were from the middle class families. It was concluded that over one third of these children would benefit from preventive interceptive orthodontics and that such care should be encouraged in our environment due to their known numerous benefits especially in a country like Nigeria where many can not afford the cost of comprehensive orthodontic services.

Orthodontics in 12-year old children. Demand, treatment motivating factors and treatment decisions.

Ninety-three per cent of all 12-year old patients at a clinic in western Sweden accepted an invitation to take part in a dental examination in order to evaluate early orthodontic treatment. Treatment in the primary or mixed dentition periods should aim at creating normal craniofacial, occlusal and dental development and, if possible, at reducing the need for later, more complicated treatment. The treatment success was low regarding overjet correction but fairly good with regard to diagnosis and treatment of crossbite/forced occlusion, ectopic eruption and congenitally missing teeth. Whether correction of crossbite had reduced crowding was impossible to evaluate in this study. However, relatively few subjects with a history of crossbite correction desired alignment of teeth. The study confirmed earlier observations that TMD prevention is not a major motivating factor for orthodontic treatment. The majority of the children, including those desiring treatment, judged their dental appearance to be fairly average. The dentists more often than the children regarded the subjects' appearance to be better than average. Prediction of later orthodontic treatment, recorded at the age of 14 years, turned out to have a weak association to evaluation of aesthetics both by the children and the dentists. Nor did recording of TMD improve prediction. The study confirms earlier observations that discussions about orthodontic treatment on mainly aesthetic grounds ought to be postponed well into the permanent dentition period, and by attempting to avoid "making the normal abnormal".

Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation.

OBJECTIVES: The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred. METHODS: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment. RESULTS: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment. CONCLUSIONS: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.

Do we really want a quick fix?

Dental practitioners have been encouraged recently to take a more structured long term view of their continuing professional development, in particular being wary of any 'weekend' courses apparently offering 'quick fix' solutions to their clinical problems.

Occlusal and oral health status of a group of 3-8-year-old South African black children.

This study determined the oral health status of a group of 3-8-year-old South African black children, comprising a total of 214 children from the townships of Garankuwa, Shosanguwe, Mabopane, Hebron and Erasmus who attended a school in Akasia, Greater Pretoria Metropolitan Substructure. The decayed, missing and filled teeth (dmft), oral hygiene status, dental IQ and malocclusion status were determined. The study found that the children's oral health status and occlusal status were unacceptable. The level of their dental IQ scores was low, their oral hygiene poor, and they were in urgent need of primary and secondary dental care. In addition they were in need of both preventive and interceptive orthodontic care. A national strategy to address primary dental health care is recommended.

The palatally displaced maxillary canine. A retrospective comparison between an interceptive and a corrective treatment group.

The purpose of this retrospective study was to analyze palatally displaced maxillary canines referred for specialist treatment compared with those successfully treated by the general practitioner by interceptive extraction of either the primary canine or the primary canine and primary first molar. Special interest was focused on chronological age, dental age and dental maturity as well as the position of the canine at the time of recognition and referral. The Interceptive Treatment group consisted of 50 consecutive cases from computerized records, median age 11.7 years (range 8.9-14.11 years). The Corrective Treatment group comprised 47 consecutive cases, median age 14.1 years (range 11.1-18.0 years), referred to the Department of Orthodontics. Information was obtained by assessing the patient charts and radiographs. The results show that age at the time of recognition and referral is the most important factor for the final outcome while the position of the canine concerning angle alpha and sector S is a compromising factor. The results suggest that about one third of the Corrective Treatment group might have had a reasonably good chance of the canine's erupting without corrective treatment if they had been diagnosed and treated with interceptive extraction of the primary canine at an earlier age.

Short-term and long-term results after early treatment with the Castillo Morales stimulating plate. A longitudinal study.

The present study is divided into 2 parts: The first explains the concept of stimulating plate therapy at the Muenster Clinic and the second presents a longitudinal study of mouth and tongue posture in trisomy 21 children treated with this concept. 47 children underwent a pre-treatment examination (Rec1), and 38 attended a first follow-up examination (Rec2) after an average of 4 months of stimulating plate treatment. The second follow-up examination (Rec3) was on average 53 months after the end of treatment and covered 18 patients. Data acquisition was based on standardized parent questionnaires and standardized clinical examination records. Rec2 showed in part a highly significant improvement in orofacial appearance. These results were confirmed by the parent interview, according to which the mouth and tongue posture improved in 76.3% of the children during the time they were wearing the plate. Even when the plate was not in place, the result remained stable in 65.8% of the patients. Up to Rec3, further improvement was recorded in some results. The symptoms: "mouth mostly wide open" and "tongue mostly protruding way over lips" were reduced. The number of children whose tongue was "mostly in the oral cavity" increased correspondingly. At Rec3, the parents also rated the mouth posture in 88.9% and the tongue posture in 77.7% of the children as stable or further improved.

Cambios dimensionales en los arcos dentales con el regulador de función Frankel-1 / Dimensional changes en the dental arches with the function regulator Frankel-I

El propósito de esta investigación fue evaluar la eficacia y estabilidad del regulador de función Frankel-1 en la resolución del apiñamiento dental en un grupo colombiano. Fue un estudio descriptivo realizado en 14 pacientes entre 7-9 años de edad, sin tratamiento ortodóntico previo, de bajo nivel socioeconómico, y tomados de una de las escuelas donde la Pontificia Universidad Javeriana presta sus servicios. Se evaluaron cambios dimensionales después de tres años de uso del aparato, midiendo la longitud de arco, distancias intercolar e intercanina en los dos arcos, e índice de irregularidad de Little descrito en la literatura. Los resultados se compararon con una muestra control reportada en la literatura, lo mismo que con un grupo control de población combinada. Se obtuvieron cambios significativos de aumento en las dimensiones trasversales de los arcos, siendo mayores en el arco inferior, y reducción en el índice de irregularidad.

Treatment of malocclusions in children and adolescents at a public dental service clinic in Sweden: extent and cost.

This study was undertaken to investigate the extent and the cost of orthodontic consultation and treatment of malocclusions in 19-year-olds at a Public Dental Service (PDS) clinic. A further aim was to evaluate the group of patients who discontinued their treatment prematurely. A total of 223 patient records were reviewed. The results showed that every second patient (106 of 223) was seen by a specialist for orthodontic evaluation. Of these, 54% (57 of 106) were treated with removable appliance, 29% (31 of 106) benefited from interceptive treatment without appliance and 12% (13 of 106) were referred to a specialist clinic. The costs for specialist consultations comprised 19% of the overall orthodontic treatment cost. Premature interruption of treatment with removable appliance was found in 17% (10 of 57) of the patients. This group consumed 12% of the overall orthodontic treatment cost. Reasons for discontinuing treatment included problems with co-operation and motivation and a lack of parental support. Seventy per cent of those who discontinued their treatment prematurely had been treated with an activator.

Effects of the Castillo-Morales stimulating plate on speech development of children with Down's syndrome. A retrospective study.

Within the scope of a follow-up examination, the speech development of 2 different groups of children with trisomy 21 was compared. The patient group (n = 20) was treated with a Castillo-Morales stimulating plate in early childhood (average treatment time = 10.8 months, average age at follow-up examination: 55 months). The control group (average age 47.4 months) comprised 18 children with Down's syndrome who had ceased stimulating plate treatment after one month or had received no treatment because, although treatment proved in retrospect to be indicated, parents were not adequately informed. Two specially developed standardized forms were used, one to document parents' concepts of speech development, and the other to record relevant medical data. Other factors evaluated included motoricitiy and hearing ability, which also have an effect on speech. Follow-up examination revealed that the patient group had better results concerning oral motoricity than the control group. Within the patient group, mouth and tongue position improved in 75% of the patients compared with the first examination. Despite a poorer average general somatic development and hearing ability, the patient group had a faster speech development than the control group with respect to 1-, 2- and multi-word sentences. We therefore believe that treatment with the Castillo-Morales stimulating plate has a positive effect at least on initial speech development due to long-term improvement of peripheral conditions in the orofacial region. Thus, not only improved oral motoricity but also earlier speech development can be interpreted as a positive social factor.