Orthodontic treatment complexity and need in a Nigerian teaching hospital.

OBJECTIVE: The aim of this study was to assess the orthodontic treatment need and complexity in a major referral orthodontic centre in Lagos, Nigeria. METHOD: Pre-treatment dental casts of 150 consecutive patients were assessed using the Index of Complexity, Outcome and Need (ICON). RESULTS: Fifty-seven (38%) of the population needed orthodontic treatment. Twenty-five (16.7%) cases were classified as difficult or very difficult, 14.7% moderate and 68.6% belonged to the easy/mild categories. The overall mean ICON score was 43 ± 17.8 SD. There were no significant age or gender differences in the pre-treatment ICON score. There was a significant association (p<0.05) between treatment need and social class: more subjects from the lower social class needed orthodontic treatment than subjects from the higher social class. CONCLUSIONS: More than one third of the population had a need for orthodontic treatment, of which close to one fifth were in the difficult to very difficult category. Patients in the lower socio-economic class had greater need for orthodontic treatment than those from the higher class.

Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria.

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region.

Pattern of presentation of oral health conditions among children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria

Objective: To evaluate the spectrum of oral health conditions that presented at the Child Dental Health Clinic. Methods: A 30-month retrospective study of oral health conditions of 462 children, 222 (48.3%) males and 238 (51.7%) females, aged 16 years and below seen at the Dental Centre, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Results: The average age of the patients was 8.5 + 3.8 (SD) years. Nineteen (4.1%) children attended for routine dental check-up and there were no routine visits before the age of one year. Two hundred and fifteen (46.2%) of the children were diagnosed with dental caries, while 91 (19.7%) of the children had chronic gingivitis. Only 42 (9.1%) children attended due to traumatic injuries to the dentition. Forty six (10%) were referred for orthodontic management. There was a female predilection for dental caries (58.1%) while the males were found to have more periodontal diseases. Conclusion: There is a poor dental awareness as reflected by the proportion of children that attended the clinic for routine visits and the severity of some of the dental conditions suggesting late presentations. An early age dental visit should be encouraged since it provides a foundation upon which a lifetime of preventive education and oral health care can be developed.

Objetivo: Avaliar as condições de saúde bucal de crianças atendidas na Clínica Odontológica Infantil. Método: Um estudo restrospectivo de 30 meses foi conduzido em 462 crianças - 222 (48,3%) do sexo masculino e 238 (51,7%) do sexo feminino, com at‚ 16 anos de idade atendidas no Centro de Odontologia da Universidade de Port Harcourt Teaching Hospital, Port Harcourt, na Nig‚éia. Resultados: A idade média dos pacientes foi de 8,5+3,8 anos. Dezenove (4,1%) crian‡çs foram atendidas para exame odontológico de rotina, não existindo consultas odontológicas nates de um ano de idade. Duzentos e quinze crianças (46,2%) possuiam lesães de c rie dent ria, enquanto 91 (19,7%) apresentavam gengivite crônica. Apenas 42 crian‡as (9,1%) foram atendidas devido a traumatismos dentários. Quarenta e seis crianças (10,0%) foram encaminhadas para tratamento ortodôntico. Houve uma predileção do sexo feminino para a cárie dentária (58,1%), enquanto os meninos apresentaram maior frequência de doença periodontal. Conclusão: H  uma deficiência nos cuidados dentários que‚ refletido pela proporção de crianças que compareceram ao ambulatório para visitas de rotina e pela gravidade de algumas das condições dentárias apresentadas sugerindo uma procura tardia pelos serviços de saúde. A consulta odontológica precoce deve ser incentivada, pois proporciona uma base sobre a qual a educação preventiva em sa£de e cuidados de saúde bucal podem ser implementados.

Conhecimento e Prática de Cirurgiões-Dentistas Nigerianos Sobre a Terapia do Arco Dental Reduzido (TADR) / Knowledge and Practice of Nigerian Dentists About Shortened Dental Arch Therapy (SDAT)

Objeti vo: Determinar o conhecimento e pratica de cirurgioes dentistas nigerianos sobre a terapia do arco dental reduzido (TADR). Metodo: Um estudo transversal foi desenvolvido usando um questionario estruturado auto-aplicavel. O questionario continha informacoes sobre o conhecimento e a pratica dos respondentes com relacao a TADR. Os questionarios foram distribuidos aleatoriamente entre os clinicos-gerais e residentes em instituicoes de Odontologia na Nigeria. Resultados: Apenas 47 (43,5%) dos respondentes estavam cientes do conceito da terapia do arco dental reduzido (TADR). A maioria dos pesquisados nao foram informados da indicacao da idade para a tecnica e dos criterios para a reducao dos arcos dentarios. O percentual de pacientes com arco reduzido situa-se entre 5%. Aproximadamente metade dos sujeitos listaram a TADR como opcao de tratamento em 5% dos casos. A maioria nunca aplicou de forma ativa ou passiva a tecnica em sua pratica clinica. Conclusao: O conhecimento dos cirurgioes-dentistas sobre a TADR e inferior ao considerado satisfatorio. A aplicacao do conceito em um pais em desenvolvimento com a Nigeria parece ser inadequado neste momento.

Objective: To determine the knowledge and practice of a cross-section of Nigerian dentists about shortened dental arch therapy (SDAT). Method: A cross-sectional study was conducted using a self administered structured questionnaire. The questionnaire requested for information on knowledge and practice of the respondents as regards to the SDAT. The questionnaires were randomly distributed among general dental practitioners and residents (postgraduate doctors) in dental training institutions in Nigeria. Results: Only 47 (43.5%) respondents were aware of the concept of shortened dental arch therapy (SDAT). Most of the respondents were not aware of the age group indication and the suggested criteria for active shortening of the dental arches. The percentage of patients with shortened dental arch was put at ? 5% by most of the respondents. About half of the respondents list the SDAT as a treatment option in ?5% of cases. Most of the respondents have never applied active and or passive shortening in their practice. Conclusion: The knowledge of the respondents about SDAT is generally less than satisfactory. The application of the concept in a developing country like Nigeria also appeared grossly inadequate at the moment.

Knowledge and practice of nigerian dentists about shortened dental arch therapy (SDAT) / Conhecimento e prática de cirurgiões-dentistas nigerianos sobre a terapia do arco dental reduzido (TADR)

Objeti vo: Determinar o conhecimento e pratica de cirurgioes dentistas nigerianos sobre a terapia do arco dental reduzido (TADR). Metodo: Um estudo transversal foi desenvolvido usando um questionario estruturado auto-aplicavel. O questionario continha informacoes sobre o conhecimento e a pratica dos respondentes com relacao a TADR. Os questionarios foram distribuidos aleatoriamente entre os clinicos-gerais e residentes em instituicoes de Odontologia na Nigeria. Resultados: Apenas 47 (43,5%) dos respondentes estavam cientes do conceito da terapia do arco dental reduzido (TADR). A maioria dos pesquisados nao foram informados da indicacao da idade para a tecnica e dos criterios para a reducao dos arcos dentarios. O percentual de pacientes com arco reduzido situa-se entre 5%. Aproximadamente metade dos sujeitos listaram a TADR como opcao de tratamento em 5% dos casos. A maioria nunca aplicou de forma ativa ou passiva a tecnica em sua pratica clinica. Conclusao: O conhecimento dos cirurgioes-dentistas sobre a TADR e inferior ao considerado satisfatorio. A aplicacao do conceito em um pais em desenvolvimento com a Nigeria parece ser inadequado neste momento.

Objective: To determine the knowledge and practice of a cross-section of Nigerian dentists about shortened dental arch therapy (SDAT). Method: A cross-sectional study was conducted using a self administered structured questionnaire. The questionnaire requested for information on knowledge and practice of the respondents as regards to the SDAT. The questionnaires were randomly distributed among general dental practitioners and residents (postgraduate doctors) in dental training institutions in Nigeria. Results: Only 47 (43.5%) respondents were aware of the concept of shortened dental arch therapy (SDAT). Most of the respondents were not aware of the age group indication and the suggested criteria for active shortening of the dental arches. The percentage of patients with shortened dental arch was put at ? 5% by most of the respondents. About half of the respondents list the SDAT as a treatment option in ?5% of cases. Most of the respondents have never applied active and or passive shortening in their practice. Conclusion: The knowledge of the respondents about SDAT is generally less than satisfactory. The application of the concept in a developing country like Nigeria also appeared grossly inadequate at the moment.

Orthodontic treatment complexity and need with associated oral health-related quality of life in Nigerian adolescents.

PURPOSE: The aim of this study was to assess the orthodontic treatment complexity and need in Nigerian adolescents as well as to ascertain the relationship between these professionally assessed facets of orthodontic provision and the oral health-related quality of life in the adolescents. MATERIALS AND METHODS: The orthodontic treatment complexity and need in 274 adolescents who were drawn from four secondary schools in Ibadan, Nigeria aged 12 to 17 years (142 (51.8%) females and 132 (48.2%) males) were examined using the index of complexity, outcome and need. The oral health-related impacts of the same subjects were assessed using the shortened version of the oral health impacts profile. In addition to the descriptive statistics, the Pearson chi-square test was used in the analysis of data. RESULTS: Cases that were considered to belong to the easy complexity grade accounted for 20.1% while difficult/very difficult complexity grades accounted for 9.8%. Boys had significantly fewer complexity grades that were in the easy grade (P < 0.05). Of the subjects, 42% would need orthodontic treatment and 62.4% had some oral health-related impacts, with boys suffering significantly more impacts than girls. The relationship between oral health-related impacts and treatment need was significant (P < 0.05) unlike with complexity (P > 0.05). CONCLUSIONS: The orthodontic treatment complexity and need in these Nigerian adolescents was comparable to Caucasians including the association with oral health-related impacts on daily activities.

Relação Entre o Índice de Complexidade, Resultado e Necessidade e o Índicede Estética Dentária na Avaliação da Necessidade e Complexidade deTratamento Ortodôntico de Adolescentes Nigerianos / Relationship Between Index of Complexity, Outcome and Need and Dental Aesthetic Index in the Assessment of Orthodontic Treatment Complexity and Need of Nigerian Adolescents

Objetivo: Avaliar a relação entre o Índice de Complexidade,Resultado e Necessidade (ICON) e o Índice de Estética Dentária(DAI) na avaliação da necessidade e complexidade de tratamentoortodôntico entre adolecentes em Ibadan, Nigéria.Método: A necessidade e complexidade de tratamento ortodônticofoi avaliada em 274 adolescentes de 4 escolas da cidade de Ibadan,Nigéria, com idades entre 12-17 anos - sendo 142 (51,8 por cento) do sexomasculino e 132 (48,2 por cento) do sexo feminino através do ICON. Anecessidade de tratamento da mesma amostra foi avaliada com ouso do DAI por um único examinador. A estatística descritiva, oteste do Qui-quadrado, Correlações não-paramétricas (Spearmane Pearson’s) foram utilizadas para testar a relação entre os indíces.Resultados: Ambos os índices identificaram que 102 (37,2 por cento) dosadolescentes não tinham necessidade de tratamento enquanto quedos 27 (9,9 por cento) que o ICON considerou como portador de um graude complexidade severo/muito severo, o DAI mostrou 22 (8,0 por cento)destes como possuidores de maloclusões incapacitantes. Aconcordância entre os índices para ambas as necesidades detratamento, bem como para a complexidade e severidade dasmaloclusões foram estatisticamente significativas (p<0,01). De ummodo geral, as correlações dos escores de ambos os índicesmostraram-se positivamente fortes e estatisticamente significante(r = 0,715; p<0,01).Conclusão: Ambos os índices ortodônticos concordaramsatisfatoriamente em ambas as facetas de avaliação de tratamentoortodôntico, sugerindo que o ICON poderia ser utilizado para aavaliar os cuidados ortodônticos dos Nigerianos.

Occlusal changes from primary to mixed dentitions in Nigerian children.

OBJECTIVE: To evaluate longitudinally the occlusal changes between the deciduous and early mixed dentition stages in Nigerian children. MATERIALS AND METHODS: The occlusion of 145 3- to 5-year-old children was initially assessed at a popular pre-primary school center in Ibadan, Nigeria in October 2002, using the Foster and Hamilton criteria. The same group of children was followed up for reexamination in October 2006 in the primary school section of the center. Of 61 students who were located and reexamined, 54 (26 male and 28 female) qualified for the study. The molar relationship was assessed using Angle classification, and other occlusal features such as spacing, crowding, overbite, and overjet were also assessed. Descriptive statistics, chi-square test, as well as Pearson correlation coefficient, were applied as appropriate in the analysis of the data. RESULTS: Of 32 subjects initially having a flush terminal relationship (Class 1), 22 (68.7%) resulted in a Class I molar relationship, seven (21.9%) had Class II, and three (9.4%) had asymmetric relationships. Mesial step (Class III) was formed initially in 18 and 11 (61.1%) resulted in Class I. A Class III developed in five (27.8%). Significant positive correlations were found for molar relationship, crowding, overbite, and overjet variables (P < .01) between the two periods of assessments, but all were below 0.7 value. CONCLUSIONS: Angle Class I molar relationship was favored by initial flush terminal plane and mesial step relationships in the deciduous dentition.

Orthodontic treatment complexity and need in a group of Nigerian patients: the relationship between the Dental Aesthetic Index (DAI) and the Index of Complexity, Outcome, and Need (ICON).

AIM: The aim of this retrospective analytical study was to assess the relationship between the Dental Aesthetic Index (DAI) and the Index of Complexity, Outcome, and Need (ICON) on the orthodontic treatment need and complexity in a group of Nigerian patients. METHODS AND MATERIALS: Fifty-six cases were randomly selected from the model storage of the orthodontic unit of the University College Hospital in Ibadan, Nigeria. The ICON was used to assess the pre-treatment study models for orthodontic treatment need and complexity of the cases while the DAI was also used to assess the same cases for treatment need. Descriptive statistics as well as the non-parametric (Spearman Rank-Order and Pearson's Product Moment) correlations were used to analyze the data. RESULTS: The mean ICON and DAI scores were 67.38+/-19.63 (SD) and 42.27+/-12 .66 (SD), respectively. Both the ICON and DAI agreed that one (1.8%) case did not need treatment while 46 (82.1%) needed treatment. All the difficult and very difficult cases according to the ICON were assessed as needing treatment by the DAI with 18 (13.1%) out of 22 (39.3%) in the very difficult category belonging to the handicapping group where treatment was mandatory. In all positive significant correlations were recorded for the ICON and DAI scores. CONCLUSION: The ICON and DAI showed favorable agreement when used to assess treatment needs through the use of study casts. The ICON could be a good substitute for the DAI in assessing pre-treatment needs of Nigerian patients.

Relationship between index of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system.

INTRODUCTION: The objectives of this study were to examine the relationships among 4 indexes that are used to score orthodontic treatment need and outcome, and to determine whether 1 index could replace the other 3. The index of complexity, outcome, and need (ICON), the dental aesthetic index (DAI), the peer assessment rating (PAR) index, and the American Board of Orthodontics objective grading system (ABO-OGS) were studied. The use of the ICON is desirable because it is faster to use than separate indexes for assessing different treatment facets. METHODS: One hundred pretreatment and posttreatment study models were randomly selected from an accredited graduate orthodontic clinic at University of Illinois at Chicago, Chicago, Ill. The sample was assessed by using the PAR index, the DAI, the ABO-OGS, and the ICON. The data were analyzed descriptively and the relationships evaluated by using the Spearman rank order correlation coefficient. RESULTS: The study showed a significant correlation between the DAI and the ICON with respect to treatment need (r = .5523, P <.001). The PAR index and the ABO-OGS had significant correlations with the ICON for treatment outcome (pretreatment PAR vs ICON, r = .6840, P <.001; posttreatment PAR vs ICON, r = .3466, P <.001; ABO-OGS vs ICON, r = .2654, P <.01). CONCLUSIONS: The ICON can be used in place of the PAR and the ABO-OGS for assessing treatment outcome and in place of the DAI for assessing treatment need.

Orthodontic treatment--improvement and standards using the peer assessment rating index.

This article is aimed at assessing the orthodontic treatment outcome in an accredited graduate orthodontic clinic in the United States, using the original Peer Assessment Rating (PAR) Index. A sample of 100 pre- and posttreatment study models was randomly selected from the clinic model storage. One investigator assessed all the components of the PAR Index. Descriptive statistics and Scheffe test were used to analyze the data. The mean weighted PAR point reduction was 22.11, and mean percentage reduction was 86.20. "Greatly improved" conditions were seen in 50% of patients while 47% accounted for the "improved category." Only 3% belonged to the "worse or no different" group. Statistically significant differences were observed between the three improvement groups for weighted pre- and posttreatment PAR scores, reduction, and percentage reduction. The results indicated an excellent improvement of the patients, with patients being treated to a high standard and a great proportion of patients with a clear need for treatment.

Perception of personal dental appearance in Nigerian adolescents.

BACKGROUND: The purpose of this study was to investigate the relationship among Nigerian adolescents' awareness of malocclusion, their satisfaction with personal dental appearance, and the severity of their occlusal irregularities. MATERIAL: The sample consisted of 577 randomly selected secondary school adolescents-306 (53%) boys and 271 (47%) girls aged 12 to 17 years (mean age, 14.73 +/- 1.12). A pretested questionnaire was used to assess the subjects' awareness of malocclusion and satisfaction with personal dental appearance; the actual severity of malocclusion was determined by using the dental aesthetic index (DAI), performed by an orthodontist in a school environment under natural illumination. RESULTS: Statistically significant, negative, weak correlations were found between awareness of malocclusion and satisfaction at the various DAI scores as follows: < or =25 (r = -0.3774, P < .001), 26 to 30 (r = -0.4305, P < .001), 31 to 35 (r = -0.5137, P < .001), and > or =36 (r = -0.5104, P < .001). Analysis of variance (ANOVA) did not show a significant value of any of the 3 factors. Multivariate analysis with age as the covariate did not show a significant effect. Also, the association between socioeconomic status and the variables was not significant ( P > .05). Generally, no statistically significant sex differences were found in relation to the DAI scores, awareness, or satisfaction ( P > .05). CONCLUSIONS: Significant, negative, weak correlations were found between Nigerian adolescents' awareness of malocclusion and satisfaction with personal dental appearance at the various severity levels of malocclusion. It would be worthwhile to assess such a relationship with the index of orthodontic treatment need in the Nigerian population.

Prevalence of malocclusion among adolescents in Ibadan, Nigeria.

The objective of this study was to determine the prevalence of malocclusion among predominantly Yoruba adolescents in Ibadan, Nigeria, and to compare the results with those of other authors. The sample for this epidemiological survey comprised 636 secondary school students, (334 [52.5%] boys and 302 [47.5%] girls), aged 12-17 years (mean age, 14.72 +/- 1.16 SD). The subjects were randomly selected, and none had received previous orthodontic treatment. Occlusal anteroposterior relationships were assessed based on the Angle classification. Other variables examined were overjet, overbite, crowding, and midline diastema. The results showed that about 24% of the subjects had normal occlusions, 50% had Class I malocclusions, 14% had Class II malocclusions, and 12% had Class III malocclusions. Over 66% had normal overbites, and 14% and 9% had increased and reduced values, respectively. Overjet relationship was normal in 66%, increased in 16%, and decreased in 8%. Crowding was observed in 20% of the subjects and midline diastema in 37%. No statistically significant differences were observed for any occlusal variables (P > .05). Class I malocclusion is the most prevalent occlusal pattern among these Nigerian students. Different patterns of Class II and Class III might be present for the dominant ethnic groups in the country. Therefore, a survey of the occlusal pattern in southeastern Nigerians (Ibo ethnic group) would appear to be worthwhile.

Comparison of malocclusions and orthodontic treatment needs of handicapped and normal children in Ibadan using the Dental Aesthetic Index (DAI).

This study compared the prevalences of malocclusion and Orthodontic needs between normal Nigerian children and their handicapped counterparts using the Dental Aesthetic Index. The samples consisted of 1,010 children -614 normal (321 males; 294 females) and 396 handicapped (199 males;197 females) aged 12-18 years with mean ages for normal and handicapped children as 14.8+/-1.9 and 15.0+/- 2.2 respectively. They were drawn randomly from their respective schools in Ibadan, Nigeria. Although some differences were observed in the ten malocclusion traits of DAI between the normal and the handicapped children, none was found statistially significant (P> 0.05). Missing teeth were noted in 1.9% of the normal children as against 4.8% of the handicapped. Crowding of incisal segments was observed in 20.0% of the normal and in 21.7% of the disabled children. Spacing of incisal segments was recorded in 47% and 55.5% of normal and handicapped children respectively. Others in that order were: Disatema-31.7% and 32.3%; Anterior maxillary irregularity - 55.5% and 40.9%; Anterior mandibular irregularity- 50.2% and 34.3%; Overjet - 20.7% and 13.1 %; Reversed overjet - 1.9% and 2.3%; Open bite - 7.5% and 9.8% and total deviations from normal molar relation in 23.8% and 31.3%. Also, although higher proportions of handicapped children than the normal group were noted having DAI scores indicative of treatment needs ranging from elective to mandatory, no significant differences were noted (P>0.05). About 13% of the normal and 16% of the handicapped children in the study sample deserved publicly funded orthodontic care.

Secondary school athletes: a study of mouthguards.

The purpose of this study was to determine the extent of mouthguard awareness and use, as well as the amount and type of oro-facial trauma associated with and without mouthguard wear in adolescent Nigerian athletes. A 13-item self-completion questionnaire was completed and returned by 1,127 secondary school athletes (completion rate of 93.9%) comprising 683 (60.6%) males and 444 (39.4%) females ranging in age from 12- to 19 years (mean age 15.18+/-2.97 SD). The athletes were randomly drawn from 23 secondary schools located in different parts of Ibadan city in Nigeria. Sixty-five-and-a-third percent of the athletes professed awareness of the need for mouthguards for sports, but only 19.6% claimed usage of the device. Thirty-four-and-a-half percent of the athletes reported having sustained one form of oro-facial injury or the other previously. The prevalence of oro-facial injuries was significantly lower while wearing a mouthguard (p<0.05), and most of the injuries occurred during contact sports. The study supports the need for the enforcement of mandatory mouthguard use in contact sports.

Orthodontic treatment need of mentally handicapped children in Ibadan, Nigeria, according to the dental aesthetic index.

PURPOSE: Proper well-organized orthodontic treatment planning for special needs patients quantifies such needs with a valid screening method to determine priority treatment. The aim of this study was to determine the orthodontic treatment needs of mentally handicapped children in Ibadan, Nigeria. METHODS: The sample consisted of 124 mentally handicapped children, 68 boys and 56 girls who were 6 to 18 years old with mean age of 14.5 +/- 1.5 years, drawn from 7 special centers/schools in the city. RESULTS: Less than 42% had normal or minor malocclusions needing slight or no treatment; 17% had definite malocclusions with treatment elective; 9% had severe malocclusions and treatment highly desirable; 32% had very severe or handicapping malocclusions with treatment considered mandatory. Significant gender differences were found in the mean dental aesthetic index (DAI) scores (P < .05) and significant association noted (P < .05) between severe mental retardation and DAI scores deserving treatment. CONCLUSIONS: There were considerable orthodontic treatment needs among the study population with a reasonable percentage deserving treatment in publicly funded programs.