Masseter Muscle Thickness in Relation to Facial Form in Angle's Normal Occlusion and Malocclusions: An Observational Study.

Background: Various clinical studies performed in adults have shown the relationship between craniofacial morphology and masticatory muscle function. However, the growth of the masticatory muscle has not received such attention, when compared with the volume of studies on the skeletal growth of face. With this background and considering the widespread use of ultrasonography (USG), the following study was undertaken to provide some insights into the relationship between muscle and bone and facial morphology. Methods: This was a prospective, observational study conducted over a period of three years from 2012 to 2015 to assess the correlation between the thickness of the masseter muscle in Angle's normal occlusion and the various malocclusions of the dental arch as well as the facial form. Patients with a full complement set of teeth, normal tooth morphology, Angle's normal occlusion, Angle's class I-III malocclusion, those with a history of third molar extraction, and impaction were included in the study. Those with a history of any prior orthodontic treatment, restorations, or any missing teeth (except the third molar) were exempted from the study. The greater thickness of masseter muscle in relaxed and clenched state was recorded on USG. Facial morphology was determined with the aid of facial photographs. Results: The study was conducted on 140 patients. The class I normal occlusion group had the thickest masseter muscle, while the class III malocclusion group had the thinnest masseter muscle. Facial parameters showed highly significant gender-wise differences in class I normal occlusion, class I malocclusion, and class II division II malocclusion. There was a significant negative co-relation between the thickness of masseter muscle and facial forms in all the categories of Angle's classification as indicated by a negative regression coefficient B (P < 0.05). Conclusion: The masseter muscle thickness correlated directly with male gender and normal occlusion, and inversely with the degree of malocclusion and facial form.

Relationship between Body Posture Assessed by Dynamic Baropodometry and Dental Occlusion in Patients with and without Dental Pathology.

Body biomechanics and dental occlusion are related, but this interaction is not fully elucidated. The aim of this study was to investigate the association between body posture and occlusion in patients with and without dental pathology. A cross-sectional study was carried out with 29 patients divided into a control group and a group with pathology (malocclusions). Body posture was evaluated by dynamic baropodometry, analyzing parameters such as the line of gait and the anteroposterior and lateral position of the center of pressure (CoP). Occlusion was classified radiographically according to the sagittal skeletal relationship. Results showed significant differences in mean position phase line between groups (p = 0.01-0.02), with means of 115.85 ± 16.98 mm vs. 95.74 ± 24.47 mm (left side) and 109.03 ± 18.03 mm vs. 91.23 ± 20.80 mm (right side) for controls and pathologies, respectively. The effect size was large (Cohen's d 0.97 and 0.92). There were no differences in the anteroposterior (p = 0.38) or lateral (p = 0.78) position of the CoP. In gait analysis, significant differences were observed in left (548.89 ± 127.50 N vs. 360.15 ± 125.78 N, p < 0.001) and right (535.71 ± 131.57 N vs. 342.70 ± 108.40 N, p < 0.001) maximum heel strength between groups. The results suggest an association between body posture and occlusion, although further studies are needed to confirm this relationship. An integrated postural and occlusal approach could optimize the diagnosis and treatment of dental patients.

Oral maxillofacial surgeons and Orthodontists’ perceptions about anterior inferior crowding and indications of mandibular third molar extraction / Percepciones de los cirujanos maxilofaciales y ortodoncistas sobre el apiñamiento anteroinferior y las indicaciones de la extracción del tercer molar mandibular

Background: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. Material and Methods: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. Results: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). Conclusions: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.(AU)

Anterior open bite correction via molar intrusion: Diagnosis, advantages, and complications.

Anterior open bite can be effectively treated nonsurgically via molar intrusion. This technique, involving the intrusion of posterior teeth using temporary skeletal anchorage devices, prompts counterclockwise rotation of the mandible. This rotation not only corrects anterior open bite but also contributes to a decrease in anterior facial height, improvements in lip incompetency, and forward movement of the chin. For successful outcomes, temporary skeletal anchorage devices, installed on both the buccal and palatal sides, must deliver equivalent intrusion force to the maxillary teeth. Treatment planning should consider factors such as skeletal discrepancies, vertical excess, incisor exposure, and configuration of the occlusal plane. Clinicians are advised to closely monitor periodontal changes and consider overcorrection to ensure lasting stability and maintenance of incisal overlap post-treatment.

Three-dimensional analysis of posterior tooth inclinations in transverse and sagittal relationships: A cross-sectional study.

OBJECTIVE: To compare tooth inclinations in different sagittal skeletal patterns and transverse maxillary relationships three-dimensionally. METHODS: A cross-sectional study carried out with 132 three-dimensional digital models in the complete permanent dentition divided into six groups (n=22); three groups with maxillary atresia: G1- skeletal class I, G2- skeletal class II and G3-skeletal class III; three groups without maxillary atresia: G4- skeletal class I; G5- skeletal class II and G6- skeletal class III. The comparison between the skeletal pattern was performed by the non-parametric tests of Kruskal Wallis and Dunn and between the groups by the non-parametric test of Mann Whitney. RESULTS: Subjects with skeletal class II and maxillary atresia had a greater lingual inclination of the maxillary teeth than those with class I and III; Subjects with skeletal class II without atresia had a less lingual inclination of the mandibular molars than the other classes (p<0.05). The maxillary premolars showed no variation in dental inclination with atresia, independent of the skeletal class in G1, G2, and G3 (p>0.05). The mandibular premolars showed that the groups without atresia G4, G5, and G6 presented no significant difference (p>0.05). Lower premolars in skeletal class III malocclusion individuals with atresia had a more negative inclination than the others. CONCLUSION: There is a difference in the inclination of posterior teeth between individuals with and without maxillary atresia and skeletal classes I, II, and III.

A Comparative Assessment of Acceptance of Different Types of Functional Appliances.

Background Modern clinical orthodontics' functional appliances, a well-established modality of treatment, exhibit an amazing diversity of design. Clinical findings show that people have difficulty adjusting to these devices due to their size and unfixed positioning inside the mouth and that patient adaptation may vary based on the type of orthodontic functional appliance employed. Despite the fact that they appear to inflict more pain and soreness than, for example, removable plates, the effects of various orthodontic functional appliances on patients' acclimation have not yet been researched. Aim The current study's goal was to assess how different functional appliances' shapes and designs affected patients' willingness to accept them. Materials and methods About 20 adult volunteers (10 males and 10 females, age 18-32 years) with marked Class II division 1 malocclusion and not familiar with orthodontic appliances were selected as test subjects. Impressions for working casts were taken, and construction bites were prepared for the fabrication of eight functional appliances of various designs for each individual test subject. These appliances had eight design variations. There were three tests: one for speech effects, one for initial acceptance, and one for final acceptance after wearing different scales. Results Overall, the correlation between the quality of speech and pronunciation after wearing the appliance and the type of functional appliance was statistically significant. The quality of speech and pronunciation after wearing the appliance was maximum in frequency range 1 (FR1), while it was minimum in the medium-size activator. The difference was statistically significant (p=0.001). Overall, the correlation between the comfort and acceptability of functional appliances after wearing them and the type of functional appliance was statistically significant. The acceptance of functional appliances after wearing was maximum in FR1, while it was minimum in the medium-size activator. The difference was statistically significant (p=0.001). Overall, the correlation between the type of functional appliance and initial acceptance was significant statistically, with the maximum initial acceptance in medium-sized activators and the minimum initial acceptance in small bionators (p=0.001). Conclusion The study's findings show that patient acceptance of various kinds of functional appliances varies significantly.

The knowledge of orthodontic and craniofacial growth amongst Italian Pediatric Medical Residents for early diagnosis in growing patients: a cross-sectional study.

Paediatric residents usually visit children since the first years of life and can potentially diagnose craniofacial anomalies and malocclusions. Therefore, the aim of this study was to assess the ability of paediatric medical residents to diagnose malocclusions in growing subjects at an early stage. Eighty-three paediatric medical residents from the University of Pavia, Italy, who were enrolled in the Paediatric Residency program, participated in an online questionnaire. The questionnaire covered demographic variables, oral examination practices, dental and orthodontic knowledge, and sources of information. Following this, the residents were presented with a photographic analysis and asked to determine the treatment priority for 10 patients with malocclusions using the Index of Orthodontic Treatment Need (IOTN). On average, it was recommended that the first orthodontic visit should occur at around 4.92 years of age. The results showed that 75.9% of the residents always performed oral examinations on their patients, and 48.1% assigned a priority score of 8 or higher. The scores obtained by the paediatric residents did not significantly differ based on the year of study, frequency of oral examinations, or sources of information reported. Notably, there was a particular underestimation of treatment priority for malocclusions characterized by a significant increase in overjet. The findings suggest a potential lack of improvement in orthodontic knowledge during the medical residency program. It is recommended to increase the availability of orthodontic information sources for paediatric residents to enhance their understanding in this area.

The Correlation of a Novel Photographic Parameter for Facial Profile Assessment in Subjects With Different Sagittal Malocclusions: A Prospective Study.

Aim The soft tissue paradigm shift is the current trend in orthodontic diagnosis and treatment planning. This study's aim was to assess the correlation of newly derived photographic Frankfort horizontal plane-subnasale to soft tissue pogonion (FSA) angle with other established soft tissue cephalometric angles, such as the Z angle and the Holdaway (H) angle, for estimating facial profile convexity in subjects with all classes of sagittal malocclusions. Materials and methods This prospective study included a sample of 60 Dravidian population subjects consisting of 30 males and 30 females with different skeletal sagittal malocclusions (Class I, Class II, and Class III) based on the radiographic criteria (ANB angle). The Z and Holdaway angles on lateral cephalograms were compared with the FSA angles in cephalograms and digital profile photographs. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS) software version 23.0 (IBM SPSS Statistics, Armonk, NY). Pearson's correlation was done to assess the correlation between soft tissue FSA angle on digital photographs and cephalometric angle (Z angle and Holdaway angle). Results The overall Pearson's correlation was significant (p < 0.05) between the Z and FSA angles in Class I, II, and III malocclusions, which had a high positive correlation. There was a significant positive correlation (p < 0.05) between the Holdaway and FSA angles in subjects with Class I and Class II malocclusions. A moderate positive correlation was noted between the Holdaway and FSA angles in Class III. Conclusion Photographic FSA angle can be used to evaluate the facial profile of subjects with different sagittal malocclusions. This angle has a good correlation with other cephalometric profile measures, such as the Z and Holdaway angles used to assess facial profile convexity.

Orthognathic Surgery and Relapse: A Systematic Review.

BACKGROUND: This review aimed to analyze the relapse in orthognathic surgery. METHODS: PubMed, Scopus, and Web of Science databases were used to find papers that matched our topic dating from 1 January 2012 up to November 2022. Inclusion criteria were (1) human studies, (2) open access studies, (3) studies concerning the correlation between orthognathic surgery and relapse. Exclusion criteria were: (1) in vitro or animal studies, (2) off-topic studies, (3) reviews, (4) other languages than English. RESULTS: A total of 482 results were obtained resulting in 323 publications after duplicate removal (158). After screening and eligibility phases 247 records were excluded: 47 reviews, 5 in animals, 35 in vitro, 180 off-topic. The authors successfully retrieved the remaining 78 papers and evaluated their eligibility. A total of 14 studies from these were ultimately included in the review. CONCLUSION: Using cephalometric examinations and digital study models, these studies reveal that the relapse after orthognathic surgery is an event that occurs in most of the cases. The limitation of our research is that most of the studies are retrospective and use small sample sizes. A future research goal should be to conduct long-term clinical trials with larger numbers of samples.

Prevalence of Malocclusions in Down Syndrome Population: A Cross-Sectional Study.

Background and Objectives: A higher prevalence of dental malocclusion has been suggested among individuals with Down Syndrome (DS) compared to controls, although no studies to date have investigated such a difference according to age group. Therefore, the aim of this study was to compare the prevalence of dental malocclusion and other orthodontic measures between DS and non-syndromic (non-DS) individuals across three age groups of children, adolescents, and adults. Materials and Methods: This cross-sectional study was conducted on a total of 147 patients. Of those, 72 were diagnosed with DS and were divided into N = 15 children (<10 years), N = 23 adolescents (10-18 years) and N = 34 adults (>18 years). The remaining 75 patients were sex- and age-matched controls. The two groups were compared according to age group in terms of the prevalence of dental malocclusion, measures of sagittal, vertical, and transverse discrepancy, facial profile, and probable sleep bruxism with chi-square tests for proportion. Results: The DS patients consistently exhibited a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to the non-DS patients, regardless of age group. The non-DS adolescents presented with a significantly higher prevalence of convex profile than the DS adolescents. The adolescent and adult DS patients most commonly presented with a maxillary transverse discrepancy and posterior crossbite compared to the non-DS controls. The DS adults had a higher prevalence of probable sleep bruxism. Conclusions: Patients with DS showed a higher prevalence of Class 3 malocclusion, concave profile and anterior crossbite compared to non-DS controls, regardless of age group. Other orthodontic measures showed a fluctuation according to the age group considered.

An Association of Morphological Characteristics of Palatal Rugae and Dental Malocclusion in an Adult Indian Population: A Cross-Sectional Study.

Introduction The formation of palatal rugae is completed in the early intrauterine stage, and because of their unique and permanent pattern in each individual, they can be utilized in forensics to identify a person. Objective The primary objective of this study was to determine an association between the rugae pattern and the dental malocclusion system described by Angle. Materials and methods A prospective cross-sectional, observational study was conducted on pretreatment dental casts of 400 subjects in an age range of 18-40 years. The samples were divided according to Angle's system of classification of malocclusion into Class I, Class II, and Class III. The number, length, pattern, and orientation of the three anterior-most primary rugae on both sides of the palatal region were studied. Results Significant differences were noted in the mean number of palatal rugae and mean lengths of rugae 1 and 2 on the right side (p < 0.001) and rugae 3 on the left (p < 0.001) side among the different malocclusion groups. Curved and wavy patterns were predominant, and significant differences were found among the groups (p < 0.05), whereas non-significant differences were observed in the rugae orientation between the groups on the right and left sides. Conclusions The current study showed significant differences in the length, number, and pattern of the palatal rugae among Angle's classes of malocclusion. Clinical implications Palatal rugae can be effectively used to identify dental malocclusion at an early stage and can, therefore, help intercept the developing malocclusion.

Association between malocclusions and amelogenesis imperfecta genotype and phenotype: A systematic review.

INTRODUCTION: The aim of this systematic review (Prospero CRD42022323188) is to investigate whether an association exists in patients with amelogenesis imperfecta (AI) between occlusal characteristics and genotype on the one hand and enamel structural phenotype on the other. MATERIAL AND METHODS: Reports up to May 2023 assessing occlusion of individuals with AI were browsed in a systematic search using Medline, Embase, ISI Web of Science, and the grey literature. Randomised control trials, case control studies, and case series specifying both occlusion, assessed by cephalometric or clinical analysis, and genotype or dental phenotype in patients with AI were included without any age limitation. Two authors independently selected the publications and extracted the data in accordance with the PRISMA statement. The risk of bias was assessed with the Critical Appraisal Checklists from the Johanna Briggs Institute. RESULTS: Twenty-five articles were chosen from the 261 results. Most of the included publications were case series (n=22) and case control studies (n=3). Thirteen studies reported both a genotype (ENAM, FAM83H, FAM20A, DLX3, CNMM4, WDR72) and occlusal diagnostic. The methodological quality of the studies was moderate. All AI phenotypes showed an open bite (OB) rate around 35%, except mixed form. The other malocclusions were not often mentioned. No correlation between occlusal phenotype and genotype or AI phenotype could be identified in patients with AI, as most studies had short occlusal descriptions and small sample sizes. CONCLUSION: OB malocclusions were more frequently reported in AI. This review highlighted the need for a more accurate description of orofacial features associated with AI, to better clarify the role of amelogenesis genes in the regulation of craniofacial morphogenesis and identify patients requiring orthognathic surgery at an early stage.

Comparative cephalometric evaluation of tongue position in subjects with skeletal class II division 1 and division 2 malocclusion.

AIM AND OBJECTIVE: To evaluate and compare the position of the tongue from rest to centric occlusion in subjects with skeletal class II division 1 and skeletal class II division 2 malocclusions with subjects of skeletal class II normal occlusion. MATERIAL AND METHODS: The study was conducted on 30 individuals equally divided into three groups of skeletal class II division (div) 1, skeletal class II div 2, and skeletal class I normal occlusion. The study was conducted on two lateral cephalograms for each subject: one taken at rest and one in centric occlusion. RESULTS: On evaluation of tongue posture, a statistically significant difference was observed at the middle portion of the tongue in class II div 1 malocclusion, and at the posteromedial portion of the dorsum of the tongue in class II div 2 skeletal malocclusions as the tongue moved from rest to centric occlusion. While statistically significant differences were found between class II div 2 malocclusion and class I normal occlusion, no statistically significant differences were observed between class II div 1 and class II div 2 malocclusions. CONCLUSION: Tongue position was observed to be the same in both class II div 1 and class II div 2 malocclusions, with no statistically significant differences. However, a great change was seen in the tongue position from rest to centric occlusion.

Malocclusions and oral dysfunctions: A comprehensive epidemiological study on 359 schoolchildren in France.

OBJECTIVES: The purpose was to conduct a comprehensive study of malocclusions and oral dysfunctions on 11-year-old children and to study the risk factors associated with malocclusions. MATERIAL AND METHODS: A cross-sectional descriptive epidemiological survey was conducted among 359 children in France. A clinical examination was conducted, and orthodontic and oral functional data were collected. In addition, the need for orthodontic treatment was evaluated using the criteria defined by of the French National Authority for Health (HAS). Finally, a univariate and multivariate analysis was performed to assess the risks associated with malocclusions. RESULTS: Most children (88%) exhibited a malocclusion, regardless of gender (p = .912). The examination of oral functions identified a large number of swallowing (87%) and respiration (42.7%) disorders. The presence of malocclusion was statistically linked to the low position of the tongue at rest (p < .001), abnormal swallowing (p = .03), and improper mouth breathing (p = .001). After a multivariate analysis, the type of respiration (odds ratio [OR] = 3.2 [1.4-7.3]) and the position of tongue at rest (OR = 3.43 [1.7-7.1]) were the two most prominent factors in the prediction of emerging malocclusion. CONCLUSION: This epidemiological survey reveals a high prevalence of dental malocclusions and functional disorders. Oral respiration and the low position of the tongue at rest are the most important factors in the prediction of a malocclusion.

The Maxilla-Mandibular Discrepancies through Soft-Tissue References: Reliability and Validation of the Anteroposterior Measurement.

This research aimed to identify a new measurement to diagnose the sagittal maxillary and mandibular difference that considers the patient's profile (soft tissue Wits appraisal: obtained by projecting points A and B on the occlusal plane and subsequently measuring the linear distance between the two points). This new measurement was compared to the conventional Wits appraisal obtained to diagnose sagittal jaw discrepancy. In total, 300 subjects (162 males, 138 females) aged between 6 and 50 years requiring orthodontic treatment were analyzed. The cephalometric tracings on the pre-treatment lateral cephalometric radiographs were obtained and the two measurements taken were the Wits appraisal and a new measurement which were both calculated and compared. The analysis of the linear correlations between the conventional Wits value and the measurement obtained on the soft-tissue were undertaken. The relevance was established at 5% (p < 0.05). The mean values were also calculated within sex and age classes, and comparisons between sexes were obtained employing the t test Student's for independent samples. Subsequently, chi-square analysis was also utilized to verify the sex distributions in the age groups considered. The results obtained suggested that these two measurements were significantly correlated with each other, with no characteristic patterns of sex or age. These data allowed an estimation of the reference values of the new measurement (-1.9 mm and 5.4 mm for patients with Class I molar relationship) showing that the former was more variable than the latter. The new measurement could allow for an accurate evaluation of the jaws sagittal discrepancy from soft tissue analysis.

Evaluation and comparison of planum clival angle in three malocclusion groups : A CBCT study.

PURPOSE: Cranial base flexure is an overlooked topic in craniofacial research. The aim of this retrospective observational study was to compare a new parameter, the planum clival angle (PCA), which represents cranial base flexure, in skeletal class I, II, and III malocclusions using cone beam computed tomographic images (CBCT) and correlate PCA with the stages of the fusion of the spheno-occipital synchondrosis (SOS). MATERIALS AND METHODS: A total of 125 CBCTs were divided into two groups based on chronological age (19-25 years and 12-18 years). The CBCT images from 57 subjects (19-25 years old) were categorized into three groups based on their skeletal malocclusion for measuring PCA and cranial base angles (CBA). In the second group, comprising 68 CBCT data sets of individuals in the age group of 12-18 years, the PCA angle was correlated with stages of fusion of the SOS. Data were statistically analyzed using independent samples t test, one-way analysis of variance (ANOVA, intergroup), Pearson correlation, and χ2 test. RESULTS: There was a statistically significant linear correlation (P < 0.001) between the two parameters PCA and CBA but no significant difference was found in PCAs between the three groups. One-way ANOVA to compare the PCA values in the three stages of fusion of the SOS revealed a highly significant relationship in male subjects (p < 0.001), thereby, suggesting that as fusion progresses, the planum clival angle increases. The χ2 test to compare the planum clival angle in males and females revealed that SOS fusion occurred earlier in females. CONCLUSION: There is a constant dynamic change in the value of the parameter PCA that progresses until completion of SOS fusion. The SOS fuses earlier in females. Assessment of the stage of fusion of the SOS can be used in deciding whether growth modification of the craniofacial complex is still possible during orthodontic therapy.

Prevalence of bullying in orthodontic patients and its impact on the desire for orthodontic therapy, treatment motivation, and expectations of treatment.

PURPOSE: This study aims at investigating the prevalence of bullying due to malocclusions in a sample of German orthodontic patients. Thereby, we analyzed the influence of self-reported bullying on initiation, desire and motivation, and expectations of orthodontic therapy. PATIENTS AND METHODS: Patients completed questionnaires by themselves in three orthodontic practices (n = 1020, mean age 11.8 years). The sample was divided into three groups: (1) subjects bullied due to dentofacial features, (2) subjects bullied due to physical features, and (3) non-bullied control group. The effect of bullying on initiation, desire and motivation, and expectation from orthodontic treatment was assessed and compared between these groups. RESULTS: Overall prevalence of bullying was 23.7% with male subjects revealing significantly higher values than females (p < 0.001). Subjects from the dentofacial features group (6.3%) initiated orthodontic therapy themselves significantly more often than subjects from the physical features (17.4%; p = 0.030) and control group (76.3%; p < 0.001). The dentofacial features group reported significantly more frequently that 'ugly teeth' were the major motivating factor to seek orthodontic treatment (40.4%). Within this group significantly higher mean scores for the expectation 'keep me from being bullied' were obtained compared with subjects in the physical features (p < 0.001) or control group (p < 0.001). CONCLUSION: This analysis demonstrated that bullying due to malocclusion impacts attitude towards orthodontic treatment. Victims who experienced bullying due to malocclusion initiate orthodontic treatment more often themselves and expect therapy to prevent them from experiencing further bullying.

Calidad de vida en pacientes atendidos durante la primera fase del tratamiento de ortodoncia / Quality of life in patients treated during the frst phase of orthodontic treatment

Objetivo: evaluar la calidad de vida en pacientes que se encuentran en la primera fase de tratamiento de ortodoncia, ofrecido por un programa de docencia-servicio de educación superior en la ciudad de Medellín. Métodos: se realizó un estudio transversal analítico en los pacientes atendidos en el servicio de ortodoncia. La muestra estuvo compuesta por un total de 104 pacientes. Se empleó un cuestionario estructurado de 12 ítems para evaluar información sociodemográfca. Para estudiar la calidad de vida relacionada con la salud bucal (CVRSB), la cual fue medida con el OHIP-14 (Oral Health Impact Profle 14) validado en el idioma español y datos clínicos tomados en el momento de la consulta odontológica. Resultados: el promedio de edad de los participantes fue de 25,7 ± 12,1 años, edad mínima de 12 y máxima de 60. Se encontraron diferencias estadísticamente signifcativas en los mayores de 30 años y con estudios superiores, principalmente en la extensión y la severidad del impacto en la calidad de vida. Respecto al OHIP-14, el mayor impacto lo presentaron aquellos con apiñamiento severo (8,1 RIC=13), mordida borde a borde (8,0 RIC=6) y relación molar clase III (9,0 RIC=10), con diferencias estadísticamente signifcativas. Conclusiones: este estudio permitió evidenciar que, en general, el impacto en la calidad de vida del OHIP-14 en los pacientes fue bueno durante la primera fase del tratamiento y que las diferencias están relacionadas con la edad, nivel de escolaridad y características oclusales, tales como apiñamiento, overbite y relación molar.

Objective: To evaluate the quality of life in patients with orthodontic treatment in the frst phase of treatment who consult in a higher education teaching-service program in the city of Medellín. Methods: An analytical cross-sectional study was conducted in the patients treated in the orthodontic service. The sample consisted of a total of 104 patients. A 12-item structured questionnaire was used with sociodemographic information, regarding quality of life related to oral health (QOLHR), which was measured with the OHIP-14 (Oral Health Impact Profle 14) validated in the Spanish language and clinical data taken at the time of the dental consultation. Results: The average age of the participants was 25.7 ± 12.1 years, with a minimum age of 12 and a maximum of 60. Statistically signifcant diferences were found in those over 30 years of age and with higher education, mainly in the extension and severity of impact on quality of life. Regarding OHIP-14, the greatest impact was presented by those with severe crowding (8.1 IQR=13), edge-to-edge bite (8.0 IQR=6) and class III molar relationship (9.0 IQR=10), with Statistically signifcant diferences. Conclusions: This study made it possible to show that in general the impact of the quality of life of OHIP-14 in patients was good in the frst phase of treatment and that the diferences are related to age, level of education and its dimensions with occlusal characteristics such as such as crowding, overbite and molar relationship of the patients reported during orthodontic treatment.

Distribution of Malocclusion Traits in the Pediatric Population of Milan: An Observational Study.

Background: Epidemiological investigations define the prevalence and distribution of the various types of malocclusions, and can help to identify etiological factors and set the most correct orthodontic therapy. Aim: The goal of this study was to verify the prevalence and distribution of various types of malocclusions in the pediatric population. Methods: The study was performed on a sample of 350 patients (ages 5-9) being treated at the ASST Grande Ospedale Metropolitano Niguarda in Milan. A comparison was presented with one similar epidemiological investigation conducted 22 years earlier by the same researchers. The values of the malocclusion indices were reported from the cephalometric analyzes of the patients and were differentiated on the basis of gender and ethnicity. Results: The predominant traits of malocclusion in the general population of the analyzed sample were: skeletal class II (47.43%), hyper-divergence (40.86%), maxillary retrusion (46%), mandibular retrusion (66%), maxillary hypoplasia (50%), mandibular hypoplasia (49.14%), Wits index > 2 mm (22.57%); overjet > 4 mm (31.1%) and overbite > 4 mm (24.86%). Substantial differences were found between Italian patients and patients belonging to different ethnic groups in almost all parameters, and between the male and female genders in some of them. Patients in the 2000 study had a higher prevalence of Class II and hyper-divergence. Conclusions: This epidemiological investigation can suggest different approaches in setting the orthodontic treatment plan based on the ethnic group of the patient taken in charge and encourage more specific and large-scale analytical studies on the subject.

Gender differences in lower facial soft tissue thickness among different skeletal patterns, based on soft tissue cephalometric analysis.

OBJECTIVE: Lower face soft tissue thickness and dentoskeletal features form the lower facial profile. Sagittal skeletal malocclusions with varying degrees of soft tissue thickness in males and females were herein examined using soft tissue cephalometric radiography. METHODS: Based on their dentoskeletal correlations, a total of 160 lateral cephalometric radiographs of adult males and females (n = 80) seeking orthodontic treatment were classified as class I (n = 40), class II division 1 (n = 40), class II division 2 (n = 40), or class III (n = 40). Holdaway analysis was used to assess soft tissue thickness in seven linear parameters. RESULTS: In class I, class II division 1, class II division 2, and class III dentoskeletal connections, males exhibited larger soft tissue thickness. They have an average lower lip thickness, chin depth H, and depth V for class I males. Males and females differed from one another when it came to the thicknesses of the upper and the lower lips. These lip thicknesses as well as the chin's width differed more between men and women in class II division 1. Except for upper lip strain, all measures in the class II division 2 sample males demonstrated a greater significance. In the class III sample, males also demonstrated more significance than females. CONCLUSION: Males with various sagittal skeletal malocclusions demonstrated a significant difference in lower soft tissue thickness (characterized as thicker lower facial soft tissue) compared to female patients in class I, class II division 1, class II division 2, and class III malocclusions.