The effect of increasing the gaps between the front teeth on torque and intrusion control of the incisors for anterior retraction with clear aligners: a prospective study.

OBJECTIVE: To investigate the effect of sequential distalization on increasing gaps in the maxillary anterior teeth, focusing on the control of torque and three-dimensional teeth movement during anterior retraction with clear aligners in extraction cases. METHODS: We recruited 24 patients who were undergoing extraction bilateral maxillary first premolars with clear aligners. According to a predetermined increment in the spaces between the maxillary anterior teeth, the patients were divided into three groups: those with no gap (9 cases), a 0.5 mm gap (6 cases) and a 1.0 mm gap (9 cases). In each group, a 2.0 mm en-mass retraction was applied on the anterior teeth. Plaster casts of the upper full dentition were obtained both before and after a 2 mm retraction. The palatal folds were used to overlap each pair of models. The three-dimensional movement of the teeth and the change of torque for the anterior teeth were subsequently analyzed using Geomagic Studio 2014 software. RESULTS: The change in torque in the groups with added gaps was significantly smaller than that in the group with no gaps (P < 0.05). There was no significant difference in this respect when comparing the group with a 0.5 mm gap added to the group with a 1.0 mm gap was added (P > 0.05). In the labial-lingual and vertical directions, the displacements of the central and lateral incisors were smaller in the groups with additional gaps compared to those in the groups without gaps (P < 0.05). However, there was no significant difference observed when comparing the group with a 0.5 mm added gap to the group with a 1.0 mm added gap (P > 0.05). Then, a comparison was made between the displacement of the second premolar to the second molar in the mesial-distal direction across all groups. The study revealed that the anchorage molars in the group without gaps demonstrated significantly smaller displacement compared to those in the group with additional gaps (P < 0.05). CONCLUSION: Advantages were observed in controlling the torque of the anterior teeth and achieving a desired pattern closer to normal bodily movement by sequentially distalizing the maxillary anterior teeth gaps. Increasing the gaps between the maxillary anterior teeth also resulted in improved control of the vertical direction of the anterior teeth. However, this retraction strategy necessitates substantial protection of the anchorage molars.

Orthodontic Implementation of Machine Learning Algorithms for Predicting Some Linear Dental Arch Measurements and Preventing Anterior Segment Malocclusion: A Prospective Study.

Background and Objectives: Orthodontics is a field that has seen significant advancements in recent years, with technology playing a crucial role in improving diagnosis and treatment planning. The study aimed to implement artificial intelligence to predict the arch width as a preventive measure to avoid future crowding in growing patients or even in adult patients seeking orthodontic treatment as a tool for orthodontic diagnosis. Materials and Methods: Four hundred and fifty intraoral scan (IOS) images were selected from orthodontic patients seeking treatment in private orthodontic centers. Real inter-canine, inter-premolar, and inter-molar widths were measured digitally. Two of the main machine learning models were used: the Python programming language and machine learning algorithms, implementing the data on k-nearest neighbor and linear regression. Results: After the dataset had been implemented on the two ML algorithms, linear regression and k-nearest neighbor, the evaluation metric shows that KNN gives better prediction accuracy than LR does. The resulting accuracy was around 99%. Conclusions: it is possible to leverage machine learning to enhance orthodontic diagnosis and treatment planning by predicting linear dental arch measurements and preventing anterior segment malocclusion.

Influence of the type of breastfeeding as a risk or protective factor for the onset of malocclusions: a systematic review.

AIM: The correlation between malocclusions in deciduous dentition and type of breastfeeding has been described by many authors in numerous articles. The aim of this article is to investigate the literature about this important topic. MATERIALS: The research was conducted by querying the following databases: PubMed, EBMR, Cochrane Library, Web of Sciences, Medline, Web of Sciences, Ovid and Embase. The key words were: "infant" OR "baby", AND "breastfeeding" AND "malocclusion". As with similar literature review papers, the PRISMA-P (Preferred Reporting Items for Systematic Reviews Protocols) was used. The examined articles were of the following types: randomised controlled trials (RCTs), case-control studies and cohort studies. For the qualitative analysis of the selected studies, it was employed the NOS scale (Newcastle-Ottawa Quality Assessment Scale). CONCLUSION: Two hundred and fifty articles were selected. After filtering out the articles deemed irrelevant or with obvious bias, only 16 articles were left. From our results, it can be concluded that breastfeeding seems to play a decisive role in preventing the onset of posterior cross-bites and Class II malocclusions, and that this protective effect appears to be time-dependent.

Early prevention of maxillary canine impaction: a randomized clinical trial.

OBJECTIVES: To investigate the effect of three interceptive measures (slow maxillary expansion (SME) with removable plates (1), extraction of both upper deciduous canines (DC) (2) and no intervention (3)) on maxillary canine (MC) position in patients with early mixed dentition (EMD) and lack of upper arch space. These three groups were additionally compared to a control group (4) with adequate upper arch space. NULL HYPOTHESIS: None of the studied strategies outperforms the others regarding improvement of MC position. TRIAL DESIGN: Four-arm parallel group prospective randomized controlled trial. PARTICIPANTS: Patients in EMD with at least one impacted MC, non-resorbed DC, and no crossbite. INTERVENTIONS: Patients with a lack of space were randomly distributed to protocols (1), (2), and (3). PRIMARY OBJECTIVE: To assess the change in MC position after 18 months follow up. SECONDARY OBJECTIVES: To assess canine eruption and need for orthodontic intervention within 18-60 month follow up. OUTCOME ASSESSMENT: Five variables defined canine position: sector, canine-to-midline angle, canine-to-first-premolar angle, canine-cusp-to-midline distance, and canine-cusp-to-occlusal-plane distance on two panoramic radiographs at 0 (T1) and 18 months (T2). Mean differences between groups were compared with linear mixed models, corrected for age and sex. RANDOMIZATION: The patient allocation sequence was generated by an electronic randomization list. BLINDING: The operator taking the measurements was blinded to the groups. RESULTS: Seventy-six patients were included (142 canines, mean age 9.2 years, 60.5 per cent male, mean follow up 1.9 years), 19, 17, 14, and 26 patients in groups 1-4, respectively. In absence of dental crossbite in patients with lack of space and impacted MC, SME improved the canine sector (P = 0.040), compared to no intervention (P = 0.028). Canine-to-midline angle and canine-to-occlusal-plane distance significantly decreased in all groups at T2. Extraction improved the canine-to-first-premolar angle at T2 more than other strategies in EMD (P = 0.015-0.000). CONCLUSIONS: Early SME improves the canine sector and reduces the need for major orthodontic intervention in the long term. Taking a first panoramic radiograph in EMD allows timely intervention in case of MC impaction. TRIAL REGISTRATION NUMBER: NCT05629312 (Clinical Trials.org). Trial status: follow up ongoing.

Interceptive orthodontics: awareness and prevention is the first cure.

It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of paediatric patients. In this respect, interceptive orthodontics plays a fundamental role in the process. Specifically, the paediatric dentist monitors the condition of the mouth from early childhood, distinguishing three age brackets for intervention, each defined by their own characteristics. It would also be desirable for other professionals who treat young patients and their mothers to various extents, such as paediatricians, gynaecologists, obstetricians and speech therapists to share valuable information with us. What follows is a brief summary of important conditions and key information regarding interceptive orthodontics. Age range 0-3 years: breastfeeding during the first months of life has been shown to have a positive effect on the development of the jaws. Later on, the transition to solid food, promoted by the eruption of the deciduous teeth, further stimulates their growth. During this phase, it is recommended to monitor and intercept any muscular hypotonia and low tongue postures. Additionally, it is essential to instruct parents on the proper dietary and lifestyle behaviours needed to ensure the physiological growth of the child, while protecting the health of their oral cavity. Age range 4-6 years: attention should be paid to the deciduous dentition and the development of the upper and lower maxillary bones, along with prompt interception and correction of bad habits such as the continued use of the pacifier, finger sucking, oral breathing and atypical swallowing. Age >6 years: within this phase, the careful monitoring of the space available in the arch, the natural exfoliation of milk teeth, the eruption of the permanent teeth and their occlusal relationship, as well as the maxillomandibular relationship are all important. If necessary, in addition to removing any risk factor, fixed or mobile orthodontic appliances can also be used during the above stages, especially stage 2 and 3, depending on the occlusal and skeletal status of the patient. Early diagnosis of malocclusion is crucial, as well as the sharing of information with other clinicians that deal with children and their parents, who need to be informed about the various therapies that their child may need. The paediatric dentist could, in fact, directly reach out to families to make them understand that malocclusion and other manifestations linked to conditions affecting oral functions such as breathing, sleeping, chewing and feeding often show the first signs as early as pre-school age, long before eruption of the first milk tooth, which is the time when the first dental visit is usually booked! We trust that awareness is the first form of prevention, and this is the message that must be conveyed to all of those involved in paediatric dentistry, patients and professionals alike: awareness and prevention is the first cure.

Guía diagnóstica de hábitos lesivos orales para pediatras / Diagnostic guide of oral injurious habits for pediatricians / Guia de diagnóstico para pediatras sobre hábitos lesivos orais

Introducción: la etiología de las maloclusiones se encuentra relacionada a factores genéticos y ambientales, siendo relevantes los hábitos lesivos orales en ella; por lo que en un concepto de Salud Integral de los niños, debemos contar no solo con el rol activo preventivo del odontólogo sino también de pediatra. Método: crear guía clínico práctica para médicos pediatras, que permitan identificar sistemáticamente hábitos no fisiológicos vinculados a maloclusiones. Resultado: el pediatra con los conocimientos básicos podrá elaborar revisiones preventivas durante los controles periódicos de rutina. Discusión: considerar la atención en equipo multidisciplinario, con énfasis en la prevención, punto donde todo el equipo de salud debe contribuir. Conclusiones: consideramos que los efectos sobre el crecimiento y desarrollo provocados por hábitos lesivos orales/funciones no fisiológicas tendrán mayor o menor repercusión según la edad en que se inicia el hábito. Si actuamos de manera temprana tendremos más posibilidades de modificar el patrón de crecimiento de los maxilares y el desarrollo de los arcos dentarios. Se impone entonces un interrogatorio y examen funcional precoz y sistemático para la detección de desviaciones y trastornos funcionales en niños, así como enfocar los tratamientos desde equipos multidisciplinarios (odontólogo, pediatra, fonoaudiólogo, otorrinolaringólogo, psicólogo) y alcanzar resultados de excelencia.

Introduction: the etiology of malocclusions is related to genetic and environmental factors, and oral injurious habits are relevant in it; therefore, in a concept of integral health of children, we should count not only on the active preventive role of the dentist but also of the pediatrician. Method: to create a practical clinical guide for pediatricians that will allow the systematic identification of non-physiological habits linked to malocclusions. Result: the pediatrician with basic knowledge will be able to elaborate preventive check-ups during routine periodic check-ups. Discussion: consider multidisciplinary team care, with emphasis on prevention, a point to which the entire health team should contribute. Conclusions: we consider that the effects on growth and development caused by harmful oral habits/non-physiological functions will have greater or lesser repercussions depending on the age at which the habit begins. If we act early we will have more possibilities of modifying the growth pattern of the jaws and the development of the dental arches. Therefore, an early and systematic interrogation and functional examination is necessary to detect deviations and functional disorders in children, as well as to focus the treatments from multidisciplinary teams (dentist, pediatrician, speech therapist, otorhinolaryngologist, psychologist) and achieve excellent results.

Introdução: a etiologia das más oclusões está relacionada a fatores genéticos e ambientais, e hábitos orais nocivos são relevantes para ela; portanto, em um conceito de saúde integral das crianças, devemos confiar não apenas no papel ativo preventivo do dentista, mas também no do pediatra. Método: criar um guia clínico prático para que os pediatras identifiquem sistematicamente os hábitos não fisiológicos ligados às más oclusões. Resultado: o pediatra com conhecimentos básicos será capaz de desenvolver check-ups preventivos durante check-ups periódicos de rotina. Discussão: considerar os cuidados de equipe multidisciplinar, com ênfase na prevenção, um ponto para o qual toda a equipe de saúde deve contribuir. Conclusões: consideramos que os efeitos no crescimento e desenvolvimento causados por hábitos orais nocivos/ funções não-fisiológicas terão maiores ou menores repercussões dependendo da idade em que o hábito começa. Se agirmos cedo, teremos mais chances de modificar o padrão de crescimento das mandíbulas e o desenvolvimento dos arcos dentários. O questionamento precoce e sistemático e o exame funcional são, portanto, necessários para a detecção de desvios e distúrbios funcionais em crianças, assim como a aproximação de tratamento de equipes multidisciplinares (dentista, pediatra, fonoaudiólogo, otorrinolaringologista, psicólogo) e a obtenção de excelentes resultados.

Prevention of malocclusion and the importance of early diagnosis in the Italian young population.

AIM: Malocclusion is an alteration of the normal relationships between skeletal, muscle and dental structures that can lead to impaired functionality as well as aesthetic alteration of the stomatognathic system. Functional alteration can affect various aspects, ranging from chewing ability to respiratory disorders. Paediatricians and dentists are called to prevent and diagnose these conditions as early as possible in order to preserve the patient's health. The purpose of this research is to study the incidence of malocclusion and its relationship with Obstructive Sleep Apnea Syndrome (OSAS) in a young population. Also, the role of paediatricians and dentists in prevention and early diagnosis of this condition was evaluated METHODS: An anonymous survey was given through Google form to 300 Italian children (139 males and 161 females) from different private dental practices in Italy. No personal information that identifies the individuals was collected, and the data was analysed in aggregate form only. All data was collected and statistically analysed. CONCLUSION: The data highlight the patients' good attitude towards dental check-ups, which help to intercept malocclusions. Unlike the past, the knowledge of the importance of oral health and dental occlusion is high among young patients, parents and paediatricians. This study underlines the role of paediatricians as key players in the prevention of dental health problems.

Prevalência de maloclusão em dentição decídua nos alunos do ensino pré-escolar do concelho de porto de mós (portugal) / Prevalence of malocclusion in deciduous dentition in preschool students in the municipality of Porto de Mós (Portugal) / Prevalencia de maloclusión en dentición temporal en preescolares del municipio de Porto de Mós (Portugal)

Introdução:A maloclusão é considerada a segunda doença oral mais comum em crianças e jovens adultos. É importante saber identificar estas alterações de forma a permitir um adequado desenvolvimento da oclusão.O diagnóstico de um desenvolvimento anormal na dentição decídua é relevante para a prevenção e quando necessáriouma intervenção precoce. Objetivo:O objetivo deste estudo transversal foi avaliar a prevalênciade maloclusão em crianças com dentição decídua e relacionar com diferentes parâmetros.Metodologia:Observaram-se 300 crianças de ambos os sexos, com idades compreendidas entre os 3 e os 6 anos. A recolha de dados foi realizada a partir do exame clínico comkits de observação(espelho bucal básico descartável,sonda descartável, babador,luvas e sacos descartáveis), sob luz natural e na cadeira escolar, no Agrupamento de Escolas de Porto de Mós, Distrito Sanitário de Leiria. Analisaram-se as seguintes características: Tipo de arco de Baume, espaços primatas, diastemas, apinhamento, relação distal dos segundos molares decíduos, relação canina, sobremordida e sobressaliência, mordida anterior e posterior.Resultados:A prevalência de maloclusão registradafoi de 67,7%, verificando-se ser mais baixa aos seis anos, sem apresentar diferenças significativas em ambos os sexos. A sobressaliência foi a maloclusão mais prevalente (42,7%) nas crianças observadas, seguida da mordida aberta anterior (23,3%). Registrou-seumaelevada prevalência de maloclusão nas crianças com arco de Baume tipo II, sem diastemas ou espaços primatas, com apinhamento, degrau distal, classe II canina ou desvio da linha média para a direita.Conclusões:Verificou-se existir uma elevada prevalência de maloclusão nas crianças do agrupamento de escolas do Concelhode Porto de Mós, estando relacionada com diferentes parâmetros oclusais (AU).

Introduction:Malocclusion is considered a second mostcommon oral disease in children and young adults. It is important to know how to identify these changes in order to allow proper development of the occlusion.The diagnosis of anabnormal development in primary dentition is relevant for prevention and when necessary, early intervention.Objective:The aim of this cross sectional study was to evaluate the prevalence of malocclusion in children with deciduous dentition and relate this prevalence with sex, age and with different occlusal parameters.Methodology:300 children of both sexes, aged between 3 and 6 years were observed. Data collection was carried out from the clinical examination using observation kits, in schools, in the Group of schools of Porto de Mós, Health District of Leiria. The following characteristics were analyzed: Baume arc Type, spaces, diastemas, crowding, the deciduous second molars distal relation, canine relationship, Overbite and overjet, anterior and posterior bite.Results:The recorded prevalence of malocclusion was 67.7%, was lower at six years old, without any differences in both sexes. The overjet was the most prevalent malocclusion (42.7%) in the observed children. There was a high prevalence of malocclusion in children with type II Baume arch, without spaces or primate spaces, with distal step, canine class II or with the middle line shifted to the right.Conclusions:There there was a high prevalence of malocclusion in children of the schools in the municipality of Porto de Mós, and is related to the different occlusal parameters (AU).

Introducción: La maloclusión se considera la segunda enfermedad bucal más común en niños y adultos jóvenes. Es importanteidentificar estos cambios para llograr un adecuado desarrollo de la oclusión. El diagnóstico precoz deldesarrollo anormal en la dentición temporal es relevante para la prevención y cuando sea necesario una intervención temprana. Objetivo: El objetivo de este estudio transversal fue evaluar la prevalencia de maloclusión en niñoscon dentición temporal y relacionarla con diferentes parámetros. Metodología: Fueran observados 300 niños de ambos sexos, con edadesentre los 3 y los 6 años. La recogida de datos del examen clínico se realizó mediante kits de observación, en un entorno escolar, en el Grupo Escolar dePorto de Mós, Distrito Sanitariode Leiria. Se analizaron las siguientes características: tipo de arco de Baume, espaciosprimates, diastemas, apiñamientos, relación distal de los segundos molares deciduos, relación canina, sobremordida horizontal y vertical, mordida anterior y posterior. Resultados: La prevalencia de maloclusión registrada fue de 67,7%, la cual resultó ser menor a los seis años, sin mostrar diferencias significativas en ambos sexos. El overjet fue la maloclusión más prevalente (42,7%) en los niños observados, seguida de la mordida abierta anterior (23,3%). Hubo una alta prevalencia de maloclusión en niños con arco de Baume tipo II, sin diastemas ni espacios de primates, con apiñamiento, paso distal, canino clase II o desviación de la línea media hacia la derecha.Conclusiones: Se encontró que hayuna alta prevalencia de maloclusión en niños dela comunidad escolar del municipio de Porto de Mós, y que se relaciona,con diferentes parámetros oclusales (AU).

China experts' consensus on preventive and interceptive orthodontic treatments of malocclusions of children.

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.

[Health relevance of malocclusions and their treatment]. / Zahn- und Kieferfehlstellungen ­ gesundheitliche Relevanz und Behandlung.

Malocclusions are among the most common human diseases impairing oral health. The present paper gives an overview on their etiology, prevalence, and consequences. It further presents the corrective and preventive potential of orthodontic treatment and gives information on the treatment-associated legal framework in Germany. The use and quality of the orthodontic health service will be described in the international context.The etiology of malocclusions has genetic, epigenetic, functional, and environmental components, which can seldomly be differentiated on the individual level. Previous small, cross-sectional studies show that up to 80% of children in Germany are affected. Eating, drinking, chewing, speaking, and breathing may be impaired and the predisposition for periodontal disease and overuse injuries of the temporomandibular joint and the masticatory musculature increase. A proclination of the upper incisors increases the risk for dental trauma. Furthermore, malocclusions may have negative psychosocial effects and impair quality of life. In cooperation with other dental and/or medical disciplines, orthodontics make positive preventive and curative contributions to oral health, general health, and quality of life.Against this background, orthodontics has a substantial potential for the enhancement of dental prevention in healthcare. This is especially true as the German social health insurance (GKV) allows for a widespread orthodontic treatment coverage of the population at an internationally accepted, high-quality level. To further improve prevention, the implementation of a systematic orthodontic screening at the age of 7-8 years in the form of a systematic preventive measure is recommended.

Non-nutritive sucking habits in a child: A clinical protocol to their prevention and management.

Patients presenting with anterior open bites can be challenging to manage. This paper discusses the clinical features and aetiology of anterior open bites caused by non-nutritive sucking habits in a young child. It explores how these should be recognised and how certain interventions can be effective in their management. Whilst further high quality research is needed into the different methods and their effectiveness, the aim of the article is to provide a practical guide for general dental practitioners, orthodontists and paediatric dentists, who are involved in monitoring the developing dentitions of these patients.

Ortodontia em saúde coletiva: epidemiologia das oclusopatias e da necessidade de tratamento ortodôntico em adolescentes / Orthodontics in public health: epidemiology of malocclusions and the need for orthodontic treatment in adolescents

A Epidemiologia tornou-se um ramo da ciência muito utilizado para a verificação das necessidades da população, o planejamento de ações e a organização dos serviços em saúde. Para isso, primeiramente, é fundamental realizar o diagnóstico situacional, a partir de dados específicos, em busca da compreensão e atuação sobre os problemas de saúde encontrados em coletividade. As oclusopatias têm sido uma das condições bucais mais prevalentes e, em consequência, houve o crescimento da demanda por tratamento ortodôntico. Nesta perspectiva, índices oclusais foram elaborados para medir a ocorrência das oclusopatias tendo em vista a priorização da necessidade de tratamento. O conhecimento da temática em escala global permitiu uma visão ampliada do problema e das estratégias desenvolvidas em saúde bucal. Neste contexto, a presente pesquisa teve os seguintes objetivos: 1) realizar uma revisão sistemática das evidências científicas existentes sobre a prevalência da necessidade de tratamento ortodôntico em adolescentes na faixa etária de 12 à 15 anos de idade; 2) investigar a prevalência das oclusopatias e a necessidade normativa de tratamento ortodôntico em adolescentes de 12 anos de idade. Na revisão sistemática foram incluídos trabalhos nacionais e internacionais publicados nas bases de dados Cochrane, Embase, Portal Regional da Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Electronic Library Online (Scielo), Scopus e Web of Science (WOS). A busca inicial não se limitou a nenhum filtro disponível nas bases de dados e utilizou os seguintes descritores: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child e adolescent. Termos utilizados na literatura científica também foram empregados: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index e DAI index. Foram incluídas publicações que avaliaram a prevalência da necessidade de tratamento ortodôntico em adolescentes entre 12 à 15 anos de idade utilizando o Índice de Estética Dentária (DAI) e/ou Índice de Necessidade de Tratamento Ortodôntico (IOTN) em estudos epidemiológicos transversais, sem restrições de ano do periódico e idioma. Do total de artigos encontrados (n=2255), 525 estudos permaneceram após a remoção por duplicidade. Os títulos e resumos destas publicações foram avaliados e aplicando os critérios de exclusão, selecionou-se 38 artigos. Para elegibilidade, os critérios de inclusão foram empregados e 11 estudos foram eleitos. Os textos completos destas publicações foram obtidos para leitura e análise da qualidade metodológica. Com relação aos achados da necessidade de tratamento ortodôntico global, houve variabilidade nos resultados, mas observou-se que a prevalência foi considerada alta. Quanto às ações desenvolvidas, foram sugeridas a educação em saúde bucal para os adolescentes e pais com foco na prevenção e no tratamento interceptativo precoce das oclusopatias, bem como, inserção da ortodontia nos programas de saúde com a implantação de mais centros especializados. A segunda etapa desta pesquisa consistiu em um estudo observacional e transversal, realizado com 461 adolescentes de 12 anos de idade, matriculados em escolas públicas de um município de médio porte do Estado de São Paulo. A oclusão e a necessidade de tratamento ortodôntico foram avaliadas por meio da Classificação de Angle e do DAI. Os dados foram analisados utilizando estatística descritiva e as distribuições absolutas e percentuais das variáveis categóricas foram tabuladas. A verificação da associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle e o DAI foi realizada por meio do teste G, adotando-se um nível de significância de 5%. O processamento e a análise dos dados foram realizados com auxílio do Programa Epi-InfoTM versão 7.2. (Center for Disease Control and Prevention). O diagnóstico da oclusão, segundo a Classificação de Angle, mostrou que 8,89% apresentavam oclusão normal, 56,83% oclusopatia em Classe I, 24,08% em Classe II e 10,20% em Classe III. A prevalência da necessidade de tratamento ortodôntico, segundo o DAI, foi de 52,69% dos adolescentes considerando tratamento eletivo à obrigatório. Houve associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle com o DAI (p <0,0001). A prevalência das oclusopatias e da necessidade normativa de tratamento ortodôntico foi elevada, sendo 18,44% dos adolescentes com necessidade de tratamento obrigatório. Os índices foram eficazes para a identificação das oclusopatias, entretanto por avaliarem aspectos clínicos distintos, poderiam ser utilizados concomitantemente para aprimorar o diagnóstico das oclusopatias(AU)

Epidemiology has become a branch of science widely used to define the needs of the population, plan actions and organize health services. For this, first, it is essential to perform the situational diagnosis, based on specific data, in search of understanding and acting on the health problems found in the community. Malocclusion has been one of the most prevalent oral conditions and, as a result, there has been an increase in demand for orthodontic treatment. In this perspective, occlusal indexes were developed to measure the occurrence of malocclusions in order to prioritize the need for treatment. The knowledge of the theme on a global scale allowed an expanded view of the problem and the strategies developed in oral health. In this context, the present research had the following objectives: 1) to carry out a systematic review of the existing scientific evidence on the prevalence of the need for orthodontic treatment in adolescents aged 12 to 15 years old; 2) to investigate the prevalence of malocclusions and the normative need for orthodontic treatment in 12-year-old adolescents.The systematic review included national and international works published in the Cochrane, Embase, Regional Portal of the Virtual Health Library (VHL Regional Portal), PubMed, Scientific Electronic Library Online (Scielo), Scopus and Web of Science (WOS) databases. The initial search was not limited to any filter available in the databases and used the following descriptors: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child and adolescent. In addition, terms used in the scientific literature were also used: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index and DAI index. Were included publications that evaluated the prevalence of the need for orthodontic treatment in adolescents between 12 and 15 years of age using the Dental Aesthetic Index (DAI) and / or Orthodontic Treatment Needs Index (IOTN) in cross-sectional epidemiological studies, without restrictions on year of the journal and language. Of the total articles found (n = 2255), 525 studies remained after removal due to duplication. The titles and abstracts of these publications were evaluated and applying the exclusion criteria, 38 articles were selected. For eligibility, the inclusion criteria were used and 11 studies were elected. The complete texts of these publications were obtained for reading and analysis of methodological quality. As for the actions developed, oral health education recommendations were suggested for adolescents and parents with a focus on prevention and early interceptive treatment of malocclusions, as well as insertion of orthodontics in health programs with the implementation and development of specialized centers. The second stage of this research consisted of an observational, crosssectional, survey-type study conducted with 461 12-year-old adolescents enrolled in public schools in the medium-sized municipality of the State of São Paulo. Occlusion and the need for orthodontic treatment were assessed using the Angle Classification and the DAI. The data were analyzed using descriptive statistics and the absolute and percentage distributions of categorical variables were tabulated. The verification of the association between the results of clinical exams for the diagnosis of malocclusions using the Angle Classification and the DAI was performed using the G test, adopting a significance level of 5%. Data processing and analysis were performed using the Epi-InfoTM version 7.2 program. (Center for Disease Control and Prevention). The diagnosis of occlusion, according to the Angle Classification, showed that 8.89% had normal occlusion, 56.83% occlusion Class I, 24.08% Class II and 10.20% Class III. The prevalence of the need for orthodontic treatment, according to the DAI, was 52.69% of adolescents considering elective treatment to mandatory treatment. There was an association between the results of clinical examinations for the diagnosis of malocclusions using the Angle Classification with the DAI (p <0.0001). The prevalence of malocclusions and the normative need for orthodontic treatment was high, with approximately 18,44% of adolescents in need of mandatory treatment. The indices were effective for the identification of malocclusions, however, by evaluating different clinical aspects, they could be used concomitantly to improve the diagnosis of malocclusions(AU)

China experts' consensus on preventive and interceptive orthodontic treatments of malocclusions of children / 华西口腔医学杂志

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.

Relationship between Breastfeeding and Malocclusion: A Systematic Review of the Literature.

BACKGROUND: The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of malocclusions. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines were used to perform the present review. The following electronic databases were searched: Pubmed, Evidence-Based Medicine Reviews (EBMR), Embase, Cochrane Library, Medline, Web of Science and Ovid. RESULTS: A primary research found a total of 279 articles. Two more papers were also considered from the gray literature. Two hundred sixty-three articles were excluded as they were deemed irrelevant on the basis of: duplicates, title, abstract, methods and/or irrelevant contents. Eighteen papers were selected and included in the qualitative analysis. CONCLUSIONS: breastfeeding is a positive factor that seems to reduce the incidence of posterior crossbite, skeletal class II and distoclusion in primary and mixed dentition. A sort of positive relationship between months of breastfeeding and risk reduction seems to exist. More longitudinal research is needed to avoid bias in the results, with data collected prospectively on the months of exclusive breastfeeding, by means of specific questionnaires and successive clinical evaluation of the occlusal condition at the primary dentition, mixed dentition and permanent dentition stages.

Factores relacionados con maloclusiones en niños ecuatorianos de 3-9 años de edad / Factors related to malocclusion in 3-9-year-old Ecuadorian children

RESUMEN Introducción: Es muy importante reconocer los factores que pueden estar relacionados con maloclusión en una determinada población, para realizar medidas preventivas basadas en su realidad. Objetivo: determinar factores relacionados con maloclusiones en niños ecuatorianos de 3 a 9 años de edad. Métodos: Estudio epidemiológico transversal realizado a 400 niños de 3 a 9 años de edad, que estaban en tratamiento en las clínicas de Odontopediatría de la Facultad de Odontología de la Universidad Central del Ecuador. Los padres de los niños respondieron a preguntas realizadas por un único investigador experimentado sobre la salud, hábitos y nivel socioeconómico. Cada niño fue evaluado clínicamente extra e intraoralmente, siendo cada cara de las piezas dentales observadas en sentido vertical, transversal y sagital, además de la cara oclusal. Se verificó sí existían interferencias oclusales, mordida cruzada posterior o anterior y mordida abierta. Los datos se tabularon en Excel y se aplicó la prueba chi cuadrado (p< 0,05). Resultados: El 77 % de niños presentó maloclusión (p< 0,001). No se encontró una relación significativa de la presencia de maloclusión en los niños con sus familiares que presentaban maloclusión, bajo nivel socioeconómico y lactancia por menos de 1 año (p> 0,05). La mordida cruzada y las interferencias oclusales estuvieron asociadas (p< 0,001). No se encontró asociación entre la mordida abierta y la respiración bucal (p= 0,944). Conclusiones: Existe una cantidad significativa de maloclusión. La herencia familiar, tipo y tiempo de lactancia y nivel socioeconómico no tienen una relación significativa con la maloclusión. La mordida cruzada y las interferencias oclusales están asociadas. La respiración bucal puede no causar mordida abierta en los niños de 3 a 9 años.

ABSTRACT Introduction: Recognizing the factors potentially related to malocclusion in a given population is crucial to implement preventive actions based on that information. Objective: Determine the factors related to malocclusion in 3-9-year-old Ecuadorian children. Methods: A cross-sectional epidemiological study was conducted of 400 children aged 3-9 years attending pediatric dental clinics at the Central University of Ecuador School of Dentistry. The children's parents answered a number of questions about health, habits and socioeconomic level at the request of a single experienced researcher. Each child underwent extra- and intraoral clinical examination in which the sides of each tooth were observed on a vertical, transversal and sagittal plane, as well as the occlusal side. Verification was made of the presence of occlusal interference, posterior or anterior crossbite and open bite. The data obtained were tabulated onto Excel spreadsheets and the chi-square test was applied (p< 0.05). Results: Of the total children studied 77% had malocclusion (p< 0.001). The presence of malocclusion in children was not found to have a significant relationship to relatives with malocclusion, low socioeconomic level or breastfeeding for less than 1 year (p> 0.05). An association was found between crossbite and occlusal interference (p< 0.001). No association was observed between open bite and mouth breathing (p= 0.944). Conclusions: Malocclusion is significantly prevalent. Family inheritance, breastfeeding type and duration, and socioeconomic level do not have a significant relationship to malocclusion. Crossbite and occlusal interference are associated. Mouth breathing may not be the reason for open bite in 3-9-year-old children.

Effectiveness of Two Types of Fixed Lingual Retainers in Preventing Mandibular Incisor Relapse.

OBJECTIVE: To compare and evaluate the relapse tendency of two types of fixed lingual retainers using Little's irregularity index for a follow-up of one year. STUDY DESIGN: Randomised clinical trial. PLACE AND DURATION OF STUDY: Department of Orthodontics, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences and Dow Dental College in Dow University of Health Sciences, Karachi, Pakistan, from November 2017 to March 2019. METHODOLOGY: A total of 54 patients were recruited and divided into two groups by random allocation. Subjects who have completed fixed appliance (MBT) orthodontic treatment and non extraction cases with moderate crowding in the lower arch were included. Subjects with caries, restoration, fracture or missing lower anterior teeth were excluded. Group 1 received fiber reinforced composite (FRC) retainers and group 2 received multistranded stainless steel (MSW) retainers. They were recalled after every three months interval for one year. Relapse tendency of retainers using Little's irregularity index was evaluated at each visit. RESULTS: Comparison of relapse tendency between two retainers showed statistically significant results (p<0.05). The mean difference of CPD between two retainers at T0 was found to be 0.09 mm (p=0.01). At T1, it was determined to be 0.3 mm (p=0.022), and at T2 it was found to be 0.3 mm (p=0.008). At T3 and T4, it was found to be 0.5 mm (p<0.001) and 0.5 mm (p=0.002), respectively. All mean differences were statistically significant. CONCLUSION: Fiber-reinforced retainers are more effective in preventing the mandibular incisor relapse. The results of the study also suggest that the irregularity of the dentition increases with the passage of time.

Management of the dentoalveolar effects of tongue hypertrophy in patients with Duchenne muscular dystrophy: A pilot study.

Subjects affected by Duchenne muscular dystrophy (DMD) develop severe malocclusions with the progression of the disease, due to changes in orofacial musculature and function, including tongue hypertrophy. We aimed to evaluate the benefits of maintaining mandibular interarch width with the help of a simple fixed orthodontic appliance. Three adolescent DMD boys were selected consecutively to receive a passive rigid mandibular lingual arch, and followed for 4-5 years. An untreated age-matched control group was chosen and followed for a similar period. Study casts were obtained at baseline and after follow-up. Outcomes measured were overjet, overbite, maxillary and mandibular intermolar widths, mandibular arch depth, molar relationships, and the presence of lateral crossbites and anterior or lateral openbites. Changes in measurements obtained between the two time points were compared in each age-matched pair. There was a clinically important increase in the mandibular intermolar width in the non-treated children ranging from 2.5 mm to 9 mm, but not in those treated. Malocclusions generally deteriorated in untreated children while they remained stable in treated children. The use of a rigid mandibular lingual arch in boys with DMD can help slow down the rapid deterioration of the developing malocclusions that accompanies the progression of the disease.

Prediction of the Dental Arch Perimeter in a Kurdish Sample in Sulaimani City Based on Other Linear Dental Arch Measurements as a Malocclusion Preventive Measure.

The current study aimed to find a prediction equation to estimate the arch perimeter (AP) depending on various arch dimensions including intercanine width (ICW), intermolar width (IMW), interpremolar width (IPMW), and arch length (AL) in a sample of the Kurdish population in Sulaimani City. The study sample was 100 pairs of preorthodontic dental casts. Calculations of dental arch dimensions and perimeter were performed by a digital vernier. Statistical analysis was performed via using the SPSS version 25 software. The developed prediction equation for the upper arch was Y = +1.3 × (arch length) + 1 × (intermolar width), whereas the equation for the lower arch was Y = +0.9 × (intermolar width) + 0.92 × (intercanine width). Paired t-test revealed no statistical difference between predicted and real arch perimeters. Two separate prediction equations for upper and lower arches were developed based on the arch length (AL) and intermolar width (IMW) for the maxillary arch, intermolar (IMW), and inter canine widths (ICW) for the lower arch. The developed equations could have further beneficial impacts on orthodontic diagnosis and treatment planning.

Factors Associated with Malocclusion in Preschool Children in a Brazilian Small Town

Abstract Objective: To analyze the prevalence and factors associated with malocclusions in preschool children. Material and Methods: A census, epidemiological study, with a cross-sectional, descriptive and analytic sample, was carried out with children aged between 4 and 6 years, matriculated in preschools in the town of Aiquara, Bahia, Brazil. Malocclusion in the deciduous dentition was determined through the application of the index proposed by WHO, with the Foster and Hamilton criteria also being incorporated. The data was tabulated in duplicate in a Microsoft Excel spreadsheet and following correction, was analyzed using the SPSS, STATA and PAST Software. In order to identify the associated factors, we opted for Multiple Poisson regression analysis and Principal Component Analysis (PCA). Results: A total of 148 children were examined and the general prevalence of malocclusions was 69.59%, with 57.5% in the group of 4-year-old, 76.92% those aged 5 years old and 72.46% among children aged 6 years old. In terms of primary canines, 66.2% were identified as class I, 25.7% as class II and 8.1% as class III. Normal overjet was 41.2%, increased overjet 34.5%, edge to edge bite 17.6% and anterior crossbite 6.8%. The normal overbite 51.4%, reduced 20.9% and deep 8.1%. Of the individuals, 20.9% had posterior crossbite. In the Poisson regression analysis and PCA, a statistical association between the malocclusions and dental caries, duration of use of pacifiers, onychophagia and thumb sucking, was identified. Conclusion: The prevalence of malocclusion in preschool children in the small town of Aiquara is high and the associated factors identified are capable of control and prevention.