Prevalencia de Anomalías Dentomaxilares y Necesidad de Tratamiento Ortodóncico en Escolares del Pueblo Originario Rapa Nui / Prevalence of Dentomaxillary Anomalies and Need for Orthodontic Treatment in School Children of the Rapa Nui Native People

El objetivo de este estudio fue determinar la prevalencia de anomalías dentomaxilares y la necesidad de tratamiento ortodóncico en escolares pertenecientes al pueblo originario de Rapa Nui. Se realizó un estudio descriptivo, observacional, transversal y no probabilístico. Se evaluaron 85 alumnos entre primero básico y primero medio, entre los 6 y 16 años de edad, de dos colegios de Rapa Nui. Se realizó un examen clínico estandarizado, realizado por dos investigadores previamente calibrados, donde se completó una ficha clínica diseñada para el estudio. Para el análisis de las anomalías dentomaxilares se realizó un escaneo digital de la cavidad oral completa para su posterior análisis. De 85 estudiantes evaluados, 75 (88,2 %) se encontraban afectados por algún tipo de anomalía dentomaxilar en el plano sagital, vertical y/o transversal, independiente de su gravedad. Un 87,1 % de los estudiantes necesitan tratamiento ortodóncico según el Índice de Necesidad de Tratamiento Ortodóncico, de los cuales un 57,7, % se clasificó dentro de los rangos de moderado, grave y muy grave. Existe una alta prevalencia de anomalías dentomaxilares en los escolares pertenecientes al pueblo originario Rapa Nui, encontrándose por sobre las cifras nacionales como internacionales, lo cual da como resultado que la mayoría de los alumnos evaluados necesiten de algún tipo tratamiento ortodóncico, ya sea preventivo, interceptivo y/o correctivo.

The aim of this study was to determine the prevalence of dentomaxillary anomalies and the need for orthodontic treatment in schoolchildren belonging to the Rapa Nui native people. A descriptive, observational, cross- sectional and non-probabilistic study was carried out. Eighty- five students between first grade and first middle school, between 6 and 16 years of age, from two schools of Rapa Nui were evaluated. A standardized clinical examination was performed by two previously calibrated investigators, where a clinical record designed for the study was completed. For the analysis of dentomaxillary anomalies, a digital scan of the full mouth was performed for subsequent analysis. Of 85 students evaluated, 75 (88.2 %) were affected by some type of dentomaxillary anomaly in the sagittal, vertical and/or transversal plane, regardless of its severity. Some 87.1 % of the students needed orthodontic treatment according to the Orthodontic Treatment Need Index, of which 57.7 % were classified within the moderate, severe and very severe ranges. There is a high prevalence of dentomaxillary anomalies in schoolchildren belonging to the Rapa Nui native people, which is above the national and international figures, resulting in the majority of the students evaluated needing some type of orthodontic treatment, whether preventive, interceptive and/or corrective.

Assessment of orthodontic treatment needs in patients with ß-thalassemia major and sickle cell disease.

Patients suffering from hemoglobinopathies may suffer from pathogic dental and orofacial features. This study aimed to assess the prevalence of malocclusion and the need for orthodontic treatment in patients with ß-thalassemia major (BTM) and sickle cell disease (SCD). The study was conducted on 311 blood transfusion-dependent patients with BTM or SCD and 400 healthy individuals aged 10 to 16. The types of malocclusion were evaluated based on Angle's classification and Dewey's modification, and their oral habits were recorded using a questionnaire. The need for orthodontic treatment was assessed through the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN), and the data were compared with normal participants. The Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) assessment showed that patients had a higher prevalence of objective need for treatment (IOTN grades 4 and 5) compared to healthy children. The prevalence of class II malocclusion was significantly higher in patients. Patients showed significantly less Angle's Class I malocclusion compared to normal participants. Oral habits were presented in 61%, 64.15% and 62.4% of normal participants, BTM and SCD patients, respectively. The higher prevalence of Angle's class II malocclusion and higher percentage of IOTN grade 4 and 5 among BTM and SCD patients reveal the importance of early orthodontic assessment and intervention in children with BMT and SDC.

Comparison of orthodontic treatment need and malocclusion prevalence according to KIG, ICON, and mIOTN in German 8- to 9-year-old children of the Sixth German Oral Health Study (DMS 6).

PURPOSE: The aim of the present study was to compare the malocclusion indices KIG (Kieferorthopädische Indikationsgruppen, Orthodontic Indication Groups), ICON (Index of Complexity, Outcome and Need), and mIOTN (modified Index of Orthodontic Treatment Need) regarding differences in malocclusion prevalence and their assessment of orthodontic treatment need in German 8­ to 9­year-old children of the Sixth German Oral Health Study (Deutsche Mundgesundheitsstudie, DMS 6). METHODS: The necessary data for the calculation of the KIG, mIOTN, and ICON were collected by a dentist as part of a clinical orthodontic examination during the field phase of the DMS 6 and by a subsequent digital orthodontic model-analytical evaluation of intraoral scans of the dental arches and the occlusal situation in habitual occlusion. RESULTS: Prevalence, severity, and treatment need of tooth and jaw misalignments differed in part considerably depending on the index used for assessment. On the other hand, there were several outcomes which yielded quite similar results for the different indices used, such as orthodontic treatment need, which ranged from 40.4% (KIG) over 41.6% (ICON) to 44.2% (mIOTN). Interestingly, orthodontic treatment need for the individual subject could differ considerably, when assessed using different indices. CONCLUSIONS: In general, the results show that the mIOTN is much more conservative in assessing malocclusion prevalences often being smaller than those derived by KIG or ICON. In contrast, KIG and ICON often yield similar prevalences with certain distinct differences due to discrepancies in the respective definitions and also clearly differentiate between treatment possibility and arbitrarily determined treatment need.

Keeping track: An intra-UK comparison of orthodontic commissioning and treatment outcome assessments.

INTRODUCTION: Across the United Kingdom (UK), National Health Service (NHS) orthodontic treatment is commissioned differently across the devolved nations. There is a relative paucity in the literature describing the way in which the orthodontic services in each country are commissioned and treatment outcomes measured. OBJECTIVE: To highlight the differences in the following: commissioning of primary care orthodontic services across the UK; assessment of treatment outcomes; and the potential impacts these differences have on contractors, performers and patient care. MATERIALS AND METHODS: Data were collected using an online mixed-methods approach. Systematic content analysis was used to extract the required information from the websites and guidance documents of orthodontic service providers, which was then catalogued and verified electronically by senior dental advisors in the four devolved UK nations. RESULTS: The Index of Orthodontic Treatment Need (IOTN) is a mandatory needs assessment tool used across all four nations, with an agreed minimum threshold of a dental health component (DHC) score of 3 and an aesthetic component (AC) score of 6 for NHS treatment. While the peer assessment rating (PAR) is the most utilised method of assessing post-treatment outcomes, it is applied differently by each country. CONCLUSION: While NHS orthodontic services across the UK share mutual elements of service delivery, there are significant differences in the prior approval process and assessment of treatment outcomes. More research is required to assess the economic feasibility of orthodontic treatment from the associated treatment outcomes.

UK dental students' ability and confidence in applying the Index of Orthodontic Treatment Need and determining appropriate orthodontic referral.

INTRODUCTION: The aim was to assess the ability and confidence of UK undergraduate dental students in applying the Index of Orthodontic Treatment Need (IOTN) and determining appropriate orthodontic referral. MATERIALS AND METHODS: This was a cross-sectional survey using a case-based online questionnaire. Fourth and fifth year undergraduate dental students were recruited from UK dental schools through their university and social media. Six cases were presented and participants were asked to provide an IOTN score and judgement about referral. Participants were asked about their confidence, experience and orthodontic teaching. RESULTS: Sixty-nine responses were returned. A quarter of participants reported having used IOTN before in a clinical setting. Clinical experience with IOTN influenced confidence. Familiarity with making orthodontic referrals was low and only one participant reported having made an orthodontic referral. Correct IOTN scores were given by 68% of participants for a large 14 mm overjet (5a) case, 43% of participants for an impacted canine (5i) case and 26% of participants for an impacted premolar (5i) case. Incorrect IOTN was most common in hypodontia cases with only 19% correctly identifying mild hypodontia (4h) and 28% identifying severe hypodontia (5h). For the majority of cases, incorrect answers about referral were due to confusion between specialist practitioner and orthodontic consultant pathways. CONCLUSIONS: Dental students' ability and confidence in correctly applying the IOTN Dental Health Component and selecting the appropriate referral pathway was inadequate. Responses suggest a lack of clinical experience in assessing patients, applying the IOTN and making referrals. The low response rate is disappointing and limits the scope for making recommendations.

Orthodontic treatment quality evaluated by partially automated digital IOTN and PAR index determination: a retrospective multicentre study.

BACKGROUND: Orthodontic therapy aims to treat misaligned teeth and jaws to improve dental occlusion as well as the function and aesthetics of the masticatory system. Continuous data collection to check treatment quality is of great importance for the constant optimization of orthodontic care. OBJECTIVE: The aim of this retrospective multicentre cohort study was to systematically determine the outcome and quality of orthodontic treatment by applying the internationally established Index of Orthodontic Treatment Need (IOTN) and Peer Assessment Rating (PAR) index in multiple clinical settings for a representative number of patient cases. MATERIALS AND METHODS: A total of 1509 consecutive orthodontic patient cases (treatment completion between January 2018 and December 2020) from three representative orthodontic centres (University clinic, city office, small town office) were analysed in a multicentre study. The pre- and post-treatment casts were scanned, digitally measured, and partially automatically evaluated using the IOTN and PAR indices. RESULTS: A statistically significant improvement in occlusion was observed for medically necessary treatment of IOTN grades 4 and 5 in 97.30 per cent of the analysed cases and for treatment-requiring grades 2 and 3 in 94.08 per cent of the analysed cases. The average percentage PAR improvement was 76.51 per cent. 72.50 per cent of cases showed improvement of more than 70 per cent. The mean PAR index score was reduced from 28.19 ±â€…9.49 to 6.22 ±â€…5.41 points. CONCLUSION: The present data demonstrate that orthodontic treatment is efficient in inducing significant improvement of malocclusions in general and has a high success rate with severe dysgnathia.

Relationship between index of orthodontic treatment need dental health component (IOTN-DHC) and caries prevalence in school-age children.

OBJECTIVES: The objectives of the study were to investigate the relationship between caries prevalence and the Index of Orthodontic Treatment Need Dental Health Component (IOTN-DHC) in school-age children who live in the dentistless area and to consider the effective way to reduce the potential progression of malocclusion with the growth through the dental survey in Arbulag district, Khövsgöl province, Mongolia. MATERIALS AND METHODS: The 95 school-age children (49 males, 46 females) who participated in the study were born in and were residents of Arbulag district, Khövsgöl province, Mongolia. The mean ages of the participants were 8.3 years (y) ± 1.7 y for males and 8.8 y ± 1.7 y for females. The Mann-Whitney U test was performed to determine the sex difference for the dmf/DMF index. The relationship between the IOTON-DHC and the dmf/DMF index was statistically examined using Spearman's rank correlation coefficient. RESULTS: Regarding the dmf/DMF index, no sex difference was observed. There were significant, fair positive correlations between the IOTON-DHC grade and F; between the IOTON-DHC grade and DMF index in males. There were significant, fair positive correlations between the IOTON-DHC grade and M; between the IOTON-DHC grade and DMF index in females. CONCLUSIONS: Significant, fair positive correlations were found between the caries prevalence and the grade of malocclusion. Thus, prevention and early treatment of dental caries in a mixed dentition may be effective to reduce the potential progression of malocclusions in dentistless area.

O impacto dos defeitos de esmalte no planejamento ortodôntico / The impact of enamel defects on orthodontic planning

Resumo A decisão pela extração de dentes permanentes para a solução de problemas ortodônticos considera, além da extração em si, outros fatores, dentre eles, as características clínicas do esmalte dos dentes a serem extraídos. O objetivo deste artigo foi apresentar como a presença de defeitos de esmalte dentário (DDE) influenciou na tomada de decisão e modificou o plano de tratamento ortodôntico proposto para o paciente. A severidade do defeito, o número de dentes afetados e a presença e complexidade de má oclusão são fatores que influenciaram na definição do plano de tratamento. Quanto mais grave os defeitos e mais complexa a má oclusão, maior a dificuldade no planejamento do tratamento e, em muitos casos, é indicado incorporar a contribuição de vários especialistas na tomada de decisões. Foi possível demonstrar que o tratamento da má oclusão associada a DDE com a exodontia dos dentes mais severamente afetados apresentou resultados estético e funcional adequados. Concluiu-se que um tratamento bem-sucedido da má oclusão com resultado estético dentofacial adequado, saudável e funcional, requer a compreensão da inter-relação entre os componentes estruturais bucais, oclusão dentária e estética facial.(AU)

Abstract The decision to extract permanent teeth to solve orthodontic problems considers, in addition to the extraction itself, other factors, and among them are the clinical characteristics of the enamel of the teeth to be extracted. The objective of this article was to present how the presence of dental enamel defects (DED) influenced decision-making and modified the proposed orthodontic treatment plan for the patient. The severity of the defect, the number of affected teeth and the presence and complexity of the malocclusion are factors that influenced the definition of the treatment plan. The more severe the defects and the more complex the malocclusion, the greater the difficulty in planning the treatment and, in many cases, it is indicated to incorporate the contribution of several specialists in the decision-making process. It was possible to demonstrate that the treatment of malocclusion associated with DED with the extraction of the most severely affected teeth, presented adequate aesthetic and functional results. It is concluded that a successful treatment of malocclusion with adequate, healthy, and functional dentofacial aesthetic results, requires understanding the interrelationship between oral structural components, dental occlusion and facial aesthetics. (AU)

Assessment of orthodontic borderline treatment need: A comparison of two aesthetic indices.

OBJECTIVE: To compare a new "guide for borderline orthodontic need" (GBON) with the "aesthetic component" (AC) of the IOTN in assessing borderline cases (dental health component DHC 3), and to compare reliability and opinions of orthodontists on the use of each index. MATERIALS AND METHODS: Cross-sectional population descriptive study. Ninety-four qualified orthodontists assessed 30 borderline malocclusions according to the GBON and AC indices and completed a questionnaire. RESULTS: Kappa analysis showed GBON and AC to have similar intra-examiner reliability (K = 0.64 and 0.60 ,respectively). Cronbach's alpha inter-examiner reliability analysis showed GBON and AC to have similar, acceptable reliability (α = 0.7 and 0.9 ,respectively). There was only fair agreement between GBON and AC in terms of the number of malocclusions deemed as needing treatment (AC threshold 6). Analysis of specific occlusal traits revealed that reverse overjets were deemed as needing treatment according to AC but not anterior open bites. Both traits were assessed as needing treatment according GBON. Despite a lack of familiarity with GBON, assessors found GBON easier to use and more appropriate in assessing borderline malocclusions. CONCLUSIONS: Both GBON and AC had good and similar inter- and intra-examiner reliability. There was substantial agreement on treatment need between GBON and AC but only when the AC threshold is reduced to 4. GBON was more able to identify malocclusal traits in need of treatment than AC. GBON was found to be easier to use and considered more appropriate than AC in judging DHC 3 malocclusions.

Malocclusion complexity and orthodontic treatment need in children with autism spectrum disorder.

OBJECTIVES: This study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for orthodontic treatment by quantifying the Discrepancy Index (DI) and Index of Orthodontic Treatment Need (IOTN). MATERIALS AND METHODS: Dental records of 48 ASD and 49 non-ASD consecutive patients aged between 9 and 18 years (median age 13.0 years) referred for orthodontic treatment were reviewed and compared. The Discrepancy Index (DI) was quantified to determine the malocclusion complexity, and the Index of Orthodontic Treatment Need (IOTN), including the Dental Health Component (IOTN-DHC) and Aesthetic Component (IOTN-AC), was quantified to determine the orthodontic treatment need. Statistical analysis included descriptive analysis, Pearson chi-square tests, Fisher's exact test, Mann-Whitney U tests, and several univariate and multivariate regression analyses. The statistical analysis used descriptive analysis, Pearson chi-square test, Fisher's exact test, and multivariate logistic regression. RESULTS: The results show that both malocclusion complexity (DI, p = 0.0010) and orthodontic treatment need (IOTN-DHC, p = 0.0025; IOTN-AC p = 0.0009) were significantly higher in children with ASD. Furthermore, children with ASD had a higher prevalence of increased overjet (p = .0016) and overbite (p = .031). CONCLUSIONS: Malocclusion complexity and orthodontic treatment need are statistically significantly higher among children with ASD than children without ASD, independent of age and sex. CLINICAL RELEVANCE: Children with autism may benefit from visits to a dental specialist (orthodontist) to prevent, to some extent, developing malocclusions from an early age.

Using artificial intelligence to determine the influence of dental aesthetics on facial attractiveness in comparison to other facial modifications.

BACKGROUND: Facial aesthetics is a major motivating factor for undergoing orthodontic treatment. OBJECTIVES: To ascertain-by means of artificial intelligence (AI)-the influence of dental alignment on facial attractiveness and perceived age, compared to other modifications such as wearing glasses, earrings, or lipstick. MATERIAL AND METHODS: Forty volunteering females (mean age: 24.5) with near perfectly aligned upper front teeth [Aesthetic Component scale of the Index of Orthodontic Treatment Need (AC-IOTN) = 1 and Peer Assessment Rating Index (PAR Index) = 0 or 1] were photographed with a standardized pose while smiling, in the following settings (number of photographs = 960): without modifications, wearing eyeglasses, earrings, or lipstick. These pictures were taken with natural aligned dentition and with an individually manufactured crooked teeth mock-up (AC-IOTN = 8) to create the illusion of misaligned teeth. Images were assessed for attractiveness and perceived age, using AI, consisting of a face detector and deep convolutional neural networks trained on dedicated datasets for attractiveness and age prediction. Each image received an attractiveness score from 0 to 100 and one value for an age prediction. The scores were descriptively reviewed for each setting, and the facial modifications were tested statistically whether they affected the attractiveness score. The relationship between predicted age and attractiveness scores was examined with linear regression models. RESULTS: All modifications showed a significant effect (for all: P < 0.001) on facial attractiveness. In faces with misaligned teeth, wearing eyeglasses (-17.8%) and earrings (-3.2%) had an adverse effect on facial aesthetics. Tooth alignment (+6.9%) and wearing lipstick (+7.9%) increased attractiveness. There was no relevant effect of any assessed modifications or tooth alignment on perceived age (all: <1.5 years). Mean attractiveness score declined with predicted age, except when wearing glasses, in which case attractiveness was rated higher with increasing predicted age. CONCLUSIONS: Alignment of teeth improves facial attractiveness to a similar extent than wearing lipstick, but has no discernable effect on perceived age. Wearing glasses reduces attractiveness considerably, but this effect vanishes with age.

The Psychosocial Impact of Dental Esthetics in Undergraduates with Borderline Malocclusion.

Background: The study investigates the existing correlation between self-perceived malocclusion, the psychosocial impact of dental esthetics, and whether this link involves personality traits. Methods: The 179 questionnaires from 615 undergraduates in Wenzhou were used for analysis after applying the exclusion criteria. The Psychosocial Impact of the Dental Aesthetics Questionnaire (PIDAQ) was administered to evaluate participants' perceptions of the psychosocial impacts of malocclusion. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). The Chinese version of the Eysenck Personality Questionnaire-Short Scale (EPQ-RSC) evaluated participants' personality characteristics. The Kruskal-Wallis test was used to assess differences between the IOTN-Dental Health Component (DHC) and expectations of orthodontic treatment. Linear regression was applied with PADAQ and its subscale scores against possible variables. Results: The total and subscale PIDAQ scores were positively correlated with neuroticism. Total PIDAQ scores, the DHC, and the Aesthetic Component (AC) were significantly positively correlated with the subjective AC. The DHC was significantly negatively correlated with extroversion. Conclusions: We confirmed a modest link between the need for orthodontic treatment and the psychosocial impact of dental esthetics.

Comparison of treatment outcomes as assessed by 3 indexes in subjects with Class I malocclusion treated by 3 different methods: A cross-sectional study.

INTRODUCTION: Various treatment modalities exist to improve and correct Class I malocclusion. This study was conducted to evaluate the outcomes of nonextraction (NE), premolar extraction (PME), and mandibular incisor extraction (MIE) treatment modalities in subjects presenting with Class I malocclusion. METHODS: A cross-sectional study was conducted at a tertiary care hospital using pretreatment and posttreatment dental casts along with intraoral photographs of 90 orthodontic subjects. These subjects were divided equally into NE, PME, and MIE groups and scored using the Index of Orthodontic Treatment Need, Index of Complexity, Outcome, and Need (ICON), and peer assessment rating (PAR) indexes. Nonparametric tests were run to compare pretreatment and posttreatment scores and to evaluate the percentage and categorical changes for the treatment modalities. Pairwise comparisons were performed using the Mann-Whitney U test. RESULTS: Statistically significant differences (P ≤0.001) were seen between the pretreatment and posttreatment scores for all modalities. Statistically significant improvements were seen between the 3 treatment modalities for the PAR (P = 0.010) and ICON (P = 0.003) indexes. Significant categorical improvements were found for the Aesthetic Component (AC) (P = 0.012) among the 3 groups. Pairwise comparison revealed significant differences between the NE and MIE groups (ICON, P = 0.001; AC, P = 0.018) and PME and MIE groups (PAR, P = 0.002; ICON, P = 0.007; AC, P = 0.007). CONCLUSIONS: Posttreatment scores of all indexes were reduced, with significant differences found among the treatment modalities for all except the Dental Health Component index. The pairwise comparison revealed suboptimal occlusal results with the MIE group. Good occlusal and esthetic treatment outcomes were achieved with the PME and NE groups.

Use of the sociodental approach in estimating orthodontic treatment needs in adolescent patients.

PURPOSE: The sociodental model integrates clinical assessment, perceived impacts of malocclusion on quality of life, and behavioural propensity when prioritising orthodontic treatment. This study compares the effect of using different instruments to measure impact-related need on the assessment of orthodontic treatment need based on the sociodental framework. MATERIALS AND METHODS: In this cross-sectional study, 206 Malaysian adolescents (age: 11-18 years) were screened in orthodontic clinics to identify those with normative need, oral impacts due to malocclusion, and having high and medium-to-high behavioural propensities. The Index of Orthodontic Treatment Need classified normative need. The Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and the Condition-Specific Child-Oral Impacts on Daily Performances (CS-OIDP) index measured oral impacts. Subjects' behavioural propensities for successful treatment outcome were based on the Basic Periodontal Examination and International Caries Detection and Assessment System. Data were analysed using the McNemar test. RESULTS: The response rate was 99.0%. Estimates of normative need (89.7%) were significantly reduced under the sociodental model by 65.7% (p < 0.0001) when impact-related need was measured using PIDA, and by 41.7% (p < 0.0001) when measured using CS-OIDP. The difference between the results of the two instruments in proportions of identified need for orthodontic treatment was 24.0% (p < 0.0001). CONCLUSION: For Malaysian adolescents, estimates of need for orthodontic treatment when assessed with the sociodental approach were substantially lower than normative clinical assessment and depended highly on the tools selected to assess the patient's impact-related need. Health policy makers should understand the implication of adopting one instrument or the other when estimating orthodontic treatment need.

The value of adult orthodontics: Do the public's willingness-to-pay values reflect the profession's?

OBJECTIVE: To explore how the public and dental professionals would value an orthodontic service for adults by eliciting their willingness-to-pay (WTP), a standardised health economics technique which quantifies 'strength of preference' in monetary terms. Despite increasing demand, adults in the UK are only eligible for NHS orthodontic treatment if there is severe dental health or complex multidisciplinary need. Orthodontic services are provided to children aged under 18 years who are eligible by their Index of Orthodontic Treatment Need (IOTN) score. Consequently, many adults who may have a need for treatment as determined by IOTN are unable to access this service. DESIGN: Cross-sectional survey. SETTING: General dental practices in North East England and national specialists approached through the British Orthodontic Society (BOS). PARTICIPANTS: Public participants were recruited from general dental practices. Dentists were recruited from local dental lists and members of the BOS. METHODS: Participants were asked if they would be willing to pay to see an orthodontic service extended to all adults in England with a qualifying IOTN. Clinical photographs of three malocclusions were presented and maximum WTP in additional tax per household per year was elicited using shuffled payment cards. RESULTS: A total of 205 dentists and 206 public participants were recruited. Pairwise tests showed a statistically significant difference in WTP between the public and professionals for all malocclusions, with the public giving higher valuations. In both groups, the Class III scenario elicited a higher WTP than the class I or II malocclusion. However, when all other factors were controlled for using a regression analysis, the group (public or profession) and the other variables did not significantly influence WTP. CONCLUSION: The public and professionals were willing to pay for an adult orthodontic service. Due to this variability and unpredictability the allocation of healthcare resources will remain contentious.

Malocclusion severity and its associations with oral health-related quality of life in an adult population.

AIM: The aim of this study was to investigate malocclusion severity and its associations with oral health-related quality of life (OHRQoL) among middle-aged adults. MATERIALS AND METHODS: The study material consisted of 1786 subjects from the Northern Finland Birth Cohort 1966 who attended dental and oral examination as part of the 46-year-old follow-up study. Malocclusion severity was assessed using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and the Peer Assessment Rating index (PAR) from digital 3D dental models. Participants also answered a questionnaire including the Oral Health Impact Profile (OHIP-14) and a question on their satisfaction with occlusal function. Differences between malocclusion severity groups were evaluated for both genders separately. For adjusted models, multivariate Poisson regression models were conducted. RESULTS: In this study population, 31.3% had great or very great orthodontic treatment need according to DHC and the mean PAR total score was 22.05. The most severe malocclusions were associated with OHRQoL, especially the psychosocial and handicap dimensions, and satisfaction with occlusal function. There was a significant difference between genders, men having more severe malocclusion but women reporting more OHRQoL impacts. CONCLUSION: One third of the study population were considered to have severe malocclusion. There was an association between malocclusion severity and OHRQoL in adult population, particularly in women.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Orthodontic Treatment Need among Nepalese High School Students

Abstract Objective: To assess the need for orthodontic treatment among Nepalese high school students. Material and Methods: This is a quantitative, cross-sectional descriptive study. The sample comprises 938 children (537 males and 401 females) with an age group above 14 years. The subjects were selected voluntarily from seven different schools of Kathmandu valley using a multistage sampling technique. The Index of Orthodontic Treatment Need comprises two components: Dental Health Component (DHC) and Aesthetic Component (AC). Two trained and calibrated examiners performed the oral examination. Results: On analysis of the DHC component, it was found that 21% had no need, 18.1% had mild/little need, 24.3% had moderate/borderline need, 35.8% had severe need, and 0.7% had extreme treatment need. Similarly on analysis of AC component, it was found that 33% were AC-1, 30.8% were AC-2, 7.2% were AC-3, 8.2% were AC-4, 2.1% were AC-5, 3.6% were AC-6, 1.8% were AC-7, 7.4% were AC-8, 1.8% were AC-9, and 3.9% were AC-10. Conclusion: The Index of Orthodontic Treatment Need can be used as a tool for planning dental health resources and prioritizing the treatment need of different populations (AU).

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).

Les avulsions dentaires au cours du traitement orthodontique à Conakry / NA

En orthodontie, l'extraction des dents saines tient une place importante parmi les moyens thérapeutiques, pour le rétablissement d'une denture fonctionnelle et esthétique. Objectifs : les objectifs étaient de déterminer la fréquence des avulsions au cours du traitement orthodontique, répertorier les types d'anomalies orthodontiques qui nécessitent des extractions dentaires et identifier les dents les plus couramment extraites. Méthodes. il s'agit d'une étude prospective de type descriptif, effectuée au service d'odontostomatologie et de chirurgie maxillofaciale de l'hôpital national Donka, CHU de Conakry sur la période d'août 2019 à avril 2020. Résultats : trois cent patients ont été examinés, 31 présentaient des anomalies orthodontiques dont les traitements nécessitaient des extractions dentaires pilotées, soit une fréquence de 10,33%. L'âge moyen était de 11 ans. Le sex-ratio était de 1,21 en faveur du sexe masculin. L'encombrement antérosupérieur était l'anomalie la plus fréquente (58,06%), les incisives temporaires étaient les dents les plus intéressées par les extractions avec 41,18%. Conclusion. La maitrise des indications, du moment et des séquences d'extractions à but orthodontique constitue l'élément clé dans la prise en charge des anomalies orthodontiques en omni pratique.