Die Eignung der „Kieferorthopädischen Indikationsgruppen” (KIG) für die zahnärztliche Vorsorgeuntersuchung des Öffentlichen Gesundheitsdienstes (ÖGD)

Abstract

In the context of the dental preventive medical examinations of the public health service, the orthodontical data-gathering in children's day-care centre and schools, in contrast to the diagnoses of caries disease, was made was based so far on a non-uniform methodology. In order to provide in future, also in the orthodontical sector, data material that is usable for comparative national and local health reporting, a uniform methodology should form the basis for the data acquisition. The present study makes a contribution to this objective. A goal of the work was to test two different collection instruments for their suitability as objective tools in the context of the preventive dental medical examinations. The occurrence and the severity level of dentofacial anomalies as well as the orthodontic treatment status of Thuringian school children of defined age groups (9 to 11 years old, 12 to 13 years old) were recorded and the orthodontic treatment need was determined. In the younger age group valid the orthodontical groups of indications (OGI) were found for the first time in Germany; in the older group we tested the already long established Dental Aesthetic Index (DAI) and equipment application recommended by the World Health Organization (WHO). The work was a component of the task spectrum of the WHO Collaboration Centre "Prevention of Oral disease" of the Health Centre for Preventive Dentistry at the Centre for Tooth, Mouth and Jaw Dentistry of the Friedrich Schiller University of Jena in Thuringia. As investigation region, a rural area ("Landkreis Eichsfeld") of Thuringia was choosen. The study was arranged into a sociological and a clinical-epidemiological part. Altogether 1845 pupils were recruited from national schools. The questionnaire was based on the WHO-initiated "International Collaborative Study of Oral Health Outcomes" (ICS II study). The investigations took place in the context of the preventive medical examinations of the public health service. The results were based on the answers and findings of 691 probants of the group of the 9-11 years old (AG 1) and 774 probants of the group of the 12-13 years old (AG 2). The sociological results of both age groups reflected social restrictions regarding the presence of dentofacial anomalies in an order of magnitude of 20% in the AG 1 and 7.3% in the AG 2. In the AG 1 11.4% confirmed an orthodontical treatment and 47.9% of the probants examined indicated a desire for treatment. On the other hand, the proportion of orthodontically treated in AG 2 amounted to 31.1% and 37.8% expressed a desire for treatment. Dentofacial anomalies determined with the help of the OGI in the AG 1 as the most frequent were in the form of a distal bite (sagittal stage/group of D) with 55.5% of the examined pupils being documented. However here severity development stages 1 and 2 outweighed. Proportionally followed: confining (group E) with 21% and the vertical stage/deep bite (group T) with 7.8%. All other groups were represented by only small proportions, craniofacial anomalies (group A) were not diagnosed. Anomalies with severity development 1 and 2 were determined in 64.1% of the examined children. In the AG 2 examined with the DAI, the anomalies of space conditions with 58% exceeded anomalies of occlusion conditions with 38.9% and anomalies of dentition with 9.8%. An urgent orthodontical treatment need was determined in the AG 1 with 35.9% of the probants (severity development 3 to 5) and in the AG 2 with 16.8% (DAI values over 32). In the AG 2 too, over 60% DAI values from 13 to 25 were determined, 26% exhibited DAI values between 26 and 31. During the statistic evaluation the "Statistical Package found for Social Sciences (SPSS)" version 11.51 S with a significant level of 5% was used. Derived from the results of our analysis, the recommendation can be made that the methodology of the Orthodontical Groups of Indications for the employment is to be regarded as a possibility with dental preventive medical examinations in the public health service as a suitable equipment and so far allows the subjective estimate of the orthodontical treatment necessity to be made.