Effect of Type of Malocclusion on the Surface Pattern of Caries on Molars and DMFT Index in Primary and Mixed Dentition Period- A Pilot Study

Abstract

Introduction: Caries pattern is multifactorial in context to the type of diet, tooth structure, time of insult, microflora and salivary contents (salivary pH, buffering action, salivary flow, etc.). Craniofacial relationship may be a contributing factor in the site of occurrence of caries i.e., mesial, distal, occlusal, palatal/lingual and buccal surfaces of primary and permanent molars. Aim: The aim of the study was to find out the effect of the type of malocclusion in primary dentition and mixed dentition period on the surface distribution of caries with respect to their molars along with overall DMFT (decayed, missing and filled teeth index) of the patient. Materials and Methods: A pilot study was conducted in Government and Private schools of district Gurugram, Haryana. Hundred children between 3-5 years of age with primary dentition and 8-10 years of age in mixed dentition period as per inclusion and exclusion criteria were included. Type of terminal plane relationship, according to Baume’s classification, i.e., Flush terminal/mesial step/distal step and affected carious site in all primary molars were examined in 3-5-year-old children. Similarly in 8-10-year-old, type of malocclusion according to Angle’s Classification and its association with carious sites in permanent first molar were examined. Decayed, missing and filled teeth index, DMFT/dmft (i.e., dmft=0-1, 1-2, ≤3 and DMFT+dmft (DMFT+dmft=0-1, 1-2, ≤3) was analysed in both groups, respectively. Results: The mesial step molar relationship was the most common malocclusion (93%) in primary dentition whereas in mixed dentition Angle’s Class I was the most common (84%) malocclusion. Caries occurrence was more in maxillary molars as compared to mandibular molars. The order of caries occurrence in primary and permanent dentition was occlusal surfaces>mesial surfaces>distal surfaces>buccal surfaces>palatal/lingual surfaces. The caries occurrence according to dmft index in primary dentition was not associated with any type of malocclusion, though it was more in mesial step molar relationship. Angle’s Class II malocclusion contributed significantly high DMFT+dmft index with p-value of 0.020. Conclusion: Type of malocclusion does not affect with surface pattern of caries on molars in primary and mixed dentition period. Decayed, missing and filled caries index may be significantly associated with Angle’s Class II malocclusion according to the present study.