Malocclusion Research Articles

Knowledge, Attitude, and Awareness of Orthognathic Surgery among Orthodontic Patient-Prospective Study.

Aim:The aim of the current survey was conducted to assess the knowledge, attitude, and awareness regarding orthognathic surgery among orthodontic patients.Materials and Methods:This is cross-sectional web-based questionnaire survey conducted among orthodontic patients in Tamil Nadu. The self-administered questions related to awareness of orthognathic surgery were collected from 500 subjects. The statistical analysis was done using the Statistical Package for the Social Sciences (V 22.0). The frequency distribution was computed.Results:This survey revealed that 466 (93.2%) respondents had awareness about the role of orthognathic surgery. 332 (66.4%) had given the correct responses related to differentiating skeletal and dental malocclusion, 454 (90.6%) had the awareness of risk factors associated with orthognathic surgery and 40 (7.0%) were experienced regarding the procedure.Conclusion:The result of the current study showed that it clearly implies that the population was aware of orthognathic surgery as a treatment modality for correcting skeletal deformities.

Prevalence of Dental Anomalies in Skeletal Malocclusions with Different Growth Patterns in North Indian Population- A Cross-sectional Study

Introduction: Anomalies of the developing dentition occur due to absence or interruption of normal tooth development along with genetic and/or environment influences. Craniofacial development and dental malocclusion is an interplay between a number of factors such as tooth size, arch size and shape, the number and arrangement of teeth, size and relationship of the jaws and related soft tissues including lips, cheeks, and tongue. Aim: To evaluate the prevalence and distribution of dental anomalies among different skeletal malocclusions and growth patterns in North Indian population. Materials and Methods: This retrospective cross-sectional study was conducted on pretreatment diagnostic records of 260 patients belonging to the age group of 15-25 years, who had reported to the Out Patient Department (OPD) of Department of Orthodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India, during the period of April 2012 to December 2020. The analysis was carried out between November 2020 and January 2021. The study sample was grouped into different growth patterns and skeletal malocclusions based on Sella-Nasion-Gonion- Gnathion (SN Go-Gn) and ANB (A point, nasion, B point), Sagittal intermaxillary angle values respectively, which were obtained from the pretreatment lateral cephalometric tracings. The prevalence of dental anomalies was evaluated in each group by examining the pretreatment diagnostic records. Chi-Square/Fisher-Freeman- Halton test were used for statistical analysis. Results: The prevalence of dental anomalies in the study sample was 65 (25%). The most common anomaly found was over retained deciduous teeth, followed by ectopic eruption with prevalence rate of 30 (11.5%) and 24 (9.2%), respectively. A total of 142 (54.6%) patients had hypodivergent growth pattern, 23 (8.8%) had normodivergent growth pattern and 95 (36.5%) had hyperdivergent growth pattern. 36 (13.8%) patients had skeletal class I malocclusion, 205 (78.8%) had skeletal class II malocclusion and 19 (7.3%) patients had skeletal class III malocclusion. Hypodivergent group showed the highest prevalence of dental anomalies with 38 (26.8%), followed by hyperdivergent group with 23 (24.2%) and normodivergent group were 4 (17.4%). Skeletal class I malocclusion group had the highest number of dental anomalies as 13 (36.1%), followed by skeletal class II malocclusion with 50 (24.4%) and skeletal class III malocclusion group with 2 (10.5%). Conclusion: Hypodivergent growth pattern and skeletal class II malocclusion were the most prevalent growth pattern and skeletal malocclusion in North Indian population. Dental anomalies were most prevalent in patients with hypodivergent growth pattern and skeletal class I malocclusion. The results of the present study indicate that dental anomalies are associated with certain malocclusions and growth patterns which may contribute to more accurate treatment predictions.

Impact of facial profile on young adults' oral health-related quality-of-life item levels: A hierarchical analysis.

ABSTRACTObjective: To assess the impact of facial profile on young adults’ oral health-related quality of life (OHRQoL) item levels. Methods: A cross-sectional study was carried out with a population-based sample of 205 young adults, with a mean age of 23.1 years. The individuals answered questions about OHRQoL (OHIP-14) and self-esteem (Global Negative Self-Evaluation). The Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) was used to evaluate normative orthodontic treatment needs and define dental malocclusion clinically. Facial profile was analyzed using photographs and dichotomized into two levels: normal (straight) and altered facial profile (convex or concave). A calibrated researcher performed the clinical examination. Association between the independent variables and the outcome (OHRQoL) was established by hierarchical multiple linear regression analysis for each item level. Considering the variable of interest (facial profile), the psychological incapacity domain was the most affected item. Results: Individuals with changed facial profile had 2.47 (1.04-5.85) times higher chances of reporting impacts on psychological incapacity than those with a normal profile (p> 0.05). The association was modulated by dental malocclusion and self-esteem. Conclusions: The convex and concave facial profile showed a negative impact on the psychological aspects of young adults’ quality of life.

Incidence of Orthodontic Problems in Northern Cypriot Population

Aim: Technologies related to big data are progressively used for various research purposes in the fields of dentistry and health-care informatics. Large amounts of clinical data have been achieved and acquired at an exceptional acceleration and advancement. The actively developing field of big data analysis has started to play a critical and decisive role in the progression of dental practices and research. It has implemented tools to collect, regulate, interpret, and comprehend enormous volumes of distinct, structured, and unstructured data established from the present healthcare systems. Big data analysis has been lately devoted in the direction of encouraging and assisting the process of problem detection and care delivery. Our study aimed at measuring the frequentness of orthodontic problems, incidence of malocclusion and the orthodontic treatment demand among children who attend secondary schools in Northern Cyprus. Methods: For the present survey, our sample included 426 school children (203 females and 223 males) who are 12–15 years of age. Molar relation in each child was assessed according to Angle's classification. To evaluate the need and demand for orthodontic treatment, the ICON index was then used. Occlusal features such as overbite and overjet were measured and the presence of malocclusal characteristics such as cross bite, deep bite or open bite was examined and recorded for each subject. Our findings indicated that among this Northern Cypriot school population: (20.6%) had no occurrence of malocclusion, (74.6%) were found to have a Class I molar relation, (21.1%) had a Class II molar relation (Division 1, 13.6%; Division 2, 1.6%) and (3.3%) had a Class III malocclusion. Moreover, (20.2%) of all the examined children were found in need of orthodontic treatment. Digital modelling derived from CBCT scanning of plaster casts is a reliable method to assure the accuracy of measurements obtained directly from clinical and dental examination. Results: 74.6% of all subjects were found to have class I dental malocclusion; class II division 1 were calculated at 13,6%, class II division 2 were 1,6%, class II subdivision 4,2%, class III were calculated to be at 3,3% and class III subdivision 2,5%. Conclusion: The most common orthodontic malocclusion in Northern Cypriot school children is Class I and the least common one is Class II division 2.

Comparison of condylar position in normal occlusion, Class II Division 1, Class II Division 2 and Class III malocclusions using CBCT imaging.

BackgroundThe aim of this study was to establish the condylar position in a group of patients with normal occlusion, compared to Class II Div 1, Class II Div 2 and Class III malocclusions using CBCT imaging. Material and MethodsRetrospective case-control study carried out by analyzing CBCT images of 80 patients. The sample was divided into 4 different groups with 20 patients each (40 TMJ). All patients were positioned using the Frankfurt plane, parallel to the floor and in maximum intercuspation. The control group included asymptomatic patients with normal occlusion (Less than 2mm of tooth size-arch length discrepancy, positive or negative, 0-2mm overjet, 2-4mm overbite, less than 15o rotations, without facial asymmetries, no previous orthodontic or occlusal treatment, without muscular or articular signs or symptoms in both TMJs) and the experimental group with (class II/1, II/2 and III) malocclusions. ResultsThe group with normal occlusion had the condyles centrally positioned within the glenoid fossa. The values obtained in this group were considered as optimal and when compared with the other groups with malocclusions. The results established that the position of the condyle was more posterior in class II/2 and more superior in class III patients than the asymptomatic normal occlusion group. ConclusionsThe data obtained in the asymptomatic group with normal occlusion could be used as a reference for future studies. The comparison of these values with those obtained from analyzing the different sagittal malocclusions show significant differences that could be valuable when establishing the diagnosis and the objectives of the treatment plan in orthodontics. Key words:Condylar position, CBCT, dental malocclusion and condylar concentricity.

Root Resorption of Central Incisor by Impacted Canine in Unusual Transposition: Orthodontics and Implant Rehabilitation: 3-Year Follow-Up

This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.

Assessment of 2D:4D ratio for the early diagnosis of caries and malocclusion in 7-15-year-old children

Background: The ratio between 2nd and 4th digit length is termed as hormonal fingerprintand is used as an indirect marker in many medical diseases.Dental studies pertaining to theimportance of hormonal fingerprint on oral health are very sparse.
 Aim and objectives: Tostudy the correlation of dental caries and malocclusion with hormonal fingerprints.
 Materialsand Methods: A total of 100 children of age group 7-15 years and both genders were randomlyselected and included in the present study. The hormonal fingerprint (2D:4D ratio) wasdone bymeasuring the length ratio of the index and ring finger with the help of digital vernier caliper.Caries assessment wascarried out using standard mouth mirrors and Community PeriodontalIndex probes. WHO assessment form (1997) was followed for assessment of dentitionstatus and treatment need.Occlusal characteristics evaluated were molar relation, anteriorand posterior crossbite, open bite, deep bite and lower anterior crowding. The subjects weredivided into high 2D:4D, equal 2D:4D digit ratio and low 2D:4D. All the measurements weredone by two investigators. The data collected were tabulated and statistically analyzed usingChi-square and ANOVA test.
 Results: Out of 100 children, 34% were males and 66% werefemales. Most of the participants were 7-8 years old (12 males and 15 females). Majority of theparticipants (87% for the right hand and 80% for left hand) had low 2D:4D ratio, only 6% forright and 11% for the left hand had high 2D:4D ratio and the remaining had equal 2D:4D ratio.Statistically insignificantcorrelation between 2D:4D ratio and deft/DMFT score and occlusalstatus of an individualwere found.
 Conclusion:The insignificant results of 2D:4D ratio with allthe parameters assessed validates that hormonal fingerprints could not be employed as an earlypredictor of caries and malocclusion in an individual.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.154-158

Analytical study of the psychosocial impact of malocclusion and maxillofacial deformity in patients undergoing orthodontic treatment.

Patients whose with facial appearance involves dental anomalies and malocclusion face an increased prevalence of various psychosocial problems such as a high level of social anxiety, social avoidance, and low quality of life. This study investigates the patients with craniofacial anomalies and their psychological adjustment concerning the facial and dental appearance. It also evaluates the expectations of this patient group from the orthodontic treatment. Two steps were done in this study. In the first step, translation and validation of the Derriford Appearance Scale (DAS59), The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and Patient Expectation from the Orthodontic Treatment (PEOTQ) questionnaires into Maithili were done, and then the main study was conducted using these valid questionnaires. This was a cross-sectional study conducted on the patients with congenital craniofacial anomalies visiting the orthodontics department of Patna Dental College and Hospital, Patna (Bihar). All the patients received the Maithili DAS, Maithili PIDAQ and Patients' Expectation from the orthodontic treatment questionnaires. The Maithili version of DAS59, PIDAQ and PEOTQ were developed with outstanding reliability and validity. A significant difference between PIDAQ (p<0.001) and DAS59 scores (p<0.001) was found. In females, the total PIDAQ score was significantly higher as compared to males, but there was no association of DAS scores with gender. Place of residence showed no association with PIDAQ and DAS59 scores in patients. Patients and controls had significant differences between various items, and a comparison was made in terms of expectation from the orthodontic treatment. Altered facial and dental appearance in patients with craniofacial anomalies showed a significant psychological impact.

Comparison of Tooth Widths, Arch Widths and Arch Lengths in Class-I Normal Dentition to Class-I and II Crowded Dentitions

Background and Objective:Dental study casts play a vital role in the diagnosis and treatment planning of various orthodontic cases. This study was carried out to compare the tooth widths, arch widths, and arch lengths in Class-I normal dentition to those in Class-I and Class-II crowded dentition in an effort to improve treatment planning and to eventually reduce treatment duration.Methods:Total 170 patients, 12 to 40 years of age with a complete set of permanent teeth till 1st molars; who presented to the Orthodontics Department at Armed Forces Institute of Dentistry (A.F.I.D), Rawalpindi from Sep 2019 to Feb 2020, were included in the study. Non-probability purposive method of sampling was used. The dental casts obtained were used to measure tooth widths, arch widths, and arch lengths. Subjects were classified into Class-I normal and Class-I and Class-II crowded occlusion and comparison of the sum of tooth widths, arch widths, and arch length discrepancies were determined among the three occlusion groups. Data was analyzed in SPSS version 21 and independent samples t-test was used to differentiate the variables of interest.Results:Out of 170 subjects, 73 (42.9%) subjects had Class-I normal occlusion while 97 (57%) had Class-I and Class-II crowded occlusions. No statistical difference was found between the occlusal groups with regard to the sum of tooth widths, inter-canine widths, inter-first premolar widths, inter-second premolar widths and inter-molar widths. However, a remarkable difference was observed between the occlusal groups with respect to arch perimeters and arch length discrepancies (p = 0.000 and 0.000 respectively).Conclusions:Results of the current study indicate that crowding of teeth occurs as a consequence of decreased arch perimeters which may lead to increased arch length discrepancies. However, no prominent difference was noticed in the sum of tooth widths and arch widths among different occlusal groups.

Relationship between Malocclusion and Obesity: A Cross-sectional Study in the Moroccan Population

Introduction: Intra-arch dental malocclusions are explained by the disharmony between the arch perimeter and the existing dental capital. The habitable perimeter is the result of the basal and alveolar growth, itself under the dependence of the musculature. The idea of working on the relationship between obesity and malocclusion is to understand whether the effects of mastication and the typology of musculature specific to this category, could have an influence on the dimensions of the arches and therefore on the genesis of malocclusions in children. The aim of this cross-sectional observational study is therefore to evaluate the impact of obesity and overweight on the development of malocclusion in growing age subjects. Materials and Methods: This study was conducted in 58 children aged 10 to 16 years old who consulted the Rabat Dental Treatment and Consultation Center CCTD-CHIS between January 2018 and December 2018. Excluded from this study were children who had received orthopedic treatment or were undergoing orthodontic treatment, children with system pathology, as well as those with incomplete dentures or proximal caries. The sample was divided into 2 groups according to their Body Mass Index (BMI): G1 normal weight children, G2 overweight or obese children. The variables studied were: dental crowding, overjet and overbite, presence of dysfunction or parafunction and height of the anterior face. The comparison of these variables between the two groups was made by Pearson's Chi-square test for qualitative variables and the non-parametric test (Mann- Whitney's U-test) for quantitative variables. Results: The results of this study showed that the frequency of dysfunctions and parafunctions, as well as the increase in the lower anterior facial height were greater in the overweight/obese group (57.1%; 62.9% and 60.9% respectively). For endo-buccal parameters, crowding was greater in the overweight/obese group with a median of 2 [0-3] for this group and 1 [0-3] for the normo-weight group. The difference between the two groups for these parameters was not statistically significant. In addition, the results of this study showed that the overjet in the overweight/obese group was slightly reduced (1[o-2]) compared to the norm-weight group (2[1-3]). This difference was statistically significant (p &lt; 0.05).

Analyzing Effects of Sickle Cell Disease on Morphometric and Cranial Growth in Indian Population.

Background:Sickle cell disease is the most pervasive autosomal recessive hereditary blood diseases and is characterized by the presence of sickle hemoglobin (HbS), which in turn gives rise to pathophysiological consequences. This HbS reduces the agility of erythrocytes plummeting their ability to pass through small vascular channels, which in turn results in increased blood viscosity and congestion of vascular beds, causing ischemia, local infarction, and hemolysis.Objectives:The current study was conducted to carry out the morphometric analysis in patients with sickle cell disease.Materials and Methods:This study was conducted on 75 subjects detected with sickle cell disease aged between 8 and 16.5 years. The study involved 38 males and 37 females. All the subjects were subjected to lateral cephalogram for the calculation of various angular and linear dimensions of the craniofacial structures. The linear measurements made were nasion-menton height, anterior nasal spine (ANS)-menton height, and nasion-ANS height, whereas the angular measurements made were Frankfurt mandibular plane angle, Frankfort mandibular incisor angle, and incisor mandibular plane angle.Results:Major chunk of the subjects had retruded mandible and vertical growth pattern. Few subjects exhibited with maxillary protrusion.Conclusion:It is concluded that early diagnosis and management of dental malocclusion in patients with sickle cell disease plays a pivotal role in an attempt to endow with a better quality of life to these individuals.

MYOFUNCTIONAL THERAPY IN ANTERIOR DEEP BITE AND TMD PATIENT-CASE REPORT

Deep bite is perhaps one of the most common dental malocclusions seen in children as well as in adults and is very demanding to be treated successfully. A skeletal or dental overbite is caused by genetic or environmental factors, or a combination of both. The ideal overbite in a normal occlusion may range from 2 to 4 mm. Mild deep bite typically requires no correction, unless correction for aesthetic reasons. Severe overbite, considered as a clinical problem may affect the temporomandibular joint, causes periodontal problems and tooth wearing, as well as traumatizing the incisive papilla or interfering with mastication function. Anterior deep bite could be caused by overeruption of upper and/or lower incisors or undereruption of posterior teeth. Correction of deep overbite has always been challenging to orthodontists, especially in adult cases. There are different modalities in orthodontic treatment of this malocclusion. Deep bite correction can be treated with intrusion of incisors, extrusion of posterior teeth, combination of both, and orthognathic surgical modality. The aim of this case report was to present treatment protocol for an adult patient with skeletal deep bite, Class II Division 1 malocclusion and temporomandibular disorder (TMD) managed with conventional orthodontics therapy combined with orofacial myofunctional exercises. The modality of exercise therapy included improvement of proprioception, tonicity and mobility, working with the facial and cervical musculature, as well as with stomatognathic functions - respiration, mastication, deglutition and speech. The most important thing is to aid long-term retention. Keywords: anterior deep bite, TMD, myofunctional therapy.

Parental knowledge about tooth growth and the condition of crowded teeth in elementary school students

Parental knowledge about tooth growth and the condition of crowded teeth in elementary school students

Pattern of Malocclusion among Patients Seeking Orthodontic Treatment at Hospitals and Private Clinics of Province 2, Nepal

Introduction: Malocclusion affect the esthetic, function of the patients, so they seek orthodontic treatment for normal function and healthy and beautiful smile. Increase in public awareness and availability of orthodontic specialty services have led to increasing number of orthodontic patients in specialty clinics and hospitals. The objective of this study is to examine the pattern of malocclusion in the patients visiting medical and dental teaching hospitals and dental clinics and to measure the different Angle’s classification of malocclusion with discrepancies in all three planes.&#x0D; Materials and Method: Three hundred seventeen acceptable study casts were selected from 403 case records of orthodontic patients who visited the different hospitals and private clinics of Province 2, Nepal. A standard guidance of Angle’s classification was used to classify the cases and casts were measured to record the data. Different Angle’s classification of malocclusion with discrepancies in all three planes was studied. Descriptive statistics (frequency, percentage, mean and SD) and inferential statistics (chi square and fisher exact test) was used to find out the association between occlusal traits and demographic variables.&#x0D; Result: According to the Angle’s classification of malocclusion, most of the patient’s cast 65.9% were of class I, followed by class II 31.8%, class III 5.3% occlusion pattern. Among the class II malocclusion, class II division 1 malocclusion was more prevalent (86.13%). Under space discrepancies, crowding of teeth was present in 42.58% of patient. Of the total teeth crowding patient, 70.3% had crowding of teeth in both the arches followed by only mandibular arch (25.18%). There is statistically significant association between the age and the occlusal traits like crowding (p value 0.008), spacing (p value 0.000) and overjet (p value 0.000) at 0.01 level of significance.&#x0D; Conclusion: Angle’s class I was the most prevalent malocclusion followed by class II and class III. Increased overjet was the commonest occlusal trait. There was statistically significant association between the age and occlusal traits like crowding, spacing and overjet.

Prevalence of malocclusion in Parsa district: A comparative study

Introduction: Malocclusion is one of the commonest problem in dentistry and the knowledge on its prevalence on particular population group is very important to plan oral health activities. The objective of this study is to assess the prevalence of malocclusion in school going children of Parsa district, Nepal, and to compare the same with previous study.&#x0D; Materials and Method: The sample consisted of 250 males and 210 females (total of 460 subjects) aged between 6 to 17 years. Subjects without any previous orthodontic treatment and with no dental anomalies were included in this study. Census sampling was done for the patient visiting orthodontic from November 2018 to March 2019. Classification of malocclusion was based on Angle’s classification of malocclusion. Collected data were entered in Microsoft Excel 2007 and converted into Statistical Package for Social Science (SPSS) Version 11.5 for statistical analysis. For descriptive statistics, percentage and proportion, were calculated, also tabular presentation were performed. For inferential statistics, Chi square test were used for intergroup comparison.&#x0D; Result: School going children of Parsa district, Nepal suggests 50.47% female and 45.6% of male exhibits Angle’s Class I malocclusion, 29.04% female and 30% male exhibits class II pattern, 11.4% female and 12.0% male exhibits class III pattern. The other findings reported in the study were, the occurrence of crowding of teeth more in males whereas the occurrence of spacing is more in females.&#x0D; Conclusion: Majority of the subjects in the study had Class I malocclusion. Only 9.04% female and 12.4% of male showed normal class I occlusion. The occurrence of crowding of teeth more in males whereas the occurrence of spacing is more in females. This may be due to the incidence of missing tooth is more in females.

To evaluate whether there is a relationship between occlusion and body posture as delineated by a stabilometric platform: A systematic review

ABSTRACT Objective To evaluate whether there is a relationship between occlusion and body posture evaluated using a stabilometric platform. Methods Observational studies that analyzed the relationship between dental occlusion (changes in mandibular position and/or dental malocclusion) and body posture evaluated with a stabilometric platform in patients older than 13 years without orthodontic or orthopedic intervention and systemically healthy were considered eligible for inclusion. PubMed, EMBASE, Science Direct, LILACS, and Google Scholar databases were searched to obtain articles published from September 2019 up to March 2020. Results Twelve articles met the inclusion criteria, of which 66.7% showed a relationship between dental occlusion and body posture, and 33.3% found no relationship. The marked heterogeneity between studies did not allow data to be combined for meta-analyses. Conclusion For the mandibular positions, the postural changes were mainly in the mediolateral direction, while in the malocclusions, they were in the anteroposterior direction.

Prevalence of spacing and crowding in permanent dentition among patients visiting a private dental hospital

Malocclusion can be defined as an occlusion in which there is a mal relationship between the arches in any of the planes or one in which there are anomalies in tooth position beyond the normal limits. The literal meaning of malocclusion is a bad bite. People equate good dental appearance with success in many aspects. With the increasing demand for orthodontic treatment, the epidemiological data of malocclusion is essential in assessing the resources for orthodontic services. To assess the prevalence of spacing and crowding in the permanent dentition of patients visiting a private dental hospital. This study was based on data of patients who reported to the Department of Orthodontics, in a private teaching hospital in Chennai, India which was collected by reviewing patients records and analysing the data of 86000 patients. The data consisted of treatment done for spacing and crowding of permanent teeth in both arches in patients of age 12 to 25 years. Prevalence of crowding (64%) was more common than spacing (36%) indicating that crowding is the most common anomaly in both maxilla and mandible. Both maxilla and mandible showed statistical significance for age and gender. This study reveals that crowding is the most common anomaly in both arches.

Psychosocial Impacts of Malocclusion among Adolescents in Kedah, Malaysia: A Qualitative Study

Dental malocclusion can affect the psychological and social aspects of adolescents. However, the knowledge of this condition has been limited in the Malaysian population. This study aims to explore the psychosocial impacts of dental malocclusion among adolescents in Kedah state, Malaysia. A qualitative study was conducted at two public specialized dental clinics. Focus group discussion (FGD) and in-depth interview (IDI) were conducted among adolescents aged between 11 and 19 years, who received orthodontic treatment for moderate to severe dental malocclusion. All the FGD and IDI sessions were video-recorded, transcribed verbatim, and translated into English. The thematic analysis method was used for the data analysis. A total of 32 adolescents participated in six sessions of FGD and five sessions of IDI. Four themes emerged from the data analysis: (i) pressure to seek treatment, (ii) negative feelings about one’s dentofacial image, (iii) negative influences on interpersonal relationship, and (iv) negative impacts on school performance. The findings indicate that adolescents with dental malocclusion had been receiving pressure from different parties and generally had low self-esteem, which eventually affected their relationship with family and friends and their involvement in school activities. Therefore, public education and interdisciplinary collaboration to address their psychosocial needs are required.

Relationship between extended head posture and malocclusion

Aim: To evaluate effects of extended head posture on dental and skeletal malocclusions. Materials and Methods: Lateral cephalograms and study models of 60 patients were divided into two groups, group I [n=30 with extended head posture (NSL-CVT angle > 106)] and group II [n=30 without extended head posture (NSL-CVT angle less than 106)]. Variables which are important were studied and compared. Results: Patients in group I showed significantly more class II skeletal relationship with increased proclination in upper and lower anteriors than that in group II. Subjects in group I showed more vertical growth pattern, with increased overjet and overbite than that in group II. Also, significantly more number subjects in group I showed crowding than that in group II. Conclusion: Patients with extended head posture showed class II skeletal malocclusion and a vertical growth pattern as compared to patients with normal head posture. There was statistically significant correlation of crowding with extended head posture as compared to that in patients with normal head posture. Overjet and overbite was found to be significantly more in patients with extended head posture as compared to that in patients with normal head posture. Upper and lower incisal proclination was also found to be significantly more in patients with extended head posture as compared to that in patients with normal head posture. Keywords: Extended head posture, Head poster, Malocclusion, Class 2.

Spring mechanics for the closure of maxillary midline diastema

Maxillary midline diastema (MMD) is a relatively common dental malocclusion characterized by a space between the maxillary central incisors, with functional and esthetic consequences. A diastema between the maxillary central incisors is a relatively common finding in the primary, mixed as well as permanent dentitions. In the primary dentition, interdental spaces help to settle down the superceding permanent teeth. Majority of these close spontaneously by the time the maxillary canines appear, but a few may persist in the permanent dentition. Various treatment modalities are implemented to bring about closure of the diastema. This paper presents a series of 10 cases treated for the closure of diastema with a M shaped spring fabricated chairside. Keywords: Midline diastema, M spring, Central incisors.