Objective Orthodontic Treatment Need Research Articles

Oral and craniofacial research in the Generation R study: an executive summary

ObjectivesOral conditions are of high prevalence and chronic character within the general population. Identifying the risk factors and determinants of oral disease is important, not only to reduce the burden of oral diseases, but also to improve (equal access to) oral health care systems, and to develop effective oral health promotion programs. Longitudinal population-based (birth-)cohort studies are very suitable to study risk factors on common oral diseases and have the potential to emphasize the importance of a healthy start for oral health. In this paper, we provide an overview of the comprehensive oral and craniofacial dataset that has been collected in the Generation R study: a population-based prospective birth cohort in the Netherlands that was designed to identify causes of health from fetal life until adulthood.MethodsWithin the multidisciplinary context of the Generation R study, oral and craniofacial data has been collected from the age of 3 years onwards, and continued at the age of six, nine, and thirteen. Data collection is continuing in 17-year-old participants.Research outcomesIn total, the cohort population comprised 9749 children at birth, and 7405 eligible participants at the age of seventeen. Based on questionnaires, the dataset contains information on oral hygiene, dental visits, oral habits, oral health–related quality of life, orthodontic treatment, and obstructive sleep apnea. Based on direct measurements, the dataset contains information on dental caries, developmental defects of enamel, objective orthodontic treatment need, dental development, craniofacial characteristics, mandibular cortical thickness, and 3D facial measurements.ConclusionsSeveral research lines have been set up using the oral and craniofacial data linked with the extensive data collection that exists within the Generation R study.Clinical relevanceBeing embedded in a multidisciplinary and longitudinal birth cohort study allows researchers to study several determinants of oral and craniofacial health, and to provide answers and insight into unknown etiologies and oral health problems in the general population.

Association Between Psychosocial Status and Orthodontic Treatment Needs in Indonesian High School Students

Objective: To determine whether psychosocial status is associated with orthodontic treatment needs in high school students using the Psychosocial Impact of the Dental Aesthetic Questionnaire (PIDAQ) and the Index of Orthodontic Need (IOTN). Material and Methods: This cross-sectional study comprised 95 adolescents, both genders, aged 15–17 years old. PIDAQ was used to assess psychosocial status. The IOTN Aesthetic Component (IOTN-AC) and the IOTN Dental Health Component (DHC) was used to assess treatment needs . Examination of the oral cavity was carried out with the help of the IOTN ruler by observing the MOCDO components: missing teeth, overjet, crossbite, displacement, and overbite. The Chi-square test was used to determine the association of psychosocial status and orthodontic treatment need. The reliability test was carried out by using Cronbach’s Alpha test (0.978). Results: There was an association between psychosocial status and orthodontic treatment need based on the IOTN-AC (p=0.001) and between psychosocial status and orthodontic treatment need based on the IOTN-DHC (p=0.140) . Conclusion: There is an association between psychosocial status based on the PIDAQ and subjective orthodontic treatment need based on the IOTN-AC, but there is no association between psychosocial status based on the PIDAQ and objective orthodontic treatment need based on the IOTN-DHC in students of SMAN 27 Jakarta.

Relationship between the psychosocial impact of malocclusion and objective orthodontic treatment need

Purpose: The purpose of this study was to evaluate the association between the psychosocial effect of malocclusion and objective orthodontic treatment need in Turkish adolescents and young adults.Materials and Methods: The study sample consisted of 152 adolescents (mean age; 14.91), and 48 young adults (mean age; 21.83). Participants were asked to answer the “Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)”. Objective treatment need was evaluated by an experienced clinician, using the Aesthetic Component (AC) of the Index of Orthodontic Treatment need. (IOTN). Results: Statistical analyzes revealed no significant difference between adolescents and young adults either in PIDAQ and AC scores. There was also no significant gender differences in PIDAQ and AC scores either in adolescents and young adults. A positive correlation was found between the PIDAQ score and the AC value just in adolescent females (r= 0.263, p=0.012).Conclusion: Malocclusion has similar degree of psychosocial impacts in adolescents and young adults. Female adolescents appear more aware of their dental appearance and feel higher psychosocial impacts than adolescent males.

Correlation between oral health-related quality of life and orthodontic treatment need in children and adolescents-aprospective interdisciplinary multicentre cohort study.

Oral health-related quality of life (OHRQoL) is aconstruct for assessing the self-perceived oral health of patients. The aim of this study was to investigate the correlation between OHRQoL and orthodontic treatment need in consideration of demographic and psychological factors. This multicentre study included 250 patients with an indication for orthodontic diagnostics. In cooperation with the Institute of Clinical Psychology at the University of Würzburg, validated and internationally acknowledged questionnaires were selected to assess OHRQoL (COHIP-G19) and health-related quality of life (HRQOL). Self-esteem and behavioural problems were taken into consideration as possible psychological factors. Orthodontic treatment need was assessed using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC), the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC) and the Dental Aesthetic Index (DAI). Possible significant correlations between the collected parameters and OHRQoL were evaluated by means of linear regression analysis. Objective orthodontic treatment need (IOTN-DHC and DAI) was significantly correlated with OHRQoL. Further factors significantly influencing OHRQoL in children and adolescents were age, HRQOL, self-esteem and behavioural problems. Objective orthodontic treatment need significantly influences OHRQoL in children and adolescents. Further studies are required to investigate if OHRQoL may be improved by correcting misaligned teeth and jaws.

The association of subjective orthodontic treatment need with oral health-related quality of life.

The existing body of evidence reports an inconsistent association between subjective and objective orthodontic treatment need. The concept of oral health-related quality of life (OHRQoL) might help to explain the differences in subjective and objective orthodontic treatment need. Our aim was to investigate the association of subjective orthodontic treatment with OHRQoL in children. This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort study. OHRQoL and subjective orthodontic treatment need were assessed by parental questionnaires. Questionnaire items were individually compared among children with no, borderline and definite subjective orthodontic need. The association between subjective orthodontic treatment need and OHRQoL was investigated in multivariate regression analysis with weighted least squares. Differences by sex and levels of objective orthodontic treatment need were evaluated. In total, 3774 children were included in the analysis. Children with borderline subjective orthodontic treatment need and those with definite subjective orthodontic treatment need had significantly poorer OHRQoL based on the fully adjusted model (adjusted regression coefficient (aβ)=-0.49, 95% CI: -0.75, -0.30; (aβ)=-1.58, 95% CI: -1.81, -1.58, respectively). The association between subjective orthodontic treatment need and OHRQoL was stronger in girls than in boys and stronger in children with objective orthodontic treatment need than in those with none. Oral health-related quality of life is poorer in children with subjective orthodontic treatment need. This has not been investigated before in such a large-population-based study and clearly offers an explanation for the lack of concurrence between objective and subjective orthodontic treatment need.

Objectification of Orthodontic Treatment Needs: Does the Classification of Malocclusions or a History of Orthodontic Treatment Matter?

Orthodontic classifications make it possible to give an accurate diagnosis but do not indicate an objective orthodontic treatment need. In order to evaluate the need for treatment, it is necessary to use such indicators as the IOTN. The aim of the study was to find (i) relationships between individual diagnosis and objective recommendations for treatment and (ii) an answer to the question whether and which occlusal anomalies play an important role in the objectification of treatment needs. Two hundred three 18-year-old adolescents (104 girls, 99 boys) were examined. In order to recognize occlusal anomalies, the classifications proposed by Orlik-Grzybowska and Ackerman-Proffit were used. The occlusal anomalies were divided into three categories: belonging to both classifications, typical of OrlikGrzybowska classification and typical of Ackerman-Proffit classification. In order to determine the objective need for orthodontic treatment, the Dental Health Component (DHC) of the IOTN was used. The occurrence of the following malocclusions covered by both classifications, namely abnormal overjet, crossbite and Angle's class, had a statistically significant (p < 0.05) impact on an increase of treatment needs in the subjects (DHC > 3). As for the classification by Orlik-Grzybowska, dental malpositions and canine class significantly affected the need for orthodontic treatment, while in the case of the Ackerman-Proffit scheme, it was asymmetry and crowding. There was no statistically significant correlation between past orthodontic treatment and current orthodontic treatment need. IOTN may be affected by a greater number of occlusal anomalies than it was assumed. Orthodontic treatment received in the past slightly reduces the need for treatment in 18-year-olds.

Prevalence of malocclusions, oral habits and orthodontic treatment need in a 7- to 15-year-old schoolchildren population in Tirana

BackgroundThe aim of present study was to determine the prevalence of malocclusions, oral habits and the need for orthodontic treatment in a sample of 7- to 15-year-old Albanese schoolchildren.MethodsThe final sample comprised 2,617 subjects (1,257 males and 1,360 females), all orthodontically untreated. Occlusal relationship and the functional analysis were recorded for all subjects. The prevalence rates for the dental health component of the index of orthodontic treatment need (IOTN) were calculated. Comparisons between genders were performed for the prevalence of malocclusions, oral habits and IOTN grades (chi-square tests).ResultsClass I, class II and class III malocclusions and asymmetries were observed in 40.4%, 29.2%, 3.2% and 27.1% of the sample, respectively. There were 2,108 subjects (80.6%) that showed oral habits, with females (82.1%) presenting with a greater prevalence rate than males (78.9%). The objective need for orthodontic treatment (grades 4 and 5 of IOTN) was registered in 1,077 subjects (41.2%). This prevalence rate is higher than those reported for other European countries. No significant differences between genders were found for the IOTN grades.ConclusionsThe findings of the present study revealed the need to improve public health plans for orthodontic prevention and screening and to organise the resources in this area in Albania.

Orthodontic treatment need in French schoolchildren: an epidemiological study using the Index of Orthodontic Treatment Need

This survey was undertaken to assess the orthodontic treatment need in a sample of 9- to 12-year-old French children (mean age: 9.77 years; standard deviation: 0.84) attending 12 different schools in the same geographic area of Ile de France. Two examiners used the Index of Orthodontic Treatment Need (IOTN) in order to estimate treatment need. Five hundred and eleven children (268 males, 243 females) who had not previously received orthodontic treatment were examined. Two examiners, who had been previously trained in the use of occlusal indices, screened all the schoolchildren. No radiographs, study casts, or previously written records of the children were used; the IOTN was calculated from direct examination. Qualitative data were analysed using the chi-square test to determine differences in treatment need between subgroups of subjects, and kappa("kappa") statistics to analyse the findings. A correlation coefficient was used to compare professional assessments. Twenty-one per cent of the children presented an objective need for orthodontic treatment, 28 per cent had crowding, 28 per cent an increased overjet, and 15 per cent an increased overbite. The dental health component (DHC) of the IOTN was found to be reliable and simple to use. The malocclusion status of French schoolchildren was lower than that recorded in epidemiological studies of European children.

A longitudinal study on subjective and objective orthodontic treatment need.

The purpose of the study was to analyse changes in professionally-defined need and self-perceived need between the ages of 12-20 years. In 1985, occlusion and perceived need for treatment were recorded in 306 12-year-olds (born 1973) living in five communes in Finnmark, the most northern part of Norway. In 1993-94, 271 of the individuals were traced through the Norwegian Central Person Register and invited in letters to attend a clinical examination and an interview. A total of 80 individuals responded, with a mean age of 20.7 years. Professionally-defined need was assessed according to the Need for Orthodontic Treatment Index (NOTI) which is used by the Norwegian Health Insurance System for reimbursement of treatment costs. Change in category of need between 12-20 years was used as a measurement of health gain. Perceived need was measured by the individuals' responses to a question about desire for treatment. Individuals who received treatment (n = 22) showed an improvement in occlusion (health gain) corresponding on average to one category of need. The occlusal status of the untreated individuals was unchanged. All the individuals that desired treatment at 12 years of age (n = 15) did not want treatment at 20, and they were satisfied with their dental arrangement. Most of these individuals had received treatment, but a few with minor malocclusions had at age 12 been informed about the small objective need and refrained from treatment. All the individuals that wanted treatment at 20 years of age, 29 per cent of the total sample, had not desired treatment at 12 years of age. The results underline the importance of information and education during orthodontic counselling of potential patients.

Subjective and objective orthodontic treatment need among orthodontically treated and untreated Finnish adolescents.

Abstract Subjective orthodontic treatment need was studied in a sample of 340 Finnish adolescents with and without previous orthodontic treatment. The subjects, who were attending two schools preparing students for college, first filled in a questionnaire. Of the 340 subjects, 24.4% of the treated and 24.0% of the untreated expressed subjective orthodontic treatment need (NS). For the clinical examination, 110 subjects were systematically sampled from four groups; subjects who had received orthodontic treatment in the past and a) felt, b) did not feel subjective orthodontic treatment need and subjects who had not received orthodontic treatment in the past and c) felt, d) did not feel subjective orthodontic treatment need. A total of 106 subjects were examined by an orthodontist. Objective treatment need was assessed by using the Treatment Priority Index. Of those clinically examined, 29.4% of the treated subjects were still found to be in objective need of orthodontic treatment; among the untreated subjects, the corresponding figure was 54.5% (P &lt; 0.05). The sensitivity of the orthodontist to detect treatment need felt by the adolescents was, among the treated, 40.0% and the specificity 75.0%. Among the untreated subjects the corresponding figures were 75.9% and 69.2%. Of those treated who had objective treatment need, 40.0% expressed the need themselves (NS). However, of the untreated who had objective treatment need, 73.3% expressed such a need (P &lt; 0.001). Subjects judged to have a very attractive denial appearance (IOTN, Aesthetic Component) were more often detected among those treated than among the untreated. As a clear discrepancy can be observed between objective and subjective treatment need estimates, in orthodontic counseling an understanding of how the patient perceives his/her dentition is essential.

Malocclusion and orthodontic treatment need of 15–74‐year‐old Dutch adults

In 1986 a nationwide dental survey was performed in the Netherlands. This article describes the prevalence of dentofacial anomalies in the age group 15-74 yr, as well as the subjective and objective need for orthodontic treatment. The main findings were: severe crowding in the mandible was found in approximately 15%; an Angle Class II situation was seen in 28%; a maxillary overjet of greater than 5 mm was found in 23%; orthodontic treatment had or was being performed in approximately 25%; 45% of orthodontic treatment was carried out by a general practitioner; using professionally defined need, 39% of the population required treatment whereas only 14% of the people felt that this treatment was necessary.