Preventive Orthodontics Research Articles

Assessing the effect of education on the level of awareness about preventive orthodontics among school hygiene instructors in Sari

Background: Proper education in oral and dental health behaviors and preventive orthodontics is vital for preventing dental diseases and orthodontic abnormalities. Since children spend much time in schools and in contact with their teachers, the current study aimed to assess the level of awareness about preventive orthodontics among school hygiene instructors in Sari, Iran. Methods: Seventy-one hygiene instructors were included in this semi-experimental study with a pre-test and post-test design. The participants completed a questionnaire before any intervention. A one-day workshop about preventive orthodontics was held for the instructors, and an educational CD and pamphlet were provided for them. The participants were asked to answer the same questions after a month. Data were compared and analyzed with SPSS 22, using paired t-test and chi-squared test. Results: The findings revealed that the training could significantly increase the level of orthodontic awareness among hygiene instructors (P<0.001). However, the participant’s level of education and years of experience was not significantly associated with their level of awareness (P>0.05). Conclusion: Considering the importance of health education, efficient training should be provided for school hygiene instructors to increase their awareness in the field of preventive orthodontics.

Anterior Open Bite Treatment in the Mixed Dentition: a Brief Review and Case Report

Anterior open bite (AOB) is a vertical plane malocclusion characterized by a negative vertical overbite and can be classified according to its nature: dentoalveolar or skeletal. The dentoalveolar anterior open bite (DAOB) occurs in individuals who have a good relationship between the bone bases and its etiology is associated with environmental factors. DAOBS´s treatment tends to have a favorable prognosis and it's up to the dentist to choose the most adequate method in each case. Thus, the objective of this study is to present a case report of DAOB. Female patient of 6 years old attended the Preventive Orthodontics Clinic of the Faculty of Dentistry of Araçatuba - UNESP, having as main complaint “open bite”. In the anamnesis the patient revealed that used a pacifier and presented a digital sucking habit. The patient was in the first transitional period of mixed dentition with permanent incisors and first molars partially erupted. The diagnosis was of Angle Class I malocclusion with dentoalveolar anterior open bite and dentoalveolar anterior crossbite of the deciduous right maxillary canine. The bi-helix with crib appliance was installed and the patient was oriented to perform myofunctional exercises daily. This therapeutic protocol represents an efficient and effective approach for the correction of DAOBs providing improved aesthetics, social well-being and a more appropriate and correct occlusion that allows oral functions (deglutition, speech and chewing) to work properly. The results acquired through this treatment are essentially of dentoalveolar nature.

Knowledge Enhancement about Preventive Orthodontic Treatment for Malocclusion and Stunting in Elementary School Children after Community Empowerment

Background: Nutritional insufficiency and stunting during infant growth and development also causes a delay in the ossification centers and may lead to poor skeletal and dental forms resulted in malocclusion. Early interceptive orthodontics can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, the overall treatment time, and the cost. Proper oral and dental health knowledge and a favorable attitude toward oral and dental health are critical in preventing numerous dental issues such as malocclusion. Purpose: the aim of this community empowerment is to enhance the knowledge of preventive orthodontic treatment for malocclusion and stunting in elementary school children. Methods: The data was collected at Miftahul Ulum Melirang's Madrasah Ibtidaiyah, or elementary school, in Melirang Village, Bungah District, Gresik, East Java. For the community empowerment program assessment, participants were requested to fill out a Google form for the pre- and post-test to identify the enhancement of knowledge about or preventative orthodontic treatment for malocclusion and stunting in primary school children. Results: The majority of the community empowerment participants understood the presentation on oral and dental health empowerment. The post-test percentage was greater (91.5%) than the pre-test rate (53.75%). Conclusion: The dental and oral health empowerment program about preventive orthodontics, malocclusion, and stunting was effectively completed, enhancing the knowledge level of elementary school children.

Comparative evaluation of dermatoglyphic patterns between skeletal class I and skeletal class III malocclusion.

Background: Dermatoglyphics is the study of various dermal configurations on the fingers, palms, and soles. These appear during the 12th week of intrauterine life and develop completely by the 24th week. It is said that they remain constant thereafter. The aim of the present study was to compare and assess the association of dermatoglyphic patterns between skeletal class I and skeletal class III malocclusion. Methods: Finger and palm prints were collected using the ink and roller method from 604 subjects who were divided into skeletal class I, class III with maxillary retrognathism and class III with mandibular prognathism based on lateral cephalogram assessment. Results: Loop pattern was more predominant in skeletal class I malocclusion subjects and whorl pattern was more frequent in the other two groups. Total finger ridge count and atd angle also showed significant difference between the study groups. Conclusions: The present study attempted in assessing the association between dermatoglyphic patterns and skeletal malocclusion. Analysing dermal configurations may aid in indicating the type of developing malocclusion and thus help in interceptive and preventive orthodontics.

Effect of COVID-19 pandemic on children’s oral health services: A cross-sectional study

Objective: Restrictions of face-to-face visits to children due to the prevalence of COVID-19 infection have had adverse effects on oral health-related complications. This study aimed to evaluate the effect of the COVID-19 pandemic on the accessibility of children to oral health services. Methods: In this descriptive-analytical study, a specific questionnaire was prepared to evaluate the views of pediatric dentists about the impact of COVID-19 on providing oral health services. The questionnaire was dispersed to a target population of 136 pediatric dentists. To evaluate the content validity of the questionnaire, content and face validity methods were used, and Cronbach's alpha coefficient was calculated using IBM SPSS statistical software, version 15 Results: The final questionnaire was prepared with 23 questions and a Cronbach's alpha of 0.92. Most participants stated that the number of children referred for routine checkups, child cooperation on dental units, no referrals due to economic problems, diagnosis of bruxism and clenching, fissure sealant, dental restorations, fluoride therapy, and preventive orthodontics had a statistically significant decrease during the COVID-19 era. Moreover, using mouthwash, toothbrush and floss, long chair side treatments, treatment of children under anesthesia, pulpotomy and pulpectomy, and chronic gingival infection did not change significantly during the COVID-19 pandemic. During the COVID-19 period, there was a statistically significant rise in plaque buildup, tooth extraction, toothache, using snacks, and acute gingival infection. Conclusions: Referrals for non-emergency and preventative treatment procedures have decreased during the COVID-19 pandemic, but referrals for emergency measures have increased.

Simplify your practice with 3D printed space maintainer

Preventive orthodontics is an aspect of pediatric dentistry, which requires exclusive set of skills and understanding to aid the patient’s treatment and properly align teeth. The safest way to prevent future malocclusions from tooth loss is to place a space maintainer (SM), which is advocated to embrace the space until the eruption of succedaneous permanent teeth. SM manufacturing is a painstaking process that requires plentiful communication with the laboratory to suitably complete and provide the patient with optimal results. Band and loop SM is mostly indicated for the premature loss of single primary molar, but this appliance has a number of limitations. Digital technology has resulted in decreasing human errors by automating the dental model fabricating process with three‑dimensional printing. The current paper provides an insight of the use of this new technology in pediatric dentistry for manufacturing of new type of SMs and a case report

Comparative evaluation of dermatoglyphic patterns between skeletal class I and skeletal class III malocclusion

Background: Dermatoglyphics is the study of various dermal configurations on the fingers, palms, and soles. These appear during the 12th week of intrauterine life and develop completely by the 24th week. It is said that they remain constant thereafter. The aim of the present study was to compare and assess the association of dermatoglyphic patterns between skeletal class I and skeletal class III malocclusion. Methods: Finger and palm prints were collected using the ink and roller method from 604 subjects who were divided into skeletal class I, class III with maxillary retrognathism and class III with mandibular prognathism based on lateral cephalogram assessment. Results: Loop pattern was more predominant in skeletal class I malocclusion subjects and whorl pattern was more frequent in the other two groups. Total finger ridge count and atd angle also showed significant difference between the study groups. Conclusions: The present study attempted in assessing the association between dermatoglyphic patterns and skeletal malocclusion. Analysing dermal configurations may aid in indicating the type of developing malocclusion and thus help in interceptive and preventive orthodontics.

Preventive and Interceptive Orthodontics Treatment

Preventive orthodontics is that part of orthodontic practice which is concerned with patients and parents education, supervision of the growth and development of the dentition and cranio-facial structures. The diagnostic procedures undertaken to predict the appearance of malocclusion and the treatment procedures instituted to prevent the onset of malocclusion. Interceptive orthodontics has been defined as that phase of science that can recognize and eliminate potential irregularities and malpositions of the developing dento-facial complex. Many of procedures are common in preventive and interceptive orthodontics, but the timings are different. Preventive procedures are undertaken in anticipation of development of a problem, whereas interceptive procedures are taken when the problem has already manifested. Orthodontic problems in children can be divided conveniently into non skeletal and skeletal problems, which are treated by tooth movement and by growth modification. Such treatment may take place in deciduous or transitional dentition and may include redirection of ectopically erupting teeth, slicing or extraction of deciduous teeth, correction of isolated dental crossbites of recovery of minor space loss.

23 - Mechanical Strength Evaluation of a Printed Dental Space Maintainer

Due to the latest progress of 3D scanning and printing technology in the medical field, attempts have been made to apply this technology also in preventive orthodontics in order to obtain an aesthetic dental space maintainer. The aim of this study is to observe the mechanical load distribution on a SLA band and loop space maintainer in order to develop a high-precision aesthetic dental space maintainer using computer-aided design (CAD) / computer-aided manufacturing (CAM) and 3D printing by resin-based additive technique. On account of increasing aesthetic requirements, an initiative was made to replace the classic band and loop space maintainer with a metal-free appliance, using an innovative technique for creating the esthetic design of the space maintainer. Four band and loop space maintainers were achieved through stereolithography (SLA). After scanning the dental cast, a 3D software Exocad was used to establish the design of the dental space maintainer. They were manufactured using two different 3D printers, two with Formlabs form2 using C&B Micro Filld Hybrid (MFH) resin and two with Creality using NextDent SG resin. After printing, all samples were placed in an isopropyl alcohol bath to clean them of residues and resin excess, then placed in the UV oven for drying. Shortly afterwards processing they were subjected to the mechanical strength test by compression using the Zwick/ Roell Z005 device. For the fulfillment of the mechanical resistance tests, the dental cast made by the classic plaster technique was used as support. Following mechanical tests, it was observed that these devices yielded to the action of a vertical force between 16-31 N. There were no significant differences between the two materials, but the highest resistance was observed in the C&B Micro resin Filld Hybrid (MFH) using Formlabs form2 printer which is consistent with the minimum masticatory forces developed in mixed dentition 26.21-41.5 N for males and 8.05-12.61 for females. Given the importance of dental aesthetics nowadays, 3D printing offers the possibility to manufacture an aesthetic dental space maintainer device with a better adaptation to the clinical situation. The mechanical properties being closely related to the object design, it is important to ensure a sufficient thickness of the device to prevent fractures under the masticatory forces.

Analysis of the prevalence of the open bite in the medical records of preventive orthodontics at the Faculdade de Ilhéus

Objective: To verify the prevalence of open bite in the medical records of preventive orthodontics at the Faculdade de Ilhéus, associating it with the individual's psychological behavior and functional analysis. Material and methods: A cross-sectional study was carried out with 145 medical records of preventive orthodontics of the Faculdade de Ilhéus in the years 2018 and 2019. Result: The prevalence of open bite identified in the medical records of preventive orthodontics of the Faculdade de Ilhéus was 15.8%. The female gender was the majority with 55%, with 61% of cases of malocclusion. Regarding the dentition that the patient was in, 73.91% were in mixed dentition, 21.74% in primary dentition and only 4.35% in permanent dentition. In the functional analysis observed in the dental document, 40.54% were oral-nasal breathers, followed by 35.14% with interposed tongue and abnormal speech was 24.22%. Patients who had an open bite in the psychological behavior item 68.75% used pacifiers and 31.25% had the habit of digital sucking. Conclusion: The data collected in this study reinforce the significant prevalence of open bite and the close association with harmful habits and the individual's respiratory, swallowing and phonation physiology. Explanatory measures are necessary for those responsible for the prevention of harmful habits that can cause open bite in children, if the open bite is already present, it should be interfered as soon as possible, as this way the less invasive treatment can be adopted by the orthodontist, enabling a satisfactory regression to the patient.

Anterior crossbite treatment in the transitional period of mixed dentition: a case report

Anterior crossbite refers to the abnormal vestibulolingual relationship in the sagittal dimension between one or more anterior superior and inferior anterior teeth. It can be classified as dental, functional or skeletal. Each has its own diagnostic criteria and specific treatment, and it is up to the dentist to know how to distinguish between these different natures of malocclusion. In this sense, the aim of this study is to show a case report about an ACM. Patient HCA, female, 7 years old, attending the Preventive Orthodontics Clinic of the Faculty of Dentistry of Araçatuba - UNESP, having as main complaint “untidy front tooth”. The patient has no history of systemic diseases or medication use. The patient was in the first transitional period of mixed dentition with her right maxillary central incisor in crossbite relationship with its antagonists mandibular central incisor. On both sides, the patient had the first permanent molars in Class I relationship, the deciduous second molars with mesial step and the deciduous canines in a Class I. Initially, an acrylic appliance with an expander was installed. Due to lack of cooperation, the treatment plan was changed and the patient received a fixed appliance with a 2x2 configuration, with brackets on maxillary central incisors and edgewise tubes on maxillary deciduous molars. In the lower arch, a bite lift was performed on the occlusal surface of mandibular deciduous molars to unblock the occlusion and facilitate the movement of right maxillary central incisor. The total treatment time was 60 days.

Lithuanian dental practitioners’ with less than five years of work experience knowledge about premature loss of deciduous teeth and space maintenance

Gabrielė Jurgelytė1, Austėja Mitalauskienė1, Arūnas Vasiliauskas2 1Lithuanian University of Health Sciences, Medical Academy, Faculty of Odontology 2Lithuanian University of Health Sciences, Medical Academy, faculty of Odontology, Clinic of Orthodontics Abstract Introduction. Premature loss of deciduous teeth is a common complication of dental caries, which can lead to space loss, crowding of teeth. The problem can be prevented by the use of space maintainers. Therefore, dentists must be aware of space maintenance methods. Aim. To analyze Lithuanian dentists’ with less than 5 years of work experience knowledge about premature deciduous teeth loss and space maintenance. Material and methods. An anonymous online survey of 36 closed questions was prepared. The survey was posted on Facebook.com group of Lithuanian dentists. Statistical data analysis was performed using “IBM SPSS” program, version 24.0. In analytical statistics, two-dimensional data analysis of the Chi-square (x2) criterion was applied to compare the distribution of phenomena between groups, when its assumptions are not met, Fisher’s exact criterion (F) was applied. The value of p < 0.05 was considered statistically significant. Results. 166 Lithuanian dentists participated in the study. A correlation between their amount of knowledge about premature deciduous teeth loss and space maintenance, and the frequency of practical work with children was found. Dentists working with children daily, answered correctly to survey’s questions more often compared to those working with children only a few times per year (p<0.05). 50% of dentists estimated their knowledge to be “satisfactorily”, while 38.6% of the participants evaluated their knowledge as “good”. Few participants (6.6%) evaluated their knowledge as “very good”. The rest of the participants (4.8%) evaluated their knowledge as “poor”. Conclusions. Dental practitioners working with children daily have better knowledge about primary teeth loss and space maintenance than those working with children a few times per year. Most of the dentists have satisfactorily knowledge about deciduous teeth loss and space maintenance methods. Therefore, it is essential to renew and expand their awareness. Keywords: preventive orthodontics, dentists, premature teeth loss, space maintainers. https://doi.org/10.53453/ms.2021.06.21

Conhecimentos e atitudes dos cirurgiões-dentistas da atenção básica sobre ortodontia preventiva e interceptora

Individual and population approaches seeking an early interception of malocclusion are skills for dentists, recommended by the Ministry of Health in Primary Care Notebook n.17. This research aimed to analyze primary health dentists´ perception on their knowledge and attitudes towards Preventive and Interceptive Orthodontics, and associated factors. Participants of this descriptive study were dentists who worked in primary health care in the city of Goiania, Goias State. Data was obtained using a self-administered questionnaire. We performed frequency analysis for categorical variables and calculated central tendency and dispersion measures for continuous variables, for characterizing the occupational and socio-demographic profile as well as describing variables related to participants´ knowledge and attitudes. To assess the relationship between variables, we used Chi-square tests, Student´s t tests and variance analysis (ANOVA), considering a 5% significance level (?). Response rate was of 78.8%. Most dentists had satisfactory knowledge and favorable attitudes towards Preventive and Interceptive Orthodontics. Nevertheless, few participants were confident about performing the main approaches related to the early interception of malocclusion, such as early diagnosis and recommending an ideal age for occlusal problems´ treatment. Attitude may be influenced by knowledge and despite dentists´ interest about the theme and awareness of the relevance of Preventive and Interceptive Orthodontics to primary care, our findings highlight the need for professional training, through continuing education and investments in resources´ availability, as well as introducing Preventive and Interceptive Orthodontics diagnosis into the dental record. Key words: Malocclusion. Preventive Orthodontics. Primary Health Care.

Comparison of orthodontic treatment need among professionals and parents in Dammam, Saudi Arabia.

This study aimed to assess parents' awareness and attitude regarding their children's malocclusion compared with professional assessments and to measure the prevalence of malocclusion among children in Dammam, Saudi Arabia. The study population consisted of 377 randomly selected children (aged 8-12 years) from five schools in Dammam, Saudi Arabia. A questionnaire was used to assess parents' awareness using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and knowledge about preventive orthodontics. A clinical examination was performed by two calibrated examiners to measure the prevalence of malocclusion using both the AC and dental health component (DHC) of IOTN. The most common Angle's molar relationship was Class I (78.2%), followed by Class II (17.5%) and Class III (4.2%). The DHC (score 3-5), which indicated the need for orthodontic treatment, was 55.4%. There was a significant difference (P < 0.05) between AC from examiners and parents, whereby the parents tended to underestimate their children's malocclusion by a factor of 1.45. Surprisingly, many parents (67.4%) lacked knowledge about preventive orthodontics. Class I malocclusion was most prevalent among children in the area of Dammam. A moderate percentage (55.4%) of the study subjects required treatment based on the DHC. Based on the lack of knowledge about preventive orthodontics in the majority of parents in our study, it is recommended that oral health-promoting programs be implemented to improve the awareness of malocclusion in the region.

Prevalence of Space Maintainers as A Treatment Modality in Maxillary Arch among Children between the Age Group of 6 to 12 Years- A Retrospective Study

Early loss of primary teeth can affect the arch length and thereby lead to malocclusion. Space maintainerswere introduced to effectively maintain the space after a premature tooth loss. This study aims to assess theprevalence of various space maintainers provided in the maxillary arch among children aged 6 to 12 yearsand describes the trends in the use of space maintainers to bring about better understanding about theseappliances. The patient records from June 2019-April 2020 of children who underwent space maintainertherapy in maxillary arch were selected by non- probability sampling. Data was collected and exported tothe Statistical package for social science for windows (SPSS version 20.0,IL,Chicago,USA) for analysis.The results of the study showed that among the space maintainers provided, Band and loops (51.6%) werecommonly used followed by Groper’s appliance (27.4%). The rarely provided space maintainers wereTranspalatal arch (1.6%). The use of space maintainers in the maxillary arch had a male predominance(62.9%). The age of the children for whom space maintainers were commonly provided were 8 year olds(53.2%). Age and type of the space maintainer given was found to have no strong association (p=0.264,p&gt;0.005).The study draws attention to the fact that space maintainers are widely used in Paediatric dentistry asa part of preventive orthodontics. In this study, Band and loop space maintainers were prevalent. Maledominance was observed and use of space maintainers especially in the age of 8 years was common. Therewas no association between age and the type of space maintainers used. Extensive research based on spacemaintainers and the dentist’s preferences and skill regarding the same has to be done. Alternatives for thecurrent space maintainers have to be found to overcome their drawbacks .

An Introduction to Preventive Orthodontics

The prevention of the malcoolusion and the control of dental spaces are problem are in the scope of preventive Orthodontics. The supervision of caries control, teeth eruption sequence and the treatment of the local factors which may influence the eruption of the permanent tooth are done during this period. With the recent improvement in diagnostic tools, novel potential therapeutic devices and techniques it is now easier for the orthodontist to adopt several techniques in the clinic to prevent the occurrence of malocclusion. However, the most significant barrier to providing the preventive orthodontic care by the practitioners may be related to the lack of self-confidence relating to the effectiveness of their chosen treatment plan. When preventive dentistry is practiced properly it helps in the proper development of functional occlusion and reduces the chance of the development of malocclusion. This article will focus on various aspects of preventive orthodontics.

Gender Wise Association between Dental Malocclusion Classes and ABO Blood Group System

Background: Malocclusion shares the third highest prevalence among oral pathologies, second to tooth decay and periodontal diseases. Objectives: In general, many studies have been conducted to find out the association between blood groups and oral and dental pathologies, for instance, some have succeeded; others have not due to the geographic diversity. So the study aimed to explore the relationship of ABO blood groups with classes of malocclusion and relative prevalence of these characters in males and females of a defined population. Method: The current study was performed on 500 individuals with an age range of 15 to 45 years, along with permanent dentition only, reporting to the department of orthodontics of Punjab dental hospital, Lahore. Complete details about the classes of malocclusion and blood group of the subjects were noted in accordance with the ABO blood group system. The sample was divided into three groups, i.e., Class I, Class II, and Class III. Data were analyzed statistically by using SPSS 21.0. Pearson Chi-square was used as statistical analysis to get the association of classes of malocclusion with blood group type. Result: A significant difference between the prevalence of classes of dental malocclusion in relation to blood group types was found among both genders. Conclusion: In conclusion, there was gender wise association difference between the classes of dental malocclusion and blood group types. The study also covered the gender wise prevalence of dental malocclusion in all the four blood groups which are A, B, AB and O. The new findings will be helpful for clinicians with regards to preventive orthodontics. The research findings are a good and informative addition to the present literature as well as provides a ground for further research studies in the same area.

The prehistory of orthodontics

Orthodontics came into being in 1728. Previously, practitioners were at a loss when confronted with crooked teeth. A Latin philosopher had an ingenious flash of orthodontic inspiration. Other authors were content to either extract the malposed teeth or to modify their shape. However, interest in an approach to preventive orthodontics had now begun.

Prevention and Intervention in Mixed Dentition Period: A Short Review

Preventive and/or interceptive orthodontics in the mixed dentition implies several different possibilities like the guiding of erupting permanent teeth into an ideal position; using simplified procedures that produce a savings of time and effort; obtaining a more stable early result with less retention problems; avoidance of extraction of permanent teeth by utilizing the additional deciduous posterior tooth mass, distalization and/or expansion of posterior segments. Guidance of the eruption and development of the primary and permanent dentitions is an integral part of the care of pediatric patients. Such guidance should contribute to the development of a permanent dentition that is in a harmonious, functional and esthetically acceptable occlusion. This article aims to provide a simple guide to the correct diagnosis of anomalies and to choosing the most suitable treatment for each case.

Relation between Angle Class II malocclusion and deleterious oral habits

INTRODUCTION: Oral habits may interfere on the growth and development of the stomatognathic system and orofacial myofunctional conditions, producing changes in the position of teeth in their dental arches. OBJECTIVE: The purpose of this study was to verify the presence of deleterious oral habits in individuals with malocclusion and see if there is a predominance of Class II malocclusion in these individuals. METHODS: The records of 140 patients treated at the Clinic of Preventive Orthodontics FORP-USP who had already completed treatment were randomly selected and analyzed. Their ages ranged from 6 to 10 years and 11 months. Associations were made between the presence or absence of deleterious oral habits, type and number of habits found in each individual and the type of malocclusion according to Angle classification. The statistical analysis used was the Chi-square test with a significance level of 5%. History of deleterious oral habits was found in 67.1% of individuals. RESULTS: The Class I malocclusion was most frequent (82.9%), followed by Class II malocclusion (12.1%) and Class III (5%). CONCLUSION: There was a predominance of Class II malocclusion in individuals with a history of deleterious oral habits.