Professional Documents
Culture Documents
MALOCCLUSION AND
ANALYZATION OF
ASSOCIATED RISK FACTORS
UNDER SUPERVISION OF DR.FURQAN AHMED
MEMBERS:
KHALIDA FASEEH
MARRIAM KHAN
ZUMER NAYYER
AMAL SAJID
AYESHA ASIF
YUSRA MASOOD
KARACHI MEDICAL AND DENTAL COLLEGE
INTRODUCTION:
Symptoms
Abnormal alignment of teeth
Abnormal appearance of the face
Difficulty or discomfort when biting or chewing
Speech difficulties (rare) including lisp
Mouth breathing (breathing through the mouth without closing the lips)
Signs and tests
Most problems with teeth alignment are discovered by a dentist during a
routine exam. The dentist may pull your cheek outward and ask you to bite
down to check how well your back teeth come together. If there is any
problem, the dentist will usually refer you to an orthodontist for diagnosis
and treatment.
Dental x-rays
head or skull x-rays.5.
Methods of recording and measuring malocclusion can be broadly divided
into two types i.e. qualitative and quantitative.6.while the severity or the
extent to which a malocclusion deviates from the normal or ideal occlusion
can be quantified by using an occlusal index.7. Among the qualitative
methods of recording malocclusion Angles method of classifying
malocclusion with or without modifications is probably the most widely
used.6.
Cephalometric indicators are used to analyze the maxillary and mandibular skeletal
positions. Both angular and linear measurements have been proposed in the
assessment of anteroposterior jaw-base relationships.8.Angles classification of
malocclusions is universally accepted because of its simplicity as a method of
description and communication between dental professionals. Based on the
relationship of the
mandibular first molars to the maxillary first molars, this system characterizes the
Class II malocclusions as having a distal relationship of the mandibular teeth relative
to the maxillaury teeth of more than one-half the width of the cusp. Two distinct types
of Class II malocclusion
exist, differing in the inclination of the maxillary central incisors. Class II Division 1
malocclusions exhibit labially inclined maxillary incisors, an increased overjet with a
vertical incisor overlap varying from a deep overbite to an openbite and the Class II
Division 2 malocclusion showing excessive lingual inclination of the maxillary central
incisors accompanied by a deep overbite and minimal overjet. An Angles Class III
malocclusion means that the mandibular first molar is anteriorly placed in relation to
the maxillary first molar. It is a symptomatic or phenotypic description that uses the
first molars and canines as criteria, and it has nothing to do with the maxillary and
mandibular skeletal bases.Class II molar relationship may occur
unilaterally, depicted or classified as a class II subdivision of the affected side[9] or
a bilaterally Class II on both the sides which is a frequently occurring type of
malocclusion out of these two.[10] Dental malocclusion is present in all societies but
its prevalence varies. There have been several studies investigating the prevalence
of various dentofacial characteristics11-15 but only a few have been conducted on an
orthodontic
population.16,17There is a high incidence of Class I malocclusion in White Americans
(Class I 52.5%, Class II 42.4% & Class III < 5%). Class I malocclusion is also more
prevalent in Black Americans (Class I 71%, Class II 16% & Class III 8.4%).
There are a number of publications that prove the influence of genes on the
development of dentofacial system.18. The environmental factors include
forces and pressures from soft tissues and muscles surrounding the dental
arches, various habits (thumb sucking, nailbiting,etc.), and the effect of
orthodontic appliances.19,20,21. The dentofacial system is also influenced by
the forces resulting from mastication.21,22. Therefore, although the majority of
the etiological factors are clear,malocclusion are one of the most urgent
stomatological problems. Individuals with Down syndrome (DS) and
cerebral palsy (CP) are particularly prone to orofacial disorders.23.
Children with DS and CP have the habit of projecting the tongue against the
teeth and out of the mouth and suffer frequent episodes of upper airway
infection, which leads to a greater prevalence of mouth breathing and
malocclusion.24.
Children with the habit of maintaining their mouth open exhibit abnormal
oromuscular movements and respiration, which compromises the
coordination and articulation of the lips and cheeks during speech and
swallowing.25
Oral habits and pressure on teeth or
the maxilla and mandible are etiological factors in malocclusion.[26,27]
In the
active skeletal growth,[28] mouthbreathing, finger sucking, thumb sucki
ng, pacifier sucking, onychophagia (nail biting), dermatophagia, pen
biting, pencil biting, abnormalposture, deglutition disorders and other
habits greatly influence the development of the face and dental
arches.[29][30][31][32][33]
Prolonged use of a bottle
Extra teeth, lost teeth, impacted teeth, or abnormally shaped teeth
Ill-fitting dental fillings, crowns, appliances, retainers, or braces
Misalignment of jaw fractures after a severe injury
Tumors of the mouth and jaw
Sociodemographic facrtors
Dental caries
Periapical inflammation.
]
METHODOLOGY:
This cross-sectional study included patients who visited the Dental OPD, at
Karachi Medical And Dental College,Karachi, from June 2002 to April 2004.
Information regarding age and sex was obtained from the patients record
files. Both males and females were included in this study.
The inclusion criteria for the sample includes those with:
1.Presence with first permanent first molars.
2.Pre-treatment.
3.Orthodontic patients and patients seeking periodontal and operative
treatment.
The exclusion criteria includes patients with:
1.Significant past medical history.
2.Previous orthodontic treatment.
3.Previous prosthodontic treatment.
4.History of maxillofacial and plastic surgery.
5.Mixed dentition.
6.Congenital malformation.
INCISORS CLASSIFICATION:
SOURCES:
10. Filho OGD, Ferrari Jr FM, Ozawa TO. Dental Arch Dimensions in Class
II division 1 Malocclusions with Mandibular Deficiency. Angle Orthod 2008;
78: 466-74.
11. Brunelle JA, Bhat M, Lipton JA. Prevalence and distribution of selected
occlusal characteristics in the U.S. population, 198891.J Dent Res
1996;75:70613.1
12. Foster TD, Day AJ. A survey of malocclusion and the need for
orthodontic treatment in a Shropshire school population. Br J Orthod
1973;1:738.
13. Ingervall B. Prevalence of dental and occlusal anomalies in Swedish
conscripts. Acta Odontol Scand 1974;32:8392.
14.Johnson JS, Soetamat A, Winoto NA. A comparison of some features of
the Indonesian occlusion with those of two other ethnic groups. Br J Orthod
1978;5:1838.
15. Proffit WR, Fields HW, Moray LJ. Prevalence of malocclusion and
Orthodontic treatment need in the United States: estimates from the
NHANES III survey. Int J Adult Orthodon Orthognath Surg 1998;13:97106.
16. Jones BW. Malocclusion and facial types in a group of Saudi Arabian patients
referred for orthodontic treatment: a preliminary study. Br J Orthod 1987;14:1436.
17. Yang WS. The study on the orthodontic patients who visited department of
orthodontics, Seoul, National University Hospital.Taehan Chikkwa Uisa Hyophoe Chi
1990;28:81121.
18. Proffit W. Contemporary Orthodontics. 3nd ed. St Louis: Year Book Medica Pub;
2000.
19. Alvesalo L. Sex chromosomes and human growth. A dental approach. Hum.
Genet. 1997; 101 (1): 1-5.
20. Takahashi S, Ono T, Ishiwata Y, Kuroda T. Effect of changes in the breathing
mode and body position on tongue pressure with respitaroty-related oscillations. Am J
Orthod Dentofacial Orthop.1999; 115 (3): 239-46.
21. Ther U, Sieber R, Ingervall B. Cheek and tongue pressures in the
molars areas and the atmospheric pressure in the palatal vault in young adults. Eur J
Orthod. 1999; 21: 299-309.
22. Proffit WR. Equilibrium Therory Revisited: factors influencing position of the teeth.
Angle Orthod. 1978; 48 (3): 175-86.
23. Weinstein S. On an equilibrium theory of tooth position. Angle Orthod.- 1963; 33:
1-26.
24.Klein ET., E (1952). "Pressure Habits, Etiological Factors in Malocclusion". Am.
Jour. Orthod. 38 (8): 569587
25. Graber TM., T (1963). "The "Three m's": Muscles, Malformation and
Malocclusion".Am. Jour. Orthod. 49 (6): 418450.
26. Bjrk A., Helm S., A; Helm, S (1967). "Prediction of the Age of Maximum
Puberal Growth in Body Height". Angle Orthod. 37 (2): 134
143. doi:10.1043/00033219(1967)037<0134:POTAOM>2.0.CO;2. PMID 4290545.[dead link]
27. Brucker M., M. (1943). "Studies on the Incidence and Cause of Dental
Defects in Children: IV. Malocclusion". J Dent Res 22 (4): 315321.
28. Calisti L. J. P., Cohen M. M., Fales M. H., L. J.; Cohen, M. M; Fales, M.
H (1960)."Correlation between Malocclusion, Oral Habits, and Socioeconomic Level of Preschool Children". J. Dent Res 39 (3): 450454.
29. Subtelny J. D., Subtelny J. D. (1973). "Oral Habits - Studies in Form,
Function, and Therapy". Angle Orthod. 43 (4): 347383
30. Aznar T., Galn A. F., Marn I., Domnguez A., T; Galn, AF; Marn, I;
Domnguez, A (2006). "Dental Arch Diameters and Relationships to Oral
Habits". Angle Orthod. 76(3): 441445.
31. Yamaguchi H., Sueishi K., H; Sueishi, K (2003). "Malocclusion
associated with abnormal posture". Bull Tokyo Dent Coll. 44 (2): 43
54.doi:10.2209/tdcpublication.44.43
32. Wellington M.; Hall C. B. (2002). "Pacifier as a risk factor for acute otitis
media".Pediatrics. 109 (2): 351352.
33. Rovers MM; Numans ME; Langenbach E; Grobbee DE; Verheij TJ;
Schilder AG (2008)."Is pacifier use a risk factor for acute otitis media? A
dynamic cohort study". Fam Pract. 25 (4): 2336.