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Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of Saudi Arabia

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The purpose of this study was to assess the status of occlusion among school children in Makkah governorate of Saudi Arabia. Materials and Methods: The sampling included 289 adolescents with age range 14-17 years. The sample was randomly selected from schools in Makkah governorate to determine the status of their occlusion. Design: Randomized cross-sectional study. The examiner assessed different type of malocclusion, crowding, diastema, cross-bite, overjet and overbite. These occlusal parameters were examined by one examiner using a mouth mirror, small light source and metallic ruler. Conclusion: This study revealed predominance of Class I molar among Saudi School children in Makkah city. Normal overjet and overbite were frequent findings. The most prevalent malocclusion trait was crowding.
Mohammed Almalky N, Mohammad Elattar H. Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of Saudi Arabia. Int J Dentistr y Oral Sci.
2018;5(6):645-648. 645
OPEN ACCESS http://scidoc.org/IJDOS.php
Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of
Saudi Arabia
Research Article
Mohammed Almalky N1*, Mohammad Elattar H2
1 Internship Student in UQUDENT, Umm Al-Qura University, Saudi Arabia.
2 Assistant Professor of Orthodontics, Umm Al-Qura University, Saudi Arabia.
International Journal of Dentistry and Oral Science (IJDOS)
ISSN: 2377-8075
Introduction
Malocclusion is considered one of the most common dental
problems together with dental caries, gingival disease and den-
tal uorosis [12]. Malocclusion may cause unpleasant appearance,
impaired oral function, speech problems, temporomandibular dis-
orders, increased susceptibility to trauma and periodontal disease
[30]. Identifying occlusal status in particular population provides
important information on treatment needs and enables the gov-
ernment to draw the appropriate preventive and treatment pro-
grams [7].
Planning orthodontic treatment service requires baseline data on
the prevalence of different types of malocclusion.
Several studies that investigated the prevalence of malocclusion
in different population groups have been reported, for instance:-
(Foster and Menezes, 1976) [16].
(Massler and Fränkel 1951) [29], (Altemus, 1959) [6] (Al-Emran et
al., 1990) [4] (Kerosuo et al., 1991) [25] (Hill 1992) [23] (Lew et al.,
1993) [27] (Otuyemi and Abidoye, 1993) [35].
(Ng’ang’a et al., 1996) [32] (Harisson, R. L. and Davis, D. W. 1996)
[17] (Johannsdottir et al., 1997) [24] (Thilander et al., 2001) [38].
The results of these studies revealed wide variations between
those populations. The variations could be due to the differences
in sample size, ethnicity, subjects age, and registration methods
[2].
A previous study was done to investigate the prevalence of mal-
occlusion in Riyadh region, Saudi Arabia, it concluded that ''the
Occlusal Status among 12-16 Year-Old School Children in Ri-
yadh, Saudi Arabia revealed predominance of Class I molar and
canine. Normal overjet and overbite were frequent ndings. The
most prevalent malocclusion trait was crowding followed by spac-
ing [7]. But due to different of ethnic origin of the people in Ri-
yadh region and the Makkah governorate of Saudi Arabia we will
apply the same study on population from Makkah governorate.
Aim of the Study
The aim of this study was to provide a description of the occlusal
*Corresponding Author:
Nasser Mohammed Almalky,
Internship student in UQUDENT, Umm Al-Qura University, Saudi Arabia.
Tel: 00966540738666
Fax:12112
E-mail: drnasseralmalky@hotmail.com
Received: June 06, 2018
Accepted: June 25, 2018
Published: June 26, 2018
Citation: Mohammed Almalky N, Mohammad Elattar H. Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of Saudi Arabia. Int
J Dentistry Oral Sci. 2018;5(6):645-648. doi: http://dx.doi.org/10.19070/2377-8075-18000127
Copyright: Mohammed Almalky N©2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
The purpose of this study was to assess the status of occlusion among school children in Makkah governorate of Saudi
Arabia.
Materials and Methods: The sampling included 289 adolescents with age range 14-17 years. The sample was randomly se-
lected from schools in Makkah governorate to determine the status of their occlusion.
Design: Randomized cross-sectional study. The examiner assessed different type of malocclusion, crowding, diastema, cross-
bite, overjet and overbite. These occlusal parameters were examined by one examiner using a mouth mirror, small light source
and metallic ruler.
Conclusion: This study revealed predominance of Class I molar among Saudi School children in Makkah city. Normal overjet
and overbite were frequent ndings. The most prevalent malocclusion trait was crowding.
Mohammed Almalky N, Mohammad Elattar H. Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of Saudi Arabia. Int J Dentistr y Oral Sci.
2018;5(6):645-648. 646
OPEN ACCESS http://scidoc.org/IJDOS.php
status of the permanent dentition among adolescents with an age
range between 14-17 years in Makkah governorate of Saudi Ara-
bia.
Materials and Methods
A cross sectional study was conducted at Makkah governorate,
Saudi Arabia.
3 schools were randomly selected from different areas of Mak-
kah governorate. A total of 289 aged 13-17 years were ran-
domly selected and examined. The ethical approval was given by
UQUDENT. All the students were informed about their rights to
participate in the study and consent forms were signed.
Inclusion Criteria
- No previous orthodontic treatment done.
- Secondary dentition present with no remaining deciduous teeth.
- All had their rst permanent molars.
- No previous extraction.
- No caries lesion that causes change in the tooth size or shape.
Clinical examination was carried out in the schools within the stu-
dents’ classrooms by one experienced examiners using a mouth
mirror, small light source and metallic ruler. The following param-
eters were recorded:
1. Angle classication system: was recorded as Class I when
the mesiobuccal cusp of the maxillary rst permanent molar oc-
cluded with the mesiobuccal groove of the mandibular rst per-
manent molar on both sides. A Class II or Class III molar relation
was recorded when the mesiobuccal cusp of the maxillary rst
permanent molar occluded at least one-half cusp width anterior
or posterior to the mesiobuccal groove of the mandibular rst
permanent molar on both sides, respectively.
2. Crowding: It was recorded when the total sum of slipped con-
tacts measured in the segment was at least 2 mm.
3. Overbite: The vertical overlap of incisors measured to the
nearest half millimeter vertically from the incisal edge of the max-
illary right central incisor to the incisal edge of the corresponding
mandibular right incisor.
Overjet: It was measured with millimeter ruler as the distance
from the most labial point of the incisal edge of the maxillary in-
cisors to the most labial surface of the corresponding mandibular
incisor.
4. Anterior cross bite: It was recorded when one or more of
the maxillary incisors occluded lingual to the mandibular incisors.
5. Posterior cross bite: It was recorded when the buccal cusp of
one or more of the maxillary posterior teeth occluded lingual to
the buccal cusps of the opposing mandibular teeth.
6. Diastema: It was recorded when the space more than 1 mm
between central incisors.
Method of Measurement
Variable Method of measurement
Sagittal occlusion Angle classication
Overjet increased if it’s more than 3 mm,
decreased if it’s less than 2 mm
Overbite increased if it’s more than 2 mm,
decreased if it’s less than 2 mm
Crowding overlapping of on tooth with respect to
other tooth
Diastema space more than 1 mm between central
incisors
Crossbite in one or more maxillary teeth are placed
palatal\lingual to the mandibular teeth
Result
Class 1 malocclusion had the highest frequency of 67.13%, class
II div-1 was 14.53%, class II div-2 was 10.7% , class III was 7.61%
(Table 1).
The normal overjet and overbite values were highest 57.4% ,
52.6% , respectively (Table 2).
Frequency of Crowding was observed in 63% , diastema was pre-
sent in 8.3%, anterior cross bite was 17% and posterior cross bite
was 21.4% (Table 3).
Discussion
In studies that were done on other populations, variations in the
prevalence values of normal occlusion and malocclusion were
evident. Some of the studies showed high percentage of normal
Table 1.
Angel classication N %
Class I 194 67.13%
Class II (d-1) 42 14.53%
Class II (d-2) 31 10.7%
Class III 22 7.61%
Total 289 100%
Table 2.
normal increase decrease Total
Over jet 166 (57.4%) 74 (25.6%) 49 (17%) 289 (100%)
Over bite 152 (52.6%) 61 (21.1%) 76 (26.3%) 289 (100%)
Mohammed Almalky N, Mohammad Elattar H. Prevalence Of Different Types Of Malocclusion Among School Children In Makkah Governorate of Saudi Arabia. Int J Dentistr y Oral Sci.
2018;5(6):645-648. 647
OPEN ACCESS http://scidoc.org/IJDOS.php
occlusion while others did not.
Although many studies have been published that describe the
prevalence and types of malocclusion. Some variabilities between
their ndings and our existed due to the varying methods and
indices used to assess and record occlusal relationships, age dif-
ferences of the study populations, examiner subjectivity, specic
objectives, and differing sample sizes. Subjects in our study were
randomly selected and were in the permanent dentition stage.
Our results showed that the most common type of molar relation
was Class I followed by Class II relation, and Class III malocclu-
sion. These results were in agreement with previous Saudi studies
that measured dental malocclusion in orthodontic patients [3, 5].
Our results were also in agreement with studies which were per-
formed in other countries that measured malocclusion in ortho-
dontic patients like Iraq, Nigeria and Turkey [15, 33, 37]. However,
it disagreed with the ndings of Gul-e-Erum and Fida (2008) [22]
who found that Pakistani orthodontic patients have a higher per-
centage of Class II malocclusion (70.5%). This might be due to
the ethnic difference between the population used in their study.
When our results were compared to studies conducted on non-
orthodontic population in other countries, we found that stud-
ies in USA, Israel, Libya, Sudan, Egypt, China, Lebanon, Nigeria,
Jordan, Iran, Brazil and Tanzania reported that the most common
type of dental malocclusion was Class I, followed by Class II then
Class III and that was similar to our results ([1, 2, 8, 10, 11, 13,
14, 18, 19, 21, 27, 28, 30, 34, 36] Silva & Kang, 2001 ; Grando et
al., 2008).
On the other hand, a study by Gelgor et al., (2007) [20] that ex-
amined 2,329 teenagers in central Anatolia, Turkey, revealed that
the most common type of malocclusion was Class II division 1
(40%) [20].
Conclusion
This study revealed predominance of Class I molar among Sau-
di School children in Makkah governorate. Normal overjet and
overbite were frequent ndings. The most prevalent malocclusion
trait was crowding. This study provides descriptive information
for occlusion status that will be valuable in planning the appropri-
ate preventive and treatment programs in Makkah governorate.
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... Consequently, it is possible that the population in the two geographical areas is subject to different selective pressures and that there is ethnic heterogeneity that was not considered by the studies but could play a role in the manifestation of the problem [24,32]. Considering the subdivisions of class II E. Aikins reported a frequency of 3.9% for the first division and 2.4% for the second [22], M. Amalky found a frequency of the division I in 14.53% of the subjects and 10.7% of division II [30]; finally, I. Gelgör's study revealed a prevalence of the division I of 40% and of the division II of 4.7% [5]. Again, the prevalence was highly variable, suggesting a difference between different countries and geographical regions, in this case Saudi Arabia, Nigeria and Anatolia. ...
... Kaur [32]) of the samples we considered. With the exception of the studies by H. Kaur, M. Amalky (21.1%) [30], S. Perrotta (18%) [27] and M. Mtaya (16.1%) [2] who reported high prevalences of openbite, in all other cases the frequency was rather low, ranging from 1.4% in the Italian sample (R. Ferro) [23] to a maximum of 8.2% for the population living in Anatolia (I. Gelgör) [5]. ...
... Perrotta) [27] and 26.3% among Arab subjects (M. Amalky) [30]. Nevertheless it is interesting to note that the prevalence of 2% was only recorded in one study; for all the other ones it ranged from 14.4% [5] to 26.3% [30]. ...
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Abstract Skeletal class II malocclusion with anterior crossbite presents a significant challenge in the field of orthodontics. Although anterior crossbite association with Class II malocclusion is not common in literature, this condition not only impacts the patient’s quality of life by affecting his facial appearance and resembling cosmetic concerns, but it can also affect masticatory and respiratory functions. The management of skeletal malocclusion class II with anterior crossbite requires a comprehensive approach that takes into account the severity of the condition, the patient's age, and their treatment preferences. A comprehensive search of prominent databases has revealed a range of management strategies used in clinical practice. This review categorizes these intervention methods into orthodontic, and surgical interventions to provide clinicians with an evidence-based decision-making foundation and help determine the best management plan that will provide optimal outcomes for patients with this complicated malocclusion. In conclusion, further high quality evidence is needed to accurately determine the incidence of Class II malocclusion with anterior crossbite and the varying outcomes according to the management strategy.
... Most epidemiological studies undertaken in Saudi Arabia have only focused on the prevalence of malocclusion in the permanent dentition stage among patients aged over 12 years. [16][17][18][19][20] Therefore, this study was conducted to assess the prevalence of malocclusal traits among male schoolchildren aged 6-9 years in Rass, Saudi Arabia. ...
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Aims: 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. Methods: 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. Results: 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. Conclusions: 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.
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Identifying occlusal status in a particular population will be valuable in planning the appropriate preventive and treatment programs. The purpose of this study was to assess the status of occlusion among school children in Riyadh, Saudi Arabia. This study was conducted at Riyadh, Saudi Arabia from September 2012 to June 2013. A total of 1825 Saudis (1007 males and 818 females) of 12-16 years old were randomly selected from 20 schools in different areas of Riyadh city to determine the status of their occlusion. The examiners assessed molar and canine relationships, spacing and crowding, overjet, overbite, anterior and posterior cross bite. These occlusal parameters were examined by two experienced examiners using a mouth mirror, small light source and calibrated fiber ruler. About 60.11% of Saudis presented with Class I molar relationship while 7.12% and 10.13% of the subjects had Class II and III molar relationship, respectively. The most prevalent canine relationship was Class I (54.13%), followed by Class II (12.4%) and Class III (11.2). Normal overjet and overbite were observed in 76% and 67% of the sample, respectively. The prevalence of malocclusion traits were crowding (45.4%), Spacing (26.9%), excessive over jet (16.4%), posterior cross bite (8.9%), anterior open bite (8.4%) and excessive overbite (6.68%). No statistically significant differences were found between the genders about the prevalence of any occlusion traits (P > 0.05). Class I molar relationship, normal overbite, and normal overjet were dominant features among Saudis. Crowding was the most prevalent malocclusion trait, followed by spacing. These findings will help in understanding the occlusion status in order to plan for prevention and treatment of malocclusion in Riyadh city.
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Malocclusion with its great hazardous effects seems to have become more prevalent in recent decades; therefore, the present study was carried out to assess the prevalence of different malocclusions among 13-15 year-old adolescents in Tabriz. The subjects in the present study consisted of 398 adolescents aged 13-15, who were randomly selected from 5 different districts of the city. Students who had previous orthodontic treatment or extraction of any permanent teeth were excluded from the study. Angle's classification was used to describe the type of malocclusion and the evaluation of other aspects of malocclusion such as overjet, overbite and crowding were considered the minor goals of the study. The prevalence of different types of malocclusion in the population under study was estimated. According to the results of the study, only 4% of 13-15 year-old adolescents under study had normal occlusion, whereas 51% had Class I, 21.9% had Class II [17.6% div 1, 4.3% div 2] and 17.1% had Class III malocclusion. With respect to overjet, the study revealed that 30.7% of the population under study had increased overjet, 33.9% had decreased overjet and 2% had reverse overjet. Increased overbite was observed in 40.2% of the population studied, whereas decreased overbite was found in 19.3%, deep bite was noted in 3.3% and open bite was detected in 3.3% of the studied population. Class I malocclusion was the most prevalent, whereas Class III malocclusion was the least prevalent among adolescents aged 13-15 in Tabriz.
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The aim of this cross-sectional study was to determine the prevalence of malocclusions, occlusal traits, and their gender distribution in urban Iranian school children. Five hundred and two subjects (253 females and 249 males, aged 11–14 years) were examined. Molar relationship, overjet (OJ), overbite, midline deviation, crossbite, and crowding/spacing were recorded. Gender dimorphism was evaluated by the chi-square test. According to the classification of Angle, the prevalence of Class I, Class II division 1, Class II division 2, and Class III malocclusions was 41.8, 24.1, 3.4, and 7.8 per cent, respectively. Symmetric molar relationship was present in 69.5 per cent. An OJ of at least 3.5 mm or more was present in 28.1 per cent; an OJ of more than 6 mm in 3.6 per cent, and 4.2 per cent had a reverse OJ. A normal overbite was observed in 60.4 per cent, while 34.5 per cent had an increased and 2.2 per cent a very deep overbite. An anterior open bite (AOB) was present in 1.6 per cent and a scissor bite or anterior crossbite in 2 and 8.4 per cent, respectively. A posterior crossbite was observed in 12.4 per cent (8.4 per cent unilateral, 2 per cent bilateral, and 2 per cent in association with an anterior crossbite). Midline deviation was present in 23.7 per cent. Severe crowding (≥5.1 mm) was observed in 16.7 and 10.8 per cent and spacing in 18.9 and 20.7 per cent of the maxillary and mandibular arches, respectively. Significant gender differences were found for overbite (P < 0.001), midline deviation (P < 0.05), and maxillary and mandibular arch crowding/spacing (P < 0.05). The prevalence of Class II malocclusions was comparable with Caucasians; however, the most severe forms of Class II malocclusions were rare in this Iranian population. The relative prevalence of Class III malocclusions in the present study was greater than in Caucasians. Crowding was the most common dental anomaly in both arches.
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The prevalence of different malocclusion features was investigated in 396 6-year-old Icelandic children, using the epidemiologic registration method described by Bjork et al. in 1964. Girls were ahead of boys with regard to dental stage (P<0.01). One or more permanent teeth were congenitally missing in 5% of the children. Postnormal occlusion was found in 27% of the boys and in 31% of the girls, and prenormal occlusion was found in 6% and 5%, respectively. Straight terminal plane at the second deciduous molars was found in individuals with either normal or postnormal occlusion. Thus, it can be misleading to use the relation of the terminal planes as a measurement of the sagittal relation between the jaws. The prevalence of hypodontia was much lower than has been reported previously for Icelandic children.
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Abstract The prevalence of different malocclusion features was investigated in 500 14-yr-old male Saudi Arabian children, using a modification of the registration method described by Björk. et al. (3). Most of the children were in dental stage DS4 (all permanent teeth anterior to the first molars erupted). Totally 62.4% of the children had one or more malocclusion features related to dentition, occlusion, or space. The treatment need was evaluated according to the guidelines used in the Norwegian Health Service. About 40% were found to need treatment with fixed appliances, and for 33% extraction of permanent teeth would be part of the treatment. Only about 2.5% would benefit from treatment with simple removable appliances.
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This study was conducted to evaluate malocclusion and crowding in 1356 patients (793 girls, 563 boys) referred to the Department of Orthodontics, Suleyman Demirel University, Turkey. Class I was the most frequently seen malocclusion in this referred Turkish orthodontic population whereas Class II, division 2 was the least frequently seen. Comparison of mean ages of the malocclusion groups indicated statistically significant difference between Class I and Class II, division 1 groups (P < .05). The lowest mean age was present in the Class II, division 1 group. Mild mandibular crowding was the most common finding whereas severe mandibular crowding was seen least frequently in all malocclusion groups. Cross tabulation of maxillary and mandibular crowding indicated that mild maxillary and severe mandibular crowding in the same patient was rarely seen in all types of malocclusions. Moderate maxillary and severe mandibular crowding in the same patient was another rare finding for all malocclusion groups.
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The aim of the present study was to determine the prevalence of malocclusions and dental characteristics of schoolchildren aged between 10 and 12 years in the city of Fortaleza, Ceará in northeastern Brazil. Two hundred and sixty-four children (107 boys and 157 girls) were examined using the Angle classification system. The occlusal characteristics studied were the measurements for overbite, overjet, crowding and midline diastema. The children who were selected had not had prior orthodontic treatment and were born in Ceará, as were their parents and grandparents. Of the schoolchildren who were studied, 25.8% had normal occlusion, 47.7% had Class I malocclusion, 22.3% had Class II malocclusion and 4.2% had Class III malocclusion. There was no statistically significant difference between age and gender; 30.3% of the individuals had a normal overbite and 36.7% and 19.7% had increased and reduced overbites, respectively. A normal overjet was found in 33.7% of the subjects and increased and reduced overjet was found in 50% and 3.4%, respectively. Dental crowding was observed in 62.5% and the presence of midline diastema was observed in 14.8% of the schoolchildren. The most prevalent occlusal status was Class I malocclusion, with no distinction between age and gender. Increased overbite and overjet were predominant. There was a high occurrence of dental crowding among the subjects in contrast to the few cases of midline diastema.