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Global distribution of malocclusion traits: A systematic review

Authors:
  • College of Dentistry, Jazan University

Abstract and Figures

Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.
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© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online a rticle*
40.e1
1
Jazan University, College of Dentistry, Department of Preventive Sciences,
Division of Orthodontics and Dentofacial Orthopedics (Jazan, Saudi Arabia).
2
Ibb University, Faculty of Oral and Dental Medicine, Department of
Orthodontics and Dentofacial Orthopedics (Ibb, Republic of Yemen).
3
Jazan University, College of Dentistry, Department of Maxillofacial Surgery
and Diagnostic Sciences (Jazan, Saudi Arabia).
4
Cairo University, Faculty of Oral and Dental Medicine, Department of
Orthodontics and Dentofacial Orthopedics (Cairo, Egypt).
5
University of Malaya, Faculty of Dentistry, Department of Pediatric Dentistry
and Orthodontics (Kuala Lumpur, Malaysia).
6
Kyoto University, Graduate School of Medicine, Department of Global Health
and Socio-epidemiology (Kyoto, Japan).
Global distribution of malocclusion traits:
A systematic review
Maged Sultan Alhammadi1,2, Esam Halboub3, Mona Salah Fayed4,5, Amr Labib4, Chrestina El-Saaidi6
Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool
data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search
was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed
and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition,
the global distributions of ClassI, ClassII, and ClassIII malocclusion were 74.7% [31 97%], 19.56% [2 63%] and 5.93% [1 20%],
respectively. Inmixed dentition, the distributions of these malocclusions were 73% [40 96%], 23% [2 58%] and 4% [0.7 13%].
Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite
affected 9.39% of the sample. Africans showed the highest prevalence of ClassI and open bite in permanent dentition (89% and 8%,
respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of ClassII in perma-
nent dentition (23%) and mixed dentition (26%). ClassIII malocclusion in mixed dentition was highly prevalent among Mongoloids.
Conclusion: Worldwide, in mixed and permanent dentitions, Angle ClassI malocclusion is more prevalent than ClassII, specifically
among Africans; the least prevalent was ClassIII, although higher among Mongoloids in mixed dentition. Invertical dimension, open
bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.
Keywords: Prevalence. Malocclusion. Global health. Population. Permanent dentition. Mixed dentition.
DOI: https://doi.org/10.1590/2177-6709.23.6.40.e1-10.onl
How to cite: Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C.
Global distribution of malocclusion traits: A systematic review. Dental Press J Or-
thod. 2018 Nov-Dec;23(6):40.e1-10.
DOI: https://doi.org/10.1590/2177-6709.23.6.40.e1-10.onl
Submitted: July 12, 2017 - Revised and accepted: June 01, 2018
» The authors report no commercial, proprietary or financial interest in the products
or companies described in this article.
Contact address: Esam Halboub
Department of Maxillofacial Surgery and Diagnostic Sciences
College of Dentistry, Jazan University, Jazan, Saudi Arabia
E-mail: mhelboub@gmail.com
Objetivo: considerando-se que os estudos disponíveis sobre a prevalência das más oclusões são de base local ou nacional, esse estudo
teve como objetivo reunir dados para determinar a distribuição dos tipos de má oclusão em uma escala global, nas dentições permanente
e mista. Métodos: foi realizada uma busca eletrônica através das ferramentas de pesquisa do PubMed, Embase e Google Acadêmico,
para reunir estudos publicados até dezembro de 2016 sobre a prevalência das más oclusões, tanto na dentição permanente quanto na
dentição mista. Resultados: dos 2.977 estudos encontrados, 53 foram analisados. Na dentição permanente, a distribuição mundial das
más oclusões de Classe I, II e III foi, respectivamente, de 74,7% [31 97%], 19,56% [2 63%] e 5,93% [1 – 20%]. Nadentição mista, a
distribuição dessas más oclusões foi de 73% [40 96%], 23% [2 – 58%] e 4% [0,7 – 13%]. Emrelação às más oclusões verticais, observou-
-se prevalência de 21,98% de sobremordida profunda e 4,93% de mordida aberta. A mordida cruzada posterior afetou 9,39% da amostra.
Os africanos mostraram a maior prevalência de Classe I e mordida aberta na dentição permanente (89% e 8%, respectivamente) e na
dentição mista (93% e 10% respectivamente), enquanto os caucasianos apresentaram a maior prevalência de Classe II na dentição perma-
nente (23%) e na dentição mista (26%). Amá oclusão de Classe III na dentição mista foi mais prevalente entre xantodermas. Conclu-
são: mundialmente, nas dentições mista e permanente, as más oclusões de Classe I de Angle são mais prevalentes do que as de Classe II,
especificamente entre os africanos; a menos prevalente foi a Classe III, ainda que mais prevalente entre os xantodermas na dentição mista.
Na dimensão vertical, as mordidas abertas foram mais prevalentes entre xantodermas na dentição mista. A mordida cruzada posterior
apresentou maior prevalência na dentição permanente na Europa.
Palavras-chave: Prevalência. Má oclusão. Saúde global. População. Dentição permanente. Dentição mista.
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article Global distribution of malocclusion traits: A systematic review
40.e2
INTRODUCTION
Angle introduced his famous classification of
malocclusion in 1899.
1
Now the World Health Or-
ganization estimates malocclusions as the third most
prevalent oral health problem, following dental caries
and periodontal diseases.
2
Many etiological factors for malocclusion have
been proposed. Genetic, environmental, and ethnic
factors are the major contributors in this context.
Certain types of malocclusion, such as ClassIII rela-
tionship, run in families, which gives a strong relation
between genetics and malocclusion. Likewise is the
ethnic factor, where the bimaxillary protrusion, for
example, affects the African origin more frequently
than other ethnicities. On the other hand, functional
adaptation to environmental factors affects the sur-
rounding structures including dentitions, bone, and
soft tissue, and ultimately resulting in different mal-
occlusion problems. Thus, malocclusion could be
considered as a multifactorial problem with no spe-
cific cause so far.
3
A search in the literature for studies on prevalence
of malocclusion and related factors revealed that most
of these epidemiological investigations were pub-
lished between the 1940s and the 1990s. Thereafter,
publications have been turned into focusing more on
determination of treatment needs, treatment tech-
niques and mechanisms, and treatment outcomes.
4
Epidemiological studies play a pivotal role in terms
of determining the size of the health problems, pro-
viding the necessary data and generating and analyz-
ing hypotheses of associations, if any. Through these
valuable information, the priorities are set and the
health policies are developed.
5
Hence, the quality
of these epidemiological studies must be evaluated
crucially and it will be valuable to pool their results,
whenever possible.
In this regard, there has been a continuous increase
in conducting critical analyses for the published epi-
demiological health studies. The aim behind this is
to generate a more precise and trusted evidence on
the health problem under investigation using strict
criteria for quality analysis. However, few have been
conducted in orthodontics. The objective of the cur-
rent study, therefore, was to present a comprehensive
estimation on the prevalence of malocclusion in dif-
ferent populations and continents.
MATERIALS AND METHODS
Search method
A literature search in PubMed, Embase, and
Google Scholar search engines was conducted up to
December 2016. The following search terms were
used: ‘Prevalence’, ‘Malocclusion’, ‘Mixed denti-
tion', and 'Permanent dentition’. In addition, an
electronic search in websites of the following jour-
nals was conducted: Angle Orthodontist, American
Journal of Orthodontics and Dentofacial Orthope-
dics, Journal of Orthodontics, and European Jour-
nal of Orthodontics.
Studies that fulfilled the following criteria were
included:
1) Population-based studies.
2) Sample size greater than 200 subjects.
3) Studies that evaluated malocclusion during
mixed and/ or permanent dentitions.
4) Studies that used Angle's classification of mal-
occlusion.
5) Studies that considered the following defini-
tions of the specified malocclusion characteristics:
“abnormal overjet” if more than 3mm; “reverse over-
jet” when all four maxillary incisors were in a cross-
bite; “abnormal overbite” if more than 2.5 mm (for
deep bite) and if less than 0 mm (for open bite); and
“posterior crossbite” when affecting more than two
teeth. The malocclusion traits included were: Angle
Classification (ClassI / II / III), overjet (increased /
reversed), overbite (deep bite / open bite), posterior
crossbite, based on the above mentioned definitions
for these traits.
A study was excluded if it was conducted in a clin-
ical/hospital-based setting and/or targeted malocclu-
sion prevalence in primary dentition or in a popula-
tion with specific medical problem.
Characteristics of all studies
6-58
analyzed were for-
mulated similar to that used in analysis of epidemio-
logical studies
59,60
(Table 1).
Critical appraisal of the included studies was done
based on a modified version of STROBE check-
list
61,62
comprising seven items related to: study
design, study settings, participants criteria, sample
size, variable description, and outcome measure-
ments. The quality of the studies was categorized
into weak (≤ 3), moderate (4 or 5) and high quality
(≥ 6), as described in Table 2.
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article
Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C
40.e3
Table 1 - Characteristics of the included studies.
M = male; F = female.
No Author Year Sample Age Gender Country Region Race Population
1 Massler and Frankel
6
1951 2758 14-18 M=1238, F=1520 America America Caucasian Schoolchildren
2 Goose et al.
7
1957 2956 7-15 Not mentioned Britain Europe Caucasian Schoolchildren
3 Mills
8
1966 1455 8-17 M=719, F=736 America America Caucasian Schoolchildren
4 Grewe et al.
9
1968 651 9-14 M=322, F=329 America America Caucasian Community
5 Helm
10
1968 1700 6-18 M=742, F=958 Denmark Europe Caucasian Schoolchildren
6 Thilander and Myrberg
11
1973 6398 7-13 M=3093, F=3305 Sweden Europe Caucasian Schoolchildren
7 Foster and Day
12
1974 1000 12 Not mentioned Britain Europe Caucasian Schoolchildren
8 Ingervall et al.
13
1978 389 21-54 M=389, F=0 Sweden Europe Caucasian Military service
9 Helm and Prydso
14
1979 1536 14-18 Not mentioned Denmark Europe Caucasian Schoolchildren
10 Lee et al.
15
1980 2092 17-21 M=1281, F=811 Korea Asia Mongoloids Community
11 Gardiner
16
1982 479 10-12 Not mentioned Libya Africa Caucasian Community
12 De Muňiz
17
1986 1554 12-13 M=655, F=899 Argentine America Caucasian Schoolchildren
13 Kerosuo et al.
18
1988 642 11-18 M=340, F=302 Tanzania Africa Africans Schoolchildren
14 Woon et al.
19
1989 347 15-19 Not mentioned China Asia Mongoloids Community
15 Al-Emran et al.
20
1990 500 14 M=500, F=0 Saudia Asia Caucasian Schoolchildren
16 El-Mangoury and Mostafa
21
1990 501 18-24 M=231, F=270 Egypt Africa Caucasian Community
17 Lew et al.
22
1993 1050 12-14 Not mentioned China Asia Mongoloids Schoolchildren
18 Tang
23
1994 201 20 Not mentioned China Asia Mongoloids Community
19 Harrison and Davis
24
1996 1438 7-15 Not mentioned Canada America Caucasian Community
20 Ng’ang’a et al.
25
1996 919 7-15 M=468, F=451 Kenya Africa Africans Community
21 Ben-Bassat et al.
26
1997 939 6-13 M=442, F=497 Israel Asia Caucasian Schoolchildren
22 Prot et al.
27
1998 14000 8-50 Not mentioned America America Caucasian Community
23 Dacosta
28
1999 1028 11-18 M= 484, F=544 Nigeria Africa Africans Community
24 Saleh
29
1999 851 9-15 M=446, F=405 Lebanon Asia Caucasian Schoolchildren
25 Esa et al.
30
2001 1519 12-13 M=772, F=747 Malaysia Asia Mongoloids Schoolchildren
26 Thilander et al.
31
2001 4724 5-17 M=2371, F=2353 Colombia America Caucasian Heath center
27 Freitas et al.
32
2002 520 11-15 M=250, F=270 Brazil America Caucasian Schoolchildren
28 Bataringaya
33
2004 402 14 M=141, F=261 Uganda Africa Africans Schoolchildren
29 Onyeaso
34
2004 636 12-17 M=334, F=302 Nigeria Africa Africans Schoolchildren
30 Tausche et al.
35
2004 197 6-8 M=970, F=1005 Germany Europe Caucasian Schoolchildren
31 Abu Alhaija et al.
36
2005 1003 13-15 M=619, F=384 Jordan Asia Caucasian Schoolchildren
32 Ali and Abdo
37
2005 1000 7-12 M=501, F=499 Yemen Asia Caucasian Schoolchildren
33 Behbehani et al.
38
2005 1299 13-14 M=674, F=625 Kuwait Asia Caucasian Schoolchildren
34 Ciuolo et al.
39
2005 810 11-14 M=434, F=376 Italy Europe Caucasian Schoolchildren
35 Karaiskos
40
2005 395 9 Not mentioned Canada America Caucasian Schoolchildren
36 Ahangar Atashi
41
2007 398 13-15 Not mentioned Iran Asia Caucasian Community
37 Gelgör et al.
42
2007 810 11-14 M=1125, F=1204 Turkey Europe Caucasian Health center
38 Jonsson et al.
43
2007 829 31-44 M=342, F=487 Iceland Europe Caucasian Schoolchildren
39 Josefsson et al.
44
2007 493 12-13 Not mentioned Sweden Europe Caucasian Schoolchildren
40 Ajayi
45
2008 441 11-18 M=229, F=212 Nigeria Africa Africans Schoolchildren
41 Mtaya
46
2008 1601 12-14 M=632, F=969 Tanzania Africa Africans Schoolchildren
42 Borzabadi-Farahani et al.
47
2009 502 11-14 M=249, F=253 Iran Asia Caucasian Schoolchildren
43 Daniel et al.
48
2009 407 9-12 M= 191, F=216 Brazil America Caucasian Schoolchildren
44 Šidlauskas and Lopatienė
49
2009 1681 7-15 M=672, F=1009 Lithuania Europe Caucasian Schoolchildren
45 Alhammadi
50
2010 1000 18-25 M=500, F=1000 Yemen Asia Caucasian Schoolchildren
46 Bhardwaj et al.
51
2011 622 16-17 M= 365, F=257 India Asia Caucasian Schoolchildren
47 Nainani and Relan
52
2011 436 12-15 M= 224, F=212 India Asia Caucasian Schoolchildren
48 Bugaighis et al.
53
2013 343 12-17 M=169, F=174 Libya Africa Caucasian Schoolchildren
49 Kaur et al.
54
2013 2400 13-17 M=1192, F=1208 India Asia Caucasian Schoolchildren
50 Reddy et al.
55
2013 2135 6-10 M=1009, F=1126 India Asia Caucasian Schoolchildren
51 Bilgic F et al.
56
2015 2329 12.5-16.2 M=1125, F=1204 Turkey Europe Caucasian Schoolchildren
52 Gupta et al.
57
2016 500 12-17 M=1125, F=1204 India Asia Caucasian Schoolchildren
53 Narayanan et al.
58
2016 2366 10-12 M=1281, F=1085 India Asia Caucasian Schoolchildren
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article Global distribution of malocclusion traits: A systematic review
40.e4
Table 2 - STROBE -based quality analysis of the included studies.
No Author Study
design Setting Participants Sample
size
Variables
description
Outcome
measurement
Statistical
analysis Total score
1 Massler and Frankel
6
X 5
2 Goose et al.
7
X ✓ X X 4
3 Mills
8
X ✓ X 5
4 Grewe et al.
9
X ✓ X 5
5 Helm
10
✓ ✓ X 6
6 Thilander and Myrberg
11
✓ ✓ X 6
7 Foster and Day
12
X X X 4
8 Ingervall et al.
13
X X X 4
9 Helm and Prydso
14
X ✓ 6
10 Lee et al.
15
X ✓ X 5
11 Gardiner
16
X ✓ X 5
12 De Muňiz
17
X ✓ X X 4
13 Kerosuo et al.
18
X ✓ X 5
14 Woon et al.
19
X ✓ X 5
15 Al-Emran et al.
20
X ✓ X X 4
16 El-Mangoury and Mostafa
21
X ✓ X X 4
17 Lew et al.
22
X ✓ X 5
18 Tang
23
X ✓ X 5
19 Harrison and Davis
24
X ✓ X 5
20 Ng’ang’a et al.
25
X ✓ X 6
21 Ben-Bassat et al.
26
X ✓ X 5
22 Prot et al.
27
✓ ✓ X 6
23 Dacosta
28
X ✓ X 5
24 Saleh
29
✓ ✓ X X 5
25 Esa et al.
30
X ✓ 6
26 Thilander et al.
31
X ✓ X 5
27 Freitas et al.
32
X ✓ X 5
28 Bataringaya
33
✓ ✓ 7
29 Onyeaso
34
X✓ ✓ X 5
30 Tausche et al.
35
✓ ✓ X 6
31 Alhaija et al.
36
X ✓ X 5
32 Ali and Abdo
37
X ✓ X 5
33 Behbehani et al.
38
X ✓ 6
34 Ciuolo et al.
39
✓ X X 5
35 Karaiskos
40
X ✓ X 5
36 Ahangar Atashi
41
X ✓ X 5
37 Gelgör et al.
42
X ✓ X 5
38 Jonsson et al.
43
✓ ✓ 7
39 Josefsson et al.
44
X ✓ X 5
40 Ajayi
45
X ✓ X 5
41 Mtaya
46
✓ ✓ 7
42 Borzabadi-Farahani et al.
47
✓ ✓ X 6
43 Daniel et al.
48
X ✓ 6
44 Šidlauskas and Lopatienė
49
X X X 4
45 Alhammadi
50
✓ ✓ X 6
46 Bhardwaj et al.
51
✓ ✓ X X 5
47 Nainani and Relan
52
✓ ✓ X X 5
48 Bugaighis et al.
53
X ✓ X 5
49 Kaur et al.
54
X ✓ X 5
50 Reddy et al.
55
✓ ✓ X X 5
51 Bilgic F et al.
56
✓ ✓ X 6
52 Gupta et al.
57
X ✓ X X 4
53 Narayanan et al.
58
✓ ✓ X X 5
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article
Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C
40.e5
Statistical analysis
Prevalence rates, by dierent variables, were pre-
sented as means and standard deviations (SD), with the
minimum and maximum values. The data were checked
for normal distribution using Kolmogorov-Smirnov
test. As the distribution was not normal, analyses were
conducted using non-parametric tests. Kruskal-Wallis
test was used for comparisons between more than two
groups. Mann-Whitney U test was used for pair-wise
comparisons between groups whenever Kruskal-Wallis
test was signicant. Spearman's coecient was calculat-
ed to determine the correlations, if any, between dier-
ent variables. All tests were supposed to be two-tailed,
and the power and the signicance values were set at 0.8
and 0.05, respectively. Statistical analysis was performed
with IBM
®
SPSS
®
Statistics for Windows soware, ver-
sion 21 (Armonk, NY: IBM Corp.)
RESULTS
Two thousands nine hundreds and seventy seven
studies were found to be potentially relevant to the
study. The ow diagram (Fig 1) describes the process of
articles retrieval; 255 articles were excluded due to du-
plication. The main cause of dropping of the retrieved
articles was removal of irrelevant titles (2,348). The nal
closely related were 374 articles published between years
1951 and 2016. Aer reading their abstracts, only 53 ar-
ticles (Table 1) fullled the inclusion criteria and were
included in the subsequent analyses.
The results of the critical appraisal of the included
studies are presented in Table 2. The total quality score
ranged from 4 to 7. Thirty eight studies (72%) were
considered of moderate quality and een (28%), of
high quality. The most common drawbacks among all
studies were failure to declare the study design (whether
it is of cross-sectional, follow-up, etc.) and lack of sam-
ple size calculation.
In permanent dentition (Table 3), the global distri-
butions of Class I, ClassII, and ClassIII were 74.7%,
19.56% and 5.93%, respectively. Increased and reverse
overjet was recorded in 20.14% and 4.56%, respec-
tively. Regarding vertical malocclusions, the observed
deep overbite and open bite were 21.98% and 4.93%,
respectively. Considering the transverse occlusal dis-
crepancies, the posterior crossbite aected 9.39% of the
total examined sample.
Regarding the distribution of malocclusion in adults
according to geographical location (Table 4), four con-
tinents classication system was considered, in which
Americas are considered as one continent. In perma-
nent dentition, Europe showed the highest prevalence
of ClassII and posterior crossbite (33.51% and 13.8%,
respectively), and the lowest prevalence of Class I
(60.38%). This was applied to mixed dentition regard-
ing ClassI and ClassII. No statistically signicant dif-
ferences in prevalence of ClassIII, increased overjet, re-
versed overjet, deep bite and open bite between the four
geographic areas were reported.
Figure 1 - Flowchart of the literature selection
process.
Records identified through
data base searching (n=1969)
Records identified through
other sources (n= 8)
Full-text assessed for eligibility
(n= 374)
Studies assessed malocclusion in decid-
uous dentition or used different diagnos-
tic methods, had small sample, etc (321)
Final included studies
(n= 53)
Removal of duplicated titles (n= 255)
Removal of totally irrelevant titles or stud-
ies focused on prevalence of malocclu-
sion in specific group of people (patients
with different disease such as mouth
breather, syndromatic patients,....) or de-
scribing the relationship between maloc-
clusions and other oral problems (caries,
periodontal diseases, etc.) (2348)
Total identified (n= 2977)
Screened records (n= 2722)
Included Eligibility Screening Identification
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article Global distribution of malocclusion traits: A systematic review
40.e6
Table 3 - Global prevalence of malocclusion in permanent and mixed dentitions
Table 4 - Prevalence of malocclusion in different geographic locations.
*: Significant at P ≤ 0.05.
Dimension Malocclusion form
Permanent dentition Mixed dentition
Min Max Mean SD Min Max Mean SD
Antero-
posterior
ClassI 31 96.6 74.7 15.17 40 96.2 72.74 16
ClassII 1.6 63 19.56 13.76 1.7 58 23.11 14.94
ClassIII 1 19.9 5.93 4.69 0.7 12.6 3.98 2.75
Increased overjet 1.6 48.4 20.14 11.13 9.4 35.7 23.01 7.56
Reversed overjet 0 20.1 4.56 5.26 0.4 11.9 3.65 3.67
Vertical Deep bite 2.2 56 21.98 14.13 3.5 57.1 24.34 14.54
Open bite 0.1 15 4.93 3.97 0.29 25.1 5.29 5.9
Transverse Posterior crossbite 4 32.2 9.39 5.04 3.72 29.1 11.72 7.22
Variable
Permanent dentition
P-valueAmerica Africa Asia Europe
Mean SD Mean SD Mean SD Mean SD
Antero-
posterior
ClassI 78.53 8.56 83.68 12.48 78.93 9.77 60.39 16.76 0.019*
ClassII 15.25 7.06 11.45 9.08 12.26 4.28 33.51 17.73 0.016*
ClassIII 6.23 2.68 4.7 5 4.6 6.32 6.46 6.2 2.75 0.5
Increased
overjet 16.67 5.61 21.4 13.91 19.79 10.5 20.79 12.38 0.9
Reversed
overjet 2.26 2.17 3.47 2.89 6.09 7 4.37 4.96 0.829
Vertical Deep bite 11.13 6 .41 25.83 18.96 23.83 12.95 21.56 13.33 0.227
Open bite 5.03 4.32 6.34 3.12 4.01 3.86 4.92 4.82 0.378
Transverse Posterior
crossbite 7.08 2.24 7.9 1.78 8.27 2.65 13.08 7.9 3 0.029*
Mixed dentition
Antero-
posterior
ClassI 69.98 19.67 90 6.11 72.78 10.29 63.95 13.77 0.035*
ClassII 27.22 20.22 7.5 5.71 21.42 10.4 31.95 12.47 0.024*
ClassIII 2.78 0.84 2.48 0.59 5.76 3.91 3.53 1.21 0.226
Increased
overjet 21.12 8.23 21.23 11.3 25.09 7.6 2 23.02 5.12 0.841
Reversed
overjet 3.9 5.01 5.25 4.22 4.35 3.63 1.33 0.9 0.348
Vertical Deep bite 14.98 7.73 23.3 15.5 22.09 9.9 7 37.4 17.62 0.122
Open bite 5.57 3.09 8.3 5.31 4.5 7.7 9 4.18 5.79 0.077
Transverse Posterior
crossbite 10.67 8.26 12.13 6.62 17.77 8.47 12.45 6.54 0.832
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article
Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C
40.e7
In permanent stage of dentition by ethnic groups, the
highest prevalences of ClassI malocclusion and open bite
(89.44% and 7.82%, respectively) were reported among
African population, although the dierence of the lat-
ter was not statistically signicant. However, the high-
est prevalence of ClassII (22.9%) was reported among
Caucasians. Otherwise, no statistically signicant dif-
ferences were found in prevalence of ClassIII, increased
overjet, reversed overjet, deep bite and posterior cross-
bite between the three main populations (Table 5).
The global distributions of Class I, Class II, and
ClassIII in mixed dentition stage were 72.74%, 23.11%
and 3.98%, respectively. The prevalence gures of in-
creased and reverse overjet were 23.01% and 3.65%, re-
spectively. Deep overbite and open bite cases were report-
ed in 24.34% and 5.29%, respectively. Posterior crossbite
represented 11.72% of the total pooled studies (Table 3).
Regarding prevalence of malocclusion in mixed
dentition according to geographical location (Table4),
Africa showed the highest prevalence of ClassI (90%)
but the lowest prevalence of Class II malocclusions
(7.5%). The highest prevalence gures of Class II,
ClassIII, and open bite malocclusions were reported in
Europe (31.95%), Asia (5.76%), and Africa (8.3%), re-
spectively. Deep bite was signicantly higher in Europe
(37.4%) compared to other geographical areas.
In mixed dentition, African population showed the
highest prevalence of Class I (92.47%), but the low-
est prevalence of ClassII malocclusions (5.1%), while
Caucasians showed the lowest prevalence of open bite
(3.7%). Mongoloid showed signicantly higher preva-
lence of ClassIII (10.95%). No signicant dierences
in the prevalence of other malocclusions were found be-
tween dierent ethnicities (Table 5).
The prevalence of Class II was observed less
frequently in permanent than in mixed dentition
(19.56 ± 13.76 and 23.11 ± 14.94%, respectively),
while the prevalence of ClassIII was observed more
frequently in permanent than in mixed dentition
(5.93 ± 4.96 and 3.98 ± 2.75, respectively).
Table 5 - Prevalence of malocclusion in different races
*: Significant at P ≤ 0.05.
Variable
Permanent dentition
P-valueAfricans Caucasians Mongoloids
Mean SD Mean SD Mean SD
Antero-
posterior
ClassI 89.44 9.34 71.61 15.15 74.87 9.68 0.027*
ClassII 6.76 4.99 22.9 14.07 14.14 4 .43 0.006*
ClassIII 3.8 4.67 5.92 49.63 9.02 0.228
Increased
overjet 14.62 6.22 22.29 11.77 12.87 6.78 0.132
Reversed
overjet 3.5 2.93 3.99 5.11 10.87 6.68 0.122
Vertical Deep bite 19.02 15.81 22.95 14.07 19.5 16.6 0.587
Open bite 7.8 2 2.24 4.52 4.17 3.27 2.89 0.074
Transverse Posterior
crossbite 7.2 1.61 10.08 5.6 4 7.53 0.31 0.149
Mixed dentition
Antero-
posterior
ClassI 92.47 4.41 70.39 14.78 66.75 1.77 0.02*
ClassII 5.1 3.8 25.91 14.86 22.1 0.85 0.028*
ClassIII 2.4 0.69 3.53 1.86 10.95 2.33 0.045*
Increased
overjet 16.4 7.21 23.62 7.3 27.45 11.67 0.305
Reversed
overjet 3.9 3.97 3.15 3.59 8.5 1.77 0.217
Vertical Deep bite 26.37 17.43 24.35 15.13 21.25 10.11 1
Open bite 10 5 3.7 3.77 14.15 15.49 0.035*
Transverse Posterior
crossbite 10.77 7.39 11.64 7.49 16.2
(one case) 0.689
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article Global distribution of malocclusion traits: A systematic review
40.e8
DISCUSSION
Global, regional and racial epidemiological assessment
of malocclusions is of paramount importance, since it
provides important data to assess the type and distribu-
tion of occlusal characteristics. Such data will aid in de-
termining and directing the priorities in regards to mal-
occlusion treatment need, and the resources required to
oer treatment — in terms of work capacity, skills, agility
and materials to be employed. In addition, assessment of
malocclusion prevalence by dierent populations and lo-
cations may reect existence of determining genetic and
environmental factors. In line with that, the hypothesized
tendency of changing prevalence of a specic type of
malocclusion, such as ClassII, from mixed to permanent
dentition stage may give an indication about the eect
of adolescent growth in correction of this problem. Fi-
nally, the availability of such global data will be important
for educational purposes. Regional and/or racial-specic
malocclusion may change the health policy toward devel-
oping the specialists’ skills and oering the resources re-
quired for that malocclusion. It must be emphasized that
the current study summarizes the global distribution of
malocclusion in mixed and permanent dentitions based
on data extracted from studies of moderate (72% of the
included studies) to high (28%) quality. None of the in-
cluded studies was of low quality.
The pooled global prevalence of ClassI was the highest
(74.7 ± 15.17%), ranging from 31% (Belgium) to 96.6%
(Nigeria). It was higher among Africans (89.44%), but
equivalent among Caucasians and Mongoloids (71.61%
and 74.87%, respectively). This pattern of distribution
was reported for both dentitions with slight dierences.
Noteworthy, the prevalence of Class I in permanent
dentition of Mongoloids tends to increase with pubertal
growth, mostly due to the associated tendency for ClassII
correction in this race specically.
The overall global prevalence of ClassII was 19.56%.
However, it was interesting to see a wide range from
1.6% (Nigeria) to 63% (Belgium). The lowest prevalence
was reported for Africans 6.76% and the highest was re-
ported for Caucasian (22.9%); the reported prevalence
for Mongoloids was in-between (14.14%). The pattern
of global distribution of Class II malocclusion by race
was somewhat similar in mixed and permanent denti-
tions. Withexception of African people (Africa), there is
a tendency for correction of ClassII with pubertal growth
upon transition from mixed to permanent dentition.
Both, prevalence and growth correction of ClassII, can
be attributed to the genetic inuence. Recent research
emphasizes the pivotal role of genetic control over con-
dylar cartilage and condylar growth.
63,64
The global prevalence of Class III was the lowest
among all Angle’s classes of malocclusion (5.93 ± 4.69%).
Therange was interestingly wide: 0.7% (Israel) to 19.9%
(China). The corresponding gures for Caucasians, Af-
ricans and Mongoloids were 5.92, 3.8% and 9.63%, re-
spectively. This pattern of global distribution of ClassIII
applies to mixed and permanent dentitions. A tendency to
develop this type of malocclusion appears to increase upon
transition from mixed to permanent dentition among Af-
ricans and Caucasians, rather than among Mongoloids.
The role of genetics must be emphasized. In fact, ClassIII
malocclusion in Asians is mainly due to the mid-face de-
ciency, rather than mandibular prognathism.
65
The positive correlation found between ClassII and in-
creased overjet is logical. Simply, this is due to the fact that
the most prevalent ClassII malocclusion globally is ClassII
division 1.
66
Similarly, the positive correlation of Class III
malocclusion with reversed overjet is related to skeletal base
discrepancy with minimal dentoalveolar compensation.
67
The lowest prevalent malocclusion traits globally were
reversed overjet and open bite (4.56 and 4.93, respectively).
There is a high variation in prevalence of both traits as re-
ported in the literature. Most of the studies reported that
open bite trait is highly prevalent in African populations and
low in Caucasian populations,
17,18,20,25
in contrast to the re-
versed overjet, which reported to be prevalent in Mongol-
oids. In general, both traits are genetically determined.
63,64
An interesting nding was the higher prevalence of
ClassII malocclusion in the mixed dentition than in the
permanent dentition. This could be explained by the fact
that self-correction of a skeletal ClassII problem might
occur in the late mixed and early permanent dentition
stage as a result of a potential mandibular growth spurt.
However, a sound conclusion can’t be drawn, as the pres-
ent study was not prospective. In addition, the dierence
in leeway space between maxillary and mandibular arch-
es, and residual growth in the permanent dentition stage
could explain the higher prevalence of Class III maloc-
clusion in the permanent dentition than in the mixed
dentition, and the fact that the mandible might continue
to grow till the mid- twenties.
The present pooled data showed a decrease in the
prevalence of deep bite upon transition from mixed to
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article
Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C
40.e9
permanent dentition. Thilander et al,
31
likewise, showed
that increased overbite was more prevalent in the mixed
dentition. Such an overbite reduction from the mixed to
the permanent dentition is due to both occlusal stabili-
zation involving full eruption of premolars and second
molars, and the more pronounced mandibular growth.
35
Thisalso explains the reduction in ClassII cases as well
as the increase in ClassIII cases (reverse overjet as well)
during the period of changing dentition.
In addition to the importance of reporting global mal-
occlusion, it is of an equal importance to report the world-
wide orthodontic treatment needs. We planned to do so if
the included studies had covered both issues. Thiswas not
the case, however, and hence we recommend addressing
this latter issue with a similar systematic review.
CONCLUSIONS
1) Consistent with most of the included individu-
al studies, ClassI and II malocclusions were the most
prevalent, while ClassIII and open bite were the least
prevalent malocclusions.
2) African populations showed the highest preva-
lence of Class I and open bite malocclusions, while
Caucasian populations showed the highest prevalence
of ClassII malocclusion.
3) Europe continent showed the highest prevalence
of ClassII among all continents.
4) Class III malocclusion was more prevalent in
permanent dentition than mixed dentition, conversely
nding for ClassII, while all other malocclusions vari-
ables showed no dierence between the two stages.
1. Angle EH. Classification of malocclusion. Dent Cosmos. 1899;41:248-64.
2. Guo L, Feng Y, Guo HG, Liu BW, Zhang Y. Consequences of orthodontic
treatment in malocclusion patients: clinical and microbial eects in
adults and children. BMC Oral Health. 2016 Oct 28;16(1):112.
3. Heimer MV, Tornisiello Katz CR, Rosenblatt A. Non-nutritive sucking
habits, dental malocclusions, and facial morphology in Brazilian children:
a longitudinal study. Eur J Orthod. 2008 Dec;30(6):580-5.
4. Brook PH, Shaw WC. The development of an index of orthodontic
treatment priority. Eur J Orthod. 1989 Aug;11(3):309-20.
5. Foster TD, Menezes DM. The assessment of occlusal features for public
health planning purposes. Am J Orthod. 1976 Jan;69(1):83-90.
6. Massler M, Frankel JM. Prevalence of malocclusion in children aged 14 to
18 years. Am J Orthod 1951;37(10):751-68.
7. Goose DH, Thompson, D.G., and Winter, F.C. Malocclusion in School
Children of the West Midlands. Brit Dent J. 1957;102:174-8.
8. Mills LF. Epidemiologic studies of occlusion. IV. The prevalence of
malocclusion in a population of 1,455 school children. J Dent Res.
1966;45:332-6.
9. Grewe JM, Cervenka J, Shapiro BL, Witkop CJ Jr. Prevalence of
malocclusion in Chippewa Indian children. J Dent Res. 1968 Mar-
Apr;47(2):302-5.
10. Helm S. Malocclusion in Danish children with adolescent dentition: an
epidemiologic study. Am J Orthod. 1968 May;54(5):352-66.
11. Thilander B, Myrberg N. The prevalence of malocclusion in Swedish
schoolchildren. Scand J Dent Res. 1973;81(1):12-21.
12. Foster TD, Day AJ. A survey of malocclusion and the need for
orthodontic treatment in a Shropshire school population. Br J Orthod.
1974 Apr;1(3):73-8.
13. Ingervall B, Mohlin B, Thilander B. Prevalence and awareness of
malocclusion in Swedish men. Community Dent Oral Epidemiol. 1978
Nov;6(6):308-14.
14. Helm S, Prydso U. Prevalence of malocclusion in medieval and modern
Danes contrasted. Scand J Dent Res. 1979 Apr;87(2):91-7.
15. Lee KS CK, Ko JH, Koo CH. Occlusal variations in the posterior and
anterior segments of the teeth. Korean J Orthod. 1980;10:70-9.
16. Gardiner JH. An orthodontic survey of Libyan schoolchildren. Br J
Orthod. 1982 Jan;9(1):59-61.
17. Muniz BR. Epidemiology of malocclusion in Argentine children.
Community Dent Oral Epidemiol. 1986 Aug;14(4):221-4.
18. Kerosuo H, Laine T, Kerosuo E, Ngassapa D, Honkala E. Occlusion among
a group of Tanzanian urban schoolchildren. Community Dent Oral
Epidemiol. 1988 Oct;16(5):306-9.
19. Woon KC, Thong YL, Abdul Kadir R. Permanent dentition occlusion
in Chinese, Indian and Malay groups in Malaysia. Aust Orthod J. 1989
Mar;11(1):45-8.
20. al-Emran S, Wisth PJ, Boe OE. Prevalence of malocclusion and need for
orthodontic treatment in Saudi Arabia. Community Dent Oral Epidemiol.
1990 Oct;18(5):253-5.
21. El-Mangoury NH, Mostafa YA. Epidemiologic panorama of dental
occlusion. Angle Orthod. 1990 Fall;60(3):207-14.
REFERENCES
Author’s Contribution (ORCID )
Maged S. Alhammadi (MSA): 0000-0002-1402-0470
Esam Halboub (EH): 0000-0002-1894-470X
Mona Saleh Fayed (MSF): 0000-0001-8124-6587
Amr Labib (AL): 0000-0003-1387-9571
Chrestina El-Saaidi (CES) 0000-0002-3993-9029
Conception or design of the study: MSA, AL. Data ac-
quisition, analysis or interpretation: MSA, EH, MSF,
AL, CES. Writing the article: MSA, EH, MSF. Critical
revision of the article: MSA, EH, MSF, AL, CES. Final
approval of the article: MSA, EH, MSF, AL, CES. Over-
all responsibility: MSA, EH.
© 2018 Dental Press Journal of Orthodontics Dental Press J Orthod. 2018 Nov-Dec;23(6):40.e1-10
online article Global distribution of malocclusion traits: A systematic review
40.e10
22. Lew KK, Foong WC, Loh E. Malocclusion prevalence in an ethnic Chinese
population. Aust Dent J. 1993 Dec;38(6):442-9.
23. Tang EL. The prevalence of malocclusion amongst Hong Kong male dental
students. Br J Orthod. 1994 Feb;21(1):57-63.
24. Harrison RL, Davis DW. Dental malocclusion in native children of British
Columbia, Canada. Community Dent Oral Epidemiol. 1996 June;24(3):217-
21.
25. Ng'ang'a PM, Ohito F, Ogaard B, Valderhaug J. The prevalence of
malocclusion in 13- to 15-year-old children in Nairobi, Kenya. Acta Odontol
Scand. 1996 Apr;54(2):126-30.
26. Ben-Bassat Y, Harari D, Brin I. Occlusal traits in a group of school children in
an isolated society in Jerusalem. Br J Orthod. 1997 Aug;24(3):229-35.
27. Prot WR, Fields HW Jr, 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(2):97-
106.
28. Dacosta OO. The prevalence of malocclusion among a population of
northern Nigeria school children. West Afr J Med. 1999 Apr-June;18(2):91-6.
29. Saleh FK. Prevalence of malocclusion in a sample of Lebanese
schoolchildren: an epidemiological study. East Mediterr Health J. 1999
Mar;5(2):337-43.
30. Esa R, Razak IA, Allister JH. Epidemiology of malocclusion and orthodontic
treatment need of 12-13-year-old Malaysian schoolchildren. Community
Dent Health. 2001 Mar;18(1):31-6.
31. Thilander B, Pena L, Infante C, Parada SS, de Mayorga C. Prevalence of
malocclusion and orthodontic treatment need in children and adolescents
in Bogota, Colombia. An epidemiological study related to dierent stages of
dental development. Eur J Orthod. 2001 Apr;23(2):153-67.
32. Freitas MR, Freitas DS, Pinherio FH, Freitas KMS. Prevalência das más
oclusöes em pacientes inscritos para tratamento ortodôntico na Faculdade
de Odontologia de Bauru-USP. Rev Fac Odontol. 2002;10(3):164-9.
33. Bataringaya A. Survey of occlusal trait in an adolescent population in
Uganda. Cabo: University of the Western Cape; 2004.
34. Onyeaso CO. Prevalence of malocclusion among adolescents in Ibadan,
Nigeria. Am J Orthod Dentofacial Orthop. 2004 Nov;126(5):604-7.
35. Tausche E, Luck O, Harzer W. Prevalence of malocclusions in the early
mixed dentition and orthodontic treatment need. Eur J Orthod. 2004
June;26(3):237-44.
36. Abu Alhaija ES, Al-Khateeb SN, Al-Nimri KS. Prevalence of malocclusion in
13-15 year-old North Jordanian school children. Community Dent Health.
2005 Dec;22(4):266-71.
37. Ali AH AM. Prevalence of Malocclusion in a Sample of Yemeni
Schoolchildren: an epidemiological study. Abstracts Yemeni Health Med Res.
2005;44:44.
38. Behbehani F, Artun J, Al-Jame B, Kerosuo H. Prevalence and severity
of malocclusion in adolescent Kuwaitis. Med Princ Pract. 2005 Nov-
Dec;14(6):390-5.
39. Ciuolo F, Manzoli L, D'Attilio M, Tecco S, Muratore F, Festa F, et al.
Prevalence and distribution by gender of occlusal characteristics in a sample
of Italian secondary school students: a cross-sectional study. Eur J Orthod.
2005 Dec;27(6):601-6.
40. Karaiskos N, Wiltshire WA, Odlum O, Brothwell D, Hassard TH. Preventive
and interceptive orthodontic treatment needs of an inner-city group of 6-
and 9-year-old Canadian children. J Can Dent Assoc. 2005 Oct;71(9):649.
41. Ahangar Atashi MH. Prevalence of Malocclusion in 13-15 Year-old
Adolescents in Tabriz. J Dent Res Dent Clin Dent Prospects. 2007
Spring;1(1):13-8.
42. Gelgor IE, Karaman AI, Ercan E. Prevalence of malocclusion among
adolescents in central anatolia. Eur J Dent. 2007 July;1(3):125-31.
43. Jonsson T, Arnlaugsson S, Karlsson KO, Ragnarsson B, Arnarson EO,
Magnusson TE. Orthodontic treatment experience and prevalence
of malocclusion traits in an Icelandic adult population. Am J Orthod
Dentofacial Orthop. 2007 Jan;131(1):8.e11-8.
44. Josefsson E, Bjerklin K, Lindsten R. Malocclusion frequency in Swedish
and immigrant adolescents--influence of origin on orthodontic treatment
need. Eur J Orthod. 2007 Feb;29(1):79-87.
45. Ajayi EO. Prevalence of Malocclusion among School children in Benin
City, Nigeria. J Biomed Res. 2008;7(1-2):58-65.
46. Mtaya M, Astrom AN, Brudvik P. Malocclusion, psycho-social impacts
and treatment need: a cross-sectional study of Tanzanian primary
school-children. BMC Oral Health. 2008 May 6;8:14.
47. Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F. Malocclusion
and occlusal traits in an urban Iranian population. An epidemiological
study of 11- to 14-year-old children. Eur J Orthod. 2009 Oct;31(5):477-
84.
48. Daniel IB PF, Rogerio G. Prevalência de más oclusões em crianças de
9 a 12 anos de idade da cidade de Nova Friburgo (Rio de Janeiro). Rev
Dental Press Ortod Ortop Facial. 2009;14(6):118-24.
49. Sidlauskas A, Lopatiene K. The prevalence of malocclusion among
7-15-year-old Lithuanian schoolchildren. Medicina (Kaunas).
2009;45(2):147-52.
50. Alhammadi M. The prevalence of malocclusion in a group of Yemeni
adult population: an epidemiologic study [thesis]. Cairo: Cairo
University; 2010.
51. Bhardwaj VK, Veeresha KL, Sharma KR. Prevalence of malocclusion and
orthodontic treatment needs among 16 and 17 year-old school-going
children in Shimla city, Himachal Pradesh. Indian J Dent Res. 2011 July-
Aug;22(4):556-60.
52. Nainani JT, Relan S. Prevalence of Malocclusion in School Children of Nagpur
Rural Region - An Epidemiological Study. J Dental Assoc. 2011;5:865-7.
53. Bugaighis I. Prevalence of malocclusion in urban libyan preschool
children. J Orthod Sci. 2013 Apr;2(2):50-4.
54. Kaur H, Pavithra US, Abraham R. Prevalence of malocclusion among
adolescents in South Indian population. J Int Soc Prev Community
Dent. 2013 July;3(2):97-102.
55. Reddy ER, Manjula M, Sreelakshmi N, Rani ST, Aduri R, Patil BD.
Prevalence of Malocclusion among 6 to 10 Year old Nalgonda School
Children. J Int Oral Health. 2013 Dec;5(6):49–54.
56. Bilgic F, Gelgor IE, Celebi AA. Malocclusion prevalence and orthodontic
treatment need in central Anatolian adolescents compared to European
and other nations' adolescents. Dental Press J Orthod. 2015 Nov-
Dec;20(6):75-81.
57. Gupta DK, Singh SP, Utreja A, Verma S. Prevalence of malocclusion and
assessment of treatment needs in beta-thalassemia major children.
Prog Orthod. 2016;17:7.
58. Narayanan RK, Jeseem MT, Kumar TA. Prevalence of Malocclusion
among 10-12-year-old Schoolchildren in Kozhikode District, Kerala: An
Epidemiological Study. Int J Clin Pediatr Dent. 2016 Jan-Mar;9(1):50-5.
59. Mattheeuws N, Dermaut L, Martens G. Has hypodontia increased in
Caucasians during the 20th century? A meta-analysis. Eur J Orthod.
2004 Feb;26(1):99-103.
60. Polder BJ, Van't Hof MA, Van der Linden FP, Kuijpers-Jagtman AM. A
meta-analysis of the prevalence of dental agenesis of permanent teeth.
Community Dent Oral Epidemiol. 2004 June;32(3):217-26.
61. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD,
Pocock SJ et al. Strengthening the Reporting of Observational Studies
in Epidemiology (STROBE): explanation and elaboration. Int J Surg.
2014;12:1500-24.
62. Kalakonda B, Al-Maweri SA, Al-Shamiri HM, Ijaz A, Gamal S, Dhaifullah E.
Is Khat (Catha edulis) chewing a risk factor for periodontal diseases? A
systematic review. J Clin Exp Dent. 2017;9:e1264-70.
63. Shibata S, Suda N, Suzuki S, Fukuoka H, Yamashita Y. An in situ
hybridization study of Runx2, Osterix, and Sox9 at the onset of
condylar cartilage formation in fetal mouse mandible. J Anat. 2006
Feb;208(2):169-77.
64. Hinton RJ. Genes that regulate morphogenesis and growth of the
temporomandibular joint: a review. Dev Dyn. 2014 July;243(7):864-74.
65. Newman GV. Prevalence of malocclusion in children six to fourteen
years of age and treatment in preventable cases. J Am Dent Assoc.
1956 May;52(5):566-75.
66. Silva Filho OG, Ferrari Junior FM, Okada Ozawa T. Dental arch
dimensions in ClassII division 1 malocclusions with mandibular
deficiency. Angle Orthod. 2008 May;78(3):466-74.
67. Kim SJ, Kim KH, Yu HS, Baik HS. Dentoalveolar compensation according
to skeletal discrepancy and overjet in skeletal ClassIII patients. Am J
Orthod Dentofacial Orthop. 2014 Mar;145(3):317-24.
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... Only 2.9% of the patients could not have their malocclusions assessed, primarily due to the absence of teeth. Alhammadi et al. 41 analyzed the global distribution of malocclusions, determining that the Class I Angle malocclusion is the most prevalent in the African population, which is in line with the results of this study. Malocclusions may not be a primary concern in the general population based on ethnicity. ...
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This descriptive study focuses on the oral health of African migrants, especially adolescents, arriving in the Canary Islands. Notably, these patients show a high prevalence of caries and oral mucosal alterations. These are influenced by multifactorial factors, such as living conditions in their country of origin, hygiene habits, and sugar-rich diets. Furthermore, it is worth noting the need for inclusive oral health policies in receiving countries and the need to develop oral health care protocols in regions with migratory flows to effectively address oral health needs and facilitate the integration of migrants. We included 104 migrant patients from different African countries, mainly from North and West Africa, and analyzed their oral health status. We found that 89.4% of the patients had dental caries, with a higher prevalence in North Africa. Moreover, 25% of patients showed oral mucosal alterations, with leukoedema being the most common condition. Regarding malocclusions, 42.6% of patients had Class I malocclusion and only 15.4% had dental crowding. Regarding intraosseous lesions, 97.1% of the patients had no lesions and most did not require dental prostheses. This study provides a detailed overview of the oral health conditions of African migrants in the Canary Islands.
... Any type of misalignment in the jaw arches or any anomalies related to tooth position is known as Malocclusion [1]. Malocclusion affect the overall personality and may lead to psychological distress in children [2,3]. In 1987, The World Health Organization (WHO) had included malocclusion under the group of "Handicapping Dentofacial anomalies [4]. ...
Article
Introduction: The relationship between Body Mass Index (BMI) and dental malocclusion remains uncertain. This systematic review aims to assess the link between BMI and malocclusion in children and adolescents. Sources of Data and Study Selection: Through electronic and manual searches up to August 2021, 1002 records were found, with 610 screened after removing duplicates. Eight studies were included in qualitative synthesis, and four in quantitative analysis. Malocclusion types, including crossbite, spacing, and crowding, were key review outcomes. The NIH quality assessment tool was used for bias assessment. This review encompassed eight studies involving 4128 children. Pooled analysis demonstrated significantly larger spacing in normal BMI children compared to those with low BMI. No significant difference was found in crossbite prevalence [1.33 (0.42, 4.25), p=0.63, I2=0%, p=0.85]. A quality assessment revealed four good-quality studies and the rest with poor/ fair quality. Conclusion: The impact of BMI on childhood malocclusion remains debated. Current research lacks consistent evidence linking BMI to malocclusion. To progress, future studies need standardized classifications and robust evaluation of confounding factors. This approach will strengthen understanding and guide effective interventions. Clinical Significance: Despite extensive research, the association between Body Mass Index (BMI) and dental malocclusion remains unclear, highlighting the complexity of this relationship. This systematic review suggests that normal BMI children tend to exhibit larger spacing between teeth compared to those with low BMI. Understanding such associations can aid in early detection and intervention strategies for malocclusion in children and adolescents.
... [13][14][15][16][17][18][19] The prevalence of malocclusion in this stage varies widely, ranging from 32.20% to 82.50%. 14,[20][21][22][23][24][25] This variability can largely be attributed to a lack of standardization in assessment tools and data collection methods, which can result in underestimation or overestimating outcomes. 5,24 Another important aspect to be highlighted is that, throughout the phase of mixed dentition, certain malocclusions have the potential to self-correct or reduce their severity, which may explain the variations noted among the diverse occlusal stages. ...
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This study aim was to evaluate the need for orthodontic treatment of mixed to permanent dentition using the Dental Aesthetic Index (DAI) in a 4-year follow-up. A longitudinal study was conducted with 353 children in the stages from mixed (T1) to permanent (T2) dentition. The need for orthodontic treatment was assessed using the DAI categorized into: DAI 1 (absence of malocclusion and orthodontic treatment need; DAI ≤ 25); DAI 2 (malocclusion is defined and elective orthodontic treatment is needed; DAI = 26 to 30); DAI 3 (severe malocclusion and a desirable orthodontic treatment need; DAI = 31 to 35) and DAI 4 (severe malocclusion and a mandatory orthodontic treatment need; DAI ≥ 36). The Bowker symmetry test was used to determine agreement in the categorization of DAI at T1 and T2, with a significance level of 5%. The results showed a significant disagreement in the need for orthodontic treatment between T1 and T2 (p<0.05). In 34.6% of children evaluated in T1, the same need for orthodontic treatment was maintained in T2. According to the DAI, in 60.8% of the children, the need decreased, and in 39.2% their need for orthodontic treatment increased. This preliminary longitudinal study using DAI, showed a decrease in malocclusion and need for orthodontic treatment as the dentition transitioned from mixed to permanent occurred. This finding has valuable implications for epidemiological data in orthodontics.
... Malocclusions are a common dental condition in childhood and adolescence. They are considered a worldwide health problem, with diverse manifestations across different populations and are caused by genetic and environmental factors [2]. These factors include growth patterns, muscle functions, breathing patterns, and early tooth extractions or losses [3,4]. ...
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Objectives: The intricate relationship between malocclusions and speech sound disorders (SSDs) is yet to be fully understood. This is particularly true for pediatric patients during the deciduous and mixed dentition stages. Employing a methodical scoping review approach, this study scrutinizes the recent literature to elucidate how these dental misalignments impact speech articulation and phonetic clarity. Methods: The present scoping review has been conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The selected articles have been found using PubMed, Scopus, Web of Science, and The Cochrane Library; the scope was limited to studies describing cases of patients in the deciduous or mixed dentition stage and the presence of both malocclusion and SSDs. Results: Out of the 1880 articles found, 44 passed the initial screening and 12 met the eligibility criteria and have been included in this review. Conclusions: The analysis reveals that while there is a consensus on the influence of malocclusions on speech production, the extent and specific nature of these effects vary across studies. anterior open bite is frequently associated with speech disorders, affecting phonemes by altering airflow and tongue placement. The review highlights the need for multidisciplinary approaches for effective treatment and calls for further investigation into the causative relationships between malocclusions and SSDs.
... At this stage, if the adolescent is exposed to AOB, it could affect his or her quality of life in terms of oral health during swallowing, pronunciation, smiling and social development due to the esthetic impact it has (15). The prevalence of malocclusions in school children varies widely, some consider a range between 4.93%, 7.1%, into 9%, so the impact that these can have on their quality of life is something that should be considered (16)(17)(18). Currently there is some research that relates the impact on quality of life in patients with anterior open bite. Others conclude that malocclusions significantly affect interpersonal relationships and self-esteem (19,20). ...
... Imbalance is influenced by several factors: genetic, environmental, growth and development, ethnic, functional, and pathology. 4 The etiology of malocclusion from environmental factors after tooth eruption can be influenced by muscle strength activity, muscle position at rest, sucking habits, and abnormalities in mandibular movement from resting position to centric position, which in every mandibular activity involves the muscles of mastication. 5,6 Assessment and measurement of muscle activity can be obtained from electromyography (EMG), which is an experimental technique for assessing muscle activity. ...
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Objectives This study aims to detect early class I, II, and III malocclusions through the muscle strength of the lips, tongue, masseter, and temporalis. Materials and Methods The study subjects were 30 pediatric patients with predetermined criteria. The subjects were divided into class I, II, and III malocclusions where each classification of malocclusion amounted to 10 people. Subjects were differentiated according to gender and age. Tongue pressure during swallowing was recorded by a palatal measurement sensor system. The strength of the activity was assessed when the lip muscles resisted as hard as possible the traction plate placed between the teeth and the lips, then the force was connected to an electromyograph (EMG) to be measured. Temporal and masseter muscle contractions were assessed when the muscles performed swallowing, chewing, mouth opening, resting, mouth closing, and biting movements. Statistical Analysis Data analysis using the SPSS application was performed with the ANOVA test if the data distribution was normal, and if the data distribution was not normal, then the Kruskal–Wallis test was used. Significant data were evaluated by post-hoc tests using least significant difference if the data distribution was normal or the Mann–Whitney test if the data distribution was not normal. Results It was found that there was a significant difference in the left masseter muscle and left temporalis muscle. Conclusion EMG can be considered as a tool to detect class I, II, and III malocclusions through muscle contraction. Biting and chewing positions have satisfactory EMG examination results for malocclusion detection. Age and gender of the child may affect the results of EMG examination in certain conditions.
Article
Background Orthodontic treatment is one of the longest and most common medical interventions in adolescence. There are certain inequalities in care leading to risk factors associated with higher rates of untreated tooth malocclusion, resulting in a significant burden on oral health. Little is known about that certain psychosocial and personal risk factors influence the uptake of orthodontic treatment. Therefore, the aim was to explore factors that might influence orthodontic treatment and psychosocial and personal factors in a representative sample in Germany. Methods The data are based on the KiGGS Survey Wave 2, a representative cross-sectional study of children and adolescents in Germany. Sociodemographic data, uptake of orthodontic treatment, parental socioeconomic status, social support, self-efficacy, and perceived health status were collected through a self-reported questionnaire. Results A total of 6599 children and adolescents between 11 and 17 years were included in the analysis. Girls, non-immigrants, children, and adolescents with higher levels of social support, and children and adolescents who have visited a dentist or orthodontist more often in the past 12 months are more likely to have received orthodontic treatment. Among 14- to 17-year-olds, the likelihood of seeking orthodontic treatment is also associated with an increasing parental socioeconomic status (odds ratio 1.07 [95% CI 1.02; 1.14] P = .013). Conclusions Certain protective and risk factors as well as personal and psychosocial factors are associated with orthodontic treatment. This knowledge can be used to determine which individuals should be targeted for need-based care to ensure that health care is provided without over- or undertreatment.
Article
Introdução: O tratamento adequado da oclusopatia é fundamental, mas nem sempre isso acontece. Objetivo: Investigar o uso de aparelho ortodôntico por jovens de 12 anos de idade. Metodologia: Realizou-se um inquérito com responsáveis de 410 escolares de um município do Estado de São Paulo. Utilizou-se um questionário com as variáveis: uso e tipo de aparelho, razões da instalação, sessões de ativação, tempo de tratamento, custo e satisfação com o tratamento. Também se investigou: recebimento de orientação sobre higiene bucal e frequência de escovação. Resultados: Do total, 15,86% apresentavam experiência de uso de aparelho ortodôntico, dos quais 63,08% atendidos em clínicas particulares, 18,46% em clínicas conveniadas e 15,38% em clínicas de universidades. Quanto ao tipo de aparelho, 60% relataram tratamento com aparelhos fixos. Entre as principais razões da instalação, 35,38% foram por estética, 26,15% por problemas mastigatórios e 15,38% por indicação do cirurgião-dentista. Quanto às ativações, 30% não realizavam todas as sessões. O tempo médio de tratamento foi de 12 ± 7.39 meses. Os custos médios mensais dos tratamentos particulares foram R72,98erealizadosporconve^nioR72,98 e realizados por convênio R56,36. Quase a totalidade dos responsáveis (92.31%) relatou que os jovens haviam recebido orientação sobre higiene bucal e que 47,69% deles realizavam escovação dentária, em média, 2 vezes/dia. Quanto à satisfação com o tratamento, 10,77% dos responsáveis estavam insatisfeitos com o custo. Conclusão: O uso de aparelho ortodôntico foi expressivo, em grande parte devido a estética, e que uma parcela considerável do acesso ocorreu por meio de convênios e universidades.
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Background Khat (Catha edulis) chewing is a highly prevalent habit in the Arabian Peninsula and East Africa, and has recently spread to Western countries. The association between khat chewing and oral mucosal lesions is well documented in the literature. However, there is no concrete evidence on the association between khat chewing and periodontal disease. The purpose of this systematic review was to analyze the influence of khat chewing on periodontal health. Material and Methods A literature search of PubMed, Scopus and Web of Sciences databases was carried out to identify relevant articles published from 1990 to May 2017. The inclusion criteria were all clinical studies that assessed the relationship between khat chewing and periodontal disease. Results The search yielded 122 articles, of which 10 were included in this systematic review. Most of the studies exhibited a positive correlation between khat chewing and periodontal disease. Conclusions Altogether, the analysis of the current evidence reveals that khat chewing is destructive to the periodontium and enhances the risk of periodontal disease progression. However, due to variability of studies, more longitudinal case-controlled studies are highly warranted to establish a causal relation between khat chewing and periodontal disease. Key words:Khat chewing, periodontal health, periodontal disease, risk factor.
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Background Malocclusion is a common disease of oral and maxillofacial region. The study was aimed to investigate levels changes of periodontal pathogens in malocclusion patients before, during and after orthodontic treatments, and to confirm the difference between adults and children. Method One hundred and eight malocclusion patients (46 adults and 62 children at the school-age) were randomly selected and received orthodontic treatment with fixed orthodontic appliances. Subgingival plaques were Porphyromonas gingivalis (P.gingivalis), Fusobacterium nucleatum (F. nucleatum), Prevotella intermedia (P. intermedia) and Tannerella forsythensis (T. forsythensis) collected from the observed regions before and after treatment. Clinical indexes, including plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), probing depth (PD) and attachment loss (AL) of observed teeth were examined. Results The detection rates of P.gingivalis, F. nucleatum, P. intermedia and T. forsythensis increased from baseline to the third month without significant difference, and then returned to pretreatment levels 12 month after applying fixed orthodontic appliances. Adults’ percentage contents of P.gingivalis, F. nucleatum, P. intermedia and T. forsythensis were significantly higher than those of children at baseline and the first month, but not obvious at the third month. PLI and SBI were increased from baseline to the first and to the third month both in adults and children groups. Besides, PD were increased from baseline to first month, followed by a downward trend in the third month; however, all patients were failed to detect with AL. Conclusions Periodontal and microbiological statuses of malocclusion patients may be influenced by fixed orthodontic appliances in both adults and children, more significant in children than in adults. Some microbiological indexes have synchronous trend with the clinical indexes. Long-term efficacy of fixed orthodontic appliances for malocclusion should be confirmed by future researches.
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Objective: To determine the prevalence of malocclusion and orthodontic treatment need in a large sample of Central Anatolian adolescents and compare them with European-other nations' adolescents. Methods: The sample included 1125 boys and 1204 girls aged between 12 and 16 years with no previous orthodontic treatment history. Occlusal variables examined were molar relationship, overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite. The dental health (DHC) and aesthetic components (AC) of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment for the total sample. Results: The results indicated a high prevalence of Class I (34.9%) and Class II, Division 1 malocclusions (40.0%). Moreover, increased (18%) and reduced bites (14.%), and increased (25.1%) and reversed overjet (10.%) were present in the sample. Conclusion: Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment need (grades 4 and 5) was 28.%. However, only 16.7% of individuals were in need (grades 8-10) of orthodontic treatment according to the AC.
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Background: A malocclusion is an irregularity of the teeth or a malrelationship of the dental arches beyond the range of what is accepted as normal. Objectives: To determine the prevalence of malocclusion in children aged 10-12 years in Kozhikode district of Kerala, South India. Materials and methods: A descriptive cross-sectional study was conducted among schoolchildren aged 10-12 years in six schools in Kozhikode district of Kerala, South India. A total of 2,366 children satisfied the inclusion criteria. Occlusal characteristics like crossbite, open bite, deep bite, protrusion of teeth, midline deviations, midline diastema and tooth rotation were recorded. The data were tabulated and analyzed using Chi-square test. Results: The results revealed that the overall prevalence of malocclusion was 83.3%. Of this, 69.8% of the children had Angle’s class I malocclusion, 9.3% had class II malocclusion (division 1 = 8.85%, division 2 = 0.5%) and 4.1% had class III malocclusion; 23.2% showed an increased overjet (>3 mm), 0.4% reverse overjet, 35.6% increased overbite (>3 mm), 0.29% open bite, 7.2% crossbite with 4.6% crossbite of complete anterior teeth, 63.3% deviation of midline, 0.76% midline diastema and 3.25% rotated tooth. No significant differences in gender distributions of malocclusions were noted except for increased overjet and overbite. Conclusion: There is high prevalence of malocclusion among schoolchildren in Kozhikode district of Kerala. Early interception and early correction of these malocclusions will eliminate the potential irregularities and malpositions in the developing dentofacial complex. How to cite this article: Narayanan RK, Jeseem MT, Kumar TVA. Prevalence of Malocclusion among 10-12-year-old Schoolchildren in Kozhikode District, Kerala: An Epidemiological Study. Int J Clin Pediatr Dent 2016;9(1):50-55.
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Background The objective of this study is to evaluate the prevalence of malocclusion and treatment needs in transfusion dependent β-thalassemia major children. Methods One hundred transfusion dependent β-thalassemia major children visiting the Department of Pediatrics were selected randomly and evaluated for malocclusion with Angle’s classification and Dewey’s modification. The orthodontic treatment needs were also assessed using Grainger’s treatment priority index (TPI). The orthodontic treatment needs were compared to normal children. Results The assessment of treatment needs revealed a higher prevalence of handicapping and severely handicapping malocclusion in thalassemic children compared to normal children. The thalassemic patients were found to show significantly more Angle’s Class II malocclusion (55 % vs. 15.7 %) when compared to normal children. Conclusions The higher prevalence of Angle’s Class II malocclusion and definitive malocclusion in thalassemic children indicates the importance of preventive orthodontic procedures and efforts towards providing orthodontic treatment to these children.
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Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
Article
The objective of this study was to determine the prevalence of malocclusion among predominantly Yoruba adolescents in lbadan, Nigeria, and to compare the results with those of other authors. The sample for this epidemiological survey comprised 636 secondary school students, (334 [52.5%] boys and 302 [47.5%] girls), aged 12-17 years (mean age, 14.72 +/- 1.16 SD). The subjects were randomly selected, and none had received previous orthodontic treatment. Occlusal anteroposterior relationships were assessed based on the Angle classification. Other variables examined were overjet, overbite, crowding, and midline diastema. The results showed that about 24% of the subjects had normal occlusions, 50% had Class I malocclusions, 14% had Class II malocclusions, and 12% had Class III malocclusions. Over 66% had normal overbites, and 14% and 9% had increased and reduced values, respectively. Overjet relationship was normal in 66%, increased in 16%, and decreased in 8%. Crowding was observed in 20% of the subjects and midline diastema in 37%. No statistically significant differences were observed for any occlusal variables (P >.05). Class I malocclusion is the most prevalent occlusal pattern among these Nigerian students. Different patterns of Class II and Class III might be present for the dominant ethnic groups in the country. Therefore, a survey of the occlusal pattern in southeastern Nigerians (Ibo ethnic group) would appear to be worthwhile.
Article
Objective: To determine the prevalence of malocclusion and orthodontic treatment need in a large sample of Central Anatolian adolescents and compare them with European-other nations’ adolescents. Methods: The sample included 1125 boys and 1204 girls aged between 12 and 16 years with no previous orthodontic treatment history. Occlusal variables examined were molar relationship, overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite. The dental health (DHC) and aesthetic components (AC) of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment for the total sample. Results: The results indicated a high prevalence of Class I (34.9%) and Class II, Division 1 malocclusions (40.0%). Moreover, increased (18%) and reduced bites (14.%), and increased (25.1%) and reversed overjet (10.%) were present in the sample. Conclusion: Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment need (grades 4 and 5) was 28.%. However, only 16.7% of individuals were in need (grades 8-10) of orthodontic treatment according to the AC.
Article
The aim of this study was to develop a valid and reproducible index of orthodontic treatment priority. After reviewing the available literature, it was felt that this could be best achieved by using two separate components to record firstly the dental health and functional indications for treatment, and secondly the aesthetic impairment caused by the malocclusion. A modification of the index used by the Swedish Dental Health Board was used to record the need for orthodontic treatment on dental health and functional grounds. This index was modified by defining five grades, with precise dividing lines between each grade. An illustrated 10-point scale was used to assess independently the aesthetic treatment need of the patients. This scale was constructed using dental photographs of 12-year-olds collected during a large multi-disciplinary survey. Six non-dental judges rated these photographs on a visual analogue scale, and at equal intervals along the judged range, representative photographs were chosen. To test the index in use, two sample populations were defined; a group of patients referred for treatment, and a random sample of 11–12-year-old schoolchildren. Both samples were examined using the index and satisfactory levels of intra- and inter-examiner agreement were obtained.