TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background: Primary dentition is determinant for future permanent occlusion.

Aim: The aim of this study was to reveal occlusion anomalies and associated risk factors among two research groups: clinically referred group and Tbilisi preschooler group.

Methods: The clinical study was conducted at the Orthodontic centre and included 206 children aged 3-6 years of both gender. 396 children aged 3 to 6 were evaluated in kindergartens of Tbilisi. Multi-stage cluster sampling with preliminary stratification was applied to obtain a representative sample of preschoolers. In each stratum kindergartens  were selected  using the PPS (Probability Proportional to Size) method. Questionnaires were given to parents to find out general health problems, functional changes and the presence of non-nutritive sucking habits. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 21.00.

Results: The prevalence of malocclusion among Tbilisi preschoolers was 49.8%, with no significant differences found in genders. This study showed that the prevalence of Class II was 21.2%(±4.091), followed by deep overbite 10.7% (±3.14), cross bite 7% (±2.561), anterior open bite 6.9% and Class III 1.6% (±1.513). Children with breathing problems had Class II in 41.5% and cross bite in 13%. Speech disorder in 46.8% of cases was associated with anterior open bite. Pacifier users had Class II in 22.5%, deep overbite in 12.2% and open bite in 9.2% of cases. There was a high prevalence of anterior open bite (25.2%) in children with a thumb sucking habit (RR=4.90). Clinically tested patients had twice as high prevalence of malocclusions than preschoolers (49.8%) and 87,9 % of the total amount had occlusal problems. The most frequent disorder was Class III (39.1%), followed by cross bite (19.9%), open bite (9.6%), deep overbite (9.3%) and Class II (6.4%). The significance level is 0.05 for all statistical tests.

Conclusions: The results revealed a high prevalence of malocclusion in primary dentition in children aged 3-6 years old of Tbilisi, Georgia, especially in sagittal dimension. The malocclusion frequency was higher in clinically referred children. The most frequent malocclusion among Tbilisi preschoolers was Class II, while clinically, the most frequent disorder was Class III. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

References

Legovic M, Mady L. Longitudinal occlusal changes from primary to permanent dentition in children with normal primary occlusion. Angle Orthod. 1999;69(3):264-266.

Onyeaso CO, Isiekwe MC. Occlusal changes from primary to mixed dentitions in Nigerian children. Angle Orthod. 2008;78(1):64-69.

Wagner Y, Heinrich-Weltzien R. Occlusal characteristics in 3-year-old children–results of a birth cohort study. BMC Oral Health. 2015;15(1):94.

Shen L, He F, Zhang C, et al. Prevalence of malocclusion in primary dentition in mainland China, 1988–2017: a systematic review and meta-analysis. Sci Rep. 2018;8(1)4716.

Kiliaridis S, Engström C and Thilander B. The relationship between masticatory function and craniofacial morphology: I. A cephalometric longitudinal analysis in the growing rat fed a soft diet. Eur J Orthod. 1985;7(4):273‐283.

Zhou X, Zhang Y, Wang Y, et al. Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China. Int J Environ Res Public Health. 2017;14(3):328.

Stahl F, Grabowski R. Orthodontic findings in the deciduous and early mixed dentition--inferences for a preventive strategy. J Orofac Orthop. 2003;64(6):401‐416.

Frazão P, Narvai PC, Latorre M, et al. Malocclusion prevalence in the deciduous and permanent dentition of schoolchildren in the city of São Paulo, Brazil. Cad Saúde Pública 2002;18(5):1197-1205.

Da Silva Filho OG, Santamaria M Jr, Capelozza Filho L. Epidemiology of posterior crossbite in the primary dentition. J Clin Pediatr Dent. 2007;32(1):73‐78.

Thilander B, Pena L, Infante C, et al. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Eur J Orthod. 2001;23(2):153‐167.

Tausche E, Luck O, Harzer W. Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need. Eur J Orthod. 2004;26(3):237‐244.

Sabashvili M. Prevalence of Malocclusion Among 6-15-Year-Old Children in Georgia: Case Report. BJSTR. 2018;7(5).

Shishniashvili TE, Suladze NN, Margvelashvili. Primary Teeth and Hair as Indicators of Environmental Pollution. J Clin Ped Dent. 2016;40(2):152-155.

Darjania O. Prevalence of maxillofacial disorders, their structural specifications, associated risk factors and the possibilities of self correction in Georgian children. PhD thesis, Tbilisi State Medical University, Georgia, 2004.

World Health Organization, Oral Health Assessment Form for Children, 2013.

www.who.int/oral_health/publications/pep_annex2formchildrentooth.pdf?ua=1.

Foster TD, Hamilton MC. Occlusion in the primary dentition. Study of children at 2 and one-half to 3 years of age. Br Dent J. 1969;126(2):76‐79.

Zhou X, Zhang Y, Wang Y, et al. Prevalence of Malocclusion in 3-to 5-year-old children in Shanghai, China. Int J Environ Res Public Health. 2017;14(3):328.

Chevitarese AB, Della Valle D, Moreira TC. Prevalence of malocclusion in 4-6 year old Brazilian children. J Clin Pediatr Dent. 2002;27(1):81‐85.

Ize-Iyamu IN, Isiekwe MC. Prevalence and factors associated with anterior open bite in 2 to 5 year old children in Benin city, Nigeria. Afr Health Sci. 2012;12(4):446‐451.

Ling HT, Sum FH, Zhang L, et al. The association between nutritive, non-nutritive sucking habits and primary dental occlusion. BMC Oral Health. 2018:18(1):145.

Urzal V, Braga AC, Ferreira AP. Oral habits as risk factors for anterior open bite in the deciduous and mixed dentition - cross-sectional study. Eur J Paediatr Dent. 2013;14(4):299‐302.

Wagner Y, Heinrich-Weltzien R. Occlusal characteristics in 3-year-old children--results of a birth cohort study. BMC Oral Health. 2015;15:94.

Grabowski R, Stahl F, Gaebel M, et al. Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition. Part I: Prevalence of malocclusions. J Orofac Orthop. 2007;68(1):26‐37.

Grippaudo C, Paolantonio EG, Antonini G, et al. Association between oral habits, mouth breathing and malocclusion. Associazione fra abitudini viziate, respirazione orale e malocclusione. Acta Otorhinolaryngol Ital. 2016;36(5):386‐394.

Fraga WS, Seixas VM, Santos JC, Paranhos LR, Cesar CP. Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies. Minerva Stomatol. 2018;67(3):129-38.

Souki BQ, Pimenta GB, Souki MQ, et al. Prevalence of malocclusion among mouth breathing children: do expectations meet reality? Int J Pediatr Otorhinolaryngol. 2009;73(5):767-73.

Chaffee BW, Feldens CA, Vítolo MR. Association of long-duration breastfeeding and dental caries estimated with marginal structural models. Ann Epidemiol. 2014;24(6):448-54.

Amaral CC, da Costa VP, Azevedo MS, Pinheiro RT, Demarco FF, Goettems ML. Perinatal health and malocclusions in preschool children: Findings from a cohort of adolescent mothers in Southern Brazil. Am J Orthod Dentofacial Orthop. 2017;152(5): 613-21.

Paglia L. Does breastfeeding increase risk of early childhood caries? Eur J Paediatr Dent. 2015;16(3):173.

Carvalho AC, Paiva SM, Scarpelli AC, et al. Prevalence of malocclusion in primary dentition in a population-based sample of Brazilian preschool children. Eur Journal Paediat Dent. 2011;12(2):107-11.

Frazao P, Narvai PC, Latorre RM, Castellanos RA. Malocclusion prevalence in the deciduous and permanent dentition of schoolchildren in the city of São Paulo, Brazil. Cad Saude Publica. 2002;18(5):1197-205.

Da Silva Filho OG, Santamaria Jr M, Filho LC. Epidemiology of posterior crossbite in the primary dentition. J Clin Pediatr Dent. 2007;32(1):73-8.