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Background and Objective: Dental study casts play a vital role in the diagnosis and treatment planning of various orthodontic cases. This study was carried out to compare the tooth widths, arch widths, and arch lengths in Class-I normal dentition to those in Class-I and Class-II crowded dentition in an effort to improve treatment planning and to eventually reduce treatment duration. Methods: Total 170 patients, 12 to 40 years of age with a complete set of permanent teeth till 1st molars; who presented to the Orthodontics Department at Armed Forces Institute of Dentistry (A.F.I.D), Rawalpindi from Sep 2019 to Feb 2020, were included in the study. Non-probability purposive method of sampling was used. The dental casts obtained were used to measure tooth widths, arch widths, and arch lengths. Subjects were classified into Class-I normal and Class-I and Class-II crowded occlusion and comparison of the sum of tooth widths, arch widths, and arch length discrepancies were determined among the three occlusion groups. Data was analyzed in SPSS version 21 and independent samples t-test was used to differentiate the variables of interest. Results: Out of 170 subjects, 73 (42.9%) subjects had Class-I normal occlusion while 97 (57%) had Class-I and Class-II crowded occlusions. No statistical difference was found between the occlusal groups with regard to the sum of tooth widths, inter-canine widths, inter-first premolar widths, inter-second premolar widths and inter-molar widths. However, a remarkable difference was observed between the occlusal groups with respect to arch perimeters and arch length discrepancies (p = 0.000 and 0.000 respectively). Conclusions: Results of the current study indicate that crowding of teeth occurs as a consequence of decreased arch perimeters which may lead to increased arch length discrepancies. However, no prominent difference was noticed in the sum of tooth widths and arch widths among different occlusal groups. doi: https://doi.org/10.12669/pjms.37.2.3240 How to cite this:Shafique HZ, Zaheer R, Jan A, Fazal A. Comparison of Tooth Widths, Arch Widths and Arch Lengths in Class-I Normal Dentition to Class-I and II Crowded Dentitions. Pak J Med Sci. 2021;37(2):345-350. doi: https://doi.org/10.12669/pjms.37.2.3240 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background To assess the prevalence of malocclusion and orthodontic treatment need among adolescents using the dental health component (DHC) of the index of orthodontic treatment need (IOTN). Methods A descriptive cross-sectional study was conducted among 500 (mean age 16.25 ± 1.09) adolescents randomly selected from the northern border region of Saudi Arabia (KSA). The northern border region is sub-divided into three governorates: Ar’ar (186), Rafha (142) and Turayf (172). The data were recorded in questionnaires to assess the prevalence of malocclusion and estimate of DHC of the IOTN index. Results The most common malocclusions in order of prevalence were Angle’s Class I (52.8%), Angle’s Class II (31.8%), Angle’s Class III (15.4%), crowding (47.2%), excessive overjet (> 2 mm) (22.2%), reduced overjet (< 1 mm) (11.4%), excessive overbite (> 2 mm) (23.4%), reduced overbite (< 1 mm) (12.2%), anterior crossbite (4.8%), posterior crossbite (9.4%) and open bite (4.6%). The most common facial profiles determined in the sagittal plane, were the straight facial profile (49.2%), convex (42.6%) and concave (8.2%). The prevalence of Grade 1 and 2 DHC was 49.4%, Grade 3 was 29.6%, Grade 4 and 5 was 21%. The grades of DHC of IOTN index were as follows: 48.73% of males and 50.22% of females showed grades 1 and 2. Grade 3 was observed in 30.32% of males and 28.69% of females. Grades 4 and 5 were recorded in 20.93% of males and 21.07% of females. Conclusions The prevalence of malocclusion and orthodontic treatment need among the north border region of KSA is comparable with that of other regional studies.

Abstract 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. Resumo 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 permanente (23%) e na dentição mista (26%). A má oclusão de Classe III na dentição mista foi mais prevalente entre xantodermas. Conclusão: 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.

Abstract Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap. RESUMO Objetivo: comparar as alterações sofridas nos tecidos moles em casos limítrofes de Classe I tratados com extrações e sem extrações. Métodos: uma amostra inicial de 150 pacientes com má oclusão esquelética e dentária de Classe I (89 pacientes tratados com extrações de pré-molares e 61 pacientes tratados sem extrações) foi aleatoriamente selecionada e submetida a uma análise discriminante, a qual permitiu selecionar uma amostra de 44 pacientes limítrofes (22 tratados com extrações e 22 tratados sem extrações). Telerradiografias obtidas antes e depois do tratamento dessa subamostra de pacientes limítrofes foram analisadas, utilizando-se 22 grandezas em tecidos moles. Resultados: nos casos limítrofes tratados com extrações, houve maior retração dos lábios superior e inferior e um maior aumento na espessura do lábio superior (p < 0,01); bem como o ângulo nasolabial tornou-se mais obtuso e o espaço interlabial sofreu redução (p < 0,01). Já nos casos limítrofes tratados sem extrações, o lábio inferior, o espaço interlabial e o ângulo nasolabial não apresentaram alterações significativas. Conclusão: as grandezas em tecidos moles que podem ajudar na tomada de decisão entre o tratamento com e sem extrações nos casos limítrofes de Classe I são: protrusão dos lábios superior e inferior em relação ao plano E e em relação à linha Sn-Pg', protrusão do lábio inferior em relação à linha vertical verdadeira (LVV), a espessura do lábio superior, o ângulo nasolabial e o espaço interlabial.

Purpose The purpose of this was to construct finite element (FE) models based on computed tomography (CT) data of individual patients during orthodontic treatment and to evaluate the relationship between strain energy density (SED) in the temporomandibular joint (TMJ) disc and the facial morphology of three skeletal patterns (Class 1–3) by cephalometric analysis. Methods Cephalometric analyses were performed on 53 patients. FE models based on the CT images of each patient were constructed, and the mean SED in the bilateral TMJ disc was calculated. The relationships between SED and the cephalometric parameters were evaluated. Results SED was significantly greater in Classes 1 and 2 than in Class 3 ( p  < 0.05). Positive correlations were observed between SED and convexity, ANB angle ( p  < 0.01), and gonial angle in Class 1 ( p  < 0.05). A negative correlation was observed between SED and facial angle in Class 3 ( p  < 0.05). Overall, correlations were found between SED and facial angle, convexity, mandibular angle, Y-axis, SNB, ANB angle, and overjet ( p  < 0.05). Conclusion Increased SED in the TMJ disc was associated with clockwise mandibular rotation and superior posterior positioning. Mandibular morphology primarily affected SED, with facial angle, convexity, and ANB being useful predictors of TMJ dysfunction.

The aim of this study was to evaluate the differences in sella dimensions and shape between growing patients with Class I, Class II, and Class III skeletal malocclusions, evaluated through morphometric analysis. Seventy-eight subjects aged between 9 and 13 years were selected and assigned to either the Class I, Class II, or Class III groups according to the measured ANB angle (the angle between the Nasion, skeletal A-point and skeletal B-point). Six landmarks were digitised to outline the shape of the sella turcica. Linear measurements of the sella length and depth were also performed. Procrustes superimposition, principal component analysis, and canonical variate analysis were used to evaluate the differences in sella shape between the three groups. A one-way MANOVA and Tukey’s or Games-Howell tests were used to evaluate the presence of differences in sella dimensions between the three groups, gender, and age. The canonical variate analysis revealed a statistically significant difference in sella shape between the Class I and the Class II groups, mostly explained by the CV1 axis and related to the posterior clinoidal process and the floor of the sella. No differences were found regarding linear measurements, except between subjects with different age. These differences in sella shape, that are present in the earlier developmental stages, could be used as a predictor of facial growth, but further studies are needed.

Background Angle Class II malocclusion typically presents with overbite, distal molar relationship, and crowding of the upper anterior teeth. The distal movement of the maxillary molars is considered an optimal treatment strategy, as it can circumvent the need for orthodontic extraction. Clear aligners are currently used for molar distalization. However, this approach is not without its limitations, including the loss of anterior tooth anchorage and an extended treatment duration. To address these issues, this study introduces a novel molar distalization appliance. A clinical randomized controlled trial will compare the efficacy of this appliance with clear aligners, specifically assessing differences in the rate of tooth movement. Methods This study will recruit 30 patients aged 18–35 with Angle Class II malocclusion, characterized by distal molar relationship, mild to moderate crowding, or protrusion of anterior teeth. Patients will be randomly divided into two groups: the experimental group using a novel molar distalization appliance, and the control group using clear aligners for molar distalization. Both groups will use orthodontic miniscrews as an anchorage, with elastic traction for molar distalization. Cone-beam CT and digital dental models will be collected before orthodontic intervention and after molar distalization for all samples. This study will register pre- and post-treatment images using maxillary bone structures and then analyze three-dimensional tooth movement. The study will further calculate the distance of molar distal movement per unit time as the tooth movement rate and compare whether there is a difference between the experimental and control groups. Discussion This randomized controlled trial will serve as evidence that the novel molar distalization device, compared to clear aligners, whether offers advantages such as shorter treatment duration and superior control of tooth movement. It can provide a novel method for orthodontic clinical treatment of patients with Angle Class II malocclusion. Trial registration ClinicalTrials.gov ChiCTR2300069122. Registered on 7 March 2023.

BackgroundOne of the most controversial issues in treatment planning of class III malocclusion patients is the choice between orthodontic camouflage and orthognathic surgery. Our aim was to delineate diagnostic measures in borderline class III cases for choosing proper treatment.MethodsThe pretreatment lateral cephalograms of 65 patients exhibiting moderate skeletal class III were analyzed. The camouflage group comprised of 36 patients with the mean age of 23.5 (SD 4.8), and the surgery group comprised of 29 patients with the mean age of 24.8 years (SD 3.1). The camouflage treatment consisted of flaring of the upper incisors and retraction of the lower incisors, and the surgical group was corrected by setback of the mandible, maxillary advancement, or bimaxillary surgery. Mann-Whitney U test was used to compare the variables between the two groups. Stepwise discriminant analysis was applied to identify the dentoskeletal variables that best separate the groups.ResultsHoldaway H angle and Wits appraisal were able to differentiate between the patients suitable for orthodontic camouflage or surgical treatment. Cases with a Holdaway angle greater than 10.3° and Wits appraisal greater than − 5.8 mm would be treated successfully by camouflage, while those with a Holdaway angle of less than 10.3° and with Wits appraisal less than − 5.8 mm can be treated surgically. Based on this model, 81.5% of our patients were properly classified.ConclusionsHoldaway H angle and Wits appraisal can be used as a critical diagnostic parameter for determining the treatment modality in class III borderline cases.

This prospective randomized clinical trial aimed to evaluate the effect of low-level laser therapy on tooth movement during Class II intermaxillary elastics treatment. Forty-two patients with Class II malocclusion were included, and their maxillary quadrants were allocated into two groups: treatment with an active diode laser and a placebo group. In each group, the time taken to obtain Class I occlusion after 6 months, rate of movement, total displacement of the maxillary canine to Class I occlusion and pain were recorded. The time to reach Class I occlusion in the active laser group (2.46 ± 2.1 months) was not significantly different from that in the placebo group (2.48 ± 2.0 months) ( p  = 0.938). Interestingly, the total distance of movement on the active laser side (2.27 ± 1.5 mm) was significantly greater than that on the placebo side (1.64 ± 1.3 mm) ( p  = 0.009). The pain levels on days 1, 2 and 3 were not significantly different between the laser and placebo sections. The rate of distance change toward Class I occlusion in the laser group (1.1 ± 0.7 mm/month) was significantly higher than that in the placebo group (0.74 ± 0.6 mm/month) ( p  = 0.037). Low-level laser therapy (970 nm) did not reduce the time needed to obtain Class I occlusion, but a significant acceleration in tooth movement was observed in the irradiated group. Trial registration: NCT02181439. Registered 04 July 2014— https://www.clinicaltrials.gov/ct2/results?term=cinelaser .

Background Class II malocclusion, particularly class II division 1, poses a significant orthodontic challenge with implications for both aesthetics and health. This study aimed to explore the impact of twin-block (TB) combined with maxillary expansion treatment (TB-ME) on upper airway dimensions and inflammatory profiles in adolescents with skeletal Class II Division 1 malocclusion in adolescent. Methods Ninety-two eligible patients were randomly assigned to two groups: TB-ME treatment and traditional McLaughlin Bennett Trevisi (MBT) straight-wire orthodontic treatment (Control). Cephalometric lateral X-ray scans were conducted before and after treatment to assess skeletal changes, including SNA, ANB, and SNB angles, which are essential to assess the anteroposterior relationships of the maxilla and mandible to the cranial base. We also measured the upper airway volumes and areas. Concentrations of inflammatory factors including intercellular adhesion molecule 1 (ICAM-1), matrix metallopeptidase 2 (MMP2), and interleukin 8 (IL-8) of gingival crevicular fluid analysis (GCF) were detected by enzyme-linked immunosorbent assay. Results TB-ME treatment induced significant improvement in cephalometric parameters, including a decrease in SNA and ANB angles and an increase in SNB angle. Upper airway volumes and areas increased significantly in both groups, with TB-ME showing greater improvements. GCF analysis revealed a reduction in ICAM-1, MMP2, and IL-8 concentrations in the TB-ME group compared to the Control group. Conclusions TB-ME treatment demonstrates multifaceted improvements in skeletal malocclusion, upper airway dimensions, and inflammatory profiles in adolescents with class II division 1 malocclusion, showing the promise of TB-ME in addressing the complexities associated with class II malocclusion.