Nature and severity of dental malocclusion in children suffering from transfusion-dependent (-thalassemia major

Abstract

Objective: To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger’s Treatment Priority Index (TPI) and index of orthodontic treatment need (IOTN)-dental health component (DHC). Methods: A cross-sectional study was conducted on 200 transfusion-dependent children diagnosed with homozygous β-thalassemia and 200 healthy school children aged 11-17 years. The TPI and IOTN-DHC data was recorded for both groups. Total TPI score for each subject was calculated and graded according to malocclusion severity estimate (MSE). Independent sample t-test was used to compare mean TPI scores, overjet and overbite between thalassemic and healthy children. Chi-square test was used to compare the frequency of IOTN-DHC grades, Angle’s classification, and MSE grades between thalassemic and healthy children. Results: The most prevalent malocclusion was Class I in normal children (67.5%) and Class II in thalassemic children (59%). The mean overjet and overbite were significantly (p<0.001) greater in thalassemic children than in healthy children. Severe tooth displacements were 3.5 times greater in thalassemic children, compared to controls. A greater proportion of thalassemic children were in IOTN grades 3 and 4, compared to the controls (p<0.001). MSE grades 4 and 5 were significantly (p<0.001) more prevalent in thalassemic children, compared to the controls. Conclusion: There is a high prevalence of Angle’s Class II malocclusion in thalassemic children. Majority of these children are categorized in higher grades of IOTN-DHC and TPI-MSE, showing a great severity of malocclusion and high orthodontic treatment needs.

Assessment of orthodontic treatment needs in patients with β-thalassemia major and sickle cell disease

“…However, Jeelani et al [33] reported grades 4 and 5 of IOTN were significantly more prevalent in thalassemic children compared to the control group; however, there were no SCD patients included in their study. In our study, this gap was bridged through which the DHC of the IOTN was used to evaluate the orthodontic treatment need, where the higher percentage of grade 4 and 5 in BTM and SCD was revealed compared to normal patients which was in line with the results obtained by Jeelani et al [33]. These results can be used as source data for the prevalence of different classes of malocclusion in different age groups of BTM and SCD patients to determine the optimal timing for orthodontic treatment.…”

“…These findings could be explained considering the economic and social status of the studied populations. European epidemiological surveys on normal adolescents reported a lower prevalence of grade 4 and 5 IOTN-DHC, which could be attributed to preventive dental management policies [30,33]. However, Jeelani et al [33] reported grades 4 and 5 of IOTN were significantly more prevalent in thalassemic children compared to the control group; however, there were no SCD patients included in their study.…”

“…European epidemiological surveys on normal adolescents reported a lower prevalence of grade 4 and 5 IOTN-DHC, which could be attributed to preventive dental management policies [30,33]. However, Jeelani et al [33] reported grades 4 and 5 of IOTN were significantly more prevalent in thalassemic children compared to the control group; however, there were no SCD patients included in their study. In our study, this gap was bridged through which the DHC of the IOTN was used to evaluate the orthodontic treatment need, where the higher percentage of grade 4 and 5 in BTM and SCD was revealed compared to normal patients which was in line with the results obtained by Jeelani et al [33].…”

Severity of mandibular arch crowding in different sagittal malocclusions

“…Mandibular arch crowding can be because of deficient mandibular arch length, early loss of primary molars, incorrect incisor and molar inclinations, and aberrant oral musculature. [ 7 ] During early stages of mixed dentition during the ages of 8 and 12 years, alterations in lower arch alignment can be seen. [ 8 ] After the eruption of the second permanent molars, crowding can become severe.…”