2020, Number 2
Prevalence of anteroinferior crowding and its relationship with different types of malocclusion
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Language: English/Spanish [Versión en español]
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ABSTRACT
Introduction: People throughout their lives experience dental changes that lead to the development of an ideal occlusion or malocclusion. Among these, crowding is one of the alterations that most affects the population. Objective: To associate the degree of anteroinferior dental crowding with the different types of malocclusion. Materials and methods: A study was carried out on models of patients from the Orthodontic Clinic of the Universidad Popular Autónoma del Estado de Puebla. The degree of crowding was identified and associated with the type of malocclusion. Results: 62% of the sample presented some degree of crowding; 12% mild, 17% moderate and 33% severe. With regard to malocclusion, the prevalence of crowding was 56.4% for class I, 25.8% for class II, 6.4% for class III, 4.8% for class II division 1 and 6.6% for class II division 2. Conclusion: The high prevalence of crowding was confirmed and with it the need for an opportune detection in order to prevent such alteration from causing changes in dental health in permanent dentitions.INTRODUCTION
In Mexico and worldwide, malocclusions are considered a public health problem due to their high prevalence. According to the World Health Organization, they are the third most prevalent oral disorders.1 Angle EH defines them as a perversion of the normal growth and development of the dentition.2 In 1899 he created an anteroposterior classification system based on the position of the upper first molar and its relationship to the lower first molar. This classification is the most widely used today and is divided into class I, class II (division 1 and 2) and class III. According to Graber TM3 the aetiological factors that produce the appearance of these malocclusions can be classified as general and local, the former being genetic determinants, habits, environmental factors and the latter dental problems such as premature loss, late eruptions, size anomalies, etcetera.
One of the dental alterations that most affects oral health is dental crowding, which is defined as the negative difference between the space available and the space required, i.e. the difference between the size of the bone base and the size of the teeth.4 Proffit WR in 1966, classified crowding as mild if it measured less than 3 mm, moderate if it measured 3 to 5 mm and severe if it measured more than 5 mm.5 Anteroinferior crowding is listed as one of the most common problems in occlusal development6 and has gained importance since it has been associated with arch development and basal size.7
The purpose of this study was to explore whether there is a relationship between anteroinferior crowding and the different types of malocclusion.
MATERIAL AND METHODS
A descriptive, cross-sectional and retrospective quantitative study was carried out. The universe was 112 pre-treatment plaster casts from the Orthodontic Clinic of the Universidad Popular Autónoma del Estado de Puebla. A sample of 100 models that met the inclusion criteria was created, and those with previous orthodontic treatment, with anteroinferior agenesis, in poor condition and in mixed dentition were eliminated. The degree of irregularity of the anteroinferior teeth was recorded, as proposed by Little R,8 in which the space available and the space required is measured. These measurements were established in mm and measured with a digital caliper (Chinese Caliper). For the space available, a brass wire that adapts to the shape of the arch is placed from the mesial side of the canine to the contralateral side, passing over the contact points of the teeth present. By straightening the wire, its rectilinear dimension represents the arch length. The space required results from the mesiodistal sum of the 6 anteroinferior teeth. The difference between the two measurements (space available and space required) indicates the osseodental discrepancy presented by the patient; if it is negative, it indicates the presence of crowding.
RESULTS
The average age was 21.6 ± 9.7 years; of the total sample analysed 51% were female and 49% male. A total of 62% had some degree of crowding (12% severe, 17% moderate and 33% mild) and 38% had no crowding. The distribution of the prevalence of crowding was divided for the different degrees of severity. Mild and moderate crowding was found in a higher proportion in females, and severe crowding was more prevalent in males. The χ2 test was used to evaluate the relationship between degree of crowding and sex, however, there was no statistically significant association (p > 0.05) (Figure 1).
The degree of crowding was mild for class I, class II, class II division 1 and class III, however, for class II division 2 the most prevalent degree of crowding was moderate. Severe crowding was found in class I and class II, with a percentage of 6% for both cases. No statistically significant relationship was found between the degree of crowding and malocclusion according to the χ2 test (Figure 2).
DISCUSSION
Mild crowding was found in the highest percentage for both men and women. Females presented a higher prevalence of this alteration. In a study carried out by Chávez BN y Turpo LC in a total sample of 147 students, they found a higher prevalence of crowding in men than in women, which is why these results differ from our study. However, they concluded that mild crowding is found in the highest percentage for both men and women, and these results are similar to those found in this research.9 Gil R et al. analysed a sample of 100 patients and obtained a prevalence of 68% of mild crowding, 23.5% of moderate crowding and 8.5% of severe crowding. The results are similar to ours and they also found a higher percentage of crowding in women than in men.10 With regard to prevalence according to type of malocclusion, we agree with the studies by Gil R et al. and Naranjo HAS in which a higher prevalence of crowding is found in class I malocclusion with 57.4% and 69.8%, respectively, followed by class II and class III, the latter being the one in which there is least anteroinferior crowding.10,11
CONCLUSION
The proportion of crowding (mild, moderate and severe) was statistically equal in both females and males. The same was true for the different types of malocclusion according to Angle. However, it was shown that the highest prevalence of crowding was observed in class I malocclusion and that females presented more crowding than males.
REFERENCES
AFFILIATIONS
1 Alumna del Posgrado de Ortodoncia. Universidad Autónoma del Estado de Puebla. Puebla, Pue.
2 Director Académico del Posgrado de Ortodoncia. Universidad Autónoma del Estado de Puebla. Puebla, Pue.
CORRESPONDENCE
Mayra Janeth Priego Ramos. E-mail: m.priego@hotmail.esReceived: Febrero 2020. Accepted: Junio 2020.