• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.60-68
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• 2005

The evaluation of malocclusion has to be done quantitatively and qualitatively. This will be lead toward an analysis of malocclusion severity as well as treatment difficulty. The method of proper evaluation of malocclusion severity and treatment difficulty is necessary to assess treatment effect and efficiency for the orthodontists and to establish fundamentals for planning and executing the health-related policies in private and public institutions. The purposes of this study as the first part of the objective and quantitative analysis of malocclusion were 1) to measure treatment difficulty based on the opinions of several orthodontists. and 2) to investigate the relationships between objective malocclusion severity and subjective treatment difficulty 100 pairs of dental casts that had various types and severity of malocclusion were selected from the orthodontic departments of Kyurghee University and Samsung Medical Center The objective malocclusion severity was measured with the PAR (Peer Assessment Rating) index and the subjective treatment difficulty was evaluated by 8 experienced orthodontists. The relationships between objective malocclusion severity and subjective treatment difficulty were statistically evaluated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty especially in the measurements of the upper anterior alignment, the buccal occlusion. the overjet, the overbite and the midline discrepancy en the malocclusion components. The results of this study can provide the background knowledge to develop a new occlusal index. which contains both the malocclusion severity and treatment difficulty for Korean orthodontists.

• The korean journal of orthodontics
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• v.23 no.1 s.40
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• pp.17-35
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• 1993

We tried to evaluate frequencies and severities of malocclusion of various socioeconomic areas according to growth and development. To obtain objective validity, we used Handicapping Labiolingual Deviation (HLD) suggested by Draker, Treatment Priority Index (TPI) by Grainger, Handicapped Malocclusion Assessing Record (HMAR) by American Dental Association and American Association of Orthodontist. Seoul and Kwangju were selected as an urban group, Ahnyang as an middle socioeconomic group and Hwasun near the Kwangju area as an rural group. 140 (male 63, female 73) of 5th grade in 'E' elementary school students in Seoul, 202 (male 101, female 101) of 'S' elementary school students in Kwangju, 207(male 105, female 102) of 'H' elementary school students in Hwasun, and 100(male 49, female 51) of 'M' elementary school students of in Ahnyang of all the same grade were analyzed and we obtained the results as follows; 1. TPI, HLD, and HMAR showed high coincidence and reproducibility between different observer. (p<0.01) 2. In comparison of TPI, HLD, and HMAR according to clinical decision, there was statistically difference between each other. (p<0.01) 3. As the severity of malocclusion increases there was high correlation between TPI and HLD, and between HLD and HMAR (p<0.05) 4. With respect to differences between areas in TPI and HLD, there was statistically difference between Ahnyang and other areas. 5. In Seoul as an urban group there was a high incidence of periodic checkup and history of orthodontic treatment than other area. 6. Mode of feeding and posture during sleeping did not affect the severity of malocclusion. As a conclusion, TPI, HLD and HMAR are so reproducible and coincident that they can be used as a guide on evaluating the frequency and severity of malocclusion and determining the priority of orthodontic treatment to determine the need and supply of orthodontic treatment. Furthermore these indices can provide objectively valid data for establishing public health problem solution.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.69-81
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• 2005

As one of the variations in growth and development of the craniofacial complex. malocclusion shows lack of concordance In the recognition and severity of malocclusion for dentists as well as the acceptance and need of orthodontic treatment for the patient The purposes of this study were 1) to examine the relationships between objective malocclusion severity aid subjective treatment difficulty. 2) to evaluate the effect of malocclusion components to the subjective perceived difficulty of treatment. 3) to establish the weighted values of malocclusion components to reflect the treatment difficulty 100 pairs of dental casts with the general characteristics of malocclusion. were selected from the orthodontic departments of Kyunghee University and Samsuug Medical Center. The severity of malocclusion was evaluated by the author with the PAR index The perceived treatment difficulty and the estimated treatment duration on these dental models were evaluated by 8 experienced orthodontists. The relationships between the objective malocclusion severity and the subjective treatment difficulty were statistically evaluated. and the weighted values of malocclusion components to reflect treatment difficulty were statistically formulated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty The malocclusion components which significantly affected the treatment difficulty and their weighted values in parentheses were as follows upper anterior alignment(1). overbite (2). buccal occlusion (3) middline (4), and overjet (5). This study Provides the fundamental principle to evaluate the objective malocclusion severity which is reflected by the subjective treatment difficulty of Korean orthodontists.

• The korean journal of orthodontics
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• v.42 no.4
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• pp.190-200
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• 2012

Objective: The displacement of the hyoid bone (HB) is a critical biomechanical component of the swallowing function. The aim of this study was to evaluate the swallowing-induced vertical and horizontal displacements of the HB in subjects with 2 different magnitudes of skeletal Class III malocclusion, by means of real-time, balanced turbo-field-echo (B-TFE) cine-magnetic resonance imaging. Methods: The study population comprised 19 patients with mild skeletal Class III malocclusion, 16 with severe skeletal Class III malocclusion, and 20 with a skeletal Class I relationship. Before the commencement of the study, all subjects underwent cephalometric analysis to identify the nature of skeletal malformations. B-TFE images were obtained for the 4 consecutive stages of deglutition as each patient swallowed 10 mL of water, and the vertical and horizontal displacements of the HB were measured at each stage. Results: At all stages of swallowing, the vertical position of the HB in the severe Class III malocclusion group was significantly lower than those in the mild Class III and Class I malocclusion groups. Similarly, the horizontal displacement of the HB was found to be significantly associated with the severity of malocclusion, i.e., the degree of Class III malocclusion, while the amount of anterior displacement of the HB decreased with an increase in the severity of the Class III deformity. Conclusions: Our findings indicate the existence of a relationship between the magnitude of Class III malocclusion and HB displacement during swallowing.

• The korean journal of orthodontics
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• v.43 no.4
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• pp.193-200
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• 2013

Objective: To evaluate the psychosocial impact of malocclusion, determine its relationship with the severity of malocclusion, and assess the influence of gender and social class on this relationship in adolescents. Methods: A random sample of 627 Spanish adolescents aged 12 - 15 years underwent intraoral examinations by 3 calibrated examiners (intraexaminer and interexaminer kappa > 0.85) at their schools. Psychosocial impact was measured through a self-rated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The severity of malocclusion was measured by the Index of Orthodontic Treatment Need (IOTN). Gender and social class were also recorded. Results: The total PIDAQ score and those of its 4 subscales, social impact, psychological impact, aesthetic concern, and dental self-confidence, presented significant differences ($p{\leq}0.05$ by analysis of variance) and linear relationships with the IOTN grades ($p{\leq}0.05$ by linear regression). Stepwise linear regression models showed that the IOTN dental health component was a predictive variable of the total and subscale PIDAQ scores. Neither gender nor social class was an independent predictive variable of this relationship, except the linear model for psychological impact, where gender was a predictive variable. The occlusal conditions responsible for higher PIDAQ scores were increased overjet, impeded eruption, tooth displacement, and increased overbite. Conclusions: Malocclusion has a psychological impact in adolescents and this impact increases with the severity of malocclusion. Social class may not influence this association, but the psychological impact seems to be greater among girls.

• Journal of the korean academy of Pediatric Dentistry
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• v.11 no.1
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• pp.121-130
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• 1984

Childrens between the ages of 13 and 15 years, living in Seoul, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. This survey encompassed 981 children and an individual chart was prepared for each subject recording an original HMAR score and classification of occlusion according to Angle. Also, subjective evaluation of "treatment needs" was carried out in 581 children. The results were as follows: 1. Of the 981 children in this survey, 12,1 percent showed excellent occlusion. (0 point) 2. The 14 percent of the children who had a score of 24 and above all appeared to belong to the "treatment highly desirable" or "treatment mandatory" category. 3. The incorporation of SAR (Supplementary Assessment Record) into the HMAR can provide more sensitive method for evaluating severity of malocclusion. 4. According to Angle's classification 77.4 percent of all malocclusion belonged to Class I, 1.3 percent to Class II, Division 1, 0.9 percent to Class II, Division 2, and 11.3 percent to Class III. 5. The mean HMAR score for Class I was significantly lower than for either Class II, Division 1 or Class III. (P < 0.05) 6. A close relationship was found between the degree of "treatment needs" and the value obtained by the HMAR scoring. (chi-square test, p < 0.05) The differences between the mean HMAR scores of the various subjectively defined categories were statistically significant. (P < 0.001)

• The korean journal of orthodontics
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• v.53 no.2
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• pp.116-124
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• 2023

Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

• The korean journal of orthodontics
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• v.43 no.1
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• pp.35-41
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• 2013

Objective: To assess the prevalence of malocclusion and its relationship with dental caries among school children in southern India. Methods: This cross-sectional study included 1,800 students aged 11 - 15 years whose Dental Aesthetic Index (DAI) and dentition status were recorded and analyzed. The chi-square test, ANOVA, and Spearman's correlation tests were carried out. Results: The mean DAI score ${\pm}$ the standard deviation was $18.61{\pm}6.1$. Approximately 85% of the students (83.0% males, 86.8% females) had DAI scores of < 26 and were classified as not requiring orthodontic treatment. One tenth of the sample had mean DAI scores between 26 - 30 (indicating definite malocclusion and elective treatment), while about 3% had mean scores between 31 - 35 (indicating severe malocclusion and treatment desirability). Only 29 children (1.6%; 16 boys, 13 girls) had a DAI score of > 35, which suggested very severe or handicapping malocclusion requiring mandatory treatment. The mean decayed, missing, filled teeth (DMFT) was $2.28{\pm}1.47$. A DMFT of > 0 was observed in 91.8% of the study subjects. Children with a DAI score of > 35 were found to have significantly (p < 0.001) higher caries experience as compared to other children. Moreover, the DAI scores showed a significant correlation with the mean DMFT scores (r = 0.368, p < 0.05). Conclusions: A positive correlation was found between the severity of malocclusion and dental caries.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.219-237
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• 1999

This study was designed to evaluate the frequency and the severity of root resorption of the permanent teeth before orthodontic treatment by means of radiograph in the malocclusion patients. In this study the author analysed the frequency and the severity of root resorption in individual teeth, the relationships of the frequency and the severity of root resorption and age, sex, Angle's classification, overjet, overbite, and maxillary and mandibular incisor inclination, and the relationships of the frequency of root resorption and the characteristics of malocclusion and marked occlusal attrition showed in individual teeth. The results were as follows. 1. All of the persons examined showed some evidence of root resorption in one or more of the permanent teeth, $35.84\%$ of the teeth examined and more frequent in female group than male group(p<0.01). 2. On the susceptibility of the root resorption in individual teeth in this study, the author found the mandibular incisors and the maxillary incisors, in the order named, to be most susceptible in all affected teeth, but maxillary central incisors, maxillary first bicuspids, and maxillary lateral incisors, in the order named, were more susceptible to marked root resolution. 3. The more proclined maxillary Incisors the more affected root resorption in four maxillary incisors and the more proclined mandibular incisors the more affected root resorption in four mandibular incisors. 4. Overbite more affected root resorption than overjet, and the higher tender to openbite the more frequent was root resorption. 5. On the characteristics of malocclusion showed in individual teeth, the openbite teeth combined with crossbite, were most frequent in root resolution.

• The korean journal of orthodontics
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• v.19 no.1 s.27
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• pp.201-218
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• 1989

This study was focused on the distribution of different facial types of the Class II division I malocclusion groups and skeletal characteristics of the each group and those that anteropsterior relationship of the maxilla and mandible calculated from the analysis of ANB angle and Wits appraisal was quite different from each other, as well. Cephalometric headplates of 140 persons of Class II division 1 malocclusion whose mean age was 11.2 years and 69 persons of normal occlusion whose mean age was 12.2 years were utilize as materials. Measurements were recorded, tabulated and statistically analyzed employing the tracings of the lateral cephalograms, then Class II division 1 malocclusion group was divided into 9 Types according to the angle of SNA and SNB for the anteroposterior relationship of the maxilla and mandible, another 9 Types according to the FH-NPog and SN-MP for the horisontal and vertical relationship, and the other 9 Types according to the ANB and Wits appraisal for intermaxillary relationship as well, with which was based on $Mean{\pm}$ 1SD of those of normal occlusion. The result allowed the following conclusion: 1. $37.1\%$ of population demonstrated maxilla within nounal range and retrognathic mandible to the cranial base, $30\%$ for both maxilla and mandible within normal range, $20\%$ for retrognathic maxilla and mandible and $12.9\%$ of the rest were ananged in Class II division 1 maloccusion groups. 2. Retrognathic mandible and hyperdivergent face accounted for $30.7\%$, mesognathic mandible and neutrodivergent face for $29.3\%$, mesognathic mandible and hyperdivergent face for $16.4\%$, retrognathic mandible and neutrodivergent face for $13.6\%$, mesognathic mandible and hypodivergent face for $10\%$ of population were computed in Class II division 1 malocclusion groups. 3. It was suggested that skeletal Class II malocclusion might be due to anomaly in size and shape of cranial base, underdevelopment of mandible, retropositioning of mandible, underdevelopment of posterior face against anterior face, or any combination of these factors. 4. Population with underdevelopment and / or retropositioning of the mandible showed hyperdivergent tendency of facia profile. 5. The ANB angle and Wits appraisal did not coincide the severity of anteroposterior dysplasia in $35.7\%$ of Class II division 1 malocclusion group each other, and this inconsistency was suggested to be related with mandibular rotation, inclination of cranial base, and anteroposterior position of the maxilla.