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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 1  |  Page : 5-7

Study cast measurements in the assessment of incisor crowding among patients attending dental clinics in Abha city, Saudi Arabia


Department of Pediatric Dentistry and Orthodontic Sciences, Division of Orthodontics, King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia

Date of Web Publication12-Apr-2016

Correspondence Address:
Ibrahim Al-Shahrani
Department of Pediatric Dentistry and Orthodontic Sciences, Division of Orthodontics, King Khalid University College of Dentistry, Abha
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.180105

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  Abstract 

Introduction: Demand for orthodontic treatment is increasing in Saudi Arabia. An observational study was planned to assess the incisor crowding in maxillary and mandibular arch among Saudi males and females reporting to different dental clinics in Abha city, Kingdom of Saudi Arabia (KSA). Materials and Methods: A cross-sectional study was conducted. Five hundred and thirty-two study casts of males and females aged between 16 and 35 years without a previous history of extraction of permanent teeth were included in the study. Labiolingual linear displacement of anatomic contact points of each maxillary and mandibular incisor from the adjacent tooth was measured. Right canine mesial aspect to the left canine mesial aspect was examined for five displacements. Results: There was a high prevalence of incisor crowding observed in the study population. Sixty-four percent (342 out of 532) casts showed bi-maxillary crowding, 14% (75 out of 352) showed mandibular, and 8.1% (43 out of 532) showed maxillary crowding. About 13.6% (72 out of 532) of the study population had well-aligned maxillary and mandibular incisors while 86.4% (460 out of 532) had some degree of incisor crowding. Females had more incisor crowding (48.5%-258 out of 532) than males (37.9%-202 out of 532). Conclusion: High prevalence of incisor crowding in Abha region reported in this study necessitates long-term planning and preventive measures for the adolescent population and treatment of the adult population of the Abha city, KSA.

Keywords: Crowding, incisor, orthodontics


How to cite this article:
Al-Shahrani I. Study cast measurements in the assessment of incisor crowding among patients attending dental clinics in Abha city, Saudi Arabia. J Dent Res Rev 2016;3:5-7

How to cite this URL:
Al-Shahrani I. Study cast measurements in the assessment of incisor crowding among patients attending dental clinics in Abha city, Saudi Arabia. J Dent Res Rev [serial online] 2016 [cited 2021 Dec 8];3:5-7. Available from: https://www.jdrr.org/text.asp?2016/3/1/5/180105


  Introduction Top


Dental malocclusions are categorized as the third most severe problems affecting oral health. A collection of epidemiological data relating to oral health is indispensable in planning and implementing preventive measures. [1] Crowding of teeth is the most common malocclusion in many ethnic populations, and it increases mostly during adulthood. Among all the teeth in which crowding is involved incisor crowding is the most prevalent type. [2] Khalid and Ahmed reported a high incidence of malocclusion in Saudi population where crowding was the most common malocclusion distributed mainly as anterior crowding. [3] Similar study carried out in Riyadh, Saudi Arabia, reported the prevalence of incisor crowding to be 67.4% in a mixed male and female population. [4] In another study, incisor crowding in Saudi males was found to be 42.8% of which mandibular incisor crowding was 23.4% and maxillary incisor crowding was 19.4%. [5] Only one-fifth of Saudi females had well-aligned incisors while 81.4% of them had a varying degree of crowding. [6] In the same study, the females exhibited more mandibular crowding than maxillary crowding. In the United States of America, 50% of the population between the age group of 15 and 50 years has little or no mandibular incisor regularity, 23% with moderate, and 17% with severe incisor irregularity. [1] In another study conducted on population ranging between 8 and 50 years, 22% did not show displacement of an incisor in the mandibular arch, and 25% did not show displacement of an incisor in the maxillary arch. [7] Completely contrasting figures were reported for North African population by Isiekwe. [8] A meager 12.9% of Nigerian school children had incisor crowding.

Posttreatment stability is of key importance in crowding which represents the most common type of malocclusion. It is also proposed that a period of slightly crowded mandibular incisors is average in early age. The eruption of permanent mandibular incisors leaves little space for the perfect alignment of the four mandibular incisors. Crowding can be handled with minimal increase in the inter-canine width, slight backward movement of the canines into the primate space, and labial positioning of the permanent incisors relative to the primary incisors. [2] A number of investigators have reported the prevalence and need for orthodontic treatment in the Saudi Arabian population. [3],[4],[5],[6],[7],[9] Many incisor-crowding studies have also been carried in the eastern, central, and western region of Kingdom of Saudi Arabia (KSA). Literature related to incisor crowding from the southern region is sparse, far, and between. Hence, the aim of the study was to assess the prevalence of maxillary and mandibular incisor crowding in Saudi population living in the Abha city (a city of the Southern Province) of KSA.


  Materials and Methods Top


A cross-sectional study was carried out with a sample of 532 study casts of Saudi males (255) and Saudi females (277) reporting to various private and government Dental Clinics in Abha city. The study population's age ranged between 16 and 35 years. None of them had undergone orthodontic treatment or extraction of any of their permanent teeth. The subjects were free of extensive restorations, fractures, or malformations in the maxillary and mandibular incisors. Socioeconomic differentiation of the study sample was not attempted. One investigator under stable lighting conditions examined the casts from the occlusal aspect. Incisor crowding was scored using linear displacement (labiolingually) of anatomic contact points of each maxillary and mandibular incisors from the adjacent tooth. Five displacement measurements from the mesial aspect of the right canine to the mesial aspect of left canine were made. [10] Slipping of contact was considered crowding. The degree of contact was not measured.

Incisor crowding measure

Frontal contact displacements, the sum of five displacements in millimeters presenting in the incisor region.

Scoring of incisor crowding

  • Incisor crowding in maxillary and mandibular arches = 1, labiolingual displacements between the maxillary incisors and mandibular incisors (crowding existed in both arches)
  • Crowding in upper incisor = 2, labiolingual displacements between the maxillary incisors only
  • Crowding in lower incisor = 3, labiolingual displacements between the mandibular incisors only
  • No incisor crowding = 0, no labiolingual displacements of incisors in both of the arches. Any mesiodistal separation between the teeth is ignored, and the score was 0 (no crowding - if applicable in both the arches).



  Results Top


The overall percentage distribution of incisor crowding in the study population is presented in [Table 1]. About 86.4% (460 out of 532) of the sample had different degrees of incisor crowding while 13.6% (72 out of 532) of the them had well-aligned incisors in both arches. Sixty-four percent (342 out of 532) casts showed bi-maxillary crowding, 14% (75 out of 532) showed mandibular, and 8.1% (43 out of 532) showed maxillary crowding [Table 2] and [Figure 1]. Incisor crowding was more prevalent in females (48.5%-258 out of 460) than males (37.9%-202 out of 460) [Table 3]. Similarly, females had more bi-maxillary incisor crowding (33.7%-179 out of 342) than males (30.6%-163 out of 342) [Table 4]. However, males had more mandibular only (7.1%-38 out of 75) and maxillary only (4.3%-23 out of 43) incisor crowding than females (6.9%-37 out of 75 and 3.8%-20 out of 43, respectively) [Table 4].
Figure 1: Percentage distribution of incisor crowding pattern

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Table 1: Overall frequency and percentage distribution of incisors crowding in study population

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Table 2: Percentage and frequency distribution of incisors crowding pattern in study population

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Table 3: Percentage and frequency distribution of incisor crowding in Saudi males and females

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Table 4: Percentage and frequency distribution of incisors crowding pattern in Saudi males and females

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  Discussion Top


The number of patients seeking orthodontic treatment in Saudi Arabia has increased markedly over the past decade. [9],[11] As a result, oral health care planners are compelled to have relevant epidemiological data on different types of malocclusions to estimate and plan for orthodontic treatment. Obtaining baseline information relating to the state of oral health of populations is imperative to planning future oral health care programs. [9] One of the main effects of incisor crowding is poor esthetics. People who are satisfied with their facial appearance seem to be more self-confident and have higher self-esteem than those who are dissatisfied. [6] A number of investigators have reported the prevalence and need for orthodontic treatment across the world. [9],[12],[13],[14] Many incisor-crowding studies have also been carried in different parts of Saudi Arabia. [3],[4],[5],[6],[7],[9] All these studies have indicated a high prevalence of malocclusion in Saudi society. Togoo et al.[9] reported incisor crowding in adolescent Saudi males attending different boys from only schools of Abha. Their results are in complete agreement with the outcome of the present study wherein incisor crowding is highly prevalent and more common in mandibular incisors. Their study was limited by the noninclusion of females from the same populations. It is also evident from the current data that incisor crowding is more prevalent in the Abha region than in other parts of the KSA. A conservative estimate states a 60-70% higher incisor crowding prevalence in Abha region. [9] This can be attributed to the ethnic identicalness of the society in the southern region of KSA. Major cities of the Eastern, Central, and Western Province have a mix ethnical population including people from the Far East to Northern Africa. It is interesting to note that incisor crowding prevalence in Saudi females is similar in compassion to previous studies. [8] Nevertheless, it is clear that Saudi society has a high prevalence of incisor crowding, more so in the southern region.


  Conclusion Top


Intercepting developing crowding can lead to good and stable occlusion. High prevalence of incisor crowding in Abha region reported in this study necessitates long-term planning and preventive measures to alleviate the socioeconomic effects arising from it. Larger cohort including other areas of the southern region should be investigated to build a comprehensive database for future planning.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Buschang PH, Shulman JD. Incisor crowding in untreated persons 15-50 years of age: United States, 1988-1994. Angle Orthod 2003;73:502-8.  Back to cited text no. 1
    
2.
Profit WR. Contemporary Orthodontics. 3 rd ed. USA: Mosby; 2000. p. 141-2.  Back to cited text no. 2
    
3.
Khalid AB, Ahmed AZ. The pattern of malocclusion in Saudi Arabian patients attending for orthodontic treatment at the college of dentistry, King Saud University, Riyadh. Saudi Dent J 1994;6:138-44.  Back to cited text no. 3
    
4.
Jones BW. Malocclusion and facial types in a group of Saudi Arabian patients referred for orthodontic treatment, a preliminary study Riyadh. Br J Orthod 1987;14:143-6.  Back to cited text no. 4
    
5.
al-Emran S, Wisth PJ, Böe OE. Prevalence of malocclusion and need for orthodontic treatment in Saudi Arabia. Community Dent Oral Epidemiol 1990;18:253-5.  Back to cited text no. 5
    
6.
Al-Hummayani FM. Prevalence of incisors crowding in Saudi Arabian female students. Cairo Dent J 2004;20:413-6.  Back to cited text no. 6
    
7.
Brunelle JA, Bhat M, Lipton JA. Prevalence and distribution of selected occlusal characteristics in the US population, 1988-1991. J Dent Res 1996;75:706-13.  Back to cited text no. 7
    
8.
Isiekwe MC. Malocclusion in Lagos, Nigeria. Community Dent Oral Epidemiol 1983;11:59-62.  Back to cited text no. 8
[PUBMED]    
9.
Togoo R, Shaheen VS, Wahab A, Abogazalah N. Prevalence of incisor crowding among 13-16-year-old school boys in Abha City, Saudi Arabia. Int J Contemp Dent 2011;2:113-7.  Back to cited text no. 9
    
10.
Little RM. The irregularity index: A quantitative score of mandibular anterior alignment. Am J Orthod 1975;68:554-63.  Back to cited text no. 10
[PUBMED]    
11.
Stephens CD, Orton HS, Usiskin LA. Future manpower requirements for orthodontics undertaken in the general dental service. Br J Orthod 1985;12:168-75.  Back to cited text no. 11
[PUBMED]    
12.
Haynes S. The prevalence of malocclusion in English school children aged 11-12 years old. Eur Orthod Soc Trans 1970;1:89-98.  Back to cited text no. 12
    
13.
Sidlauskas A, Lopatiene K. The prevalence of malocclusion among 7-15-year-old Lithuanian schoolchildren. Medicina (Kaunas) 2009;45:147-52.  Back to cited text no. 13
    
14.
Helm S. Prevalence of malocclusion in relation to development of the dentition. Acta Odontol Scand 1970;28:73-8.  Back to cited text no. 14
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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