Diagnostic performance of increased overjet in Class II division 1 malocclusion and incisor trauma. 2010

Tiziano Baccetti, and Veronica Giuntini, and Andrea Vangelisti, and M Ali Darendeliler, and Lorenzo Franchi
Department of Orthodontics, The University of Florence, Italy. tbacc@tiscali.it

OBJECTIVE The objectives of this study were: 1) to evaluate the associations between an increased overjet (IO) and other dentoskeletal characteristics of Class II division 1 malocclusions in the mixed dentition; 2) to assess whether Class II division 1 malocclusions or rather an increased overjet per se is a risk factor for upper incisor trauma (UIT). METHODS A sample of 900 mixed dentition subjects, was observed by clinical inspection, analysis of dental casts, and lateral cephalograms. The diagnostic performance of IO (overjet ≥ 7 mm) was evaluated in relation to other Class II dentoskeletal features (Class II molar and canine relationships, and skeletal Class II relationships). Secondly, the diagnostic performance of IO and of the other Class II dentoskeletal components was tested with regard to the prevalence of UIT. Diagnostic performance was assessed by odds ratio and positive likelihood ratio. RESULTS The diagnostic performance of IO with regard to the other dentoskeletal components of Class II malocclusions was not significant. The only Class II features associated significantly with an increased risk of UIT was IO. CONCLUSIONS When used as an isolated occlusal feature, IO is not a valid diagnostic indicator for Class II division 1 malocclusions. An increased overjet per se, and not Class II malocclusions, appears to be a significant risk factor for UIT. These findings recommend discrimination between clinical conditions showing an isolated IO from comprehensive Class II malocclusions during diagnosis, analysis of treatment outcomes, and evaluation of the risk of upper incisor trauma.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D008297 Male Males
D008312 Malocclusion, Angle Class II Malocclusion in which the mandible is posterior to the maxilla as reflected by the relationship of the first permanent molar (distoclusion). Angle Class II,Angle Class II, Division 1,Angle Class II, Division 2,Class II Malocclusion, Division 1,Class II Malocclusion, Division 2,Malocclusion, Angle Class II, Division 1,Malocclusion, Angle Class II, Division 2,Class II, Angle
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003481 Cuspid The third tooth to the left and to the right of the midline of either jaw, situated between the second INCISOR and the premolar teeth (BICUSPID). (Jablonski, Dictionary of Dentistry, 1992, p817) Canine Tooth,Canine Teeth,Cuspids,Teeth, Canine,Tooth, Canine
D003765 Models, Dental Presentation devices used for patient education and technique training in dentistry. Dental Models,Dental Model,Model, Dental
D003818 Dentition, Mixed The complement of teeth in the jaws after the eruption of some of the permanent teeth but before all the deciduous teeth are absent. (Boucher's Clinical Dental Terminology, 4th ed) Dentition, Transitional,Dentitions, Mixed,Dentitions, Transitional,Mixed Dentition,Mixed Dentitions,Transitional Dentition,Transitional Dentitions
D005147 Facial Bones The facial skeleton, consisting of bones situated between the cranial base and the mandibular region. While some consider the facial bones to comprise the hyoid (HYOID BONE), palatine (HARD PALATE), and zygomatic (ZYGOMA) bones, MANDIBLE, and MAXILLA, others include also the lacrimal and nasal bones, inferior nasal concha, and vomer but exclude the hyoid bone. (Jablonski, Dictionary of Dentistry, 1992, p113) Bone, Facial,Bones, Facial,Facial Bone

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