Epidemiological Investigation on the Characteristics of a Large Sample of Orthodontic Population of Northern Italy

Introduction: During the last two decades, many studies have been published to investigate, from an epidemiological point of view, the relationship between malocclusions and ethnic origins of the populations examined (Isiekwe, 1983; de Muniz, 1986; Kerosuo, 1990; Brunelle et al, 1996;. Tschill et al, 1997; Otuyemi et al., 1999; Thilander et al. , 2001). Some authors (Isiekwe, 1983; de Muniz, 1986; Kerosuo, 1990; Brunelle et al., 1996; Tschill et al., 1997) have evaluated the occlusal characteristics using the classification developed by Bjork in the 1964 or the Angle’s classification of 1907. Nowadays, the orthodontic need of treatment is summarized in several different indices, like the Dental Aesthetic Index, the Treatment Priority Index and the Index of Orthodontic Treatment Need. Despite the amount of literature on the subject, which has been summarized by Thilander (2001), there are few authors that have analyzed the distribution of the occlusal and dento-facial characteristics of the Italian population (Sticco et al., 1989; Anelli and Montaruli, 1998; Ciuffolo et al., 2005; Nobile et al., 2007; Perrillo et al., 2009; Migale et al., 2009; Luzzi et al., 2011), especially of the population of northern Italy. Aim: The aim of this study was to analyze a large sample of population who came to our attention for an orthodontic visit, in order to obtain useful information for proper orthodontic planning in the public health system and to set up appropriate programs for screening and prevention. The epidemiologic investigation concerns personal data, objective vs. subjective problems, dental and orthodontic aspects, and is a retrospective analysis of the data collected in the first visit of 500 patients. Materials and methods: In the period between the year 2003 and the year 2013 the authors have collected data from the first visit of 500 patients (368 of 132 Italian origin and foreign origin, mean age 12.3 years) and each one was assigned a IOTN grade. Each visit was performed by the same operator; we can summarized data into four sections: anamnestic section orthodontic section dentistry section neuromuscolar section Results and discussion: Anamnestic SectionFifty-eight per cent of patients claims to do periodic checks at the dentist; forty-two per cent of the sample does not make periodic visits. The ability to implement preventive or interceptive strategies of orthodontic problems of childhood involves, first, an adequate knowledge of the same, in order to formulate a correct and early diagnosis. So we examined the role that pediatricians or other specialists play in this way, through the analysis of the professionals and not who recommended a specialist orthodontic evaluation. In 16.4% of cases, the visit was recommended by the family doctor, and in 19.4% by the pediatrician; 29.6% of the sample on a proposal of the family dentist or other specialists (13%), while in 21.7% of cases for the advice of a relative or a friend. The reasons for the request of an orthodontic visit denote a greater attention to aesthetic problems (dental irregularities, protruding teeth, crowding and diastema; 83% of sample), while only 15% of the population examined requires the correction of a skeletal problem. Dentistry Section53% of patients has good oral hygiene and periodontal conditions; 47% of the sample, on the contrary, presents gingival and periodontal problems. The prevalence of caries was 36%; other detections concern: decalcifications (9.6%) and abrasions (6%), traumatized dental elements (6.8%), presence of agenesis (8%), in line with what is reported in the literature, and supernumerary (0, 4%). Orthodontic SectionWe have found an higher prevalence of dental class II (45,6%), with increased values of overjet and overbite, in line with the results of other studies on European populations. Crowding is very frequent (52% in the upper arch and 48.6% in the lower arch), as well as the deviation of the median lines (38.2% for the upper midline, 55,8% for the lower midline); we have found an anterior and/or lateral cross-bite in 39.4% of patients. Neuromuscular SectionMore than half of the sample has a good labial competence, 43% of patients shows an anterior lingual push in activity, and 22% of this patients also at rest. The analysis of mandibular movement of closure showed that 14,5% of the population examined presents an anterior and/or posterior sliding between the position of first contact in centric relation and that of maximum intercuspidation. ConclusionsThe results of this study showed an high percentage of patients with malocclusion of IV and V IOTN grade (49%), a much higher value than the results of previous studies in Italian and European populations.