BACKGROUND: The purpose of this study was to evaluate the complexity of malocclusion and existing patterns in children with autism spectrum disorders (ASD) using the index of complexity, outcome and need (ICON).
METHODS: This cross-sectional study included children diagnosed with ASD, aged 9-15 years. A group of healthy children with the same demographic characteristics was randomly selected as the control group. Malocclusion was assessed according to ICON scoring protocol. The following parameters were recorded: dental aesthetics, upper arch crowding/spacing, presence of crossbite, anterior-vertical relationship (open and deep bite) and buccal segment anterior-posterior relationship. Finally, an overall ICON score was derived and reported for each patient. Descriptive analysis was performed for all investigated variables. Significance level was set at p < 0.05.
RESULTS: A total of 324 children, divided into ASD (162) and control (162) groups, comprised the study population. Our results demonstrated that the average overall ICON score was significantly higher in the ASD group compared to the control group (38.77 vs. 27.43, p < 0.001). ASD children also obtained significantly higher scores regarding the dental aesthetics component (3.84 vs 2.78, p < 0.001). Study groups were significantly different in terms of the prevalence of incisor overbite and open bite (p = 0.002 and p < 0.001, respectively). Patients in the ASD group showed a higher prevalence of Class II and Class III malocclusions (p < 0.001).
CONCLUSIONS: ASD children obtained significantly higher overall ICON scores, indicating more complex and severe malocclusions. These children also exhibited a greater tendency towards Class II and III malocclusions.

OBJECTIVE: Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients\' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances.
METHODS: 85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN).
RESULTS: The initial type of malocclusion affected the children\'s OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains \"Oral symptoms\" and \"Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015).
CONCLUSIONS: At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values.
CONCLUSIONS: The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child\'s satisfaction and overall quality of life.

OBJECTIVE: This cross-sectional study analyzed the socio-psychological need for orthodontic treatment in children and adolescents with and without Autism Spectrum Disorder (ASD) and its association with deleterious oral habits.
METHODS: Children/adolescents aged 6-14 years old, with and without ASD, and their respective caregivers were included. Caregivers completed a questionnaire addressing children and adolescents\' deleterious oral habits. To assess the socio-psychological need for orthodontic treatment, we utilized the aesthetic component of the Index of Orthodontic Treatment Needs (IOTN). Caregivers and an orthodontist independently used the standardized IOTN aesthetic attractiveness scale containing ten intraoral photographs and compared them with the most similar condition of the child/adolescent. Data collection occurred at two universities in northeastern Brazil and at an ASD referral center. Statistical analyses encompassed descriptive statistics, Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, and Chi-squared tests with linear trend (α5%).
RESULTS: The study involved 144 participants, evenly divided into two groups (ASD and non-ASN). The ASD group showed higher average IOTN-AC scores as evaluated by both professionals (mean score = 4.78 [± 2.34], p = .182) and caregivers (mean score = 4.31 [± 2.71], p = .992). Caregivers reported notably elevated IOTN-AC scores in cases where onychophagy was absent (p = .049).
CONCLUSIONS: Patients with ASD are indicated as having a relatively higher socio-psychological need for orthodontic treatment.

UNASSIGNED: Since general dentists (GDs) usually act as the primary referral source for the patients in need of orthodontic treatments, having the proper knowledge and understanding of the accurate diagnosis of clinical situations is very important. The aim of this study was to assess GDs about the identification of orthodontic treatment needs and their referral practices.
UNASSIGNED: This descriptive and analytical cross-sectional study was carried out in Iran 2020. A questionnaire consisting of three main parts was designed and distributed electronically among GDs. The first section included 11 image and scenario-based questions meant to assess the ability of GDs to correctly diagnose the orthodontic treatment needs of the patients. The next two parts were to assess the dentists\' knowledge of the necessity of referral to an orthodontist with 11 questions, and the proper timing of orthodontic treatments with 8 questions. Data were analyzed using SPSS 26, by conducting Mann-Whitney, Kruskal-Wallis, and correlation tests α = 0.05.
UNASSIGNED: Among 384 participated dentists, 50.3% (193) were female. The mean score of knowledge was 17.3 ± 3.5 out of 30. The highest percentage of good knowledge (70% of range) was related to the diagnosis of orthodontic problems, while the lowest one belonged to the referring pattern. There was a weak positive correlation between the working experience and the proper timing of referral (R = 0.15, P = 0.004 (. Kruskal-Wallis test also showed a significant difference between the total knowledge scores (P = 0.04) and the knowledge of the proper timing of treatment (P = 0.04) based on the age groups of participants. Eighty-seven percentage (n = 334) reported that they would refer the patients in need of orthodontic treatment.
UNASSIGNED: The knowledge level of orthodontic treatment needs among GDs was moderate, thus emphasizing the importance of planning more educational courses for them to improve their knowledge, thus reducing the possible detriments of postponed or inaccurate treatments.

UNASSIGNED: Low cognitive ability may reduce the ability to understand the importance of oral health and to perform the necessary practices to maintain proper oral hygiene. Early loss of primary teeth following high caries risk may lead to malocclusion of permanent dentition. This study aimed to evaluate the relationship between the cognitive levels of adolescents and their orthodontic treatment needs.
UNASSIGNED: Between January 2018 and May 2018, 200 adolescents aged 10 - 15 who applied to the Pediatric Dentistry Clinic of Marmara University and sought orthodontic treatment were invited to participate in the study. The orthodontic treatment needs of 150 adolescents who agreed to participate were evaluated with the Index of Orthodontic Treatment Need - Aesthetic Component and their cognitive levels were evaluated with the Raven Standard Progressive Matrices (SPM) Test. P-value < 0.05 was considered statistically significant.
UNASSIGNED: The mean age (± standard deviation) of 126 adolescents (77 females and 49 males) who completed the SPM test was 11.8 (± 1.3). There was no consistency between the intellectual level and the need for orthodontic treatment (Kappa value = 0.071, p-value = 0.081). There was no correlation between malocclusion severity and intelligence quotient scores of adolescents (ρ [rho] = -0.089, p = 0.322). According to Multiple logistic regression results, there was no difference between \'borderline need\' (p = 0.059) and \'great need\' (p = 0.881) from \'no need\' for orthodontic treatment in adolescents with different intelligence quotients.
UNASSIGNED: The results showed no evidence for an association between malocclusion and intelligence quotient.

Patients suffering from hemoglobinopathies may suffer from pathogic dental and orofacial features. This study aimed to assess the prevalence of malocclusion and the need for orthodontic treatment in patients with β-thalassemia major (BTM) and sickle cell disease (SCD). The study was conducted on 311 blood transfusion-dependent patients with BTM or SCD and 400 healthy individuals aged 10 to 16. The types of malocclusion were evaluated based on Angle\'s classification and Dewey\'s modification, and their oral habits were recorded using a questionnaire. The need for orthodontic treatment was assessed through the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN), and the data were compared with normal participants. The Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) assessment showed that patients had a higher prevalence of objective need for treatment (IOTN grades 4 and 5) compared to healthy children. The prevalence of class II malocclusion was significantly higher in patients. Patients showed significantly less Angle\'s Class I malocclusion compared to normal participants. Oral habits were presented in 61%, 64.15% and 62.4% of normal participants, BTM and SCD patients, respectively. The higher prevalence of Angle\'s class II malocclusion and higher percentage of IOTN grade 4 and 5 among BTM and SCD patients reveal the importance of early orthodontic assessment and intervention in children with BMT and SDC.

OBJECTIVE: The aim of the present study was to compare the malocclusion indices KIG (Kieferorthopädische Indikationsgruppen, Orthodontic Indication Groups), ICON (Index of Complexity, Outcome and Need), and mIOTN (modified Index of Orthodontic Treatment Need) regarding differences in malocclusion prevalence and their assessment of orthodontic treatment need in German 8‑ to 9‑year-old children of the Sixth German Oral Health Study (Deutsche Mundgesundheitsstudie, DMS 6).
METHODS: The necessary data for the calculation of the KIG, mIOTN, and ICON were collected by a dentist as part of a clinical orthodontic examination during the field phase of the DMS 6 and by a subsequent digital orthodontic model-analytical evaluation of intraoral scans of the dental arches and the occlusal situation in habitual occlusion.
RESULTS: Prevalence, severity, and treatment need of tooth and jaw misalignments differed in part considerably depending on the index used for assessment. On the other hand, there were several outcomes which yielded quite similar results for the different indices used, such as orthodontic treatment need, which ranged from 40.4% (KIG) over 41.6% (ICON) to 44.2% (mIOTN). Interestingly, orthodontic treatment need for the individual subject could differ considerably, when assessed using different indices.
CONCLUSIONS: In general, the results show that the mIOTN is much more conservative in assessing malocclusion prevalences often being smaller than those derived by KIG or ICON. In contrast, KIG and ICON often yield similar prevalences with certain distinct differences due to discrepancies in the respective definitions and also clearly differentiate between treatment possibility and arbitrarily determined treatment need.
UNASSIGNED: ZIEL: Das Ziel der vorliegenden Studie war es, die Indizes KIG (Kieferorthopädische Indikationsgruppen), ICON (Index of Complexity, Outcome and Need) und mIOTN (modifizierter Index of Orthodontic Treatment Need) hinsichtlich Unterschieden in der Malokklusionsprävalenz und deren Einschätzung des kieferorthopädischen Behandlungsbedarfs bei deutschen 8‑ bis 9‑jährigen Kindern der Sechsten Deutschen Mundgesundheitsstudie (DMS 6) zu vergleichen.
METHODS: Die notwendigen Daten zur Berechnung von KIG, mIOTN und ICON wurden von einem Zahnarzt im Rahmen einer klinisch-kieferorthopädischen Untersuchung während der Feldphase der DMS 6 und durch eine anschließende digitale kieferorthopädische modellanalytische Auswertung von Intraoralscans der Zahnbögen und der okklusalen Situation in habitueller Okklusion erhoben.
UNASSIGNED: Prävalenz, Schweregrad und Behandlungsbedarf von Zahn- und Kieferfehlstellungen unterschieden sich je nach dem zur Bewertung herangezogenen Index zum Teil erheblich. Andererseits gab es mehrere Endpunkte, die für die verschiedenen verwendeten Indizes recht ähnliche Ergebnisse lieferten, wie etwa der kieferorthopädische Behandlungsbedarf, der von 40,4 % (KIG) über 41,6 % (ICON) bis 44,2 % (mIOTN) reichte. Interessanterweise konnte der kieferorthopädische Behandlungsbedarf des einzelnen Probanden erheblich variieren, wenn er anhand verschiedener Indizes bewertet wurde.
UNASSIGNED: Im Allgemeinen zeigen die Ergebnisse, dass der mIOTN beim Assessment der Malokklusionsprävalenzen deutlich konservativer ist, sie waren oft geringer als beim Assessment mit KIG bzw. ICON. Dagegen ergeben sich nach KIG und ICON oft ähnliche Prävalenzen mit gewissen deutlichen Unterschieden aufgrund von Diskrepanzen in den jeweiligen Definitionen. KIG und ICON differenzieren auch klar zwischen Behandlungsmöglichkeit und willkürlich festgestelltem Behandlungsbedarf.

OBJECTIVE: The objectives of the study were to investigate the relationship between caries prevalence and the Index of Orthodontic Treatment Need Dental Health Component (IOTN-DHC) in school-age children who live in the dentistless area and to consider the effective way to reduce the potential progression of malocclusion with the growth through the dental survey in Arbulag district, Khövsgöl province, Mongolia.
METHODS: The 95 school-age children (49 males, 46 females) who participated in the study were born in and were residents of Arbulag district, Khövsgöl province, Mongolia. The mean ages of the participants were 8.3 years (y) ± 1.7 y for males and 8.8 y ± 1.7 y for females. The Mann-Whitney U test was performed to determine the sex difference for the dmf/DMF index. The relationship between the IOTON-DHC and the dmf/DMF index was statistically examined using Spearman\'s rank correlation coefficient.
RESULTS: Regarding the dmf/DMF index, no sex difference was observed. There were significant, fair positive correlations between the IOTON-DHC grade and F; between the IOTON-DHC grade and DMF index in males. There were significant, fair positive correlations between the IOTON-DHC grade and M; between the IOTON-DHC grade and DMF index in females.
CONCLUSIONS: Significant, fair positive correlations were found between the caries prevalence and the grade of malocclusion. Thus, prevention and early treatment of dental caries in a mixed dentition may be effective to reduce the potential progression of malocclusions in dentistless area.

Orthodontic therapy aims to treat misaligned teeth and jaws to improve dental occlusion as well as the function and aesthetics of the masticatory system. Continuous data collection to check treatment quality is of great importance for the constant optimization of orthodontic care.
The aim of this retrospective multicentre cohort study was to systematically determine the outcome and quality of orthodontic treatment by applying the internationally established Index of Orthodontic Treatment Need (IOTN) and Peer Assessment Rating (PAR) index in multiple clinical settings for a representative number of patient cases.
A total of 1509 consecutive orthodontic patient cases (treatment completion between January 2018 and December 2020) from three representative orthodontic centres (University clinic, city office, small town office) were analysed in a multicentre study. The pre- and post-treatment casts were scanned, digitally measured, and partially automatically evaluated using the IOTN and PAR indices.
A statistically significant improvement in occlusion was observed for medically necessary treatment of IOTN grades 4 and 5 in 97.30 per cent of the analysed cases and for treatment-requiring grades 2 and 3 in 94.08 per cent of the analysed cases. The average percentage PAR improvement was 76.51 per cent. 72.50 per cent of cases showed improvement of more than 70 per cent. The mean PAR index score was reduced from 28.19 ± 9.49 to 6.22 ± 5.41 points.
The present data demonstrate that orthodontic treatment is efficient in inducing significant improvement of malocclusions in general and has a high success rate with severe dysgnathia.

UNASSIGNED: Thalassemia major (TM) is a severe life-threatening hemoglobinopathy. It causes a typical chipmunk face due to increased hematopoiesis. Severe malocclusion often accompanies facial deformity, which may affect Oral Health-related Quality of Life (OHRQoL). The aim of this study was to assess the relationship between orthodontic treatment needs and OHRQoL in TM patients.
UNASSIGNED: One hundred and five adult patients with TM participated in this cross-sectional study. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure OHRQoL and the patient\'s need for orthodontic treatment was evaluated using the Index of Orthodontic Treatment Need (IOTN). The comparison of OHIP-14 scores between groups regarding orthodontic treatment need was carried out using t-test (SPSS software); P < 0.05 was considered statistically significant.
UNASSIGNED: The mean age of participants was 24.92 (±9.33) years, with 52% female versus 48% male. Orthodontic treatment need was 27.6%. The mean score of OHIP-14 was 12.95 (±7.02). A statistically significant relationship was found between OHIP-14 score and age, gender, and orthodontic treatment need (P < 0.05). All domains of OHIP-14 were significantly related to orthodontic treatment need (P < 0.05), except for \"physical disability\" (P = 0.282).
UNASSIGNED: OHRQoL was lower in TM patients with orthodontic treatment needs. Planning to treat malocclusion seems necessary to improve the quality of life in these patients.