Rune Lindsten

The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3-year-old children.

The upper and lower intercanine arch widths and the prevalence of posterior crossbite were registered for 445 3-year-old children with and without a continuing or previous dummy-sucking or finger-sucking habit in different areas in Sweden and Norway. Sami children from northern Norway also took part in the study, as well as 15 medieval skulls with intact deciduous dentitions. Compared with the nonsuckers, an increased prevalence of posterior crossbite was observed for the finger suckers, especially the Swedish girls. Stepwise logistic regression showed that posterior crossbite could be predicted with upper intercanine arch width alone. The finger sucking variable would not improve prediction; neither did other entities such as cohort (residental area), sex, lower intercanine arch width, nor the difference between upper and lower intercanine arch width. High prevalences of posterior crossbite were registered for dummy suckers (pacifiers) especially the Swedish girls (26%). Stepwise logistic regression showed that posterior crossbite in dummy suckers could be predicted with upper and lower intercanine arch width. Stepwise linear regression showed that both arches tended to be narrower in Swedes and girls, and that dummy sucking decreased the upper and increased the lower intercanine arch width. Analyses of covariance revealed that at least 2 years of dummy sucking is necessary to produce a significant effect in the upper jaw and 3 years in the lower jaw. (AM J ORTHOD DENTOFAC ORTHOP 1994;106:161-6.).The upper and lower intercanine arch widths and the prevalence of posterior crossbite were registered for 445 3-year-old children with and without a continuing or previous dummy-sucking or finger-sucking habit in different areas in Sweden and Norway. Sami children from northern Norway also took part in the study, as well as 15 medieval skulls with intact deciduous dentitions. Compared with the nonsuckers, an increased prevalence of posterior crossbite was observed for the finger suckers, especially the Swedish girls. Stepwise logistic regression showed that posterior crossbite could be predicted with upper intercanine arch width alone. The finger sucking variable would not improve prediction; neither did other entities such as cohort (residential area), sex, lower intercanine arch width, nor the difference between upper and lower intercanine arch width. High prevalences of posterior crossbite were registered for dummy suckers (pacifiers) especially the Swedish girls (26%). Stepwise logistic regression showed that posterior crossbite in dummy suckers could be predicted with upper and lower intercanine arch width. Stepwise linear regression showed that both arches tended to be narrower in Swedes and girls, and that dummy sucking decreased the upper and increased the lower intercanine arch width. Analyses of covariance revealed that at least 2 years of dummy sucking is necessary to produce a significant effect in the upper jaw and 3 years in the lower jaw.

Autotransplantation of teeth in 215 patients. A follow-up study.

OBJECTIVE To evaluate the success rate of autotransplantation of teeth in consecutive patients and to analyze factors affecting the outcome. MATERIALS AND METHODS The subjects consisted of 215 consecutive patients (101 women and 114 men; aged 9.1-56.4 years, median age 15.2 years [P(10) = 11.4, P(90) = 19.7]) who had undergone transplantation of a total of 269 teeth, all by the same surgeon. In patients with multiple transplants, only the first transplant was included, to ensure that all transplanted teeth were independent units. The transplants were recorded as unsuccessful if the tooth had been extracted or was surviving but with root resorption or ankylosis. The interval between transplantation and final follow-up was a median 4.8 years (P(10) = 2.0, P(90) = 5.5) for successful transplants and a median of 2.4 years (P(10) = 0.4, P(90) = 7.7) for unsuccessful transplants. RESULTS One-hundred seventy-five (81%) of the transplantations were recorded as successful and 40 (19%) as unsuccessful. Twenty-five teeth had been extracted and 15 had survived but did not fulfill the criteria for success. CONCLUSIONS The success rate of 215 consecutively transplanted teeth was 81%. The highest success rate was for transplantation of premolars to the maxillary incisor region (100%). Complications at surgery such as difficult extraction, deviant root anatomy, or damaged root periodontium affected the outcome. During growth, a successful transplant preserves alveolar bone.

Transverse Dental and Dental Arch Depth Dimensions in the Mixed Dentition in a Skeletal Sample from the 14th to the 19th Century and Norwegian Children and Norwegian Sami Children of Today

Secular changes in transverse dental arch dimensions and dental arch depth were studied. Four cohorts with mixed dentitions were selected. The skull group comprised 48 skulls dating from the 14th to the 19th century and belonging to The Schreiner Collection at the Department of Anatomy, University of Oslo. The 1980s Sami group was comprised of 39 boys and 34 girls born in 1987 and living in the northern part of Norway. The 1960s Oslo group was comprised of 31 boys and 30 girls born in 1963 and living in the southern part of Norway. The 1980s Oslo group was comprised of 32 boys and 26 girls born in 1983 and living in the same area in southern Norway as the previous Oslo group. Sex was unknown in the skeletal sample, and the groups were analyzed with the sexes pooled; separate descriptive values are presented for the modern groups. The mandibular intercanine distance was smaller in the skulls compared with the modern groups. The transverse intermaxillary difference between the molars was larger in the skull group than in the 1980s Oslo group. The difference between the maxillary and mandibular intercanine distances was larger in the skulls compared with the modern groups, although the small number of measurements in the skull group impeded further analysis. The arch depth was smaller in the skull group compared with the modern groups; the 1960s Oslo group deviated because of a higher prevalence of caries in the second deciduous molars. The overjet was smaller among the skulls. The arch form measured as the angle between the left and right molar tooth rows was more acute in the skulls than in the modern groups. It was concluded that smaller arch depths are found in skeletal samples at early ages and that attrition does not explain the more upright incisors found in skeletal samples. A secular trend was found in the intermaxillary relation, which indicated that children in the 1980s Oslo group were at greater risk of developing a posterior cross-bite than children born in the 14th to 19th centuries.

Factors determining perceived orthodontic treatment need in adolescents of Swedish and immigrant background

The aim of this study was to evaluate the association between self-perceived orthodontic treatment need and malocclusion in 12 to 13-year-old-adolescents of Swedish and immigrant background. The sample consisted of 379 students, stratified according to geographic background: both parents born in A/Sweden (n=269), B/Eastern Europe (n=56), and C/the Middle East (n=54). Registrations were based on a questionnaire, a clinical examination, radiographs, and patient records. Treatment need was classified according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Logistic regression analysis was used for comparison of the results. There was a strong association between subjects who thought that they needed an orthodontic appliance and IOTN-DHC grades 4 and 5, an anterior crossbite, those who avoided smiling because of their teeth, and those who considered their teeth to be somewhat worse or much worse than those of their peers. The self-perceived need for orthodontic treatment was significantly (P<0.05) higher in the Swedish than in the eastern European group.

A qualitative study of the influence of poor dental aesthetics on the lives of young adults.

Abstract Objective. Although many countries offer some publicly funded orthodontic treatment for children, not all conditions receive treatment and some adolescents enter adulthood with persisting poor dental aesthetics or malocclusions. The aim of this study was to generate a theory highlighting the main concerns of young adults, either native-born or of immigrant background, with poor dental aesthetics and the measures they adopt to manage their condition in everyday life. Material and methods. A qualitative method, classic grounded theory, was applied in order to generate a substantive theory highlighting the main concerns and managing mechanisms of 13 strategically selected 19- and 20-year-olds with poor dental aesthetics. Open interviews were conducted with each participant, the topics covering different aspects of social and dental conditions. Results. A core category and three conceptual categories were generated. The core category was labelled “Being under the pressure of social norms” and was related to categories explaining three different ways in which these young adults handle their main concern: (1) avoiding showing their teeth; (2) minimizing the importance of appearance; and (3) seeking orthodontic treatment. The theory offers the potential for improved understanding of young adults who, despite poor dental aesthetics, are managing well with life, and also of those who have not adjusted well. Conclusions. In early adolescence it may be problematic to make decisions about orthodontic treatment. Undisclosed dental fear can be an important barrier. Some of the young adults in the present study would probably benefit from treatment.

Anterior space relations and lower incisor alignment in 9-year-old children born in the 1960s and 1980s.

The anterior arch spaces and the effect of early loss of deciduous canines have been studied in 2 different cohorts of 9-year-old children. One group of 119 children was from Norway and consisted of 56 girls and 63 boys, and 1 group of 133 children was from Sweden and consisted of 72 girls and 61 boys. Within these cohorts, half of the children were born in the 1960s and half in the 1980s. The 1960s group has been compared with the 1980s group to look for anterior arch changes occurring during this period of time. The children who had lost a lost deciduous canine at the age of 9 years were also compared with the children with all deciduous canines remaining. Groups were compared with analysis of variance. It was found that children with a lost deciduous canine at the age of 9 years belong to a group with less available arch space and are a crowded group when compared with an earlier study. For the girls, this was also associated with larger teeth. Anterior arch space did not differ between the 1960s and the 1980s groups except for the Swedish boys, where there was less available mandibular arch space in the 1980s group. The irregularity index for the 4 mandibular incisors was increased in the 1980s group compared with the 1960s group. This could indicate a secular trend toward an increased prevalence of malocclusion in the present population.

Twelve-year follow-up of mandibular incisor stability: Comparison between two bonded lingual orthodontic retainers.

OBJECTIVE To compare the long-term outcome 9 years after removal of two different types of fixed retainers used for stabilization of the mandibular anterior segment. MATERIALS AND METHODS Sixty-four children who had undergone orthodontic treatment with fixed appliances in both arches were divided into two groups depending on which kind of retainer being used. Twenty-eight of the patients had a canine-to-canine retainer bonded to the canines and 36 had a bonded twistflex retainer 3-3, bonded to each tooth. Measurements were made on study models and lateral head radiographs, before and after treatment, 6 years after treatment, and 12 years after treatment, with a mean of 9.2 years after removal of the retainers. RESULTS No significant differences were found between the two groups at the long-term follow-up according to Littles Irregularity Index or available space for the mandibular incisors. The overjet and overbite were reduced after treatment in both groups and stayed stable throughout the observation period. Also, no differences in bonding failures between the two retainers were found. CONCLUSIONS Both a canine-to-canine retainer bonded only to the canines and a twistflex retainer 3-3 bonded to each tooth can be recommended. However, neither of the retention types prevented long-term changes of mandibular incisor irregularity or available space for the mandibular incisors after removal of the retainers.

Difference in dental lateral arch length between 9-year-olds born in the 1960s and the 1980s

This study was carried out in two cohorts of 9-year-olds, born in the 1960s and the 1980s in Sweden and Norway, to test the hypothesis that there has been a change in the lateral arch space conditions of the dentition during the last decades. In Norway, 61 children born in 1963 and 58 children born in 1983 were examined. In Sweden, 66 children born in 1961 and 67 children born in 1984 were examined. Children with a prolonged sucking habit, major dentofacial anomalies, history of orthodontic treatment, and ancestors of foreign origin were excluded to avoid influence of these factors on the development of the dentition. Linear measurements were performed between the mesial surface of the first permanent molars and the distal surface of the permanent lateral incisors in the maxillary and mandibular dental arches with use of a sliding caliper. The results showed that the children born in the 1980s had significantly larger lateral arch spaces in the maxillary dental arch (P <.05) and in the mandibular dental arch (P <.01) than did the children born in the 1960s. The amount of tissue loss in the second deciduous molars (the teeth having caries lesions or having been extracted) was greater in the 1960s groups than in the 1980s groups (P <.001). Thus, the hypothesis, that there has been a change in the lateral arch space conditions during the last decades, was confirmed. The most obvious reason is the decline in caries prevalence that has occurred in the same period; thus, there has been less loss of proximal tooth material of posterior teeth.

Perception of orthodontic treatment need among Swedish children, adolescents and young adults

Abstract Objective: Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19. Materials and methods: A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo. Results: The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2 ± 1.5), than among subjects, age 15 (3.6 ± 1.2) (p = .0009), and subjects, age 19 (3.5 ± 1.2) (p = .00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p = .002 and .001, respectively) and (ii) previous orthodontic treatment (p = .005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p = .002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p = .047) than Swedes, age 19. Conclusions: The lower limit for orthodontic treatment need among subjects, age 10, was higher – compared to subjects, ages 15 and 19 – and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.

Treatment of missing maxillary lateral incisors: a clinical and aesthetic evaluation

OBJECTIVE The aim of this study was to evaluate whether implant therapy or orthodontic space closure was the best treatment option for patients with missing maxillary lateral incisors. SUBJECTS AND METHODS The implant group (I group) consisted of 22 patients aged <26 years who had one or both maxillary lateral incisors substituted by a single implant-supported crown. The space-closure group (SC group) consisted of patients matched with I group patients based on diagnosis, gender, and number. Examinations were performed by one examiner and occurred at least 5 years after the prosthetic therapy or orthodontic treatment was finished. Clinical examination of the 44 patients involved assessing the aesthetics and gingival conditions of the implant-supported crown and the replacement canine, the occlusal morphology and the extraoral characteristics. Both the patient and examiner answered a question about their satisfaction with the aesthetic result. RESULTS Of the 12 variables analysed by the examiner, one variable was significantly improved in the I group and five variables were improved in the SC group. There were no significant differences between the treatment groups for the remaining six variables. Gingival colour and crown length were better in the SC group, and crown colour was better in the I group. There were no significant differences between the groups with regards to the patients and examiners overall aesthetic satisfaction of the maxillary anterior teeth or between the patients and examiners opinion. CONCLUSION If both treatment alternatives are available, space closure is preferable.