Hareketli Aparey ile Yavaş Maksiller Genişletme İhtiyacı Olan Farklı Maloklüzyonlara Sahip Çocukların ve Ebeveynlerinin Maloklüzyon Algısının Değerlendirilmesi

Year 2025, Volume: 9 Issue: 3, 150 - 156, 31.12.2025

Elif Aybüke Öztürk , Yasemin Bahar Acar

https://doi.org/10.29228/erd.107

Abstract

AMAÇ: Öncelikli amaç, çocuklar ve ebeveynlerinin karma dişlenme döneminde karşılaşılabilen farklı maloklüzyonların tedavi ihtiyacını nasıl değerlendirdiklerinin belirlenmesidir. İkincil amaç; çocukların kendi maloklüzyon farkındalıklarını ve ebeveynlerin çocuklarının dişlerini tanıma düzeyinin değerlendirilmesidir.
GEREÇ VE YÖNTEM: Faz-I ortodontik tedavi endikasyonu olan 8-10 yaş aralığındaki 32 çocuğa (15 erkek,%47; 17 kız,%53) ve 32 ebeveyne, ilk muayene sırasında karma dişlenme dönemine ait 10 farklı ağız içi fotoğraf içeren bir powerpoint sunumunda; çapraşıklık, artmış overjet, derin kapanış, ön açık kapanış, anterior diastema, anterior ve posterior çapraz kapanış, tek diş çapraz kapanış gibi maloklüzyonlar; ideal karma dişlenme; ve çocuğun kendi ağız içi fotoğrafı gösterilmiştir. Tedavi ihtiyacının değerlendirilmesi için 100 mm’lik Görsel Analog Skala kullanılmıştır. Anlaşılırlığının artması amacıyla Görsel Ağrı Şiddeti Ölçekleri eklenmiştir. Her katılımcıya The Index of Orthodontic Treatment-Aesthetic Component
ölçeğinin 1 ve 10 numaralı fotoğrafı ve çocuğun ağız içi fotoğrafı gösterilmiş; çocuğun dişlerinin görünümüne en yakın fotoğrafı belirlemesi istenerek çocukların maloklüzyon farkındalıkları ve ebeveynlerin çocuklarının dişlerini tanıma düzeyi değerlendirilmiştir.
BULGULAR: Cinsiyete göre çocuklarda skorlar arasında anlamlı fark bulunmamıştır. Çocukların posterior çapraz kapanış, anterior diastema ve derin kapanış için skorları; artmış overjet, ön açık kapanış ve tek diş çapraz kapanış skorlarından anlamlı şekilde düşük bulunmuştur. Ebeveynlerde posterior çapraz kapanış; artmış overjet (p:0.041), ön açık kapanış (p:0.022) ve tek diş çapraz kapanış (p:0.015) görüntülerinden anlamlı şekilde düşük bulunmuştur. Her iki grupta ideal karma dişlenme ortalaması diğer maloklüzyon tiplerinden anlamlı şekilde düşük olmakla birlikte; ebeveynlerin ideal görüntü (p:0.013), anterior diastema (p:0.048) ve posterior çapraz kapanış (p:0.003; p<0.05) için ortalamaları, çocuklardan anlamlı düzeyde yüksektir. İki çocuk kendi fotoğrafını tanıyamazken ebeveynlerin hepsi tanımıştır.
SONUÇ: Çocuklarda ve ebeveynlerde ideal algısının bulunduğu ancak normal algılarının aynı olmadığı tespit edilmiştir. Her iki grupta posterior çapraz kapanışın VAS ortalamasının diğer maloklüzyonlardan anlamlı derecede düşük bulunması; gözden kaçabilecek bir maloklüzyon çeşidi olduğunu, bireylerin bilinçlendirilmesi gerektiğini göstermektedir.

Keywords

Algılama , Farkındalık , Koruyucu Tedavi , Maloklüzyon

Assessment of Malocclusion Perception in Parents and Children for Various Types of Malocclusion Requiring Slow Maxillary Expansion with Removable Appliance

Abstract

Objective: Primary aim was to determine how young children and their parents evaluate different malocclusions that may be encountered in the mixed dentition in terms of treatment needs. The secondary aims were to evaluate children's awareness of their own malocclusion and the level of parents' recognition.
Materials and Methods: 8 to 10 year-old children (n=32; mean age: 9.3 years; 47% male, 53% female) with indications for Phase-I orthodontic treatment and their parents (n=32; mean age 35.4 years; 44% male, 46% female) were included in this cross-sectional study. During initial orthodontic examination, a PowerPoint presentation containing 10 different anterior intraoral photographs of mixed dentition (representing patient’s dentition, ideal dentition and malocclusions including crowding, increased overjet, deep bite, anterior open bite, anterior diastema, anterior and posterior crossbite, single tooth crossbite) were shown. Each participant rated the photographs independently using Visual Analog Scale. Face Rating Scale was added to increase intelligibility. A second survey including 3 photos (patient’s anterior intraoral photograph and photographs #1 and #10 from Index of Orthodontic Treatment-Aesthetic Component was applied and subjects were asked to identify the patient’s teeth. Intragroup and intergroup parameters were statistically analyzed.
Results: There was no significant difference between genders. Children’s scores for posterior crossbite, anterior diastema and deep bite were significantly lower than increased overjet, anterior open bite and single tooth crossbite. In parents, posterior crossbite scores were significantly lower than increased overjet (p:0.041), anterior open bite (p:0.022) and single tooth crossbite (p:0.015). In both groups, score for ideal mixed dentition was significantly lower than others. However, mean scores of parents for ideal dentition (p:0.013), anterior diastema (p:0.048) and posterior crossbite (p:0.003) were significantly higher than children.
Conclusion: Both children and parents displayed similar ideal perceptions, but their perceptions of “normal” were not the same. Posterior crossbite malocclusion can be neglected inadvertently by laypeople.

Keywords

Malocclusion , Perception , Preventive Orthodontics , Awareness

Ethical Statement

Ethical approval for this cross-sectional study was received from the Ethics Committee of Clinical Studies, Faculty of Medicine (06.05.2022.823).

References

• Aikins EA, Da Costa DD, Onyeaso CO, Isiekwe MC. Self-perception of malocclusion among Nigerian Adolescents using the aesthetic component of the IOTN, The Open Dentistry Journal. 2012;(6):61-66.
• Avinash B, Shivalinga BM, Balasubramanian S, Shekar S. The index of orthodontic treatment need- a review. International Journal of Recent Scientific Research. 2015;6(8):5835-5839.
• Badran SA. The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents. Eur J Orthod. 2010;32(6):638–44.
• Benson P, O’Brien C, Marshman Z. Agreement between mothers and children with malocclusion in rating children’s oral health- related quality of life. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;137:631-8.
• Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod. 1989;11:309-320.
• Chew MT, Aw AK. Appropriateness of orthodontic referrals: self- perceived and normative treatment needs of patients referred for orthodontic consultation. Community Dent Oral Epidemiol. 2002;30:449-54.
• De Souza ET, Da Silva BT, Maia FBM, Forte FDS, Sampaio FC. Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study, Progress in Orthodontics. 2016;17:37.
• De Souza FA, Carneiro DPA, Meneghim, M.C, Vedovello SAS, Parental perception of malocclusion, its severity and aesthetic concerns in children with mixed dentition: A cross-sectional study. International Orthodontics. 2022;20:100637.
• Espeland LV, Ivarsson K, Stenvik A, Alstad TA, Perception of malocclusion in 11-year-old children: a compariosn between personal and parental awareness, European Journal of Orthodontics 1992;14:350-358.
• Evans R, Shaw W. Preliminary evaluation of an illustrated scale for rating dental attractiveness. Eur J Orthod. 1987;9:314-8.
• French D, Christie M: Developing outcome measures for children: “quality of life” assessment for pediatric asthma. In: Hutchinson A, McColl E, Christie M, Riccal- ton C, editors. Health Outcome Measures in Primary and Out-Patient Care. Amsterdam, Hardwood Academic Publishers, 1996;p.45-64.
• Jaeken K, Cadenas de Llano-Pérula M, Lemiere J, Verdonck A, Fieuws S, Willems G. Difference and relation between adolescents' and their parents or caregivers' reported oral health-related quality of life related to orthodontic treatment: a prospective cohort study. Health Qual Life Outcomes. 2019;17(1):40.
• Jenny J, Cons NC. Comparing contrasting two orthodontic indices the index of orthodontic treatment need and the dental aesthetic index. Am J Orthod Dentofacial Orthop 1996;110(4):410–6.
• Johal A, Cheung MYH, Marcene W. The impact of two different malocclusion traits on quality of life. Br Dent J. 2007;27;202(2).
• Jokovic A, Locker D, Guyatt G. What do children’s global ratings of oral health and well-being measure? Community Dent Oral Epidemiol. 2005;33:205-11.
• Jokovic A, Locker D, Stephens M, Kenny D, Tompson B, Guyatt G: Validity and reliability of a questionnaire for measuring child oral- health-related quality of life. J Dent Res. 2002;81:459-463.
• Kiyak HA. Does orthodontic treatment affect patients’ quality of life? J Dent Educ. 2008;72:886–94.
• Kragt L, Jaddoe V, Wolvius E, Ongkosuwito EM. The association of subjective orthodontic treatment need with oral health-related quality of life. Community Dent Oral Epidemiol. 2017;45(4):365–71.
• Kragt L, Wolvius EB, Jaddoe VWV, Tiemeier H, Ongkosuwito EM. Influence of self-esteem on perceived orthodontic treatment need and oral health-related quality of life in children: The Generation R Study. Eur J Orthod. 2016;40(3):254–61.
• Lewit DW, Virolainen K. Conformity and indepence in adolescents’ motivation for orthodontic treatment. Child Development. 1986;39:1198-1200.
• Moura C, Cavalcanti AL, Gusmão ES, Soares RSC, Moura FTC, Santillo PMH. Negative self-perception of smile associated with malocclusions among Brazilian adolescents. Eur J Orthod. 2013;35(4):483–90.
• Osman L, Silverman M: Measuring quality of life for young children with asthma and their families. Eur Respir J Suppl. 1996;21:35-41.
• O’Brien CH. Validation of a quality of life measure for children with malocclusion. University of Sheffield, MClinDent Thesis, South Yorkshire. 2005.
• Pal D. Quality of life assessment in children: a review of conceptual and methodological issues in multidimen- sional health status measures. J Epidemiol Community Health. 1996;50:391-396.
• Sardenberg F, Martins MT, Bendo CB, Pordeus IA, Paiva SM, Auad SM, et al. Malocclusion and oral health-related quality of life in Brazilian school children. Angle Orthod 2013;83(1):83–9.
• Shaw WC. Factors influencing the desire for orthodontic treatment. European Journal of Orthodontics. 1981;3:151-162.
• Singh VP, Moss TP. Psychological impact of visible differences in patients with congenital craniofacial anomalies. Prog Orthod. 2015;16:5.
• Ulgen M. Ortodontik Tedavi Prensipleri. Ankara Üniversitesi Basımevi, Türkiye: Ankara, 2005;p.1-8.
• Vedovello SAS, Ambrosano GM, Pereira AC, Valdrighi HC, Filho MV, Meneghim MC. Association between malocclusion and the contextual factors of quality of life and socioeconomic status. Am J Orthod Dentofacial Orthop 2016;150(1):58–63.
• Vedovello SAS, de Carvalho ALM, de Azevedo LC, Santos PRD, Vedovello-Filho M, Meneghim MC . Impact of anterior occlusal conditions in the mixed dentition on oral health- related quality-of-life item levels. Angle Orthod. 2020 July 1;90(4):564-570.
• Yesilyurt M, Faydalı S. Ağrı değerlendirmesinde tek boyutlu ölçeklerin kullanımı, Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2020;23(3): 444-451.