Magister Scientiae Dentium - MSc(Dent) (Orthodontics)

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Browsing by Subject "Aesthetics"

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    Orthodontic treatment need in children aged 12-14 years in Mombasa, Kenya
    (University of the Western Cape, 2016) Mwang'ombe, Fiona Githua; Shaikh, A.; Elkhadem, A.
    A public orthodontic system generally is designed to prioritize patients so that those who have the greatest need receive treatment. The aim of this study was to compare the subjective perceptions of the occlusal appearance of 11 to 12 year-old schoolchildren of Nairobi with the modified Aesthetic Component (AC) scale of the Index of Orthodontic Treatment Need (IOTN). The objectives were to assess the children's perception of their occlusal appearance, categorise the occlusal appearance using the AC scale, by both the children and researcher; and to compare the children's' perception and the AC of the IOTN. Satisfaction with appearance of teeth and occlusion as well as peer comparison was investigated. The treatment need and demand was assessed using the modified AC photographs of the IOTN. Altogether, 488 school children (249 girls and 239 boys) assessed their perception of the anterior teeth using a Verbal Descriptor Scale (VDS) and a Visual Analog Scale (VAS) questionnaire. The researcher examined the anterior teeth of the participants and categorised them using the AC of the IOTN. The following results were reported: about two-thirds of the respondents were satisfied with the appearance of their teeth, with the gender difference being statistically significant. About 35% were dissatisfied or very dissatisfied, but reasons for it varied. More than half of the respondents rated their teeth as better than those of their peers and three-quarters were satisfied with their occlusion, the two responses elicited no gender difference. Treatment need was assessed by use of the AC indicated that there was a moderate agreement between researcher and respondents’ in treatment need assessment. The researcher found 36.3% needed treatment against self-perceived need of 30.9%. One-third of the respondents determined by the researcher to 'need treatment', felt 'no need'. There was no statistical gender difference in perceived need for treatment. The selection of ranked photographs of the AC by both researcher and respondents demonstrated skewed distributions towards the 'low ranked' or attractive end of the ranking order irrespective of the state of occlusion. Statistical comparison of the two methods used, namely the VDS and VAS, indicated that the responses were significantly different. Therefore it is suggested that any treatment priority assessment should take perceptions of occlusal appearance. into consideration.
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    The perceived and normative orthodontic treatment need of a group of South African children
    (University of the Western Cape, 2015) Rampersadh, Yuvthi; Harris, Angela Manbre Poulter; Barrie, Robert
    Introduction: Improvement of aesthetics is often the reason patients seek orthodontic treatment. The ability to accurately assess aesthetic treatment need from the viewpoint of the patient is necessary. The threshold for orthodontic treatment is not constant in all countries and no previous attempts to determine this threshold has been made in South Africa. By ensuring that patient’s perceptions of treatment need are incorporated into the index chosen to assess perceived need, accurate data can be obtained. Determining perceived need from the patient’s viewpoint is important, and understanding its relationship with perceived need according to the professional, as well as normative need can facilitate better patient communication and management of expectations. Aims: There were three main aims of this study. First, South African children’s perceptions of treatment need according to the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was assessed to determine if they were similar to those of the dentists who established the threshold, or if the threshold of the grading system should be altered to better suit laypeople’s opinions. Second, the newly established threshold could then be used to determine the perceived needs for orthodontic treatment, and compare them to the normative need of the population. Finally, factors that may influence the perceived needs of the patients such as gender, ethnicity and socio-economic position could be investigated. Methodology: A cross-sectional study on 317 children aged between 11 and 14 years was done. 43.8% were male and 56.2 % were female. The sample was chosen from five schools in the Lekwa District of Mpumalanga using a multi-stage sampling technique. The study population comprised of four groups based on ethnicity; Asian (3%), black (74%), coloured (6%) and white (17%). The socio-economic position (SEP) was determined by Principal Component Analysis of household assets. Societal perceived, subjective perceived and self-perceived needs were assessed using a questionnaire and the child-rated AC of the IOTN. An intra-oral examination was conducted using the AC of the IOTN to assess objective perceived need and the modified Dental Health Component (DHC) of the IOTN to assess normative treatment need. Results: Treatment threshold was determined to be grade 3 of the AC of the IOTN according to societal perceived need of the group of South African children, and was confirmed by self-perceived need. Subjective perceived need for treatment was assessed using the AC grade participants felt best reflected their aesthetic impairment, and was found to be 20.2%, compared to actual self-perceived need of 38.5%. The latter was deduced by comparing the child-rated AC (subjective perceived need) to their perception of treatment need of that grade (societal perceived need). The objective perceived need measured by the examiner-rated AC was 60%. Definite need for orthodontic treatment based on the modified DHC of the IOTN was 41.2%. No significant difference between societal perceived or self-perceived need and gender or socio-economic position was found. White children have lower societal perceived treatment need regarding others’ aesthetic impairment. Conclusion: The treatment threshold grade should be lowered to better represent the societal perceived and self-perceived need of the South African population. Normative need was higher than perceived needs from the patients’ point of view (subjective perceived and self-perceived need), but lower than the perceived need from the professional’s point of view (objective perceived need). Ethnicity was found to have an influence on societal perceived need.