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ORIGINAL ARTICLE Prevelance of Mandibular Anterior Crowding in Tumkur Population Madhusudhan.V1, Mahobia yogesh1 1 Department of Orthodontic and Dentofacial Orthopedic Sri Siddhartha Dental College and Hospital, Tumkur Karnataka, India ABSTRACT Journal of Dental Sciences and Research Vol. 2, Issue 2, Pages 1-5 This study was carried out to determine the prevalence of incisor crowding in Tumkur population. A group of one thousands twenty, with an age range (13-22 years) were randomly selected from governmental and private schools in different districts at Jeddah city from Department of Orthdodontics ,Sri Siddhartha dental college and hospital Tumkur. Clinical examinations were performed to evaluate the maxillary and mandibular incisors crowding using the method described by (little, 1975). The findings indicated that 43.33% of the patients have well-aligned incisors. Incisor crowding decreases by age in lower arches. (56.66 %) of the examined sample had different degrees of incisors crowding. Keywords: Anterior crowding, Prevelance. INTRODUCTION Correct tooth position is an important factor for esthetics, function and for overall preservation or restoration of dental health. Individuals with dental crowding are the most frequent patients in the orthodontic clinic. The prevalence of dental crowding was highest in the anterior region (central incisor, lateral incisor, and canine), whereas it decreased in the premolar and molar region. The factors that influence dental crowding at the stage of eruption of the permanent dentition include the position of the permanent tooth germs, the timing of the loss of deciduous teeth and permanent tooth eruption, the order of replacement of the dentition from deciduous to permanent, the soft tissue pressure, and the position of the opposite teeth. Lower anterior crowding is a relevant topic to explore because it has an impact on prognosis, treatment methods, and retention. As malocclusion is considered to be a public health problem (Draker, H.L., 1960)[1], the prevalence of occlusal anomalies, the need and demand for orthodontic treatment should be ascertained within a given community as reported by several authors (Stephens et al., 1985)[2] Therefore, it is useful to know the contributing factors of dental crowding for the planning of orthodontic treatment and Address for correspondence: Dr. Madhusudhan.V E-mail: [email protected] Access this article online Website: http://www.ssdctumkur.org/jdsr.php. 6 achieving stability in retention. The purpose of this study is to determine the prevalence of mandibular incisor crowding in Tumkur population. MATERIAL AND METHOD This investigation comprised of 120 patient cast , within an age range13 – 22. They are randomly selected from Department of Orthdodontics, Sri Siddhartha dental college and hospital TUMKUR. Inclusion criteria v Age 13 - 22 v No pervious orthodontic treatment. v Presence and complete eruption of all permanent teeth excluding third molars. v Absence of large fillings, fractured anterior teeth. v No pervious history of permanent teeth extraction. The examination is done by using vernier caliper. The little's irregularity index[3] is used as scoring method of incisor crowding involves measurement of liner displacement (labio -lingually) of anatomic contact points of each mandibular incisor from the adjacent tooth. Five displacements from the mesial aspect of the right canine to the mesial aspect of left canine were examined (Fig. 1). Measurements are obtained directly from the mandibular cast. Caliper is held parallel to the Vol. 2, Issue 2, September 2011 occlusal plane. Each of the five measurements represents a horizontal linear distance between the anatomic point of the adjacent teeth. Fig. 1 : Measurement of anatomic contact points of each mandibular incisors Table 3. Cross-tabulation between the overall incisors crowding frequency (n) and the age ranges in tumkur population Age Range (years) Incisor Crowding No Incisor Crowding Total 13- 15 25 12 37 15 - 17 17 16 33 17-19 12 10 22 19-22 14 14 28 RESULT Scoring are given foe each patient cast according to little's irregularity index 0 perfect alignment 1-3 minimal irregularity 4-6 moderate irregularity 7-9 severe irregularity 10 Very severe irregularity Table 1. Overall frequency (n) and percentage (%) distribution of incisors crowding Incisor Crowding Frequency (n) Percentage (%) Incisor crowding 68 56.66% No incisor crowding 52 43.33% Total 120 100% Table 2. frequency (n) and percentage (%) distribution of incisor crowding Incisor Crowding Frequency (n) Percentage (%) Lower Incisor crowding 68 31.19% Upper incisor crowding 15 6.8% Both upper and lower incisor crowding 83 38.07% No incisor crowding 52 23.85% Table (1) represents the overall percentage (%) distribution of incisor crowding among the 120 patients. (56.66%) of the sample had different degree incisor crowding. Whereas, (43.33%) of the total sample size have well aligned incisors .Table ( 2 ) presents, the percentage (%) distribution of incisors crowding pattern among the 120 tumkur population. (38.07%) of the examined patients shows crowding in both arches (Bimaxillary crowding). Whereas lower incisors crowding alone were seen in (31.9%) and upper incisors crowding alone were seen in (6.8%). DISCUSSION The number of patients seeking orthodontic treatment in Tumkur has increased markedly during recent years. Therefore it is important to have relevant epidemiological data on different types of malocclusion in order to estimate the total need for treatment. Studies concerning the prevalence and incidence of occlusal trait such as incisor crowding in young adults provide essential epidemiological data, The information obtained may be used to assess the state of dental health and form a baseline for planning future dental care programs in the society. The age ranges of the examined sample were (13-19 years) because at this age range all the permanent incisors are full erupted to the level of occlusion and this was necessary in order to obtain a clear and valid picture of the prevalence and distribution pattern of incisors crowding in the presence of all of the permanent teeth This study shows a low incidence of well aligned incisors (43.33%) and high incidence of incisors crowding (56.66%), which were in agreement with other the investigators that have reported similar incidence .The prevalence of incisor crowding in the Nigerian population done by Isiekwe 1983[4], was much less prevalent (12.9%), compared to 7 Journal of Dental Sciences and Research the results of the present study (56.66%). This difference could be due to different of racial and ethnic origins of both populations. The Nigerian population are black African in origin (Negroid race), whereas, the subjects of the present study are of tumkur population asian race. Isiekwe, stated that the low prevalence of incisors crowding in black Africans maybe attributed to the broad arches, and favorable dento-alveolar ratio. In the present study, the age range 17-19 years exhibits the highest frequency of well aligned incisor and age ranges 13-15 years shows the highest frequency incisors crowding among all of the age groups. The significant reduction in the percentage of students presenting with incisor crowding with age have been also noticed by others .as age advances there is increase in arch length. Helm[5] noticed that crowding in the anterior segment increases during development especially in the mandible. Foster et al.[6], demonstrated that crowding tends to increase until 13 or 14 years of age than tends to decrease until late teens. The role of third molars in lower incisor crowding has been debated for more than a century. The literature is almost equally divided with arguments for both sides. One theory commonly reported is that of the their molars creating space to erupt by causing anterior teeth to crowd[7]. Woodside[8] postulated that in the absence of third molars, the dentition could settle distally in response to forces generated by growth changes or soft tissue pressures. This implies a passive role of the third molars in the development of late crowding by hindering that adjustment. Richardson[9] demonstrated a significant forward movement of first molars between the ages of 13 and 17 years. This was correlated with the increase in lower arch crowding that occurred during the same period. Mesiodistal incisor lengths are significantly correlated with crowding. it is somewhat surprising that the magnitude of the correlation is relatively low. Even the mesiodistal length of incisor teeth contributes little to differences among individuals in incisor crowding. It is rapidly becoming a cliche to suggest that many factors contribute to lower incisor crowding or relapse[10]. There are various factors affect the prevalence of mandibular crowding since Tumkur population is more of vegetarian food habit, soft diet and refined food habit which might have led to lower anterior crowding. CONCLUSION The conclusion that can be drawn from this study is that the prevalence crowding of one or more incisors was a common feature in the Tumkur population. It was more common in the mandibular arch than the maxillary arch and incisor crowding tends to decrease with age. 8 REFERENCES 1. Draker, H.L.: "Handicapping Labio - Lingual condition: proposed index for public health purposes" American J. Orthodontics. Vol. 46: 296-305, 1960. 2. Stephens, C.D. Orton, H.S. ans Usiskin, L.A.: "Future manpower requirements for orthodontics undertaken in the General dental Services" British J. Orthodontics. Vol. 12: 168-175, 1985. 3. Little RM. The irregularity index: a quantitative score of mandibular anterior alignment. Am J. Orthod 1975; 68:55463. 4. Isiekwe M.C.,: “Malocclusion in Lagos, Nigeria” Community Dent. Oral Epidemiol, Vol.11: 59-62, 1983. 5. Helm, S.: “Prevalence of malocclusion in relation to development of the dentition” Acta Odontol Scand. Vol. 28: 73-78, 1970. 6. Foster, T. D., Hamilton, M.C., and Lavelle, C. B .: “A Study of dental arch crowding in four age groups” Dental Practitioner Vol. 21: 9-12, 1970. 7. Marielle Blake, Retention and stability: A review of the literature Volume 1998 Sep (299-366) 8. Woodside DG. Round table: extra oral force. J Clin Orthod 1970: 4: 554-77. 9. Richardson ME. Late lower arch crowding in relation to primary crowding. Angle Orthod 1982: 52:300-12. 10. Sanin, C., and Savara, B. S.: Factors that affect the alignment of the mandibular incisors: A longitudinal study, AM. J. ORTHOD. 64: 248-257. 1973.