Download University of Medicine and Pharmacy "Grigore T.Popa

University of Medicine and Pharmacy "Grigore
T.Popa" Iasy
General Dentistry
Preventive Dentristry
THESIS
Clinical study of malocclusion and orthodontic
treatment needs in young people in Roumania
(ABSTRACT)
Scientific coordinator:
Prof.Univ.Dr. Ioan DĂNILĂ
PhD:
Sorana Nicoleta ZETU( ROŞU )
2014
IASY
Content
General part
Introduction
Pagina
1
Chapterl I - Dentoalveolar malocclusion prevalence in children and
adolescents
I.1 Types of dento-alveolar after Angle's classification
I.2 prevalence of dento-maxillary anomalies in children
I.3 The prevalence of malocclusion in adolescents
3
3
4
5
Chapter II - Evolution orthodontic indices
II. 2 Indices of diagnosed classification
II. 3 Epidemiological indices
II. 4 Indices of Treatment Success-Outcome
II.5 Indices of need orthodontic treatment need- IOTN
II.6
Labiolinguală Deviation Index (handicapping
Labiolingual
Deviation Index) -HLDI
II.7 Treatment Priority Index TPI
II.8 Registration of handicapping malocclusion Handicap
Malocclusal Record-HMAR
II.9 Occlusion Index - Occlusal Index (OI)
II.10 Swedish National Council for Health and
Welfare
II.11 indices of orthodontic treatment needs assessment and
quantification of the results
II.12 index of orthodontic treatment need (Index of
Orthodontic Treatment Need, IOTN)
II.13 Index dental aesthetics (Dental Aesthetic Index, DAI)
II.14 Index of complexity, outcome and need for orthodontic
(Index of Complexity, Outcome and Need, ICON)
II.15 Orthodontic treatment outcome evaluation index (Peer
Assessment Rating index, PAR)
II.16 Malocclusion and its treatment. their impact
dental health related quality of life (OHRQOL)
II.17 Evaluation of dental health related quality of life
(OHRQOL)
9
9
10
12
14
14
15
15
16
16
17
17
20
24
26
27
28
31
32
Chapter III - Quality of life and its importance in orthodontics
III.1 Introduction
III.2 health to quality of life and healthcare outcomes
III.3 Measuring quality of life
III.4 Orthodontics and health related quality of life
34
The personal part
Chapter IV - Research Methodology
40
Chapter V - Assessment of oral health indices and access to specialist
services to young people in NE Moldavia
53
Chapter VI Study on the association between quality of life and oral
health in adolescents in Romania
Chapter VII Dento-maxillary annomaly –a public health problem
77
Chapter VIII Study on evaluation of pain assessment in relation to
the emotional state of children with malocclusions
114
Conclusion
122
References
124
Anexe
103
Introduction
Dental anomaly of the jaws is an increasingly spread
condition, and with its physiognomic and functional disorders that it
produces, it affects oral and dental health, with multiple social
phisique implications on the patient and thus on the quality of his
life, which justifies establishing of an orthodontic therapy.
The continuous growth of the frequency in dental
anomalies of the jaws, estimating that the ideal occlusion is found in
only 1-2% of the actual population and high expenses of the
treatments as well, impose a severe selection of the cases that could
benefit of certain financial compensations from the health
insurances.
While the patient‘s addressability is also in a continuous
growth, not all are willing to endure such a difficult treatment on the
strength of time and complexity. In this regard, the permanent
concerns for developing therapeutical solutions that contribute to the
acceptability increase of the orthodontic treatments are still ongoing.
Although there are many epidemiological studies
conducted in several countries concerning malocclusions, the
comparative analysis of those are difficult to be made, whereas the
indexes and the criteria used in the studies are not standardized, for
example the ones from the epidemiological studies concerning
dental caries and periodontal diseases.
Today, even the Global Bank of Data concerning Oral
Health from the Global Health Organisation posses limited
informations about malocclusions.
As a response to the necessary increase of the ortodontic
treatments extension, it was undergo the development of certain
indices that will allow the clinical cases a classification depending
on the strictness of the malocclusion and the treatment needs for
several population groups.
In public programs that promote health, the insurance of the
ortodontic services raise some issues because of the increased care
needs and the limited resources for this purpose.
Chapter I
The prevalence of the alveolar and dental malocclusions in
children and adolescents
In the past years, in most of the countries the request for orthodontic
treatments increased. In this regard, in order to attain information
about the prevalence of dental and maxillary abnormalities and to
assess the need of orthodontic treatment at a national level, the
epidemiological studies are a must. These informations can be used
for developing public health programs in order to prevent and find
orthodontic anomalies and to organize the resources in this field
[1,2].
Chapter II
The evolution of orthodontic indices
The facial and dental abnormalities and the morphological
and functional disorders in the dental maxillary aparatus have an
increasingly higher tendency, Proffit‘s survey estimating that the
need for orthodontic treatment in the children under 18 years old is
of 60% [53].
Over time, many authors were preoccupied by the right
approach for evaluating malocclusions. By synthesizing the current
data, we can speak about 4 types of indices:
 Indices for diagnostic classification
 Epidemiological indices
 Indices for the success of the treatment
 Indices for the need of orthodontic
treatment
By going through the literature regarding this subject, I
found that there are still some controverses about the understanding
and the utility of these indices and that‘s the reason it seemed
necessary their review.
Chapter III
The Quality of Life and Its Importance in Orthodontics
In the past 10-15 years, the terms quality of life (QOL) and
health-related quality of life (HRQL) seem to appear increasingly
more often in the medical literature. Most of the orthodontic
treatment is justified on improving health-related quality of life.
That being said, studying HRQL in orthodontic patients have the
potential to provide information about treatment needs and
outcomes and it also could facilitate improved care. Thereby, the
clinicians should be aware for at least some part of the ways that
HRQL can be assessed.
The quality of life (QOL) can be defined as the person‘s
state of well-being that ranges from satisfaction or dissatisfaction
with the important areas of his/her life [119]. This is not a new
concept, much of te pioneering work was undertaking by Thorndike
in 1939 and, yet, it is a rapidly expanding area with over 1000 new
articles every year under the heading ‗quality of life‘ [120]. The
term `quality of life` bacame a keyword in Medline Computer
Search System as recently as 1977, since the interest in this area
increased enormously. Between 1966 and 1974 there were found
only 40 references about quality of life; however, this has increased
to over 10,000 between 1986 and 1994 [121].
Personal contribution
Chapter VI
Oral Health and Quality of Life Association for Children with
Dento-Maxillary Abnormalities Survey
Oral health is an important factor that has a crucial
influence over the global health. Oral hygiene is essential in
mentenance whole body‘s health. Oral health is a status lacking
facial and oral pain, chronic diseases and congenital malformations.
It represents the absence of dental conditions, like dental caries,
absence of teeth and periodontal diseases.
Oral health is a condition for oral cavity and associated
structures where the disease can be contained, the occurrence of new
diseases inhibited, where the occlusion is appropriate for chewing
and teeth have a social acceptance regarding their appearance [171].
Another definition is presented by Dolan, who states that
oral health is represented by a comfortable and functional dentition
that allows individuals to live their desirable social life [171].
VI.2 Purpose of the study
The aim of the current survey is to assess oral health status
and the children‘s self-perception about oral and dental condition.
The main purpose of this survey is estabilishing the major problems
that affects the oro-dental systemand whether if it affects or not
children‘s life. The survey examines the capacity and necessary
knowledge of children inorder to self-evaluate their oro-dental
status. Also,it‘s exploring the validity and the reliability of the CPQ
11-14 questionnaire as a devoted measure for evaluating the quality
of its influence over life [178].
VI.3 Material and Methods
The subjects of the study were children between 11-14
years old.
The survey evaluated 130 children from urban and rural
areas, in which 67 are boys and 63 girls. The subjects filled the CPQ
11-14 questionnaire, and parents responded questions regarding
their children oral cavity status, attitude towards solving problems
and social economic status [179]. A dental examination provided
informations regarding dental caries prevalence, oral hygiene and
occlusion problems.
There were gathered informations both in the stomatological history
and in questionnaire regarding:
 General condition of teeth (number and caries
status, edentulous teeth) – DMFT
 Oral hygiene (dental plaque, calculus over and
under gingival line)the presence of bleeding)
 Gum swelling (the presence of the bleeding)
 Occlusal connections (malocclusions)
 IOTN CPQ 11-14 self-evaluation
 Oral health attitudes
 Socio-economic status
The survey has two phases and it targeted two categories of
children:
 Phase I. – 130 CPQ11-14 questionnaires [173,
180] distributed to students and parents for filling.
 Phase II. We examined 69 children and we
collected informations about DMFT, DHC and
AC al IOTN [180]
o
1.
2.
3.
First group has 24 children presenting
different stages of malocclusion,
crowding and dental rotations, dental
malpositioning, anodontia.
o Second group has 45 children without
maloclusion or dental malpostioning but
with dental caries, plaque and calculus
under and over the gingival line. 10
children had no dental lesions.
VI.6 Conclusions
The result and analysis of CPQ11-14 questionnaire showed
that most children have problems with oral hygiene. The
explanation is that they have poor knowledge about the
right tehnique and about additional means of oral hygiene
and their purpose. As a result, most of the children showed
dental plaque and calculus more than it should at their age.
Most of them have extensive dental caries, especially on
molars, sometimes with root residues. Also, there are a
large number of dental malpositioning, malocclusions, and
most of them remain untreated bacause of the poor
knowledge about these anomalies.
The survey showed that educating the children about
prevention, hygiene and diseases is a requirement. The
purpose is to awaken the interest of the children and
parents for these problems. It is necessary to be well
informed in order to get apropriate help. Only in such
manner one can seek help from a dentist or a
orthodontics/periodotal specialist.
During the study we noticed thatis necessary such kind of
periodic evaluation of the oro-dental status and it represents
an additional diagnosis and treatment of occlusal
anomalies. AC and IOTN helps educating children to
recognise different abnormalities and and their severity
status. It was noticed that the children‘s self-evaluate is
based upon what they see and thus, a photographic example
of such problems would be helpful for recognising their
own flaws. Only then they could make an accurate selfreport. The aim of the CPQ questionnaire is to assess the
current condition of oral health, emotional status, the oro-
dental system functionality and its influences over the real
life.In the questionnaire, the answers are not always real,
but they still reflect to a certain degree the oral health status
and the children‘s
dentistry knowledge. All these
evaluation forms have the purpose to motivate the childpatient and to involve him in diagnosis and treatment.
4. To prevent worsening the situation, it would be advisable
to implement and extensive preventive program alongside
dentists, parents and teachers regarding learning and use of
a helpful brushing technique supervision; choosing the
appropriate diet – rich in fibers, low on shugar and the
proper techniques for cleaning the oral cavity (flossing,
rinsing).
Chapter VII
Dento-maxillary abnormalities – oro-dental public health
problem
Psychosocial
Impact
of
Dental
Aesthetic
QuestionnairePIDAQ was designed by Klages et al., in 2006 and it
represents the only mean of measure of the quality of life
appropriate for malocclusions [190].
PIDAQ is a specific health-related quality of life validated
index for orthodontics and it takes the form of a self-reported
questionnaire. This questionnaire is designed due to preliminary
work of Klages and col. In 2004 and 2005 [191], which is inspired
from OQLQ (Orthognatic Quality of Life Questionnaire), and he‘s
resuming some questions that he restate.
VII.2 Purpose of the study
The current study aimes:
 To study the ties between these different aspects of the
orthodontics care preview (the psychometric properties of
the the single specific instrument designed for evaluating
the malocclusion impact over the quality of life);
 To validate the Romanian version of PIDAQ questionnaire
for use in Romania.
VII.3 Material and methods
In order to achieve our goal, we conducted a crosssectional survey in 3 Universities: Iaşi, Tg. Mureş, Timişoara, on a
sample of 1126 subjects.
The evaluation of orthodontic aesthetic perception of their
teeth and their need for orthodontic treatment was made with the
help of Psychosocial Impact of Dental Aesthetic(PIDAQ). By the
same questionnaire was made also the potential impact of
orthodontic abnormalities that showed in their quality of life.It has
also been evaluated the normative need for orthodontic care on each
subject in the study using the Index of Orthodontic Treatment Need
(IOTN).
-
-
-
-
-
VII.5 Conclusions
So far PIDAQ questionnaire we used in this study remains
the onlyspecific instrument for orthodontics that
appreciates the connection between dento-maxillary
anomalies and quality of life.
Analysis of the results shows that PIDAQ has very good
psychometric quality with good reliability.
The internal consistency is good and the reproductibility is
near-perfect with an intra-class correlation coefficient
ranging from 0.72 for social impact to 0.90 for aesthetic
perception.
The scores of different fields (dimensions) of PIDAQ that
we found in this study may be comparable to those reported
in three studies found the specialty literature that have been
using this tool.
By assessing reliability and association with other closely
related variables measuring PIDAQ, we walked one of the
final steps necessary to adapt the cross-cultural validation
of PIDAQ, leading to the final validation of the Romanian
version.
The results of this study provide evidence supporting the
validity of the Romanian version of PIDAQ as a useful
measure for assessing the psychosocial impact of dental
aesthetics related to malocclusion. Its psychometric
discriminatory and effective assessment properties provide
theoretical evidence for further use in the study of specific
orthodontic aspects of quality of life among Romanian
young adults.
Chapter VIII
Study on Evaluation of Pain Assessment in Relation to the
Emotional State of Children with Malocclusions
Recognition of the importance of psychological factors in
shaping human interactions and approaching this problem through
complex correspondenceestablished between the patient-child and
pediatric dentist (pedodontist, orthodontist) are particularly useful in
pediatric dental practice.To understand the psychological
development of the child, should I consider a "budding existence",
given the particular stages of childhood; child should not be
compared with the adult model and should not be considered and
treated as a "miniature adult" [202, 203]. Therefore, the child must
be addressed through the changes occurring gradually throughout its
development, under the influence of external and intrinsic factors
[204].
VIII.2 Purpose of the study
The aim of this study was to evaluate the relationship
between emotional pain and emotional status in children with
malocclusions.
VIII.3 Material and methods
A prospective study was conducted in Infant Clinical
Dentistry in Iasi, Romania.The study group consisted of 110
children, aged 6-11 years who have addressed the service for
various orthodontic problems and were asked to answer a
questionnaire with 10 open and closed questions with items that
highlighted the extent and ability of child mental reflection in terms
of the relationship with the dentist and pediatric dentist.Because the
responses can alert the physician about potential behavior problems,
the questions focused on various aspects, as follows: previous
possible child visits to the dentist and its positive or negative impact
factors that have caused fear of the child in the dental office (for
example, injection of anesthetic / needle, dental turbine noise, odors
in dental office) of testing parents' afraid of the dentist from the
children's point of view, children's complains about dental and facial
appearance and the opinion of children regarding on orthodontic
treatment need. Latest concepts were analyzed in relation to
pediatric dentist opinion.
VIII.6 Conclusions
Children can be taught to monitor behavior in the dental
office and at the same time to understand the advantages that certain
maneuvers can bring, even if some pleasant experiences occurred in
the past.The therapeutic approach for the harmonious development
of the child's dento-maxillary system and appropriate psychoaesthetics can not be completed successfully unless the patient is
seen in the complexity of his personality, such as foreshadowing in
the future adult life.
Conclusions
Application of IOTN index allows identification of
potential patients and quantification for the need for treatment (in
terms of aesthetics and dental health) in order to establish priority
for orthodontic treatment.
In our sample, the highest percentage of subjects (36.24%)
were classified in the group with a moderate need (at the limit) in
terms of aesthetics, but associated with a greater need in terms of
dental health.
The little necessity in terms of dental health was associated
with a reduced need or no need for aesthetics.
The AC component does not always capture the real
treatment needs imposed by the dento-maxillary anomaly, because
the aesthetic appearance cannot be the sole criterion in determining
indication for orthodontic treatment.
It was proved to be necessary to associate an assessment
through the DHC component in order to limit the bias of AC
component.
Regarding dental health, on the group examined there were
common the 5.i high scores (teeth eruption disorders excepting
molar 3 tooth due to crowding, displacement, the presence of
supernumerary teeth, persistent deciduous teeth and any
pathological cause), followed by 4c (anterior or posterior reverse
occlusion with the difference more than 2 mm between the retrudet
contact position and IC position).
In the study group, we identified a small number of
subjects who did not need orthodontic treatment (14.38%).
The results of the CPQ11-14 questionnaire and its
examination showed that most children have problems with oral
hygiene. The explanation is poor knowledge about the correct
technique and the additional oral hygiene means and their role. As a
result, most children were presenting dental plaque and tartar quite
abundant for their age.A lot suffer from extensive tooth decay,
especially molars, are sometimes root debris are present. Also there
are presented in large number the dental malpositions, malocclusion,
of which many remain untreated due to low knowledge about these
anomalies.
The study revealed that it is a great need for educating
children about prevention, hygiene and disease. The aim should be
to awaken the interest of children and parents to these problems. As
someone seeking help need to receive appropriate information. Only
then can you know when to seek help to a dental specialist in
orthodontics, pedodontics.
During the study it was observed that such periodic
evaluation of the oro-dental status is benefic as an additional tool for
diagnosis and treatment of dental occlusal anomalies. AC of IOTN
help educate children to recognize different anomalies and their
degrees of severity. It was observed that children evaluate
themselves based upon what they see, so a photo example of the
ground problems can be helpful in recognizing their own self
defecte.Thus it would be possible to assess correctly their situation.
The CPQ questionnaire has the role is to assess the current status of
oral health, emotional state, oro-dental system functionality and its
influence over the general life. Questionnaire replies are not always
real, but still reflects to some degree the situation of oral health,
dental knowledge of children. All these forms of assessment are
intended to motivate the patient-child to involve in making
diagnoses and treatment.
To prevent worsening of the situation it would be advisable
to implement a preventive program to incorporate dentists, teachers
and parents, which would cover: teaching and supervision of the use
of effective brushing techniques; choosing appropriate diet - rich in
fiber, low in sugars - the use of adjuvant techniques for cleaning the
mouth (dental floss, mouthwash).
So far PIDAQ questionnaire we used in this study remains
the only instrument specifically for orthodontics.
Analysis results demonstrate that PIDAQ has a very good
psychometric quality with good reliability.
Besides, internal consistency is good (Cronbach's alpha
coefficient ranging from 0.67 for "aesthetic concerns" to 0.87 for
"social impact" - none of Cronbach's α coefficient does not exceed
0.90, which would indicate some redundancy of items). And
reproducibility is near-perfect with an intra-class correlation
coefficient ranging from 0.72 for social impact to 0.90 for perceived
aesthetics.
Scores of different fields (dimensions) of PIDAQ that we
found in this study may be comparable to those reported in three
studies found in the dental literature that have been using this tool
[32,22].
Assessing reliability and association with PIDAQ to other
variables measuring closely related concepts, we walked upon one
of the final steps necessary to adapt the cross-cultural validation of
PIDAQ, leading to the final validation of a Romanian version.
Children can be taught to monitor their behavior in the
dental office and at the same time to understand the advantages that
certain maneuvers can bring, even if some pleasant experiences
occurred in the past.
The therapeutic approach for the harmonious development
of the dento-maxillary system of the child and a psycho-aesthetics
appropriate for the child can not be completed successfully unless
the patient is seen in the complexity of his personality, such as
foreshadowing in future adult life.
Selective references
1. Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipuor F.
Malocclusion and occlusal traits in an urban Iranian population: an
epidemiological study of 11- to 14-year-old children. Eur J Orthod.
2009; 31:477-84.
2. Perillo L, Masucci C, Ferro F, Apicella D, Baccetti T. Prevalence
of orthodontic treatment need in southern Italian schoolchildren. Eur
J Orthod. 2010; 32:46-53.
3. Michael L. Riolo and James K. Avery Essential for orthodontics
practuce , First Edition, University Litho Press, Ann Arbor and
Grand Haven, Mich; Chapter 6 pages 163-178)
4. Lew KK, Foong WC, Loh E. Malocclusion prevalence in an
ethnic Chinese population.Austr Dent J. 1993; 38:442-9.
5. Abdullah MS, Rock WP. Assessment of orthodontic treatment
need in 5,112 Malaysian children using the IOTN and DAI indices.
Community Dent Health. 2001;18:242-8.
6. Silva RG, Kang DS. Prevalence of malocclusion among Latino
adolescents. Am J Orthod Dentofac Orthop. 2001; 119:313-5.
7. Thilander B, Pena L, Infante C, Parada SS, de Mayorga C.
Prevalence of malocclusion and orthodontic treatment need in
children and adolescents in Bogota, Colombia: an epidemiological
study related to different stages of dental development. Eur J
Orthod. 2001; 23:153-67.
8. Abu Alhaija ES, Al-Nimri KS. Orthodontic treatment need and
demand in 12–14 year-old Jordanian school children. Eur J Orthod.
2004; 26:261-3.
9. Ngom PI, Diagne F, Dieye F, Diop-Ba K, Thiam F. Orthodontic
treatment need and demand in Senegalese school children aged 12–
13 years: an appraisal using IOTN and ICON. Angle Orthod. 2007;
77:323-30.
10. Johannsdottir B, Wisth PJ, Magnusson TE. 1997 Prevalence of
malocclusion in 6-year-old Icelandic children. Acta Odontol Scand.
1997; 55:398-402.
11. Tschill P, Bacon W, Sonko A. Malocclusion in the deciduous
dentition of Caucasian children. Eur J Orthod. 1997; 19:361-7.
12. Keski-Nisula K, Lehto R, Lusa V, Keski-Nisula L, Varrela J.
Occurrence of malocclusion and need of orthodontic treatment in
early mixed dentition. Am J Orthod Dentofac Orthop. 2003;
124:631-8.
13. Chestnutt IG, Burden DJ, Steele JG. The orthodontic condition
of children in the United Kingdom, 2003. Br Dent J. 2006; 200:60913
14. Josefsson E, Bjerklin K, Lindsten R. Malocclusion frequency in
Swedish and immigrant adolescents—influence of origin on
orthodontic treatment need. Eur J Orthod. 2007; 29:79-87.
15. Lux CJ, Ducker B, Pritsch M, Komposch G, Niekusch U.
Occlusal status and prevalence of occlusal malocclusion traits
among 9-year-old schoolchildren. Eur J Orthod.2009; 31:294-9.
16. Manzanera D, Montiel-Company JM, Almerich-Silla JM,
Gandía JL. Orthodontic treatment need in Spanish schoolchildren:
an epidemiological study using the Index of Orthodontic Treatment
Need. Eur J Orthod. 2009; 31:180-3.
17. Giuseppina Laganà,Caterina Masucci, Francesco Fabi, Patrizio
Bollero and Paola Cozza , Prevalence of malocclusions, oral habits
and orthodontic treatment need in a 7- to 15-year-old schoolchildren
population in Tirana , Progress in Orthodontics 2013, 14:12
18. Aznar T, Galan AF, Marin I, Dominguez A. 2006 Dental arch
diameters and relationships to oral habits. Angle Orthod. 2006;
76:441-5.
19. Hebling SR, Cortellazzi KL, Tagliaferro EP, Hebling E,
Ambrosano GM, Meneghim Mde C, Pereira AC. Relationship
between malocclusion and behavioral, demographic and
socioeconomic variables: a cross-sectional study of 5-year-olds. J
Clin Pediatr Dent. 2008; 33:75-9.
20. Luzzi V, Guaragna M, Ierardo G, Saccucci M, Consoli G, Vestri
AR, Polimeni A.Malocclusions and non-nutritive sucking habits: a
preliminary study. Progr Orthod.2011; 12:114-8.
21. Souames M, Bassigny F, Zenati N, Riordan PJ, Boy-Lefevre
ML. Orthodontic treatment need in French schoolchildren: an
epidemiological study using the Index of Orthodontic Treatment
Need. Eur J Orthod. 2006; 28:605-9.
22. Thilander B, Wahlund S, Lennartsson B. The effect of early
interceptive treatment in children with posterior cross-bite. Eur J
Orthod. 1984; 6:25-34.
23. McNamara JA, Brudon WL. In: Introduction and overview.
Orthodontics and dentofacial orthopedics. Ann Arbor: Needham
Press, Inc; 2001: p.1-11.
24. Franchi L, Baccetti T, McNamara JA. Postpubertal assessment
of treatment timing for maxillary expansion and protraction therapy
followed by fixed appliances. Am Jl Orthod Dentofac Orthop. 2004;
126:555-6.
25. Angle EH. Malocclusion of the teeth. 7th edn. Philadelphia: S.
S. White Manufacturing Co.; 1907
26. Du SQ, Rinchuse DJ, Zullo TG. Reliability of three methods of
occlusion classification. Amercan Journal of Orthodontics and
Dentofacial Orthopedics 1998;113:463-470.
27. Brin I, Weinberger T, Ben-Choirin E. Classification of occlusion
reconsidered .European Journal of Orthodontics 2000;22:169-174
28. Helm S. Malocclusion in Danish children with adolescent
dentition: an epidemiologic study. American Journal of
Orthodontics 1968;54:352-366
29. Goose DH, Thompson DG, Winter FC. Malocclusion in school
children of the West Midlands. British Dental Journal
1957;102:174-178.
30. Wood BF. Malocclusion in the modern Alaskan Eskimo.
American Journal of Orthodontics 1971;60:344-354
31. Proffit WR, Fields HW Jr, Moray LJ. Prevalence of
malocclusion and orthodontic treatment need in the United States:
estimates from the NHANES III survey. International Journal of
Adult Orthodontics and Orthognathic Surgery 1998;13:97-106
32. Grewe JM, Cervenka J, Shapiro BL, Witkop CJ. Prevalence of
malocclusion in Chippewa Indian children. Journal of Dental
Research 1968;47:302-305
33. Homan BT, Davies GN. An oral health survey of Aborigines and
Torres Strait Islanders in far north Queensland. Australian Dental
Journal 1973;18:75-87.
34. Sclare AR. Orthodontics and the school child: a survey of 680
children. British Dental Journal 1945;79:278-280.
35. Demir A, Uysal T, Basciftci FA, Guray E. The association of
occlusal factors with masticatory muscle tenderness in 10- to 19year old Turkish subjects. Angle Orthodontist 2005;75:40-46.
36. El-Mangoury NH, Mostafa YA. Epidemiologic panorama of
dental occlusion. Angle Orthodotist 1990;60:207-214.
37. Saleh FK. Prevalence of malocclusion in a sample of Lebanese
schoolchildren: an epidemiological study. Eastern Mediterranean
Health Journal 1999;5:337-343.
38. Isiekwe MC. Malocclusion in Lagos, Nigeria. Community
Dentistry and Oral Epidemiology 1983;11:53-62; Diagne F, Ba I,
Ba-Diop K, Yam AA, Ba-Tamba A. Prevalence of malocclusion in
Senegal. Community Dentistry and Oral Epidemiology
1993;21:325-326;
39. Ng‘ang‘a PM, Ohito F, Ogaard B, Valderhaug J. The prevalence
of malocclusion in 13 to 15-year-old children in Nairobi, Kenya.
Acta Odontologica Scandinavica1996;54:126-130
40. Gardiner JH. A survey of malocclusin and some aetiological
factors in 1000 Sheffield school children. Dental Practitioner
1957;6:187-198.
41. Haynes S. The prevalence of malocclusion in English school
children aged 11-12 years. Transactions of the European
Orthodontic Society 1970:89-98.
42. Foster TD, Day AJW. A survey of malocclusion and the need
for orthodontic treatment in a Shropshire school population. British
Journal of Orthodontics 1974;1:73-178
43. Altemus L. The frequency of the incidence of malocclusion in
American Negro children aged 12-16. Angle Orthodontist
1959;29:189-200.
44. Aggarwal SP, Odusanya SA. Orthodontic status of school
children in Ile-Ife Nigeria.Acta de Odontologia Paediatrica
1985;6:9-12.
45. Garner LD, Butt MH. Malocclusion in black Americans and
Nyeri Kenyans. An epidemiologic study. Angle ; Otuyemi OD,
Abidoye RO. Malocclusion in 12-year-old suburban and rural
Nigerian children. Community Dental Health 1993;10:375-380.
46. Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment effect of
combined maxillary protraction and chin cap appliance in severe
Skeletal III cases. American Journal of Orthodontics and
Dentofacial Orthopedics 1987;92:304-312.
47. Allwright WC, Burndred WH. A survey of handicapping
dentofacial anomalies among Chinese in Hong Kong. International
Dental Journal 1964;14:505-519.
48. Moorrees CF, Gron AM. Principles of orthodontic diagnosis.
Angle Orthodontist1966;36:258-262
49. Brunelle JA, Bhat M, Lipton JA. Prevalence and distribution of
selected occlusal characteristics in the U.S. population, 1988–91.
Journal of Dental Research1996;75:706-713.
50. Ravanmehr H, Rashidi-Birgani M. A study on prevalence of
dentofacial anomalies in 12 to 14 years old students in Tehran.
Journal of Dentistry. Tehran University of Medical Sciences
1998;11:38-45. (in Persian).
Scientiific activity - Doctorand Rosu( Zetu) Sorana
Lucrari ISI publicate :

SELF-CONCEPT, SOCIAL PHYSIQUE ANXIETY, SOCIAL
COMPARISON, SHYNESS, SOCIABILITY AND ORAL
HEALTH IN ROMANIAN UNDERGRADUATES -Sorana Roşu
, Alexandrina L. Dumitrescu, Ioan Dănilă, Irina Zetu, Procedia
Social and Behavioral Sciences(ISI), ed Elsevier ISSN: 18770428- Volume 78-PSIWORLD 2012, mai 2013,Pages 481–485,
http://dx.doi.org/10.1016/j.sbspro.2013.04.337

THE EVALUATION OF THE APPERCEPTION REGARDING
THE PAIN RELATED EMOTIONAL STATUS OF CHILDREN
WITH DENTAL MAXILLARY ABNORMALITIES -Sorana
Roşu, Carmen Savin , Alexandru Ogodescu, Radu Cioata, Irina
Zetu, Procedia Social and Behavioral Sciences(ISI), ed Elsevier
ISSN: 1877-0428- Volume 78-PSIWORLD 2012, mai 2013,
Pages 486–490, http://dx.doi.org/10.1016/j.sbspro.2013.04.337
Lucrari BDI publicate

‖Computer assisted interpretation of the profile teleradiographySteiner analysis‖ M. Iacob, Sorana Rosu, Valentina Dorobat, Irina
Zetu, Romanian Journal of Oral Reahabilitation, issn: 2066-7000 ,
vol 4, nr. 2, mai-iulie 2012.http://www.rjor.ro/2012/computerassisted-interpretation-of-the-profile-teleradiography%E2%80%93-steiner-analysis.html?lang=en

―Stress distribution as a function of the point of force application
on the upper first permanent molar during distalization‖ L.I. Vata,
Sorana Rosu, M. Pacurar, I. Zetu, International Journal of Medical
Dentistry, issn : 2066-6063, vol 16, issue 3, iul-sept 2012, pag
202-208

.‖The etiological factors involved in dental arch perimeter
shortening‖ L. I. Vata, Sorana Rosu, Irina Zetu, International

Journal of Medical Dentistry, issn:2066-6063, vol 16, issue 4, octdec 2012, pag291-295
Evaluation of Child Self-perception Regarding Their Oro-dental
Status – Martha I.Kristina,Rosu Sorana,G.Reka,V.Katalin,Acta
Medica Maresiensis, 2013;59(5):264-266,www.ammjournal.ro
Rezumate ISI publicate:

Evaluation of the index of orthodontic treatment need in a young
Romanian
population.
;R.Mocanu,K.Martha,A.Ogodescu,S.Rosu,I.Zetu.,abstract
EOS,Warsaw,pg.14,2014

Evaluation of malocclusion impact on quality of life in the young
population of Romania. –I.Zetu,S.Rosu,M.Iacob,L.Zetu,abstract
EOS,Warsaw,pg.13, 2014
Rezumate publicate

Auto-aprecierea esteticii dentare la pacientii cu anomalii dentomaxilare, D.Olteanu,Sorana ROSU,abstract
The 13 th
International Congres of dentistry for students and young
doctors,Bucuresti,2014 – PREMIUL II

Dento-maxillary anomalie and the orthodontic treatment needs of
the young population in the north-east of Romania,
D.Olteanu,Sorana ROSU,DENTis2014,Cluj Napoca, PREMIUL
II
Colaborator carte:
 Prevention des affections oro-dentaires- traveaux pratique, Lucia
Barlean,Livia Bobu, collaborator Sorana Zetu, Ed,PIM
Iasi,2012,ISBN 978-606-13-0838-5.

Coautor carte :

.,Pedodontie Note de curs Vol.II, chapitre INTERRELATIONS
ORTHODONTIE –PEDODONTIE,-Irina Zetu,Mihnea Iacob,
RalucaVieriu, Sorana Rosu,Ed.Gr.T.Popa,Iasi 2013,ISBN :978606-544-157-6

Ortodontie.Tehnica arcului drept. Irina Zetu., traducere Sorana
ZETU,Ed.Tehnopress,Iasi,2010, ISBN978-973-702-769-6