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KJO Korean Journal of Orthodontics

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Original Article

Korean J Orthod 2022; 52(3): 165-171

Published online May 25, 2022 https://doi.org/10.4041/kjod21.259

Copyright © The Korean Association of Orthodontists.

Occlusal deviations in adolescents with idiopathic and congenital scoliosis

Hao Zhanga , Jingbo Mab , Zhicheng Zhangc , Yafei Fengd, Chuan Caie, Chao Wangf

aState Key Laboratory of Military Stomatology National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
bDepartment of Thoracic Surgery, The Seventh Medical Center of PLA General Hospital, Beijing, China
cDepartment of Orthopedics, The Seventh Medical Center of PLA General Hospital, Beijing, China
dDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
eDepartment of Stomatology, The First Medical Center of PLA General Hospital, Beijing, China
fDepartment of Stomatology, The Seventh Medical Center of PLA General Hospital, Beijing, China

Correspondence to:Chao Wang.
Professor, Department of Stomatology, The Seventh Medical Center of PLA General Hospital, No. 5 Nanmencang, Dongcheng District, Beijing 100700, China.
Tel +86-010-66721597 e-mail wangchao51115111@126.com

Hao Zhang, Jingbo Ma, and Zhicheng Zhang contributed equally to this work.

How to cite this article: Zhang H, Ma J, Zhang Z, Feng Y, Cai C, Wang C. Occlusal deviations in adolescents with idiopathic and congenital scoliosis. Published online May 10, 2022. https://doi.org/10.4041/kjod21.259

Received: October 14, 2021; Revised: January 1, 2022; Accepted: January 5, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods: Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results: In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions: Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

Keywords: Facial asymmetry, Dentofacial anomalies, Scoliosis, Malocclusion

Article

Original Article

Korean J Orthod 2022; 52(3): 165-171

Published online May 25, 2022 https://doi.org/10.4041/kjod21.259

Copyright © The Korean Association of Orthodontists.

Occlusal deviations in adolescents with idiopathic and congenital scoliosis

Hao Zhanga , Jingbo Mab , Zhicheng Zhangc , Yafei Fengd, Chuan Caie, Chao Wangf

aState Key Laboratory of Military Stomatology National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
bDepartment of Thoracic Surgery, The Seventh Medical Center of PLA General Hospital, Beijing, China
cDepartment of Orthopedics, The Seventh Medical Center of PLA General Hospital, Beijing, China
dDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
eDepartment of Stomatology, The First Medical Center of PLA General Hospital, Beijing, China
fDepartment of Stomatology, The Seventh Medical Center of PLA General Hospital, Beijing, China

Correspondence to:Chao Wang.
Professor, Department of Stomatology, The Seventh Medical Center of PLA General Hospital, No. 5 Nanmencang, Dongcheng District, Beijing 100700, China.
Tel +86-010-66721597 e-mail wangchao51115111@126.com

Hao Zhang, Jingbo Ma, and Zhicheng Zhang contributed equally to this work.

How to cite this article: Zhang H, Ma J, Zhang Z, Feng Y, Cai C, Wang C. Occlusal deviations in adolescents with idiopathic and congenital scoliosis. Published online May 10, 2022. https://doi.org/10.4041/kjod21.259

Received: October 14, 2021; Revised: January 1, 2022; Accepted: January 5, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods: Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results: In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions: Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

Keywords: Facial asymmetry, Dentofacial anomalies, Scoliosis, Malocclusion

Fig 1.

Figure 1.X-ray and dental images of an 18-year-old female patient with congenital scoliosis and an Angle Class II subgroup classification. A, Full-length anteroposterior spine X-ray image showing a severely deformed and twisted spine. B, Dental image showing normal mandibular occlusion on the right side. C, Dental image showing an oblique occlusal plane. D, Dental image showing mandibular deviation on the left side.
Korean Journal of Orthodontics 2022; 52: 165-171https://doi.org/10.4041/kjod21.259

Table 1 . Sex distribution, age, severity distribution, and treatment method distribution in patients with scoliosis.

VariableIS group (n = 58)CS group (n = 48)p-value
Sex distribution0.001**
Male7 (12.1)19 (39.6)
Female51 (87.9)29 (60.4)
Age-
Mean14Y8M15Y3M
Min?max12Y4M?20Y2M10Y5M?23Y6M
Severity distribution0.020*
Cobb angle ≥ 45°22 (37.9)31 (64.6)
Cobb angle < 45°36 (62.1)17 (35.4)
Treatment method distribution< 0.001**
Surgical treatment20 (34.5)42 (87.5)
Physical therapy38 (65.5)6 (12.5)

Values are presented as number (%)..

Chi-squared test was performed to compare IS and CS groups..

IS group, idiopathic scoliosis group; CS group, congenital scoliosis group; Y, year; M, month..

*p < 0.05; **p < 0.01..


Table 2 . Distribution of angle classification in the idiopathic scoliosis, congenital scoliosis, and control groups.

Angle classificationIS group
(n = 58)
CS group
(n = 48)
Control group
(n = 152)
p-value
(IS vs. control)
p-value
(CS vs. control)
p-value
(IS vs. CS)
n%n%n%
Normocclusion and Class I3458.62245.810367.80.3110.006**0.136
Class II1322.41020.82415.80.2600.4171.000
Class II subgroup1017.21429.2117.20.031*< 0.001**0.144
Class III11.724.2149.20.0600.2610.450

Chi-squared test was performed to compare IS and control groups, CS and control groups, IS and CS groups..

IS group, idiopathic scoliosis group; CS group, congenital scoliosis group..

*p < 0.05; **p < 0.01..


Table 3 . Occlusal patterns in the idiopathic scoliosis, congenital scoliosis, and control groups.

Occlusal patternIS group
(n = 58)
CS group
(n = 48)
Control group
(n = 152)
p-value
(IS group vs. control)
p-value
(CS group vs. control)
p-value
(IS vs. CS)
n%n%n%
Asymmetric molar relationship1017.21429.2127.90.048**< 0.001**0.144
Asymmetric canine relationship1119.61429.8149.50.0940.001**0.232
Deviation of the upper middle line1525.91531.32617.10.1520.034*0.540
Deviation of the lower middle line2339.72245.83925.70.047**0.008**0.522
Anterior deep overbite2136.21939.63623.70.0680.003**0.721
Unilateral posterior crossbite1119.01327.1138.60.0340.001**0.320
Canted occlusal plane1220.71327.1159.90.0360.003**0.440

Chi-squared test was performed to compare IS and control groups, CS and control groups, IS and CS groups..

IS group, idiopathic scoliosis group; CS group, congenital scoliosis group..

*p < 0.05; **p < 0.01..