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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.
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
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.
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
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.
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
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.
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
Table 1 . Sex distribution, age, severity distribution, and treatment method distribution in patients with scoliosis.
| Variable | IS group (n = 58) | CS group (n = 48) | |
|---|---|---|---|
| Sex distribution | 0.001** | ||
| Male | 7 (12.1) | 19 (39.6) | |
| Female | 51 (87.9) | 29 (60.4) | |
| Age | - | ||
| Mean | 14Y8M | 15Y3M | |
| Min?max | 12Y4M?20Y2M | 10Y5M?23Y6M | |
| Severity distribution | 0.020* | ||
| Cobb angle ≥ 45° | 22 (37.9) | 31 (64.6) | |
| Cobb angle < 45° | 36 (62.1) | 17 (35.4) | |
| Treatment method distribution | < 0.001** | ||
| Surgical treatment | 20 (34.5) | 42 (87.5) | |
| Physical therapy | 38 (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..
*
Table 2 . Distribution of angle classification in the idiopathic scoliosis, congenital scoliosis, and control groups.
| Angle classification | IS group (n = 58) | CS group (n = 48) | Control group (n = 152) | (IS vs. control) | (CS vs. control) | (IS vs. CS) | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | ||||||
| Normocclusion and Class I | 34 | 58.6 | 22 | 45.8 | 103 | 67.8 | 0.311 | 0.006** | 0.136 | ||
| Class II | 13 | 22.4 | 10 | 20.8 | 24 | 15.8 | 0.260 | 0.417 | 1.000 | ||
| Class II subgroup | 10 | 17.2 | 14 | 29.2 | 11 | 7.2 | 0.031* | < 0.001** | 0.144 | ||
| Class III | 1 | 1.7 | 2 | 4.2 | 14 | 9.2 | 0.060 | 0.261 | 0.450 | ||
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..
*
Table 3 . Occlusal patterns in the idiopathic scoliosis, congenital scoliosis, and control groups.
| Occlusal pattern | IS group (n = 58) | CS group (n = 48) | Control group (n = 152) | (IS group vs. control) | (CS group vs. control) | (IS vs. CS) | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | ||||||
| Asymmetric molar relationship | 10 | 17.2 | 14 | 29.2 | 12 | 7.9 | 0.048** | < 0.001** | 0.144 | ||
| Asymmetric canine relationship | 11 | 19.6 | 14 | 29.8 | 14 | 9.5 | 0.094 | 0.001** | 0.232 | ||
| Deviation of the upper middle line | 15 | 25.9 | 15 | 31.3 | 26 | 17.1 | 0.152 | 0.034* | 0.540 | ||
| Deviation of the lower middle line | 23 | 39.7 | 22 | 45.8 | 39 | 25.7 | 0.047** | 0.008** | 0.522 | ||
| Anterior deep overbite | 21 | 36.2 | 19 | 39.6 | 36 | 23.7 | 0.068 | 0.003** | 0.721 | ||
| Unilateral posterior crossbite | 11 | 19.0 | 13 | 27.1 | 13 | 8.6 | 0.034 | 0.001** | 0.320 | ||
| Canted occlusal plane | 12 | 20.7 | 13 | 27.1 | 15 | 9.9 | 0.036 | 0.003** | 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..
*
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