1. The pattern of presentation of malocclusion among orthodontic patients in Kano, Northern Nigeria. 0ral presentation at the 11th international conference of the Nigerian Association of Orthodontists in Ile-Ife, Osun state, Nigeria
Dr Adeyemi T.E

2. OUTLINE Introduction Aim Methodology Results Discussion Conclusion
Recommendations
References

3. Introduction
Occlusion is defined as the relationship of the maxillary and mandibular teeth as they are brought into functional contact; while malocclusion is the deviation from the normal or ideal occlusion. (John Daskalogiannakis,2000)
According to WHO (2009), malocclusion is defined as an anomaly which causes disfigurement or which impedes function, and requiring treatment “if the disfigurement or functional defect was likely to be an obstacle to the patient’s physical or emotional well-being”.

4. Dental malocclusion is present in all societies but its prevalence varies.
Knowledge about the distribution of different malocclusions, their prevalence and the need for treatment can help orthodontic practitioners to understand the existent problem in a geographic location and help them in planning awareness, preventive, interceptive treatment and manpower needed in orthodontics. (Goyal S, Goyal S; 2012).

5. Aim
This study aimed at understanding the pattern of presentation of malocclusion among patients who visited the orthodontic unit of dental and maxillofacial surgery department of AKTH,Kano.

6. Materials and method
This retrospective study included those patients who visited the orthodontic unit of Dental and Maxillofacial surgery department of Aminu Kano Teaching hospital, Kano, Nigeria during the period of June 2011 to June 2015 with chief complaints of ‘’not liking the arrangement of their teeth’’.

7. The cases selected included only patients that had a casenote and any two of the following records viz: clinical photographs, study models and lateral cephalometric radiograph.
The records of the patients were retrieved and the needed information extracted from all the cases that met the inclusion criteria.

8. The following parameters were recorded: Angle’s classification (Angle EH,1899), increased overbite (more than 3 mm), increased overjet (more than 3 mm), spacing, crowding, cross bite, scissors bite and treatment plan.
The subdivisions of Angle’s class II & III were not considered during this study.

9. No quantitative measurement for crowding, spacing, crossbite and scissors bite was done in any arch. They were recorded as either present or absent in either of the dental arch.
Descriptive statistics were calculated to find the means and standard deviations. The software used for data analysis was SPSS version 20.

10. Results
A total of 103 patients consisting of 58(56.3%) males and 45(43.7%) females were seen during the period under review.
The age ranged from 7 to 33 years with mean of ±5.0
Angle’s classes I, II and III accounted for 78%, 17% and 5% respectively of the total number of patients seen.

11. Table 1: Distribution of cases according to different age groups
Age group (years)
Frequency (n)
Percentage (%)
Cumulative Percent (%)
5-10 37
35.9
11-15 39
37.9
73.8
16-20 17
16.5
90.3
21-25 7
6.8
97.1
26-30 2
1.9
99.0
31-35 1
1.0
100.0
Total
103

12. Table 2: Distribution of malocclusion according to their sex
Angle’s
classification
Sex
Fisher’s exact test
Male
Female
Total x2
P-value
Class 1
47(58.00)
34(34.00)
81(100.00)
Class 2
9(52.90)
8(47.10)
17(100.00)
0.824
0.746
Class 3
2(40.00)
3(60.00)
5(100.00)

13. Table 3: Distribution of malocclusion traits according to sex
Total (%) X2
P -value
Male(%)
Female(%)
Crossbite
9(56.20)
7(43.80)
16(100.00)
0.00
0.996
Scissorsbite
1(100.00)
0(0.00)
1.00
1.000
Upper spacing
15(68.20)
7(31.80)
22(100.00)
1.60
0.206
Lower spacing
12(63.20)
7(36.80)
19(100.00)
0.44
0.505
Upper crowding
28(58.30)
20(41.70)
48(100.00)
0.15
0.699
Lower crowding
29(55.80)
23(44.20)
52(100.00)
0.01
0.911

14. Figure 1: Treatment plans

15. Table 4: Distribution of overbite and overjet across the study population
Value
Overbite (%)
Overjet(%)
Reduced
21(20.40)
18(17.50)
Normal
66(64.10)
50(48.50)
Increased
16(15.50)
35(34.00)

16. Discussion
Most of the participants were males (56.30%) which suggests that males have more access to health facilities in this environment due possibly to cultural reasons which requires that females should be accompanied to places by a chaperon and this ultimately limits their access to health facilities since the adults may not be available at all times; this is in contradiction to the pattern seen in south western Nigeria(Onyeaso CO,2004).

17. The mean age of the participants was 13
The mean age of the participants was years with standard deviation of 5.00 years which signifies higher demand for orthodontic treatment during adolescent years(Onyeaso CO,2004).Majority of the participants (78%) had Angle’s class I malocclusion which is in agreement with studies done in other parts of the country and the wold.8-11

18. There were more cases of increased overjet (34
There were more cases of increased overjet (34.00%) than increased overbite (15.50%) which is same pattern noticed in other studies.8,12 There was less crowding in the upper (46.60%) than the lower segment (50.49%) while spacing was more prevalent in the upper (21.40%) than the lower anterior segment (18.45%), this is similar to other studies8 but in contrast with some other studies.13

19. Fixed appliance for treatment was required to correct the malocclusion in almost all the participants (94.2%) which shows that the malocclusion presented was a real source of worry to the participants, this is in contrast to findings by Onyeaso who reported that over 43% of participants needed removable orthodontic appliances while close to 17% required treatment with fixed appliances in his study.7

20. Conclusion
Relatively more males present for orthodontic treatment in this environment.
Adolescents are more concerned about their occlusion than adults, thus seek treatment more.
Angle’s class I malocclusion is the most prevalent and fixed orthodontic treatment is the most required to solve the malocclusion issues in this environment.

21. Recommendations
More orthodontists should be produced/trained in order to meet up with the personnel need
An indigenous company should be encouraged by government to start manufacturing orthodontic materials in order to meet the material need

22. References
John Daskalogiannakis: Glossary of Orthodontic Terms. Publisher. Quintessence, 2000, 1st Ed.
Organização Mundial Da Saúde. Levantamento epidemiológico básico de saúde bucal: manual de instruções. 3. ed. São Paulo: Ed. Santos, Cited from Daniel Ibrahim BritoI; Patricia Fernanda DiasI; Rogerio GleiserII Prevalence of malocclusion in children aged 9 to 12 years old in the city of Nova Friburgo, Rio de Janeiro State, Brazil. R Dental Press Ortodon Ortop Facial 118 Maringá, v. 14, n. 6, p , Nov./Dez. 2009
Goyal Sandeep, Goyal Sonia: Pattern of dental malocclusion in orthodontic patients in rwanda: a retrospective hospital based study. Rwanda Medical Journal, Vol.69 (4); December 2012, pp 13-18

23. National Population Commission, Nigeria Population Census (Online)
National Population Commission, Nigeria Population Census (Online) Availablefrom:URL: last accessed August 01, 2016.
Angle EH: Classification of malocclusion, Dental Cosmos, vol. 41, pp. 248–264, 1899
6Moyers RE: handbook of orthodontics. 4th edition. Chicago: year book medical publisher; 1988.
Onyeaso CO. Demand and referral pattern for orthodontic care at University College Hospital, Ibadan, Nigeria. Int Dent J. 2004 Oct;54(5):250-4.

24. Ajayi E: Prevalence of Malocclusion Among School Children in Benin City, Nigeria. Journal of Medicine and Biomedical Research, Vol. 7, No. 1 & 2, 2008, pp
Onyeaso CO, Aderinokun GA, Arowojolu MO. The pattern of malocclusion among orthodontic patients seen in Dental Centre, University College Hospital, Ibadan, Nigeria. Afr J Med Med Sci. 2002;31(3):207-11
Onyeaso CO. Prevalence of malocclusion among adolescents in Ibadan, Nigeria. Am J Orthod Dentofacial Orthop. 2004 ;126(5):604-7.
Mtaya M, Brudvik P, Astrøm AN. Prevalence of malocclusion and its relationship with socio-demographic factors, dental caries, and oral hygiene in 12- to 14-year-old Tanzanian schoolchildren. Eur J Orthod. 2009;31(5):

25. Gul-e-Erum, Fida M. Pattern of malocclusion in orthodontic patients: a hospital based study. J Ayub Med Coll Abbottabad. 2008;20(1):43-7.
Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour 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(5):