Malocclusion Traits and Orthodontic Treatment Needs Among 7–12-year-old Children With Adenotonsillar Hypertrophy in Three Referral Hospitals

Abstract

Background: The relationship between adenotonsillar hypertrophy, chronic mouth breathing and its associated pattern of malocclusion has been a subject of intense research as well as controversy. Various authors have reported that children with mouth breathing develop an array of morphological disorders during the growth phase which manifests as both dental and skeletal malocclusion. Malocclusion has been associated with several unfavorable consequences which comprise dental caries, traumatic dental injuries, periodontal diseases and impaired oral function. In recent years, there has been increasing interest in the early detection and treatment of malocclusion with emphasis on preventive and interceptive procedures that seek to modify skeletal, muscular and dentoalveolar abnormalities in the mixed dentition stage. Study Objectives: The study aim was to determine malocclusion traits and Orthodontic treatment needs in 7–12-year-old children with adenotonsillar hypertrophy in three referral hospitals. Materials and Methods: This was a cross-sectional study with hospital-based participants at the Kenyatta National Hospital, Mbagathi Hospital and Gertrude’s Children Hospital ENT clinics. A total of 162 children aged 7-12 years diagnosed to have adenotonsillar hypertrophy and who fulfilled the inclusion and exclusion criteria were recruited into the study. Data collection was carried out using a data collection form and clinical examination. Malocclusion traits were registered following the WHO/FDI malocclusion registration index and the Orthodontic treatment needs assessed via the modified aesthetic scale of the Index of Orthodontic Treatment Need. Data Analysis and Presentation: Analysis was carried out using SPSS version 25.0 for Windows. The data was subjected to descriptive statistics. Thereafter, data was subjected to Chi-square test, Fischer’s exact test and Spearman’s correlation to compare and relate the variables. A p-value of ≤ 0.05 was considered statistically significant. The results obtained are presented using tables and figures. Results: A total of 162 participants comprising of 82 (50.6%) boys and 80 (49.4%) girls participated in the study. The mean age was 8.85 + 1.77 years. Majority of the participants (n=

132, 81.4%) were in mixed dentition while 30(18.4%) were in permanent dentition. The most common anteroposterior molar relationship was an Angles class I molar relationship in 72.8% of the participants. Angles Class II molar relationship was present in 22.8% of the participants. An increased overjet was detected in 21.0% of the participants. Posterior cross bite was present in 14.8% of the participants and occurred significantly more in participants aged 9-12 years (Fisher’s = 26.874, p < .001). With regards to orthodontic treatment needs, majority of the participants in permanent dentition had moderate to great Orthodontic Treatment Needs. Conclusions: Majority of the participants were in mixed dentition and there was a statistically significant positive correlation between the overjet measurements, occurrence of posterior crossbite and tonsillar hypertrophy grade. Most of the participants in permanent dentition had moderate to great Orthodontic Treatment Needs.