Modality of malocclusion according to regional difference using HLD(handicapping labiolingual deviation), TPI(treatment priority index) and HMAR(handicapped malocclusion assessing record)

Sohn, Byung Wha; Hwang, Chung Ju; Hwang, Hyun Sik

Abstract

We tried to evaluate frequencies and severities of malocclusion of various socioeconomic areas according to growth and development. To obtain objective validity, we used Handicapping Labiolingual Deviation (HLD) suggested by Draker, Treatment Priority Index (TPI) by Grainger, Handicapped Malocclusion Assessing Record (HMAR) by American Dental Association and American Association of Orthodontist. Seoul and Kwangju were selected as an urban group, Ahnyang as an middle socioeconomic group and Hwasun near the Kwangju area as an rural group. 140 (male 63, female 73) of 5th grade in 'E' elementary school students in Seoul, 202 (male 101, female 101) of 'S' elementary school students in Kwangju, 207(male 105, female 102) of 'H' elementary school students in Hwasun, and 100(male 49, female 51) of 'M' elementary school students of in Ahnyang of all the same grade were analyzed and we obtained the results as follows; 1. TPI, HLD, and HMAR showed high coincidence and reproducibility between different observer. (p<0.01) 2. In comparison of TPI, HLD, and HMAR according to clinical decision, there was statistically difference between each other. (p<0.01) 3. As the severity of malocclusion increases there was high correlation between TPI and HLD, and between HLD and HMAR (p<0.05) 4. With respect to differences between areas in TPI and HLD, there was statistically difference between Ahnyang and other areas. 5. In Seoul as an urban group there was a high incidence of periodic checkup and history of orthodontic treatment than other area. 6. Mode of feeding and posture during sleeping did not affect the severity of malocclusion. As a conclusion, TPI, HLD and HMAR are so reproducible and coincident that they can be used as a guide on evaluating the frequency and severity of malocclusion and determining the priority of orthodontic treatment to determine the need and supply of orthodontic treatment. Furthermore these indices can provide objectively valid data for establishing public health problem solution.