Tooth wear patterns in subjects with class II division 1 and class II division 2 malocclusion

Abstract

Introduction: There is an increasing trend of malocclusion among children, so it is necessary to identify the cause of the tooth wear so that the orthodontist can treat the patient accordingly. It is necessary to determine the wear patterns of different malocclusions. Therefore, the aim of our study was to compare the patterns of tooth wear among two categories of Angle's class II malocclusions, i.e. class II division 1 and class II division 2.

Material and methods: The sample consisted of 100 pretreatment orthodontic patients in the age group of 15-25 years with Angle's class II malocclusion and were divided into following two groups: (a) Group 1: 50 subjects with full cusp Angle's class II division 1 malocclusion. (b) Group 2: 50 subjects with full cusp Angle's class II division 2 malocclusion. Clinical examination of the patients for tooth wear was done supplemented with dental casts, intraoral photographs and intraoral radiographs. Then each group was assessed for severity of tooth wear according to modified tooth wear index (TWI) given by de Carvalo Sales-Peres et al. Scores were subjected to statistical analysis and the pattern of tooth wear among the two groups of class II malocclusion was compared. A correlation between the gender of the patient and the tooth wear was also determined. The level of statistical significance (p-value) was less than 0.05.

Results: The class II division 1 subjects showed statistically greater wear on the occlusal surfaces of the maxillary canines, first, second premolar and first molar, and the occlusal surfaces of the mandibular first molars. The class II division 2 subjects showed statistically greater tooth wear on the labial surfaces of the mandibular central and lateral incisors, the incisal surface of maxillary and mandibular incisors, the palatal surfaces of the maxillary second premolars, first and second molars. In class II division 1 subjects, the tooth wear was significant on the buccal surface of maxillary canines, occlusal surface of mandibular first premolars and second molars in males. In class II division 2 subjects, the tooth wear was significant on the buccal surface of mandibular canines, palatal surface of maxillary central incisors in females and palatal surface of maxillary first premolars in males.

Conclusions: The results of this study suggested that the two categories of Angle's class II malocclusion have different tooth-wear patterns. The wear patterns were different in both the sexes. Men showed higher occlusal wear scores than did women. The findings also suggest that tooth wear in relation to malocclusion is physiologic and is due to dissimilar interocclusal arrangement.

Keywords: attrition; malocclusion; tooth wear.