Early orthodontic treatment need over a 10-year period and evaluation of short-term intervention stability

Abstract

Objective Early orthodontic treatment with cost reimbursement within the framework of the German statutory health insurance (GKV) is only possible for a strictly defined malocclusion group as defined by the orthodontic indication groups (KIG). It is not yet clear whether the application of the KIG criteria and corresponding successful early orthodontic interventions result in no or significantly less need for treatment in the late mixed dentition or in the permanent dentition. This study therefore investigated short-term intervention stability from a 10-year-period. Materials and methods Between 2009 and 2019, n=661 patients were diagnosed with indication groups D (increased overjet), M (reversed overjet), B (scissors bite), K (crossbite), or P (lack of space) including orthodontic treatment need. N=70 patients (35 female, 35 male) met the inclusion criteria of the study and had received early orthodontic treatment with a mean duration of 15.44±2.20 months. Orthodontic indication groups (KIG) were evaluated at the beginning (aged 7.99±1.44 years) and the end of early orthodontic treatment (aged 9.63±1.49 years) and at a voluntary control or the beginning of additional orthodontic treatment (aged 11.85±1.72 years). The evaluation included established procedures for categorization of orthodontic indication groups and their respective classification. Statistics included Chi-square test and Kendall´s tau-b. The level of significance was set at p<0.05. Results The results showed reversed overjet in 44.3% and crossbites in 41.4% of the patients as most common indication for early orthodontic treatment. At the end of early orthodontic treatment, no orthodontic treatment need was present in 87.1%. At the late mixed dentition, the treatment result of early orthodontic treatment was stable in N=61 out of N=70 patients. Conclusions The results of our study confirm preventive benefits of early orthodontic treatment, especially in patients with transverse anomalies or reversed overjet. Clinical relevance A short-term orthodontic intervention with correct indication during primary or early mixed dentition can prevent or reduce further treatment need during late mixed or permanent dentition, and should therefore not be postponed.