INTRODUCTION:

Children differ considerably from each other, even with in the same family, with regard to growth factors, skeletofacial patterns, and spacing of teeth^[1]. Occlusion of growing child is regarded as dynamic rather than static relation between facial structures. Childhood is the mirror in which the propensities of adulthoodare reflected; similarly the type of occlusion in primary dentition predicts the occlusion of the permanent dentition^[2].

Concerning the deciduous dentition, generalised spacing in the anterior region is the most common characteristic and is accepted by some authors as favourable for the alignment of permanent anterior teeth^{[3,4,5,6,7,8,9]}. So spaced primary dentition is an indicator for the favourable development of permanent dentition. These deciduous spaces are a prerequisite to compensate for the discrepancy between the tooth sizes of primary and permanent dentitions, and play a critical role in the later eruption of permanent teeth and the establishment of occlusion^{[10,11,12,13]}. Additionally, a lack of these spaces in deciduous dentition may result in disproportionate jaw and tooth sizes^[14,15,16]. However, some authorsexplain that crowding constitutes a problem not only from an orthodontic point of view, but also because it predisposes to greater retention of dental plaque^[17]. A study has mentioned that the crowding of deciduous incisors is probably followed by crowding of permanent incisors and advocated that this characteristic should be considered a malocclusion^[18]. Furthermore, even though growth and development cause dimensional and cephalometric changes between the deciduous and permanent dentitions, some children may deviate from the normal pattern^[19]. Thus, it may be assumed that the follow-up of children with crowding in the deciduous dentition up to the permanent dentition would be a method of Preventive Orthodontics.

Spacing in the primary dentition can be subdivided into two types:primate space and developmental space^[20]. Primate spaces are located between the lateral incisors and canines in the upper arch, and between the first molars and canines in the lower arch, whereas developmental spacing (also called interdental spacing) is found between the incisors in both the upper and lower arches^[21]. Notably, closed dentition without primate or interdental spaces can increase the risk of proximal dental caries^[22,23]. In short, spaced deciduous dentition is necessary for the development of permanent dentition and normal occlusion.

There are several methods by which to investigate spaced and closed dentition. Dental casts are used to confirm the presence of spacing, and to measure the distance of spacing in the primary dentition^{[24,25,26,27]}. Intraoral photography is also common, and used to inspect the spacing in the upper and lower arches^[28]. Apart from these methods, some studies have examined and recorded the spacing through direct visualisation^[29,30,31]. These methods are both useful and popular in detecting the spacing in the primary dentition. Spaced or closed dentition is the most crucial characteristic of the dental arch, and the dental arch is closely related to ethnicity^{[32,33,34,35]}. Several studies have examined the prevalence of spaced dentition among diverse ethnic groups. So, the aim of the study is to determine the anterior spacing and primate spacing in primary dentition in pre-school children in chennai.

MATERIALS AND METHODS:

A total of 100 children, aged 3 to 6 years old (65 girls and 35 boys)were recruited for the presentstudy, and 100 were determined to meet all of the criteria. The children were examined in their respective schools by a single examiner under good daylight and primate and interdental spaces were recorded by intraoral photographs.

The inclusion criteria comprised complete primary dentition, no premature loss of primary teeth, no erupted permanent teeth, and no proximally damaged teeth resulting from caries. In contrast, the exclusion criteria comprised eruption of any permanent molar or permanent incisor, and other abnormalities such as supernumerary teeth, fusion, missing teeth, or submerged teeth.

RESULTS:

The present study assessed the primate spacing and anterior spacing(incisal liability) of the primary dentition of 100 children aged, three to six years. The results are presented in [Fig-1-4].

Ratios of incidence of primate and anterior spacing of primary dentition in upper and lower arches

Fig.1

Fig.2

Fig.3

Fig.4

The ratios of closed dentition was significantly higher than that of spaced dentition,indicating that regardless of the upper or lower arch, closed dentition is common in chennai children. Moreover, the girlsdemonstrated a higher ratio of closed dentition than the boys.

DISCUSSION:

The importance of spaced primary dentition has long been a topic of discussion regarding the development of permanent dentition. Numerous studies in several ethnic groups have been conducted^[36,37]. Overall, the spaced type is more universal than the closed type. However, similar studies in Asian children are lacking; this study is therefore the first that explored spaced primary dentition and gender differences in the chennai population. Our results indicate that most of the Chennai children present with closed dentition and closed dentition is more common in girls than in boys. In addition, primate space is more frequently found in the upper arch than in the lower arch, and interdental space is reversed. Spacing in the primary dentition indicates proper alignment for future permanent dentition^[31]. Closed primary dentition produces crowded anterior incisors in 40% of people^[38]. Poor anterior spacing may contribute to Class II malocclusion^[39]. Other researches have indicated that the sum of the mesiodistal crown diameter of the closed dentition is larger than spaced dentition^[24,29]. Besides, closed dentition produces a significantly narrower dental arch^[24]. Therefore, closed dentition and associated factors may contribute to the increased chance of developing crowded permanent dentition.

The importance of spaced primary dentition is ineffable because these spaces are vital for the eruption of permanent teeth, as well as the establishment of occlusion^[29]. The absence of spacing in the primary dentition may increase the necessity of orthodontic treatment. Spaced dentition has been shown to be more common in males than in females^[25,29]. Boys have more primate space than girls^[26]. The prevalence of primate space is found to be lower among girls^[24]. Similarly, our study determined that boys had higher prevalence rates of interdental space in both upper and lower arches and a higher ratio of upper primate space than the girls. Coincidentally, crowded permanent dentition occurs more frequently in girls^[40], and malocclusion and the demand for orthodontic treatment are higher in girls than in boys according to the Dental Aesthetic Index ^[41]. Because spaced primary dentition is very important for the development of permanent teeth, the scarcity of these spaces likely increases the occurrence of malocclusion and the necessity of orthodontic treatment.

Detecting the presence of spacing is crucial for this type of study, and is usually determined by three methods: dental casts, intraoral photography, and direct visualisation. Examination from the dental casts is the most precise method, but retrieving impressions from young children is difficult because of the necessary cooperation required. The application of dental casts in clinical usage is very low. Direct visualisation is the easiest and the most convenient method, but it is not recorded and cannot be traced or followed. Therefore, intraoral photography was selected to determine the existence of spaced dentition in our study. This method was relatively easier to implement compared with dental casts, but is more precise than direct visualisation. Using photography is an established method to examine primary dentition.

CONCLUSION:

The present study provides hitherto data pertaining to the state of dentition, occlusal pattern and spacing in the primary dentition of Indian children of chennai region. We conclude that most of the children present with closed dentition, and boys have higher prevalence of spaced dentition than girls. Future studies are needed to survey the amount of the space and to investigate the influence of amount of spaced dentition on the development of occlusion.Data compiled from various parts of the country, could serve as a database for prediction of malocclusion among the Indian population.

REFERENCES:

1. Penido RS, Carrel R, Chialastri AJ. Occlusal assessment of a 3 to 5 year old population. Pediatr Dent 1979;1:104-8.

2. Abu Alhaija ESJ, Qudeimat MA. Occlusion and tooth/arch dimensions in the primary dentition of preschool Jordanian children. Int J Paediatr Dent. 2003;13(4):230-9.

3. Alexander S, Prabhu NT. Profiles, occlusal plane relationships and spacing of teeth in the dentitions of 3 to 4 year old children. J Clin Pediatr Dent. 1998;22(4):329-34.

4. Anderson AA. The dentition and occlusal development in children of African American descent. Angle Orthod. 2007;77(3):421-9.

5. Baume LJ. Physiological tooth migration and its significance for the development of occlusion: I. The biogenetic course of the deciduous dentition. J Dent Res. 1950;29(2):123-32.

6. Bishara SE, Jakobsen JR. Individual variation in toothsize/arch-length changes from the primary to permanent dentitions. World J Orthod. 2006;7(2):145-53.

7. Carvalho KL, Valença AMG. Prevalênciadascaracterísticasnormais da oclusãodecídua em crianças de 2 a 6 anos. Pesqui Bras Odontopediatria ClínIntegr. 2004;4(2):113-20.

8. Dinelli TCS, Martins LP, Pinto AS. Mudançasdimensionais dos arcosdentários em criançasentre 3 e 6 anos de idade. Rev Dental Press OrtodOrtop Facial. 2004;9(4):60-7.

9. El-Nofely A, Sadek L, Soliman N. Spacing in the human deciduous dentition in relation to tooth size and dental arch size. Arch Oral Biol. 1989;34(6):437-41.

10. Ferreira RI, Scavone-Jr H, Castro RG, Nascimento MAS, Romero CC. Assessment of interdental spacing in the anterior segment of deciduous arches. Rev OdontolUniv Cid São Paulo. 2005;17(2):101-10.

11. Foster TD, Hamilton MC. Occlusion in the primary dentition. Study of children at 2 ½ to 3 years of age. Br Dent J. 1969;126(2):76-9.

12. Sato VCB, Scavone-Junior H, Garib DG, Ferreira RI. Associaçãoentrehábitos de sucçãonãonutritivos e as relaçõesoclusaisântero-posteriores em criançasnipobrasileiras. CiêncOdontol Bras. 2008;11(1):19-26.

13. Joshi MR, Makhija PG. Some observations on spacing in the normal deciduous dentition of 100 Indian children from Gujarat. Br J Orthod. 1984;11(2):75-9.

14. Kabue MM, Moracha JK, Ng’ang’a PM. Malocclusion in children aged 3-6 years in Nairobi, Kenya. East Afr Med J. 1995;72(4):210-2.

15. Kerosuo H. Occlusion in the primary and early mixed dentitions in a group of Tanzanian and Finnish children. ASDC J Dent Child. 1990;57(4):293-8.

16. Kharbanda OP, Sidhu SS, Shukla DK, Sundaram KR. A study of the etiological factors associated with the development of malocclusion. J Clin Pediatr Dent. 1994;18(2):95-8.

17. Leighton BC. The early signs of malocclusion. Eur J Orthod. 2007;29(1):189-95.

18. Moorrees CFA, Chadha JM. Available space for the incisors during dental development: a growth study based on physiologic age. Angle Orthod. 1965;35(1):12-22.

19. Onyeaso CO. Occlusion in the primary dentition. Part 1: a preliminary report on comparison of anteroposterior relationships and spacing among children of the major Nigerian ethnic groups. Odontostomatol Trop. 2006;29(114):9-14.

20. J. Janiszewska-Olszowska, P. Stepien, M. Syrynska. Spacing in deciduous dentition of Polish children in relation to tooth size and dental arch dimension. Arch Oral Biol, 54 (2009), pp. 397-402.

21. L.J. Baume. Physiological tooth migration and its significance for the development of occlusion. I. The biogenetic course of the deciduous dentition. J Dent Res, 29 (1950), pp. 123-132.

22. P. Subramaniam, K.I.G. Babu, J. Nagarathna. Interdental spacing and dental caries in the primary dentition of 4–6 year old children. J Dent (Tehran), 9 (2012), pp. 207-214.

23. J.J. Warren, R.L. Slayton, T. Yonezu, M.J. Kanellis, S.M. Levy. Interdental spacing and caries in the primary dentition. Pediatr Dent, 25 (2003), pp. 109-113.

24. A. el-Nofely, L. Sadek, N. Soliman. Spacing in the human deciduous dentition in relation to tooth size and dental arch size. Arch Oral Biol, 34 (1989), pp. 437-441.

25. M. Facal-Garcia, D. Suarez-Quintanilla, J. De Nova-Garcia. Diastemas in primary dentition and their relationships to sex, age and dental occlusion. Eur J Paediatr Dent, 3 (2002), pp. 85-90.

26. M.R. Joshi, P.G. Makhija. Some observations on spacing in the normal deciduous dentition of 100 Indian children from Gujarat. Br J Orthod, 11 (1984), pp. 75-79.

27. J.J. Ravn. Occlusion in the primary dentition in 3-year-old children. Scand J Dent Res, 83 (1975), pp. 123-130.

28. R. Khan, N. Singh, S. Govil, S. Tandon. Occlusion and occlusal characteristics of primary dentition in North Indian children of East Lucknow region. Eur Arch Paediatr Dent, 15 (2014), pp. 293-299.

29. N. Ohno, K. Kashima, T. Sakai. A study on interdental spaces of the deciduous dental arch in Indian sample. Aichi Gakuin Daigaku Shigakkai Shi, 28 (1990), pp. 79-91.

30. O.D. Otuyemi, E.O. Sote, M.C. Isiekwe, S.P. Jones. Occlusal relationships and spacing or crowding of teeth in the dentitions of 3–4-year-old Nigerian children. Int J Paediatr Dent, 7 (1997), pp. 155-160.

31. G.R. Shavi, N.V. Hiremath, R. Shukla, P.K. Bali, S.K. Jain, S.L.Ajagannanava. Prevalence of spaced and non-spaced dentition and occlusal relationship of primary dentition and its relation to malocclusion in school children of Davangere. J Int Oral Health, 7 (2015), pp. 75-78.

32. M. Bayome, G.T. Sameshima, Y. Kim, K. Nojima, S.H. Baek, Y.A.Kook. Comparison of arch forms between Egyptian and North American white populations. Am J Orthod Dento facial Orthop, 139 (2011), pp. e245-e252.

33. Y. Gafni, L. TzurGadassi, K. Nojima, R.P. McLaughlin, Y. Abed, M.Redlich. Comparison of arch forms between Israeli and North American white populations. Am J Orthod Dentofacial Orthop, 139 (2011), pp. 339-344.

34. Y.A. Kook, K. Nojima, H.B. Moon, R.P. McLaughlin, P.M. Sinclair. Comparison of arch forms between Korean and North American white populations. Am J Orthod DentofacialOrthop, 126 (2004), pp. 680-686.

35. K. Nojima, R.P. McLaughlin, Y. Isshiki, P.M. Sinclair. A comparative study of Caucasian and Japanese mandibular clinical arch forms. Angle Orthod, 71 (2001), pp. 195-200.

36. P.F. Infante. Malocclusion in the deciduous dentition in white, black, and Apache Indian children. Angle Orthod, 45 (1975), pp. 213-218.

37. A. Kaufman, E. Koyoumdjisky. Normal occlusal patterns in the deciduous dentition in preschool children in Israel. J Dent Res, 46 (1967), pp. 478-482.

38. C. Moorrees. Growth changes of the dental arches: a longitudinal study. J Can Dent Assoc, 24 (1958), pp. 449-457.

39. J. Varrela. Early developmental traits in class II malocclusion. Acta Odontol Scand, 56 (1998), pp. 375-377.

40. B. Thilander, L. Pena, C. Infante, S.S. Parada, C. de Mayorga. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Eur J Orthod, 23 (2001), pp. 153-167.

41. L.A. Foster Page, W.M. Thomson. Malocclusion and uptake of orthodontic treatment in Taranaki 12–13-year-olds. N Z Dent J, 101 (2005), pp. 98-105.

Received on 23.07.2018 Modified on 15.08.2018

Research J. Pharm. and Tech 2018; 11(12): 5413-5416.

DOI: 10.5958/0974-360X.2018.00988.5