Orthodontic treatment needs in 10–12-year-old school children from Sulaimani City, Iraq: a cross-sectional study

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Abstract
Malocclusion is a prevalent oral health concern worldwide, ranking third after dental caries and periodontal disease. Early identification and intervention in childhood can prevent its progression into adulthood. The Index of Orthodontic Treatment Need (IOTN) is widely used to assess malocclusion severity. However, global studies using the IOTN have reported varying malocclusion prevalence rates, which are influenced by socioeconomic and ethnic factors. This study aimed to examine the orthodontic treatment needs among Iraqi children aged 10–12. A total of 384 children (173 boys and 211 girls) were randomly selected from four distinct regions in Sulaimani, Iraq. Eligibility criteria included Iraqi children aged 10–12 years with no history of orthodontic treatment, non-nutritive sucking habits, or craniofacial anomalies. Evaluations took place in school environments, using criteria from the American Board of Orthodontics to assess overjet, reverse overjet, overbite, anterior openbite, and buccal crossbite. Malocclusion severity was categorized using the Dental Health Component of the IOTN. Data analysis included chi-square testing, and 95% confidence intervals to interpret findings. Most children had mild treatment needs (Grade 2: 36.2%), followed by no treatment required (Grade 1: 31.3%) and moderate needs (Grade 3: 24.5%). More severe cases were less common, with Grade 4 (4.7%) and Grade 5 (3.4%). Overbite was the most prevalent malocclusion requiring treatment, while overjet had the lowest demand. No significant gender differences were found (p > 0.05). Mild to moderate malocclusion was prevalent, with overbite and crossbite being the most frequent conditions requiring treatment. Overjet exhibited the lowest treatment demand, and gender differences were not significant, suggesting equal applicability of orthodontic programs to both boys and girls. Not applicable.

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