Clinical Study
Index of Orthodontic Treatment Need in Obese Adolescents
Maria Rita Giuca,
1
Marco Pasini,
1
Silvia Caruso,
2
Simona Tecco,
3
Stefano Necozione,
2
and Roberto Gatto
2
1
Department of Surgical, Medical, Molecular and Critical Area Pathology, Unit of Pediatric Dentistry,
University of Pisa, Via Roma 67, 56126 Pisa, Italy
2
Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito Piazzale Salvatore Tommasi 1,
67100 L’Aquila, Italy
3
University Vita-Salute San Rafaele, Dental Clinic, Via Olgettina 60, 20132 Milano, Italy
Correspondence should be addressed to Silvia Caruso; silvia.caruso@graduate.univaq.it
Received 4 January 2015; Revised 21 March 2015; Accepted 25 March 2015
Academic Editor: Claudio R. Leles
Copyright © 2015 Maria Rita Giuca et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Aim. his case-control retrospective study is aimed at assessing if obese adolescents need more orthodontic treatment in comparison
with normal-weight patients of the same age. Methods. he test group included 100 obese subjects (50 males and 50 females; average
age: 13.09 ± 1.19 years old) and the control group included 100 normal-weight patients matched for age and sex (50 males and 50
females; average age: 13.07 ± 1.26 years old). Clinical examinations were conducted on dental casts to assess the need of orthodontic
treatment, by using the Index of Orthodontic Treatment Need (IOTN) (DHC, dental health component; AC, aesthetic components).
Results. No statistically signiicant diference ( > 0.05) was observed between the two groups with regard to AC. Obese females
showed a signiicant ( < 0.05) higher percentage of DHC 3 (32%) in comparison to the normal-weight girls (22%); for the other
grades of DHC and for the single kind of malocclusion, no signiicant diference was found. Conclusions. Obese adolescents showed
a similar need for orthodontic treatment compared to normal-weight patients of the same age. However, in obese females, a slightly
greater need for orthodontic treatment was observed, compared to normal-weight patients.
1. Background
Obesity is nowadays an increasingly growing health problem,
even in childhood and adolescents: the prevalence of child-
hood obesity in Italy ranged from 7.5% in the North to 16.6%
in the South [1].
It is an abnormal accumulation of body fat, usually 20%
or more over an individual’s ideal body weight and it is oten
accompanied by an increased risk of morbidity and mortality
[2]. Obesity is oten associated with poor eating habits or
excessive supply of food and a sedentary lifestyle; however,
obesity can also be linked to genetic, environmental factors,
hormonal dysfunctions, and the psyche of the patient [3, 4].
here are two forms of obesity: primary and secondary.
he primary is due to genetics, nutrition, and behavioural and
psychosocial factors that lead to an imbalance between food
intake and energy expenditure. Secondary obesity is linked to
speciic pathological conditions such as Cushing’s syndrome,
hypothyroidism, insulinoma, the Stein-Leventhal syndrome,
some forms of diabetes mellitus, use of certain drugs, and
hypothalamic endocrine disorders [5, 6].
Because obesity can be considered as a systemic disease
that predisposes to a variety of comorbidities and complica-
tions that afect overall health, people who are obese require
a multidisciplinary approach [7]. Moreover, it was suggested
that childhood obesity may afect also the maxillofacial
morphology of growing patients [8].
An advanced craniofacial growth, measured by the carpal
analysis and cervical vertebral maturation method, was found
in young obese patients in comparison to normal-weight
patients; thus, the authors stated that an earlier examination
and orthodontic treatment in obese children might be neces-
sary compared to normal-weight patients [9].
Leptin, a hormone mainly produced by white adipose
tissue for controlling appetite and the build-up of reserves
in the form of adipose tissue, might be directly involved
Hindawi Publishing Corporation
International Journal of Dentistry
Volume 2015, Article ID 876931, 7 pages
http://dx.doi.org/10.1155/2015/876931