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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Prevalence of Malocclusion and Occlusal Traits in Young Eastern Indian Population: A Multicentric Cross-sectional Study
Correspondence Address :
Dr. Shiladitya Sil,
Assistant Professor, Department of Oral Medicine and Radiology, North Bengal Dental College and Hospital, Sushrutanagar District, Darjeeling-734012, Siliguri, West Bengal, India.
E-mail: shiladitya.sil@gmail.com
Introduction: Malocclusion is emerging as a common oral health problem with an increasing demand for treatment. Studying the prevalence of malocclusion will help generate public awareness of its deleterious effects while bringing attention to the benefits of orthodontic treatment. Compiling such data will provide an understanding of the national scenario of the condition.
Aim: To determine the prevalence of malocclusion and occlusal traits with gender variation among adolescents and young adults in an Eastern Indian population.
Materials and Methods: This descriptive multicentric cross-sectional study was conducted in the Department of Orthodontics and Dentofacial Orthopaedics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India, from February to May 2024. A total of 1062 samples, comprising 453 males and 609 females in the age group of 14-22 years, reporting to the Outpatient Department (OPD) of Government Dental Colleges of West Bengal, were randomly selected. The samples were clinically examined and classified according to Angle’s classification into Class I, Class II (Div 1 and Div 2) and Class III cases. The Class I cases were further subdivided into normal occlusion, crowding, proclination, spacing, deep bite, open bite and crossbite. To obtain gender-wise distribution of malocclusion, the subjects were categorised into male and female subjects. Data were tabulated and statistically analysed using the Chi-square (χ2) test.
Results: The mean age of participants was 18.37±2.19 years. Normal occlusion comprised 109 (10.26%) cases, while malocclusion was found in 953 (89.74%) of the total subjects. In the malocclusion group, Class I was found in 724 (68.17%) cases, Class II Div 1 in 162 (15.25%), Class II Div 2 in 33 (3.11%) and Class III in (3.2%) of the total sample. Crowding was significantly higher at 287 (39.64%) (p<0.001) than other variants of Class I malocclusion. Gender dimorphism was evaluated using the Chi-square test. Significant gender differences were observed for Class I (p<0.001), Class II Div 1 and Div 2 (p<0.001).
Conclusion: Class I malocclusion showed the highest prevalence, with crowding being the most common variant. Females showed a higher prevalence of developing Class I malocclusion, whereas males presented with a higher prevalence of Class II Div 1 and Div 2 malocclusion.
Crossbite, Crowding, Deep bite, Open bite, Proclination
World Health Organisation (WHO) (1987) included malocclusion under the heading of Handicapping Dentofacial Anomaly, defined as an occlusal anomaly that causes disfigurement or impedes function and requires treatment, if the disfigurement or functional defect is likely to be an obstacle to the patient’s physical and emotional well-being (1). It is considered the third most common oral health problem after dental caries and periodontal diseases (1).
In the modern era, awareness of the benefits of an aesthetically pleasing face and a functionally healthy dentition has vastly increased. Adverse consequences of malocclusion include poor aesthetics, susceptibility to dental diseases, loss of tooth substance, low self-esteem, psychological disturbances, increased susceptibility to dental trauma and Temporomandibular Joint (TMJ) disorders (2), among other problems. Malocclusion not only affects the arrangement of teeth but can also cause restricted normal growth and development, affecting the morphology of jaws, face and cranium. Variations in the prevalence of malocclusion have been found among different races and ethnic groups (3),(4). Studying the incidence of malocclusion can provide quantitative information on the pattern of dentofacial characteristics within a population (5).
West Bengal is a state in the eastern part of India with a population of approximately 16.5 million in the age group of 14-22 years (6). Extensive multicentric studies are required to obtain nationwide representative data. Studies on malocclusion will not only help in orthodontic treatment planning and the evaluation of dental health services and manpower requirements but will also offer a valid research method for validating the operation of distinct environmental and genetic factors in the aetiology of malocclusion. Population-based data on dental conditions like malocclusion are a prerequisite for systemic planning and meeting the oral health needs of society.
The purpose of the study was to evaluate and quantify the malocclusion status through clinical examination and classify them according to Angle’s classification. Angle’s classification (1899) (7) is the most widely used and accepted method to classify major types of malocclusions. It provides a description of malocclusion that allows for easy communication between clinicians. Similar studies on the prevalence of malocclusion have been conducted in other regions like North India, South India and Maharashtra. However, no published record of the malocclusion status is available in West Bengal to date (3). Thus, the objective was to determine and compare the prevalence of malocclusion and occlusal traits among young adults (males and females) in an Eastern Indian population.
The descriptive multicentric cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India, from February 2024 to May 2024, spanning a period of 4 months. Approval was obtained from the institutional Ethics Committee of Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, before the study commenced (Ethical Committee Reg. no EC/NEW/INST/2023/3191, approval no RADC/EC/13/2023). Written informed consent was obtained from parents/individuals willing to participate in the study.
Inclusion criteria: Young male and female patients between 14-22 years of age, with a full complement of fully erupted permanent teeth except third molars and having either Class I malocclusion, Class II malocclusion, or Class III malocclusion, were included.
Exclusion criteria: Teeth with caries, periodontal diseases, large restorations or crowns, fractured incisors with a history of orthodontic treatment, subjects with severe systemic diseases and syndromic conditions and teeth with abnormal buccolingual relationships were excluded.
Sample size: The study involved 1062 subjects, comprising 453 males and 609 females aged 14-22 years, who were available for clinical examination in the OPD of different Government Dental Colleges of West Bengal, namely Dr. R. Ahmed Dental College and Hospital in Kolkata, North Bengal Dental College in Siliguri and Burdwan Dental College and Hospital in Burdwan, within the study period.
Study Procedure
Intraoral examinations were performed in centric occlusion by instructing the patients to swallow and bring their teeth into maximum intercuspation. Subjects were classified according to Angle’s classes (5), as listed below. Other malocclusion parameters such as overjet, overbite, anterior crossbite and upper and lower arch crowding and spacing were assessed. The examinations were conducted using a sterile mouth mirror and the horizontal and vertical overlapping of incisors were measured using a divider and metal ruler.
Subjects were then grouped as follows:
• Normal occlusion (Table/Fig 1)
• Class I malocclusion
• Class II Div 1 malocclusion (Table/Fig 2)a,b
• Class II Div 2 malocclusion (Table/Fig 3)
• Class III malocclusion (Table/Fig 4)
• The groups were further categorised by gender.
Subjects with Class I malocclusion were subdivided into the following types:
• Crowding (Table/Fig 5)
• Proclination (Overjet >2 mm)
• Spacing (Table/Fig 6)
• Deep bite (Table/Fig 7)
• Open bite (Anterior) (Table/Fig 8)
• Anterior crossbite (Table/Fig 9)
Statistical Analysis
The collected data was tabulated in a spreadsheet using Microsoft Excel 2021 and then statistical analysis was carried out using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 27.0 (Armonk, NY: IBM Corp). Descriptive statistics were used to report the categorical variables in terms of counts and percentages along with the 95% Confidence Intervals (CI) and they were tested using the Chi-square (χ2) test. A p-value of ≤0.05 was considered the level of significance.
Total 1062 samples, comprising 453 males and 609 females, reporting to the OPD of Government Dental Colleges of West Bengal, were randomly selected. The age group considered was 14-22 years, with a mean age of 18.37±2.19 years.
It was observed that in the current study population, 109 subjects had clinically normal occlusion (10.26%, 95% CI: 8.58-12.23). It was also noted that the proportion of subjects diagnosed with Class I malocclusion was significantly higher than other variants (p<0.001). The results indicate that in the current study population, females had a higher propensity of developing Class I malocclusion, while Class II malocclusion (Division 1 and 2 respectively) was more prevalent in males (Table/Fig 10).
Out of the 724 subjects with Class I malocclusion, 287 subjects had crowding (39.64%, 95% CI: 36.14-43.25%), 287 subjects had proclination (23.2%, 95% CI: 20.28-26.42%), 149 subjects had spacing (20.58%, 95% CI: 17.79-23.68%), 55 subjects had crossbite (7.6%, 95% CI: 5.88-9.76%), 41 subjects had deep bite (5.66%, 95% CI: 4.2-7.59%), while the remaining 24 reported with an open bite (3.31%, 95% CI: 2.24-4.89%). It was noted that the proportion of subjects with crowding was significantly higher than other variants (p<0.001) (Table/Fig 11).
When stratified by gender, crowding was found to be higher in males (41.04%, 95% CI: 35.32-47.02%) than in females (38.82%, 95% CI: 34.45-43.36%) (p<0.001). Proclination was found to be higher in males (26.12%, 95% CI: 21.22-31.69%) than in females (21.49%, 95% CI: 17.97-25.49%). Spacing was found to be higher in females (21.93%, 95% CI: 18.38-25.95%) than in males (18.28%, 95% CI: 14.12-23.35%). Deep bite was slightly higher in females (5.7%, 95% CI: 3.92-8.22%) than in males (5.6%, 95% CI: 3.42-9.03%). Open bite was higher in males (3.36%, 95% CI: 71.28-78.16%) than in females (3.29%, 95% CI: 2-5.36%) and crossbite was slightly higher in females (8.77%, 95% CI: 6.51-11.72%) than in males (5.6%, 95% CI: 3.42-9.03%). All the proportions did not significantly differ from each other (p>0.05), implying a similar pattern of distribution of the Class I malocclusion traits across genders (Table/Fig 12).
In the study, normal occlusion was recorded in 10.26% of the total subjects, while malocclusion was observed in 89.74%. A face with misaligned teeth can lead to discrimination against individuals, impacting their well-being. Malocclusion, a developmental issue influenced by hereditary and environmental factors, can vary in type and frequency within different populations (8).
Similar studies conducted in various regions of India have been compiled and presented in (Table/Fig 13) (5),(9),(10),(11),(12),(13),(14). The current research involved 1062 subjects (453 males and 609 females) from an Eastern Indian population in West Bengal, India. Malocclusion was assessed based on Angle’s classification (7).
The prevalence of malocclusion in the study was found to be 89.74%, while normal occlusion was only 10.26%. These results were consistent with studies conducted by Sidhu S et al., in Indian populations and Aikins EA and Onyeaso CO in the Nigerian population (15),(16). However, a study by Kharbanda OP in 1991 on a North Indian population reported a much lower prevalence of malocclusion compared to the current study on an Eastern Indian population (5).
Class I malocclusion was the most common type, representing 68.17% of the total sample and this finding was statistically significant (p<0.001). This aligns with the results of studies by Sidhu S et al., in Delhi and Narayanan RK et al., in Kerala (9),(15). However, the prevalence was higher than the findings of Das UM and Reddy D but lower than those of Kumar DA et al., in Maharashtra, Kaur H et al., in Karnataka and Babu AS et al., in Davangere city [10-13]. An interesting observation in the present study was the gender difference noted. A significantly higher proportion of female subjects exhibited Class I malocclusion (74.88%) (p<0.001) compared to males. Similar gender differences were observed in a Nigerian population by Aikins EA and Onyeaso CO, in British school children by Goose DH et al., and in Eskimos by Wood BF (16),(17),(18).
Out of the 724 subjects with Class I malocclusion, crowding was present in 39.64% of them, which was significantly higher than other variants (p<0.001). Comparable results were reported in a Nigerian population (16). Kumar DA et al., and Thilander B et al., individually stated that crowding was more prevalent in females than in males, contrary to the findings of the current study (11),(19).
The findings regarding the prevalence of other features of Class I malocclusion were as follows: an increased overjet (more than 2 mm) was observed in 23.2% of the studied population, spacing in 20.58%, deep bite in 5.66%, open bite in 3.31% and crossbite in 7.6%.
Once again, males showed a higher predisposition than females regarding the prevalence of proclination, which was consistent with the studies by Harrison RL and Davis DW, Al-Emran S et al., while female subjects in the current study reported a higher prevalence of spacing, deep bite and crossbite (20),(21).
The prevalence of Angle’s Class II (Div 1 and Div 2) malocclusion was recorded as 15.25% and 3.11% of subjects in an eastern Indian population, respectively. These findings were slightly higher than the results obtained by Kharbanda OP (14.6%) in the North Indian population, Das UM and Reddy D and Reddy ER et al., (13.9%) in Nalgonda and 6.8% in Bangalorian subjects (5),(10),(14). Proffit WR et al., (22) reported Class II Div 1 in approximately 15% of American children and youth. Ravanmehr H, Rasidi Birgani M recorded a prevalence of 15.6% in Iranian subjects in Tehran.
The gender distribution showed that the prevalence of Class II malocclusion was statistically more significant in males (p<0.005) than in females.
The prevalence of Class III malocclusion was 3.2% of the studied population, which was in accordance with studies by Kharbanda OP (5) in North Indian subjects. A study by Narayan RK et al., in Kerala showed slightly higher results than ours (9). According to Proffit WR et al., Class III malocclusion is more prevalent (3% to 5%) in Japan, nearly 2% in China with an additional 2% to 3% pseudo Class III (22).
Limitation(s)
The sample size considered in the study was limited. More diagnostic criteria and parameters are required to substantiate the malocclusion traits.
Normal occlusion in the study was recorded as 10.26%, while the prevalence of malocclusion was found to be 89.74% of the total subjects. Class I was found to be the most common type, with females showing a significantly higher prevalence, whereas Class II malocclusion was predominant in male subjects. The proportion of subjects with crowding was significantly higher than other variants in the Class I malocclusion group. However, all the proportions did not significantly differ from each other, implying a similar pattern of distribution of Class I malocclusion traits across gender. There is a large variation in the prevalence of malocclusion due to differences in food habits, nutritional status and genetic patterns. More multicentric studies should be conducted and compared.
DOI: 10.7860/JCDR/2024/73299.20334
Date of Submission: Jun 05, 2024
Date of Peer Review: Jul 24, 2024
Date of Acceptance: Aug 29, 2024
Date of Publishing: Nov 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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