{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T12:14:20Z","timestamp":1772021660426,"version":"3.50.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"DOI":"10.1186\/s12903-026-07659-2","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:17:41Z","timestamp":1769750261000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The orthodontic treatment needs of high school students within the Buffalo City Metropolitan Municipality \u2013 a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7472-8777","authenticated-orcid":false,"given":"Chetan-Kumar Rama","family":"Jeram","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandla Dominic","family":"Nyakale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faheema","family":"Kimmie-Dhansay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"7659_CR1","unstructured":"South African Society of Orthodontists. Orthodontists. https:\/\/saso.co.za\/directory-orthodontist\/ Accessed March 14, 2025."},{"key":"7659_CR2","first-page":"77","volume-title":"Epidemiology: A research manual for South Africa","author":"M Morroni","year":"2007","unstructured":"Morroni M, Myer L. Study design. In: Joubert G, Ehrlich R, Katzenellenbogen J, Karim SA, editors. Epidemiology: A research manual for South Africa. Cape Town: Oxford University Press; 2007. pp. 77\u201393."},{"issue":"2","key":"7659_CR3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/S1073-8746(99)80027-9","volume":"5","author":"S Nelson","year":"1999","unstructured":"Nelson S. Epidemiology for the practising orthodontist. Semin Orthod. 1999;5(2):77\u201384. https:\/\/doi.org\/10.1016\/S1073-8746(99)80027-9.","journal-title":"Semin Orthod"},{"issue":"1","key":"7659_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/jos.JOS_87_18","volume":"8","author":"SM Taibah","year":"2019","unstructured":"Taibah SM, Al-Hummayani FM. Agreement and association between normative and subjective orthodontic treatment need using the index of orthodontic treatment need. J Orthod Sci. 2019;8(1):1\u20136. https:\/\/doi.org\/10.4103\/jos.JOS_87_18.","journal-title":"J Orthod Sci"},{"issue":"5","key":"7659_CR5","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1067\/mod.2002.128465","volume":"122","author":"AR Firestone","year":"2002","unstructured":"Firestone AR, Beck FM, Beglin FM, Vig KW. Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need. Am J Orthod Dentofacial Orthop. 2002;122(5):463\u20139. https:\/\/doi.org\/10.1067\/mod.2002.128465.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"2","key":"7659_CR6","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.ajodo.2008.08.040","volume":"138","author":"MH Jung","year":"2010","unstructured":"Jung MH. Evaluation of the effects of malocclusion and orthodontic treatment on self-esteem in an adolescent population. Am J Orthod Dentofac Orthop. 2010;138(2):160\u20136. https:\/\/doi.org\/10.1016\/j.ajodo.2008.08.040.","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"7659_CR7","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1093\/oxfordjournals.ejo.a035999","volume":"11","author":"PH Brook","year":"1989","unstructured":"Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod. 1989;11:309\u201320. https:\/\/doi.org\/10.1093\/oxfordjournals.ejo.a035999.","journal-title":"Eur J Orthod"},{"key":"7659_CR8","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.pio.2011.06.001","volume":"12","author":"A Borzabadi-Farahani","year":"2011","unstructured":"Borzabadi-Farahani A. An insight into four orthodontic treatment need indices. Prog Orthod. 2011;12:132\u201342. https:\/\/doi.org\/10.1016\/j.pio.2011.06.001.","journal-title":"Prog Orthod"},{"issue":"3","key":"7659_CR9","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1067\/mod.2001.116401","volume":"120","author":"FM Beglin","year":"2001","unstructured":"Beglin FM, Firestone AR, Vig KW, Beck FM, Kuthy RA, Wade D. A comparison of the reliability and validity of 3 occlusal indexes of orthodontic treatment need. Am J Orthod Dentofac Orthop. 2001;120(3):240\u20136. https:\/\/doi.org\/10.1067\/mod.2001.116401.","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"7659_CR10","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1111\/j.1600-0528.1997.tb00955.x","volume":"25","author":"JW Younis","year":"1997","unstructured":"Younis JW, Vig KW, Rinchuse DJ, Weyant RJ. A validation study of three orthodontic treatment need indices in the united States. Community Dent Oral Epidemiol. 1997;25:358\u201362. https:\/\/doi.org\/10.1111\/j.1600-0528.1997.tb00955.x.","journal-title":"Community Dent Oral Epidemiol"},{"key":"7659_CR11","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/j.1600-0528.1995.tb00224.x","volume":"23","author":"S Richmond","year":"1995","unstructured":"Richmond S, Buchanan IB, Burden JB, O\u2019brien KD, Andrews M, Roberts CT, et al. Calibration of dentists in the use of occlusal indices. Community Dentistry Oral Epidemiol. 1995;23:173\u20139. https:\/\/doi.org\/10.1111\/j.1600-0528.1995.tb00224.x.","journal-title":"Community Dentistry Oral Epidemiol"},{"issue":"1","key":"7659_CR12","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/s0917-2394(11)70224-5","volume":"21","author":"SM Hammad","year":"2011","unstructured":"Hammad SM, Awad SM. Orthodontic treatment need in Egyptian schoolchildren. Pediatr Dent. 2011;21(1):39\u201343. https:\/\/doi.org\/10.1016\/s0917-2394(11)70224-5.","journal-title":"Pediatr Dent"},{"issue":"4","key":"7659_CR13","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1093\/ejo\/cjq086","volume":"33","author":"N Puertes-Fern\u00e1ndez","year":"2010","unstructured":"Puertes-Fern\u00e1ndez N, Montiel-Company JM, Almerich-Silla JM, Manzanera D. Orthodontic treatment need in a 12-year-old population in the Western Sahara. Eur J Orthod. 2010;33(4):377\u201380. https:\/\/doi.org\/10.1093\/ejo\/cjq086.","journal-title":"Eur J Orthod"},{"key":"7659_CR14","unstructured":"Serebe C. The orthodontic treatment needs in children aged 12\u201315 years in a school in the Khomas region, Namibia. Research Dissertation UWC (2018)."},{"key":"7659_CR15","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.mjafi.2012.02.003","volume":"69","author":"P Kumar","year":"2013","unstructured":"Kumar P, Londhe SM, Kotwal A, Mitra R. Prevalence of malocclusion and orthodontic treatment need in schoolchildren - an epidemiological study. Med J Armed Forces India. 2013;69:369\u201374. https:\/\/doi.org\/10.1016\/j.mjafi.2012.02.003.","journal-title":"Med J Armed Forces India"},{"key":"7659_CR16","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1093\/ejo\/cjl045","volume":"28","author":"M Souames","year":"2006","unstructured":"Souames M, Bassigny F, Zenati N, Riordan PJ, Boy-Lefevre ML. Orthodontic treatment need in French schoolchildren: an epidemiological study using the index of orthodontic treatment need. Eur J Orthod. 2006;28:605\u20139. https:\/\/doi.org\/10.1093\/ejo\/cjl045.","journal-title":"Eur J Orthod"},{"key":"7659_CR17","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1093\/ejo\/cjn089","volume":"31","author":"D Manzanera","year":"2009","unstructured":"Manzanera D, Montiel-Company JM, Almerich-Silla JM, Gand\u00eda JL. Orthodontic treatment need in Spanish schoolchildren: an epidemiological study using the index of orthodontic treatment need. Eur J Orthod. 2009;31:180\u20133. https:\/\/doi.org\/10.1093\/ejo\/cjn089.","journal-title":"Eur J Orthod"},{"issue":"4","key":"7659_CR18","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/S0889-5406(96)70044-6","volume":"110","author":"J Jenny","year":"1996","unstructured":"Jenny J, Cons NC. Comparing and contrasting two orthodontic indices, the index of orthodontic treatment need and the dental aesthetic index. Am J Orthod Dentofacial Orthop. 1996;110(4):410\u20136. https:\/\/doi.org\/10.1016\/S0889-5406(96)70044-6.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"1","key":"7659_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0889-5406(95)70151-6","volume":"107","author":"WC Shaw","year":"1995","unstructured":"Shaw WC, Richmond S, O\u2019brien KD. The use of occlusal indices: a European perspective. Am J Orthod Dentofacial Orthop. 1995;107(1):1\u201310. https:\/\/doi.org\/10.1016\/S0889-5406(95)70151-6.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"10","key":"7659_CR20","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1038\/sj.bdj.2016.377","volume":"220","author":"Z Jawad","year":"2016","unstructured":"Jawad Z, Bates C, Hodge T. Can dental registrants use the index of orthodontic treatment need accurately? Part 1: knowledge of IOTN among dental registrants. Br Dent J. 2016;220(10):527\u201332. https:\/\/doi.org\/10.1038\/sj.bdj.2016.377.","journal-title":"Br Dent J"},{"issue":"2","key":"7659_CR21","first-page":"111","volume":"10","author":"H Lunn","year":"1993","unstructured":"Lunn H, Richmond S, Mitropoulos C. The use of the index of orthodontic treatment need (IOTN) as a public health tool: a pilot study. Community Dent Health. 1993;10(2):111\u201321.","journal-title":"Community Dent Health"},{"key":"7659_CR22","unstructured":"Statistics South Africa. Census dissemination. https:\/\/census.statssa.gov.za\/#\/province\/2\/2. Accessed 24 Nov 2025."},{"issue":"8","key":"7659_CR23","first-page":"334","volume":"60","author":"PJ van Wyk","year":"2005","unstructured":"van Wyk PJ, Drummond RJ. Orthodontic status and treatment need of 12-year-old children in South Africa using the dental aesthetic index. SADJ: J South Afr Dent Association = tydskrif Van Die Suid-Afrikaanse Tandheelkundige Vereniging. 2005;60(8):334\u20136.","journal-title":"SADJ: J South Afr Dent Association = tydskrif Van Die Suid-Afrikaanse Tandheelkundige Vereniging"},{"key":"7659_CR24","volume-title":"Oral health surveys: basic methods","author":"World Health Organization","year":"2013","unstructured":"World Health Organization. Oral health surveys: basic methods. France: World Health Organization; 2013."},{"key":"7659_CR25","unstructured":"University of Manchester. MOCDO. http:\/\/rhogos.mc.man.ac.uk\/iotn\/mocdo1.htm Accessed March 14, 2025."},{"issue":"2","key":"7659_CR26","doi-asserted-by":"publisher","first-page":"323","DOI":"10.2319\/031106-97","volume":"77","author":"PI Ngom","year":"2007","unstructured":"Ngom PI, Diagne F, Dieye F, Diop-Ba K, Thiam F. Orthodontic treatment need and demand in Senegalese school children aged 12\u201313 years. An appraisal using IOTN and ICON. Angle Orthod. 2007;77(2):323\u201330. https:\/\/doi.org\/10.2319\/031106-97.","journal-title":"Angle Orthod"},{"issue":"2","key":"7659_CR27","doi-asserted-by":"publisher","first-page":"224","DOI":"10.2319\/021014-105.1","volume":"85","author":"CA Feldens","year":"2015","unstructured":"Feldens CA, Nakamura EK, Tessarollo FR, Closs LQ. Desire for orthodontic treatment and associated factors among adolescents in Southern Brazil. Angle Orthod. 2015;85(2):224\u201332. https:\/\/doi.org\/10.2319\/021014-105.1.","journal-title":"Angle Orthod"},{"issue":"2","key":"7659_CR28","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/j.1600-0528.2007.00382.x","volume":"36","author":"KG Peres","year":"2008","unstructured":"Peres KG, Barros AJ, Anselmi L, Peres MA, Barros FC. Does malocclusion influence the adolescent\u2019s satisfaction with appearance? A cross-sectional study nested in a Brazilian birth cohort. Community Dent Oral Epidemiol. 2008;36(2):137\u201343. https:\/\/doi.org\/10.1111\/j.1600-0528.2007.00382.x.","journal-title":"Community Dent Oral Epidemiol"},{"issue":"2","key":"7659_CR29","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.ajodo.2008.09.033","volume":"138","author":"D Feu","year":"2010","unstructured":"Feu D, De Oliveira BH, De Oliveira Almeida MA, Kiyak HA, Miguel JA. Oral health-related quality of life and orthodontic treatment seeking. Am J Orthod Dentofacial Orthop. 2010;138(2):152\u20139. https:\/\/doi.org\/10.1016\/j.ajodo.2008.09.033.","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"6","key":"7659_CR30","first-page":"565","volume":"72","author":"H Kerosuo","year":"2002","unstructured":"Kerosuo H, Abdulkarim E, Kerosuo E. Subjective need and orthodontic treatment experience in a Middle East country providing free orthodontic services: a questionnaire survey. Angle Orthod. 2002;72(6):565\u201370. https:\/\/doi.org\/10.1043\/0003-3219(2002)072<0565:SNAOTE>2.0.CO;2.","journal-title":"Angle Orthod"},{"key":"7659_CR31","unstructured":"Rampersadh Y. The perceived and normative orthodontic treatment need of a group of South African children. Research Dissertation UWC (2015)."},{"key":"7659_CR32","unstructured":"Booysen JL. Orthodontic treatment need and demand in the Upington area of the Northern Cape Province. Research Dissertation UWC (2017)."},{"issue":"5","key":"7659_CR33","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.ajoda.2003.07.012","volume":"126","author":"CO Onyeaso","year":"2004","unstructured":"Onyeaso CO. Prevalence of malocclusion among adolescents in Ibadan, Nigeria. Am J Orthod Dentofac Orthop. 2004;126(5):604\u20137. https:\/\/doi.org\/10.1016\/j.ajoda.2003.07.012.","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"7659_CR34","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1093\/ejo\/24.1.53","volume":"24","author":"O Hunt","year":"2002","unstructured":"Hunt O, Hepper P, Johnston C, Stevenson M, Burden D. The aesthetic component of the Index of Orthodontic Treatment Need validated against lay opinion. Eur J Orthod. 2002;24:53\u20139. https:\/\/doi.org\/10.1093\/ejo\/24.1.53.","journal-title":"Eur J Orthod"},{"issue":"2","key":"7659_CR35","first-page":"39","volume":"89","author":"MK Muasya","year":"2012","unstructured":"Muasya MK, Ng\u2019ang\u2019a PM, Opinya GN, Macigo FG. Malocclusion and orthodontic treatment need among 12-15-year-old children in Nairobi. East Afr Med J. 2012;89(2):39\u201344.","journal-title":"East Afr Med J"},{"issue":"4","key":"7659_CR36","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1111\/j.1875-595x.1999.tb00523.x","volume":"49","author":"OD Otuyemi","year":"1999","unstructured":"Otuyemi OD, Ogunyinka A, Dosumu O, Cons NC, Jenny J. Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the Dental Aesthetic Index (DAI). Int Dent J. 1999;49(4):203\u201310. https:\/\/doi.org\/10.1111\/j.1875-595x.1999.tb00523.x.","journal-title":"Int Dent J"},{"key":"7659_CR37","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1111\/ipd.12416","volume":"25","author":"AS Monte-Santo","year":"2018","unstructured":"Monte-Santo AS, Viana SV, Moreira KM, Imparato JC, Mendes FM, Bonini GA. Prevalence of early loss of primary molar and its impact on schoolchildren\u2019s quality of life. Int J Paediatr Dent. 2018;25:595\u2013601. https:\/\/doi.org\/10.1111\/ipd.12416.","journal-title":"Int J Paediatr Dent"},{"issue":"2","key":"7659_CR38","doi-asserted-by":"publisher","first-page":"126","DOI":"10.4103\/2231-0762.189739","volume":"6","author":"SA Murshid","year":"2016","unstructured":"Murshid SA, Al-Labani MA, Aldhorae KA, Rodis OM. Prevalence of prematurely lost primary teeth in 5-10-year-old children in Thamar city, yemen: a cross-sectional study. J Int Soc Prev Community Dent. 2016;6(2):126\u201330. https:\/\/doi.org\/10.4103\/2231-0762.189739.","journal-title":"J Int Soc Prev Community Dent"},{"issue":"3","key":"7659_CR39","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.ajodo.2005.11.003","volume":"129","author":"LS Marques","year":"2006","unstructured":"Marques LS, Ramos-Jorge ML, Paiva SM, Pordeus IA. Malocclusion: esthetic impact and quality of life among Brazilian schoolchildren. Am J Orthod Dentofacial Orthop. 2006;129(3):424\u20137. https:\/\/doi.org\/10.1016\/j.ajodo.2005.11.003.","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"7659_CR40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jdent.2022.104157","volume":"122","author":"S Su","year":"2022","unstructured":"Su S, Lipsky MS, Licari FW, Hung M. Comparing oral health behaviours of men and women in the United States. J Dent. 2022;122:1\u20138. https:\/\/doi.org\/10.1016\/j.jdent.2022.104157.","journal-title":"J Dent"},{"issue":"5","key":"7659_CR41","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.ajodo.2016.08.0","volume":"150","author":"N Pandis","year":"2016","unstructured":"Pandis N. The chi-square test. Am J Orthod Dentofacial Orthop. 2016;150(5):898\u20139. https:\/\/doi.org\/10.1016\/j.ajodo.2016.08.0.","journal-title":"Am J Orthod Dentofacial Orthop"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-026-07659-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-07659-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-026-07659-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:31:12Z","timestamp":1772019072000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12903-026-07659-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7659"],"URL":"https:\/\/doi.org\/10.1186\/s12903-026-07659-2","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]},"assertion":[{"value":"2 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in full compliance with the principles outlined in the Declaration of Helsinki as developed by the World Medical Association. Ethical clearance to conduct this research was acquired from the Biomedical Science Research Ethics Committee of the University of the Western Cape (BM22\/7\/8). Permission to conduct the study was also acquired from the Eastern Cape Department of Basic Education as well as from the principals of each participating high school. Each high school was visited to inform grade eight and nine students of the study, its purpose, and what participation entailed. All students were provided with an information sheet for their legal guardians\u2019 perusal. The information sheet served to inform the legal guardians of the purpose of the study, what participation entailed, and the ethical implications. Informed consent for participation was sought from legal guardians using a consent form attached to the information sheet. Only students who returned with consent forms signed by their legal guardians were allowed to participate. Assent for participation was sought from the students. Participation in this study was voluntary, and students were informed that they were free to decline participation at any time. Anonymity and confidentiality were maintained throughout the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"385"}}