{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:19:08Z","timestamp":1784542748484,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Strategic Reference Framework of Greece","award":["5402\/29-05-2013"],"award-info":[{"award-number":["5402\/29-05-2013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The purpose of this research was to assess the orthodontic status and orthodontic treatment needs of 12- and 15-year-old schoolchildren in Greece, in relation to sociodemographic factors and parental education level. A total of 1102 12-year-old children and 1131 15-year-old adolescents across Greece were assessed using the Modified Dental Health component (DHC) of the Index of Orthodontic Treatment Need (IOTN). An amount of 38.7% of 12-year-olds and 33.7% of 15-year-olds were in definite need of orthodontic treatment. The most common etiologic factors were tooth eruption and position anomalies. A higher rate of orthodontic treatment need was recorded among subjects with lower parental education level. Class I malocclusion was found in 50.9%, Class II in 38.4% and Class III in 10.8% of the total sample. A higher incidence of dental trauma was found in the 12-year-olds presenting with a Class II molar relationship and &gt;3 mm overjet. The need for orthodontic treatment in Greece was higher, in comparison to other European countries, with one out of two children presenting a severe overjet associated with a high incidence of dental trauma. One out of three adolescents were still judged as having a need for orthodontic treatment by the age of 15.<\/jats:p>","DOI":"10.3390\/ijerph182211790","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T09:19:21Z","timestamp":1636535961000},"page":"11790","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Orthodontic Status and Orthodontic Treatment Need of 12- and 15-Year-Old Greek Adolescents: A National Pathfinder Survey"],"prefix":"10.3390","volume":"18","author":[{"given":"Ioulia-Maria","family":"Mylonopoulou","sequence":"first","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9686-7423","authenticated-orcid":false,"given":"Iosif","family":"Sifakakis","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Berdouses","sequence":"additional","affiliation":[{"name":"Independent Researcher, 15231 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Kavvadia","sequence":"additional","affiliation":[{"name":"Department of Paediatric Dentistry, European University of Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Arapostathis","sequence":"additional","affiliation":[{"name":"Department of Paediatric Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine J.","family":"Oulis","sequence":"additional","affiliation":[{"name":"Department of Paediatric Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1093\/ejo\/cjn125","article-title":"Prevalence of malocclusion and its relationship with socio-demographic factors, dental caries, and oral hygiene in 12- to 14-year-old Tanzanian school children","volume":"31","author":"Mtaya","year":"2009","journal-title":"Eur. J. Orthod."},{"key":"ref_2","first-page":"649","article-title":"Preventive and interceptive orthodontic treatment needs of an inner-city group of 6- and 9-year-old Canadian children","volume":"71","author":"Karaiskos","year":"2005","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.ajodo.2005.11.003","article-title":"Malocclusion: Esthetic impact and quality of life among Brazilian school children","volume":"129","author":"Marques","year":"2006","journal-title":"Am. J. Orthod. Dentofacial. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bernab\u00e9, E., Flores-Mir, C., and Sheiham, A. (2007). Prevalence, intensity and extent of oral impacts on daily performances associated with self-perceived malocclusion in 11\u201312-year-old children. BMC Oral. Health, 7.","DOI":"10.1186\/1472-6831-7-6"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1038\/sj.bdj.2012.372","article-title":"Summary of: Changes in dental health investment across the adolescent years","volume":"212","author":"Brocklehurst","year":"2012","journal-title":"Br. Dent. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/ejo\/23.2.153","article-title":"Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development","volume":"23","author":"Thilander","year":"2001","journal-title":"Eur. J. Orthod."},{"key":"ref_7","unstructured":"World Health Organization (2013). Oral Health Surveys: Basic Methods, World Health Organization. [5th ed.]."},{"key":"ref_8","first-page":"97","article-title":"Oral health status and treatment needs of the Hellenic Population\u2014A path finder survey-proposals for improvement","volume":"53","author":"Oulis","year":"2009","journal-title":"Hell. Stomatol. Rev."},{"key":"ref_9","first-page":"15","article-title":"Caries experience among Greek Pomakchildren living in rural north-eastern Greece. A cross-sectional study","volume":"15","author":"Sapourides","year":"2011","journal-title":"Balk. J. Stom."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/BF03262795","article-title":"Socio-behavioural factors influencing oral health of 12 and 15 year old Greek adolescents. A national pathfinder survey","volume":"12","author":"Vadiakas","year":"2011","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_11","first-page":"29","article-title":"Caries prevalence of 5, 12 and 15-year-old Greek children: A national pathfinder survey","volume":"29","author":"Oulis","year":"2012","journal-title":"Community Dent. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/BF03262835","article-title":"Oral hygiene and periodontal status of 12 and 15-year-old Greek adolescents. A national pathfinder survey","volume":"13","author":"Vadiakas","year":"2012","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_13","first-page":"289","article-title":"Epidemiological study of the type and frequency of malocclusion in the child population of the Pieria district","volume":"39","author":"Adamidis","year":"1985","journal-title":"Odontostomatol. Prood."},{"key":"ref_14","first-page":"29","article-title":"Prediction model of regional orthodontic workforce needs, using Greece as an example","volume":"17","author":"Tsiouli","year":"2016","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/oxfordjournals.ejo.a035999","article-title":"The development of an index of orthodontic treatment priority","volume":"11","author":"Brook","year":"1989","journal-title":"Eur. J. Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1034\/j.1600-0528.2001.290308.x","article-title":"Modified IOTN: An orthodontic treatment need index for use in oral health surveys","volume":"29","author":"Burden","year":"2001","journal-title":"Community Dent. Oral. Epidemiol."},{"key":"ref_17","first-page":"18","article-title":"British Association for the Study of Community Dentistry (BASCD) guidance on the statistical aspects of training and calibration of examiners for surveys of child dental health. A BASCD coordinated dental epidemiology programme quality standard","volume":"14","author":"Pine","year":"1997","journal-title":"Community Dent. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/ortho\/28.1.45","article-title":"The use of the index of orthodontic treatment need (IOTN) in a school population and referred population","volume":"28","author":"Ucuncu","year":"2001","journal-title":"J. Orthod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/ejo\/26.3.261","article-title":"Orthodontic treatment need and demand in 12\u201314-year-old north Jordanian school children","volume":"26","author":"Alhaija","year":"2004","journal-title":"Eur. J. Orthod."},{"key":"ref_20","first-page":"69","article-title":"Orthodontic treatment needs in an urban Iranian population, an epidemiological study of 11\u201314 year old children","volume":"10","author":"Eslamipour","year":"2009","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1590\/S1806-83242009000200015","article-title":"Orthodontic treatment need in a group of 9\u201312-year-old Brazilian schoolchildren","volume":"23","author":"Dias","year":"2009","journal-title":"Braz. Oral Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/ejo\/cjp050","article-title":"Prevalence of orthodontic treatment need in southern Italian schoolchildren","volume":"32","author":"Perillo","year":"2010","journal-title":"Eur. J. Orthod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/ejo\/cjl045","article-title":"Orthodontic treatment need in French schoolchildren: An epidemiological study using the index of orthodontic treatment need","volume":"28","author":"Souames","year":"2006","journal-title":"Eur. J. Orthod."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.pio.2012.03.002","article-title":"A review of the oral health-related evidence that supports the orthodontic treatment need indices","volume":"13","year":"2012","journal-title":"Prog. Orthod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1038\/sj.bdj.4813640","article-title":"The orthodontic condition of children in the United Kingdom, 2003","volume":"200","author":"Chestnutt","year":"2006","journal-title":"Br. Dent. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/ortho\/30.1.39","article-title":"Orthodontic treatment need and self-perception of 11\u201316-year-old Saudi Arabian children with a sensory impairment attending special schools","volume":"30","author":"Bedi","year":"2003","journal-title":"J. Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1038\/sj.bdj.4807903","article-title":"The Scottish Health Boards\u2019 Dental Epidemiological Programme: Initial surveys of 5- and 12-year-olds","volume":"172","author":"Pitts","year":"1992","journal-title":"Br. Dent. J."},{"key":"ref_28","first-page":"236","article-title":"Relationship between orthodontic anomalies and masticatory function in adult subjects","volume":"76","author":"Ngom","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_29","first-page":"36","article-title":"Prevalence of occlusal traits and orthodontic treatment need in 14 year-old adolescents in Northeast Italy","volume":"17","author":"Ferro","year":"2016","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_30","first-page":"11","article-title":"Assessment of orthodontic treatment need in mixed dentition period (11\u201312 years) among school children in Marathahalli, Bangalore","volume":"5","author":"Wakhloo","year":"2017","journal-title":"J. Dent. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Tolessa, M., Singel, A.T., and Merga, H. (2020). Epidemiology of orthodontic treatment need in southwestern Ethiopian children: A cross sectional study using the index of orthodontic treatment need. BMC Oral. Health, 20.","DOI":"10.1186\/s12903-020-01196-2"},{"key":"ref_32","first-page":"113","article-title":"Global distribution of malocclusion traits: A systematic review","volume":"24","author":"Alhammadi","year":"2019","journal-title":"Dent. Press J. Orthod."},{"key":"ref_33","first-page":"203","article-title":"Orthodontic treatment need and timing: Assessment of evolutive malocclusion conditions and associated risk factors","volume":"21","author":"Grippaudo","year":"2020","journal-title":"Eur. J. Pediatr. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s40510-020-00341-5","article-title":"Large overjet as a risk factor of traumatic dental injuries: A prospective longitudinal study","volume":"21","author":"Schatz","year":"2020","journal-title":"Prog. Orthod."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1600-0528.2006.00271.x","article-title":"Social gradients in periodontal diseases among adolescents","volume":"34","author":"Lopez","year":"2006","journal-title":"Community Dent. Oral. Epidemiol."},{"key":"ref_36","first-page":"94","article-title":"Oral health in Denmark under different public dental health care schemes","volume":"27","author":"Christensen","year":"2010","journal-title":"Community Dent. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11790\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:28:03Z","timestamp":1760167683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,10]]},"references-count":36,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182211790"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182211790","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,10]]}}}