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Published on: November 4, 2025
Malocclusion and orthodontic treatment needs among individuals with down syndrome in Egypt: a multicentre
Hani AlSwafeeri1, Nancy Bedwani2, Mariam Badran3
1Department of Orthodontics, Faculty of Dentistry, Pharos University, Alexandria, Egypt. hani.alswafiri@pua.edu.eg.
Background:
Individuals with Down syndrome commonly present with a variety of craniofacial and dental anomalies that increase the prevalence of malocclusion and the need for orthodontic treatment. Despite this, data regarding orthodontic needs in this population in the middle east, particularly in Egypt, remain limited.
Aim Of The Study:
This study aimed to assess the patterns of malocclusion and orthodontic treatment needs among individuals with Down syndrome.
Materials And Methods:
A total of 117 individuals with Down syndrome aged 12-25 years, who met the study's eligibility criteria, were recruited from specialized institutions in Egypt in a multi-centred cross-sectional study. Clinical examination included extraoral and intraoral assessment, occlusal analysis using Angle's classification, and assessment of the need for orthodontic treatment using Dental Health Component of Index of Orthodontic Treatment Need (IOTN). Additional data on oral hygiene, oral habits, and craniofacial features were recorded. Descriptive statistics were computed for all study variables. Qualitative (categorical) variables were presented as frequencies (n) and percentages (%).
Results:
Class I molar relationship was the most common (41.0%), followed by Class II (29.9%) and Class III (29.1%). Anterior open bite (23.1%) and posterior crossbite (21.4%) were also frequently observed. Regarding orthodontic treatment need, 71.7% of participants demonstrated borderline to very great need (IOTN Grades 3-5), with 49.6% exhibiting great or very great need (Grades 4-5). Fair or poor oral hygiene was identified in 81.2% of participants. Mouth breathing was the most common oral habit (32.5%).
Conclusion:
Patients with Down syndrome exhibit a high prevalence of malocclusion and a significant need for orthodontic treatment. Early orthodontic assessment, preventive strategies, and multidisciplinary management are essential to improve oral health outcomes in this population.
Clinical Trial Number:
Not applicable.