Perspectives of Indonesian Orthodontists on the Ideal Orthodontic Treatment Time

Figures & data

Table 1 Demographic Data of Participants

Variable	Participants (n = 152)
Gender:
Male	54 (35.5%)
Female	98 (64.5%)
Age:
20–30 (years)	3 (1.9%)
31–40 (years)	59 (38.8%)
41–50 (years)	55 (36.1%)
51–60 (years)	29 (19%)
More than 60 years	6 (3.9%)
Highest qualification:
PhD	20 (13.1%)
Master	78 (51.3%)
Board	13 (8.5%)
Spesialis Ortodonti	41 (26.9%)
Qualificaction place:
Indonesia	148 (97.3%)
North America	1 (0.6 %)
Europe	1 (0.6%)
Australia and New Zealand	1 (0.6%)
East Asia	1 (0.6%)
Speciality training duration:
2 years	3 (1.9%)
2–3 years	54 (35.5%)
4–5 years	69 (45.3%)
More than 5 years	26 (17.1%)
Practice type:
Private practice	111 (73%)
Teaching institution	40 (26.3%)
Governmental Hospital	44 (28.9%)
Private Hospital	14 (9.2%)
Practice location:
Western part of Indonesia	97 (63.8%)
Middle part of Indonesia	39 (25.6%)
Eastern part of Indonesia	16 (10.5%)
Experience (years):
Less than 3 years	15 (9.8%)
3–5 years	20 (13.1%)
6–10 years	47 (30.9%)
11–15 years	33 (21.7%)
16–20 years	22 (14.4%)
More than 20 years	15 (9.8%)

Table 2 Participants Opinion on the Treatment Timing

Variable	Number 152 (%)
Treatment phase:
Single-phase treatment	55 (36.2%)
Two-phase treatment	97 (63.8%)
Ideal age for first orthodontic assessment:
Less than 6 years	7 (4.6%)
6 years	13 (8.5%)
7 years	39 (25.6%)
8 years	25 (16.4%)
9 years	20 (13.1%)
10 years	17 (11.1%)
11 years	8 (5.2%)
12 years	11 (7.2%)
Over 12 years	12 (7.8%)
Prefered time to initiate orthodontic treatment:
Primary Dentition (4–6 years)	6 (3.9%)
Early mixed dentition (7–9 years)	83 (54.6%)
Late mixed dentition (10–13 years)	66 (43.4%)
Permanent dentition (14–18 years)	36 (23.6%)
Age determenation method:
Dental age	69 (45.3%)
Chronologic age	62 (40.7%)
Brother/sister growth pattern	25 (16.4%)
Pubertal indicators	75 (49.3%)
Skeletal age based on hand-wris x-ray	55 (36.1%)
Skeletal age based on cervical vertebra	77 (50.6%)

Table 3 Most Frequent Indications for Orthodontic Treatment in Each Stage

Primary Dentition (4–5):
Anterior crossbite	18 (11.8%)
Posterior crossbite	7 (4.6%)
Sucking habit	68 (44.7%)
Open bite caused by sucking habits	43 (28.3%)
Dental manifestations of tongue thrust	37 (24.3%)
Mouth breathing	42 (27.8%)
Severe Class III malocclusion	14 (9.2%)
Early mixed dentition (7–9 years):
Anterior crossbite	113 (74.3%)
Posterior crossbite	64 (42.1%)
Sucking habit	75 (49.3%)
Open bite caused by sucking habits	77 (50.7%)
Dental manifestations of tongue thrust	79 (52%)
Mouth breathing	82 (54.3%)
Incisor ectopic eruption	83 (54.6%)
Moderate crowding (3–6 mm)	55 (36.2%)
Severe crowding (>6 mm)	48(31.6%)
Maxillary midline diastema > 2 mm	28 (18.4%)
Severe Class II division 1 with increased overjet	63 (41.4%)
Severe Class II division 2 with severe deep bite	49 (32.5%)
Severe Class III malocclusion	70 (46.1%)
Skeletal open bite	47 (31.3%)
Late mixed dentition (10–13 years):
Anterior crossbite	34 (22.4%)
Posterior crossbite	78 (51.3%)
Sucking habit	31 (20.4%)
Open bite caused by sucking habits	46 (30.3%)
Dental manifestations of tongue thrust	48 (31.6%)
Mouth breathing	45 (29.8%)
Incisor ectopic eruption	55 (36.2%)
Moderate crowding (3–6 mm)	72 (47.4%)
Severe crowding (>6 mm)	72 (47.4%)
Maxillary midline diastema > 2 mm	78 (51.3%)
Impacted canines	74 (48.7%)
Severe Class II division 1 with increased overjet	91 (59.9%)
Severe Class II division 2 with severe deep bite	95 (62.9%)
Severe Class III malocclusion	70 (46.1%)
Skeletal open bite	64 (42.7%)
Permanent dentition (14+ years):
Anterior crossbite	9 (5.9%)
Posterior crossbite	19 (12.5%)
Open bite caused by sucking habits	10 (6.6%)
Dental manifestations of tongue thrust	13 (8.6%)
Mouth breathing	12 (7.9%)
Incisor ectopic eruption	21 (13.8%)
Moderate crowding (3–6 mm)	40 (26.3%)
Severe crowding (>6 mm)	48 (31.6%)
Maxillary midline diastema > 2 mm	58 (38.2%)
Impacted canines	82 (53.9%)
Severe Class II division 1 with increased overjet	56 (36.8%)
Severe Class II division 2 with severe deep bite	58 (38.4%)
Severe Class III malocclusion	45 (29.6%)
Skeletal open bite	60 (40%)

Table 4 Preferred Appliances Used in Each Developmental Stage

Appliance	Primary Dentition	Early Mixed Dentition	Late Mixed Dentition	Permanent Dentition
Quad Helix	7 (4.6%)	14 (9.2%)	20 (13.2%)	29 (19.1%)
Removable appliance	70 (46.1%)	98 (64.5%)	61 (40.1%)	17 (11.2%)
Functional appliance/activator	58 (38.2%)	71 (46.7%)	70 (46%)	19 (12.5%)
Clear Aligners (eg Invisalign, eCligner)	0 (0%)	0 (0%)	0 (0%)	34 (22.4%)
Full arch fixed appliances	13 (8.6%)	5 (3.3%)	52 (34.2%)	149 (98.1%)
Partial arch fixed appliances (ie 2X4)	14 (9.2%)	56 (36.8%)	78 (51.3%)	13 (8.6%)
Protraction facemask	12 (7.9%)	22 (14.5%)	27 (17.8%)	19 (12.5%)
Rapid maxillary expander	19 (12.5%)	49 (32.2%)	61 (40.1%)	42 (27.6%)
Headgear	10 (6.6%)	16 (10.5%)	21 (13.8%)	14 (9.2%)
Chin-cup	10 (6.6%)	15 (9.9%)	14 (9.2%)	4 (2.6%)
None used	49 (32.2%)	10 (6.6%)	2 (1.3%)	0 (0%)
Other	2 (1.4%)	0 (0%)	0 (0%)	6 (3.9%)