Early Detection Of Malocclusion Patterns In Adolescents Using Digital Orthodontic Screening Tools

Abstract

Background: Malocclusion represents a significant oral health concern among adolescents, affecting masticatory function, aesthetics, and psychosocial well-being. Early detection enables timely intervention during optimal growth periods, yet traditional screening methods remain resource-intensive and examiner-dependent. Digital orthodontic screening tools offer potential solutions for standardized, efficient malocclusion identification. Objective: This study aimed to evaluate the diagnostic accuracy and clinical utility of digital orthodontic screening tools for early detection of malocclusion patterns among adolescents compared to conventional clinical examination. Methods: A cross-sectional diagnostic accuracy study was conducted among 612 adolescents aged 11–16 years. Participants underwent both digital screening using intraoral scanning with automated analysis software and conventional clinical examination by calibrated orthodontists. Malocclusion was classified according to Angle's classification and Dental Aesthetic Index (DAI). Diagnostic accuracy metrics including sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic curves (AUC-ROC) were calculated. Results: Overall malocclusion prevalence was 67.3% (n=412). Digital screening demonstrated high sensitivity (94.2%) and specificity (89.5%) for detecting any malocclusion, with AUC-ROC of 0.943 (95% CI: 0.921–0.965). Agreement between digital and conventional methods was excellent (Cohen's kappa=0.847). Class II malocclusion showed highest detection accuracy (sensitivity 96.1%, specificity 91.8%), while Class III demonstrated slightly lower sensitivity (88.4%). Mean screening time was significantly reduced with digital tools (4.23±1.12 minutes vs 12.67±3.45 minutes; p<0.001). Severe malocclusion (DAI≥36) was identified with 97.3% sensitivity. Conclusion: Digital orthodontic screening tools demonstrate excellent diagnostic accuracy for early malocclusion detection in adolescents, offering significant time efficiency advantages while maintaining clinical reliability. Implementation in school-based screening programs may facilitate earlier orthodontic intervention and improved treatment outcomes.