Prevalence of malocclusions associated with pernicious oral habits in a Mexican sample
Prevalencia de las maloclusiones asociada con hábitos bucales nocivos en una muestra de mexicanos
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"EPUB" => 41 "HTML" => 705 "PDF" => 241 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Beginnings of orthodontics in Mexico" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e214" "paginaFinal" => "e215" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inicios de la ortodoncia en México" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Martha Díaz Gómez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Martha" "apellidos" => "Díaz Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2395921516301507?idApp=UINPBA00004N" "url" => "/23959215/0000000200000004/v2_201610190115/S2395921516301507/v2_201610190115/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "titulo" => "Prevalence of malocclusions associated with pernicious oral habits in a Mexican sample" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e216" "paginaFinal" => "e223" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Laura Mendoza Oropeza, Arcelia F. Meléndez Ocampo, Ricardo Ortiz Sánchez, Antonio Fernández López" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Laura" "apellidos" => "Mendoza Oropeza" "email" => array:1 [ 0 => "lauramendozaoropeza@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Arcelia F." "apellidos" => "Meléndez Ocampo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">§</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Ortiz Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Antonio" "apellidos" => "Fernández López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">‖</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Orthodontics professor, Faculty of Dentristry, UNAM" "etiqueta" => "*" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Chief of Preventive Dentistry and Oral Health Department, Faculty of Dentistry, UNAM." "etiqueta" => "§" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Orthodontics professor at the Postgraduate Studies and Research Division, Faculty of Dentristry, UNAM." "etiqueta" => "‖" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de las maloclusiones asociada con hábitos bucales nocivos en una muestra de mexicanos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1016 "Ancho" => 1003 "Tamanyo" => 168961 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Prevalence of terminal planes. <span class="elsevierStyleBold">A)</span> Mesial step, 15.49% male, 21.05% female. <span class="elsevierStyleBold">B)</span> Exaggerated mesial step; 4.22% male, 2.63% female. <span class="elsevierStyleBold">C)</span> Flush terminal plane; 8.45% male, 9.21% female. <span class="elsevierStyleBold">D)</span> Distal step; 2.63% female.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec1015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The World Health Organization considers malocclusions as a variable public health problem that ranks third in prevalence of oral anomalies associated with different risk factors such as genetic<a name="p2"></a> and environmental.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Among the environmental risk factors is the presence of pernicious oral habits which may influence the development of a malocclusion depending on their frequency, duration and intensity during growth and development, causing specific changes in the occlusion and in bone and facial tissues.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Occlusal normal patterns for the first dentition according to the terminal position of the primary second molars are the terminal plane (flush) and the mesial step relationship, which lead to an Angle molar class I in the permanent dentition. The severe mesial and distal steps are considered malocclusion precursors for the second dentition.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6–7</span></a> To consider the position of the upper first molar with respect to the lower first molar in class I, II (sub. div. I and II) and III is of vital importance as guidelines during the diagnosis of any habit- associated malocclusion.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8–10</span></a></p><p id="par1015" class="elsevierStylePara elsevierViewall">Identification of any of the abovementioned conditions and recognition of risk factors could prevent major anomalies; the problem is that, while it is true that a large number preventive studies has been published, these generally focus in the dental caries problem in preschool and school age children in contrast to those related with the prevention of oral habits.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Risk factors such as thumb sucking for extended periods of time, may cause specific abnormal effects on occlusion and bone development<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> and although breastfeeding has been considered greatly beneficial, it has also been associated with malocclusions such as open bite when maintained for too long.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Malocclusion prevalence studies in children have established that oral habits can affect tooth position and arch shape, interfering with normal growth and orofacial musculature function.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Authors as Warren J, Bishara S, attempted to relate nonnutritive habits with facial morphology and malocclusions in Brazilian schoolchildren of 4 years of age and observed that 49.7% of the sample had malocclusions and that 28.5% had 2 or 3 factors for malocclusions; 12.1% had posterior cross bite and the 36.4% anterior open bite. It was also determined that there was an association between thumb sucking habit and malocclusion.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Considerable problems could be avoided if pediatricians, general dental practitioners, pediatric dentists and orthodontists when examining 4-6 year-old children, identified the presence of oral habits in order to prevent and intercept them which would avoid physical and psychological repercussions during puberty and adolescence.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Epidemiologic studies provide a great amount of information about the profile of malocclusions associated with different variables. Agavish reported that female adolescents, 15 to 16 years old, of high social class, showed a high prevalence of pencil eraser biting and ice chewing; 92% referred biting the pencil eraser daily and 48% doing it for three hours a day. Effects on the masticatory muscles were observed which caused TMJ noises and palpation sensitivity.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In a study designed to identify and prioritize the possible relationship between atypical swallowing, open bite, diction and school performance by sex and age in children from preschool through sixth grade, it was determined that children between 7 and 8 years of age had more language problems and that girls presented atypical swallowing that caused open bites.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The abovementioned information highlights the importance of identifying clinical characteristics of oral habits associated with the development of some of the malocclusions that are more frequently present in the child population, in order to prevent, intercept or correct them during growth and development.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Materials and methods</span><p id="par0050" class="elsevierStylePara elsevierViewall">A cross-sectional study was performed on 147 children of both genders, ages between 2 and 15 years who attended the Venustiano Carranza peripheral clinic of the Dental School of the National Autonomous University of Mexico for dental care and whose parents previously signed a consent form to participate in this study. The epidemiologic information was obtained with the informed consent of the parents or guardians.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The survey contained a section with direct questions for the children in a personal way, and distraight and another section addressed to parents in order to identify the presence of oral habits. Finally, epidemiologic variables such as mouth breathing, lip competence, incompetence, or biting; onychophagia and presence of calluses caused by thumb sucking were obtained. The child was asked to swallow saliva to assess if the swallowing was atypical or not and if it there was tongue thrust.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20–22</span></a></p><p id="par1055" class="elsevierStylePara elsevierViewall">Oral habits were also assessed by means of the information provided by the parents. Variables such as thumb sucking, mouth-breathing, atypical swallowing, onychophagia, bruxism, self-mutilation of lips or cheeks, lip sucking and baby’s bottle prolonged use were determined.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Arch shape, overjet, presence or absence of edge to edge bite upon occlusion, upper and lower anterior crowding, molar relationship class I, II and III, according to<a name="p3"></a> Angle’s classification, in early mixed dentition and complete permanent dentition; as well as the terminal planes in cases in which the molar class could not be registered or in those cases in which the first molars did not erupt.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24–26</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In cases with crossbite a milimetrical rule and a fine-tipped caliper were used to determine the transverse dimension or the maxillary compression. This was measured from the central fossa of the upper right first molar to the fossa of the upper left molar. In the lower arch, it was determined from the distal cusp of the right molar to the left molar as the parameters described by Korkhaus.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> The study variables were determined as present or absent: prolonged use of baby’s bottle, pacifier, lip suction, lingual thrust or interposition, atypical swallowing, mouth breathing, inadequate posture, bruxism, onychophagia, open bite, posterior cross bite, overbite, overjet, edge-to-edge bite and upper and lower anterior crowding.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Malocclusion was determined according to the relationship between the primary upper second molars with the lower second molars, identifying the flush, mesial, mesial-exaggerated and distal terminal plane, in the primary dentition according to Baume’s classification. For permanent teeth, malocclusion was determined by the position of the upper first molar with respect to the lower first molar as Class I, II (div. I and II) and III.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> The obtained data were presented as percentage distribution, averages and it was calculated if there was a relationship between oral habits and malocclusions by means of Chi<span class="elsevierStyleSup">2</span> (χ<span class="elsevierStyleSup">2</span>) with the aid of the SPSS program version 15.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">In the present study 147 children from 2 to 15 years of age participated. 48.2% belonged to the male gender and 51.7% female. The average age was 8 years presenting a minimum age of 2 and a maximum of 15 (<a class="elsevierStyleCrossRef" href="#fig0005"><span class="elsevierStyleItalic">Figure 1</span></a>). With regard to the prevalence of pernicious oral habits, it was determined that it was 96.6% (<a class="elsevierStyleCrossRef" href="#fig0010"><span class="elsevierStyleItalic">Figure 2</span></a>). To analyze the frequency by age and gender it was observed that the prevalence of oral habits is higher in males than in females and more frequent at the age of 4 and from 6 to eleven years old, when they are in the mixed dentition. For females it was also noted that in age groups the largest number of cases were present (<a class="elsevierStyleCrossRef" href="#tbl0005"><span class="elsevierStyleItalic">Table I</span></a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The most prevalent pernicious oral habits were tongue thrust with a 66.2%, 49.3% lip sucking, 41.9% and 31.8% onychophagia and mouth breathing. To a lesser proportion inadequate posture was 25.7% and thumb sucking 23.6%, while only 2.0% reported using baby’s bottle. There were no cases of pacifier use or bruxism in the study sample <span class="elsevierStyleItalic">(</span><a class="elsevierStyleCrossRef" href="#fig0015"><span class="elsevierStyleItalic">Figure 3</span></a><span class="elsevierStyleItalic">).</span></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">It is worth mentioning that the same patient was susceptible to presenting more than one oral habit,<a name="p4"></a> of the total of the survey sample (147 children), 114 children found themselves in this situation meaning that from a 100%, 77.5% showed it.</p><p id="par0085" class="elsevierStylePara elsevierViewall">When analyzing the percentage distribution by gender, it was noted that, for females as well as for males, lingual interposition was the most prevalent since more than half of the children presented it; lip suction and onychophagia occupied second and third place respectively <span class="elsevierStyleItalic">(</span><a class="elsevierStyleCrossRef" href="#tbl0010"><span class="elsevierStyleItalic">Table II</span></a><span class="elsevierStyleItalic">).</span> The most prevalent malocclusion were open bite with a 35.1%, in second place, lower anterior crowding with a 26.4%; thirdly, upper anterior crowding with 19.6%, followed by anterior cross bite with 12.8%; overbite, 11.5%, edge to edge bite 9.5% and, finally, overjet with 7.4% <span class="elsevierStyleItalic">(</span><a class="elsevierStyleCrossRef" href="#fig0020"><span class="elsevierStyleItalic">Figure 4</span></a><span class="elsevierStyleItalic">).</span></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In regard to the presence of malocclusions in relation to gender, the largest proportion was open bite with a 38.15% for females, and 32.39% for males; lower anterior crowding with 28.94% in females and 23.94% in male. In primary dentition, the highest prevalence was the mesial terminal plane with 21.05% in females and 15.49% in males. In the permanent dentition class I molar was more prevalent with 36.84% in females and 43.66% for males.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Posterior crossbite was observed in the 14.47% girls, while in males, it was 11.26%.</p><p id="par0100" class="elsevierStylePara elsevierViewall">It was observed that the mesial step was the most prevalent in the first dentition cases and for the second dentition it was the Angle’s class I, by which the studied patients had a tendency to the normo-occlusion in a high percentage <span class="elsevierStyleItalic">(</span><a class="elsevierStyleCrossRef" href="#fig0025"><span class="elsevierStyleItalic">Figures 5</span></a><span class="elsevierStyleItalic">and</span><a class="elsevierStyleCrossRef" href="#fig0030"><span class="elsevierStyleItalic">6</span></a><span class="elsevierStyleItalic">).</span><a name="p5"></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">With regard to the relation between pernicious oral habits and malocclusions present in children, ages 2 to 15 years, it was determined that there is an association between lingual interposition and open bite (p < 0.000). There was also found an association between malocclusions such as overbite (p < 0.005) and Angle class III (p < 0.050).</p><p id="par0110" class="elsevierStylePara elsevierViewall">On the other hand, thumb sucking, if present, a significant association with the presence of open bite (p < 0,049) to demonstrate the event, were also associated with the terminal rectum level in patients who were with primary dentition (p < 0.009).</p><p id="par0115" class="elsevierStylePara elsevierViewall">A mouth-breathing association with posterior crossbite and Angle Class II was found (and 0.012 p < 0008). The standard deviation with respect to transverse measures of the maxilla and the mandible was a 6mm discrepancy for 4:4 and an 8 mm discrepancy for 6:6 (<a class="elsevierStyleCrossRef" href="#tbl0015"><span class="elsevierStyleItalic">Table III</span></a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The habit of inadequate body posture showed signifi cant association with Angle class III ranking third place among the main data (p < 0.006). It was also observed an association with the flush terminal plane (p < 0.017) if this condition was present. Onychofagia<a name="p6"></a> was found associated with Angle class III malocclusion (p < 0.009).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discussion</span><p id="par1120" class="elsevierStylePara elsevierViewall">Pernicious oral habits may be predisposing factors for malocclusions which, unfortunately, are present in the child population at an early age, causing substantial alterations in the second dentition and proving to be a real public health problem. The total sample consisted of 147 patients (100%), of which 71 were men (48%) and 76 women (52%); the prevalence of oral habits was 96.59% which differs from the results of Alonso, Bosnjak, Agurto and Montiel<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30–33</span></a> who reported prevalences of 34.8%, 33.37%, 66% and 75% respectively in studies with a larger number of individuals.</p><p id="par0125" class="elsevierStylePara elsevierViewall">In terms of gender, prevalence was similar for both habits and malocclusions. Bayardo and Barrios<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> reported that the female sex was predominant in their studies, as well as Alonso,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> stating that malocclusions<a name="p7"></a> were more prevalent in girls. However, Bosnjak<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> found that the boys showed more habits than girls, and observed trends toward a certain gender. In general, the prevalence of oral habits according to gender in this study behaved similar for both males and females.</p><p id="par0130" class="elsevierStylePara elsevierViewall">In relation to age, subjects between the ages of 6 and 11 years showed a higher prevalence of pernicious oral habits as well as of malocclusions. Similar results were found in studies conducted in Mexico, Brazil, Nigeria, the United State<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> and Spain, which indicates that oral habits and their implications are more notorious and aggressive during the mixed dentition. Therefore, it has been established that the oral habits with higher prevalence are: lingual thrust 66.2%, lip suction 49.3%, and onychophagia 41.9%. In terms of prevalence of malocclusions, the ones with the highest observed prevalence were the following: open bite, 35.1%; lower anterior crowding, 26.4%; and upper anterior crowding, 19.6%.</p><p id="par0135" class="elsevierStylePara elsevierViewall">In regard to the relationship of terminal planes (primary dentition), the most prevalent was the mesial step with 18.2% and for the molar classification (permanent dentition) the prevalence was higher in molar class I with 39.9%. These results agree with the ones from Montiel<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> who obtained results for onychophagia with 41% and lingual thrust with 14%, showing a predisposition toward Angle’s class I. The study was carried out in a population of Mexican children of Nezahualcoyotl City, a municipality adjacent to the location in which the present study was carried out.</p><p id="par0140" class="elsevierStylePara elsevierViewall">The study performed by Bayardo13 found a 23.7% prevalence for onychophagia, thus being the most prevalent The study was conducted in Guadalajara, Mexico; in contrast, a study conducted by Tornisiello<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> in Brazil, found that the most prevalent habit was open bite with 36.4%, which cooncides with our results. According to other studies conducted by authors such as Warren<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> (USA), Bishara<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> (USA), Kharbanda<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> (India), Bosnjak<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> (Croatia) and Alonso<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> (Brazil), it was found that the most prevalent pernicious oral habits were: tongue thrust, suction (thumb or lip) and onychophagia. These results are in agreement with the data obtained from this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusions</span><p id="par1135" class="elsevierStylePara elsevierViewall">The most prevalent pernicious habits in the studied population were lingual interposition and thumb suction, which caused anterior open bite. Mouth breathing was found to have a relation to posterior cross bite. Thus, it is important to know the prevalence of pernicious oral habits associated with certain malocclusions that develop in early ages in order to prevent, intercept or correct during growth. In addition, it should be borne in mind that in the child population there is an increased susceptibility to develop these anomalies so preventive measures should be adopted such as periodic clinic exams, timely diagnosis, early treatment and prevent the development of more severe and costly problems. It is also important to mention that this type of anomalies should be treated in a multidisciplinary manner.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres741847" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:1 [ "identificador" => "abst0005" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec746076" "titulo" => "Key words" ] 2 => array:3 [ "identificador" => "xres741848" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:1 [ "identificador" => "abst0030" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec746077" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec1015" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0010" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec746076" "palabras" => array:3 [ 0 => "Pernicious habits" 1 => "malocclusions" 2 => "mixed dentition" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec746077" "palabras" => array:3 [ 0 => "Hábitos nocivos" 1 => "maloclusiones" 2 => "dentición mixta" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Malocclusions are considered by the WHO as the third event by its prevalence and they represent a public health problem. Genetic and environmental risk factors such as abnormal oral habits are of vital importance to consider its frequency, duration and intensity in order to avoid creating specific changes in the occlusion.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of malocclusions and its association with risk factors, such as pernicious oral habits in a 2 to 15-year-old child population who requested dental care in the Venustiano Carranza peripheral clinic of the UNAM.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was conducted in 147 children. Previously, the examiners who participated in the study were calibrated with a 98% concordance for pernicious habits and 92% for malocclusions. The epidemiologic information was recollected in one phase that comprised two stages to identify the presence of pernicious oral habits and diagnose the type of malocclusion. The statistical package SPSS 15 was used.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of pernicious oral habits was 96.6%. The largest number of cases presented at age 4 and in the 6 to 11 years of age during the mixed dentition. Malocclusions were present in both genders with no significant difference. The habit with the highest prevalence was lingual interposition (66.2%); the second was lip suction (49.3%); the third was onychophagia (41.9%) and finally, mouth-breathing (31.8%). In regard to malocclusions, the most prevalent was open bite (35.1%) followed by lower anterior crowding (26.4%), upper anterior crowding (19.6%) and lastly, posterior crossbite (12.8%). There was an association between tongue thrusting and open bite (p < 0.000), and with mouth breathing-posterior crossbite (p < 0.012) and Angle class II (p < 0.008).</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Child population presents greater susceptibility to develop malocclusions during growth so preventive measures should be adopted during this stage.</p></span>" "secciones" => array:5 [ 0 => array:1 [ "identificador" => "abst0005" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las maloclusiones son consideradas por la OMS como el tercer evento por su prevalencia; éstas representan un problema de salud pública. Los factores de riesgo genéticos y ambientales, como hábitos bucales nocivos son de vital importancia, considerar su frecuencia, duración e intensidad para evitar crear cambios específicos en la oclusión.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de las maloclusiones y su asociación con factores de riesgo, como hábitos bucales nocivos en la población infantil de 2 a 15 años que solicitaron atención dental en la clínica Periférica Venustiano Carranza de la UNAM.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Método</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio de tipo transversal en 147 niños. Previamente se calibraron las personas que participaron en el estudio, con una concordancia del 98% para los hábitos nocivos y 92% en las maloclusiones. La información epidemiológica se levantó en una sola fase, que constó de dos etapas para identificar la presencia de los hábitos bucales nocivos y diagnosticar el tipo de maloclusión. Se utilizó el paquete estadístico SPSS 15.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de hábitos bucales nocivos fue del 96.6%. El mayor número de casos se presentó a la edad de 4 años, y de 6 a 11 años durante la dentición mixta. Se presentó indistintamente de acuerdo con el género. El hábito de mayor prevalencia fue el de interposición lingual: 66.2%; en segundo lugar, succión labial: 49.3%; en tercer lugar, onicofagia: 41.9%; y, por último, respiración bucal: 31.8%. En cuanto a las maloclusiones: mordida abierta, 35.1%; apiñamiento anteroinferior, 26.4%; apiñamiento anterosuperior, 19.6%, y mordida cruzada posterior, 12.8%. Se encontró asociación del hábito de interposición lingual y mordida abierta (p < 0.000), respiración bucal con mordida cruzada posterior (p < 0.012) y la clase II de Angle (p < 0.008). Conclusiones: La población infantil presenta mayor susceptibilidad a desarrollar maloclusiones durante el crecimiento, por lo que se deben tomar medidas preventivas durante esta etapa.</p></span>" "secciones" => array:4 [ 0 => array:1 [ "identificador" => "abst0030" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] ] ] ] "multimedia" => array:9 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 611 "Ancho" => 856 "Tamanyo" => 42805 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Total percentage of children by gender.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 404 "Ancho" => 753 "Tamanyo" => 32877 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Prevalence of pernicious oral habits.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1690 "Ancho" => 2105 "Tamanyo" => 344535 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Prevalence of pernicious oral habits. <span class="elsevierStyleBold">A)</span> Lingual thrust, frontal and lateral view 66.2%. <span class="elsevierStyleBold">B)</span> Lip suction 49.3%. <span class="elsevierStyleBold">C)</span> Thumb sucking 23.6%. <span class="elsevierStyleBold">D)</span> Baby’s bottle 2%. <span class="elsevierStyleBold">E)</span> Mouth breathing 31.8%. <span class="elsevierStyleBold">F)</span> Onycophagia 41.9%.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1596 "Ancho" => 1501 "Tamanyo" => 311267 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Malocclusion prevalence. <span class="elsevierStyleBold">A)</span> 12.8% anterior cross bite, frontal and lateral view. <span class="elsevierStyleBold">B)</span> 35.1% anterior open bite. <span class="elsevierStyleBold">C)</span> Overjet, lteral and occlusal view (7.45%). <span class="elsevierStyleBold">D)</span> Edge to edge bite. <span class="elsevierStyleBold">E)</span> Overbite. <span class="elsevierStyleBold">F)</span> 19.6% upper anterior crowding. <span class="elsevierStyleBold">G)</span> 26.4% lower anterior crowding.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1016 "Ancho" => 1003 "Tamanyo" => 168961 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Prevalence of terminal planes. <span class="elsevierStyleBold">A)</span> Mesial step, 15.49% male, 21.05% female. <span class="elsevierStyleBold">B)</span> Exaggerated mesial step; 4.22% male, 2.63% female. <span class="elsevierStyleBold">C)</span> Flush terminal plane; 8.45% male, 9.21% female. <span class="elsevierStyleBold">D)</span> Distal step; 2.63% female.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 679 "Ancho" => 1003 "Tamanyo" => 94722 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Angle molar class prevalence. <span class="elsevierStyleBold">A)</span> Class I; male 43.66%, female 36.84%. <span class="elsevierStyleBold">B)</span> Molar class II; male 12.67%, 21.05% female. <span class="elsevierStyleBold">C)</span> Molar class III; 15.49% male, 6.57% female.</p>" ] ] 6 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table I" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " rowspan="2" align="center" valign="bottom" scope="col" style="border-bottom: 2px solid black">Age</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Gender</th></tr><tr title="table-row"><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Female \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Male \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">147 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1226340.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Prevalence of oral habits by age and gender.</p>" ] ] 7 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table II" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " rowspan="2" align="center" valign="bottom" scope="col" style="border-bottom: 2px solid black">Oral habit</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Gender</th></tr><tr title="table-row"><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Female % \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Male % \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Baby’s bottle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Thumb sucking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lip sucking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Onycophagia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.68 w \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mouth breathing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Body posture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.76 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tongue thrust \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.38 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1226339.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Percentile distribution of the prevalence of oral habits by gender.</p>" ] ] 8 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table III" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Upper</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Lower</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Difference</th></tr><tr title="table-row"><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">N \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">6:6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">4:4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">6:6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">4:4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">6:6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">4:4 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">49 mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">51 mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="center" valign="top">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-2.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">-1.91 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1226338.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Ratio of patients with posterior crossbite.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 66 | 7 | 73 |
| 2024 September | 95 | 14 | 109 |
| 2024 August | 57 | 8 | 65 |
| 2024 July | 67 | 12 | 79 |
| 2024 June | 49 | 10 | 59 |
| 2024 May | 49 | 7 | 56 |
| 2024 April | 62 | 9 | 71 |
| 2024 March | 90 | 21 | 111 |
| 2024 February | 103 | 25 | 128 |
| 2024 January | 131 | 24 | 155 |
| 2023 December | 108 | 28 | 136 |
| 2023 November | 132 | 36 | 168 |
| 2023 October | 156 | 27 | 183 |
| 2023 September | 102 | 13 | 115 |
| 2023 August | 89 | 17 | 106 |
| 2023 July | 95 | 28 | 123 |
| 2023 June | 133 | 28 | 161 |
| 2023 May | 157 | 25 | 182 |
| 2023 April | 93 | 15 | 108 |
| 2023 March | 95 | 23 | 118 |
| 2023 February | 80 | 24 | 104 |
| 2023 January | 84 | 7 | 91 |
| 2022 December | 64 | 23 | 87 |
| 2022 November | 97 | 7 | 104 |
| 2022 October | 71 | 16 | 87 |
| 2022 September | 76 | 17 | 93 |
| 2022 August | 73 | 13 | 86 |
| 2022 July | 60 | 18 | 78 |
| 2022 June | 69 | 20 | 89 |
| 2022 May | 71 | 9 | 80 |
| 2022 April | 102 | 23 | 125 |
| 2022 March | 96 | 17 | 113 |
| 2022 February | 86 | 15 | 101 |
| 2022 January | 82 | 30 | 112 |
| 2021 December | 68 | 15 | 83 |
| 2021 November | 67 | 23 | 90 |
| 2021 October | 72 | 37 | 109 |
| 2021 September | 74 | 11 | 85 |
| 2021 August | 96 | 26 | 122 |
| 2021 July | 49 | 18 | 67 |
| 2021 June | 45 | 13 | 58 |
| 2021 May | 96 | 21 | 117 |
| 2021 April | 241 | 28 | 269 |
| 2021 March | 127 | 11 | 138 |
| 2021 February | 166 | 34 | 200 |
| 2021 January | 82 | 15 | 97 |
| 2020 December | 95 | 16 | 111 |
| 2020 November | 91 | 20 | 111 |
| 2020 October | 48 | 9 | 57 |
| 2020 September | 61 | 12 | 73 |
| 2020 August | 47 | 13 | 60 |
| 2020 July | 52 | 6 | 58 |
| 2020 June | 52 | 13 | 65 |
| 2020 May | 55 | 13 | 68 |
| 2020 April | 45 | 11 | 56 |
| 2020 March | 58 | 10 | 68 |
| 2020 February | 56 | 41 | 97 |
| 2020 January | 51 | 13 | 64 |
| 2019 December | 39 | 8 | 47 |
| 2019 November | 30 | 7 | 37 |
| 2019 October | 41 | 7 | 48 |
| 2019 September | 57 | 14 | 71 |
| 2019 August | 28 | 10 | 38 |
| 2019 July | 32 | 7 | 39 |
| 2019 June | 49 | 35 | 84 |
| 2019 May | 106 | 64 | 170 |
| 2019 April | 84 | 34 | 118 |
| 2019 March | 10 | 2 | 12 |
| 2019 February | 22 | 9 | 31 |
| 2019 January | 13 | 7 | 20 |
| 2018 December | 13 | 6 | 19 |
| 2018 November | 26 | 2 | 28 |
| 2018 October | 41 | 13 | 54 |
| 2018 September | 71 | 8 | 79 |
| 2018 August | 15 | 10 | 25 |
| 2018 July | 15 | 2 | 17 |
| 2018 June | 31 | 0 | 31 |
| 2018 May | 170 | 1 | 171 |
| 2018 April | 18 | 0 | 18 |
| 2018 March | 23 | 1 | 24 |
| 2018 February | 27 | 0 | 27 |
| 2018 January | 10 | 0 | 10 |
| 2017 December | 25 | 2 | 27 |
| 2017 November | 9 | 0 | 9 |
| 2017 October | 28 | 2 | 30 |
| 2017 September | 7 | 4 | 11 |
| 2017 August | 8 | 3 | 11 |
| 2017 July | 14 | 1 | 15 |
| 2017 June | 15 | 8 | 23 |
| 2017 May | 31 | 12 | 43 |
| 2017 April | 11 | 12 | 23 |
| 2017 March | 26 | 14 | 40 |
| 2017 February | 64 | 4 | 68 |
| 2017 January | 11 | 0 | 11 |
| 2016 December | 21 | 0 | 21 |
| 2016 November | 8 | 0 | 8 |
| 2016 October | 4 | 0 | 4 |
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