A constant value, which also corresponded to the molar occlusion, was added to the TPI score. For each student, recorded malocclusions find more were summed and a total TPI score was calculated. The severity of malocclusion was assessed according to the Malocclusion Severity Estimate (MSE) [9]. According to the scale modification proposed by Ghafari et al. [18], the constant value for neutrocclusion on the TPI form was scored as normal occlusion. Here, the normal occlusion level was assessed as 0.27 and a score of 0.27�C3.99 was regarded as a minor manifestation of malocclusion. In the current study, this modification was preferred. The periodontal status was recorded using the CPITN scores as described by WHO [17].

The CPITN scores were set so that 0 = healthy, 1 = bleeding on gentle probing, 2 = calculus or other plaque-retentive factors, 3 = shallow pocketing of 4-5mm, and 4 = deep pockets of 6mm or more. For the periodontal examination we used a dental mirror, an explorer, and the periodontal probe, as recommended by WHO [17]. During oral examination of each child, the number of decayed, missing, or filled teeth was recorded as the DMFT score.2.1. Statistical Analyses The data were analyzed using SPSS for Windows, version 13.0 (SPSS Inc., Chicago, IL, USA). TPI measurements for the different genders were compared using Student’s t tests and age groups were compared using analysis of variance (ANOVA). The effects of age, gender, mothers’ and fathers’ education levels, parents’ monthly income, and CPITN scores on TPI scores were examined using the chi-square test.

Spearman’s rank correlation coefficients were estimated to provide a measure of the association between TPI, CPITN, and DMFT scores. Levels of statistical significance were set at P < 0.05. 3. Results The children's parents' monthly income and educational status are shown in Tables Tables11 and and2.2. In the present study, the TPI scores showed that 36.4% of the students had normal occlusion, while 41.2% had slight, 15.7% had definite, 4% had severe, and 2.7% had very severe malocclusion (Table 3).Table 1Parental monthly income.Table 2Parental educational status.Table 3Orthodontic treatment need according to TPI scores.TPI values did not show any significant differences between pupils in different age, gender, and socioeconomic status groups, as calculated based on the children's mothers' and fathers' education and monthly income (Table 4).

Table 4Comparison of TPI scores with age, gender, parental education, and parental monthly income.According to the CPITN scores, 36.6% of students had a healthy periodontium, 35.3% showed bleeding on gentle probing, and 21.9% had signs calculus or other plaque-retentive factors. Only 13 students (1.5%) had shallow Batimastat pocketing of 4-5mm and 39 students (4.6%) had deep pockets of 6mm or more.