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Introduction Incorporation of remineralizing agents with fluoride-releasing bracket adhesives may prevent the development of white spot lesions (WSL) or reverse the established WSL in patients undergoing fixed orthodontic treatment. We aimed to find out how effectively casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride varnish (FV) can remineralize teeth when mixed with fluoride-releasing orthodontic adhesive. Materials and methods We randomly assigned a total of 60 premolar teeth, therapeutically extracted for orthodontic purposes, into two equal groups. Group I (n = 30) utilized fluoride-releasing adhesive (FR), and Group II (n = 30) bonded with non-fluoride adhesive (NFR). Based on the applied remineralizing agent, we further divided each of the two groups into three equal subgroups of 10: Group IA (FR+FV), Group IB (FR+CPP-ACP), Group IC (control-only FR), Group IIA (NFR+FV), Group IIB (NFR+CPP-ACP), and Group IIC (control-only NFR). Following bonding procedures, all the samples underwent pH cycling for 28 days, where the enamel samples were immersed in 20 ml of demineralizing solution for three hours, followed by immersion in 30 ml of remineralizing solution for 17 hours. The samples were analyzed for shear bond strength (SBS) on a universal testing machine and hardness values (HV) by the Vickers microhardness test (VMT) using the indentation method. We also evaluated the adhesive remnant index (ARI) scores to determine the site of bracket failure. Statistical analysis The shear bond strength (SBS) and hardness value (HV) were expressed as the mean, standard deviation (SD), and median for each subgroup. We used the non-parametric Kruskal-Wallis test to analyze the SBS and HV, followed by the Dunn-Bonferroni test for intra-pair differences. The ARI score was expressed as the frequency of the percentage distribution, and the difference in the distribution of ARI scores between the groups was assessed by the Cochran chi-square test. The probability (p) value equal to or less than 0.05 was considered statistically significant. Results The results show that Group IB, bonded with a fluoride-releasing adhesive and a CPP-ACP remineralizing agent surface treatment, has the highest HV of 300.23 units. Group IIC (only NFR) has the lowest hardness of 153.3 units, which is statistically significant (p < 0.001). However, the ARI scores are not statistically significant between the groups tested. Conclusion The bond strength of the adhesive and the surface hardness of the enamel increased with the addition of fluoride varnish and CPP-ACP to both the fluoride-releasing and non-fluoride-releasing adhesives.
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INTRODUCTION: Malocclusion has a psychological impact related to the patient's age. It also influences the quality of life. This research aims to test the null hypothesis that there is no association between the self-perceived psychosocial impacts of dental aesthetics with the severity of malocclusion, oral health-related quality of life (OHRQoL), and self-image of the body in young adults seeking orthodontic treatment. MATERIALS AND METHODS: A convenience sample of young adults between 19 and 30 years old was selected for the study. The severity of malocclusion and orthodontic treatment needs were evaluated using the Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile-14 (OHIP-14), and Body Satisfaction Scale (BSS) were used to evaluate the self-perceived effects of malocclusion. STATISTICAL ANALYSIS: The Kruskal-Wallis test is used to analyze the distribution of components with different grades of DAI. Spearman's correlation test evaluated the correlation between independent variables and their domains. The study utilized stepwise multiple linear regression analysis to assess the predictive value of independent factors on the PIDAQ and its domains. RESULTS: A total of 181 subjects with a mean age of 24.4 ± 1.5 years, 42% males and 58% females, participated in this study. There was a significant correlation (p < 0.05) between all variables (OHIP-14, DAI, and BSS) and PIDAQ. There were significant correlations between the independent variables and the total score of PIDAQ (R2 = 0.16), psychological impact (R2 = 0.09), and social impact (R2 = 0.18), as well as dental self-confidence (R2 = 0.21) and aesthetic concern (R2 = 0.16). CONCLUSION: In young adults, the self-perceived impact of dental aesthetics is moderated by the severity of malocclusion, oral health-related quality of life, and body satisfaction. The null hypothesis is rejected.
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Objective: This study examined the glenoid fossa in Class II and Class III malocclusions with mandibular retrusion and protrusion. Materials and Methods: A retrospective investigation examined 60 Class II and 60 Class III cephalometric radiographs. Cephalometric landmarks and glenoid fossa measurements were taken. Statistical analysis contrasted the two malocclusion groups' glenoid fossas. Results: Class II malocclusion had a much lower mean Sella-Nasion-Condylion (SNCd) angle (glenoid fossa sagittal position) than Class III (14.6° ± 1.9). Class II malocclusion had a lower mean Sella-Nasion-Gonion (SNGo) angle (32.5° ± 4.3) than Class III (36.2° ± 3.9). The SNCd angle and SNGo angle in both groups demonstrated a negative correlation, demonstrating a relationship between the glenoid fossa and the mandibular sagittal axis. Conclusion: The glenoid fossa location differs significantly between Class II malocclusion with mandibular retrusion and Class III with protrusion. Class II malocclusion has a posterior glenoid fossa, while Class III has a less posterior one. Understanding these links may help patients receive more personalized treatment.
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BACKGROUND: Orthodontists, like any other medical professional, are susceptible to cumulative stressors and their undesirable consequences. The study aims to assess the self-perceived occupational stress levels and the psychological link between predictors and stress among orthodontic practitioners in India. MATERIALS AND METHODS: The participants in this cross-sectional study are active members of the Indian Orthodontic Society (IOS). The data for the survey were collected by a previously validated closed-ended occupational stress assessment (OSA) questionnaire and a job satisfaction questionnaire, which were sent through the registered e-mails. A five-point Likert scale was used to assess the severity of individual stressors, and an overall severity score was obtained by summing up the individual scores. The predictors of stress based on socio-demographic parameters were assessed using a binomial multiple logistic equation. Statistical significance was set at a p-value of <0.05. RESULTS: A total of 311 responses were received. Male orthodontists, unmarried, in the age group of 30-40 years, working in urban areas without any academic attachment were more stressed compared to the other groups in the respective categories. Tiredness/headache (39%) was reported as the most common consequence of occupational stress. The most concerning stressor was patients not wearing retainers. Orthodontists showed overall job satisfaction that is negatively correlated to overall stress (p <0.0001)(r = -0.260). CONCLUSION: A profound variation in stress levels was found among the orthodontists with their socio-demographic and professional characteristics. Despite the stress, orthodontists were highly satisfied with their careers.
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INTRODUCTION: An effective space opening for band placement with minimal pain and gingival inflammation is a prime requisite during fixed orthodontic procedures. The study aimed to compare the effectiveness of two types of separators, elastomeric and Kansal, in the amount of space opening, pain perception elicited, and gingival inflammation. METHODS: A random split-mouth study was designed with 30 subjects undergoing fixed orthodontic treatment. Two different separators (Elastomer and Kansal) were placed alternatively on the left and right sides around the mesial and distal sides of the first molars in the mandibular arch of each subject. After 3 days, the amount of separation after 3 days was assessed with a leaf gauge on both mesial and distal sides. The subjective pain perception by visual analog Scale (VAS) at different points and during different functions for each of the 3 days was evaluated. A self-filled chart was utilized to be performed by the patients. Gingival index was used to assess the inflammatory changes. RESULTS: The most significant amount of separation (0.28 mm) was found with elastomers on the mesial side and is statistically significant (p < 0.001) compared to the mesial side (0.18 mm). The Kansal separators produced equivalent separation on mesial (0.19 mm) and distal sites (0.17 mm). The highest pain score was found after 24 h with elastomeric separators (median-40) for chewing and biting and the least for sleep (median-30). There is a statistical difference of pain perception between elastomers and Kansal separators at different points for the given function (p < 0.001). Both the separators resulted in mild gingival index of score less than 1 (0.70 ± 0.65, 0.97 ± 0.720, and there was no statistically significant difference between the two types of separators. CONCLUSION: Both the separators produced adequate separation after a minimum 3 days. Kansal produces minimum discomfort and pain compared to elastomeric separators. Mild gingival inflammation was observed with both the separators.
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Hyperdontia involving the premolar teeth can be single or multiple or even related to a syndrome. These are frequently encountered in permanent dentition, but their occurrence has ranged between 0.09 and 0.64% in the general population. These are commonly found between the permanent canines and first premolars but rarely between the first and second premolars. These are usually eumorphic and can be easily identified as they follow the conventional tooth morphology. These are usually asymptomatic and not easily palpable unless they are very close to eruption. A lingual approach is preferred during their removal over the buccal method as it poses less risk of root trauma. In this case, bilateral accessory premolar tooth buds were present between the first and second premolars. Since the patient was undergoing orthodontic treatment, she was advised to remove these accessory teeth. For their removal, a Neumann flap with a buccal approach was used, which led to fracturing the root apex of the mandibular right second premolar root. On follow-up over the next 1 year, no other complications or secondary tooth germs were observed, and following a period of bone formation, the bone in the affected area formed normally again.
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INTRODUCTION: Bonding of brackets with adhesives during orthodontic fixed appliance therapy is associated with white spot lesions (WSLs). An adhesive developed with an antimicrobial property is advantageous to prevent decalcification of the enamel surface. The current study assesses the antimicrobial and shear bond strength (SBS) characteristics of an experimental conventional orthodontic adhesive incorporated with different concentrations of nanoparticles (NPs) prepared from the leaves of Calotropis gigantea and compares them with non-admixed conventional adhesive. MATERIALS AND METHODS: A total of 40 premolar teeth therapeutically extracted for orthodontic purposes were randomly assigned to four equal groups of n = 10 each. In control Group I, unmodified conventional adhesive was used to bond the brackets. In the three experimental groups, Group II, Group III, and Group IV, the brackets were bonded with modified conventional adhesive admixed with the C. gigantea NPs in concentrations of 1%, 5%, and 10%, respectively. The agar well diffusion test and the disc agar diffusion (DAD) test were utilized for assessing the anti-microbial activity of the composite discs. The SBS of the groups was determined by a universal testing machine. STATISTICAL ANALYSIS: A one-way ANOVA and Tukey's honestly significant difference (HSD) post-hoc test was used to analyze the difference in shear bond strength and microbial inhibition zone diameter between the groups with a probability (p) value of equal to or less than 0.05 as statistical significance. RESULTS: The mean SBS for Group I without nanoparticles is 6.99±0.75 MPa. The SBS value decreased inversely in proportion to the concentration of NPs: Group II (1% NP) 6.29±0.67 MPa; Group III (5% NP) 4.40±0.47 MPa; and Group IV (10% NP) 1.98±0.21 MPa, which is statistically significant (p < 0.001). The incorporation of C. gigantea NPs resulted in a decrease in the actual microbial potency of the conventional adhesive. CONCLUSION: Isolated C. gigantea NPs, when used alone, proved to have antimicrobial efficacy, but orthodontic adhesives admixed with C. gigantea NPs showed no additive effect, and SBS values decreased with increased concentrations of NPs.
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Introduction The debonding procedures should restore the enamel surface to its pre-treatment state as much as possible after removing orthodontic attachments and all remaining adhesive remnants from the surface of the tooth. The orthodontic attachments are bonded commonly by a light-cured composite system. Light-cured glass ionomer cement has been developed as an alternative to the composite as a bonding agent for orthodontic brackets. There are different methods for cleaning the residual adhesive after the removal of orthodontic attachments. The study aims to evaluate and compare the enamel surface roughness of teeth between two different adhesive systems - light cure composite and glass ionomer cement adhesives - after debonding followed by the removal of resin remnants with a tungsten carbide (TC) bur. A null hypothesis is proposed that there exists no difference in the enamel surface roughness between the two adhesive systems. Materials and methods The test sample of 40 freshly extracted human premolar teeth (n = 40) for orthodontic purposes was taken up for this in vitro study based on the inclusion and exclusion criteria. The sample was randomly assigned into two equal groups, with metal brackets bonded in Group-I (n = 20) by light cure adhesive (Trans bond XT, 3M Unitek, Monrovia, CA) and Group-II (n = 20) with light glass ionomer cement (GC Fuji Ortho LC, Tokyo, Japan). All samples were stored in water at room temperature for 24 h and brackets were debonded with a debonding plier. The removal of cement adhesive remnants was performed with a TC bur with a low-speed handpiece. The three surface roughness parameters, average roughness (Ra), root mean square roughness (Rq), and maximum roughness depth (Rmax), were measured at T1 (before bonding) and at T2 (after debonding and finishing) and the values were compared. The mode of bond failure was assessed by a modified adhesive remnant index (ARI) and the time required for the clean-up of adhesive was also noted. Statistical analysis The continuous quantitative data were statistically analyzed using SPSS Statistics v. 25.0 (IBM Corp., Armonk, NY). Student's independent t-test/independent-samples t-test is an inferential statistical test for analyzing the difference between the two groups. Paired t-test was used for comparison within the group. The ARI between the groups was analyzed by a chi-square test. The probability (p) value for statistical significance was 0.05 or less for the difference between any two groups for all the analytical tests. Results A comparison of enamel surface roughness before bonding and after debonding for both groups revealed that there was a statistically significant difference within each group. The surface roughness values of composite resin - Ra (98.75 ± 0.96), Rq (120.38 ± 1.06), Rmax (650.14 ± 1.12) - and glass ionomer cement group - Ra (98.75 ± 0.96), Rq (62.76 ± 1.32), Rmax (434.36 ± 1.60) - show that there was a statistically significant difference between the groups with p <0.01. Conclusion There was a significant increase in the surface roughness of enamel after debonding of brackets and finishing with a TC bur with both the light cure and the glass ionomer cement adhesive systems. The light cure group showed more enamel surface roughness when compared to the glass ionomer cement group. In this study, the null hypothesis was rejected as there is a significant difference between the groups tested.
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Background: The purpose of this randomized trial is to compare the efficacy of weekly once regime of neutral sodium fluoride (NaF) oral rinse with that of acidulated phosphate (APF) formulated daily mouth rinse in the reduction of white spot lesions (WSLs) associated with fixed orthodontic appliance treatment. Methods: The participants (n = 90) of this single-center, two-arm parallel study without a control group were randomly assigned with 1 : 1 distribution to each of the two groups after the bonding of brackets. Group A/test group 1 (n = 45) was given weekly rinse of neutral sodium fluoride (Colgate® PreviDent® Dental Rinse-0.2% NaF), and for group B/test group 2 (n = 45), an APF formulated daily oral rinse (Colgate® Ortho Defense@ PhosFlur® Rinse-0.044% w/v of NaF) was given for six months. The outcome was assessed by the International Caries Detection and Assessment System (ICDAS) index for scoring the demineralization, and for scoring gingivitis, Loe and Silness gingival index (GI) was utilized. Four different time points "T0"immediately before bonding procedures, "T1" after 4weeks, "T2" after 12 weeks, and "T3" after 24 weeks were taken to assess the ICDAS and GI scores. Results: The mean ICDAS scores for group A (NaF) were 0.025, 0.051, 0.093, and 0.113 and for group B (APF) were 0.014, 0.022, 0.038, and 0.015 at different points of time. The GI scores for group A were 0.008, 0.22, 0.33, and 0.38 and for group B were 0.003, 0.136, 0.181, and 0.097 at different time points. There was a statistically significant difference (p < 0.05) for both groups in terms of reducing WSL and GI. Conclusion: APF formulated daily oral rinse-0.044% w/v of NaF-is more effective than the weekly once regimen of 0.2% NaF oral rinse to prevent white spot lesions.
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Cárie Dentária , Gengivite , Fluoreto de Fosfato Acidulado , Cariostáticos , Cárie Dentária/tratamento farmacológico , Cárie Dentária/prevenção & controle , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Antissépticos Bucais/uso terapêutico , Fluoreto de SódioRESUMO
Introduction The objective of this observational study is to compare the dental and skeletal changes that occur following the release of incisor locking in class II division 2 patients in the decelerating phase of the adolescent growth spurt. Materials and methods Lateral cephalograms of 17 subjects with skeletal class II and division 2 malocclusion, taken at the pre-treatment (T1) and post-leveling and alignment (T2) phases, were analyzed. All these patients were treated with non-extraction methods in the initial stage. A total of 25 skeletal and dental parameters, which included linear and angular measurements, were evaluated. Statistical analysis A paired t-test was used to compare the difference in the dimensional values between (T1) and (T2) points of the time period. The results were considered statistically significant at Bonferroni adjusted p<0.002. Results A statistically significant positional change was noted in the condylar position both in the vertical and sagittal directions, resulting in sagittal changes of the mandible in the forward direction. The deep bite was relieved by vertical changes in the dental structures in both the posterior and anterior segments. Growth changes in the vertical direction were also noted but not conclusive. Conclusions There was a definite horizontal shift of the mandible, improving maxillo-mandibular relations following the unlocking of the bite in class II division 2 patients. This shift is mostly attributed to the condylar repositioning in the forward and downward directions.
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BACKGROUND: There are different types of retention protocols and retainers prescribed by the orthodontists across the globe. AIM: The study was conducted with the aim of evaluating the retention practices followed by the orthodontists in India. MATERIALS AND METHODS: A questionnaire link with a set of 29 questions was generated using the Google Forms App. The questions related to the basic demographic details followed by retention procedures in maxilla and mandible as related to the type of retainer, duration of wear, retention check-ups, and adjunctive procedures being followed. The Google forms were mailed to 1147 registered life members of the Indian Orthodontic Society. RESULTS: The overall response rate was 20.1%. On receiving of the completed questionnaires, the data were statistically analyzed. Dual mode of retention, fixed retainers with removable thermoplastic resin (TR)/vacuum formed retainers (VFR) (24%) were the common type of retention in maxilla whereas the fixed bonded retainer (44.5%) was more commonly used in mandible. Full time wear of maxillary retainer was recommended by 85.2% of the respondents. The recommended duration of the fixed retainer is for 2-5 years (41.9%). CONCLUSION: A trend towards more dual retention instead of solitary removable or solitary fixed retention, more VFR instead of Hawley-type retainers has been demonstrated in the survey.
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OBJECTIVE: The treatment protocol in the modern health care paradigm has shifted considerably towards enhancing the quality of life in the last decade. This is particularly important in cosmetic and elective treatments, and hence the interest in oral health-related quality of life (OHRQoL) also has increased. OHRQoL always been measured by endogenous, functional, social, or psychological determinants. Self-esteem (SE) is one of the internal factors that affect the perception of malocclusion and hence OHRQoL before and after treatment. The purpose of this review is to assess whether there exists any correlation between the Oral Health-Related Quality of Life, Self-esteem (SE) in patients following orthodontic treatment. METHODS: A literature search was confined to the English language using Medical Subject Heading terms (MeSH) in PubMed, Cochrane Library, and Ovid® covering the period from January 1, 1951 to May 15, 2020. Search in Google Scholar, grey literature, and hand search on cross-references was performed to find additional data. The studies found to be suitable were selected based on the predefined inclusion and exclusion criteria. The quality of assessment and risk of bias for the included studies were evaluated independently by two invigilators utilizing "The Cochrane Collaboration's tool for assessing the risk of bias" and "Modified version of the Newcastle Ottawa scale" for Randomized Controlled Trials (RCTs) and non-randomized trials respectively. RESULTS: A total of 7688 studies were retrieved from all the sources. After screening all the titles and excluding the duplicates, 28 studies were finally included for text review, and all of them were fit for quality appraisal. The design of the final studies included comprised of 3 RCTs, 14 cohort studies, 9 cross-sectional studies, and 2 case-control studies. CONCLUSION: There is moderate evidence to show that fixed orthodontic treatment improves OHRQoL and SE in children. OHRQoL also increased in adolescents and adults. However, there is a weak correlation between SE and OHRQoL. More evidence-based studies are needed to analyze the relationship.
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INTRODUCTION: Enamel loss is a common problem during various orthodontic procedures. The study aims to compare the efficacy of a desensitizer and remineralizer in the reduction of the dentin hypersensitivity (DH) associated with enamel microcracks after orthodontic debonding. METHODS: A unicentric two arm parallel study with 30 subjects randomly assigned to each groups following debonding. Group-1 subjects were treated with Gluma® desensitizer (5% glutaraldehyde and 35% hydroxyethyl methacrylate (HEMA)) and the Group-2 intervention included a remineralizing agent GC Tooth Mousse Plus® (casein phospho peptide and amorphous calcium Fluro phosphate (CPP:ACFP)). The Visual Analogue Scale (VAS) was utilized to evaluate DH as subjective perception of pain following the Air blast test and Cold test. The VAS scale was indexed from 0-10 markings based on the intensity of perception. Five different time points T0 and T1 - immediately after debonding and intervention on day 1, T2 - 48 hours, and T3 after 72 hours were taken for the assessment of VAS scores. RESULTS: The VAS scores for the airblast test for group 1 were (2.73, 0, 0.06, 0.03) and group 2 (2.46, 0, 0.16, 0.13) at different periods. The sensitivity scores for the cold blast test for group 1 were (2.73, 0, 0.13, 0.03) and for group 2 (2.46, 0, 0.16, 0.13). There was 98 percent reduction in DH between T0 and T3 and was statistically significant (p<0.05) for both the groups. CONCLUSION: Gluma® desensitizer and GC Tooth Mousse Plus® are equally effective in the reduction of DH in the orthodontic patient following debonding.
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Every practicing orthodontist today is aware of the importance of considering arch form in the attainment of a functional orthodontic correction [1]. Arch perimeter or circumference prediction is an essential component when Tooth Size Arch Length Discrepancy (TSALD) is estimated. Arch perimeter is the distance from mesial contact of the permanent molar on one side to the mesial contact of the permanent molar on the other side, with the line connecting the buccal/incisor tip points in the intervening teeth. This is most evident when seeking to resolve dental crowding or arch-length discrepancy (ALD) [2]. The shape of the arch form of maxillary and mandible resembles that of the various geometric forms such as including ellipse, parabola, hyperbola, and catenary curve [3], [4], [5], [6]. Ellipse is the best form that fits the shape of the Maxillary arch [1,2]. The mathematical equation formulated by Srinivasan Ramanujan in 1914 for widely considered to be the most accurate for calculation of the circumference of an ellipse is [7]. The computation of the circumference of the ellipse by this equation requires two values- 'a' and 'b,' the semi-major and semi-minor axis [half of the major axis and minor axis of the ellipse] respectively [8]. The perimeter (P) of an ellipse is given by the formulae;â¯=â¯π(a+b){1+(3h/(10-â(4-3h))}; where h=(a-b)2/(a+b)2 and calculated Maxillary arch perimeter (CP) =1/2 P. This necessitates a complex series of steps, and to overcome this, a statistical formula is developed by algorithm steps for mathematical equation where perimeter can be directly obtained by just two inputs 'a' and 'b' in excel sheet. We correlated this calculated arch perimeter (CP) with directly measured perimeter (MP) and marginal difference estimated in three different classes of malocclusion.
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BACKGROUND: Restricted mandibular growth is observed in Class II Div 2 malocclusions. The fixed functional appliances are used to effect the skeletal changes in patients with end stages of skeletal maturity. AIM: This cephalometric study aimed to distinguish the skeletal and dental corrections done in the mandible on skeletal Class II Div 2 subjects when treated with PowerScope appliance (American Orthodontics, Sheboygan, WI). MATERIALS AND METHODS: This is a cephalometric study based on the retrospective data. The patients selected for this study were with Class II Div 2 malocclusion and assessed to be in decelerating phase of skeletal growth. A total of 12 patients were selected after applying inclusion and exclusion criteria. A PowerScope was placed after incisor correction and followed up till Class I molar relation was achieved. The initial values (T1) at the time of placement of the appliance and the final values at the end of the molar correction (T2) were noted. The cephalometric parameters at T1 and T2 were assessed using sagittal occlusal (SO) analysis by Pancherz. The paired Student's t-test was used to analyze pre- and posttreatment changes. RESULTS: There was sufficient lengthening of the mandible (4.38 mm). Both the dental and skeletal alterations were observed in the mandible. These changes were marked compared to the maxilla. The pre- and posttreatment changes were statistically significant for the mandibular skeletal changes (P < 0.001) as well as mandibular incisor proclination (P < 0.001). CONCLUSION: The PowerScope can be used as a propeller for sagittal mandibular correction in Class II Div 2 patients.
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AIMS AND OBJECTIVES: The present study aims to evaluate the gender dimorphism of the angle SN-FH between the sella-nasion (SN) plane and the Frankfort horizontal (FH) plane among the three types of skeletal malocclusion in South Indian population. The objectives included measurement of angle SN-FH, FH to the nasion (NFH), FH to the sella (SFH), and the difference of NFH and SFH (Δ). The null hypothesis was that there exists no variation of the angle SN-FH, NFH, SFH, and Δ between males and females and in the different skeletal relationship of jaws. MATERIALS AND METHODS: Cephalometric data were retrieved from the archived records of 180 patients, comprising 90 males and 90 females, within three subgroups. Class I (60), Class II (20), and Class III (10) in each of the gender class were examined. Student's "t" test was used to analyze means of the gender differences and analysis of variance between subgroups, and significance was set at P < 0.05. RESULTS: The average values obtained from this study for the overall population are 8.06 ± 3.34; for males, it is 7.42 ± 3.62, and for females, it is 8.7 ± 3.48. The gender difference is statistically significant only in Class I malocclusion (0.002). There is no statistical difference between different skeletal classes of malocclusion. CONCLUSION: The null hypothesis is partially rejected for as significant difference is established only for some of the parameters under the study.
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Herewith, a case is reported of an adolescent female patient with maxillary retrognathism due to restricted growth arising out of the previous cheiloplasty and palatoplasty surgeries treated for cleft lip and palate. She also presented an oroantral fistula in the scarred tissues of the palatal region. There was anterior crossbite and distorted occlusion in the anterior segment with crowding and open bite. There is maxillomandibular discrepancy of 6 degrees°. The distraction osteogenesis was performed so as treat the maxillary hypoplasia. This allows undermanding adaptation of the soft-tissue structures to the modification in the skeletal structures as a result of surgical procedures and ensures long-term stability. A custom made intraoral rapid maxillary expansion device was prepared utilizing the hyrax screw for the distraction of the bony segments. At the end of the treatment and a retention period of 24 months, the patient exhibited improved facial profile and hence esthetics.
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OBJECTIVE: To test the null hypothesis that there is no effect of esthetic perception of smiling profile in three different facial types by a change in the maxillary incisor inclination and position. MATERIALS AND METHODS: A smiling profile photograph with Class I skeletal and dental pattern, normal profile were taken in each of the three facial types dolichofacial, mesofacial, and brachyfacial. Based on the original digital image, 15 smiling profiles in each of the facial types were created using the FACAD software by altering the labiolingual inclination and anteroposterior position of the maxillary incisors. These photographs were rated on a visual analog scale by three panels of examiners consisting of orthodontists, dentists, and nonprofessionals with twenty members in each group. The responses were assessed by analysis of variance (ANOVA) test followed by post hoc Scheffe. RESULTS: Significant differences (P < 0.001) were detected when ratings of each photograph in each of the individual facial type was compared. In dolichofacial and mesofacial pattern, the position of the maxillary incisor must be limited to 2 mm from the goal anterior limit line. In brachyfacial pattern, any movement of facial axis point of maxillary incisors away from GALL is worsens the facial esthetics. The result of the ANOVA showed differences among the three groups for certain facial profiles. CONCLUSION: The hypothesis was rejected. The esthetic perception of labiolingual inclination and anteroposterior of maxillary incisors differ in different facial types, and this may effect in formulating treatment plans for different facial types.
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INTRODUCTION: The orthodontic mini-screws are the mainstay of direct skeletal anchorage which requires minimal compliance and provides maximal anchorage control. However, the timing of initiation of orthodontic loading of these mini-screws is not clearly established in the available studies. AIM: The purpose of this study was to determine the reciprocal effects on mini-screw implant with immediate loading in comparison to that of delayed loading during retraction. MATERIALS AND METHODS: The prospective clinical study included a sample of 25 orthodontic patients in the age range of 18-25 years. All the cases were of bi-maxillary proclination with Type-A anchorage demands. All the first premolars were indicated for extraction. A split mouth technique for each patient was utilized by loading mini-implant immediately after its placement on one side and the opposite side implant was loaded after a time lag of two weeks post-insertion. Retraction force of 150g was applied for three months on each side. The displacement of the head and tail of the implant, molar anterior tooth retraction was measured on Orthopantomograph (OPG) taken at T1 (initial) and T2 (after three months). A grid method with each 1mm magnified to 500 pixels was superimposed on OPG and the relative displacements were evaluated. Student's unpaired 't' test was used for comparison between left and right side and paired 't' test for the parameters on the same side. The p-value equal to or less than 0.05 was taken as statistically significant. RESULTS: The mean displacement of head of the implant on the immediate loading is 0.57mm where as the tail exhibited 0.75 mm. The head and tail of the implant on the delayed loading displaced by 0.35mm and 0.38mm respectively, on an average when data was analysed. Significant difference between the two types of loading was noted. CONCLUSION: Delayed loading is beneficial as compared to immediate loading during extraction space closure.
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INTRODUCTION: The initial leveling and aligning phase has been simplified with the introduction of superelastic nickel-titanium archwires. The relatively high cost of these wires has prompted some of the clinicians to reuse them after sterilization. The quantitative changes in the surface properties of superelastic 'NiTi' wires after clinical application and recycling by autoclave method have not been established in earlier studies. AIM: To quantify the changes in mechanical and physical properties of four different commercially available superelastic nitinol (NiTi) archwires after clinical usage and recycling. MATERIALS AND METHODS: The superelastic 'NiTi archwires obtained from four different manufacturers: Group I-GAC (McMinnville, USA); Group II- 3M Company (California, USA); Group III- G&H Company(Franklin, USA) and Group IV- American Orthodontics (AO) (Sheboygan, USA) were selected for the study. Each of the four groups comprised of 20 samples of wire with 10 of them selected randomly as control and remaining 10 as test specimen in each group. The experimental archwires were placed on selected patients for a period of three months followed by Standard Autoclave sterilization at 121°C and 15 to 20 psi pressure for 20 minutes and were retrieved. The tensile strength was evaluated by Instron-Universal Testing Machine. The quantification of changes in surface roughness was investigated by grid method using Scanning Electron Microscope (SEM). The Control Wires (C) were evaluated at initial time "T1" where as the Experimental sample of wires (T) were subjected to testing at an initial time 'T1' and after clinical usage and sterilization at 'T2'. STATISTICAL ANALYSIS: Paired t-test was used for intra-group comparison and one way ANOVA and Post Hoc Tukey tests were used for inter-group comparison. RESULTS: There was significant decrease in tensile strength (p = 0.0015 to 0.001) and surface roughness (p< 0.001) between control and experimental arch wires within each group when properties at T1 and T2 were compared. CONCLUSION: The study suggests discouraging the use of clinically used and sterilized superelastic NiTi archwires.