Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction.

BACKGROUND: The demand for orthodontic treatment among adults has witnessed a substantial rise in recent years. This study aims to explore the complexities of adult orthodontics, focusing on challenges faced, treatment outcomes, and the influence of factors such as age, gender, and education on patient compliance and satisfaction. METHODS: A multi-dimensional approach was employed, combining a review of clinical records with structured patient surveys. Descriptive statistics summarized demographic characteristics, treatment duration, and orthodontic problems addressed. Inferential statistics included Pearson correlation, Chi-squared tests, and analysis of variance to examine age compliance, gendersatisfaction, and education-orthodontic problem relationships. Qualitative analysis enriched findings, and statistical software facilitated data processing. RESULTS: The analysis revealed a statistically significant negative correlation between age and compliance (r = -0.28, P < 0.05), indicating that younger participants demonstrated higher compliance rates. Gender emerged as a significant factor influencing patient satisfaction (P = 0.024), with females reporting notably higher levels of satisfaction than males. Furthermore, participants with advanced education levels (Master's/Ph.D.) were significantly more likely to have orthodontic issues related to malocclusion (P = 0.041). CONCLUSION: The study provides an insight into the multi-dimensional aspects of adult orthodontics, recognizing the challenges, compliance, and satisfaction levels. Tailored approaches considering age, gender, and education are essential. This research contributes to a deeper understanding of orthodontic treatment in adults and its potential implications for enhanced patient care.

Impact of class II and class III skeletal malocclusion on pharyngeal airway dimensions: A systematic literature review and meta-analysis.

Background: This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods: An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion: Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.

Comparative evaluation of transpalatal arch and vertical holding appliance at different heights.

Objectives: An effective method for controlling vertical dysplasia remains a concern for orthodontists. This study aims to compare the stresses on the maxillary first molars while changing the height of the loop/acrylic pad of the transpalatal arch (TPA) and vertical holding appliance (VHA) during swallowing using finite element analysis. Methods: Head and neck computed tomography (CT) of a patient with levelled and aligned maxillary teeth was taken for a three-dimensional reconstruction. Six models comprising the maxilla, molars, and surrounding periodontal ligament (PDL) with different heights of loop/acrylic pads of the appliances were constructed. A force of 112 g/cm2 was applied to the loop/acrylic pads of both appliances to simulate the average tongue pressure. The distribution of von Mises stresses occurring at the PDL due to the tongue pressure was mapped at the cervical area, furcation, distobuccal, mesiobuccal, and palatal root apices. Separately, subjects requiring TPA and VHA at different heights during orthodontic treatment were asked to rate their comfortability with the appliance on the visual analogue scale (VAS). Results: The VHA demonstrated higher values of stresses at all heights from the palatal floor compared to the corresponding heights of the TPA. The 8 mm model of VHA was found to be functionally effective. This height was also perceived to be acceptable for most patients on the VAS. Conclusions: The acrylic pad of VHA when kept at a distance of 8 mm from the palatal floor enhances the functional efficiency of the appliance with an acceptable comfortability for the patient.

Comparative Evaluation of the Fracture Strength of Pulpotomized Primary Molars: An In Vitro Study.

PURPOSE: This study evaluates the fracture strength of pulpotomized primary molars restored with amalgam, miracle mix, cermet, resin-modified glass ionomer cement, and nanocomposites. MATERIALS AND METHODS: Fifty primary first and second molars were collected for this study. All the teeth were randomly divided into five groups (n = 10). Standard pulpotomy cavities were prepared. Teeth were air dried and the canal orifices were capped with a layer of zinc oxide eugenol. A lining of calcium hydroxide was placed over it. Amalgam, miracle mix, cermet, resin-modified glass ionomer cement, and nanocomposite were placed in groups I, II, III, IV, and V, respectively. All the samples were then subjected to the fracture strength test using the universal testing machine and the results were statistically analyzed. RESULTS: All the groups were compared by the ANOVA one-way test which indicated that there were statistically significant differences among the five groups. CONCLUSION: Nanocomposites can be considered to be the best restorative material in terms of fracture strength among amalgam, miracle mix, cermet, and resin-modified glass ionomer cement. HOW TO CITE THIS ARTICLE: Mohammad N, Pattanaik S, et al. Comparative Evaluation of the Fracture Strength of Pulpotomized Primary Molars: An In Vitro Study. Int J Clin Pediatr Dent 2019;12(1):5-9.

Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances.

BACKGROUND: Patients with class II malocclusion generally seek orthodontic treatment for esthetic concern. Various myo-functionl appliances can be used for the treatment of skeletal as well as the dental malocclusion in a growing patient. Among various functional appliances, twin block appliance is most commonly used due to better patient compliances. It redirects the mandibular growth to correct the maxillomandibular relationship, enhancing facial esthet ics. This article presents a modified design of the twin block appliance which is less bulky, more esthetic, can be used concurrently with fixed orthodontic appliance, and is easily accepted by uncooperative patients. CASE SUMMARY: An 11-year-old-boy, who presented himself with a skeletal class II malocclusion, was treated with simultaneous use of fixed twin block along with fixed orthodontic appliance to correct both the skeletal and dental malocclusion. The twin block design was modified to have a better compatibility with the fixed orthodontic appliance.How to cite this article: Pattanaik S, Puvvula N, Mohammad N. Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances. Int J Clin Pediatr Dent 2018;11(2):146-150.

Modified Wrap-Around Retainer: A Quick Tip To Enhance the Retention of the Appliance.

As the teeth are in an inherently unstable position after the completion of the orthodontic treatment, a little pressure even from the soft tissues may create a relapse tendency. So there is always a need for a retention period until the gingival and periodontal reorganization is completed around the new position of the tooth. Removable appliances can be used effectively for the retention purpose of which Begg's wrap around retainers are most commonly used. This article presents a new modification in the design of the appliance which will help us to use the retainer more efficiently.

Treatment of Class III with Facemask Therapy.

Class III malocclusion is one of the most difficult problems to treat in the mixed dentition. It has a multifactorial etiology involving both genetic and environmental causes. The dental and skeletal effects of maxillary protraction with a facemask are well documented in several studies. Although treatment in the late mixed or early permanent dentition can be successful, results are generally better in the deciduous or early mixed dentition. The following case shows early treatment of a young patient with severe sagittal and transverse discrepancy of the maxilla and mandible, using a facemask.