Assessment of Palatal Plane and Occlusal Plane for Determining Anteroposterior Jaw Relation.

INTRODUCTION: Sagittal jaw relationship is an important parameter for orthodontic treatment planning. Angular and linear measurements both have been proposed and used in orthodontic cephalometrics to assess the sagittal jaw relationships. However, angular measurement has been questioned over the years for its reliability as a result of changes in facial height, jaw inclination and the variable positions of Nasion. So, the objective of our study was to assess the linear anteroposterior jaw relation in a sample of Nepali population using occlusal (Wits appraisal) and palatal planes as reference lines. METHODS: A descriptive cross-sectional study was conducted using the lateral cephalogram of 101 individuals visiting the Department of Orthodontics, Kantipur Dental College, Kathmandu, Nepal. Individuals with Class I skeletal relation were selected using convenience sampling method. Radiographs were standardised and traced. Occlusal and palatal planes were drawn that were bisected by the perpendicular lines from Point A and Point B. The linear distances between the intersections were measured to determine sagittal jaw relations. RESULTS: In Nepali individuals with normal ANB angle (3.05°±2.511°), the sagittal jaw relation with reference to occlusal (Wits appraisal) and palatal planes were found to be 0.203±3.343mm and 3.574±4.074mm respectively. CONCLUSIONS: Various methods has been proposed and used to assess the sagittal jaw relation and each method has its own strength and limitations. So, it is well advised to use additional cephalometric analysis whenever possible before arriving at any diagnosis and treatment plans.

Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study.

OBJECTIVES: The study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expenditure (CHE) and distress financing due to hospitalisation and outpatient care among industrial workers in Eastern Nepal. METHODS: We conducted a cross-sectional study involving industrial workers employed in a large-scale industry in Eastern Nepal. Those who were hospitalised in the last 1 year or availed outpatient care within the last 30 days were administered a structured questionnaire to estimate the cost of illness. CHE was defined as expenditure more than 20% of annual household income. Distress financing was defined as borrowing money/loan or selling assets to cope with OOP expenditure on health. RESULTS: Of 1824 workers eligible for the study, 1405 (77%) were screened, of which 85 (6%) were hospitalised last year; 223 (16%) attended outpatient department last month. The median (IQR) OOP expenditure from hospitalisation and outpatient care was US$124 (71-282) and US$36 (19-61), respectively. Among those hospitalised, the prevalence of CHE and distress financing was found to be 13% and 42%, respectively, and due to outpatient care was 0.4% and 42%, respectively. Drugs and diagnostics account for a large share of direct costs in both public and private sectors. More than 80% sought hospitalisation and outpatient care in a private sector. CONCLUSION: Industrial workers face significant financial risks due to ill health compared with the general population. Poor utilisation and higher cost of care in public health facilities warrant strengthening of public sector through increased government spending. The labour act 2014 of Nepal should be strictly adhered.

Comparison of adverse effects between lingual and labial orthodontic treatment.

OBJECTIVE: To compare adverse effects between labial and lingual orthodontic treatments through a systematic review of the literature. MATERIALS AND METHODS: The protocol of this systematic review (CRD42012002455) was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search was conducted in PubMed, Embase, Web of Science, CENTRAL, SIGLE, ProQuest Dissertations & Theses, and ClinicalTrial.gov for articles published between January 1980 and December 2012. Primary outcomes included pain and caries; secondary outcomes were eating difficulty, speech difficulty, oral hygiene, and treatment duration. Meta-analyses were conducted in Comprehensive Meta-Analysis version 2.2.064. RESULTS: Six studies were included, two randomized controlled trials and four clinical controlled trials; of these, four were medium quality and two were low quality in terms of the risk of bias. Five of the six outcomes were evaluated in the included studies, and treatment duration was not; pain, eating difficulty, speech difficulty were statistically pooled. Meta-analysis revealed that the pooled odds ratios were 1.20 (95% confidence interval [CI]  =  0.30-4.87) for overall pain, 32.24 (95% CI  =  14.13-73.55) for pain in tongue, 0.08 (95% CI  =  0.04-0.18) for pain in cheek, 0.11 (95% CI  =  0.03-0.42) for pain in lip, 3.59 (95% CI  =  1.85-6.99) for eating difficulty, and 8.61 (95% CI  =  3.55-20.89) for speech difficulty. Sensitivity analysis showed consistent results except for eating difficulty. No publication bias was detected. CONCLUSIONS: The likelihood of overall pain was similar between the two modalities. Patients who underwent lingual orthodontic treatment were more likely to suffer from pain in the tongue and less likely to suffer from pain in the cheek and lip. Lingual orthodontic treatment increased the likelihood of speech difficulty. Eating difficulty, oral hygiene, caries, and treatment duration could not be compared in this systematic review.

Interventions for accelerating orthodontic tooth movement: a systematic review.

OBJECTIVE: To evaluate the effectiveness of interventions on accelerating orthodontic tooth movement. MATERIALS AND METHODS: We searched the databases of PubMed, Embase, Science Citation Index, CENTRAL, and SIGLE from January 1990 to August 2011 for randomized or quasi-randomized controlled trials that assessed the effectiveness of interventions on accelerating orthodontic tooth movement. The processes of study search, selection, and quality assessment were conducted independently in duplicate by two review authors. Original outcome data, if possible, underwent statistical pooling by using Review Manager 5. RESULTS: Through a predefined search strategy, we finally included nine eligible studies. Among them, five interventions were studied (ie, low-level laser therapy, corticotomy, electrical current, pulsed electromagnetic fields, and dentoalveolar or periodontal distraction). Six outcomes were evaluated in these studies (ie, accumulative moved distance or movement rate, time required to move tooth to its destination, anchorage loss, periodontal health, pulp vitality, and root resorption). CONCLUSION: Among the five interventions, corticotomy is effective and safe to accelerate orthodontic tooth movement, low-level laser therapy was unable to accelerate orthodontic tooth movement, current evidence does not reveal whether electrical current and pulsed electromagnetic fields are effective in accelerating orthodontic tooth movement, and dentoalveolar or periodontal distraction is promising in accelerating orthodontic tooth movement but lacks convincing evidence.