An Orthodontic Approach for the Correction of Transposition along with Multiple Impacted Teeth.

Impaction of teeth affects patients' esthetics, speech, and masticatory efficiency. In addition, the transposition of teeth makes a case difficult to manage. This case report describes a case of a 14-year-old boy with the impaction of the maxillary right central incisor and canine along with the transposition of the right canine and lateral incisor. The impacted teeth were surgically exposed and guided into the arch using orthodontic traction. Likewise, the transposition was corrected orthodontically by moving the teeth to their desired position without any detrimental effect on the adjacent teeth. The patient's esthetics and occlusion improved substantially after the orthodontic intervention.

Nepal measles outbreak response immunization during COVID-19: A risk-based intervention strategy.

In 2020, National Immunization Programme (NIP) of Nepal implemented a measles outbreak response immunization (ORI) campaign, which was additional to an ongoing preventive measles-rubella SIA campaign. Both campaigns were implemented during ongoing COVID-19 transmission. By April, 220 measles cases and two deaths were confirmed from eight districts of Nepal. The NIP triangulated information from surveillance (measles and COVID-19), measles immunization performance and immunity profile, programme capacities and community engagement and applied a logical decision-making framework to the collated data to inform 'Go/No-Go' decisions for ORI interventions. This was reviewed by the National Immunization Advisory Committee (NIAC) for endorsement. Outbreak response with non-selective immunization (ORI), vitamin-A administration and case management were implemented in affected municipalities of four districts, while in the remaining districts outbreak response without ORI were undertaken. The structure and iterative application of this logical framework has been described. ORI was implemented without interrupting the ongoing measles-rubella vaccination campaign which had targeted children from 9 to 59 months of age. The age group for ORI was same as SIA in one sub-district area, while for the other three sub-district areas it was from 6 months to 15 years of age. More than 32,000 persons (97% coverage) were vaccinated in ORI response. Overall measles incidence decreased by 98% after ORI. The daily incidence rate of measles was 94 times higher (95% confidence interval: 36.11 - 347.62) before the ORI compared to two weeks after ORI until year end. Close attention to surveillance and other data to inform actions and seamless collaboration between NIP and core immunization partners (WHO, UNICEF), with guidance from NIAC were key elements in successful implementation. This was an example of feasible application of the global framework for implementation of a mass vaccination campaign during COVID-19 through application of a simple decision-making logical framework.

A Comparative Study on the Effect of Different Methods of Recycling Orthodontic Brackets on Shear Bond Strength.

AIM: The aim of this study was to evaluate and compare the effect of different methods of recycling stainless steel orthodontic brackets on shear bond strength. METHODS: One hundred twenty human premolars extracted for orthodontic purpose were randomly divided into four groups. Standard MBT (0.022″) brackets were bonded on the buccal surface of all samples with light cured adhesive primers using an LED curing unit for 10 seconds. Group I was assigned as control, and the brackets of Group II, Group III, and Group IV were subjected to recycling by flaming, flaming with sandblasting, and flaming with ultrasonic cleaning, respectively. The recycled brackets were rebonded, and final debonding of all brackets was performed using a universal testing machine at a crosshead speed of 0.5 mm/min and shear bond strength was determined. Data were analyzed with descriptive statistics, ANOVA, and post hoc tests. The adhesive remnant index was evaluated using a stereomicroscope at 10X magnification. RESULTS: The highest shear bond strength was obtained with Group I (10.35 ± 0.46 MPa), followed by Group III (9.36 ± 0.55 MPa) and Group IV (5.97 ± 0.66 MPa), and the least value was obtained with Group II (4.30 ± 0.55 Mpa). Significant differences among the groups were detected by analysis of variance. Tukey's post hoc multiple comparison test showed that the shear bond strength of each group was significantly different from one another (p < 0.001). CONCLUSIONS: Shear bond strength of new brackets was significantly higher than that of the recycled brackets. Among recycled brackets, flaming with sandblasting provided adequate shear bond strength, flaming with ultrasonic cleaning provided a borderline value for clinical use, and flaming alone led to a significantly lower value.

Shear bond strength of a bracket-bonding system cured with a light-emitting diode or halogen-based light-curing unit at various polymerization times.

PURPOSE: To determine and compare the shear bond strength (SBS) of bracket-bonding system cured with light-emitting diode (LED) and halogen-based light-curing unit at various polymerization times. MATERIALS AND METHODS: Ninety six human maxillary premolar teeth extracted for orthodontic purpose were divided into four groups, according to the light-curing unit and exposure times used. In the halogen group, the specimens were light cured for 20 and 40 seconds. In the LED group, the specimens were light cured for 5 and 10 seconds. Stainless steel brackets were bonded with Enlight bonding system, stored in distilled water at 37°C for 24 hours and then submitted to SBS testing in a universal testing machine at a crosshead speed of 0.5 mm/minute. Adhesive remnant index (ARI) was used to evaluate the amount of adhesive remaining on the teeth determined by stereomicroscope at 10× magnification. RESULTS: The highest mean SBS was obtained with the halogen 40 seconds (18.27 MPa) followed by halogen 20 seconds (15.36 MPa), LED 10 seconds (14.60 MPa) and least with LED 5 seconds (12.49 MPa) group. According to analysis of variance (ANOVA) and Tukey's multiple-comparison test, SBS of halogen 20 seconds group was not significantly different from halogen 40 seconds group, LED 5 seconds group and LED 10 seconds group, whereas halogen 40 seconds group was significantly different from LED 5 seconds and LED 10 seconds group. The method of light curing did not influence the ARI, with score 2 being predominant. CONCLUSION: Polymerization with both halogen and LED resulted in SBS values that were clinically acceptable for orthodontic treatment in all groups. Hence, for bonding orthodontic brackets, photoactivation with halogen for 20 seconds and LED for 5 seconds is suggested.

Mixed dentition space analysis among Nepalese Brahmins/Chhetris.

BACKGROUND: Mixed dentition space analysis forms an important part of orthodontic diagnosis and treatment planning. Regression equations are widely used for mixed dentition analysis which can vary among races. This study aimed to find out the new regression equation in estimating the size of unerupted canines and premolars for Nepalese Brahmins/Chhetris. METHODS: Hundred Nepalese Brahmins/Chhetris (50 males and 50 females) who met our criteria were selected among the patients attending to the Orthodontic Out-Patient Department, Institute of Medicine, Kathmandu. The mesiodistal widths of all mandibular permanent incisors; maxillary and mandibular canines and premolars were measured and analyzed. The results were also compared with predicted values from the Moyers and the Tanaka and Johnston methods. Correlation and linear regression analyses were performed between the predicted and actual tooth sizes for Nepalese Brahmins/Chhetris and standard regression equations were developed. RESULTS: No significant differences were observed when the sum of canine and premolars of one quadrant is compared between sides and sex. Significant and high positive correlations were found between the mandibular incisors and the combined mesiodistal widths of the canines and premolars for the maxillary (r = 0.72) and mandibular (r = 0.73) segments. Significant differences were observed between the measured values from this study and from Moyers (50 % and 75 % probability) and Tanaka-Johnston methods. CONCLUSIONS: The equations and charts commonly used for North American children (50(th) or 75(th) percentile) did not accurately predict for our sample, so new regression equations and tables were developed for Nepalese Brahmins/Chhetris children.

Assessment of skeletal maturation with permanent mandibular second molar calcification stages among a group of Nepalese orthodontic patients.

BACKGROUND: Assessment of growth status of a patient is a key component in orthodontic diagnosis and treatment planning for growing patients with skeletal discrepancy. Skeletal maturation based on hand-wrist radiograph and cervical vertebral maturation (CVM) are commonly used methods of growth assessment. Studies have shown that stages of dental calcification can also be used to assess skeletal maturation status of an individual, whereas other studies have suggested that the relationship between dental calcification and skeletal maturation should be interpreted with caution owing to racial variation. OBJECTIVE: To evaluate the relationship between permanent mandibular second molar calcification stages and skeletal maturity assessed by CVM among a group of Nepalese orthodontic patients. MATERIALS AND METHODS: One hundred and sixty-eight digital radiographs (84 orthopantomograms and 84 lateral cephalograms) were obtained from the records of 84 patients who sought orthodontic treatment in Orthodontic and Dentofacial Orthopaedic Unit, Department of Dentistry, Institute of Medicine, Kathmandu. Two parameters were used in this study, namely, CVM stages from lateral cephalogram and Demirjian index (DI) stages from orthopantomogram. The evaluation of digital radiographs was carried out on a computer screen with a resolution of 1,280×800 pixels. The association between DI stages of permanent mandibular second molar and CVM stages was assessed. RESULTS: A statistically significant association was found between DI and CVM stages for both male and female subjects with Pearson's contingency coefficient value of 0.751 and 0.766 for male and female subjects, respectively. CONCLUSION: Skeletal maturation can be reliably assessed with dental calcification stages of permanent mandibular second molar for Nepalese orthodontic patients.

Development of 2010 national land cover database for the Nepal.

Land cover and its change analysis across the Hindu Kush Himalayan (HKH) region is realized as an urgent need to support diverse issues of environmental conservation. This study presents the first and most complete national land cover database of Nepal prepared using public domain Landsat TM data of 2010 and replicable methodology. The study estimated that 39.1% of Nepal is covered by forests and 29.83% by agriculture. Patch and edge forests constituting 23.4% of national forest cover revealed proximate biotic interferences over the forests. Core forests constituted 79.3% of forests of Protected areas where as 63% of area was under core forests in the outside protected area. Physiographic regions wise forest fragmentation analysis revealed specific conservation requirements for productive hill and mid mountain regions. Comparative analysis with Landsat TM based global land cover product showed difference of the order of 30-60% among different land cover classes stressing the need for significant improvements for national level adoption. The online web based land cover validation tool is developed for continual improvement of land cover product. The potential use of the data set for national and regional level sustainable land use planning strategies and meeting several global commitments also highlighted.

Decadal land cover change dynamics in Bhutan.

Land cover (LC) is one of the most important and easily detectable indicators of change in ecosystem services and livelihood support systems. This paper describes the decadal dynamics in LC changes at national and sub-national level in Bhutan derived by applying object-based image analysis (OBIA) techniques to 1990, 2000, and 2010 Landsat (30 m spatial resolution) data. Ten LC classes were defined in order to give a harmonized legend land cover classification system (LCCS). An accuracy of 83% was achieved for LC-2010 as determined from spot analysis using very high resolution satellite data from Google Earth Pro and limited field verification. At the national level, overall forest increased from 25,558 to 26,732 km(2) between 1990 and 2010, equivalent to an average annual growth rate of 59 km(2)/year (0.22%). There was an overall reduction in grassland, shrubland, and barren area, but the observations were highly dependent on time of acquisition of the satellite data and climatic conditions. The greatest change from non-forest to forest (277 km(2)) was in Bumthang district, followed by Wangdue Phodrang and Trashigang, with the least (1 km(2)) in Tsirang. Forest and scrub forest covers close to 75% of the land area of Bhutan, and just over half of the total area (51%) has some form of conservation status. This study indicates that numerous applications and analyses can be carried out to support improved land cover and land use (LCLU) management. It will be possible to replicate this study in the future as comparable new satellite data is scheduled to become available.