Interarch Traction Strategy for Palatal Cuspid Impactions.

AIM AND OBJECTIVE: To disimpact a palatally impacted canine using a novel, compliance-dependent technique. BACKGROUND: Orthodontic traction of palatally impacted teeth warrants careful mechanical strategies to avoid complications that include r oot damage to adjacent teeth and r esorptions. Sound biomechanical control to avoid these side effects is considered paramount in planning the traction. TECHNIQUE: The palatally impacted canine was pulled into the arch with the aid of a modified power arm on the exposed canine and a miniscrew on the lower arch. CONCLUSION: The impacted canine was successfully brought into occlusion within 11 months. CLINICAL SIGNIFICANCE: This paper highlights the use of a simple strategy using interarch mechanics and temporary anchorage devices (TADs) to aid in the safe mechanical eruption of impacted palatal canines without the need to bend complex wire designs.

Orthodontic exposure of multiple lmpactions: a case report.

There are rare cases of impacted permanent central incisors with dilacerations, a dental deformity characterized by pronounced angulations of the longitudinal tooth axis. Impaction of maxillary canines is an orthodontic anomaly that causes facial and dentoalveolar system problems, both functional and esthetic. A combination of surgery and orthodontics is important in bringing impacted teeth to their ideal position in the dental arch. This is a case report of a 10-year-old patient with impacted and dilacerated right central incisor and impacted left maxillary canine, following surgical exposure and appropriate orthodontic traction, the impacted teeth were surgically exposed and aligned into the dental arch.

Activated omega loops for anterior crossbite correction in transitional dentition.

Key Clinical Message: Several approaches can correct pseudo-Class III anterior crossbite. 2 × 4 appliance, compressed open-coil springs, Class III elastics, etc. All cause either soft tissue lacerations, smile line flattening, or upper incisor overproclination. This paper describes a novel method to tip lower incisors into a normal overjet without compromising the upper dentition. Abstract: In pseudo-class III cases, a "two by four" multibracketed appliance has been utilized to put the incisors into a typical overjet during transitional dentition. Compressing a rectangular super elastic archwire creates continuous force, but its length restricts activation and risks cheek impingement. Open-coil springs on rigid archwires advance incisors labially, although a 4-5 mm of wire distal to the molar tube may injure soft tissue. Reciprocally anchored Class III intermaxillary elastics restore anterior overjet through lower incisor lingual tipping and upper incisor proclination. Class III elastics extrude maxillary molars and mandibular incisors, rotating the dental occlusal plane counterclockwise and reducing maxillary incisor exposure and aesthetics. A unique method is reported in this report to tip the lower incisors back into normal overjet without affecting the upper dentition.

Interdisciplinary orthodontics-implants management of a challenging hypodontia case complicated by a class II division 2, bimaxillary retroclination.

INTRODUCTION: The case in this study had moderate hypodontia, with both lower lateral incisors and the lower-left second premolar missing. A Class II division 2 relationship with severe crowding in the upper arch and a traumatic deep bite over a skeletal I base complicated the occlusion. MATERIALS AND METHODS: The plan was to extract the upper first premolars to relieve upper arch crowding and the lower-left impacted second premolar to preserve the bilateral class I molar relationship. A class I occlusal relationship was achieved through space opening in the lower lateral incisors region and space closure in the upper and lower premolars regions. RESULTS: The use of orthodontic screws for bite opening and anterior segment retraction, in conjunction with bi-metric slot size selection in bracket prescription, was effective in controlling incisor inclination and interincisal angle. The use of an implant fixture before beginning the finishing stage allowed for a reduction in total treatment time and facilitated the provision of the final prosthesis before debonding the case. As a result, the patient was able to receive a satisfactory occlusion on the day of debonding. CONCLUSION: This case of moderate hypodontia was successfully resolved by combining space closure and space opening effectively. To solve the arch problems in such Class II division 2 cases with severe crowding, extractions were required. To complete the case, this was combined with intrusive and retractive mechanics. In hypodontia cases, implants are an excellent choice for both aesthetics and functional restoration.

Alveolar bone exostoses following orthodontic treatment. Diagnostic considerations and clinical management.

Alveolar bone exostoses (ABE) are benign localized convex outgrowths of buccal or lingual bone, which could be delineated from the surrounding cortical plate, also known as a buttress bone formation. Our review and case series demonstrate the development of alveolar bone exostoses during orthodontic therapy. It is crucial to keep in mind that every case presented had a history of palatal tori. In our clinical observations, higher precedence of ABE development was seen in participants during incisor retraction, especially with preexisting palatal tori. Additionally, we have successfully demonstrated surgical techniques to eliminate ABE in the event that self-remission does not occur once orthodontic forces are discontinued.

Calcium Channel Blockers Induced Gingival Overgrowth: A Comprehensive Review from a Dental Perspective.

Background: Gingival overgrowth (GO) as a manifestation of calcium channel blockers (CCBs) was first introduced in the literature by Ramon et al. in 1984. Since then, the use of CCBs as a treatment modality for hypertension has been recorded extensively in the literature for its association with GO. Aim: The aim of our study is to evaluate histopathology, treatment, and follow-up for the cases detailed in various studies and also to highlight the protocol mentioned to identify these presentations. Materials and Methods: A broad search was conducted from the period 1980 to 2021 using electronic databases PubMed Central, Scopus, Cochrane, and SciELO databases. About 293 articles were initially chosen. The articles further excluded did not fit the criteria for the study and eventually 50 articles which met the inclusion criteria were chosen as part of this literature review. Results: A comparative analysis was carried out regarding histopathology, treatment modalities, drug dosage, and duration to evaluate the differences in cases between 1980 and 2021. From the available studies, it was found that the histopathological and clinical findings were varied. Treatment strategies employed were different, though follow-ups in most cases were uniform. Conclusion: CCBs and their relationship with GO have been widely reported in the literature. Dentists should approach this condition by taking appropriate medical and dental history and follow evidence-based treatment guidelines to provide more relevant and judicious management of this condition. Inter-disciplinary treatment approaches would provide better outcomes.

Correction of anterior open bite of varying severity using clear aligner therapy-A case series.

In open bite cases, a comprehensive diagnostic differentiation is crucial in determining the best corrective therapy. In non-surgical open bite treatment, fixed appliances, either labial or lingual, are usually employed. With the addition of extra-radicular screws, more sophisticated orthodontic movements may now be performed without the necessity for orthognathic surgery. Clear aligner therapy, on the contrary, has grown in popularity as a treatment option for more complex cases, such as open bite malocclusions. This article discusses three cases with an anterior open bite that were treated using various mechanics as dictated by the malocclusion. Case 1 was addressed wholly using clear aligner therapy, with careful consideration of attachment geometry and mechanics. Case 2 with clear aligner therapy, attachment geometry selection, and vertical elastics; and Case 3 with clear aligner therapy, attachments, and temporary anchorage devices.

The cell phone quandary.

Cell phones are used by almost everyone and have become an integral part of our daily life. They are an almost universal instrument for gathering and transmitting information. The amount of bacteria crawling on a typical cell phone has been a point of contention, although studies show that they contain at least 10 times the amount of bacteria found on most toilet seats. As medical workers in hospital and clinic settings, we use our cell phones extensively, for paging, texting, calling, and recreational activities; thus, the risk of contamination by pathogens is a legitimate issue. Cell phones in the operating room may give patients the impression that they are not the main priority or the center of care, in addition to being a potential source of infection. Cell phones also have been found to be the number-one productivity killer in workplaces, amongst a long list of other distractions. All workers must be fully aware of their Health Insurance Portability and Accountability Act (HIPAA) compliance responsibilities and obligations, including the protection of health information, while using their cell phones at workplaces. On clinic or hospital grounds, reasonable diligence and strict adherence to cell phone policies may help us maintain greater safety, productivity, and professionalism, resulting in better service for our patients.

The Effects of Additional Filtration on Image Quality and Radiation Dose in Cone Beam CT: An In Vivo Preliminary Investigation.

Purpose: The aim of this study was to investigate the effect of reduced radiation doses on the image quality of cone-beam computed tomography scans and the suitability of such imaging for orthodontics, oral surgery, dental implantology, periodontology, and endodontology. Materials and Methods: Cone-beam computed tomography scans of a live patient were performed using seven attenuation filters with increased thickness to decrease the effective radiation dose from 22.4 to 1.8 µSv, and the effects of different radiation doses on image quality were further analysed. Quantitative image quality was calculated using dedicated measures, such as signal and contrast-to-noise ratio and sharpness. A panel of five certified raters assessed the cone-beam computed tomography scans qualitatively. Nine anatomical structures relevant to dentistry were identified, and the overall acceptance was assessed. Results: Linear reduction of the effective radiation dose had a nonlinear effect on image quality. A 5-fold reduction in the effective dose led to acceptable quantitative and qualitative image quality measures, and the identification rate of dental anatomical structures was 80% or greater. The use of less than 40% of the reference dose was unacceptable for all dental specialties. Conclusions: The ideal radiation dose for specific diagnostic requirements remains a patient-related and specialty-related decision that must be made on an individual basis. Based on the results of this study, it is possible to reduce exposure in selected patients, and at the same time obtain sufficient quality of images for clinical purposes.

The World Wide Web of orthodontics- A comprehensive narrative on teledentistry pertaining to the orthodontics of the 21st century.

Teledentistry has proven effective in practically all dental fields. It also allows access to inaccessible and underdeveloped locations. Better treatment outcomes were documented in patients treated by an orthodontist supervised by teledentistry than by a general dentist with minimal orthodontic experience alone. It may also help to focus referrals to specialists and weed out those who do not need them. But, on a critical note, a doctor-patient relationship is much more than a business transaction. A face-to-face initial consultation instills trust that a remote session cannot. Teledentistry includes professional networking of doctors. This contact includes digital information exchange, CPD programs, case discussions, and analysis that bring dentists from all around the world together to improve patient care. Teledentistry has not only spanned the distance between dentists worldwide, but has also served as a conduit between customer (patient) and manufacturer. This spawned Direct to Consumer (DTC) dentistry, sparking substantial debate among dentists worldwide. In DTC dentistry, inadequately trained customers conduct complex procedures on themselves with minimal guidance of a dentist. One of the major issues today is the general availability of clear aligners to patients without the requirement for an intermediary skilled orthodontist. The American Association of Orthodontists (AAO) has publicly questioned the validity of Smile Direct Club, a private firm that dominates the DTC industry. European Federation of Orthodontic Specialists Association, on the other hand, has sponsored a joint declaration with the representative orthodontic associations in Europe to highlight and alert patients about the potential risks of DTC products. Unfortunately, public shaming hasn't slowed commercialization of DTC firms. Teledentistry has been a boon for healthcare, but a nightmare for our profession, raising fundamental questions like what is the difference between a customer and a patient? Is dentistry a just another discipline of cosmetics? Is teledentistry making us less connected with our patients?