Reliability of landmark identification among orthodontic residents using traditional and indirect digital cephalometry

To determine the inter examiner reliability of landmark identification among Orthodontic Residents using Traditional and Indirect Digital Cephalometry and to determine the intra examiner reliability of landmark identification. A cross-sectional study of six months duration done at Orthodontics Department of KMDC. One conventional Lateral Cephalometric radiograph was randomly selected. Study subjects were 8 residents with mean age was 28.8 years, with a range of 27.5 to 31 years. Cephalometeric tracing was done and landmarks S or Sella, N or Nasion A or Point A, B or Point B, Pog or Pogonion, Gn or Gnathion, Go or Gonion, Me or Menton, Or or Orbitale, Ba or Basion, API or apex of upper incisor, APT or apex of lower incisor were identified using traditional method by an Orthodontic consultant and then tracing was scanned and digitized to obtain the Indirect Digital Cepha image. The same cepha was asked to trace by all 8 study subjects. Kappa statistics was applied to see the agreement between the residents for landmarks identification in conventional and indirect digital cephalograph. Results: The study subjects were 8 orthodontic residents [3 males and 5 females]. Residents had excellent agreement for landmark identification on the conventional and the indirect digital cephalogram. The value of agreement for inter-examiner and intra-examiner reliability was found to be 0.80 [CI: 0.71, 0.89] and 0.83 [CI: 0.79, 0.87] respectively. The reliability of landmark identification was good among residents for both the conventional and the indirect digital cephalometery

Frequency of class-III malocclusion reported in dental OPD, Karachi medical dental college

To determine the frequency of Class-III malocclusion reported Orthodontic department in Karachi Medical Dental College, Pakistan. It was a cross sectional study of orthodontic patients. With convenience sampling a total of 384 patients [267 girls, 117 boys] referred to the Department of Orthodontics, Karachi Medical Dental College, were evaluated in this study. The mean age of the patients was 11.86 +/- 3.16 years. There malocclusion were classified from I, II [Div-1 and Div-2 with sub division right and left], and III, and recorded according to angle classifications. Class-III malocclusion was the least common malocclusion present in the major category of malocclusion and found 8.1% of the samples. Class-III malocclusion requires very early treatment then class-II and Class I malocclusion and has totally reverse treatment philosophy. Having the lower frequency of Class-III malocclusion in the population makes doctor to focus more in later age group and puts less burden on health resources as more patients of Class-II and I can be treated using the same resources. The type of malocclusion, also an important factor that affects a patient's motivation to seek treatment

Diagnosis and evaluation of Crouzon syndrome

Crouzon syndrome is an autosomal dominant condition characterized by craniosynostosis with associated dentofacial anomalies. This report describes the different clinical features in two affected individuals of different families with particularn reference to characteristic findings of this syndrome

Position of canine in the maxillary and mandibular arches

To determine the position of canine in the maxillary and mandibular arches. Cross-sectional analytical Setting: Orthodontic department, Karachi Medical and Dental College. The study was completed in 6 months. 200 patients were included in our study out of which females were138. The subjects were selected on non-probable, purposive technique. Inclusion criteria was patients not orthodontically treated previously, having symmetric arches of either sex between 14years and 25years having adult dentition. Patients exhibiting incisal or cuspal attrition, fractures of teeth or ectopically erupted teeth, having mixed dentition, with anomalies of tooth size e.g. micro dontia, macrodontia, peg laterals etc. were excluded. Patients with anomalies of tooth number e.g. hyperdontia, hypodontia were also not included in this study. Position of canine in the arch were determined on the scanned image of the occlusal surface of the patients casts. For both maxillary and mandibular arches, with-in the arch group showed significant values. In our study, the second most frequent position of canine in the maxillary arch was labial [15% of the total sample]. In the mandibular arch the second most position of canine was also labial. [30% of the total sample]. In the maxillary arch, 85% of the casts showed canine with-in the arch [P< .001]. In the mandibular arch, 65% of the casts showed canine with-in the arch [P< .001]. In our study we found the canine with-in the arch in significant number in both maxilla and mandible

Best fit prefabricated arch

To determine the best-fit arch wires using the 3M MBT arch wire system Cross-sectional analytical Setting: Orthodontic department, Karachi Medical and Dental College. Best-fit arch wire was determined by superimposing scanned image of the occlusal surface of the patients casts and the three different arch wires [orthoform I, II and III]. Two hundred patients were enrolled. In the maxillary arch, none of the arch wires fits best by both cuspid and maximum number of teeth methods [69% and 81%] [P<.001]. In the mandibular arch, arch wire fits best by cuspid method is Orthoform I [35%] and Orthoform III [53%] according to maximum number of teeth method [P<.001]. It was concluded that when treating Pakistani patients, one should expect to use tapered arch forms in a significant percentage of patients. The current preformed NiTi wires are too wide for many patients and should be modified when these patients are being treated

Bolton tooth size discrepancies among different malocclusion groups

One of the goals in comprehensive orthodontic treatment is to obtain an optimal final occlusion, overbite and overjet. It is the descriptive, cross sectional study conducted in orthodontic department of KMDC. Sampling methods was non probability convenient. Sample sizes were 55 patients. Age ranges between 12 to 23 years old. In the current study the men of anterior and overall ratio for class I malocclusion were similar to those of Bolton figures when comparing the mean tooth size ratio for these malocclusion group. It was found that class III> class II> class I for the overall anterior ratio. In the orthodontics treatment during diagnostics phase Bolton analysis should be used for the initial diagnostics and for treatment planning. In our study the mean and overall ratio for class I malocclusion similar to Bolton, no statistical difference were found among different malocclusion groups

Comparison of condylar positions in centric relation and centric occlusion in pre-treatment malocclusion cases

To compare the centric relation-centric occlusion discrepancy in Angle's class II and class III with Angle's class I malocclusion cases in sagittal [antero-posterior] plane as determined by the difference in the overjet. Comparative; cross-sectional study Orthodontic Outpatient Department, Karachi Medical and Dental College, from June 2003- August 2004. Patients were divided into 3 groups according to the Angle's classification. Leaf gauges were employed for muscle deprogramming. Bimanual manipulation technique was used to guide the mandible in to centric relation. Softened red modeling wax was used to obtain the centric bite registration. The study casts were trimmed in centric relation using bite registration. Overjet was recorded in centric relation and centric occlusion by dial caliper on casts. The overjet values for centric relation-centric occlusion discrepancy were highly significant for Angle's class II [pvalue 0.002] and Angle's class III [p-value 0.005] when compared with Angle's class I malocclusion. Centric relation-centric occlusion discrepancy can occur in any dental class regardless of age and gender. However, especial emphasis should be given to Angle's class II and III [with functional shift] cases when evaluating any orthodontic patient

Relation between centric slide and angle's classification

To compare the difference in sagittal cephalometric analysis in centric occlusion [CO] and in centric relation [CR], among Angle's classes i.e. class I, class II, and class III. Comparative, cross-sectional study. Orthodontic Outpatient Department, Karachi Medical and Dental College, Karachi, from July 2003 to December 2004. Eighty pre-treatment orthodontic patients were divided into 3 groups according to Angle's classification. The first lateral cephalogram was taken in CO. Then leaf gauges were placed in between incisors for deprogramming. The second cephalogram was taken with leaf gauges in place to obtain centric relation. Both the radiographs were traced. Angle ANB was measured for sagittal analysis. ANB angle compares the position of mandible with the maxilla relating it with the cranial base. Angles from both cephalograms were compared with each other. Significant difference [p<0.0001] was found in values of ANB in CO [2.93° +/- 3.7] and CR [4.88° +/- 3.4] cephalograms. Significant CO-CR discrepancy was found [p<0.05] in Angle's class III patients [3.05° +/- 0.55] in comparison to Angle's class I [1.96° +/- 0.94] and class II [1.65° +/- 0.65]. CO-CR discrepancy can occur regardless of Angle's classification. Special emphasis should be given to Angle's class III patients for the centric slide

Sagittal discrepancy in centric Relation and centric occlusion positions in pretreatment orthodontic patients

To compare the centric relation [CR] - centric occlusion [CO] discrepancy in sagittal [antero-posterior] plane as determined by the differences in overjet. Design: Comparative; cross sectional study. Place and Duration: Orthodontic outpatient department, Karachi Medical and Dental College. The study period was 18 months. Subject And Eighty patients were divided into 3 groups according to Angle's classification. Leaf gauges were employed for muscle deprogramming. Bimanual manipulation technique was used to guide the mandible in centric relation. Softened red modeling wax was used to obtain the centric bite registration. The study caste were trimmed in centric relation using bite registration. Overjet was recorded in centric relation and centric occlusion by dial caliper on castes. A statistically p-value

Frequency of malocclusion in a sample taken from Karachi population

To find out the frequency of malocclusion in a sample taken from Karachi population- aged 6-25 yrs.It is an analytical cross sectional study. Malocclusion was clinically examined by using Angle's classification in 1880 OPD subjects out of which 710 were males and 1170 were females malocclusion .Results of this study showed that 75% of the total sample had malocclusion and most common type is Angle's class I malocclusion [59.4%] Malocclusion has a high prevalence in our society. Angles class I is most prevalent among all age groups

Mixed dentition analysis for Pakistani population

To examine the applicability of the Tanaka and Johnston method of prediction and to find the significant difference in Pakistani population. Comparative cross sectional study. Place and Duration: The study was conducted at Karachi Medical and Dental College, Karachi, from September 2001 to September 2003. The 300 study dental plaster casts of Pakistani subjects under the age of 21 years, who presented with complete eruption of permanent mandibular incisors, canines and premolars, as well as maxillary canines and premolars were measured. The measuring device was a modified Boley's gauge. The sampling technique was non-probability with a comparative. study design. Statistical analysis was made by using SPSS version-10. Descriptive statistics was used for data presentation. Students t- test and test of linear correlation was used for testing the null hypothesis. Level significance was taken at p<0.000. The difference between the predicted widths of the canine and premolars with the Tanaka and Johnston equations and the actual widths were highly significant in the statistical sense, indicated by t test. The actual widths of the maxillary and mandibular canine and premolars showed a significant difference in size [p < 0.000] from the widths predicted by the Tanaka and Johnston method. The data illustrates the limitation of Tanaka and Johnston method when applied to our population. The Tanaka and Johnston prediction method does not accurately predict the mesiodistal diameters of unerupted canines and premolars in Pakistani population

Leveling with continuous archwires and its effect on mandibular arch length in extraction and non-extraction cases

To compare the mandibular arch length changes during leveling of curve of Spee in extraction and non-extraction cases. Study Design: Quasi-experimental, interventional. Setting: Orthodontic department, Karachi Medical and Dental College Subjects: Forty cases were divided into extraction and non-extraction group. Depth of curve of Spee and arch length were measured on 40 pretreatment and post-treatment plaster models with the help of sharpened Boley gauge. The arch length proved to be significantly different [P<.022] between extraction and non-extraction cases. During leveling of curve of Spee the mandibular arch length in nonextraction cases significantly increased than in extraction cases