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.

Mean Mesiodistal Width of Canine in Patients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The measurement of the teeth is one of the most reliable method of identification. The teeth represent the most durable, resilient, and chemically stable part of the skeleton. The comparison of tooth dimensions is one of the tools of sex determination. Canines, in particular, are found to have the greatest degree of sexual dimorphism. The aim of the study was to determine the mean mesiodistal width of canines in patients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was done among patients visiting a tertiary care centre from 25 August 2021 to 28 December 2021. The ethical approval was taken from the Institutional Review Committee [Reference number: 61 (6-11)E2 078/079]. The maximum mesiodistal width of the permanent maxillary canine was measured by a digital vernier caliper. The formula given by Garn and Len was used to calculate sexual dimorphism. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 104 maxillary casts studied, the mean mesiodistal width of the maxillary canine was 7.85±0.45 mm (7.76-7.93, 95% Confidence Interval). The mean mesiodistal width of the right maxillary canine in males and females were 7.90±0.48 mm and 7.83±0.45 mm respectively and that of the left maxillary canines in males and females were 7.92±0.44 mm and 7.75±0.45 mm respectively. The sexual dimorphism in the right and left maxillary canine was seen in 10 (0.96%) and 22 (2.12%) respectively. Conclusions: The mean mesiodistal width of the maxillary canine was similar to other studies done in similar settings. Keywords: canine teeth; maxillary bone; sexual dimorphism.

A randomized controlled trial to evaluate the effectiveness of different methods on pain management during orthodontic debonding.

BACKGROUND: Orthodontic treatment procedures like separator placement, archwire placement, orthodontic force application, miniscrew placement and debonding procedure usually involve pain and discomfort. Pain perception and methods to reduce pain during debonding in regard to gender and different locations of oral cavity is still a poorly documented issue in orthodontics. The aim of this study was to evaluate the effectiveness of different methods on pain management during debonding and its association with gender and location. MATERIALS AND METHODS: One hundred and forty orthodontic patients in the stage of debonding were randomly assigned into four groups according to different methods used during debonding; Group A: Medication group (Paracetamol given 1 h before debonding), Group B: Finger pressure group, Group C: Stress relief group and Group D: Control group. A visual analog scale (VAS) was used to assess the pain intensity just after debonding for each sextant. RESULTS: Among 140 participants, 61 (43.57%) were males and 79 (56.43%) were females. Differences in VAS score in different areas of oral cavity among all groups were found to be significant (p < 0.05). Total VAS score was greater in control group (16.67) followed by stress relief group (13.33) and finger pressure group (10) and least in medication group (8.33). The VAS score was higher in the upper front and lower front sextants in all the groups. Females reported higher VAS score and in upper front sextant, it showed significant difference (p = 0.018). On comparison, total VAS scores were statistically significant difference in medication-stress relief arm pair (p = 0.009), medication-control arm pair (p < 0.001) and finger pressure-control arm pair (0.002). The total VAS score comparison between medication-finger pressure arm was not significant (p = 0.172). CONCLUSIONS: Pain perceived during debonding varies in different areas of oral cavity among all the groups. Anterior area of oral cavity and female seems to be more sensitive to pain. Use of finger pressure can be used effectively for pain management during debonding.

Association between Hypodontia and Angle's Malocclusions among Orthodontic Patients in Kathmandu, Nepal.

Background: Disturbances during the early tooth development stages may result in the congenital absence of teeth. The purpose of this study was to assess the relationship between hypodontia and Angle's malocclusions. Materials and Methods: The sample comprised 601 orthodontic patients' pretreatment records (242 men and 259 women), selected from the achieved orthodontic records. Developmental anomalies of teeth affecting the number were examined on dental panoramic radiographs. Based on Angle's classification, pretreatment dental casts were assessed and classified into different classes of malocclusion. The relationship between hypodontia and different classes of malocclusion was evaluated using the chi-square test. Results: The prevalence of tooth agenesis was 7.48%, that is, 45 out of 601 samples. There were a total of 72 (0.42%) missing teeth, excluding the third molars. The most frequent missing tooth was the maxillary lateral incisor (35, 48.61%), followed by the mandibular lateral incisor (14, 19.44%), the mandibular central incisor (6, 8.33%), the mandibular second premolar (5, 6.294%), and the maxillary second premolar (4, 5.55%). Hypodontia was more common in the upper jaw. Although hypodontia was mostly seen in Class I malocclusion patients (7.87%), followed by Class II malocclusion patients (6.99%) and least in Class III malocclusion patients. However, there was no significant difference in hypodontia among different classes of malocclusions (p = 0.352). Conclusion: The most frequently missing tooth was the maxillary lateral incisor, followed by lateral and central mandibular incisors and mandibular second premolars, while excluding the third molars. The present study did not find any association between various types of malocclusions and hypodontia.

The Morphological Variation of the Soft Palate in Hospital Visiting Patients.

BACKGROUND: The soft palate anatomy of individuals can have a range of morphologies. Cephalometric analysis is a low-cost approach to analyze the soft palate in patients with or without developmental abnormalities. METHODS: The lateral cephalogram of the patients visiting Tribhuvan University Teaching Hospital, Institute of Medicine for various dental treatment purposes was evaluated. The soft palate was delineated on the radiographs by sketching the soft palate's contour along its radiolucent outline using the curve lines and connectors of Microsoft PowerPoint. The soft palate was then categorized according to the study by You M et al. Results: The different types of soft palate morphology observed in the study were rat tail (42.4%), leaf-like (40.8%), butt-like shape (8.9%), straight-line (4.7%), s-shaped (1.9%), and crooked (0.9%). The males had rat-tail (44.4%), leaf-like (41.1%), butt-like shape (8.4%), straight-line (3.9%), s-shaped (1.3%), and crooked (0.6%), whereas the females had rat-tail like (40.6%), leaf-like (40.6%), butt-like shape (9.5%), straight-line (5.6%), s-shaped (2.5%), and crooked (1.2%) types of soft palate. CONCLUSIONS: The rat-tail form of the soft palate was the most prevalent, followed by the leaf-like in both sexes. The least common type was the crooked form. This study found no evidence of sexual dimorphism.

Orthodontic Space Closure of a Missing Maxillary Lateral Incisor Followed by Canine Lateralization.

Maxillary lateral incisor agenesis is the most prevalent developmental dental anomaly. The management of missing lateral incisor was either closure using canine as substitution or creation of space orthodontically for prosthetic replacement. A careful diagnosis and treatment plan are deemed essential to address the patient's needs as the spacing is present in the esthetic region. Such problem is very challenging for orthodontists, prosthodontists, and general practitioners. This case report describes the orthodontic management of a 22-year-old adult female patient with missing upper left lateral incisor tooth and upper anterior spacing by closing the space with canine lateralization and reshaping to simulate it with the lateral incisor. However, some modifications in the treatment mechanics are crucial to achieve the optimal esthetic and to improve the occlusion. Space closure with canine lateralization option seems less invasive, treatment can be completed relatively in a short period of time, and its adaptation with the facial changes throughout life without having artificial prosthesis provided other factors favoring for this option.

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.