Interobserver and Intraobserver Reliability of Cephalometric Measurements Performed on Smartphone-Based Application and Computer-Based Imaging Software: A Comparative Study.

Objective: The aim was to compare the reliability of cephalometric analysis using a smartphone-based application with conventional computer-based imaging software. Methods: Pre-treatment cephalometric radiographs of 50 subjects (26 males, 24 females; mean age, 19.2 years; ±4.2) were traced using the OneCeph® application and Dolphin imaging software®. Two independent observers identified seventeen landmarks and measured fourteen cephalometric measurements at an interval of. Interobserver and intraobserver reliability were evaluated using the intraclass correlation coefficient. Student's t-test was used to compare the means of two measurement methods for observer 1 and observer 2. Additionally, the time taken to complete the cephalometric measurements was also compared between the two methods. Results: Good (ICC 0.75-0.90) to excellent (ICC 0.90-1.00) interobserver and intraobserver reliability was observed for all hard and soft tissue measurements with both methods. No significant differences were found between the two measurement methods for both observers (p<0.05). OneCeph application took significantly more time to complete the analysis than Dolphin imaging software (p<0.001). Conclusion: Cephalometric measurements made through a smartphone-based application showed good to excellent interobserver and intraobserver reliability and are comparable with the computer-based software. Therefore, it can be recommended for clinical use. The time taken to complete the cephalometric measurements was more with a smartphone-based application (OneCeph application) compared to computer-based software (Dolphin imaging software).

Rate and anchorage loss during en-masse retraction between friction and frictionless mechanics: A randomized clinical trial.

OBJECTIVE: To compare rate and anchorage loss during en-masse retraction of anterior maxillary teeth between friction mechanics (FM) and frictionless mechanics (FLM). SETTING AND SAMPLE POPULATION: Thirty-eight patients requiring en-masse retraction of protruded anterior maxillary teeth were randomly allocated into FM and FLM groups. METHODS: En-masse retraction with sliding mechanics (FM) using an elastomeric chain was compared with continuous mushroom loop archwire mechanics (FLM). Study models and lateral cephalograms were taken before (T1) and immediately after retraction (T2). The primary outcome was the rate of en-masse retraction. Anchorage loss was the secondary outcome. Intergroup comparison was performed using an independent t test (P < .05). RESULTS: Baseline characteristics were similar between groups. Thirty-six patients completed the trial. Two patients were lost to follow-up in the FLM group. The rate of en-masse retraction did not differ significantly (P = .625) between FM (0.7 mm/mo) and FLM (0.8 mm/mo) groups. The intragroup comparison showed significant anchorage loss in FM (2.28 mm) and FLM (1.13 mm) groups; however, the intergroup comparison showed no statistically significant difference (P = .093). Maxillary first molar showed a statistically significant change in angulation between the two mechanic groups (P < .001). Vertical movement of the maxillary incisor and first molar showed no significant difference between FM and FLM groups (P = .143, P = .546, respectively). CONCLUSIONS: The rate of en-masse retraction and anchorage loss was comparable between the FM and FLM groups. Significant anchorage loss was seen with both mechanics. The result suggests that both the mechanic group require external reinforcement to prevent anchorage loss.

Comparative assessment of cephalometric with its analogous photographic variables.

Objective: The purpose of this study was to evaluate the accuracy of photographic measurements and compare it with its analogous cephalometric variables. Materials and Methods: Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 120 subjects (92 females, 28 males; age 12-22 years with mean age of 17.5 years). A total of 4 linear and 7 angular measurements along with 3 ratios analogous to one another were measured on both. Descriptive statistics for all measurements were computed. Pearson's correlation coefficients were computed between analogous measurements, and regression analysis was done for each variable measured on the photograph to accurately predict the cephalometric variable. Results: The reliability of the standardized photographic technique was satisfactory. Most photographic measurements showed highly significant correlations (P < 0.001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric (r2= 0.35). The Frankfort-mandibular plane angle' angle showed best results for vertical assessment (r2= 0.81) along with anterior face height (AFH) and lower anterior facial height (r2= 0.859) and ratio lower posterior facial height/AFH (r2= 0.702). Conclusions: Although we cannot rule out lateral cephalogram as the primary record in orthodontics, photographic assessment can always be used through proper standardization, as an alternative diagnostic aid, and also for large-scale epidemiological purposes and places with unavailability of cephalostat.

Nasal changes in different age groups.

OBJECTIVE: The objective of this study was to evaluate nasal changes in different age groups and to detect gender difference in nasal dimensions. MATERIALS AND METHODS: Clinical measurement and profile photographic records of 279 randomly selected subjects were obtained for the evaluation of nasal changes. Thirty-nine subjects were excluded, and the final sample consisted of 240 subjects. The subjects were divided into four groups by age: Group 1 (16-20 years), Group 2 (21-30 years), Group 3 (31-40 years), and Group 4 (41-50 years). Each group was further subdivided on the basis of gender. Data were collected and analyzed by two-way multivariate analysis of variance with Duncan's multiple range post hoc test. RESULTS: In both males and females, nasal height and breadth increased with except nasal index and nasolabial angle. More nasal changes were seen in males as compared to females of the same age group. CONCLUSIONS: Nonconsistent age-related changes were found for nasal index and nasolabial angle. The rest of the nasal parameters increased with age and differ between the genders. Larger nasal changes were seen in males as compared to females of the same age group.

Management of a Patient with Impacted Maxillary Canine, Peg-Shaped Lateral Incisors and Transmigrated Mandibular Canine: A Case Report.

To treat morphological abnormalities, impaction, and severe malposition of the teeth, the lateral incisors are sometimes extracted, followed by orthodontic space closure. This procedure often requires special consideration, not only with regard to esthetics but also for functional issues. However, thusfar, few reports that have performed a functional evaluation in such cases. The purpose of this article is to report the successful treatment of a 23 year-old male patient with the complaint of irregular placement and abnormal shape of his teeth. The patient had an impacted maxillary unilateral left canine, peg shaped lateral incisor, and transmigrated mandibular canine. Patient was treated with extraction of the upper lateral incisors and eruption of the impacted canines was guided to the place of the lateral incisor and extraction of the transmigrated mandibular canine.

Single Wire with Helices to Guide Different Labially Impacted Canine Eruption -Technique Clinic.

Impacted canines vary greatly in the inclination and location and can lead to resorption of neighboring teeth depending on their location. Occasionally labial impaction of the maxillary canine may occur over the maxillary lateral incisor, over the first premolar, and sometimes over the alveolus in between the lateral incisor and premolar. In this article, we will discuss a multipurpose single wire with 3 helices or 2 helices to guide the labially impacted canine, positioned in different inclinations and located differently on the labial side, so as to provide traction force in proper direction.

Modified Transpalatal Arch (m-TPA) for Vertical Control and Anchorage.

Transpalatal arch (TPA) is commonly used, but it has some limitations; like, it can be used as an anchorage appliance in extraction cases with minimal to moderate anchorage requirement, but, for maximum anchorage cases TPA needs to be supported by extraoral traction. In cases where expansion greater than 1-2 mm is required, other expansion appliances seem to be more efficient. To overcome the drawbacks of TPA we designed modified transpalatal arch (m-TPA) for various purpose.

Bolton ratio in a North Indian population with different malocclusions.

OBJECTIVE: The objective was to evaluate the Bolton ratio in a North Indian population in Lucknow with different malocclusion. MATERIALS AND METHODS: Totally, 110 study cast [Age: Female (14.2 ± 1.5 years, Male (13.9 ± 2.3 years)] were taken from the patients undergoing orthodontic treatment and Subjects were divided into three groups: Group I (Angle's Class I, n = 40), Group II (Angle's Class II, n = 50) and Group III (Angle's Class III, n = 20) according Angle's classification of malocclusion. The mesiodistal widths of all maxillary and mandibular teeth from right first molar to left first molar were measured with a digital caliper to calculate the Bolton ratio. The readings were then used to compute the anterior and total Bolton ratios. ANOVA and Tukey's test were used for the statistical analysis. RESULTS: A mean total Bolton ratio of 91.36 ± 2.13 and a mean anterior Bolton ratio of 78.14 ± 4.09 were found for the sample, Significantly higher mean anterior tooth ratios were found for Group II (Angle's Class II) patients (P < 0.01). All other ratios were within close range of Bolton's norms. CONCLUSIONS: Angle's Class II patients showed a tendency toward wider mesiodistal widths of teeth in the mandibular anterior region or smaller tooth sizes in the maxillary anterior region.

Cephalometric norms for the upper airway in a healthy North Indian population.

OBJECTIVE: The aim was to obtain normative data for cephalometric measurements of the upper airway in the North Indian population. DESIGN: Observational study. SETTING: University department and teaching hospital out-patient clinic. SUBJECTS AND METHODS: A total of 180 healthy patients were included out of which 90 were males (age range, 8-16 years), and 90 were females (age range, 8-16 years), with normal skeletal facial profile, no history of snoring, sleep apnea, upper airway disease, tonsillectomy or adenoidectomy, obesity, or pathology in the pharynx. Twenty cephalometric airway measurements, including size of the tongue, soft palate, nasopharynx, oropharynx, hypopharynx, and relative position of the hyoid bone and valleculae were obtained. Landmarks on cephalometric radiographs were digitized and measurements were made using a specially designed computer program. Error analysis of measurements was performed and comparison of measurements according to sex was made. RESULTS: Significant sex dimorphism was seen for the majority of measurements, with the exception of minimal depth of the airway, oropharyngeal depth of the airway, and the soft palate angle with the hard palate. CONCLUSION: A minimum sagittal dimension of the upper airway was evident despite differences in measurements between sexes. Findings from this study should be a useful reference for the assessment of sleep apnea in the North Indian population.

Synergistic Approach with Twin Block and Fixed Appliance Therapy in Class II Div 2 Malocclusion: A Case Report.

This case report describes the orthodontic treatment of a male, aged 13.2 years, with permanent aentition, sagittal skeletal Class II division 2 malocclusion. His chiefcompliant was the position of the maxillary incisors, displaced too palatally, and an impaired facial profile. Twin block and 0.022 x 0.028 inch pre-adjusted-edge wise appliance, were used to correct the sagittal discrepancy and to improve the attractiveness of the impaired facial profile. The total treatment duration was decreased with the use of synergistic approach.

Correction of a Overjet and Overbite In Class II Division 1 Malocclusion Using Twin Block Appliance Therapy: A Case Report.

Class II division 1 malocclusion is the most common malocclusion. It shows specific clinical characteristics such as large overiet and deep overbite resulting in a soft tissue profile imbalance. Majority of the patients with class II division 1 malocclusions have an underlying skeletal discrepancy between the maxilla and mandible. The treatment of skeletal class II division 1 malocclusion is done taking into consideration the age, growth potential, severity of malocclusion, and compliance of patient with treatment. Myofunctional appliances can be successfully used to treat growing patients with class II division 1 malocclusion. This article presents a discussion on successful treatment of class II division 1 malocclusion with growth modification approach using twin block appliances.

A newer simultaneous space creation, eruption, and adjacent root control spring for the management of impacted tooth.

USUALLY, TREATMENT OF IMPACTION INCLUDES: Welcome preparation (to create space), surgical exposure and attachment to the impacted tooth and the orthodontic guidance for the eruption of the impacted tooth. Sometimes, due to deficiency of space, creation of space for impacted tooth requires first, and space regaining efforts may require the distal movement of posterior teeth and or mesial movement of anterior teeth in the arch, but it may create some problems. To overcome the unwanted problem in this clinical situation and to reduce overall treatment duration of the patient, we have developed the Simultaneous space creation, Eruption and Adjacent root control spring to control crown as well as root movement.

Alignment of palatally impacted canine with open window technique and modified K-9 spring.

The patient was an 18-year-old female who had an Angle Class I malocclusion with a left palatally impacted maxillary canine. The orthodontic treatment of a palatally impacted canine is aimed at bringing the tooth into its correct position in the dental arch without causing any periodontal damage. To achieve this goal, a variety of surgical and orthodontic techniques have been proposed in relation to the position of the impacted tooth and there are various treatment methods used for traction. The duration of the traction was 3 months and alignment duration was 12 months the total treatment time was 15 months. In the following case, we presented that maxillary palatally impacted canine was brought into the arch with open window method for canine exposure and modified K-9 spring for traction, that is simple spring for orthodontic traction of the palatally impacted canines.