Success rate, treatment duration, and pain perception in the management of palatally impacted canines using the K9 and Ballista spring: a randomized clinical trial.

OBJECTIVES: To evaluate the success rate, treatment duration, and pain perceived during forced eruption of maxillary palatally impacted canines using the K9 and Ballista springs. MATERIALS AND METHODS: Thirty unilateral palatal canine impactions of moderate and difficult category as determined by KPG index (score between 10 and 19) were enrolled. Group 1 comprised canine impactions managed with K9 springs, and Group 2 comprised Ballista springs. Block randomization and opaque sealed envelopes were used for allocation. The success rate and treatment duration (application of force to ligation of the impacted canine into the initial alignment archwire) were recorded. Pain perception was evaluated on a 10-point visual analogue scale (VAS) and modified McGill Pain Questionnaire. Chi-square test and Mann-Whitney U-test were used to compare the groups. RESULTS: The success rate for eruption of palatally impacted canines was 100%. The average treatment duration was 296.13 ± 96.45 days and 311.93 ± 94.34 days, respectively for Group 1 and Group 2. VAS scale scores for pain were greater for Group 2 compared to Group1, and the differences were statistically significant at all time intervals except at T1. The frequency of none and mild pain was significantly greater at all time intervals in both groups. CONCLUSIONS: The impacted canines of moderate and difficult category were erupted with a 100% success rate and similar treatment duration with both interventions. The pain scores of Ballista springs were greater after 24 hours of force application.

Three dimensional changes of maxillary arch in Unilateral cleft lip and palate patients following comprehensive orthodontic treatment on digital study models.

OBJECTIVE: To compare the effects of comprehensive orthodontic treatment on palatal area, volume, inter-canine and inter-molar width in patients with Unilateral Cleft Lip and Palate (UCLP) using scanned models of the maxillary arch. DESIGN: Retrospective cohort study. SETTING: Tertiary setting. PATIENTS: Two hundred and ten plaster study models of 70 patients with Unilateral Cleft Lip and Palate (Study group SG) and Control Group (n = 70) were scanned using Maestro 3D Dental scanner. The study groupwas further divided into subgroups; Subgroup I: treated with orthodontic treatment only (non-surgical), Subgroup II: patientsmanaged with combined orthodontics and orthognathic surgery (either maxillary advancement or maxillary distraction), Subgroup A: age >14 years and Subgroup B: age <14 years. INTERVENTIONS: Comprehensive orthodontic and Orthosurgical treatment. MAIN OUTCOME MEASURES: Pre- and post-treatment scanned maxillary models of the study group were compared for palatal area and volumeand intercanine and intermolar width. The palatal dimensions of post-treatment scanned models were also compared to that of the control group. RESULTS: The Palatal area and volume, intercanine and intermolar width were significantly higher in the post-treatment as compared to pre-treatment study models (P < 0.01). The measurements ofthe maxillary arch were significantly higher in the control group compared to the post-treatment measurements of the study group. The increase in palatal area and volume was greater in Subgroup I and A compared to Subgroup II and B patients, respectively. CONCLUSION: The 3-Dimensional palatal dimensions in UCLP group improved after orthodontic treatment but were still not comparable to the normal subjects. The patients with age >14 years showed more improvement in the maxillary arch.

A custom made extraoral aid for retaining interim obturator in edentulous patients with bilateral maxillectomy: A report of four patients.

It is a considerable challenge for a prosthodontist to rehabilitate and sustain the prosthesis in edentulous patients with bilateral maxillectomy. Compelling evidence is lacking with respect to the treatment outcome when the maxillary defects are closed surgically in comparison to their prosthetic rehabilitation. Four edentulous male patients, with bilateral maxillectomy defects were referred for prosthodontic intervention to meet their nutritional and speech issues. In the absence of intra oral supporting and retentive structures, it was decided to retain the obturator utilizing extraoral aid to address their functional needs. Customized headgear face-bow retained obturators were adequately retentive and did serve its purpose well in all four patients. It also gave the liberty to alter retention and refine the prosthesis at will, provided access to the operated site for a quick evaluation of disease recurrence, and was economical to the patients. Considering the encouraging outcome experienced in this special category of individuals, it would be reasonable to believe that the headgear face-bow assembly has an immense potential to function as a valuable, prudent, and a viable retentive aid for a non-implant retained obturator in edentulous patients with extensive maxillary defect.

Oral health-related quality of life among male subjects with oral submucous fibrosis in a tertiary care hospital.

BACKGROUND: Oral submucous fibrosis is very common in Asia. It has many deleterious effects on individual's oral functions. Thus, there is a need to assess the effect of oral submucous fibrosis on quality of life. OBJECTIVE: To assess the oral health-related quality of life (OHRQoL) in male subjects with oral submucous fibrosis. METHODS: Two hundred and thirty male subjects in the age range of 20-40 years were recruited in the cross-sectional, two-group comparative study. Of 230 male subjects, 115 were oral submucous fibrosis subjects who were included in the study group and 115 healthy subjects formed the control group. English version of the oral health impact profile-14 (OHIP-14) was used to assess the OHRQoL. Wilcoxon signed-rank, Kruskal-Wallis, and Bonferroni tests were applied, and the P = 0.05 was considered as level of significance. RESULTS: The mean and median OHIP-14 scores were 19.10 ± 0.66 and 18.00 in the study group and 3.98 ± 3.80 and 3.00 in the control group subjects, respectively (P < 0.001). Mean score of all the seven domains of OHIP-14 was significantly more in oral submucous fibrosis subjects (P < 0.001). All the oral submucous fibrosis subjects had one or more negative effects on OHRQoL compared to 64.34% of healthy subjects. Stage-4 of the oral submucous fibrosis had maximum effect on quality of life compared to other stages (P < 0.001). CONCLUSIONS: The quality of life among males is severely affected by oral submucous fibrosis, and Stage-4 of oral submucous fibrosis has maximum effect on the quality of life.

PGI Bracket Positioner: A Novel Combination of Reverse Bracket Tweezer and Positioning Gauze.

The accurate bracket positioning is essential for the expression of the bracket system that affects the treatment outcome considerably and is also essential for good functional occlusion as well as facial esthetics. The proper alignment cannot be achieved without proper bracket positioning. Thus, the brackets positioning devices are an integral part of orthodontic armamentarium. Here, we present a new innovation that provides a unique combination of reverse bracket tweezer and positioner and hence is very helpful in precise vertical positioning of brackets with increased efficiency.

Sleeve Push Technique: A Novel Method of Space Gaining.

Space gaining is frequently required in orthodontics. Multiple loops were initially used for space gaining and alignment. The most common used mechanics for space gaining is the use of nickel-titanium open coil springs. The disadvantage of nickel-titanium coil spring is that they cannot be used until the arches are well aligned to receive the stiffer stainless steel wires. Therefore, a new method of gaining space during initial alignment and leveling has been developed and named as sleeve push technique (SPT). The nickel-titanium wires, i.e. 0.012 inches and 0.014 inches along with archwire sleeve (protective tubing) can be used in a modified way to gain space along with alignment. This method helps in gaining space right from day 1 of treatment. The archwire sleeve and nickel-titanium wire in this new SPT act as a mutually synergistic combination and provide the orthodontist with a completely new technique for space opening.

Vanishing Mandible in a 7-year Old Child: Response to Radiation Therapy.

Massive osteolysis in a 7-year old child is a rare condition. The etiology of massive osteolysis is unknown and it results in the progressive destruction of bony structures. There is no standard therapy available in the literature. Conservative treatment is often used for its management. Radiotherapy is considered as an accepted form of treatment with greater chance of success when it is used in the early course of disease. There are few case reports in the literature in which radiotherapy has been used for the treatment. This article highlights the literature update on various treatment modalities and a case managed by radiation therapy.

Management of Developing Skeletal Class III Malocclusion in a Prepubertal Girl with Prognathic Mandible in Late Mixed Dentition.

Treatment of skeletal Class III patients at younger age is highly unpredictable. The patient may respond well to the treatment or may show excessive mandibular growth during growth spurt which may require orthognathic surgery later on. If not treated at earlier stages of life, the condition may worsen with time. This case report will present the comprehensive orthodontic management of a 9-year-old prepubertal girl in late mixed dentition with prognathic mandible. Chin cup therapy was started and continued for 3 years. After chin cup therapy, maxillary and mandibular dentition were bonded with standard edgewise appliance. After leveling and alignment, Class III elastics were started. Fixed orthodontic treatment was completed in 3 years. At the end, good Class I molar and canine relationship with normal overjet and overbite were achieved. The total treatment time of orthopedic and orthodontic correction was 6 years, 2 months. The patient revealed the same Class I molar and canine relationship after 6 years of treatment. Redirection of mandibular growth pattern from hyperdivergent to normodivergent advocates the use of chin cup as a viable treatment regimen for the management of prognathic mandible in prepubertal patients.

Effects of various remineralizing agents on the outcome of post-orthodontic white spot lesions (WSLs): a clinical trial.

BACKGROUND: One of the most undesirable side effects of comprehensive orthodontic treatment is white spot lesions (WSLs). Despite many attempts at prevention of WSLs, its prevalence remains very high on debonding. There are many agents like fluoride toothpastes, fluoride varnishes, and fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is frequently used for the remineralization of WSLs. However, there is no consensus in the literature with respect to the success rates of these agents. Thus, the present study was designed to evaluate the efficacy of fluoride toothpaste alone and in combination with fluoride varnish and CPP-ACP plus crème in the remineralization of post-orthodontic WSLs. METHODS: Forty-five subjects in the age range of 16-25 years having at least one post-orthodontic WSL were included in the study. All the subjects were randomly divided into three groups (toothpaste group, varnish group, and CPP-ACP group). The efficacy of various remineralizing agents on the remineralization of WSLs was evaluated clinically and by DIAGNOdent immediately after debonding and subsequently after 1, 3, and 6 months of their use. RESULTS: Twice daily use of fluoride toothpaste alone had no significant effect on remineralization of WSLs at various intervals of observations (P = 0.078). Application of fluoride varnish along with twice daily use of fluoride toothpaste for 6 months significantly decreased the severity of WSLs (P < 0.01). Twice daily use of CPP-ACP plus crème along with fluoride toothpaste had significant effect on remineralization of WSLs at the end of 6 months of observation (P < 0.05). Between the group comparison showed that the mean visual and DIAGNOdent scores at various time intervals of observations were decreased more when fluoride varnish and CPP-ACP crème were used in addition to daily use of fluoride toothpaste, but the differences were not statistically significant (P > 0.05). CONCLUSIONS: The use of fluoride varnish and CPP-ACP plus crème in addition to twice daily use of fluoride toothpaste had no additional benefit in the remineralization of post-orthodontic WSLs.