Frictionless Mechanics for Correction of Bimaxillary Protrusion: A Case Report.

The condition of bimaxillary protrusion is commonly seen by orthodontic practitioners in the course of our daily clinical work. It is characterized by both jaws being forwardly placed and increased prominence of the teeth along with lips. When there is a severe bimaxillary protrusion, it can be challenging to correct it effectively with maximum anchorage. In patients with protrusions or crowding, extraction therapy is often necessary. There are two ways to retract anteriors during extraction space closure: friction or frictionless. The present case report explains the frictionless mechanic protocol for the correction of bimaxillary protrusion using a reverse closing loop.

Integrated Care Strategies for Unilateral Cleft Lip and Palate: A Multidisciplinary Treatment Approach for Profile Correction.

Cleft lip and palate (CLP) is a prevalent congenital craniofacial deformity that can be unilateral or bilateral. This case report highlights the interdisciplinary approach to managing a 24-year-old male with unilateral CLP (UCLP), emphasizing the complexity of associated dental and skeletal challenges. The patient had undergone multiple surgeries, including lip closure at three months, palate repair at seven years, and alveolar bone grafting at 12 years. Clinical assessments revealed a retruded maxilla, an absence of lateral incisors, and scars from previous surgeries. Radiographic evaluations indicated a Class III skeletal pattern and confirmed the presence of a cleft on the left side. Orthodontic treatment commenced with maxillary arch alignment, followed by Le Fort I surgery to address maxillary retrusion, correct skeletal malocclusion, and close the alveolar cleft space. The post-surgical phase involved orthodontic adjustments, crossbite correction, and alignment of the mandibular arch. Despite the discontinuation of treatment due to the patient's relocation, the interdisciplinary collaboration achieved significant improvements, including a corrected facial profile, maxillary advancement, closure of the cleft space, and enhanced dental alignment. The patient's confidence and functionality were positively impacted. This case underscores the importance of a coordinated interdisciplinary approach to addressing the multifaceted challenges associated with UCLP, aiming to optimize both aesthetic and functional outcomes for improved patient well-being.

Dewey's Modification for Angle's Class I Malocclusion: Revisited.

Introduction Classification is a crucial communication tool between dental school professors and students, between practitioners, and between practitioners and insurance companies or government bureaucracies. The management of patients is significantly impacted by classification. Once a patient has been categorized, the practitioner will frequently use treatment strategies corresponding to that classification. The classification used by orthodontists most frequently is Dewey's version of Angle's categorization. To date, the shortcomings of Dewey's modification were not mentioned in the literature. Various other malocclusions are still not included in this classification system that was modified by Dewey.  Aim The aim of this study was to re-evaluate and re-establish Dewey's modification for class I malocclusion for the various other types of malocclusions that are not included in the classification system. Material and method An observational study was carried out on a total of 600 patients in the Department of Orthodontics. The study duration was eight months. The photographic method was used for the evaluation of the malocclusion. Photographs were taken and clinical evaluation was done of the selected cases. The type of malocclusion was observed and recorded. Result The results showed that other types of malocclusions other than that of Dewey's modification are observed in the population. A total of 4% of the population was affected with single tooth crossbite and 5% were affected in more than one tooth. A total of 1% of the population was affected with single-tooth scissor bites, and in 2%, more than one tooth was involved. In 9% of the population, single-tooth rotations were present, whereas in 6%, more than one tooth was involved. A total of 35% of the population showed other types of malocclusions. Conclusion To conclude, various other malocclusions are present in the population suggesting a lacuna in Dewey's modification. Hence, there was a need to revisit.

Comprehensive Multidisciplinary Management of Bilateral Cleft Lip and Palate.

Cleft lip and palate (CLP) represent a multifaceted congenital deformity encompassing skeletal, dental, and functional discrepancies. This case report presents the management of a 13-year-old female with bilateral CLP, focusing on the challenges associated with permanent dentition and retained deciduous teeth. The patient's history included prior lip and palate repair surgeries, leading to poor aesthetics and functional concerns. A multidisciplinary approach involving orthodontics, oral surgery, and prosthodontics was implemented. Clinical examinations revealed dental abnormalities, oro-nasal fistula, and skeletal discrepancies, necessitating a comprehensive treatment plan. The orthodontic intervention aimed at aligning the dentition, followed by surgical closure of the oro-nasal fistula and alveolar bone grafting (ABG) to facilitate permanent canine eruption. Prosthetic replacement of missing maxillary lateral incisors was accomplished, enhancing aesthetics with minimal invasiveness. Results demonstrated significant improvements in profile, dental alignment, and functional stability. Cephalometric and dental parameter analyses confirmed the corrections and enhancements achieved, affirming the success of the multidisciplinary treatment. This case report emphasizes the importance of a collaborative multidisciplinary approach in effectively addressing the complexities of bilateral CLP in patients with permanent dentition and retained deciduous teeth. The comprehensive treatment strategy rectified dental and skeletal issues and positively impacted the patient's overall well-being and self-confidence.

Treatment of Skeletal Class II Division 1 Using Twin Block Myofunctional Appliance.

Myofunctional appliances are customarily used to treat Class II malocclusions in growing children to alter their growth. Functional appliances are widely accepted to enhance skeletal relationships in the short term efficiently. It utilizes muscular forces by muscles to make dental and skeleton modifications. The myofunctional appliance might be removable or fixed. The variation of mode and method of action depends on the design, but the forces created by the muscles' stretching provide their effect. According to research, the effectiveness of functional appliances as a therapy for Class II malocclusion might be influenced by mandibular growth patterns. Their low skeletal maturation influence outweighs the primary dentoalveolar impact of the twin block myofunctional orthodontic appliances. Class II malocclusions can benefit by using myofunctional appliances in specific clinical situations, such as when the patient is still developing. These devices make the fixed appliance phase easier to use, but their effectiveness depends heavily on the patient's compliance. In this case, an 11-year-old female expressed concern about the forward positioning of her upper front teeth when she visited the department of orthodontics. Twin block, a myofunctional appliance, was used to manage it, and then fixed orthodontic treatment was used to fine-tune the occlusion. This case report illustrates the design and treatment effects.

Non-extraction Orthodontic Treatment Protocol of Moderate Crowding.

Dental crowding is referred to as the swarming of teeth, mainly due to the discrepancy between the size of the jaw bases and that of the teeth. When the amount of space required for the teeth is more than that in the jaws, it leads to crowding. The prevalence of crowding has now increased to almost 30-60%. It can be classified into mild, moderate, and severe according to the amount of overlap. Depending on the severity of the crowding, the decision of extraction is made. The given case presents a non-extraction protocol for treating moderate crowding. The present case report explains the non-extraction treatment of moderate crowding using inter-proximal stripping.

A Case of Supernumerary Incisors in a Young Male Child: A Rare Occurrence of Four Central Incisors in the Maxillary Anterior Region.

Multiple supernumerary teeth in the central incisor region are an uncommon occurrence; the most frequently occurring type of supernumerary teeth are mesiodens. A 10-year-old male had reported to Sharad Pawar Dental College with the chief complaint of extra teeth. An intraoral examination revealed the presence of two labially placed incisors and two palatally placed incisors at a transitional phase of dentition. During a radiographic examination, the maxillary occlusal view revealed four incisors with similar morphology. Extraction of the palatally placed incisor was done under local anaesthesia which was followed by alignment of the anterior teeth and closure of space. Supernumeraries that have erupted should always be removed, unless the teeth next to them are absent, in which case they should be left in place. After alignment, closure of spaces was done since the permanent canines had not yet erupted; it was decided against trying to completely close any gaps between the teeth.

Analysis of Variations in Maxillary Second Molar Buccopalatal Inclination in Angle's Class I, Angle's Class III Malocclusion, and Unilateral Cleft Lip and Palate (UCLP) Cases: A Comparative Observational Study.

Introduction Cleft of the lip and/or the palate is commonly inherited defect which involves cleft of lip and palate. Maxillary second molar inclination has been studied in various malocclusion. Every abnormality in body is compensated to some extend by compensation. Our objectives were to evaluate maxillary second molar inclination in Angle's Class I, Class III malocclusion, and unilateral cleft lip and palate (UCLP) patients in transverse plane and to compare variation in maxillary second molar inclination in Angle's Class I, Class III malocclusion, and UCLP cases buccopalatally in transverse plane. Material and method Model of 45 subjects were analyzed. The maxillary second molar inclination was measured using aid of protractor fixed on the surveyor. Axis under consideration was the axis along the long axis of the central fossa of maxillary second molar. Various standardization regarding measurement of second molar inclination were set. The maxillary second molar inclination was compared among 3 groups Angle's Class I, Class III malocclusion, and UCLP cases. Results Data was analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey test. There was a significant difference between inclination of maxillary second molar when Angle's Class I malocclusion was compared with Angle's Class III malocclusion and UCLP cases (p = 0.003 and p = 0.011, respectively). There was not a significant difference between Angle's Class III malocclusion and UCLP cases (p = 0.87). Conclusion Amongst Class III patients and UCLP patients the inclination of maxillary second molar had greater buccal inclination. Maxillary second molar correction would alleviate the effect of deleterious force on periodontium and bone generated by malpositioned teeth.

Multidisciplinary Approach to Treatment of Midline Diastema With Edge-to-Edge Bite.

Aesthetic treatments have gained massive popularity in the recent past. Patients with midline diastema and spacing are among the most common complaints reported to an orthodontic clinic. The major complaint with such cases is the poor aesthetics that accompany them. Although many restorative treatment options are available to treat these cases, their long-term success is still questionable. The primary aetiology is abnormal frenal attachment, as seen in the case. Getting rid of the etiologic factor is vital to attain a stable treatment. In the present case, a frenectomy was performed to correct the abnormal frenal attachment. Even after correcting the aetiology, correct retention protocol is equally essential. The present article presents the treatment of a case with midline diastema and an edge-to-edge bite, and a high frenal attachment.

The Comparative Evaluation of the Morphology and Dimensions of the Sella Turcica in Skeletal Class III Patients and Patients With Unilateral Cleft Lip and Palate in Post-Pubertal Age Group.

Background The clinical features of unilateral cleft patients have great similarity to class III patients, viz., ANB <2° and Wits appraisal <-3 mm. In this study, we determined the frequency of various shapes of the sella in cleft and class III patients. We also measured the dimensions of the sella turcica in the aforementioned groups. Studying the morphology and dimensions of the sella in different groups can help us to understand the role of the cranial base in the development of malocclusion. Material and methods The study is composed of 46 patients, divided into two groups with an age range of 14 to 21 years. The linear dimensions of the sella were measured, and the shape of the sella was determined. Comparison was done between the two groups using Student's t-test. Result When the two groups were compared, length was found to be similar in both groups, but depth and diameter were greater in the class III group. An abnormal shape of the sella was found predominantly in both class III and cleft cases. The normal morphology accounted for only 13.04% of all the cleft patients, whereas 39.13% of the class III cases exhibited a normal shape of the sella. Sella turcica bridging was seen in 30.43% of cleft patients as opposed to 21.73% of class III patients exhibiting the bridging. Conclusion With the finding that 74% of the subjects exhibited abnormal morphology of the sella, confirming that it can be one of the factors for malocclusion must be given more consideration.