Comparison Of Different Methods Of Controlling Pain During Debonding Of Orthodontic Brackets.

Objective: To compare the efficacy of finger pressure and plastic wafers in terms of pain control during debonding. METHODS: This cross sectional study was conducted at the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to June 2020, and comprised patients of either gender aged 13-21 years who had completed fixed orthodontic treatment with 0.022 brackets of Roth prescription and required debonding. The patients was divided into two equal groups. In group A, teeth were stabilised with finger pressure with cotton between the finger and teeth, and then debonding was done using open mouth technique. In group B, teeth were stabilised using a plastic wafer between maxillary and mandibular teeth, and then debonding was done using closed mouth technique. Pain was assessed using a visual analogue scale VAS. Data was analysed using SPSS 23. RESULTS: Of the 110 patients, each of the 2 groups had 55(50%) subjects. Overall, there were 35(32%) males and 75(68%) females. The mean age of the sample was 16±2.4 years. Mean pain scores among the males was 32.0±7.68 compared to 34.067±12.59 among the females (p>0.05). Subjects in group B had significantly less pain than those in group A (p<0.05). Conclusion: Plastic wafer was found to be more effective in terms of controlling pain during debonding compared to finger pressure.

Correlation of lip profile preferences in Pakistani population; and its comparison with orthodontic norms.

OBJECTIVE: To determine the most desired lip profile and compare the subjective sense of aesthetics among orthodontists, general dentists and the general population. METHODS: The cross-sectional study was conducted at the Orthodontic Department of the Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January 1 to February 25, 2020, and comprised different silhouettes for each gender with increasing lip procumbence from -6mm to +6mm with respect to Rickett's E-line which were created using Photoshop CS 8.0 after cephalometric analysis of 20 cephalograms. The sample comprised an equal number of orthodontists in group A, general dentists in group B and orthodontic treatment-seekers in group C with equal representation of the two genders. Data was analysed using SPSS 24. RESULTS: Of the 180 subjects, there were 60(33.3%) in each of the three groups, with 30(50%) males and as many females in all the groups. All the three groups preferred the average lip profile for males (p=0.018) and 2mm procumbent lips for females (p=0.008). There was significant difference of opinion between groups A and C (p=0.034) and between groups B and C (p=0.022). CONCLUSIONS: There was found to be a marked difference of opinion among the orthodontists, the general dentists and the orthodontic treatment-seekers regarding the desired lip profile.

Comparison of Collum Angle of Maxillary Central Incisors in Different Incisor Relationships.

OBJECTIVE: To compare the collum angle of maxillary central incisors in patients with different incisor relationships. STUDY DESIGN: Comparative, cross-sectional study. PLACE AND DURATION OF STUDY: Department of Orthodontics, Armed Forces Institute of Dentistry, Combined Military Hospital, Rawalpindi, from March to October 2019. METHODOLOGY: Patient data was obtained from the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi. One Hundred patients were included in the study, which were divided into four groups, 25 patients in each group, based on incisor relationship, i.e. class I, class II div 1, class II div 2, and class III. The collum angle of maxillary central incisors was then measured twice by a single investigator on lateral cephalograms. Sagittal skeletal relationship, age and gender were noted. Molar relationship of the above groups was also recorded from their respective casts. RESULTS: Out of the 100 patients, 31 were males, while 69 were females. Mean collum angles of maxillary central incisors for class I, class II div 1, class II div 2, and class III were 5.12 ±3.78, 6.09 ±4.57, 15.02 ±7.99, and 6.94 ±3.80, respectively. Collum angle of class II div 2 incisor relationship was significantly greater than other classes (p <0.05). Collum angle of incisors of casts with class II molar relationship also exhibited the same trend, i.e. a greater angle than other groups (p=0.002). There was no significant difference in collum angle among different sagittal skeletal relationships (p=0.476), between males and females (p-value .731) and among different age groups (p=0.194). ICC showed good agreement between the readings of collum angle (Crohnbachs Alpha .997). CONCLUSION: Class II div 2 incisor relationship had a significantly greater collum angle than other groups. Key Words: Collum angle, Incisor inclination, Crown to root angle, Class II div 2 malocclusion.

Silver-Russell Syndrome: Orthodontic Perspective.

Silver-Russell syndrome (SRS) is a rare disorder characterised by prenatal and postnatal growth deficiency, a relatively large head size with triangular face, a prominent forehead, body asymmetry, feeding difficulties, clinodactyly and other features.  Abnormalities of chromosome number 7 and 11 have been found in 60% of patients, but the diagnosis of the disease is mainly by ascertaining clinical features. We, herein, report a case of an 11-year boy who presented to Orthodontics Department of Armed Forces Institute of Dentistry (AFID), for treatment of craniofacial and oral problems, which included small-sized jaws and severely crowded teeth. The patient is undergoing serial extraction treatment at the moment, which will be followed by further orthodontic treatment. Key Words: Silver-Russell syndrome, Growth deficiency, Triangular face, Body asymmetry.

Canine Retraction Using a Closed Nickel Titanium Coil Spring and an Elastic Module.

OBJECTIVE: To compare the mean change of tooth movement in canine retraction between elastic module and Ni Ti coil spring. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Orthodontics Department, Armed Forces Institute of Dentistry, Rawalpindi, from May 2015 to January 2016. METHODOLOGY: Thirty-two patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed Ni Ti coil spring on one side of the maxillary arch and with active tie back on the other side. The distance between the lateral incisor and the canine was measured on both sides before starting canine retraction. The same measurements were recorded after four weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test. RESULTS: The study included 56% females and 43% males. The mean rate of tooth movement in Ni Ti coil group and in the elastomeric module group was 1.1 mm and 0.7 mm in one month, respectively (p=0.05). CONCLUSION: The rate of tooth movement is more rapid with Ni Ti coil spring than with the elastomeric module.