Prediction of spontaneous eruption of palatally displaced canine based on variables measurements in panoramic radiograph: A systematic review.

OBJECTIVE: This systematic review was aimed to find out possible predictive variables measured on panoramic radiographs to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition. MATERIALS AND METHODS: Electronic database searches were performed in MEDLINE, Cochrane's CENTRAL, Scopus, and in other sources up to June 2020. Randomized and nonrandomized controlled trials, and pre-post prospective studies without control groups were considered for review. Study selection, data extraction, risk of bias assessment (by RoB 2.0, ROBINS-I, and NHLBI score), and the certainty of evidence evaluation (GRADE approach) were performed during reviewing process. Only qualitative analyses of included literature were done due to presence of between study heterogeneity. RESULTS: Out of 970 retrieved records, 3 controlled trials and 3 prospective before and after studies without control fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk to high risk of bias. Overall certainty was moderate to very low. Results shows that PDCs in distal sectors, lower alpha angle, younger subjects, PDCs with less advanced developed root were significantly benefited from interceptive extraction. However, Vertical distance had insignificant roll on eruption prediction. CONCLUSIONS: Interceptive extraction at younger age, mesial canine crown position (sectors), and mesial inclination of PDC (alpha angulation) are the most important variables predicting the spontaneous eruption of palatally displaced canine. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well designed clinical trials are recommended to strengthen the evidence.

Clinical differences of hand and rotary instrumentations during biomechanical preparation in primary teeth-A systematic review and meta-analysis.

BACKGROUND: The hand and rotary instruments are used for cleaning and shaping of root canals during biomechanical preparation in primary teeth. AIM: To determine clinical differences of hand versus rotary root canal instrumentation in primary teeth. DESIGN: Comprehensive searches were made in four electronic databases [MEDLINE (via PubMed), EMBASE, Google Scholar, and The Cochrane Central Register of Controlled Trials] till March 2020, and prospective studies that met the inclusion criteria were included. The primary outcome was instrumentation time, whereas the secondary outcomes were quality of obturation, obturation time, and clinical and radiographic success. From 604 screened studies, eleven studies qualified for meta-analysis. The random-effect model and generic inverse variance approach were used for meta-analysis. RESULTS: There was significant decrease in instrumentation time [MD-5.00 minutes (95% CI: 3.05-6.94), P < .00001, moderate evidence quality] and obturation time [MD-0.43 minutes (95% CI: 0.15-0.71), P = .003, low evidence quality] with rotary instrumentation. Optimal quality of obturation was achieved in significantly more number of teeth [risk ratio (RR) = 0.71(95% CI: 0.53-0.95),P = .02, moderate to high evidence quality] with rotary instrumentation. Similar clinical and radiographic success was observed in hand and rotary instrumentation techniques. CONCLUSION: Significant reduction in instrumentation time of five minutes was observed using rotary instrumentation with moderate quality evidence.

Role of structured rehabilitation protocol in post surgical cases of restricted mouth opening.

BACKGROUND: Long term effectiveness of surgical management of chronically restricted mouth opening in OSMF or TMJ ankylosis depends largely on postoperative physiotherapy. This in turn is dependent on patient's compliance. Use of adjunctive aids besides pharmacotherapy that reduces patients pain and improves compliance with exercise is warranted. AIMS: To evaluate the role of TENS and structured rehabilitation programme in postoperative physiotherapy in OSMF and TMJ ankylosis patients. METHODS AND MATERIALS: A pilot study was conducted in which 6 patients of restricted mouth opening were put on a structured rehabilitation protocol in which TENS, heat and cold therapy with structured mouth opening exercise regimes. Interincisal opening, VAS score and a subjective assessment of post surgical discomfort was evaluated. RESULTS AND CONCLUSIONS: Results revealed an improved compliance and cooperation by patients. Pain on VAS scale also reduced from mean of 7.8 on day 1 to 3.6 on day 5 in this group. The mean discomfort on day 3 was reported as mild to moderate. An early attainment of passive mouth opening closest to intraoperative mouth opening was also reported on day 5 which is usually not achievable without any physiotherapy intervention.

An unusual variation of radicular dentin dysplasia: A rare case report with review of literature.

Dentin dysplasia (DD) is a rare autosomal dominant disorder of dentin development, which is generally divided into two types based on the clinical and radiographic appearance of the affected dentinal tissues: Type-I (Radicular DD) and Type-II (Coronal DD). This paper reports the case of a 17-year-old female patient with both classical and atypical features of radicular DD in the permanent dentition. The present case shows clinically normal appearing crowns, localised mobility in the maxillary teeth, completely obliterated pulp chambers, widened root canals without any obliterations and the presence of multiple periapical radiolucencies. The clinical and radiographic findings observed in this present case report are different from those reported in the past literature, which suggests that the present case could be a variation of radicular DD.

Monoclonal Antibodies: A Review.

BACKGROUND: Over the last three decades, monoclonal antibodies (MAbs) have made a striking transformation from scientific tools to powerful human therapeutics. Muromonab CD3 a murine MAb was the first FDA approved therapeutic MAb for the prevention of kidney transplant rejection. Since its approval in 1986, there has been a decline in further application and approvals until the late 1990s when the first chimeric Mab, Rituximab was approved for the treatment of lowgrade B cell lymphoma in 1997. With the approval by licensing authorities of chimeric, followed by humanized and then fully human monoclonal antibodies, the rate of approval and monoclonal antibodies available in the market for the treatment of various diseases has increased dramatically. As of March 2017, FDA has approved approximately 60 therapeutic MAbs which are currently under evaluation in various phases of clinical trials. OBJECTIVE: MAbs are approved for the treatment of diseases belonging to various systems like cardiovascular, respiratory, hematology, kidney, immunology and oncology. MAbs are approved for the treatment of orphan diseases or indications such as paroxysmal nocturnal hemoglobinuria as well as cancers and multiple sclerosis where hundreds of patients are treated and even diseases such as breast cancer, asthma and rheumatoid arthritis where millions are being treated. This review focuses briefly on types, molecular targets, mechanism of actions and therapeutic indications of FDA approved MAb products that are currently available in the market. CONCLUSION: With the advent of fully human MAbs, the efficacy and safety have improved in the treatment of various cardiovascular, cancer, respiratory, hematology, autoimmune diseases and infections. The introduction of biosimilars will increase the affordability and utilization of MAbs in the treatment of various diseases.

A comparison of shear bond strength of orthodontic brackets bonded with four different orthodontic adhesives.

OBJECTIVES: The objective of this study is to compare the shear bond strength (SBS) of stainless steel (SS) orthodontic brackets bonded with four different orthodontic adhesives. MATERIALS AND METHODS: Eighty newly extracted premolars were bonded to 0.022 SS brackets (Ormco, Scafati, Italy) and equally divided into four groups based on adhesive used: (1) Rely-a-Bond (self-cure adhesive, Reliance Orthodontic Product, Inc., Illinois, USA), (2) Transbond XT (light-cure adhesive, 3M Unitek, CA, USA), (3) Transbond Plus (sixth generation self-etch primer, 3M Unitek, CA, USA) with Transbond XT (4) Xeno V (seventh generation self-etch primer, Dentsply, Konstanz, Germany) with Xeno Ortho (light-cure adhesive, Dentsply, Konstanz, Germany) adhesive. Brackets were debonded with a universal testing machine (Model No. 3382 Instron Corp., Canton, Mass, USA). The adhesive remnant index (ARI) was recordedIn addition, the conditioned enamel surfaces were observed under a scanning electron microscope (SEM). RESULTS: Transbond XT (15.49 MPa) attained the highest bond strength. Self-etching adhesives (Xeno V, 13.51 MPa; Transbond Plus, 11.57 MPa) showed clinically acceptable SBS values and almost clean enamel surface after debonding. The analysis of variance (F = 11.85, P < 0.0001) and Chi-square (χ(2) = 18.16, P < 0.05) tests revealed significant differences among groups. The ARI score of 3 (i.e., All adhesives left on the tooth) to be the most prevalent in Transbond XT (40%), followed by Rely-a-Bond (30%), Transbond Plus with Transbond XT (15%), and Xeno V with Xeno Ortho (10%). Under SEM, enamel surfaces after debonding of the brackets appeared porous when an acid-etching process was performed on the surfaces of Rely-a-Bond and Transbond XT, whereas with self-etching primers enamel presented smooth and almost clean surfaces (Transbond Plus and Xeno V group). CONCLUSION: All adhesives yielded SBS values higher than the recommended bond strength (5.9-7-8 MPa), Seventh generation self-etching primer Xeno V with Xeno Ortho showed clinically acceptable SBS and the least amount of residual adhesive left on the enamel surface after debonding.

Interdisciplinary treatment of a periodontally compromised adult patient with multiple missing posterior teeth.

This article reports the comprehensive, interdisciplinary treatment of a 50-year-old periodontally compromised adult patient with multiple missing posterior teeth. After initial periodontal treatment, the maxillary first molars and right central incisor were intruded orthodontically. Miniscrews were used to intrude the maxillary first molars by 3 mm. The mandibular arch was restored with a tooth-supported overdenture. Root coverage of the maxillary right central incisor was performed using Alloderm (Biohorizons, Birmingham, Ala). At the end of the interdisciplinary therapy, the results were esthetically pleasing, with the patient's oral functions restored to the optimum. The emphasis of this report is to highlight the importance of integrating various specialties such as periodontics, orthodontics, endodontics, and restorative dentistry toward a common goal of improving the patient's oral health, function, and esthetics.

Dynamics of a smile in different age groups.

OBJECTIVE: To evaluate smile in different age groups and to detect gender differences in smile. MATERIALS AND METHODS: Digital videographic records of 241 randomly selected subjects were obtained for smile analysis. The subjects were divided into four groups by age (15-20 years, 21-30 years, 31-40 years, and 41-50 years). Each group was further subdivided by gender. After 41 subjects were excluded, the smile dimensions of 200 subjects were analyzed by two-way multivariate analysis of variance (MANOVA) with Duncan's multiple range post hoc test. RESULTS: All dynamic measurements (change in upper lip length, upper lip thickness, commissure height, and intercommissural width from rest to smile) decreased with age in both males and females. Changes in upper lip length and commissure height on smiling were greater in males as compared with females of the same age groups. Changes in intercommissural width on smiling were greater in females as compared with males in all age groups. CONCLUSION: Smile changes with increase in age, and the changes differ between males and females. Females had a wider smile as compared with males of similar age groups.

Brodie bite with an extracted mandibular first molar in a young adult: a case report.

Total buccal crossbites are rare, but, when they occur, they can be extremely difficult to correct, even with surgery and orthodontics. In most patients with in-locking crossbites, the maxillary teeth erupt past their mandibular antagonists, creating severe occlusal difficulties. This article presents an adult patient with scissors-bite or partial telescoping bite bilaterally in the posterior region and an extracted mandibular first molar on the right side. She was treated with expansion of the mandibular arch, and the subsequent open bite was closed with the help of masticatory muscle exercises and high-pull headgear. The second and third molars were uprighted and moved mesially to close the extraction spaces.

Prevalence of malocclusion in jaipur, India.

A study was undertaken to determine the prevalence of malocclusion in Jaipur city, India. A total of 700 subjects, in the age group of 16-26 years were divided into five groups of normal occlusion, Angle's Class I, Class II Div 1, Class II Div 2 and Class III malocclusion. The results revealed that the prevalence of malocclusion was 66.3%, with the majority of them having Class I malocclusion (57.9%), while the prevalence of Class III malocclusion was found to be the least (1.4%). There was no statistically significant gender difference among the subjects studied.