Diabetes mellitus (DM) is a chronic disorder of carbohydrate, fat and protein metabolism. The prevalence of DM is growing rapidly worldwide and is reaching epidemic proportions. Traditionally, orthodontic treatment was considered to be a treatment modality for healthy young people. However, with increasing patient awareness the trend has changed with adults now seeking orthodontic treatment. Approximately, half of the patients with diabetes are undiagnosed and a dental examination may provide the first indication of the disease, and therefore a clinician must have a basic knowledge of the oral manifestations of DM. This article briefly deals with the medical aspects of DM, its oral manifestations and orthodontic treatment considerations.

Orthodontic intrusion is a common treatment approach in managing orthodontic esthetic and functional problems, including gummy smile and deep bite. This review presents contemporary reports related to the intrusion, types of dental intrusion, clinical observations, and the tissue reactions after the application of intrusive force, as well as indications and contraindications for intrusion. This paper concisely describes the fixed and removable appliances used for intrusion accomplishment.

Aim: The following study aims to investigate the prevalence and distribution of the peg-shaped maxillary lateral incisors in a Turkish orthodontic subpopulation. Materials and Methods: A study sample consisted of 2925 patients of which 1746 were females and 1179 were males with aged range from 10 to 18 years; (mean age, 13.40 ± 1.9 years) were retrospectively examined using panoramic radiographs, dental cast and pre-treatment records for the presence of the peg-shaped maxillary lateral incisors. Pearson's Chi-square and Fisher exact tests were used for statistical comparisons. Results: Peg-shaped maxillary lateral incisors were found in 2.15% of the patients (63/2925; 41 females and 22 males) with no statistically significant difference between the genders. However, females had more peg-shaped maxillary left lateral incisors compared with the males (P = 0.007). It was almost equally distributed as bilateral (1.09%, 32/2925) or unilateral (1.06%, 31/2925). Conclusion: It was found to be 2.15% (63 out of 2925 patients) with no gender difference except for the peg-shaped maxillary left lateral incisors. Clinicians should be aware of this anomaly prior to treatment for possible complications.

Introduction: The aim of this study was to examine the effect of Allium sativum (garlic) extract on the biofilm formation by Streptococcus mutans on the surface of orthodontic mini-implants. Materials and Methods: Three brands (Dentos, Forestadent and Hubit) of titanium mini-implants were used as samples, which were divided into four groups each containing S. mutans along with four different concentrations of garlic extract-0 mg/ml, 16 mg/ml, 32 mg/ml, 64 mg/ml and 1 mini-implant from each of the three brands. The amount of viable S. mutans bacteria, as well as its biofilm formation on the surface of mini-implants was determined quantitatively as well as qualitatively using microbial viability assay, electron dispersive X-ray spectroscopy and scanning electron microscopy analysis. ANOVA test was done. Results: 32 mg/ml and 64 mg/ml concentration of garlic extract showed a considerable antimicrobial efficacy against S. mutans and effectively prevented the biofilm formation by S. mutans on the surfaces of all the mini-implants with 32 mg/ml being the lowest effective concentration of garlic extract to prevent S. mutans biofilm formation and 64 mg/ml being the most potent concentration. Conclusion: Garlic extract can be a promising alternative to other chemical agents used in mouthwashes to prevent bacterial biofilm formation on the surface of orthodontic mini-implants and can thus help in the reduction of mini-implant failure due to biofilm formation. It has a potential to serve as a herbal substitute to chlorhexidine, which has been shown to exhibit several side-effects during long-term use.

Objectives: Several studies on faciolingual inclination have been published and a few statistical investigations have been performed with regard to the preadjusted edgewise appliances, but there is lack of studies which have evaluated the inbuilt characteristics of the MBT preadjusted appliance. This retrospective study was conducted to evaluate the efficacy of the MBT appliance system in terms of expressing its inbuilt characteristics of tip and torque values. Materials and Methods: The study sample consisted of 30 subjects who received full fixed appliance treatment involving four 1 ^st premolar extractions using the MBT appliance. Pretreatment and posttreatment study models of these subjects were measured for the tip and torque using Torque Angulation Device. Treatment changes were analyzed statistically and the posttreatment measurements were compared with the MBT prescription values. Results: The posttreatment angulation and inclination values when compared with MBT prescription a mean difference of ±2.1° for the tip and ±11.9° for torque. Tip was almost fully expressed in all teeth except for the maxillary 2 ^nd premolar, 1 ^st molar, mandibular canine, 2 ^nd premolar, 1 ^st and 2 ^nd molar, where the discrepancy was more than 1°. Torque was under expressed in maxillary central incisor by 1.8°, 1 ^st molar by 1.5° and 2 ^nd molar by 11.9°. Torque was over expressed in maxillary lateral incisor by 2.1°, canine by 2.4° and mandibular central and lateral incisor by 4.9° and 4.6°, canine by 4.8°. Torque was sufficiently expressed in maxillary 2 ^nd premolar, 1 ^st and 2 ^nd molar and mandibular 2 ^nd premolar, with a discrepancy between 0.5°. Conclusion: Tip was almost fully expressed in all teeth except for the maxillary-2 ^nd premolar, 1 ^st molar, mandibular- canine, 2 ^nd premolar, first and 2 ^nd molar, where the discrepancy was only around 1°. Torque was sufficiently expressed in maxillary-2 ^nd premolar, 1 ^st and 2 ^nd molar and mandibular- 2 ^nd premolar, where the discrepancy was between 0° and 0.5°. Torque was under expressed in maxillary-central incisor, 1 ^st molar and 2 ^nd molar. Torque was over expressed in maxillary- lateral incisor, canine and mandibular-central, lateral incisor and canine. Deviation around the mean measurements was found for all the parameters in all teeth. Keeping in account of individual bracket positioning errors it would be fair to anticipate that MBT appliance would result in reasonably optimal tooth positioning at the end of the treatment without any manual archwire adjustments. Tip was comparatively better expressed when compared to torque.

Objectives: The objective of this study is to assess skeletal and dental changes contributing to sagittal correction of Class II malocclusion with fixed lingual mandibular growth modificator (FLMGM). Materials and Methods: A total of 38 patients with dental Class II division 1 malocclusion and retrognathic mandible comprised the study sample. All were in the pubertal growth spurt. While FLMGM was applied to the treatment group (n = 21, 13.2 years), no treatment was performed on the control group (n = 17, 12.5 years). Digital lateral cephalograms obtained at the beginning and end of treatment/observation period of 8 months were evaluated using sagittal occlusal analysis. Paired and independent t-tests were used to assess the differences within and between groups. Results: Fixed lingual mandibular growth modificator treatment resulted in the following significant changes: (1) Total mandibular length increased; (2) sagittal jaw relation enhanced due to chin advancement; (3) overjet reduced (4.06 mm) mainly as a result of skeletal mandibular advancement (83%) in combination with maxillary incisor retraction (17%); (4) Class II molar relation improved (5.56 mm) by a contribution of mandibular advancement (61%) and maxillary molar distalization (39%). Conclusions: Sagittal occlusal relationships efficiently improved by greater skeletal than dental changes. Stable horizontal position of lower molars and incisors was a benefit of FLMGM treatment.

Objective: To evaluate the treatment effects of a removable functional appliance (modified bionator) on young adults. Materials and Methods: A total of 12 skeletal CLII (class two) female patients, with average skeletal age 15.8-years old, used the modified bionator 16 h a day for 8 months. Lateral cephalometric X-rays were taken and analyzed before and after the treatment using paired t-test. Hand wrist X-rays were taken before the application of the appliance only. Results: After 8 months of treatment Angle CLI (class one) relationship was achieved; there was a significant reduction in the ANB (A-point Nasion B-point), SNA (Sella-Nasion-Apoint), face convexity, and overjet. SNB (Sella-Nasion-Bpoint) and face length significantly increased. Conclusion: The removable functional appliance - modified bionator - is an available option for correcting of borderline skeletal class II malocclusion in young adults or patients in late developmental stage.

Objectives: The aim of this study is to investigate advantageous to the clinician and patient to carry on a computed tomography (CT) investigation in order to have a successful outcome for using orthodontic implants. Materials and Methods: This study was carried out on a sample of 10 patients (5 male and 5 female patients) aged ranges between 16 and 25 years who reported to the Department of Orthodontics, M.R. Ambedkar Dental College, for the treatment of malocclusion. Using CT, the bucco-palatal thickness of the soft-tissue and cortical bone at the posterior region of the maxilla between 1 ^st PM and 2 ^nd PM (Group I), 2 ^nd PM and 1 ^st M (Group II) and 1 ^st M and 2 ^nd M (Group III) were measured at four different levels, at points a, b, c, d, (soft-tissue) and A, B, C, D (cortical bone) and on the palatal side at points e, f, g, h (soft-tissue) and E, F, G, H (cortical bone) at an interval of 2 mm each. Results: All groups showed soft-tissue thickness was greater on the palatal side than on buccal side and the palatal cortical bone thickness was greater in Group I and III except in Group II where buccal cortical bone was greater. Conclusion: CT has been a reliable tool to assess implant placement sites. It will also help in assessing and avoiding the sinus perforation, root injury, soft-tissue complication, and utilizing appropriate cortical bone thickness.

This case report describes the treatment of a case with skeletal Class II, gummy smile, anterior deep bite and convex facial profile. While treating such a severe case, the outcome may not always be successful with orthodontic therapy alone. For this reason, surgical therapy is often chosen to gain an esthetic facial profile and a good smile. However, sometimes the patients reject surgical treatment and an alternative method must be considered. Skeletal anchorage systems such as miniscrews are now frequently used for correcting severe malocclusion that should be treated by orthodontics and surgical therapy. In this case report, we treated a skeletal Class II malocclusion with convex profile and gummy smile using miniscrews, which were placed in the mid-palatal region for simultaneous intrusion and retraction of upper anteriors.

The timing at which orthodontic treatment starts, has always been a debatable matter. Pseudo Class III malocclusion is highly recommended to be treated early as this type of malocclusion worsens by age. If left untreated it may lead to serious problems like abnormal wear of the lower incisors, dental compensation of mandibular incisors leading to thinning of labial alveolar plate and/or gingival recession. There are different methods for solving this problem. The case report describes an effective method which corrects pseudo class III malocclusion in a short time in early mixed dentition by using a protrusive arch wire.