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REVIEW ARTICLES |
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Diagnosis and management of facial asymmetries
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p. 81 |
Sandhya Maheshwari, Sanjeev Kumar Verma, Aditi Gaur, Sushma Dhiman DOI:10.4103/2321-3825.149054 Facial esthetics evaluation is the most important part of the orthodontic treatment-planning procedure. The attainment of the best facial esthetic appearance for a given patient is a primary goal of orthodontic treatment. The evaluation of a patient's frontal symmetry is the most critical aspect of diagnosis because this is most appreciated view for any individual. Even the most esthetic faces are associated with mild forms of facial asymmetry. The individuals who report for an orthodontic treatment are often associated with facial asymmetry that may be greater than the acceptable norms. Such asymmetries may have a skeletal or dental etiology. The diagnosis, treatment planning, and the mechanics for the asymmetric patient require the identification of the cause of the asymmetry. A careful differential diagnosis together with a thorough treatment plan can ensure successful treatment outcomes in the management of such cases. |
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A systematic nutritional and dietary guideline for orthodontic patients |
p. 88 |
Amit Jaikumar Ajmera, Suchita Sadashiv Tarvade, Vishal Ramesh Patni DOI:10.4103/2321-3825.150875 A review of the basic principles of nutritional science indicates its applicability to the orthodontics to the many levels. Nutritional considerations are most critical during growth and development and environmental challenges. The orthodontic patients avoid many types of food, particularly fruits, raw vegetables, and other hard and tough foods, as they cannot chew these properly, because of pressure sensitivity of the teeth in the initial 3-5 days period after routine. As a result, such individuals consume significantly less proteins and other key nutrients, fiber, calcium, nonhaem iron, and some vitamins. This paper presents an overview of the relationship between diet and orthodontic treatment. The nutritional guidelines to obtain good oral and general health in orthodontic patients are discussed. |
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ORIGINAL ARTICLES |
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Comparison of tooth size discrepancy in Angle's class I and class II malocclusion in Rajasthani population |
p. 92 |
Chiranjeev Saini, Elizabeth Moirangthem DOI:10.4103/2321-3825.146364 Aim: The purpose of this study was to compare the tooth size discrepancy according to Bolton ratios and norms between class I and class II malocclusion groups in Rajasthani population. Materials and Methods: A quantitative study was carried out at all dental colleges of Rajasthani. Cross-sectional data were gathered from the study casts of patients undergoing orthodontic treatment at all dental colleges of Rajasthan. 105 out of 150 study casts were filtered based upon the inclusion and exclusion criteria. The mesiodistal widths of all maxillary and mandibular teeth from right first molar to left first molar were calibrated with the use of a manual caliper. The readings were then used to compute the anterior and total Bolton ratios. Results: Significantly higher mean anterior tooth ratios were found for class II (P < 0.01) patients. All other ratios were within close range of Bolton's norms. Conclusion: Class II patients showed a tendency toward higher mesiodistal widths of teeth in the mandibular anterior region |
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Shear bond strength of orthodontic brackets after antioxidant treatment on previously bleached teeth: An in vitro study |
p. 96 |
US Krishna Nayak, Aneeshv Katyal DOI:10.4103/2321-3825.146363 Context: Bleaching of the enamel surface reduces shear bond strength. This can be reversed by use of antioxidants prior to bonding of brackets. Aims: The aim of the study was to verify and validate the improvement in bond strength through the application of antioxidant on previously bleached teeth. Materials and Methods: Thirty-six sound maxillary and mandibular premolars extracted for orthodontic purposes were collected and divided into three groups of 12. Specimens in Group 1 were bleached with 35% hydrogen peroxide as a bleaching agent. Specimens in Group 2 were bleached and subsequently treated with 10% antioxidant (sodium ascorbate). Specimens in Group 3 served as a control. All specimens were stored in artificial saliva for 24 h prior to the bonding of orthodontic brackets. After bracket attachment, the samples were stored in distilled water for 1-week and then tested for shear bond strength using an INSTRON testing machine. Results: The data revealed that there was a significant difference between shear bond strengths of the bleached group; bleached + antioxidant group and the control group. Group 2 showed greater bond strength compared with Group 1, but lesser than the bond strength of the control group. Conclusion: The results confirmed the positive effect of antioxidant treatment on the bond strength of orthodontic brackets after tooth bleaching. |
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Does self-etching primer safely bond bleached teeth? An in-vitro study
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p. 101 |
Arjun Karra, Mohammadi Begum Khan DOI:10.4103/2321-3825.149047 Aim: The purpose of this in-vitro study was to compare the effect of carbamide peroxide, 16% clinex-gel bleaching on shear bond strength using conventional bonding and self-etching primer bonding (SEP) and to find out how far the changes affect the shear bond strengths at clinically significant level on extracted human tooth enamel. Materials and Methods: Eighty freshly extracted human premolar teeth having moderate to severe dental fluorosis as per Dean's criteria were collected and divided into four groups of 20 each. The four groups are: Group I: Acid etching followed by bonding with Transbond XT (white), Group II: Bleaching, acid etching followed by bonding with Transbond XT (pink), Group III: SEP followed by bonding with Transbond XT (white). Group IV. Bleaching, acid-etching, followed by bonding with Transbond XT (pink). Results: There was a statistically significant difference between the four groups on comparing the mean shear bond strength of Group I, II, III, and IV by one-way analysis of variance test. Summary and Conclusion: Bleaching and bonding with SEP after 30 days storage have comparably similar shear bond strength to the unbleached acid etching group. |
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Cephalometric evaluation of the airway dimensions in subjects with different growth patterns
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p. 108 |
Juhi Ansar, Raj Kumar Singh, Preeti Bhattacharya, Deepak K Agarwal, Sanjeev K Verma, Sandhya Maheshwari DOI:10.4103/2321-3825.149051 Objective: The purpose of this study was to compare the pharyngeal airway dimensions by cephalometric examination of individuals with different morphological patterns. Materials and Methods: The sample comprised pretreatment lateral cephalometric radiographs of 90 subjects, aged 16-25, which were divided into three distinct groups, according to their morphological patterns, that is, hypodivergent, normodivergent and hyperdivergent. The upper and lower pharyngeal airways were assessed according to McNamara's airways analysis. Results: The results showed that the upper and lower pharyngeal width in hyperdivergent growth patterns subjects was statistically significantly narrower than in the normodivergent and hypodivergent growth pattern groups (P < 0.05). Conclusions: Subjects with vertical growth patterns have significantly narrower upper and lower pharyngeal airways than those with Class II malocclusions and horizontal and normal growth patterns. These patients may be more prone to mouth breathing as a result of their relatively diminished pharyngeal dimensions. |
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An interim analysis of the maxillary canine in determining the maxillary occlusal plane
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p. 113 |
Shanti Varghese, Vinaya Bhat, Sapna Bhaskaran, Suja Joseph DOI:10.4103/2321-3825.149053 Aim: A pilot study on dentate subjects was done to evaluate the relationship of the incisal edge exposures of the maxillary central incisor (CI) and maxillary canine to the maxillary lip at rest, to the maxillary lip length, and the influential effects of incisal wear and anteroposterior skeletal relation. Materials and Methods: Thirty males and 67 females of Indian origin and age group 15-59 years were examined. A calibrated manual vernier caliper was used to record the incisal exposures of the maxillary left CI and canine to the maxillary lip at rest and the maxillary lip length. The tooth wear index by Smith and Knight (1984) was used to assess the extent and severity of the incisal attrition. Anteroposterior skeletal relation was assessed using soft tissue cephalometric points. A descriptive statistical analysis and Pearson's correlation analysis was done. Results: On descriptive analysis of the data recorded, 94% of the female subjects recorded a mean CI exposure of 3.25 mm to the maxillary lip at rest while 91% of the female subjects recorded a mean canine exposure of 0.29 mm. 93% of the male subjects recorded a mean CI exposure of 2.63 mm to the maxillary lip at rest. 80% of the male subjects recorded a mean canine exposure of −0.42 mm to the maxillary lip at rest. Canine displayed a narrow range of tooth visibility. In both genders, CI exposure to the mean lip length averaged 1-3 mm and the canine exposure to the mean lip length averaged −1-0 mm. CI and canine incisal edge exposures decreased with an increased incisal wear. CI exposure averaged 0-3 mm and canine exposures averaged −1-1 mm. Class II and Class I skeletal relation observed an increased CI exposure of 3 mm and 2.4 mm respectively compared to Class III (2.125 mm). Increased canine exposures were observed for Class III (0.3 mm) and Class II (0 mm) compared to Class I (−0.7 mm). Pearson's correlative analysis demonstrated a highly significant positive correlation of the canine with a P value of 0.01. Conclusion: Within the scope of this study, descriptive analysis demonstrated a linear favorable relationship of the canine to the CI. Correlative analysis also demonstrated a favorable relationship of canine to CI with borderline significance of anteroposterior relationship. |
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An evaluation of tooth size discrepancies among different malocclusion groups in North Indians |
p. 119 |
Vinay Kumar Chugh, Pradeep Tandon, Vijay Prakash Sharma, Amit Nagar, Rana Pratap Maurya, Ankita Chugh DOI:10.4103/2321-3825.150569 Objective: A study was conducted to evaluate tooth size discrepancies among different malocclusion groups. Materials and Methods: This study consisted of 160 North Indian subjects, 50 normal occlusion group and 110 subjects with varying degree of malocclusion, that is, Angle's Class I (40), Class II Division 1 (40) and Class III (30) malocclusion, respectively. Tooth size measurements were performed on the study models by using a digital Caliper with a liquid crystal display digital output to the nearest 0.01 mm, and various inter-arch ratios were analyzed. Statistical Analysis: One-way analysis of variance was used to analyze the difference in groups followed by Tukey post hoc test. Chi-square test was performed to demonstrate the prevalence of tooth size discrepancies among three malocclusion groups. Results: Significant differences were found for inter-arch ratios between the groups. Conclusions: Anterior, overall, and posterior ratios were higher in Class III followed by Class I and Class II Division 1 malocclusion, respectively. Anterior and overall tooth size discrepancy was found to be 20% and 17.2%, respectively, in the malocclusion sample. |
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Evaluation of vertical mandibular asymmetry in unilateral and bilateral posterior crossbite adult patients
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p. 124 |
Amjad Al Taki, Omar Othman, Fatma Al Kaddah DOI:10.4103/2321-3825.149067 Objective : t0 he aim of this study was to estimate possible differences in skeletal asymmetry between group of adult subjects with normal occlusion and unilateral and bilateral posterior crossbite malocclusions. Materials and Methods: A sample of 91 subjects (consisted of 37 unilateral posterior crossbite [14 male and 23 female; mean age 22.49 ± 4.19 years] and 31 bilateral posterior crossbite patients [18 male and 13 female; mean age 24.36 ± 3.76 years] and a control group (CG) of 23 subjects with normal occlusion [13 male and 10 female; mean age 22.74 ± 1.74 years]) was examined in the study. Condylar, ramal, and condylar-plus-ramal asymmetry values were measured for all subjects on panoramic radiographs. Data were analyzed statistically by means of paired t-test. Results: Unilateral crossbite group (UCG) and bilateral cossbite group (BCG) showed significant asymmetric indices (condylar, ramal, and condylar-plus-ramal) relative to the CG, except for condylar index when comparing BCG and CG (P > 0.05). Comparisons within the crossbite groups showed no statistically significant differences in condylar, ramal, or condylar-plus-ramal heights (RHs) between left and right sides of the UCG, while for the BCG, significant difference was found only for the condylar-plus-RH (P < 0.05). Conclusions : b0 oth UCG and BCG have asymmetrical condyles compared to CG. Side comparisons within crossbite groups showed asymmetric mandible in BCG. |
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Comparison of rate of retraction and anchorage loss using nickel titanium closed coil springs and elastomeric chain during the en-masse retraction: A clinical study |
p. 129 |
Charushila Vinay Chaudhari, Suchita Madhukar Tarvade (Daokar) DOI:10.4103/2321-3825.150582 Introduction: The aim of this study was to compare the clinical effectiveness of nickel titanium (NiTi) closed coil spring and elastomeric chain on rate of space closure in terms of anterior retraction and anchor loss. Materials and Methods: A total of 40 patients with first premolar extraction were randomly divided into two groups for space closure. Group 1 consisted of 20 patients in whom space closure was done with NiTi closed coil springs whereas in group 2 consisted of 20 patients with elastomeric chain. The amount of anterior retraction, anchor loss and rate of space closure was measured before start of retraction and at end of 4 months clinically and radiographically. Results: The observations obtained in the study were subjected to statistical analysis, so as to get their interpretation. All qualitative variables were compared using Fisher exact test. All quantitative variables were described using mean ± standard deviation and compared using unpaired t-test. P < 0.05 was considered as significant. The unpaired t-test, when applied, revealed there was a faster rate of space closure by NiTi closed coil springs when compared with elastomeric chain. Furthermore, anchor loss was more with NiTi springs as compared with elastomeric chain. Conclusion: The results of this study demonstrated faster space closure (with anterior retraction) along with significant anchorage loss was achieved by using NiTi closed coil springs when compared to the elastomeric chain. |
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Establishing lateral cephalometric norms for Nalgonda children with mixed dentition
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p. 134 |
Manjula Meka, Thabitha Rani Sandipamu, Rajendra E Reddy, Sreelakshmi Natta, Rajesh Aduri, Sandeep S Dande DOI:10.4103/2321-3825.150580 Aim: The aim was to establish lateral cephalometric norms among Nalgonda children with mixed dentition and also to compare these norms with the established value of Caucasian norms. Materials and Methods : A total of 100 children (50 girls and 50 boys), aged between 8 and 12 years was selected based on the following inclusion criteria: Class I molar relationship without any crowding, no skeletal abnormality and no previous orthodontic treatment. A new custom made software was developed into which the subject's data were uploaded for cephalometric analysis of skeletal, dental angular and linear measurements. Results: Nalgonda children demonstrated forwardly placed maxillary and mandibular incisors in relation to NA and NB planes giving an acute interincisal angle of 116.1°. A statistical difference was observed between boys and girls in few variables which include ANB. Lower incisor-NB (linear), angle of convexity, occlusal cant and gonial angle. Conclusion: These children displayed horizontal growth pattern and Class II skeletal tendency with acute interincisal angle which varied from Caucasians. The values provided here would aid in the diagnosis and treatment planning for orthodontic interventions among Nalgonda children. |
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CASE REPORTS |
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Clinical blackout in orthodontics
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p. 138 |
Deepak Kumar Gupta, Ashok K Utreja DOI:10.4103/2321-3825.149048 Due to increased awareness of the general public in today's world of consumer information the nobility related to the health profession has become a thing of the past. Now-a-day, the patients are consumers, and the malpractice lawsuits are on the rise. There is a strong need to focus our mind and body while working on the patients. Further, there is an urgent need to make the body of literature that can help the common practitioner to see what are the most common error/mistakes, usually, committed and at least avoid those which have been reported. |
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Nonextraction management of the labially displaced canine
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p. 141 |
Zeeshan Iqbal Bhat, Charu Dutta Naik DOI:10.4103/2321-3825.150570 Maxillary canine impaction is an anomaly often encountered in children. Although it has been reported that the incidence of palatally impacted canines is higher than that of labially impacted ones, it has been found that labial impaction of canines is more common than palatal impaction in Asian populations. Bringing the ectopic canine into a normal position is important for functional occlusion and the final esthetics of the orthodontic treatment. This article represents a nonextraction treatment approach for a labially displaced canine of a young boy, aged 12 years 6 months, with maxillary transverse discrepancy, labially placed maxillary canine, cross bite with UL3, UL4, UL5, midlines discrepancy, severe crowding in mandibular arch. The orthodontic treatment plan included slow palatal expansion followed by fixed orthodontics which guided the maxillary canine into the arch. This treatment strategy achieved optimal occlusion with improvements to the transverse, vertical, and sagittal relationships and achieved a harmonious smile. |
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