Special Feature

A 13-year-old female with a chief complaint of continuing treatment presented with Class I skeletal pattern and slight facial asymmetry. Intraorally, she had Class II molar relationship on the right side, class l on the left side and 3mm. of midline discrepancy. Her upper and lower incisors were proclined and slightly crowded. She had 1 mm. overbite and 5mm. overjet in initial mounted casts. Splint therapy was suggested to stabilize mandibular position. After splint wear, a new mounting was made, which resulted in an open bite from left second molars to right second molars. A visual treatment objective was prepared with four first bicuspid extractions. After 9 months, upper second molars were extracted and temporary anchorage devices (TADs) were placed in the upper arch for intrusion. Detailing strategies such as bracket repositioning, occlusal adjustment, and elastics were used. The role of segmented models, second molar extraction treatment, and superimposition analysis in patients with discrepancies in mandibular position is discussed. It is concluded that a thorough case workup is needed to provide patients with a successful treatment for open bite cases. This case was treated orthodontically in 2 years with four bicuspid and upper second molar extractions as well as vertical control with TADs.

Book Review

Objective: The aim of this study was to evaluate skeletal and dentoalveolar changes before and after skeletal anchorage-assisted rapid palatal expansion in young adults by cone beam computed tomography. Materials and Methods: This pilot study included ten patients with a mean age of 21.5 years with maxillary transverse deficiency treated with the skeletal expander. Three dimensional evaluation of the changes before and after expansion was evaluated with Cone Beam CT. Statistical analysis was performed using paired t-test. Results: Skeletal expander produced an increase in maxillary transverse dimension at the skeletal, alveolar, and dental level. The maximum expansion was at the level of dentition, and the least amount of expansion was at the level of the frontonasal suture. There was also evidence of sutural divergence and buccal tipping. Conclusion: The maxillary skeletal expander is an effective method for correction of maxillary transverse deficiency without surgery in adults.

Aims and Objectives: We evaluated the factors which affect patient satisfaction and their expectations toward “surgery first” and conventional orthognathic surgery. Materials and Methods: Questionnaires consisting of 17 questions were given to the subjects postoperatively who had undergone Le fort 1 maxillary superior impaction for skeletal gummy smile correction with conventional orthognathic surgery and “surgery first” approach. Eleven-point rating scale based on a (visual analog scale; 0 = poor; 10 = excellent) were used to answer six questions. Ten closed-form questions were also included as well as one open question for “further remarks.” Results: Nineteen patients (12 females, 07 males; mean age, 23.4 ± 4.9 [standard deviation] years) gave their consent to participate in the study. The intention to undergo surgery only for esthetics was noted in 42.11% of patients; only improvement of chewing function in 21.05% and both in 36.84%. Conclusion: The most common factor for patient satisfaction after “surgery first” and conventional orthognathic surgery was facial esthetics, but masticatory function and even psychological aspects should be considered equally when planning surgery. The patient satisfaction was more in “surgery first” than conventional orthognathic surgery. The timing of treatment and immediate results are important factors toward patient satisfaction

Introduction: Tweed’s diagnostic triangle is simple yet provides a definite guideline in treatment planning. The aim of the present study was to establish the Tweed’s norms for Bangladeshi people. Methods: The study was conducted for 89 Bangladeshi young adults (45 males and 44 females), aged 19–27 years, having balanced and harmonious facial profiles. Lateral cephalograms taken of these subjects were used for a series of morphometric analyses. Results: All three angular parameters Frankfort-mandibular plane angle (FMA), Frankfort-mandibular incisal angle (FMIA), incise mandibular plane angle (IMPA)were measured and found to be 24.52°, 54.60°, and 100.88°, respectively. The mean FMA has been found to be 24.52° (with a range of 14°–36°) which is quite close to Tweed’s norm and found to be statistically insignificant. However, IMPA and FMIA values of Bangladeshis found to be statistically significantly different from that of the Caucasians. The linear regression equation of IMPA on FMA was fitted, and the estimated value of IMPA was computed for a given FMA. Conclusion: The results support the idea that treatment objectives of IMPA should be considered according to the facial pattern, i.e., FMA. Ethnic variations of norms cannot be overlooked while outlining goals and planning the treatment.

Editorial

Introduction: The aim of this systematic review was to compare still photography and videography for smile analysis. Materials and Methods: Based on the available data, two authors conducted an electronic database PubMed search from January 1, 2000, to December 31, 2015, and ten strategies were designed using five keywords along with their respective synonyms. Twelve articles were shortlisted for the systematic review. Results: The search yielded 91 articles, of which 12 were included based on the selection criteria. Of these 12, five concluded videography compared to be a better tool. Seven articles had variable conclusions based on the study setting and population evaluated. Conclusions: Digital video clips offer a tremendous amount of information for analyzing the dynamic character of the smile, but a standard digital photograph allows for immediate viewing