Nonsurgical improvement of an occlusal cant, lip cant, and soft tissue chin deviation has been considered not possible merely through orthodontic treatment without surgical intervention. The purpose of this report was to illustrate a possible new field in orthodontics for a non-invasive improvement of the occlusal cant and soft tissue chin deviation through orthodontic approach by an innovative orthodontic archwire (Yin-Yang wire) and the others.

Editorial

Over the past 15 years, I have been involved in different roles as author of orthodontic and non-orthodontic manuscripts, reviewer of orthodontically related submissions and assistant/associate editor of different orthodontic journals. Over that span, I have committed multiple mistakes both while writing a manuscript and while critically appraising one. I hope these few timbits* would help you strengthen any future manuscript submission you may consider working on. I have identified 10 common mistakes that I have observed while preparing/reading scientific articles. The list is not ordered according to importance but following the template of a typical scientific article.

Introduction The aim of this study was to examine whether dental professionals and lay people group do agree in their perception of digitally altered facial components or not. Materials And Methods A frontal photograph of a Saudi young man was taken, imported, and digitally altered to a series of images of 16 photographs. Eyes, nose, mouth, and chin were altered gradually from the original photograph and were rotated 1°, 3°, and 5°. 225 raters (60 lay people, 41 orthodontists, 77 dentists, and 47 dental students) were invited and asked to evaluate the original and altered images using a visual analog scale. Results Lay people were less critical and gave higher ratings than dentists when evaluating rotated eyes of 5°. Orthodontists gave higher ratings than lay people and dental students at distinguishing of 1° of rotated nose. Orthodontists were less critical in rating larger alterations of the nose at 3° than lay people. Orthodontists were also less discriminating of minor alterations of the lips. They could not detect mouth rotation of 1° compared to lay people and dental students. Conclusions The results of this study underline the importance of developing an objective index to enumerate the magnitude of facial asymmetries.

A 15-year-old female presented with a chief complaint of unesthetic smile and protrusive lips. Lower facial height and convexity were within normal limits, but the lower lip was protrusive (3mm to the E-Line). Bimaxillary retrusion (SNA 79.5°, SNB 76°, and ANB 3.5°) and a high mandibular angle (SN-MP 38°) were noted. Lower incisors were prominent (L1 to MP 96° and L1 to NB 8 mm). Molars were Class I, but the upper right canine (UR3) was Class II. The upper left deciduous canine (ULc) was retained, and the UL3 was labially impacted. An oblique direction of canine eruption wedged the impaction between the keratinized mucosa and the adjacent incisor, eliciting root resorption on the labial surface of the UL2. The discrepancy index (DI) was 16. Following extraction of all four first premolars and the ULc, all teeth except the UL2 were bonded with a Damon Q® passive self-ligating bracket system. Vertical incision subperiosteal tunnel access (VISTA) technique was performed to produce a submucosal space for retraction and extrusion of the impacted UR3. A button was bonded on the UL3, and a power chain was attached. The elastomer chain exited the mucosa through a more distal incision, and traction was applied with a custom lever arm, anchored by an OBS® inserted into the left infrazygomatic crest. The impaction was retracted into a normal position between the UL2 and UL4. Once the UL3 was extruded to the occlusal plane, the UL2 was bonded and its axial inclination was corrected with a labial root torquing auxiliary. Both arches were detailed and finished. After 24 months of active treatment, the UL3 was well aligned, but the labial gingiva supporting it was immature and only partially keratinized. Follow-up visit 1.5 years later showed its maturation into a stable but relatively thin band of gingiva. In retrospect, this UL3 gingival problem may have been avoided by adjusting the three-dimensional (3D) lever arm for a more palatal emersion of the impaction. There was no change in the preexisting labial root resorption of the UL2, but no additional root resorption on any teeth occurred during active treatment. Final alignment and dental esthetics were excellent as evidenced by an American Board of Orthodontics Cast-Radiograph Evaluation score of 12, and the IBOI Pink and White Esthetic Score of 2. VISTA with an OBS 3D lever arm is an important advance for orthodontic impaction recovery. Submucosal retraction of a labially- impacted, partially transposed maxillary canine permits optimal emergence into the arch. Differential biomechanics of soft and hard tissue explains impaction-related root loss before treatment, as well as the mechanism for protecting an unrestrained lateral incisor while the impacted canine is recovered.

Introduction Skeletal maturity is of paramount importance for the diagnosis and prognosis of orthodontic treatment undertaken in adolescents. This can be assessed by different methods. The study here aims at evaluation of the effect of the onset of menarche and body mass index (BMI) percentile, i.e., overall body growth, on the skeletal maturation of adolescent females and, to find the relationship between age at menarche, cervical maturation stages, and BMI percentile in female orthodontic patients of Indian origin. Materials And Methods Adolescent females were asked to fill a questionnaire to extract the history of their menarche and chronological age and those within 3 months of menarche were selected. Their height and weight were measured under standard conditions and BMI was calculated. Lateral cephalograms obtained for them were scaled for cervical vertebrae maturation stages according to Hassel and Farman’s method. These parameters were then statistically correlated. Results The results showed that the girls with higher BMI percentile attained menarche early than their healthier counterparts, whereas attaining menarche did not correlate with any specific stage of skeletal maturity. Conclusion Young girls coming for orthodontic treatment should be carefully assessed for skeletal maturity, as variable amount of skeletal growth may be left even after attaining menarche.

ntroduction Patients undergoing fixed orthodontic treatment are usually recalled electively for the adjustments of the appliances, but sometimes they appear suddenly for emergency visit which must be addressed immediately. The primary objective of this study was to assess the nature and frequency of emergency visits made by patients under labial fixed orthodontic therapy. The secondary objective was to compare these visits between genders and age groups. Materials And Methods The study was conducted at orthodontic clinic, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. All the patients undergoing fixed labial orthodontic treatment were included and followed up for a period of 6 months. The reason for emergency appointment was recorded along with the demographic and clinical details. Chi-square test was used to find out the possible association between gender and age group with emergency appointment. Results Of 327 patients undergoing active fixed orthodontic therapy, 199 were female and 128 were male. A total of 176 emergency appointments were encountered during the study period of 6 months. The most common reason was the loosening of brackets or bondable buccal tubes (118) followed by loosening of bands (45). Other reasons were trauma to the buccal mucosa by the overextended wire (5), detachment of buccal tubes from the band (5), tearing of bands (3), breakage of acrylic plate (2), loosening of ligature tie (1), and dislodgement of elastomeric chain (1). Emergency appointments were not found to have statistically significant association with age group (?2 = 0.073, P = 0.787) or the gender (?2 = 3.196, P = 0.074). Conclusions Loosening of the brackets or bondable buccal tubes was the most common cause for emergency visit. No significant association was found between the gender and age group with such visits.

Introduction The purpose of the present study was to evaluate the long-term stability of open bite correction with spring-loaded and magnetic bite blocks. Materials And Methods A total of 14 patients out of the original sample of 20 were evaluated clinically and cephalometrically at post-treatment, post-retention, and 4.2 years after retention. Of 14 patients, eight were from spring-loaded bite block group, while remaining six were from magnetic bite block group. Normality of data was checked with Shapiro–Wilk test and one-way repeated measures analysis of variance was used to compare the values at different time intervals. Pearson correlation analysis was used to examine the correlations between various cephalometric variables. Results Clinically, decrease in overjet and increase in overbite were evident in 12 patients, while two patients showed non- significant decrease in overbite. Skeletal changes in the form of the closure of mandibular plane angle, clockwise rotation of palatal plane, and significant increase in posterior face height were seen. Molar intrusion relapsed in the follow-up period but was compensated by the incisor extrusion. Overall, the success rate of 85.8% was seen. Conclusion Stability of early treatment with active bite blocks is comparable to any other treatment modality for correction of mild-to-moderate skeletal open bite cases. Importance of retention using the passive bite blocks needs further evaluation.

Introduction The palatal bone is a suitable site for mini-implant placement due to it being a “rootless area” with dense bone. This application has increased with mini-implant-assisted rapid palatal expansion becoming the preferred method of expansion. It is necessary to measure the vertical bone height with a reasonable accuracy, at the implant insertion site, to utilize the maximum available bone support, and to avoid the risk of perforations. As an accepted method, full-volume cone-beam computed tomography (CBCT) scan is advised for the same. This requires an additional procedure, further, radiation exposure, and cost to the patient. The aim of the study was to establish the utility of lateral cephalogram as a simple and reliable method to measure palatal bone thickness for placement of mini-implants in the 1st premolar and 1st molar region, which are the most common sites of mini-implant placement. Materials And Methods A total of 30 CBCT scans and digital lateral cephalograms of patients were selected and analyzed at the 1st premolar and molar region and were statistically evaluated using Student’s t-test and Wilcoxon rank-sum test. Results The results obtained indicated a highly significant correlation between the measurements obtained on lateral cephalograms at both the 1st premolar and 1st molar areas, P < 0.001. Conclusion The data presented show that lateral cephalometry provides a reliable assessment of the quantity of vertical bone for paramedian insertion of a palatal implant.

The current paper depicts the challenges faced during the treatment of a complicated case of mandibular condylar head fracture, facial asymmetry, and centric relation-centric occlusion (CR-CO) discrepancy along with Class III malocclusion. A 20-year-old female reported with the chief complaint of difficulty in chewing and concern with her appearance due to deviated jaw and had a history of trauma over chin region. The clinical and radiographic examination revealed significant facial asymmetry with long face, right-sided deviation of the mandible, fractured condyle, CR-CO discrepancy, cross- bite with Class III malocclusion, and a missing mandibular single incisor along with non-vital 21 and 22. She was treated with 0.022 MBT appliance along with guiding plane for CR-CO correction followed by asymmetric bilateral sagittal split osteotomy and differential set back on the right and left sides and finally rigid fixation. A good facial profile and functional occlusion were achieved and non-vital 21 and 22 were esthetically rehabilitated with PFM crowns. The stability of surgical as well as orthodontic corrections was excellent and appreciable in the records obtained 2-year post-treatment. When faced with mutilated malocclusion, with multiple problems, sequential correction of functional malocclusion with dental decompensation followed by skeletal correction with surgical approach has yielded a appreciable facial correction with good stability showing 2-year post-treatment follow-up.