Editorial

Dentoskeletal Class III malocclusions are one of the greatest challenges to the orthodontists due to the interaction of both environmental and genetic etiological factors. Over the years, several interceptive treatments for Class III dentoskeletal malocclusions have been proposed in growing patients. Our orthopedic approach includes two occlusal Splints combined with Class III Elastics and Chincup and so it is named SEC III protocol. The main difference with all the other appliances is the vertical control that is crucial, above all, in the most difficult cases as the hyperdivergent Class III malocclusions.

Aims And Objectives The aim of this scoping review was to identify the type of outcomes measured in surgery- first orthognathic approach (SFOA). The objectives were to classify the outcomes into predetermined domains and explore the degree of representation of each domain. Furthermore, to identify which domains are over- or under-represented and determine whether the findings of this scoping review could be employed to provide a template for core outcome sets (COS). Five outcomes were identified, and all the research pertinent to SFOA were assigned to these outcomes. Materials And Methods Electronic databases and additional records were searched from January 2009 to March 2019 to source the data, and 525 records were identified. Results The initial database and additional search resulted in 525 records, of which 54 potentially relevant articles were retrieved in full. 35 studies met the selection criteria following screening and were included in the scoping review with the results of the search depicted in the preferred reporting items for systematic reviews and meta-analyses. Domains such as morphological features or changes in maxillofacial skeleton and occlusion (n = 25, 71.42%) and psychosocial well-being including quality of life outcome (n = 8, 22.85%) were well represented while functional status (n = 1, 2.85%), health resource utilization (n = 0), and adverse effects (n = 1, 2.85 %) were under-represented. Conclusions Limited research on SFOA precludes development of COS. However, future SFOA clinical trials should consider underrepresented outcome domains to address the SFOA treatment modality comprehensively.

Background Adult patients used to be daunted with the prospect of having fixed appliances to correct malocclusions. However, this has gradually changed and recent literature reported an increasing trend in adults receiving orthodontic treatment. To date, there has been no information regarding the trend of adult orthodontic patients in Singapore. Objective The objective of this study was to determine the changes in the proportion of adult patients seeking orthodontic treatment at the National Dental Centre Singapore (NDCS) from 2011 to 2017. Materials And Methods The study sample consists of all patients who commenced active orthodontic treatment from 2011 to 2017 at the NDCS. The data collected were analyzed for the number, gender, and proportion of adult orthodontic patients treated annually from 2011 to 2017. Linear-by-linear association test was used to test for any significant linear trend in proportion of adult orthodontic patients over the 7 years. Pearson’s Chi-squared test was used to test for any significant gender differences. Results There was a significant increasing linear trend (p = 0.001) in the proportion of adult orthodontic patients from 2011 to 2017. No significant difference (p = 0.770) between the proportions of male and female adults undergoing orthodontic treatment was found. The ages of adults undergoing orthodontic treatment ranged from 21 to 73 years old and majority (48.61%) of them was in the 21–25 years old age range. Conclusion There is a rising trend in adults seeking orthodontic treatment at the NDCS from 2011 to 2017. No statistically significant gender difference was observed in this rising trend.

Objective The aim of this study was to assess the effect of fixed orthodontic treatments with steel-ligated conventional brackets and self-ligating brackets (SLBs) on periodontal clinical parameters. Materials And Methods Seventy-seven patients (24 male and 53 female) aged between 18 and 30 years were enrolled in the study. Periodontal parameters including plaque index (PI), gingival index (GI), and bleeding on probing (BOP) index were obtained from all the bonded teeth. Results When the effect of bracket type and duration of treatment on gingival tissues was examined, there was no statistically significant difference between the treatment times (P = 0.670) and bracket types (P = 0.596) in terms of PI. The GI was significantly different between the different treatment durations (P = 0.045); it was higher in patients with a treatment duration of 18–36 months. However, the GI did not change according to the bracket types (P = 0.270). This result was not significantly different between different treatment durations (P = 0.270). There was no significant difference between the treatment periods (P = 0.189) in terms of BOP index, and this result did not change according to the bracket types (P = 0.621). Conclusion SLBs do not require ligatures, which may facilitate plaque accumulation. However, our results showed that SLBs were not advantageous over CBs in terms of periodontal health.

Aims This study aims to find the prevalence of orthodontic treatment need and malocclusion problems in 8–9-year-old schoolchildren in the south of Thailand. Materials And Methods A number of 202 children (100 boys and 102 girls) samples were randomly selected from all schools in Hat Yai District, Songkhla Province, Thailand. A cross-sectional survey of dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and malocclusion problems was investigated by clinical examination and dental model. Results Levels 4 and 5 of orthodontic treatment need according to DHC of IOTN of the sample were presented in 18.8% and 1.49%, respectively. Children who need orthodontic treatment (Grade 2–4) showed more than one highest DHC problem that indicated the level of treatment need (39.68%). Normal occlusion was found at 6.43%. Malocclusions such as Class I, Class II division 1, Class II division 2, and Class III malocclusion were observed in 78.71%, 7.92%, 3.47%, and 3.47%, respectively. Reversed overjet and overjet >9 mm were detected in 5.64% and 1.58%, respectively. Approximately half of the children (46.67%) had overbite >3.5 mm. Conclusions High percentage of children in mixed dentition period who need orthodontic treatment was found in this study. Some children who presented with the orthodontic treatment need Grade 2–4 had more than one DHC problem which identified the grade of treatment need. Class I malocclusion was most frequently found in this group of children.

This case report describes the use of a miniscrew-anchored sliding jig (SJ) to distalize molars in a patient with maxillary midline deviation. A 41-year-old female presented with a chief complaint of maxillary midline deviation toward the left caused by prior orthodontic treatment involving unilateral extraction of a maxillary left premolar. Clinical examination revealed facial symmetry and a straight profile. The maxillary midline was deviated 2.5 mm to the left. The patient was treated with molar distalization using miniscrew-anchored SJs. Midline correction and alignment were obtained with maxillary unilateral distalization and mandibular full-arch distalization. The total active treatment period was 32 months. Appropriate occlusion and centered midlines were maintained after 29 months of retention. Our results suggest that the treatment method described herein is effective to distalize the unilateral posterior segment in either arch.

Objectives Orthodontic bracket removal from a porcelain crown can roughen the surface and lead to plaque accumulation, discoloration, and esthetic problems. Porcelain polishing after debonding is one strategy to decrease such consequences. This study aimed to compare the efficacy of two polishing systems (Sof-Lex discs and Meisinger polishing system) for correction of surface roughness and discoloration of porcelain after orthodontic bracket debonding. Materials And Methods Twenty porcelain blocks were evaluated in two groups of 10. First, the baseline surface roughness and color parameters of the samples were measured using atomic force microscopy and spectrophotometry, respectively. After bracket bonding, a fine cutter was used for bracket debonding, and resin remnants were removed by a tungsten carbide bur and low-speed handpiece. Samples were then polished using Sof-Lex discs (group 1) and Meisinger porcelain polishing kit (group 2). Surface roughness and color parameters were measured again. Data were analyzed using SPSS 18 through the Shapiro–Wilk test, Student’s t-test, and paired t-test at 5% level of significance. Results Porcelain color change (?E) was significantly greater in the Meisinger system than Sof-Lex (P < 0.001). The Rq, Ra, and Rt surface roughness parameters significantly increased in both the groups after the intervention compared to baseline (P < 0.05), but the two groups were not significantly different in this respect after the polishing procedures (P > 0.05). Conclusion The porcelain color after polishing with Sof-Lex discs was closer to the baseline. Furthermore, the two systems were not significantly different regarding surface roughness. However, Sof-Lex discs may be recommended due to lower cost.

This article presents the orthodontic treatment of a 15 year old male patient with an Angle class I malocclusion with a class II skeletal base, lower incisor proclination along with a hyperdivergent facial pattern. Such situations that involve camouflage treatment, usually results in further lower incisor proclination which can be reduced to an extent by adding buccal root torque. Placement of additional torque in this case however, resulted in positioning of the root apex of the lower right lateral incisor outside the alveolar housing, although no gingival signs were present. The mechanics were then reversed and at the end of 21 months of treatment, the apices were back within the alveolar housing. A 4-year post-treatment cone-beam computed tomography showed normal bone coverage of the affected tooth; and no clinical signs of gingival pathology were present. Orthodontists should be aware of possible complications of excessively torqueing lower incisors in order to prevent proclination. If root apices are inadvertently moved through the cortex, a good long-term prognosis is possible using orthodontics alone by reversing the mechanics, if no gingival complications are present.