Editorial

Adult patients with a multitude of problems require seamless integration of interdisciplinary protocols. This article presents a case of an adult female who reported with temporomandibular disorders, a crossbite and a Class III skeletal pattern. An interdisciplinary approach using expansion and surgery was used to treat the condition, followed by an esthetic/restorative protocol, achieving excellent results.

Book Review

Aims And Objective The purpose of this study was to examine different components of a smile in subjects with class I occlusion and to formulate a comprehensive photographic analysis of a smile. This study was designed to find a correlation between upper lip elevation and retraction with upper lip morphology during smiling among male and female groups. Materials And Methods Lateral cephalogram and standardized frontal photographs were taken at rest and smiling. Results A significant sexual dimorphism was apparent in several of the parameters studied. Middle portion of lower border of upper lip (MUL’-MUL) rose significantly higher by 0.91 mm in the male group than in the female group, during smiling (P = 0.003). Decrease in vermillion display (VE-VE’) was significantly higher in the male group than the in female group by 0.668 mm (P = 0.021). Conclusion This comprehensive study of lip mobility, when applied to a larger population can enable us to further evaluate the correlation between lip morphology and mobility.

Cleft lip and palate (CLP) is defined as a congenital deformity caused by failed fusion of medial and lateral palatine processes during 4-12th weeks of embryogenesis, resulting in an open communication between oral and nasal cavities. In CLP patients, maxillary hypoplasia, velopharyngeal insufficiency, and alveolar clefts are the major issues that have to be taken care of after labiopalatal reconstruction. Rather than several consecutive operations, such as bone-grafting and orthognathic surgery, alveolar distraction can be a better treatment option in many cases. Archwise Distraction Appliance (AWDA) is a rigid, tooth-borne, custom-made appliance that is developed to control the distraction vector with double archwire system. Our experiences show that the AWDA is a successful appliance in cases of distraction osteogenesis. Moreover, alveolar distraction has significant advantages over conventional treatment modalities for CLP patients.

Background And Objectives The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeç et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials And Methods A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001). Interpretation And Conclusion The results suggested that modified corticotomy technique serves as an effective and safe way to accelerate orthodontic tooth movement, without adversely affecting the periodontium, root resorption, and the vitality of the teeth, as concluded by clinical and radiographic examination.

Context There has always been a need for nonnumeric facial analyses that would not compare an individual’s facial measurements with the preestablished norms, rather evaluate the facial form individually. This would help in diagnosis and treatment planning, unique to that individual. Aims The purpose of the study was to determine and establish a relation between skeletal, dental and soft tissue structures using centrographic analysis (CGA) in pleasing faces of Western Uttar Pradesh population. Materials And Methods A total of 50 subjects (22 males and 28 females) with “most pleasing faces” were taken up for the study, within the age group of 20-25 years. Frontal facial photographs and lateral cephalograms were taken for all the subjects. Conventional cephalometric analysis and CGA were applied to each lateral cephalogram. Arithmetic mean and standard deviation values were calculated, and an independent t-test was performed for calculating cephalomorphic norms and comparison between the male and female sample. Results The results showed that, the adults in the age group of 20-25 years, belonging to the Western Uttar Pradesh population have protrusive maxillary and mandibular skeletal bases and retrusive upper lip on contrary to a protrusive lower lip, though a sexual dimorphism was observed. The upper centroid and lower centroid values were statistically greater in women (P = 0.05 and P = 0.04 respectively) whereas, upper lip linear value was statistically greater in men. Conclusions The CGA is valid for Western Uttar Pradesh population. The Western Uttar Pradesh adults have protrusive mandible and a retrusive upper lip though there exists a sexual dimorphism. These practical centrographic norms can be used as an adjunct to the conventional cephalometric evaluation of an individual for diagnosis and treatment planning.

Aim The purpose of this investigation was to (1) compare the credibility of four recently introduced cephalometric measurements in assessing the antero-posterior jaw relationship; (2) To assess the correlation between various measurements used for assessment of antero-posterior discrepancy, including Yen linear, Yen angle, W angle and Pi angle. Materials And Methods The sample size for the study consisted of 45 subjects with age group of 15-19 years (mean age 17 ± 2.1) and was subdivided into Skeletal Class I, II and III groups of 15 each based upon the ANB angle derived from the pre treatment lateral cephalogram. Landmarks were located and Yen angle, Yen linear, W angle and Pi angle were assessed for each group. All the lateral cephalograms were traced by a single examiner. Intra examiner reliability was assessed by Intraclass co-efficient correlation (ICC) test. Correlation coefficients were obtained for each of parameters to compare their relationship with other parameters in Class I group. Receiver operating characteristics (ROC) curves were run to examine sensitivity and specificity of all the angles. Results The results showed that ICC for all the groups were =0.90 showing good repeatability of the measurements. There was statistically significant correlation between Yen angle and ANB angle, Yen linear and Yen angle for Class I group, between W angle and Yen angle for Class II group, between Yen angle, Yen linear and ANB for Class III group. ROC curves showed that Pi angle had 100% sensitivity and specificity to discriminate a Class II and a Class III group from a Class I and a Class III group from a Class II. Yen linear and W angle showed very low specificity to differentiate a Class II from a Class I group. Interpretation And Conclusion The new parameters considered in the study were found to be equally reliable and are not affected much by local remodeling due to tooth movements or by occlusal or Frankfurt horizontal plane. These parameters measure the antero-posterior discrepancy more consistently and accurately, with Pi angle being the most accurate.

The new and innovative technologies are unprecedentedly improving the level of proficiency in orthodontics in the recent history of this area of expertise. The proliferation of advances, such as self-ligating systems, temporary anchorage devices, shape-memory wires, robotically wire bending, intraoral scanners, cone-beam computed tomography, bring the virtual planning, and confection of dental devices through CAD/CAM systems to the real world. In order to get efficiency and efficacy in orthodontics with these new technologies, we must understand the importance of systemically managed clinical information, medical, and dentistry history of the patients, including the images resources, which ensures the use of a communication that is assisted by the technology, with an interdisciplinary team so that the database is able to help and support the process of therapeutic decision-making. This paper presents the clinical case of a borderline patient for orthognathic surgery who had his final treatment planning supported by these new tools for three-dimensional diagnosis and virtual planning.

This paper describes modified Nance palatal button by which problems encountered in the palatal region around the acrylic button during space closure and molar distalization can be minimized.