Editorial

Interdisciplinary teamwork is a complex process in which different specialties work together to share expertise, knowledge, and skills to impact on patient care. This article describes the interdisciplinary management of a patient with a new innovative method of using endodontic post and core in orthodontics for three-dimensional root control of a root stump.

Background To ascertain the prevalence of malocclusion and orthodontic treatment need among 15 year old school children in Galle district in the Southern Province in Sri Lanka. Objective To ascertain the prevalence of malocclusion and orthodontic treatment need among 15-year-old school children in Galle district in the Southern Province in Sri Lanka. Materials And Methods A descriptive cross-sectional study was carried out among 802 school children in the Galle district. Multi-stage cluster sampling technique combined with probability proportionate to size method was used to select the sample. Occlusal characteristics including overjet, overbite, crossbites, crowding, and spacing were recorded using a standard pro forma and the need for orthodontic treatment was assessed using the index of orthodontic treatment need dental health component. SPSS 17 for Windows was used to analyze the data. The awareness of malocclusion among the subjects was also assessed. Results It was observed that the prevalence of malocclusion among the sample was 69.5%, and the overall treatment need was 26.6%.

Introduction Condylar growth direction and rotation affect the occlusion, especially in the vertical dimension. The first objective of this study was to evaluate the reliability of a novel three-dimensional semi-automated landmark computer software on mapping the head of the mandibular condyle using cone-beam computed tomography (CBCT). The second objective was to evaluate qualitatively how condylar morphology differs three-dimensionally according to skeletal vertical pattern and mandibular morphology in healthy adults using CBCT. Materials And Methods A total of 242 (169 females and 73 males) participants were eligible for the study. Participants were selected at random from the 242 to create three groups of 10 participants based on their MP-SN° and assigned to a brachyfacial group, dolichofacial group, and mesofacial group. The thirty participants were also divided by mandibular symphyseal morphology according to the chin angle (Id-Pg-MP°). Each subject’s condyles were landmarked using Stratovan’s Checkpoint software. A Procrustes analysis was then used to generate an average condylar shape for each of the six groups from which to evaluate shape differences. Results Checkpoint proved to be a reliable method of placing landmarks on the condyle with a low coefficient of variation of 1.81% (standard deviation/mean). Qualitative analysis of the Procrustes averages revealed brachyfacial average showed a moderate anterior lean from the sagittal, anterior convexity from the axial, and medial lean from the coronal views. The dolichofacial average showed a mild anterior lean from the sagittal, anterior concavity from the axial, and a symmetrical half-dome shape from the coronal. The obtuse chin angle group average displayed morphology similar to the brachyfacial average, whereas the acute chin angle group average displayed morphology similar to the dolichofacial average. Conclusions Checkpoint is reliable software to landmark the temporomandibular joint. There are differences in average morphologies between all groups.

Objectives To find out if there exists any correlation between clivoaxial angle (CXA) and skeletal malocclusions. Materials and Methods: Lateral cephalograms of 33 filipino patients equally divided in three types of skeletal malocclusions were traced, and cephalometric parameters CXA, BaSN, ANB, SNMPA, FMA, MMPA, and Y-axis were traced. Data underwent bivariate correlation and curve estimation analysis in SPSS 17.0 statistical software at confidence interval of 95% and 0.05 significance level. Results A highly significant (P = 0.003) strong negative correlation was revealed in Class III patients between CXA and BaSN. Conclusion Class III patients seem to have higher chances of craniocervical junction anomalies and thus might be at risk of developing neurodegenerative disorders in future.

Objectives The relationship between the presence of bone defects (fenestrations and dehiscences) observed in lateral slices in computerized axial tomography (CAT) images and maxillomandibular transverse discrepancies was determined. Methods The sample was composed of 160 CAT scan files, corresponding to 9–25-year-old patients, which had been taken prior to orthodontic treatment at a radiology center in Guadalajara, México, from 2009 to 2012. They were grouped by age, and we identified bone defects in maxillary teeth (first and second premolars and first molars). The maxillary (JL-JR) and mandibular (GA-AG) widths were measured, and the maxillomandibular discrepancy ([GA-AG]-[JL-JR]) was calculated. Chi-square and t-tests were performed. Results The values of maxillomandibular discrepancies increased with the age of the patient. There was no association between the magnitude of the maxillomandibular discrepancy and the presence of bone defects. The gender of the individual was not a decisive factor in whether bone defects were present. Conclusion Bone defects occur in the vast majority of patients pretreatment regardless of the magnitude of the maxillomandibular discrepancy.

Compliance for removable Twin-block appliance wear is one of the most common problems for successful functional correction. This article describes a simple but versatile semi-fixed Twin-block design that ensures full-time wear of the appliance with provision of possible modifications in different clinical situations.

Skeletal Class III malocclusion is considered to be one of the most difficult orthodontic problems to treat. This malocclusion is associated with the retrognathic maxilla or prognathic mandible or sometimes a combination of both. The treatment of such cases requires an integrated approach and a comprehensive treatment plan including growth modification, dental camouflage, or orthognathic surgery. In a growing patient, orthopedic correction of skeletal Class III malocclusion with the help of a reverse pull headgear is crucial as it can reduce the chances of further surgical treatment to correct the skeletal discrepancy. This case report describes the management of skeletal Class III malocclusion in a 12-year-old female child with a retrognathic maxilla. The patient did not have any other genetic abnormality or significant known comorbidity. The treatment plan involved fixed orthodontic appliance therapy in combination with a reverse pull headgear for an orthopedic effect. This treatment was continued for 3 years, and well-aligned dental arches with a positive over jet were achieved at the conclusion of treatment. Using facemask therapy in conjunction with fixed orthodontic appliances has been a successful treatment option in growing children. Treatment should be carried out as early as possible to correct the skeletal discrepancy nonsurgically and achieve better results.

This case report demonstrates an orthodontic method that offers short treatment time and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 23-year-old female with Angle’s Class I moderately to severely crowded malocclusion with periodontal pocket with 31 and reduced thickness of the buccal cortical plate of lower anteriors, requested shortened orthodontic treatment time. This surgery technique included buccal full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, the case was completed in approximately 7 months and 3 weeks. Posttreatment evaluation of patient revealed good results. Preexisting thin labial bony cortical plate with lower anteriors was covered. This finding suggests credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon.

Book Review