Editorial

Ligation of archwire to lingual bracket is a tedious and time-consuming process. Any excessive clinical working time on a lingually treated patient has a direct bearing on pain and discomfort experienced due to prolonged mouth opening. An aid to quick and efficient ligation is described below.

Invisalign initially had limitations which have now been overcome.Advances in the quality of aligner materials, attachments and the introduction of a new force system, have expanded the range of treatment possibilities from severe crowding to more difficult extraction cases, open bite cases, and lower molar distalization cases.

A technique of accurately assessing left and right maxillary molar movement is described, using superimposition of digital study models. This method has distinct advantages over the traditional method of measuring tooth movement using cephalometric radiographs.

The usage of the portable electronic devices such as the smartphones and handheld tablets has increased over the years, and this is true in the health-care industry also. This is because of the development of various patient management softwares. The use of apps to manage, educate, and inform patient is not uncommon among orthodontists nowadays. The aim of this article was to review the various apps available on the Google Play Store and iOS Apple Store for orthodontists and patients. Four smartphones using orthodontically relevant keywords such as orthodontics, orthodontists, and braces were searched and reviewed in detail. Out of the 354 orthodontically relevant apps available in both Android and Apple operating systems, the apps could be categorized as orthodontist-related apps or patient-related apps. Under these categories they could be further classified as practice managements apps, patient education apps, model analysis apps, tooth material calculators, patient reminder apps, etc.

Objective: Permanent mandibular second molar impaction can lead to dental problems including periodontal pockets. In this study, uprighting of impacted mandibular second molars was carried out. Two surgical techniques were compared for time taken to upright the impacted mandibular second molar and if any periodontal pocket was formed on the distal aspect of the uprighted molar due to the surgical removal of bone distal to the impacted second molar after uprighting. Materials and Methods: A total of 20 subjects with impacted mandibular second molars were chosen from our orthodontic practice for this study. All the second molars were mesio-angularly impacted and unerupted. The subjects were divided into two groups. Group I comprised ten subjects with the cementoenamel junction (CEJ) of the unerupted impacted second molar apical to the level of the alveolar ridge. Group II comprised ten subjects with the CEJ of the unerupted impacted second molars at or coronal to the level of the alveolar ridge. 1.8 mm diameter and 10 mm length self-drilling microscrews (3M Unitek temporary anchorage devices) were placed into the retromolar area distal to the impacted second molars. Groups II and I underwent surgical exposure of the impacted second molars and placement of 10 mm length microscrews. In Group I subjects, bone was removed from the entire distal aspect (furrowing) of the impacted second molar. Group II subjects did not undergo any removal of bone on the distal aspect of the impacted second molars. One button each was bonded on the buccal and lingual surfaces of the surgically exposed second molars. Elastomeric chains were attached from the microscrew head to the buccal and lingual buttons so as to bodily upright the molar. After complete uprighting, a single examiner (periodontist) who was blinded to the type of surgical technique evaluated the periodontal status of the second molar by clinical probing of the sulcus depth (SD). The comparison of the significance of the difference of average duration and average SD between the two study groups was tested using Mann–Whitney U-test (a nonparametric test). The value of P < 0.05 is considered to be statistically significant. Results: Average duration of uprighting was significantly longer in Group II compared to Group I (P < 0.001). SD on an average is significantly deeper in Group I (furrowing) as compared to Group II (no furrowing) at distal surfaces (P < 0.001 for all distal sites). Average SD did not differ significantly between Groups II and I at mesial surfaces (P > 0.05 for all mesial sites). Conclusion: In Group I subjects, uprighting was hastened in comparison to Group II subjects where the CEJ was at or coronal to the alveolar bone. The furrowing of the bone does cause a deepening of the SD on the distal surface of the second molar, but this is not clinically significant. This deepening cannot be termed as a periodontal pocket as it is well within normal limits.

Objective: The study conducted to assess the effects of a fixed functional appliance (Forsus Fatigue Resistant Device; 3M Unitek, Monrovia, CA, USA) on the mandible with three-dimensional (3D) finite element stress analysis. Materials and Methods: A 3D finite element model of mandible with miniplate at mandibular symphysis was prepared using SolidEdge software along with the plate geometry. The changes were deliberated with the finite element method, in the form of highest von Mises stress and maximum principal stress regions. Results: More areas of stress were seen in the model of the mandible at cortical bone in canine region at bone and miniplate interface. Conclusions: This fixed functional appliance studied by finite element model analysis caused more von Mises stress and principal stress in both the cortical bone and the condylar region.

Background and Objectives: Connecting the contralateral upper molars by means of a transpalatal arch (TPA) is thought to decrease the tendency of the molars to move mesially in response to orthodontic force (i.e., provide orthodontic anchorage). This study was hence conducted to investigate the effects of the TPA on the displacement of the molars and stresses generated in the periodontium during orthodontic tooth movement using the finite element method (FEM). Materials and Methods: A three-dimensional (3D) model was generated using medical modeling software (Mimics) using the computed tomography slice images of the skull which were obtained at a slice thickness of 1 mm. From this, the finite element model was built using HyperMesh and analysis was performed using PATRAN software (MSC Software Corporation, 4675 MacArthur Court, Newport Beach, California 92660). The 3D finite element models were fabricated in two versions such as maxillary first molars including their associated periodontal ligament and alveolar bone one with TPA and another without TPA. Both were subjected to orthodontic forces, and the resultant stress patterns and displacements between the models with and without TPA were determined. Results: The stress and displacement plots in this study failed to show any significant differences in stress and displacement within the periodontium of molars, between the two models – one with TPA and the other without, in response to the orthodontic force. Interpretation and Conclusion: The results of the current finite element analysis, therefore, suggest that the presence of a TPA brings about no change in the initial dental and periodontal stress distribution and displacement.

Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.