Editorial

Intrusion of the supra erupted molar is one of the most difficult treatment. Supra eruption is common in a mutilated dentition. This article describes an effective way to bring about intrusion of supra erupted molars.

In recent years, maxillary molar distalization with noncompliance mechanics has been an increasingly popular method for the resolution of Class II malocclusion. This communication describes one particular molar distalizing appliance, the Smart distal-propeller appliance which is simple, inexpensive, easily fabricated that can be used for unilateral or bilateral molar distalization.

The article explores the current orthodontic landscape with respect to the challenges that affect the pursuit of excellence in the specialty. These challenges include marketing by manufacturing companies, financial pressures, marketplace competition, attaining practice efficiency, new product introduction with limited supporting evidence, attributing greater importance to patient experience than the best approach to treatment, and lack of public education regarding their best interests. Home or DIY treatment, bypassing office visits and the practitioner, have also emerged as a concerning trend with the public not clearly understanding the detrimental consequences that may ensue. An over reliance on technology may override individualized treatment and further compromise treatment results.

Objective Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc) improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and preliminarily evaluate their clinical effects. Patients And Methods Six patients in late teenage with Class III malocclusion were included in this preliminary report. Bite raisers were first placed on the upper molars to open the bite and clockwise rotate the mandible. Intermaxillary elastics were then applied vertically between the upper and lower dentitions in 3 patients for bimaxillary extrusion (Technique-1) or between the upper dentition and the lower temporary anchorage devices (TADs) in another 3 patients (Technique-2) for upper dentition extrusion and closure of the anterior open bite. The three-dimensional cone-beam computed tomography images taken before and after orthodontic treatment were superimposed to evaluate the treatment effects of MMc clockwise rotation for both techniques. Results The Technique-1 extruded the upper and lower dentitions, rotated the mandible clockwise 2.01°, moved chin down 2.98 mm, and back -1.64 mm, although the mandible grew 2.47 mm during the treatment period. The Technique-2 extruded the upper dentition, rotated the mandible clockwise 0.90°, moved chin down 1.78 mm, but slightly forward 0.47 mm due to the mandible grew 2.50 mm and lower dentition was not extruded. Conclusions The orthodontic clockwise rotation of MMc is an effective technique for orthognathic camouflage. The applications of bite raisers and bimaxillary dentition extrusion could be more effective than single dentition extrusion with TADs in the mandible for clockwise rotation of MMc and improvement of occlusion and facial profile in late teenagers with Class III malocclusion. However, the comprehensive clinical effects and long-term stability need further clinical studies.

The American Board of Orthodontics (ABO) was founded nearly ninety years ago as the first American specialty board in the field of dentistry. The ABO, in affiliation with the American Association of Orthodontists, is, in fact, the only orthodontic specialty board that is recognized by the American Dental Association. In order to become board-certified by the ABO, an orthodontist must successfully pass a written examination as well as a clinical examination. Important to the clinical exam is the ability to measure case complexity and case outcome. To this end, the ABO has established a comprehensive Discrepancy Index (DI) system which systematically analyzes and scores every element of the selected case and its difficulty, thereby measuring case complexity. Similarly, the ABO has established a comprehensive Cast-Radiograph (CR) evaluation which systematically analyzes every element of the selected case and its finished occlusion, thereby measuring case outcome. This review article presents an overview of the ABO certification process and reviews a classic high-angle Class II growing patient case that successfully passed the ABO exam. This article further presents a walkthrough of how to complete the DI and CR evaluation using the high-angle Class II growing patient case as an example. By establishing the DI form and CR evaluation and by making this information available to the public, the ABO strives to be both objective and transparent in allowing orthodontists to self-assess their finished cases.

Introduction Cortical bone thickness is an important factor in mini implant stability. Many studies have evaluated cortical bone thickness by different methods, but this study is a step ahead in measuring cortical bone in wet mandibles from cadavers comparing thickness values from computed tomograms to images from a stereomicroscope (SM). In this study, we investigated buccal cortical bone thickness at three interdental areas using computed tomography (CT) scan and SM. Methods From the CT scans of 30 wet human cadaveric mandibles, 2-dimensional slices through three interdental area (mesial of canine, interpremolar, and inter-molar) were generated. On these, cortical bone thickness was measured at 2, 4, and 6 mm from the cementoenamel junction (CEJ). The cortical bone thickness at same areas was compared with an SM. Results By both methods, it was observed that thickness of cortical bone increased from mesial of canines toward the premolar region and then decreased in the molar region. Increase in thickness of cortical bone was observed with increase in height from the CEJ toward the apical region up to 6 mm. CT scans underestimated the measurements as compared to the SM method. Conclusions The mean buccal cortical bone thickness at all interdental sites at 2, 4, and 6 mm from CEJ was 1.7 ± 0.4 by the CT scan method and 1.9 ± 0.5 by the SM method, indicating that results observed with the CT method were underestimated by 11% than SM method.

Objectives The aim of the study is to explore the desired expectation (DE), adequate expectation (AE), zone of tolerance (ZoT), and perceived level (PL) from the patients attending a preorthodontic treatment consultation at Orthodontic Clinic, Dental School, Prince of Songkla University, Thailand. Materials And Methods A total of 170 patients aged 15 years and older were asked to express their DE and AE before the consultation and to give their PL after the consultation. Two sets of questionnaires were used in this study. The first set was designed to gain data regarding general information and the measured level of expectation. The second set was used to measure the PL of patients after the preorthodontic consultation. Both questionnaires contained four dimensions of the service: Dentist’s courtesy, dentist’s care and examination, dentist’s communication, and convenience of the services. Results The communication dimension especially information regarding the orthodontic treatment need got rather low PL compared to others. Conclusion The information regarding the orthodontic treatment need was the main item that patients need to receive in the consultation.

Introduction Tooth size, occlusal traits, and ethnicity are closely interrelated, and their impact on desirable orthodontic treatment outcome cannot be underestimated. This study was undertaken to assess the occlusal characteristics and ethnic variations in occlusion of Malaysian orthodontic patients and evaluate their correlation with Bolton’s tooth size discrepancy. Materials And Methods On 112 pretreatment study models of orthodontic patients, molar relationship, overjet, overbite, spacing, crowding, midline shift, and Bolton’s ratios were assessed. ANOVA, one-sample t-test, Chi-squared test, and Spearman’s rho correlation coefficient were used for statistical analysis. Results Significant difference between anterior ratio of our study and Bolton’s ideal values was found, for the entire study sample and Chinese ethnic group. Differences between races and malocclusion groups were not statistically significant (P > 0.05). Significant correlations were found as follows – in Angle’s Class I malocclusion between 1) anterior ratio and overbite, 2) overall ratio and maxillary crowding and spacing; in Angle’s Class II malocclusion between 1) anterior ratio and overjet and midline shift, 2) overall ratio and mandibular crowding; in Angle’s Class III malocclusion between 1) anterior ratio and mandibular crowding and both maxillary and mandibular spacing 2) overall ratio and mandibular crowding. Conclusions Significant differences in anterior ratio and Bolton’s ideal values for the Malaysian population were found, indicating variations in anterior tooth size as compared to Caucasians. Statistically significant correlations existed between Bolton’s ratios and occlusal traits. These findings can be applied clinically in diagnosis and treatment planning by keeping in mind the specific discrepancies that can occur in certain malocclusions and addressing them accordingly.

This article presents the orthodontic treatment of a 24-year-old female patient with gummy smile and proclination along with a hyperdivergent profile. The patient showed excessive gingival display in both the anterior and posterior areas in the maxilla. Such situation in an adult patient often demands surgical therapy. However, due to patient reluctance toward surgery, the gummy smile was treated by the intrusion of the whole maxillary arch. After alignment and leveling, absolute anchorage system as well as a modified transpalatal arch was designed to achieve posterosuperior movement of the entire upper dentition. The active treatment period was 2.3 years.