Non-extraction orthodontic treatment in a patient with severe anterior crowding

A 12 years 6 months old Indian male presented with a chief complaint of irregular upper and lower front teeth. Patient exhibited a mild convex profile on Class l skeletal base with slightly decreased vertical proportions. This was complicated by severe upper and lower labial segment crowding. Also the molar relationship was half unit class ll bilaterally. Since the patient did not want to go for extraction of premolars, treatment involved use of Pendulum appliance along with upper and lower pre-adjusted edgewise appliance (0.022x0.028” slot) with MBT prescription. Various elastics and overlay wires were used along with proximal stripping for the correction of severe crowding in upper and lower anterior teeth.: Clinically Angle’s Class I occlusion was achieved bilaterally with good intercuspal relationship. Vertical growth continued throughout the treatment.

Role of impacted teeth in dental arch crowding

Estimates show that the prevalence of mandibular dental anterior crowding is high and might be up to 40%. The etiology of the condition has been multifactorial and evidence regarding the impact of mandibular third molars is still controversial. We discussed the potential role that impacted teeth (particularly mandibular third molars) might have in developing dental arch crowding. Evidence from different original studies and reviews regarding the impact of lower third molars on dental crowding was controversial. However, most of these studies showed that the correlation between these events was insignificant and additional studies might be needed for further validation. We have also identified many factors that can lead to dental arch crowding among the relevant studies in the literature. These factors might include general factors (including gender and age), skeletal factors (including malocclusion and growth of jaws) and dental factors (including primary tooth loss and tooth crown size), all of which were extensively discussed in the current study. Accordingly, further attention should also be paid to studying these factors.

Trueness of full-arch IO scans estimated based on 3D translational and rotational deviations of single teeth—an in vitro study

Objectives To three-dimensionally evaluate deviations of full-arch intraoral (IO) scans from reference desktop scans in terms of translations and rotations of individual teeth and different types of (mal)occlusion. Materials and methods Three resin model pairs reflecting different tooth (mal)positions were mounted in the phantom head of a dental simulation unit and scanned by three dentists and three non-graduate investigators using a confocal laser IO scanner (Trios 3®). The tooth-crown surfaces of the IO scans and reference scans were superimposed by means of best-fit alignment. A novel method comprising the measurement of individual tooth positions was used to determine the deviations of each tooth in the six degrees of freedom, i.e., in terms of 3D translation and rotation. Deviations between IO and reference scans, among tooth-(mal)position models, and between dentists and non-graduate investigators were analyzed using linear mixed-effects models. Results The overall translational deviations of individual teeth on the IO scans were 76, 32, and 58 µm in the lingual, mesial, and intrusive directions, respectively, resulting in a total displacement of 114 µm. Corresponding rotational deviations were 0.58° buccal tipping, 0.04° mesial tipping, and 0.14° distorotation leading to a combined rotation of 0.78°. These deviations were the smallest for the dental arches with anterior crowding, followed by those with spacing and those with good alignment (p < 0.05). Results were independent of the operator’s level of education. Conclusions Compared to reference desktop scans, individual teeth on full-arch IO scans showed high trueness with total translational and rotational deviations < 115 µm and < 0.80°, respectively. Clinical relevance Available confocal laser IO scanners appear sufficiently accurate for diagnostic and therapeutic orthodontic applications. Results indicate that full-arch IO scanning can be delegated to non-graduate dental staff members.

Georeferencing of adolescents with malocclusion in a capital of Southern Brazil

The aim of this study was to analyze the prevalence and to georeference the malocclusion traits in adolescents in the city of Curitiba, Paraná, Brazil. Data from a previous cross-sectional study with 538 adolescents aged 10 to 14 years were used. In addition, the following variables were used: gender, Health District (HD) of residence, and presence and malocclusion traits. Fisher’s Exact Test, georeferencing, and kernel mapping were used for data evaluation. Malocclusion was observed in 52.4% of individuals, and the most prevalent occlusal trait was deep bite (22.7%), followed by excessive overjet (19.9%), anterior crowding (8.0%), posterior crossbite (6.5%), anterior open bite (4.8%), and anterior crossbite (1.7%). Malocclusion was not associated with gender (p = 0.389) or HD (p = 0.079). However, when stratified by gender, the deep bite prevailed among male. The highest malocclusion trait’s prevalence was observed in the HDs of Cajuru, Pinheirinho, Boa Vista, and Cidade Industrial de Curitiba. Despite the absence of significant differences in relation to gender and HD, the prevalence of malocclusion traits in the sample studied was high, especially for deep bite. Additionally, georeferencing proved to be useful for identifying the distribution of malocclusion in Curitiba.

Correlation of Lower Third Molar Angulation and Posterior Space Discrepancy with Mandibular Anterior Crowding using 3d Intra Oral Scanner

OBJECTIVES: To objectively determine the correlation of lower third molar angulation and posterior space discrepancy with mandibular anterior crowding digitally using intraoral scanner. METHODOLOGY: Cross sectional analytical study conducted at Rehman College of Dentistry (RCD) Peshawar from15th November 2020 till 15th December 2020. Lower third molar angulation and posterior space discrepancy were measured by IC 3.1 measure software, using digital Orthopantomograms (OPG). Digitally scanned models by (CS 3600 intraoral scanner) were analyzed using (CS 3600 3D software). Sample was divided into Control (N=30; perfect alignment), Experimental (N=30; crowding >1mm) groups, based on Little’s Irregularity Index. Both lower third molar angulation and posterior space discrepancy (Ganss Ratio) were correlated with lower anterior crowding using Pearson’s Correlation. To determine any difference between two groups independent t-test was used. RESULTS: Statistically insignificant difference and a weak correlation were found for Ganss ratio and third molar angulation in both control and experimental groups. CONCLUSION: Third molar angulation and the retro molar space has no direct effect on the lower anterior crowding.

ISW for the Treatment of Adult Skeletal Class II Case with Temporary Anchorage Device

Patients with a Class II malocclusion, proclination, severe crowding of the maxillary and mandibular anterior teeth, and high mandibular plane angles are a treatment-planning challenge. This case report describes an orthodontic treatment and maxillary premolar extraction without orthognathic surgery for a 18-year old man. Maximum anchorage is needed for upper anterior retraction by using Temporary Anchorage Device (TAD’s). The use of IME and ISW unilateral MEAW was important to relieve upper and lower anterior crowding. After treatment, the patient had a better profile, adequate overjet and overbite. This case report demonstrates that a minimally invasive treatment can successfully correct a severe skeletal Class II malocclusion with large overjet.

RELATIONSHIP BETWEEN LOWER ANTERIOR CROWDING WITH FACIAL HEIGHT AND DEPTH IN BENGALEE POPULATION - À CEPHALOMETRIC STUDY

INTRODUCTION- A study of head and face presents a multidimensional problem which includes height, depth and width dimension and esthetics. The head and face is not spherical with qual radius in all directions. It is rather an irregular polygon and could not be measured by simple geometrical and mensurational methods. Malocclusion and dentofacial deformity arise through variations in normal developmental process and so must be evaluated against a perspective of normal development of the craniofacial morphology like facial height and depth. AIMS AND OBJECTIVES- The basic aim of this study was to nd the co-relation between lower anterior crowding with facial height and depth in Bengalee population by the lateral cephalometrics. MATERIALS AND METHODS- The present study was conducted on thirty young Bengalee subjects comprising of males and females of fourteen to twenty years of age. Fifteen subjects were selected with noncrowded normal class - 1 cases and fteen with crowded mandibular incisors. The purpose of this study was to evaluate the relationship between facial height, facial depth and lower anterior crowding among the two above mentioned groups. RESULT AND CONCLUSION- Both linear dimensions and angular values were compared between the two sample groups. The measurements were taken from lateral cephalograms. The parameters used were Anterior facial height, Posterior facial height, mandibular length, Facial depth (SN length), 'e' and 'f' values (linear dimensions). The angular values compared were SN-MP angle, SN-Occlusal plane angle and SNEndognathion angle. For each measurement the mean, standard deviation and standard error were established. Correlation were made by comparing the different parameters between the crowded and non-crowded sample group.