Prevalence of Malocclusion among School Children of Biratnagar, Nepal

Introduction: Various forms of malocclusion are a matter of serious concern in Nepalese population. This study was carried out to understand the prevalence of malocclusion among the school children of Biratnagar. The objective of this research is to find out the prevalence of malocclusion of children from different schools of Biratnagar visiting the Pedodontics and Orthodontics department of Nobel Medical College and Teaching Hospital, Biratnagar. Materials and Method: A descriptive cross sectional study method was used in this research. Data was collected by using direct observation of the subjects and occlusal assessment was done according to Angle’s classification and Dewey’s modification types of class I, class II and class III malocclusion. Result: Subjects with normal occlusion was found to be 39 % and with malocclusion was found to be 61%. Among them, class I malocclusion (60%) and angles class II div I subjects (88.33%) were in majority of the total study population. Conclusion: The present study helps to determine the prevalence of malocclusion and need of orthodontic treatment for the school children of Biratnagar

Psychological factors influencing motivation, cooperation, participation, satisfaction, self appraisal, and individual quality of life in adolescents and adults undergoing Orthodontic treatment

Introduction: To bring the best outcome from both the sides i.e. the orthodontist and the patient , it is of prime importance to understand certain psychological factors, and to treat every patient with an individualistic approach. The need was to study all such psychological factors and to find a method to deal with the same; to evaluate the psychological factors that influences the self appraisal and individual Quality of life. To compare psychological factor affecting the self appraisal and individual quality of life before treatment and after treatment, to study psychological factors of patients which influences the treatment outcome and to find a method to manage them. Materials and Method: This In-vivo study, includes case study and survey. Two separate sets of questionnaires (before and after undergoing orthodontic treatment) were given to patients. The study also included psychological test scales like OHIP-14 and 12-CSES. The sample size of patient was 150. Result: The study revealed that esthetics (95%) is the main concern for getting treatment especially for female (56%). There is improvement in OHIP and CSES (interval of 12.63, 14.66) score of patients before and after treatment. Patients’ satisfaction (94.7%) increases on having healthy orthodontist-patient relationship. Conclusion: Esthetics is the main concern. Most patients wants improvement in smile. Lack of awareness and lack of financial supports is the main reason for delay in getting treatment. The main discomfort about the treatment reported by participants was pain after activation appointments, ulcers and change in food eating habit. The orthodontic therapy improves confidence, satisfaction, individuals’ appraisal and quality of life. There were no variations in response for patients’ satisfaction by gender, age, education or by treatment duration.

Suffocated Maxillary Central Incisors (Surgical and Orthodontic Management): A Report of Two Cases

Clinically, supernumerary teeth are able to cause different local disorders and the most common one is impaction of maxillary incisors. Impacted maxillary incisors substantially affect esthetics, function, and self‑esteem of patients. Impaction of maxillary permanent incisor is a rare clinical entity in dental practice. Although impaction of a permanent tooth is rarely diagnosed during the mixed dentition period, an impacted central incisor is usually diagnosed accurately when there is delay in the eruption of tooth. Multiple treatment options are available for impacted incisors. Surgical-orthodontic treatment is one of the alternative option for the correction. Early diagnosis and management of supernumer¬ary teeth is important to prevent the need for more complex surgical and orthodontic treatment. Here, we present a report of two cases of impacted maxillary incisors and its management

A study on orthodontic retention practices in Nepal

Introduction: Retainers are used after all orthodontic treatment, to prevent or minimize relapse and recurrence. Among various retainers used, Hawley retainer and ‘invisible’ retainers are the most common. Most of the orthodontists favored permanent retention. It is obvious that the retention procedures are variable and depended largely on personal preferences, and there does not seem to be any consistent pattern in the application of retention methodologies. The purpose of this study was to survey the retention protocols among orthodontists in Nepal. Materials and Method: The complete lists of the names and addresses of orthodontists in Nepal was obtained from the ODOAN. The questionnaire was sent to them which consisted of multiple-choice questions and short answer, related to background information of the individual orthodontist, retention use in general, the frequency of different types of bonded or removable retainers that are used, the retention protocol, the type of retainer used in specific situation. All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS), version 12.0.1 (SPSS Inc, Chicago, Illinois, USA) Result: The survey questionnaires were completed by 90.42% of the 94 orthodontists of Nepal, 58.8% males and 41.2% females with a mean age of 36.7 years. Most of the orthodontists used a clear (vacuum) retainer (80%) in the maxilla and fixed bonded retainer in the mandible. Most of them prefer the use of retainer for a continuous 24 hours except during eating and brushing for 6 months to 1 year (56.5%) and if possible, for 1 to 2 years (28.2%). Conclusion: Majority of Nepalese orthodontists provide vacuum formed retainer on maxillary arch and bonded retainer in mandibular arch. There is no specific consensus on other type of retainers, duration of wear and follow up visits which is affected by various other factors.

The Season of Orthodontic Harvesting

No abstract available.

Growth Pattern in Skeletal Class I Malocclusion: A Cephalometric Study

Introduction: Great emphasis has been given to the evaluation of sagittal apical base relationship in orthodontic diagnosis and treatment planning. The prediction of magnitude and direction of facial growth based on sagittal relationship will help in orthodontic treatment with growth modification. The objective of the study is to assess the growth pattern in skeletal Class I malocclusion. Materials and Method: 104 subjects (52 male and 52 female) with the age between 18-30 years with Class I skeletal relation was selected from lateral cephalograms of patients visiting the Department of Orthodontics, Kantipur Dental College. The ANB angle was measured to assess the sagittal jaw relationship and the Jarabak’s ratio to access the growth pattern. Descriptive statistics were calculated for each parameter. Pearson’s test was done to evaluate the correlation between the parameters. Independent t-test was done to compare Anterior Facial height (AFH), Posterior Facial Height (PFH) and Jarabak’s ratio between male and female subjects. Result: Among the total subjects with skeletal Class I malocclusion; hyperdivergent growth pattern was least (10.57%), followed by normodivergent (18.26%) and hypodivergent growth pattern (71.15%). Mean Jarabak’s ratio for hyperdivergent, normodivergent and hypodivergent growth pattern were 58.65±1.94, 63.98±0.85 and 69.98±4.13 respectively. Very strong correlation was found between AFH and PFH in hyperdivergent (r = 0.821) and normodivergent group (r =0.978). Strong correlation was found in hypodivergent group between AFH and PFH (r =0.743). Also, strong correlation was found in hypodivergent group between PFH and Jarabak’s ratio (r =0.643). Conclusion: Hypodivergent growth pattern was the dominant growth pattern in skeletal Class I malocclusion. PFH influenced the determination of Jarabak’s ratio more than the AFH in hypodivergent growth pattern. Hypodivergent growth pattern is correlated with large SNB angle.

Prevalence of Dental Fear and Anxiety among Orthodontic patients visiting Nobel Medical College

Introduction: Anxiety is the state of feeling nervous or worried that something bad is going to happen. Dental anxiety is defined as a patient’s response to stress that is associated with a dental procedure. The aim of our study is to investigate the anxiety status of dental patients visiting Orthodontic department at Nobel Medical College Teaching Hospital, Biratnagar. Materials and Method: Total 80 ongoing orthodontic patients (M =21 F=59) who completed modified Dental Anxiety Scale questionnaire were included in the study. Result: Majority of patients (65%) had moderate anxiety where as 25% had mild anxiety and around 9% had severe to extreme anxiety. Patients’ age and education level had significant association with the level of dental anxiety. Conclusion: Dental anxiety in orthodontic patients is unavoidable but needs appropriate counseling. Orthodontist’s role is crucial in bridging the gap between patients’ perception towards orthodontic treatment and the actual treatment.

Vertical Proportion of the Face: A Cephalometric study

Introduction: Balance in vertical facial proportion is an important criteria for good esthetics. Variations in vertical growth are common and have certain orthodontic implications. The objectives of this study were to determine mean upper anterior facial height and lower anterior facial height, ratio between UAFH to LAFH and their difference among genders in skeletal Class I patients with different vertical growth pattern among patients visiting department of Orthodontic and Dentofacial orthopedics, Tribhuvan University Dental Teaching Hospital, Kathmandu. Materials and Method: This study was descriptive observational cross sectional study with 105 sample aged from 18-25 years. Pretreatment cephalometric radiograph of Skeletal Class I patients were taken and divided into three growth patterns as group I (normal growth pattern), group II (horizontal growth pattern ) and group III (vertical growth pattern ). Upper anterior facial height (N-ANS) and lower anterior facial height (ANS-Me) of all samples were measured on lateral cephalogram with cephalometric tracing ruler parallel to true vertical line. Descriptive statistics was used to calculate mean, minimum, and maximum values standard deviations with p value <0.05. Result: The upper anterior facial height (UAFH) and lower anterior facial height (LAFH) measurements in normal growth pattern was 52.37 and 64.4 , in horizontal growth pattern was 53.0 and 62.2, in vertical growth pattern was 53.37 and 64.42 respectively. The mean ratio of upper and lower anterior facial height in normal, horizontal and vertical growth pattern was 0.81, 0.85 and 0.79 respectively. There was no statistically significant difference in upper and lower facial heights between males and females. There was no statistically significant difference in UAFH between normal, horizontal and vertical growth pattern but statistically significant difference was observed in LAFH between groups. Conclusion: The cephalometric values for different vertical groups in skeletal class I can be used more specifically for diagnosis and treatment planning of Nepali population.

Orthodontic Assessment of Lip Prominence in Pakistani population

Introduction: Many reference planes are being used to determine prominence of upper and lower lip for orthognathic face profile. E-line and S-line are being used to determine lip position in local popuation of Multan city of Pakistan. Materials and Method: Execution of present study was done in Nishtar Institute of Dentistry, Multan during the period of November 2019-March 2020. 300 (112 Males and 188 Females) subjects were selected for this study from all provinces of Pakistan. Their radiographic records (Lateral cephalograms) were taken from radiographic department of related institution. Acetate matte sheets were used to construct reference planes by using 3H pencil. Steiner’s E-line and Rickett’s S-line were used to find Upper and Lower lip position from these reference lines. SPSS was used to analyze data after applying independent t-test. Result: Mean Upper and lower lip position from E- line was -1.74mm & -0.33mm and from S-line was 0.82mm and 1.47mm Conclusion: Cephalometric lip morphology assessment in Multan, Pakistani adults by using Steiner’s and Rickettsreference planes on lateral cephalogram is slightly different as compare to other populations

“A Century of Orthodontic Progress” – Innovations in Orthodontics

Innovation is the roadmap towards improvement .Creation, implementation and execution of new ideas, methods and technology aiming at efficiency and improvement is known as innovation. Innovation is the roadmap towards improvement. The speciality of orthodontics has obtained new dimensions due to innovations such as holistic orthodontic approach, Laser assisted orthodontics, digitization in diagnosis and treatment planning, nanotechnology, genetically driven orthodontic treatment plans with gene therapy, interactive self ligating bracket and flash free adhesive coated appliance system, robotic wire bending, 3D bioprinted scaffolds to treat osseous defects of the craniofacial complex, forensic orthodontics, mobile apps in orthodontics and dentoalveolar distraction modalities. These innovations have lead to an accurate treatment with reduced clinician efforts, enhanced treatment precision and better patient compliance. The future of orthodontic speciality with these adjunts is bright and progressive. With reduced clinician’s efforts and improved patient’s compliance these advancement are certainly a boon to our orthodontic speciality