A novel method using 3D CBCT to assess anterior malar prominence among native Bangalore population- A descriptive study

There is a lack of accurate three-dimensional studies to locate malar prominence for specified population, this study aims to locate the malar prominence using stable landmarks using CBCT. To derive a novel method to accurately locate the malar prominence and to assess and compare the malar prominence between males and females among Bangalore population using 3D CBCT study. All CBCT scans of study subjects belong to Bangalore population were collected from the pre-existing data available in Radiology imaging Solutions (CBCT centre), Bangalore during the period of September 10th to October 10th 2020. This is a descriptive study. A total of 42 subjects including 21 Males and 21 females were assessed using full skull CBCT scans which were converted to DICOM format and reconstructed into 3D images using NEMOCEPH 3D software. Landmarks used to locate the malar prominence were Fzs, Z, Zm and Ans. The intersection of these landmarks is considered to be as constructed maxillozygion(My). For the accuracy of the constructed Maxillozygion point (My), the distance between the actual Maxillozygion (Mzy) and constructed Maxillozygion (My) is measured and calculated between left and right halves of males and females. Three Orthogonal planes constructed were Midsagittal, Axial and Coronal Planes and the linear measurements with reference to all three reference planes in both the groups are measured. Student paired t- Test, Independent Student t Test, Mann Whitney Test. The mean distance from Mzy and my between right and left half of the face was compared using student paired t- Test. There is no significant difference (p=0.35).The mean values of the constructed anatomical landmark (maxillozygion) coordinated to three orthogonal planes between right and left sides of the face is compared using student paired T test and for both the genders (males and females) was compared using Independent Student t Test, and it is significantly higher in males as compared to females and it is statistically significant at (p=0.01). The location of malar prominence using CBCT by a novel method for Bangalore population is found which can be helpful in diagnosis and treatment planning for malar augmentation, camouflage treatment in subjects with midface deficiencies.

A comprehensive review on loops in orthodontics

Extraction therapies are commonly done in patients with protrusion and/or crowding which demands a thorough understanding of biomechanics. Two basic types of space closing mechanics are friction/sliding and frictionless/loop mechanics. In the former, the wire and position of the bracket are important factors in tooth movement but the simplicity of friction mechanics is offset by the binding between bracket and archwire and may be associated with undesirable side effects such as uncontrolled tipping and deep bite. In frictionless mechanics, specially designed springs are used which provides the required moment to force ratio (M/F ratio) in three dimensions and they are more predictable and versatile. An electronic literature search was conducted via google scholar, PubMed, and dental associations’ of different countries’ website using the key word “Loops” and “Frictionless mechanics.Different configuration of loops have been used in orthodontic treatment and a comprehensive review of types of loops commonly used in retraction has been highlighted in this article.: Provide appropriate messages of about 35-50 words to be printed in centre box:In frictionless mechanics, specially designed springs are used which provides the required moment to force ratio in three dimensions and they are more predictable and versatile. Different configuration of loops have been used and a comprehensive review of types of loops commonly used in retraction has been highlighted in this article.

Combination approach for treatment of mandibular prognathism: Bilateral saggital split osteotomy with pre & post surgical orthodontics

Various features of a human face collated in different ratios produce a distinct smile and esthetics. Any deflection from the accepted facial development and symmetry brings about vexatious facial appearance, depression and diffidence of patient. So a compendious smile designing is imperfect without scrutinizing the dentofacial features. Tremendous progress in the surgical discipline has made it possible to treat the major dentofacial deformities successfully, for whom orthodontic camouflage and growth modification would have resulted in unstable and displeasing results. Orthognathic surgery is the art and science of diagnosis, treatment planning and implementation of treatment to correct musculoskeletal, dentoosseous and soft tissue deformities of the jaws and orofacial appratus. With bona fide diagnosis and treatment planning, pleasing smile and functionally stable results can be obtained in skeletal class 3 malocclusion. Orthognathic surgery should be flawlessly integrated with orthodontics and other dental treatments to achieve satisfactory outcome. In orthognathic correction of skeletal discrepancies, various treatment modalities should be considered to come up with adequate outcome and least trauma to patient. Due to the meticulous advancement in recent decades, combined approach of orthognathic surgery and orthodontic treatment has been rewarded for severe dentofacial deformities. We are presenting here a case of skeletal class 3 malocclusion with symmetrical mandibular prognathism treated with combination approach.

Orthosurgical management of skeletal class-II malocclusion with vertical growth pattern- A case report

Edward H Angle first gave the classification for malocclusions into Classes I, II and III. Amongst these, Class II is the most prevalent and commonly treated at orthodontic clinics. Treatment of Class II malocclusion with mandibular deficiency in adult patients is usually managed with ortho-surgical treatment modality. In this article a case of Skeletal Class II malocclusion with vertical growth pattern is represented which was treated with BSSRO and mandibular advancement was carried out.

Self ligating brackets: from past to present

Self-ligating brackets, as the name suggests, do not use any steel ligature wires or elastic ligature modules in holding the archwires into the bracket slots. Rather they have their own mechanics of holding the archwire, either by a clip already in the bracket or a sliding lock mechanic in the bracket. These brackets can be active or passive depending on how the wire is engaged in between the slot and the self-ligating mechanism. In this review article, various systems of self-ligating brackets have been shown as they have been introduced from the past since their introduction in the early 1930s to the present.

Temporomandibular joint disorders in children and adolescent: A review

Temporomandibular disorders (TMD) are a group of joint and muscular dysfunctions affecting the Cranio-orofacial area. Historically, TMDs were once believed to solely affect adults; however, recent studies have discovered an increased prevalence of TMD signs and symptoms in children and adolescents. The reported prevalence of these disorders in pediatric patients varies significantly due to methodological variations among studies; as a result, standardized diagnostic criteria for children are required. In this age group, TMDs can cause pain in the masticatory muscles and TMJs, as well as limited or asymmetric mouth opening and TMJ sounds. Rather than a single causative element, TMDs are produced by a combination of factors such as trauma, occlusion, systemic and developmental problems, and psychological disorders. A complete history and examination, which may include imaging, are essential to obtain a precise diagnosis and assure successful treatment of many disorders. For these issues, there is a range of therapeutic interventions available, although reversible treatments should be favored.

Combination of forsus fatigue resistant device and premolar extraction for the management of a skeletal class II malocclusion

Treatment of class II malocclusion requires accurate diagnosis and treatment planning. This case report outlines the successful management of a growing skeletal class II using Forsus fatigue resistant device for correction of skeletal parameters and premolar extractions for correction of dental parameters. The patient’s profile improved significantly with a 4° reduction in ANB angle. An ideal overjet, overbite and molar relation were also attained.

Post covid-19 fungal infection and its impact on orthodontic practice: A review

As COVID-19 cases are reducing worldwide, the patients recovered from this disease are showing some complications include impact on lungs, kidneys, heart, and cases of a black fungal infection, called mucormycosis. There are a variety of bacterial and fungal co-infections which is associated with poorly controlled diabetes mellitus and other immune impaired condition. The COVID-19 exhibits, a specific pathophysiological feature, which will result in secondary fungal infections. The recent COVID-19 wave showed that many children and young people are testing positive for this disease. There is high chance for some of them can come across an orthodontic clinic. Oral mucormycosis is normally developed from the breathing of spores or through an open contaminated oral wound, affecting mainly immunocompromised patients. Oral mucormycosis is reported in some patient, following tooth extraction. The fungal spore can reach the body when there is a loss of anatomical continuity as can occur after a tooth extraction or in an ulcer. Chance for Post COVID-19 Mucormycosis in orthodontic patients are very rare. However, Orthodontist should take care when doing minor surgical procedure in the patient recovered from severe COVID-19 infection. Orthodontic appliances can increase the number of bacteria and fungus by limiting oral hygiene. Orthodontist should advise patients to the importance of maintaining basic oral hygiene measures, which include simple things like changing the toothbrush once they test negative, oral rinsing and brushing.

Measurement of inter radicular bone width in different growth patterns for determining safe zone for placement of miniscrew implants – A cone beam computed tomography study

To measure the inter-radicular spaces in both arches for miniscrew implant placement and to determine the most reliable sites using CBCT. A CBCT radiograph was taken for 75 subjects that met with inclusion criteria. They were divided into 3 categories- Hypodivergent, average, and hyperdivergent group. Images were calibrated by using software and printed as a film. Interradicular space on the right side of the jaw was measured in the sagittal plane after assuming the jaw to be symmetrical. Bucco-lingual and mesiodistal width were measured up to desired bone levels. In vertical growth pattern, in posterior maxilla highest mesiodistal width between 2nd premolar and 1st molar at 7mm. In the mandible, it was between the 1st and 2nd molar at 11mm. In horizontal growth pattern, in posterior maxilla highest mesiodistal width between 1st and 2nd premolar, and mandible it was between 1st and 2nd molar at 11mm. In average growth pattern, in posterior maxilla highest mesiodistal width between 2nd premolar and 1st molar and 1st molar at 7mm. In the mandible, it was between the 1st and 2nd molar at 11mm. The importance of the relationship between the growth pattern and the availability of inter radicular space may aid the clinician in planning appropriate surgical sites for miniscrew implant placement.

Etiology and management of disorders of temporomandibular joint: A literarure review

Temporomandibular disorders usually represented as a group of painful as well as altered conditions involving the muscles of mastication and the muscles around the temporomandibular joint. Usually the patient are un aware of the condition. Temporomandibular joint disorders affects twenty five percent of the population. Temporomandibular disorders represent with musculoskeletal degenerative conditions of the joint which results in functional as well as morphological deformities of the temporomandibular joint. As temporomandibular disorders cases are complex with unique nature with respect to each case, so the diagnosis and treatment modality is quite different for each type of case.