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Orthodontic treatment planning decisions are dependent on the assessment of growth status. Skeletal maturity could be assessed with various radiologic and non-radiologic biologic markers.The purpose of our study was to investigate the reliability of serum Insulin like Growth Factor – 1(IGF-1) as a skeletal maturity indicator in comparison to the stages in cervical vertebral maturation (CVM). Twenty five subjects with skeletal class II malocclusion in the age range of 11-19 years were recruited for the study. The cervical vertebrae staging was assessed by lateral cephalograms. Blood was collected aseptically and serum was separated. The serum levels of IGF- 1 were quantitatively assessed using a commercial ELISA kit, IGF-1 600 ELISA (DRG Instruments GmbH, Germany). There was a significant decline in the mean IGF-1 levels with increase in age in both the sexes. Statistically significant difference was observed in the concentration of IGF-1 among the different age groups. There was a significant decline in the mean IGF-1 levels with increase in CVM staging from stage 2 to stage 4. IGF-1 could be a more reliable biologic skeletal maturity indicator in comparison to cervical vertebral maturity indicator and thus could predict more accurately the growth status of the mandible to facilitate correction of skeletal class II jaw discrepancies.

Objective:This study was designed to evaluate the efficiency of microwave sterilization of orthodontic instruments and molar bands immersed in plain distilled water with and without oral rinse, and to ascertain the minimum time of exposure required to sterilize.Materials and Methods:The orthodontic instruments (hinged and nonhinged), molar bands and mouth mirrorsused in the patient 's mouth were selected for the study. The instruments were divided into two groups – Group I with oral rinse-set A (0.01% chlorhexidine gluconate) and set B (0.025% betadine) and Group II (included sets C and D without oral rinse). The instruments of set A, B and C were microwaved at 2,450 MHz, 800 W for 5 min, whereas, set D was microwaved for 10 min at the same above mentioned specifications. The efficacy of sterilization was assessed by stab inoculation of the instruments onto trypticase soya agar plates. The plates were checked for bacterial growth following incubation at 37 °C for 24 h. For sterility control,Geobacillus stearothermophilus (MTCC 1518) was included.Results:No growth was observed in the plates that were inoculated with the microwaved orthodontic instruments of sets A, B and D, whereas scanty bacterial growth was observed in the plates inoculatedwith the microwaved set C instruments.Conclusion:Effective sterilization was achieved when the orthodontic instruments and molar bands were immersed in distilled water without oral rinse and microwaved for 10 min as also for those that were immersed in distilled water with oral rinse and microwaved for 5 min.

This case report highlights the treatment of a mild skeletal class III malocclusion with an invisible thermoplastic retainer. A 15-year-old female patient presented with a mild skeletal class III malocclusion with a retrognathic maxilla, orthognathic mandible, a low mandibular plane angle with Angle's class III malocclusion with maxillary lateral incisors in anterior cross-bite with crowding of maxillary anteriors, imbricated and rotated mandibular incisors and deep bite. Accurate upper and lower impressions and a bite registration were taken with polyvinyl siloxane rubber base impression material. This was then sent to the lab for the processing of a series of ClearPath aligners. The ClearPath virtual set-up sent from the lab provided the treatment plan and interproximal reduction estimation complete with posttreatment results. This enabled the clinician to actively participate in the treatment plan and provide the necessary suggestions. The ClearPath three-dimensional aligner was found to have effectively corrected the anterior cross-bite and crowding of the maxillary anteriors.

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The solitary median maxillary central incisor (SMMCI) syndrome is a rare dental anomaly and has an incidence of 1:50,000 live births. In SMMCI, there is only one central incisor present, and it develops exactly at the midline. SMMCI occurrence has been described with growth hormone deficiency or other structural anomalies in the midline of the body. In this case, the 8-year-old female patient reported a single median maxillary central incisor with missing maxillary and mandibular frena, with apparently no other abnormalities. Early diagnosis and recognition of SMMCI are important for all practicing Orthodontists, as it may be a sign of other severe congenital or developmental abnormalities.

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