Abstract Objective: To assess the frequency of maxillary ectopic canine both buccally and palatally displaced with incisor root resorption and dental agenesis. Methods: The cross-sectional study was conducted from April 8 to June 29, 2019, at the Department of Orthodontics, Dr. Ishrat Ul Ebad Khan Institute Of Oral Health Sciences, and Dow Dental College, Dow University Of Health Sciences, Karachi, and comprised orthodontic patients diagnosed with maxillary ectopic canine eruption. Root resorption and agenesis were diagnosed on panoramic films. Root resorption was further confirmed by periapical radiographs. Data was analysed using SPSS 21. Results: Of the 98 subjects, 86(87.8%) had buccally displaced canines of which 38(44.2%) were associated with root resorption, while 12(12.2%) patients had palatally displaced canines of which 10(83.3%) had root resorption (p=0.011). Overall, 30(30.6%) lateral incisors were resorbed, 7(7.1%) both central and lateral incisors, 5(5.1%) premolars, and 6(6.1%) both lateral incisors and premolars were resorbed. Agenesis was detected in 10 (10.2%) subjects (p=0.62). Conclusion: There was found to be no association of maxillary ectopic canines with incisor root resorption and dental agenesis. Key Words: Root resorption, Agenesis, Ectopic canine, Buccally displaced canine, Palatally displaced canine.

OBJECTIVE: The vast spread of COVID-19 not only affected the major businesses of the world but also the health care facilities like dentistry. Due to the unprecedented closure of dental services, on-going orthodontic patients also suffered the brunt. The aim of this study was to assess the at-home management approaches used by the patients to tackle the complications associated with orthodontic treatment. METHODOLOGY: It was a cross-sectional questionnaire-based study carried out from June 15 to September 15, 2020 in orthodontic OPD of Jinnah Medical and Dental College, Karachi. A total of 300 orthodontic patients, 208 females and 92 males between ages from 15 to 35 years completed a questionnaire on the complications faced by them and management techniques adopted by them during COVID-19 related office closures. Convenient sampling method was used for data collection. RESULTS: The majority of patients reported in this study were females. Approximately 69.33% (n = 300) of the responders were females and 31% were males. The highest numbers of complications reported during the lockdown period were loose brackets, loose bands and poking of archwire. The most common at-home hack used was removing the loose bracket/ bands and cutting of free end of arch wire with nail cutter like instrument. CONCLUSION: It is the responsibility of the clinician to keep in touch with their patients during pandemic like situation through telemedicine portal. In case of emergencies, patients should be provided with an adequate amount of information to tackle any complications with ease and without hurting themselves. KEYWORDS: COVID-19, Pandemic, Orthodontic Emergencies

Objective: To evaluate the awareness of emergency trauma management and the potential role of dentists in handling tooth avulsion injuries. Method: The cross-sectional study was conducted at the Dental outpatients department of Jinnah Medical and Dental College, Karachi, from December 2020 to March 2021, and comprised dentists and final year dental students of either gender. Data was collected using a 17-item questionnaire to assess the awareness level regarding the knowledge of traumatic dental emergencies and the role of a dentist in handling a traumatic tooth injury. Data was analysed using SPSS 20. Result: Of the 170 subjects, 52(30.5%) were males and 118(69.4%) were females. Overall, 139(81.8%) subjects had prior knowledge regarding avulsion, 164(96.5 %) were aware of the term avulsed tooth, 106(62.4%) considered milk to be the best transport media for an avulsed tooth, 159(93.5%) knew the significance of extra-oral time, and all 170(100%) subjects said they wanted to study more about dental traumatic injuries. Conclusion: There was adequate knowledge about the term avulsion, transport media and extra-oral time, and there was evidence of interest about learning more among the subjects. Key Words: Avulsion, Emergency handling, Dental trauma, TDIs, Traumatic dental injuries, Knowledge, Appropriate management, Expert.

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Objectives: This study was conducted to determine the perceived attractiveness of the face by change in chin position between orthodontic patients and the general public and determine their desire for surgery to correct it. Study Design: Cross Sectional Study Setting: Orthodontic OPD, Period: March 2021- July 2021 Material & Methods: An ideal facial outline was created with a computer software. 150 participants, divided into two groups (pre-treatment orthodontic patients and lay person) were part of the research. Each participant was given a survey and asked to fill it out and rank images on a summative scale Results: Results showed that the aesthetic judgement of both observer groups was the same for most images; The rating was decided by the amount of shift in the chin position, with the scoring being higher when the chin was more forward than when it was backward. Keywords: attractiveness, chin position, esthetics, facial profile, orthodontics

Background: Hypodontia is one of the frequently observed dental anomalies in which dentofacial esthetics, phonetics, mastication, self-esteem and quality of life can be adversely affected. Awareness of disproportionate tooth number is important and must be considered by orthodontists while making treatment plans to achieve proper occlusion, overbite, and overjet, in order to restrain oral health deterioration. The aim of this study was to determine the frequency of non-syndromic hypodontia in orthodontic patients and its association with skeletal malocclusion. Methods: This retrospective case-series was conducted at the department of Orthodontics, Sharif Medical & Dental College. It involved screening the records of orthodontic patients from last 5 years from October 2017 – October 2021, consisting of standardized good quality orthopantomograms and lateral cephalograms. Patient files with incomplete records, any craniofacial syndrome and/or previous history of tooth loss were excluded. Non-syndromic hypodontia and skeletal malocclusion was recorded along with demographic data, in predesigned proforma. Results: Out of 244 orthodontic patients, 18 patients (7.37%) had non-syndromic hypodontia. Moreover, 63 teeth were missing in 18 patients of NSH. Maxillary arch (52.4%) and upper left quadrant (28.6%) were found to be more frequently affected. The difference of non-syndromic hypodontia among dental arches, quadrants and skeletal malocclusion was statistically significant while for genders it was insignificant. Conclusion: Non-syndromic hypodontia was significantly associated with skeletal malocclusion, highlighting their genetic etiology. Most commonly absent tooth was maxillary lateral incisor followed by mandibular second premolar and lateral incisor. Keywords: congenitally missing tooth, dental anomaly, dentofacial esthetics, genetic etiology, skeletal malocclusion

Background. COVID-19, a viral infection, has negatively impacted the physical and psychological health of the people worldwide. This was a descriptive, cross-sectional study, which aimed to investigate orthodontic postgraduate residents’ knowledge regarding COVID-19, its association with anxiety around quality of their training, and performance of routine orthodontic procedures during the pandemic. A questionnaire was circulated online through WhatsApp to the orthodontic residents enrolled in the four-year postgraduate training program across the country which comprised the following sections: demographic data, questions to test knowledge of COVID-19, self-grading of anxiety around performing routine orthodontic procedures, academic aspects of the training program, and residents’ thoughts on the current status of their training program in general during the pandemic. The residents were grouped based on their awareness on COVID-19, with >70% score taken as having adequate knowledge and ≤70% as inadequately updated. The association between COVID-19-related knowledge and the anxiety level of the residents experienced during training was assessed. Results were analyzed using SPSS (Statistical Package for Social Sciences) version 23.0. Counts and percentages were reported on baseline characteristics of studied samples. Descriptive methods were used to report the outcomes of this survey on knowledge of COVID-19, anxiety around performing orthodontic procedures, and different academic aspects of training. Statistical significance was set at p < 0.05 using the Pearson chi square test. Results. Most of the residents (51.5%) were adequately updated about the COVID-19 virus. Increased awareness was associated with more anxiety about the following: contracting the virus ( p < 0.01 ), performing different orthodontic procedures ( p < 0.05 ), disturbed patients’ appointments ( p < 0.01 ), timely completion of their cases ( p < 0.01 ), and exam’s preparation ( p = 0.04 ). The group with <70% COVID-19 related knowledge opted for extension of their training period (51.8%). Conclusion. COVID-19 related knowledge was clearly associated with anxiety experienced by the orthodontic residents during training in the pandemic. Awareness regarding the infection led to more anxiety around working during the pandemic, preparing for postgraduate exams, and concerns about its negative influence on the overall quality of the training program.

To evaluate the bite force (BF) changes in bilateral cleft lip and palate (BCLP) in contrast to the non BCLP children after ALT-RAMEC Facemask therapy. The prospective study was carried out on a total of 60 subjects of age 6 to 13 years in a tertiary care hospital; treatment group, 30 children with BCLP and control group, 30 children without cleft lip and palate. Each cleft patient was received ALT-RAMEC Facemask treatment and their BF assessed at 4 different stages. Bite force taken before treatment, immediately, 3 months and 6 months after treatment. Bite force of the control group was taken at baseline to compare with the treatment group to demonstrate the difference in BF values. Independent t test and analysis of variance were used to perform statistical analysis. There was a significant difference in BF between the treatment group (BCLP) 122.53 ± 8.64 N and the control group (non BCLP) 181.38 ± 18.84 N at baseline. After the Alt RAMEC protocol, changes in BF recorded over 3 and 6 months of therapy showed significant improvement. The mean values of BF at 3months and 6 months were 106.7 ± 9.3 N and 137.4 ± 9.5 N, respectively. Bite force was significantly improved after ALT-RAMEC protocol followed by facemask therapy in BCLP patients.