In orthodontics and dentofacial orthopaedics, a thorough knowledge of growth and development is essential in order to understand various factors that contribute as to how a particular type of growth takes place. When planning of orthodontic treatment for a malocclusion, one has to take into account the growth pattern, because it would considerably affect the success of the treatment. The purpose of this study was to compare antegonial notch depth, symphysis morphology, and ramus morphology in different growth patterns in skeletal class I and class II subjects. In this study, a total of 60 cephalograms were taken which comprised 30 cephalograms in skeletal class I and 30 cephalograms of skeletal class II patients. The groups were further divided into three groups, namely average, horizontal, and vertical growth patterns based on Jarabak’s ratio. Antegonial notch depth, symphysis width and symphysis angle, and ramus height were measured and compared between the growth patterns and between class I and class II skeletal patterns. An analysis of variance (ANOVA) test was performed to determine the comparison between groups for all these variables in both skeletal class I and class II. Independent 't' test was done to determine the comparison between skeletal class I and class II subjects for all variables. Mean and SD values for all variables were determined for all the groups. Depth of antegonial notch was found to be greater in vertical growth patterns compared to horizontal and average growth patterns. Large symphysis angle and symphysis width were noted in a horizontal growth pattern. Increased ramus height was noted in horizontal and average growth patterns. There was no significant difference between skeletal class I and class II malocclusion for all parameters.
Biomedical Waste Management practice in Dentistry is an important issue. Therefore, it is of interest to document awareness on such issues among clinical practitioners, academicians and students. A survey was completed using a questionnaire from 355 dentists consisting of 201 students, 39 academicians and 115 clinicians in India. Analysis of the survey data shows that majority of students, practitioners, and academicians are aware of laws binding with such issues. However, the Biomedical Waste Management practice among them is not satisfactory. Therefore, education on such issues among clinical practitioners, academicians and students is critical in this part of the globe.
Objectives: The study aimed to investigate the optimum level for the placement of ramal implants as a source of anchorage for disimpacting mandibular molars. The criteria in relation to the maximum transverse width of the ramal bone and proximity of the implant to the inferior alveolar canal (IAC) were evaluated using a three-dimensional cone-beam computed tomography scan for predictable placement of ramal implants. Material and Methods: The cone-beam computed tomographic scans of 53 untreated patients (aged between 18 and 48 years) were utilized in this study. The maximum transverse width of the ramus and the proximity to the IAC from the site of insertion were measured at six different levels above the central groove of the mandibular first molar. To measure the proximity to the IAC, the mid-point of the maximum transverse width of the ramus was selected as the site of insertion of the implant. Results: The maximum and minimum transverse ramal width was 12.48 ± 1.76 mm at 3 mm and 10.42 ± 2.08 mm at 8 mm above the central groove of the permanent mandibular first molar. An average clearance of 9.62 ± 2.59 mm was measured from the site of insertion to the IAC at the different levels evaluated. Conclusion: The ramus of the mandible can be a predictable site for implant placement provided the variations in the anatomical structures have been carefully analyzed. It can be concluded that the ramal implants can be safely placed at a level 3–8 mm above the permanent mandibular first molar in relation to the occlusal plane.
Pain is the worst perceived side effect of the orthodontic treatment. Even though momentary, the amount of pain is the major deciding factor when patient compliance is considered. The aim of the study was to evaluate the pain perception during the initial alignment phase with conventional metal and Dual activation self-ligating brackets. The study group consisted of 20 subjects who were selected for orthodontic treatment of malocclusion. The mean age of the samples chosen at the start of treatment was 16 years 3 months. Patients after complete strap up were given a coding sheet and were asked to code the amount of pain perception. The values were tabulated and statistical analysis was performed. Independent sample T test was done to analyze the statistical significance of the results obtained. The intergroup variation in the pain perception showed a statistical significance (p <0.05) at all the time intervals excepting one recorded during the end of the first month (p >0.05) when pain dropped to the minimum in both the groups. Intra group analysis between different time intervals was performed by post hoc Tuckey test. After the initial stages of unbearable pain during the first day after the appointment, a drop down in the rate of pain was noted which reached baseline values by 1 month. Some amount of pain was always perceived irrespective of the brackets used. But dual activation self-ligating brackets showed comparatively lesser pain than the conventional brackets. Amount of pain perceived also depends on certain patient factors and the amount of force applied. Maintenance of very low initial force levels will have a better effect in improving patient comfort and compliance.
A Removable functional appliance is composed of polished acrylic shields and stainless steel wires prescribed for patients with more pronounced class II malocclusion or open bite. These appliances work comfortably with a patient’s inherent growth to produce the desired Skeletal or Dental development. It can be achieved by dentoalveolar effects, alteration of soft tissue and utilisation of greater Mandibular growth potential. The commonly used Removable functional appliances are Twin Block appliance, Activator, Bionator, Frankel appliance, etc. This study aims to assess the frequency of the usage of removable functional appliances in a hospital based set up. The data of patients undergoing Removable functional appliance therapy was retrieved from the case sheets of the patients.The collected data was tabulated in Excel and statistically analysed with the help of SPSS software. From the results obtained, Twin block appliance was the most prevalent Removable functional appliance with a frequency of 60.6%. Frankel appliance and Activator each had a frequency of 9.1%. Twin block appliances were mostly preferred for males than females whereas Activator is preferred mostly for females. Based on the age, Twin block appliance was preferred for the age group 10-15 years, Frankel appliance for 5-10 years, Activator and Other appliances for 10-15 years. Therefore, within the limits of this study, we observed that Twin block appliance was the most preferred Removable functional appliance used in the management of Class II malocclusion and the most common age group receiving appliance therapy is 10-15 years.
TPA, also known as Transpalatal Arch is used as an adjunctive equipment during orthodontic therapy to regulate anchorage in the vertical, transverse and sagittal (antero-posterior) dimensions. TPA have many uses such as space maintenance, retention and molar anchorage after rapid maxillary expansion. TPAs have eminent versatility, appearing as a stand-alone appliance or as an accessory appliance to fixed appliances. Hence the aim of this study is to assess the number of patients who required TPA/LSA during an orthodontic therapy. Retrospective cross sectional study was carried out and the case records of patients requiring TPA/LSA was collected by reviewing patient records and analyzing the data of patients between June 2019- April 2020. The collected data was subjected to Chi-square test for statistical analysis and correlation using the SPSS software. The findings of this study showed female predilection with a percentage of 53% and males with a percentage of 47%. It also revealed that the prevalence of patients requiring TPA during an orthodontic therapy was 32% and LSA was 26%. This study shows that 32.24% of the patients required TPA and 25.75% of the patients also required LSA during an orthodontic treatment and this was found to be statistically significant.
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