Objectives To assess the linear and angular cranial base measurements (Bjork polygon) in different anteroposterior (AP) skeletal relationships using Bjork-Jarabak analysis. Materials and Methods Pretreatment lateral cephalograms of 288 (146 women, 142 men, mean ages 21.24 ± 2.72 years and 22.94 ± 3.28 years, respectively) adult patients were divided into Class I, II, and III skeletal relationships according to their ANB angle. Linear and angular measurements of Bjork polygon were measured and compared among different skeletal relationships. Analysis of variance was performed to detect the differences among groups. Independent-sample t-test was used to detect differences between men and women. Results The Class II skeletal relationship has a significantly larger saddle angle than Class III does (P < .05), whereas Class III has a significantly larger gonial angle than Class II does (P < .05). The articular angle and sum of Bjork polygon angles were not significantly different among groups (P > .05). Anterior (N-S) and posterior (S-Ar) cranial base lengths were similar in the different AP skeletal relationships (P > .05). The ramal height and body of the mandible length were significantly larger in Class III compared with Class I and II (P < .05). Women had a significantly larger articular angle than men did (P < .05), although men had significantly larger linear measurements of Bjork polygon than women did (P < .05). Conclusions The Class III skeletal relationship has a smaller saddle angle and larger mandibular length and gonial angle. Men have a larger cranial base and mandibular linear measurements and a smaller articular angle compared with women.

The objective of this study was to assess the efficacy of Hyaluronic Acid (HA) on interdental papilla (IDP) loss in the esthetic zone. Twenty one subjects (14 females and 7 males) from those referred for treatment of IDP loss at Periodontics postgraduate clinics at the Jordan University of Science and Technology. A total of 86 interdental sites (58 sites in the maxillary jaw and 28 sites in the mandibular jaw) were treated and followed up. A 0.2 ml of Hyaluronic acid was injected in each receded IDP site and injections were repeated after 21 days. Papilla sites were evaluated and statistically analyzed. At the 3 week interval the mean reduction of black triangle (BT) height was 0.17 mm (8% reduction) (P‐value <0.001), at the 3 month interval there was a mean reduction of BT height of 0.83 mm (39% reduction) (P‐value <0.001). At 6 months however, the reduction in BT height was 0.62 mm (29% reduction) (P‐value <0.001). Within the limitations of this study, it can be concluded that the use of commercially available HA gel for the treatment of interdental papillae loss may have promising results over the first 6 months after injection. The maximum improvement in black triangles was at 3 months after injection with a reduction of improvement between 3 and 6 months. Clinical Relevance Helping clinician to take evidence based decision while considering Hyaluronic acid injection as a short term nonsurgical treatment modality for interdental papilla loss.

In-offce methods; slow speed CB and US are effective, quick and cheap methods for bracket base cleaning for rebonding.

Objectives To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated. Materials and Methods A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model. Results The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P &lt; .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons. Conclusions The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

Summary Background Pain is an unpleasant side-effect that can be experienced during orthodontic procedures including debonding of fixed appliances. Pain experience can vary depending on the appliance, debonding technique, as well as adjunctive measures used. Objectives The primary objective of this systematic review was to assess the effectiveness of different debonding techniques and adjunctive methods on pain/discomfort perception during debonding procedure (PDP) of fixed orthodontic appliances. The secondary objective was to assess the effects of anatomic location and gender on PDP of fixed orthodontic appliances. Search methods Multiple electronic databases were searched from inception to August 2018. Reference lists of the included articles were manually screened. Selection criteria Randomized clinical trials (RCTs) and controlled clinical trials were included. Data collection and analysis Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers according to Cochrane guidelines, with disputes resolved by a third reviewer. Clinical heterogeneity in study design and methodology prevented quantitative synthesis of the data. Results The search yielded 198 articles after the removal of duplicates. Seven studies were included in the final review with a total of 307 participants aged 12–60 years. Of the four studies comparing different debonding instruments of labial fixed appliances, two studies showed that the lift-off debonding instrument (LODI) produced lower PDP levels than ligature cutting pliers. Three studies compared adjunctive measures to reduce PDP of labial fixed appliances. Finger pressure and bite wafers significantly reduced PDP levels. Analgesics administration (ibuprofen + paracetamol tablets) 1 hour prior to debonding also reduced PDP. PDP was significantly higher in anterior segments and in females. Limitations The authors acknowledge that there was clinical heterogeneity among the included studies and that the potential effect of diurnal variation on pain during debonding was not considered in any of the included trials. Conclusions and implications There is weak evidence indicating that using the LODI may reduce PDP of labial fixed appliances. Adjunctive measures such as an intrusive force with finger pressure, bite wafers, and preoperative analgesia may further aid PDP control. Further well-designed parallel-group RCTs taking into consideration the diurnal variation in pain are required. Registration PROSPERO (CRD42017084474). Funding None. Conflict of Interest The authors declare that there is no conflict of interest.