Introduction:Rapid maxillary expansion (RME) is an orthopedic treatment procedure routinely used to treat constricted maxillary arches and also a potential additional treatment in children presenting with sleep-disordered breathing (SDB).Aims and Objectives:The main objective of this study was to evaluate the effects of RME on sleep characteristics in children.Materials and Methods:Polysomnography was done on children of 8-13 years of age before expansion (T0), after expansion (T1) and after a period of 3 months after retention (T2). Bonded rapid maxillary expander was cemented in all children. Inter-molar distance was also measured at T0 and T2.Statistical Analysis:Nonparametric Friedman test was used for comparing the averages of sleep parameters at different time period (T0, T1, T2). Wilcoxon signed ranks test was used for comparing the averages of inter-molar width (T0-T2). P < 0.05 were considered as significant.Results:All children showed an improvement in sleep parameters with an increase in sleep efficiency, decreased in arousal and desaturation index after expansion. Total sleep time showed a statistically significant increase after expansion. A statistically significant increase in inter-molar distance was obtained after expansion.Conclusions:Rapid maxillary expansion is a useful treatment option for improving quality of sleep even in normal children without SDB. It also induces widening of the maxilla, corrects posterior crossbites and improves maxillary and mandibular dental arch coordination.

Background and Objectives:A normal airway is required for the normal growth of the craniofacial structures. The present study was designed to evaluate and compare the airway in Class I and Class II skeletal pattern and to see if there is any association between the airway and maxillomandibular relationship.Materials and Methods:Peripheral nervous system computed tomography scans of 30 patients were divided into two groups as Class I (ANB ≤ 4.5°), Class II (ANB ≥ 4.5°). The Dolphin three-dimensional version 11 was used to assess the airway.Statistical Analysis:Correlations between the variables were tested with the Pearson correlation coefficient. Independent sample t-test was performed to compare the averages between the two groups. P < 0.05 was considered as statistically significant.Results:The ANB angle was negatively correlated with all the airway parameters. The airway area and volume was significantly reduced in Class II subjects compared to Class I.Conclusion:The results suggest a strong association between the airway and skeletal pattern showing a reduced airway in Class II patients with a high ANB angle.

Objective:The objective of this study was to compare the surface morphology and dimensional stability of the bracket slot at the onset of treatment and after 12 months of intraoral exposure. The study also compared the amount of calcium at the bracket base which indicates enamel loss among the three orthodontic brackets following debonding after 12 months of intraoral exposure.Materials and Methods:The sample consisted of 60 (0.022” MBT) canine brackets. They were divided into three groups: self-ligating, ceramic bracket with metal slot, and stainless steel (SS) brackets. The slot dimensions, micromorphologic characteristics of as-received and retrieved brackets were measured with a stereomicroscope and scanning electron microscope (SEM), respectively. The amount of calcium at the bracket base which indicates enamel damage was quantified using energy-dispersive X-ray spectrometry (EDX).Results:The results showed statistically significant alterations (P < 0.05) in the right vertical dimension, internal tie wing width (cervical), right and left depth of the slot (Kruskal–Wallis test). Multiple comparison using Mann–Whitney test showed that ceramic brackets underwent (P < 0.05) minimal alterations in the right vertical dimension, internal tie wing width (cervical), right and left depth of the slot (0.01 mm, −0.003 mm, 0.006 mm, −0.002 mm, respectively) when compared with the changes seen in SS and self-ligating brackets. SEM analysis revealed an increase in the surface roughness of ceramic with metal slot brackets and self-ligating bracket showed the least irregularity. The presence of calcium was noted on all evaluated brackets under EDX, but ceramic with metal slot brackets showed a significantly greater amount of enamel loss (P = 0.001).Conclusion:Ceramic brackets were found to be dimensionally stable when compared to SS and self-ligating. Self-ligating bracket showed minimal surface irregularity. Ceramic with metal slot brackets showed a greater amount of enamel loss following debonding.

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Introduction:oral appliance for the treatment of OSA is considered as an effective, low-risk alternative to CPAP. Demand for oral appliance increases as an alternative for those who cannot tolerate CPAP and refuse surgery. Oral appliances uses the traditional methods to advance the mandible thus modify the posture and their by enlarge the airway or otherwise reduce the collapsibility.Aims and Objectives:The main objective of this study was to evaluate the efficacy of custom made oral appliance on sleep characteristics of OSA patients. Materials and Methods: Polysomnography was done on 15 patients of 24-60 years of age before (T1), and after the delivery of the custom made oral appliance (T2).Statistical Analysis:Paired t tests were performed to determine the significance of change in the polysomnographic and cephalometric variables. P < 0.05 was considered as significant. Results: All patients with oral appliance showed an improvement in sleep parameters with an increase in sleep efficiency, and desaturation index with the use of oral appliance. ESS and cephalometric findings showed improvement in the sleep apnea in concordance with the sleep parameters.Conclusions:Custom made oral appliance is a useful treatment option for improving quality of sleep and can be considered as an alternative treatment modality.

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Introduction: Recent innovations in bonding propose laser ablation as an alternative method to acid etching. Objectives: The objective of this study is to compare the effect of laser irradiation at medium-short pulse (MSP) mode, quantum-square pulse (QSP) mode, and acid etching on the shear bond strength (SBS) of orthodontic brackets to enamel. Materials and methods: Forty-two premolars were allocated to three groups (14 each): (1) 37% phosphoric acid etching; (2) erbium-doped yttrium aluminum garnet (Er:YAG) laser etching with MSP mode; (3) Er:YAG laser etching with quantum-square pulse mode. Metallic brackets were bonded with Transbond XT. After photo polymerization, the SBS values were recorded with universal testing machine. Surface morphology was evaluated with scanning electron microscopy (SEM). The remaining adhesive was assessed using adhesive remnant index (ARI). Results: Nonparametric test was used to analyze the statistical significance. A mean rank of 18.29 and 10.71 was obtained for QSP mode and acid etching with p = 0.015, 18.14; and 10.86 for MSP mode and acid etching with p = 0.019; and 14 and 15 for QSP mode and MSP mode with p = 0.748. Statistically significant difference was found between laser and acid-etched group. The SEM scan showed MSP mode with regular and uniform surface, like acid-etched sample, whereas QSP samples had irregular and severely rough surface. The ARI indicates that failure sites are mainly at the enamel/adhesive interface in the acid-etched and MSP mode group and at the bracket base/adhesive interface in QSP mode group. Conclusion: Laser etching in MSP mode is a successful alternative to acid etching, and provides a safer debonding of the brackets from the enamel surface without causing fractures.

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