Aims:To determine if the palatal rugae have a characteristic pattern in untreated class II div 1 malocclusions compared to normal class I occlusions, and to provide a valuable insight whether palatal rugae can be taken up as additional criteria for classifying malocclusions.Materials and Methods:The study was conducted on initial maxillary dental casts of 24 individuals with untreated class II div 1 malocclusion with an overjet of minimum of 5mm, of whom 12 were females and 12 were males, with age ranging from 16 to 24 years and compared with Class I patients casts.Results:There was no statistically significant difference in the mean intermolar widths of the two groups. The first, second and third palatal rugae were shorter in class II div 1 patients than in class I patients which was statistically significant. All the patients with Angle's class I occlusion had good pattern of palatal rugae falling in the score range of 1–3, whereas 22% of the patients with class II div 1 had poor pattern of palatal rugae, with score 4 and 2 patients exhibiting a score of 4 and 5, respectively, but this was not statistically significant.Conclusion:There was a significant constriction of the palatal rugae in class II div 1 individuals as compared to class I individuals, though they were matched for the same intermolar widths. There was a distinct pattern of palatal rugae between the two groups.
Aim The objective of this study was to evaluate density changes around the apices of teeth during orthodontic treatment by using digital subtraction radiography to measure the densities around six teeth (maxilla central incisors, lateral incisors, and canines) before and after orthodontic treatment in 36 patients and also assess treatment variables and their coorelation with root resorption. Materials and methods A total of 36 consecutive patient files were selected initially. The selected patients presented with a class I or II relationship and were treated with or without premolar extractions and fixed appliances. Some class II patients were treated additionally with extraoral forces or functional appliances. External apical root resorption (EARR) per tooth in millimeters was calculated and was also expressed as a percentage of the original root length. Image reconstruction and subtraction were performed using the software Regeemy Image Registration and Mosaicing (version 0.2.43-RCB, DPI-INPE, São José dos Campos, São Paulo, Brazil) by a single operator. A region of interest (ROI) was defined in the apical third of the root and density calibration was made in Image J® using enamel (gray value = 255) as reference in the same image. The mean gray values in the ROIs were reflective of the change in the density values between the two images. Statistical analysis The root resorption of the tooth and the factors of malocclusion were analyzed with a one-way ANOVA. An independent t-test was performed to compare the mean amount of resorption between male and female, between extraction and nonextraction cases. The density changes after orthodontic treatment were analyzed using the Wilcoxon signedrank test. In addition, the density changes in different teeth were analyzed using the Kruskal-Wallis test. The cut-off for statistical significance was a p-value of 0.05. All the statistical analyses were carried out using SPSS (version 13.0 for Windows, Chicago, IL, USA). Results Gender, the age at which treatment was started and Angle's classification was not statistically related with observed root resorption. The mean percentage density reduction as assessed by DSR was greatest in both central incisor: by 27.2 and 25.2% in the upper-right and upper-left central incisors, respectively, followed by the upper-right and upper-left canine teeth (23.5 and 21.0%) and then the upper-right and upper-left lateral incisors (19.1 and 17.4%). Conclusion Tooth extraction prior to treatment initiation and the duration of orthodontic treatment was positively correlated with the amount of root resorption. DSR is useful for evaluating density changes around teeth during orthodontic treatment. The density around the apices of teeth reduced significantly after the application of orthodontic forces during treatment. Clinical significance Assessment of density changes on treatment radiographs of patients undergoing orthodontic therapy may help in the monitoring of external apical root resorption during course of treatment. How to cite this article Sunku R, Roopesh R, Kancherla P, Perumalla KK, Yudhistar PV, Reddy VS. Quantitative Digital Subtraction Radiography in the Assessment of External Apical Root Resorption Induced by Orthodontic Therapy: A Retrospective Study. J Contemp Dent Pract 2011;12(6):422-428.
The protruding and deviated premaxilla in bilateral complete cleft lip and palate (BCL/P) patients causes a perplexing problem in achieving a tension-free primary lip closure. An innovative noninvasive active intraoral Fixed Pre-Surgical Cleft Orthopedic (FPSCO) appliance is presented that has enabled to successfully reposition the premaxillary segment to a more favorable position prior to the surgical repair in 4 BCL/P patients, who reported late for treatment with a mean age of 18 ± 3 months. All the patients had at least 1 deciduous tooth erupted in 3 cleft segments, 1 premaxilla (PM), and 2 lateral maxillary (LM) segments. This innovative approach is a noninvasive method of getting the cleft segments closer prior to chelioplasty, where conventional presurgical nasoalveolar molding (PNAM) is not possible, which needs to be done early in life as it requires circulating maternal estrogen levels to achieve results preferably possible in patients younger than 3 to 6 months. Bonding to erupted teeth with glass ionomer cement was implemented to secure the appliance. Nickel-titanium (Ni-Ti) closed-coil springs were used that delivered continuous forces of 150 g/5 oz per side to retract the premaxillary segment. The mean active period of treatment time was 3.5 ± 1.6 months and the retention period was 1.2 ± 0.6 months, following which cheiloplasty was performed.
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