Association of temporomandibular joint sounds with malocclusion

Temporomandibularjoint disorder is a multi-factorial condition affecting the joint or muscles of the jaw. A descriptive cross-sectional study was conducted to determine association oftemporomandibular joint [TMJ] sounds with various categories ofmalocclusions. 384 subjects, who fulfilled the inclusion criteria of the study, were clinically examined for the presence or absence of temporomandibular joint sounds and type ofmalocclusion. A Chi-Square test [p < 0.05] was used to find any significant association of TMJ sounds with different categories ofmalocclusion. Joint sounds were found to be present in 100 [26%] subjects. Joint sound were present in 55 [22.6%] subjects with Class I malocclusion, 36 [32%] subjects with Class II malocclusion and only 9 [31%] subjects with Class III malocclusion. Chi- Square test revealed no significant association of TMJ sounds with malocclusion or gender. TMJ sounds can be a frequent finding in healthy individuals with no other symptoms ofTMD. In the light of results of current study and other recent studies that have been carried out around the globe, it can be concluded that clicking itself is not indication of any active disease and it can rarely progress to any significant clinical problem, so there needless management must be avoided

Prevalence of dental anomalies among orthodontic patients

Dental anomalies are clinically evident abnormalities which can cause various dental problems, which may complicate orthodontic treatment planning. Clinical and radiological inspection play crucial role in identification of various anomalies. This study was carried over the period of 2 years to determine the pattern and distribution of various morphological dental anomalies among orthodontic patients. Demographic details along with detailed medical, dental and family histories were obtained from every patient. In addition to the intraoral examination, study casts and dental panoramic radiograph were also evaluated for dental anomalies causing disturbance in number, size, form, and location of teeth. Patients with syndromes were not included in the study. Out of 520 patients, dental anomalies were present in 83 [16%] patients. Hypodontia was the most prevalent dental anomaly occurring in 37 [7.1%] patients and maxillary lateral incisor was found to be the most commonly missing tooth. Microdontia was second most prevalent dental anomaly observed in 21 [4%] patients with the maxillary lateral incisor being the most commonly affected tooth. Double tooth was rare finding present only in 1 [0.19%] patient. All dental anomalies showed higher prevalence in female patients except for double tooth and transposition which were more prevalent in male patients. . Dental anomalies can lead to disturbance in occlusion. Orthodontists have the responsibility to observe each patient carefully for various dental anomalies and have full knowledge of them as it can help them in planning treatment for these patients and executing them without any complications

Evaluation of patient preparation and positioning errors on digital panoramic radiographs

Dental panoramic radiograph, in addition to clinical examination, is a valuable diagnostic tool for the dentist to obtain information. Quality of each radiograph is of supreme importance. Unsatisfactory quality of radiograph can lead to misinterpretation that may result in inadequate diagnosis and treatment plan. Good quality radiograph will avoid any further need of repeating radiograph, thus reducing any unnecessary exposure of ionizing radiation to the patient. The objective of this study was to determine the relative frequency of common preparation and positioning errors observed on dental panoramic radiographs and to assess quality of radiographs as well. Dental panoramic radiographs were obtained from pretreatment records of patient undergoing orthodontic treatment and each radiograph was assessed for preparation and positioning errors. A three point quality scale proposed by National Radiological Protection Board was used by the examiner to rate each radiograph as being excellent, diagnostically acceptable or diagnostically unacceptable. Out of 480 panoramic radiographs examined, 100 [21%] radiographs were free from any type of preparation or positioning error while 380 [79%] radiographs had some preparation or positioning errors. The most frequent preparation error observed was patient wearing nose pin [8.3%]. While the most common positioning error observed was patient's failure to position tongue against the palate [62.5%]. More than one positioning or preparation error was found in 41.6% of the faulty radiographic films. Only 21% of radiographs were rated excellent, 64.5% were diagnostically acceptable, and 14.5% were unacceptable. Quality of panoramic radiograph must be assessed regularly making sure that they are free of any preparation or positioning error. All dental professionals must identify patient preparation and positioning errors and must understand consequence of these errors on diagnostic yield of radiograph

Prevalence of malocclusion and its relation with crowding and spacing

Study was carried out to determine the prevalence of malocclusion and its relation with crowding and spacing in orthodontically referred patients in a Karachi sample. 1082 patients were examined [362 males and 720 females] over the period of three years. Malocclusion was categorized according to Angles classification. Study model of each subject was used to assess crowding and spacing in both maxillary and mandibular dentition. Chi Square test was used to find relationship of crowding and spacing with different categories of malocclusion. Class II division 1 was most prevalent type of malocclusion [32%]. Relation of maxillary and mandibular crowding or spacing with different categories of malocclusion was found to be statistically significant [p < 0.05]. Mild maxillary crowding, mild mandibular crowding and mild mandibular spacing were most common finding in all malocclusion categories. Except for Class III malocclusion category, where moderate maxillary spacing was more prevalent, mild maxillary spacing was most frequently observed in remaining categories. Class II was most prevalent category of malocclusion. Relationship of crowding and spacing with different malocclusion categories was statistically significant. These results do not necessarily reflect the trend of entire Pakistani population as study was conducted in southern Pakistani population

Frequency of bolton tooth size discrepancies outside 2 standard deviation of the Bolton's mean among orthodontic patients

To evaluate, the mesiodistal dimensions of permanent teeth, frequency of Bolton ratio and the presence of Bolton discrepancy outside 2 SD of the Bolton's mean in an orthodontic population, irrespective of the type of mal occlusion. The study was carried out at the department of orthodontics Fatima Jinnah Dental College and Hospital, Karachi. The sample comprised of 150 pairs of good quality pre- treatment study models with fully erupted and complete permanent dentition from first molar to first molar, which were selected from the orthodontic patient pool. Dental casts having grossly carious teeth, prosthesis or anomalies of teeth were not included. The mean, range and standard deviation were calculated for the mesiodistal dimensions of the teeth, anterior ratio and overall ratio.A2- sample t- test was used to test for the statistical difference between means. In general there was no difference between the mesiodistal dimensions of the males and females so the subgroups were combined for further calculations. Mean overall ratio was found to be 91.54%[SD2] and the value ranged from 86.42%to 96.70%.Mean anterior ratio was found to be 78.85%[SD 2.3] and the values ranged from 72.49%to 83.14%. This study found that 13 subjects [9.1%] had overall ratioand 22 subjects [14.7%] had anterior ratio outside 2 SD of Bolton's mean.: With such a high number of significant discrepancies, it is important to routinely perform Bolton tooth size analysis before starting orthodontic treatment as TSD is prevalent among orthodontic patients