Lower facial height treatment changes in bi-maxillary protrusion orthodontic cases

Aim of the study was to investigate the change in lower anterior facial height [LAFH] following 1[st] premolar extraction and incisor retraction in bimaxillary proclination orthodontic cases. 35 patients [M:F ratio 18:17] with bimaxillary protrusion with age ranging from 14-17 years [mean calculated age 15.6 years] were treated with 1[st] premolar extractions followed by retraction of the upper and lower labial segments with fixed orthodontic appliances. Pre and post cephalometric values were recorded for each patient. The skeletal parameters measured were SNA, SNB, ANB, MMA, SN-MP and the facial height ratio. The angular soft tissue parameters measured were the naso-labial and the labio-mental angle to investigate the soft tissue changes compared with lower facial height. Pre and post cephalometric values were calculated separately for each patient and the mean value was calculated. The lower anterior facial height decreased by 3 percent following 1[st] premolar extraction space closure and retraction of the upper and lower labial segments. The naso-labial angle showed 4 degrees mean value change following upper incisor retraction, while the labio-mental angle demonstrated a mean value change of 2 degrees post-treatment. Lower facial height can be altered following 1[st] premolar extractions and incisor retraction in bimaxillary proclination patients with increased anterior vertical discrepancies. Skeletal effects were more pronounced as compared to the overall soft tissue profile changes

Soft tissue changes with retraction in bi-maxillary protrusion orthodontic cases

To investigate the profile soft tissue changes, and associated dental and skeletal effects, in upper and lower incisors following 1[st] premolar extraction and incisor retraction in bimaxillary proclination orthodontic cases. Thirty-five patients [M:F ratio 18:17] with bimaxillary protrusion with age ranging from 14-17 years [mean calculated age 15.6 years] were treated with 1[st] premolar extractions followed by retraction of the upper and lower labial segments with fixed orthodontic appliances. Pre and post cephalometric values were recorded for each patient. The angular and linear soft tissue parameters measured were the naso-labial angle, labio-mental angle and the upper and lower lips distance to Ricketts esthetic plane to investigate the soft tissue changes compared with incisor retraction following treatment. The skeletal parameters measured were SNA, SNB, ANB, MMA, SN-MP and the facial height ratio, while the dental parameters measured were upper incisors to maxillary and SN plane, lower incisors to mandibular plane and the inter-incisal angle. Pre and post cephalometric values were calculated separately for each patient and the mean value was calculated. The upper lip prominence decreased by 3mm while the lower lip retracted by 5 mm following 1[st] premolar extraction space closure and retraction of the upper and lower labial segments. The naso-labial angle showed 4 degrees mean value change following upper incisor retraction, while the labio-mental angle demonstrated a mean value change of 2 degrees post-treatment. The facial soft tissue profile demonstrated both angular and linear changes post-treatment following 1st premolar extractions and incisor retraction in bi-maxillary proclination patients, followed by dental changes while skeletally the lower facial height dimension reduced post-treatment

Bracket de-bonding and breakage prevalence in orthodontic patients

The aim of this study was to investigate the prevalence of orthodontic bracket breakage and de-bonding amongst orthodontic patients at Jinnah Medical and Dental College, Karachi. The study stretched over a 13-month period from April 2008 to May 2009. For this cross sectional study 470 routine patients undergoing fixed orthodontic treatment at the Department of Orthodontics were examined. The male to female ratio was 225:245 with a mean age of 16.4 years. The patients were divided into 4 age groups namely A [8-10 years], B [11-13 years], C [14-16 years] and D [>18 years] respectively. In this study, 150 patients had skeletal class 1, 265 had skeletal class II division one and 55 had skeletal class II division two malocclusions, respectively. All patients were bonded with 3M Transbond XT[TM] light cure orthodontic syringe adhesive system. Prior to bonding, the enamel was polished with 10-15 seconds slurry of pumice paste on slow-speed rotation rubber cup. The teeth were washed and dried, followed by 15-30 seconds enamel etch time per tooth with Coltene Whaledent Swiss-Tec_ 35% ortho-phosphoric acid gel. The results of the present study demonstrated more mandibular dentition bracket de-bonding as compared to the maxillary dentition. Both sexes demonstrated greater lower buccal segment bracket breakage followed by the lower anterior segment, with males having slightly higher de-bonding rate as compared to their female counterparts. Furthermore, the lower age groups demonstrated greater breakage compared to older age groups. It was concluded that both sexes had affinity for bracket de-bonding during active orthodontic treatment especially in the mandibular buccal segments. Teenage subjects had more bracket breakage compared to adults. This could be due to greater self-awareness self-motivation and proper oral care in adults during treatment. However, further studies are required to investigate the reasons for bracket breakage and to compare chemically and light-cured composite systems in orthodontics

Prevalence of dental anomalies in JMDC orthodontic patients

To study the prevalence of commonly encountered dental anomalies in JMDC orthodontic patients during routine clinical oral examination and diagnosis. A total of 345 patients [male: female ratio 148:197] were examined both orally and radiographically at the department of orthodontics regarding the commonly encountered dental anomalies regarding number [hyperdontia / hypodontia], size [microdontia macrodontia, fusion, gemination], shape [dens evaginatus, dens in dente, taurodontism] and structure of enamel [amelogenesis imperfecta] and dentine [dentinogenesis imperfecta]. The age range was from 9 to 44 years [Mean age 26.4]. The study was combined with the department of prosthodontics, periodontology and the out-patient filter clinic of the Jinnah Medical and Dental College, Karachi. The patients selected had no associated systemic disorders or syndromes. Overall, 18.8% of the patients examined demonstrated dental anomalies. Males [total mean value 78.3] had more dental anomalies as compared to the females at 23.7. Amongst the wide range of anomalies encountered, hypodontia accounted for the highest prevalent dental anomaly [mean value 57.8] followed by supernumerary teeth [Mean value 12.4] and taurodontism [mean value 7.2]. The sex distribution for hyperdontia showed male subjects with higher affinity [mean value 77.4] compared to female [mean value 23.7], while microdontia, hypodontia and amelogenesis imperfecta had more prevalence in female subjects. Furthermore, females had more affinity towards supernumerary paramolars [mean value 84.7] compared to males [mean value 15.3], while mesiodens were more common the male [mean value 87.6] compared to females [mean value 12.4]. Females showed greater affinity for missing teeth especially mandibular premolars [mean value 88.4] and maxillary lateral incisors [mean value 65.4]. A wide variety of dental anomalies were encountered which cause localized malocclusion, orthodontic space loss, dental cosmetic problems. These anomalies require a team effort consisting of orthodontics, restorative and periodontics for proper functional and esthetic restoration of the dentition. Therefore, proper identification and diagnosis of dental anomalies should be routinely performed during clinical and radiographic evaluation

Skeletal class 1 and 2 malocclusion evaluation in JMDC orthodontic patients

The study was carried out to investigate the etiological skeletal factors differentiating class 2 malocclusions from class one malocclusion patients at Jinnah Medical and Dental College, Orthodontics department. A total of34 [M:F ratio 13: 21] skeletal class 1 malocclusion patients [group A] and 39 [M:F ratio 23:16] severe class 2 division one malocclusion [group B] patients were selected at the department of orthodontics, Jinnah Medical and Dental College, Karachi. The age ranged between 18-22 years [mean age 19.8 years]. All group A cases selected had ANB angle range of2-4 0 [mean value 2.70] indicating skeletal class one antero-posterior relationship, while the group B had ANB angle greater than 4 0 [mean value 8.3 0] indicating skeletal class two malocclusion with severe antero-posterior discrepancy. Lateral cephalogram radiographs were traced for both Group A and B, and composite cephalometric analysis comprising skeletal, dental and soft tissue parameters were noted and the mean value obtained by SPSS 10.0 statistical evaluation program. Group Apatients had less cranial base length [S-N], less cranial base angle [S-N-Ar] and greater SNB angle values as compared to the Group B class 2 patients. Furthermore, group B demonstrated backward mandibular rotation tendency [mean Y-axis angle value 65.8 0], high angle tendency and sagittal mandibular deficiency. Cranial base morphology has a significant effect on the underlying skeletal relationship of the jaws. Class two malocclusions have obtuse cranial base angle and longer cranial base lengths. Clockwise mandibular growth rotation pattern may contribute to the mandibular skeletal deficiency in class two patients

Prevalence of carious lesions in early and late mixed dentition orthdontic patients

To investigate the commonly affected carious teeth in the early and late mixed dentition period of male and female orthodontic patients. A total of 224 [Male: Female ratio 118: 106] patients were diagnosed in the early mixed and late mixed dentition in 3 age subgroups; 6-7 years, 8-10 years and 11-13 years at the patients were investigated regarding carious lesions in the maxillary and mandibular dentition, carious lesions in male and female subjects, carious lesions in primary and permanent teeth. Intra-oral examination and radiographs [orthopantogram and peri-apical] were done for each patient to confirm the carious lesions. The mandibular dentition was affected 3 times more than the maxillary dentition [mean values for total mandibular dentition 62.3 and total mean value for maxillary dentition 28.6]. Males [total mean value 75.7] were affected 3 times greater as compared to the female patients [total mean value 21.9]. 8-10 years age group has the highest carious prevalence [total mean value 54.6] followed by the 11-13 years age group [total mean value 24.6] and the 6-7 years age group [total mean value 18-7]. Both primary and permanent mandibular molars had more carious lesions as compared with the maxillary molars. Mandibular 2nd primary and 1st primary molars and permanent lower 1st permanent molars had the highest carious lesions. 8-9 years age group had the highest carious lesions for both primary and permanent teeth. Males had more [ratio 3:1] carious lesions as compared to the females

Non-extraction orthodontic treatment of class 2 division one malocclusion in adult population

The purpose of this study was to find the skeletal, dental and soft tissue changes following a non-extraction orthodontic treatment regimen in mild to moderate class 2 skeletal base relationships in the adult population

46 mild to moderate class 2 skeletal base relationships were treated with fixed orthodontic appliances in the adult permanent dentition with non-extraction approach. The patients selected were assessed according to pre-treatment and post-treatment cephalometric records. 7 Sagittal, 7 vertical, 8 dento-skeletal and 6 soft tissue profile cephalometric parameters were measured for each patient

Class one molar and incisor relationship was achieved mostly as a result of forward mandibular dento-alveolar movement as compared to skeletal and soft tissue changes. Camouflage orthodontic treatment by non-extraction approach for late adolescents and adults can be achieved with good results