Three point fixation is superior to two point fixation technique for zygomatic complex fracture

Background:Isolated zygomatic or malar bone fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is appropriate for isolated zygomaticbone fracture. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques (two point and three point)in patients with zygomatic complex fracture.Methods:This randomized controlled trial was conducted at Department of Oral and Maxillofacial Surgery, MMDC, Multan, during a period of six months from 1st June 2017 to 30th November 2017. A total 182 patients of both genders were included in this study. Two point fixation techniques were used in Group-A patients. While 3 point fixation was used in Group-B patients. After 6 weeks follow-up, patients were assessed for malar height. Outcome was measured by comparing the mean difference of pre and postoperative malar height of both techniques. Data were analyzed using computer program SPSS-21. P≤0.05 was taken as significant in all analysis.Results:Among patients in two pointfixation group, the mean malar height was 67.55±2.98 mm and in three pointfixation group, meansmalar height was 71.55±2.36 mm. The difference of malar height among two treatments was highly significant with p<0.01. Conclusions: Using three point fixation results better as compared to two point fixations in terms of malar height outcome

Frequency of Different Types of Mandibular Third Molar Impactions

Objective: Impacted third molars are a major problem in modern dentistry and the decision of whether to remove an impacted third molar is probably one of the most frequent treatment decisions faced by dentists. Impacted mandibular third molars are often associated with pericoronitis, periodontitis, cystic lesions, neoplasm, and pathological root resorption and can cause detrimental effects on the adjacent tooth. Therefore, the objective of the present study was to determine the frequency of different types of mandibular third molar impactions. Materials and Methods: This cross-sectional study was carried out in the outdoor patient Department of Oral and Maxillofacial Surgery, Multan Medical and Dental College, Multan during a period of 6 months from 15 December 2017 to 14 June 2018. After written informed consent, a total of 200 patients were recruited, diagnosed clinically and radiographically as having impacted mandibular 3rd molar. Angulation of impacted third molar was classified according to the long axis of the adjacent second molar on periapical and OPG radiographs. Statistical analysis was done through SPSS version 20. Results: Out of 200 patients, the frequency of mesioangular, vertical, distoangular, and horizontal impactions were 84 (42%), 60 (30%), 40 (20%), and 16 (8%) respectively. The depths of the impactions were 67 (33.5%) depth A, 92 (46%) depth B, and 41 (20.5%) depth C. Conclusion: Mesioangular impaction was more common followed by vertical. Depth B was the most common.

Factors associated with mortality of oral squamous cell carcinoma (OSCC) patients managed at Hospital USM

@#This study was to determine the sociodemographic and clinicopathological factors that were associated with mortality of OSCC patients managed at Hospital USM. The prevalence of high-risk human papillomavirus (HPV) in these patients and its association with epithelial proliferation rate were also determined. A retrospective study was conducted whereby medical records of patients diagnosed with OSCC and tissue specimens from 2005 to 2015 were studied. Formalin-fixed paraffin-embedded (FFPE) tissue specimens were evaluated for histological grading of OSCC, p16 overexpression and Ki-67 immunostaining. Descriptive statistics, simple and multiple logistics regressions were used for data analysis. Prognostic factors for mortality includes male gender (AOR=10.89; 95% CI: 1.99, 59.65; p = 0.006), alcohol consumption (AOR = 16.45; 95% CI: 1.36, 59.65; p = 0.028), not receiving treatment (AOR = 5.88; 95% CI: 1.03, 33.61; p = 0.046) and late stage (T3, T4) at presentation (AOR = 4.85; 95% CI: 1.12, 21.02; p = 0.035). Significant association was found between high-risk HPV positivity and higher epithelial proliferation rate expression (p < 0.003) in the OSCC tissue specimens.

Comparison of shear bond strength of moisture insensitive primer and conventional primer

There are controversial results in the published literature about the use of primers on bonding strength of orthodontic brackets. The purpose of this study was to compare the mean shear bond strength of orthodontic brackets cured with or without the prior application of primer resins. Sixty extracted first premolars were included. In group MP, 30 teeth were cured using standardized bonding protocol including application of moisture insensitive primer resin while 30 teeth in group P were cured using standardized bonding protocol, including a step of application of conventional primer resins. Later on bonding strength was measured using universal testing machine and student's t-test was used for comparison of bond strength in both the groups. Results revealed that although bond strength values were higher in MP group but statistically insignificant differences were found in bond strength in both the groups [p 0.079]. It is concluded that there is no statistically significant difference in the shear bond strength of orthodontic brackets cured with moisture insensitive primers or with conventional primers in our present study

Excessive over bite: frequency of local dental and skeletal factors

Deep bite is multifactorial in nature with involvement of many local dental and skeletal factors. The aim of present cross sectional study was to find out the frequency of dental and skeletal factors involved in deep bite subjects visiting department of Orthodontics, Faisalabad Medical University and de'Montmorency College of dentistry. Orthodontic models and lateral cephalograms of 100 deep bite patients were included to find out the frequency of involved dental and skeletal factors. The mean age of the sample was 20.35 +/- 3.45 years. Results showed that in dental factors, deepening of Von spee curve was the most frequent dental factor while decreased mandibular plane angle was the most frequent skeletal factor. It was concluded that deep curve of spee was the most frequent dental factor while decreased mandibular plane angle was the most frequent skeletal factor involved in deep bite subjects

Maxillary intermolar width of Pakistanis with untreated normal occlusion

Objective: Intermolar width is a key measurement which assists in treatment planning of orthodontic patients requiring expansion as an alternate to premolar extraction. The present research was aimed at determining the mean value of intermolar arch width [IMW] of untreated normal arch Pakistani patients visiting tertiary care dental hospital

Material and Methods: This cross sectional study was carried out using IMW measurements on plaster model of 120 untreated normal occlusion patients, at Department of Orthodontics, Faisalabad Medical University and de'Montmorency College of dentistry, from 15-12-2016 to 15-10-2017. The non probability consecutive sampling technique was used in this study. Data analysis was done using SPSS software 21.0.0

Results: The mean age of the subjects was 18.23+/-3.75 years. The mean value of IMW in selected subjects was 45.33+/-3.42 mm

Conclusion: Study results concluded that in Pakistanis, ideally align maxillary arch and occlusion can be achieved with upper intermolar distances of 45.33+/-3.42 mm

Posterior X-Bite: frequency and distribution by gender in a sample of Pakistani population

Introduction: The mass spread of orthodontic setups in Pakistan highlights the need of having data for planning orthodontic therapy need. The worldwide prevalence of posterior cross bite ranges from 8 percent - 28 percent and varies between ethnic groups and by age and gender. This study was design to find out the frequency of posterior X-bite [PXC] and its gender distribution in our population

Objective: The purpose of present study was to estimate the frequency of PXC among patients visiting Faisalabad medical university

Study design: A cross sectional study

Setting: Department of Orthodontics and ENT, Faisalabad medical university

Duration of study: 6 months from 15.3.2017 to 15.09.2017. Sample size: The calculated sample size was 300 patients. Sampling technique: Purposive sampling technique. Data collection procedure: Clinical intraoral examination was used to confirm the presence of PXC. Using established recording criteria, a single operator assessed the posterior crossbites in a sample of 300 patients. The data was analyzed in Statistical Package for the Social Sciences software package [SPSS] 20

Results: The mean age of the patients was 13.46+/-4.34 years. The frequency of PXC was found to be 20 percent. Male to female ratio was 1:1. Bilateral PXC was more prevalent

Conclusion: Frequency of posterior X-bite was found to be 20 percent and both genders were equally affected, with bilateral type more prevalent as compared to unilateral type. Further studies are suggested in order to further clarify and provide more accurate calculations of the PXC frequency in Pakistani subjects

Applicability of index of Orthognathic functional treatment need [IOFTN]

Introduction: The Index of Orthognathic Functional Treatment Need [IOFTN] was introduced to overcome the limitations of IOTN index to determine treatment need for Orthognathic surgery, and to assist in prioritising public resources for Orthognathic surgery

Objective: To apply IOFTN in patients who were in preparation for Orthognathic surgery

Study design: Across sectional study

Setting: Department of Orthodontics, Faisalabad Medical University [FMU], Faisalabad

Duration of study: 6 months from 10.6.2017 to 10.12.2017

Sample size: The calculated sample size was 50 patients

Sampling technique: Purposive sampling technique

Data collection procedure: Findings were recorded on data collection Performa. The data was analysed in Statistical Package for the Social Sciences software package [SPSS] 21

Results: Results showed that 90 percent of the cases scored grade 4 and 5. 51 percent of female patients and 49 percent of male patients were needed definite Orthognathic treatment according to IOFTN. No significant gender difference was found for Orthognathic treatment need. IOFTN showed 40 percent [Grade 5], 45 percent [Grade 4], 7 percent [Grade 3], 2= percent [Grade 2] and 0 percent [GradE[1]] results respectively.7 percent of the patients were classified as being in need of moderate treatment, with 2 percent having mild treatment needs. Class II malocclusions [60 percent] and Class III skeletal patterns [40 percent] were the most prevalent type

Conclusion: IOFTN found 90 percent of orthognathic patients as having great to very great functional needs

Outcome of mesh envelope bone grafting for traumatic segmental bone defects

Background: Long bone defects treatment is a technically demanding procedure in orthopedic surgery and may require bone graft pieces, which are loosely applied to the bone and few pieces can spill over in the surrounding area, resulting in failure in obtaining beneficial effects. The vicryl mesh envelope around the bone graft may be a solution

Objective: To determine the role of mesh regarding bone graft containment and union in long bone defects of > 4cm

Methodology: This experimental study was conducted in orthopedic department of Lahore General Hospital, Lahore from 1[st] January 2012 to 31[st] December 2014. Total 28 cases were included in the study and randomized into two equal groups. Fourteen patients were managed with vicryl mesh [group A] while 14 patients were treated routinely without the use of vicryl mesh envelope [group B]. Data was entered and analyzed by using SPSS version 18.0

Results: The mean age of all the patients was 29.11+/-6.16 years. The mean age of patients in group A was 29.71+/-6.56 years and in group B was 28.50+/-5.92 years. There were 20 [71%] male patients and only 8 [29%] female patients presented with long bone defects. Most of the patients were managed with dynamic compression plating i.e. 20 [71.43%]. In group A, 1 [7.1%] patient developed infection and re-operation was done while in group B 6 [42.9%] patients has infection and reoperation was executed to eradicate it. The difference was significant for post-operative infection between both groups [pvalue= 0. 029]

Conclusion: This study concluded that there was significant difference between both techniques in graft containment, consolidation and graft failure. Patients managed with vicryl mesh have better outcome than without vicryl mesh

Assessment of antibacterial activity of herbal formulations used in typhoid fever, available in local markets of twin cities of pakistan

Herbal formulations are used for so many years in various countries including Pakistan for the treatment of different diseases. Thus six herbal formulations were purchased from local market of Islamabad and Rawalpindi in order to assess antibacterial activity like minimum inhibitory concentration [MIC] and zone of inhibition [ZOI] on Salmonella typhi ATCC [14028]. The results revealed that only two formulations showed activity against S. typhi. Two herbal formulations failed to show any antibacterial activity. While remaining formulations had weak activity. To promote the role of alternative medicines, appropriate measures should be taken by Regulatory authorities to promote standard and good quality herbal products?

Lateral open bite: Frequency and distribution

Objective: This study was designed to determine the frequency of lateral open bite and its gender distribution among the patients visiting Orthodontics department of de.Montmorency College of Dentistry, Lahore

Methodology: This cross sectional study was carried out at department of Orthodontics, de.Montmorency College of dentistry, Lahore, where orthodontic records of 200 patients were included to find out frequency of lateral open bite [LOB]. The amount of LOB was confirmed by measuring vertical distance between cusp tips of posterior teeth affected by lateral open bite, with standardized digital vernier calipers on plaster models

Results: 200 patients were included [98 boys, mean age: 19.3 +/-1.3 years; 102 girls, mean age: 19.0 +/- 1.5 years] The frequency of lateral open bite was found to be 1%. Male to female ratio was 1:1

Conclusion: It was concluded that male and female were equally affected by lateral open bite and frequency was find out to be 1%

Level of vitamin d in Orthopaedic Trauma among adult patients

Background: The evidence on level of vitamin D in trauma patients is scarce in the developing countries

Objective: To determine the levels of vitamin D in trauma patients above 18 years of age

Methodology: This was a cross sectional study conducted on patients admitted in the Orthopedic department of Sheikh Zayed Medical College /Hospital, Rahim Yar Khan, patients included in this study were 340. The duration of study was 21st July to 16th March 2016. Vitamin D level were measured by using vitamin D kits [Roche]. Patients less than 18 years were not included in the study. Data was analyzed by using SPSS version 16

Results: A total of 340 patients admitted in orthopedic department were included in this study. Overall 92.6% patients have deficient or insufficient level of vitamin D. Most of the patients [68.8%] were less than 45 years of age. Majority of the patients were male [71.8%]. Most of the patients [72.4%] were not smokers. Majority belonged to rural areas [56%], and have no history of steroid intake

Conclusion: This study confirmed that majority of the trauma patients were vitamin D deficient or insufficient. This highlights that trauma surgeons should consider vitamin D in the armamentarium of orthopaedic treatment

Comparison between ibuprofen and chewing gum for orthodontic pain control

Pain is common experience in orthodontic patients that begins two hours after force application and reaches peak at 24 hours, then lasts for 5 to 7 days. The objective of this study was to compare the decrease in pain score with ibuprofen and chewing gums in orthodontic pain control during the first week after initial arch wire placement. This study was conducted at de,Montmorency College of Dentistry, Lahore, from April 2014 to October 2014. 250 patients with age range of 12 to 16 years of both sex were selected and divided in to ibuprofen and chewing gum groups [125 each group] using random number table. The patients in each group received pain control 24 hours after initial arch wire insertion and then at 8-hour interval till 7th day. Patients were asked to complete a Visual Analog Scale [VAS] Questionnaire, at 24 hours after arch wire insertion, then at 24 hours, and 7th day. Two-way ANOVA was used for analyzing significance of mean decrease in VAS between two groups. Results showed that decrease in pain score for ibuprofen group; baseline to 24 hours was 2.35 +/- 1.36 which was significantly lower than decrease in pain score for chewing gum group 3.34 +/- 1.34. At 7th day, ibuprofen group showed decrease in pain score as 4.07 +/- 1.43 which was significantly lower than decrease in pain score of 5.86 +/- 1.56 for chewing gum group. This was concluded that chewing gums showed more decrease in pain score for orthodontic patients as compared to ibuprofen

Reasons for cancellation of operation in A235 bedded public sector hospital dedicated for gynecology and obstetrics in Lahore

Objective: to evaluate the reasons for cancellation of elective surgical operation of the patients who presents for pre-Anesthesia evaluation one day before surgery or on the day of surgery in a 235 bedded public sector hospital in Lahore

Methods: the medical records of all the patients, from 1st June 2014 to 30th May 2015, who had their operations cancelled one day before surgery or on the day of surgery in all gynecology and obstetrics units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented in detail

Results: 2160 patients were scheduled for elective surgical procedures during the study period of one year; 204 [9.4 %] of these were cancelled one day before surgery during pre-Anesthesia fitness or on the day of surgery. The most common cause of cancellation was inadequate patient preparation. 59 [28.92%] patients were cancelled as they were not adequately prepared for surgery as per anesthetist advice [incomplete NPO, Investigations or referrals required]. The second most common cause of cancellation was the optimized medical status of the patients53 [25.98%]. 36[17.65%] cancellations were because of equipment failure/Electricity shutdown; 17 [8.33%] cancellations due to lack of operation theater time; 16 [7.85%] were cancelled due to patient's refusal/patient left against medical advice; 12 [5.88%] were cancelled by the surgeon due to a change in the surgical plan and 11 [5.39% ]patients were cancelled due to non-availability of surgeon

Conclusions: most causes of cancellations of operations are preventable

Comparison of outcome of fractures of inferior pole of patella

Background: Fractures of patella are common and it constitutes about significant proportion of all skeletal injuries resulting from either direct or indirect trauma

Objective: To evaluate the outcome of inferior pole fractures of patella treated with tension band wiring and resection of avulsed fragment and re-attachment of ligament to patella

Methodology: This was an comparative study, carried out in Department of Orthopaedic surgery of Lahore General Hospital, Lahore from 16[th] June 2012 to 15[th] June 2014. A total of 20 patients were included in this study. These patients were randomly divided into two groups. In Group-A patients were treated with open reduction and internal fixation with tension band wire and in Group-B patients were treated by resection of the avulsed fragment and reattachment of the patellar ligament to the patella. Patients were followed up for surgical site infection and functional outcome at 1[st], 7[th], 15[th], day one month, three months and six months post operatively. Final outcome was assessed by using Bostman criteria. Data entry and analysis was done by using SPSS version 17

Results: Mean age of all 20 patients was 34.20 +/- 12.13 years. Although both treatment groups had statistically same rate of surgical site infection from 1[st] day till 15[th] day post operatively. From 1[st] month till 6[th] months follow up time period none of the patients had surgical site infection in both treatment groups. At 1[st] month and 6[th] month post operatively in Group-B outcome was statistically better as compared to Group-A patients. But at 2[nd] month outcome of patients was statistically same in both treatment groups

Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had good outcome according to the Bostman criteria as compared to open reduction and internal fixation with tension band wire

Modified Kugel versus Lichtenstein operation for inguinal hernia repair: a prospective randomized study

Objectives: the purpose of this prospective randomized clinical study was to compare the outcome regarding pain and recurrence following Lichtenstein repair with Modified Kugel repair of inguinal hernias

Study Design: this was a prospective randomized clinical study

Materials and Methods: patients with inguinal hernia who were treated during Sep. 2010 to May 2012 using Preperitoneal Modified Kugel approach [PP group, n: 89] and the Anterior Lichtenstein approach [AL group n:87]. The operation time, hospital stay, postoperative complications and recurrence after surgery were assessed and compared statistically in both groups

Results: a total of 176 patients [173 men and 03 women] randomized to either group PP or group AL. No significant differences were observed regarding seroma and infection in both groups, however postoperative hematoma and operative time were higher in AL Group without any statistical significance [p< 0.098].The rate of recurrence and pain were significantly high with in AL group versus PP Group during period of follow up time [23.34 +/- 1.07 months Vs 23.01 +/- 0.13 months in group PP and AL respectively]. The operative time in Preperitoneal Modified Kugel Repair [PP Group] was 45.16 +/- 10.14 minutes and 52.34 +/- 07.04 minutes for Anterior Lichtenstein Repair [AL Group]

Conclusion: modified Kugel Repair of Inguinal Hernia is minimal invasive method and as safe as Anterior approach with less recurrence and pain than Lichtenstein operation

Diaphyseal femoral fractures; outcome treated with close vs open

The femur fractures usually happen with oomph forces like motor vehicle accidents. To assess the mode of injury and complications of the management, in diaphyseal femoral fractures, in comparison of close versus open intramedullary interlocking nail [IMN]. Experimental and comparative study. April 2013 to March 2014. Department of Orthopaedic Surgery, Peoples University of Medical and Health sciences, Nawabshah. The cases were divided into two groups A and B. Group A was treated by open nailing [n = 20] and group B by close nailing [n = 20], all the cases were operated within 48 hours of admission. All the data were recorded on well structured proforma. Serial radiographies were performed at 3, 6, 12 weeks, and 6 months; additional radiographies were performed as needed postoperatively. Knee, ankle, and hip motions were begun and protected weight bearing was started on the second day postoperatively and increased gradually to full WB depending on x-ray findings of callus formation. The patients were followed for two years. Results of open and closed I.M.N were assessed and the complications if any were observed over a mean follow-up period of two years. The mean age in group A was 29.40 years and the mean age in group B was 30.45 years. Out of 40 cases, 32[80.0%] were males with male to female ratio 1:4. Mean +/- SD hospital stay was 19.80 +/- 14.60 days in group A, and 17.90 +/- 5.95 days in group B [p value 0.55]. Average time between injury and admission was 1.53 days [n = 40], in the group A it was 1.05 days, and in the group B it was 2.0 days [p value 0.03]. The average of time between injury and operation in the group A was 8.75 days, and in the group B, it was 8.20 days, [p value 0.71]. The average of time between admission and discharge in the group A was 11.0 days, and in the group B was 9.15 days, [p value 0.55]. Mean +/- SD union time was 11.70 +/- 6.45 weeks, in group A and 11.90 +/- 5.77 weeks, in group B. [p value 0.91]. All the patients had full ranged of hip motion and 2 [10.0%] patients of group A had mild limitation of knee motion with a flexion ranges between 80 and 110 degrees. Final functional results based on Thoresen BO criteria16. Excellent results were observed in 19 [47.5%] cases, out of them 5[25.0%] were in group A and 14[70.0%] were in group B. Good results were found in 13[32.5%] patients, out of these 7[35.0%] were in group A and 6[30.0%] were in group. Fair and poor results were detected in 4[10.0%] cases of group A. Road traffic accidents by motorcycle was found the commonest [47.5%] cause of femur fracture, a few complications were observed in open interlocking nailing as compared to closed interlocking nails

Outcome of tissue sparing conservative surgery in blast injuries to limbs

Background: Blast injuries are common in countries affected by conflict

Objective: To evaluate the outcome of conservative surgical intervention in the blast injuries of limbs in civilian population

Methodology: Study Design: Cross sectional study. Place and Duration of Study: Department of Orthopedic Surgery, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1[st] September 2011 to 31[st] March 2013. Fifty patients suffering from blast injuries to upper and lower extremities in civilian population regardless of age and sex were enrolled. Those patients who already had been treated after injury at some other centers were excluded from the study. Only clinical evaluation was used to check the vascular status and viability of the remaining attached tissues. Patients were operated either under general or regional anesthesia. Repeated debridement's followed by skin coverage in the form of split thickness skin graft or rotational flaps were the treatment option for soft tissues and exposed bone respectively. Post operative antibiotics were given for a period of one week at least. Rehabilitation exercises were continued up to six months after discharge from the hospital. The data was entered and analyzed by using SPSS version 15

Results: Mean age of the victims in this study was 22 years. Twenty nine patients had some sort of traumatic amputation at presentation resulting from original injury. Original injuries occurred were as follows; loss of limb below knee 7[14%], loss of limb at ankle region 05[10%], mid foot amputations 08[16%], and hemi foot amputation in 05[10%]. In upper limb injuries pattern was as follows; 01[2%] mid palmer amputation, 02[4%] two fingers amputation, and 04[8%] had soft tissue involvement of hand. Infection rate was 22% in patients who did not have wound dressing by the primary physician while it was 10% in patients who had wound dressing by primary physician before presenting to this institution, the collective infection rate was 32%

Conclusion: Conservative wound debridement, early skin coverage, preserving maximum soft tissues and bone results in functionally and cosmetically better limb in blast injuries

Short term outcome of clubfoot correction by Ponseti method

Background: Congenital Talipes Equino Varus [CTEV] is a common complex congenital deformity of the foot. Treatment still continues to challenge the skills of the pediatric orthopedic surgeon as it has a notorious tendency to relapse, irrespective of whether the foot is treated by conservative or operative means

Objective: To evaluate the short term outcome of Ponseti method of serial manipulation and casting in Congenital Talipes Equino Varus [CTEV] in children up to 6 months of age

Methodology: A descriptive case series study was carried from 16[th] February to 15[th] August 2012 in the department of orthopaedic surgery, Sheikh Zayed Medical College/Hospital Rahim Yar Khan. A total of 200 feet were included in this study. The first cast application corrects the cavus deformity by aligning the forefoot with the hind foot, supinating the forefoot to bring it in line with the heel, and elevating the first metatarsal. One week after application, the first cast was removed, and after about 2-3 minutes of manipulation, the next toe-to-groin cast was applied. Manipulation and casting continued weekly for the next 5 to 6 weeks

Results: Mean age of patients was 3.9 +/- 1.7 months. Ninety one patients [62.3%] were male while remaining 55 patients [37.7%] were female. Left foot deformity was seen in 48 [33%] patients, right foot deformity was found in 34 [23%] patients and 64 [44%] patients were suffering from bilateral deformity. Percutaneous tenotomy of Tendo-Achilles was performed in 167 patients [83.5%]. Out of 200 feet, correction was achieved in 177 feet [88.5%] with zero Pirani score

Conclusion: Ponseti's method is simple, easy to learn, effective and reproducible method for correction of Congenital Talipes Equino Varus [CTEV] deformity in children

Correlation between curve of spee and vertical eruption of anterior or posterior teeth in class-II division imalocclusion

The objective of this crossectional study was to relate the depth of curve of Spee to the eruption of anterior or posterior teeth quantitatively, and to determine whether the depth of the Curve of Spee is affected by the vertical eruption of anterior or posterior teeth. The study was conducted at Department of Orthodontics, de'Montmorency College of Dentistry, Lahore; in which two hundred fifty lateral cephalograms and models of untreated Class II Division 1 malocclusion patients [127 boys, mean age: 15.4 +/- 1.4 years; 123 girls, mean age: 17.1 +/- 1.8 years] were included. The depth of the Curve of Spee was measured on lateral cephalograms as perpendicular distance from incisal tip of the mandibular central incisor to the mandibular plane [L1-MP], distobuccal cusp tip of the mandibular second molar [M7-MP] to the mandibular plane, the deepest point of the Curve of Spee to the mandibular plane [S-MP], and proportioned with each other. Right and left side Curve of Spee was measured on models. Results showed that the mesiobuccal cusp of the first molar was the deepest part of the Curve of Spee, and eruption of mandibular molars [M7-MP/S-MP] was more significantly related to depth of Curve of Spee as compared to eruption of mandibular incisors [L1-MP/S-MP]. There was no significant difference between Right and left side Curve of Spee. It was concluded that vertical eruption of the posterior teeth made a significant effect on the depth of the Curve of Spee in Class II Division I malocclusion patients