Current trends of orthodontic research in Pakistan

Orthodontic research in Pakistan has evolved rapidly in the past decade. The aim of this paper is to give an overview of the trends of the research in past 5 years with reference to study type, designs and subject of research. Citations of orthodontic articles from 2008-2012 from Pakistan were identified by electronic as well as manual search in major local as well as international databases and journals. All citations were then organized and analyzed in Microsoft Excel 2010 software. The studies were classified on the basis of their designs and topic of interest. A total of 137 studies were included after screening. Cross-sectional descriptive studies dominated the study designs [43%], while experimental studies were only 12 [8.7%]. Cephalograms [33%] and dental casts [22%] were the most common topics of interest, comprising more than half of all the studies, while adhesives based studies were lowest in number [3%]. Cross sectional descriptive studies on cephalometry and dental casts were the most common trends seen in this review, but many deficiencies were also identified. Orthodontic training programs in Pakistan must incorporate more research oriented workshops, continuing education on medical writing and biostatistics and awareness programs for improvement in the quality of orthodontic research

Staged correction of facial asymmetry: a case report

Management of the facial asymmetry requires meticulous clinical and radiologic assessment to assess which bones are at fault. Correction of advanced cases may require surgically addressing occlusal cant deviation with asymmetrical impactions or down-grafting of maxilla, an asymmetrical rotation of mandible using either bilateral sagittal split or other ramus osteotomies and correction of residual chin deformity with a genioplasty. This may be accomplished within a single stage or stacked in a multi-staged plan. This is done in conjunction with orthodontics. Presented here is a case report of a post-pubertal young male patient with a skeletal class III profile, lower third facial asymmetry, occlusal canting and chin deviation

Accuracy of linear cephalometric measurements with scanned lateral cephalograms

Digital Cephalometry needs to be as accurate as conventional cephalometry in order to be taken as a standard of care in contemporary orthodontics. Objective of this study was to compare the accuracy of linear cephalometric measurements on scanned cephalograms with manual tracing as the gold standard. Cephalometric analysis of specified linear measurements was performed on cephalometric radiographs manually. Radiographs were subsequently scanned and the images were analyzed digitally with a computer software for the same measurements. Paired sample t tests were used for statistical significance [p<0.05]. Clinical significance was set as more than 2mm difference between the methods for any linear measurement. Cephalometric comparisons between original and digital images showed statistically significant differences for S-Go, N-Me and ANS-Me. None of the means of the difference between the two methods exceeded 2mm. Although some measurements showed statistically significant differences, the difference was regarded as clinically insignificant. Scanned cephalograms can be safely used for linear cephalometric analysis

Comparison of measurements from manual and photographed lateral cephalograms

To compare the accuracy of cephalometric measurements on photographed cephalograms with traditional manual tracing as the gold standard. Cephalometric analysis of specified measurements was performed on cephalometric radiographs manually. Radiographs were subsequently photographed with a digital camera and the images were analyzed digitally with computer software for the same measurements. Paired sample t tests were used for statistical significance [p<0.05]. Clinical significance was set as more than 2o difference between the methods forany angular measurement. Cephalometric comparisons between original and digital images showed statistically significant differences for eight measurements. None of the means of the difference between the angular measurements in the two methods exceeded 20. Photographed cephalograms are reasonably accurate but careful photography technique must beadopted

Accuracy of angular cephalometric measurements with scanned lateral cephalograms

Digital Cephalometry is fast becoming the standard of care in contemporary orthodontic diagnosis. Before it can completely take over the traditional methods, it must be demonstrated that it is as accurate as conventional cephalometric radiography. This study was done to compare the accuracy of angular cephalometric measurements on scanned cephalograms with manual tracing as the gold standard. Cephalometric analysis of specified angular measurements was performed on cephalometric radiographs manually. Radiographs were subsequently scanned and the images were analyzed digitally with a computer software for the same measurements. Paired sample t tests were used for statistical significance [p<0.05]. Clinical significance was set as more than 2° difference between the methods for any angular measurement. Cephalometric comparisons between original and digital images showed statistically significant differences for SNA, MMA, IMPA and Nasolabial angles. None of the means of the difference between the two methods exceeded 1°. Although some measurements showed statistically significant differences, the difference was regarded as clinically insignificant. Scanned cephalograms can be safely used for angular cephalometric analysis

Applicability of melgaco equations for predicting the size of unerupted mandibular canines and premolars in patients reporting to Islamic International Dental Hospital, Islamabad

The aim of this study was to examine the applicability of simple equations proposed by Melgaco to predict the mesiodistal widths of the unerupted mandibular permanent canines and premolars in patients visiting Islamic International Dental hospital, Islamabad. This study was conducted during 2007-2008 at orthodontic department of Islamic International Dental Hospital, Islamabad. The sample consisted of 200 dental casts [100 male 100 female], obtained from patients reporting at the department of orthodontic, Islamic International Dental Hospital Islamabad, with the age range between 13 to 21 years. Mesiodistal tooth widths were measured with a digital vernier caliper. Correlation and determination coefficients were found between Sum of mandibular Incisors and first Molars [SMI] and Sum of actual width of mandibular Canine and Premolars [SCPM] of mandibular arch. A paired Student t test was used to compare the predicted and actual sum of the mandibular permanent Canines and Premolars [SCPM] for both genders combined and separately. Correlation coefficient was 0.673 and determination coefficient was 0.452 between SMI and actual SCPM. Significant difference was found between predicted and actual values of SCPM for male [0009] and for both genders combined [0.000]. Female subjects showed no significant difference [0.010].Only the simple equation proposed for female subjects by Melgaco et al is applicable in our sample

In vitro comparison of shear bond strength of transbond XT and heliosit orthodontic as direct bracket bonding adhesives

Heliosit Orthodontic was developed to ease the bonding procedure of orthodontic attachments by eliminating the need for primer application both on the bracket base and the etched tooth surface. The aim of this study was to determine the shear bond strength of Heliosit Orthodontic and then compare it with the control group of Transbond XT. The study consisted of two groups A and B of 80 human premolar teeth each bonded with mesh based metal brackets. The bonding agent used in group A was Transbond XT and that of group B was Heliosit Orthodontic, Every effort was made to control the cofounding variables including light tip distance, force of application of bracket, storage of teeth before and after bonding and orientation of bracket in the acrylic block this was followed by debonding of the brackets by shearing in a universal testing machine. It was found that the mean shear bond strength of Transbond XT was 25.5 MPa and that of Heliosit orthodontic was 10.54 MPa. The t-test revealed that there was a significant difference between the shear bond strength of the two groups. In conclusion the bond strengths of both the composites tested were greater than the recommended values of Reynolds for the composites to be clinically useful. It is recommended that the bond strength and the viscosity of the Heliosit Orthodontic be increased for it to be clinically as efftctive as Transbond XT