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

Effect of diabetes mellitus on orthodontic tooth movement in a rat model

The objective of this study was to observe bone response in terms ofosteoclast count and orthodontic tooth movement under optimal orthodontic force in diabetic and normoglycemic rat model. This experimental study was conducted at Animal House and Histopathology Department, Post Graduate Medical Institute, Lahore. Duration of study was June 2013 December 2013. 44 male wistar rats were included in the study and equally divided into two groups; group 1 [Normoglcemic or NG group] and Group 2 [Experimental Diabetic or EDB group]. Type-1 diabetes mellitus was induced by injecting streptozotocin [STZ] in EDB group. Citrate buffer solution was injected in NG group. Maxillary right first molar was moved mesially by applying 10 cN force using closed coil spring. All rats were euthanized on the 21st day after placement of the appliance. The orthodontic tooth movement was recorded by digital vernier caliper. Maxillae of the rats were dissected along with the molar teeth. Serial transverse sections of each maxilla in the interradicular bone at furcation area of first molar distobuccal root of control and appliance side were obtained for quantification of osteoclasts by histomorphometric study. Results showed that mean osteoclast count was significantly more in EDB group as compared to NG group, while no osteoclast was found on the non-appliance control side of both groups. Mean orthodontic tooth movement of rats in EDB group was significantly higher than NG group. It was concluded that Type-1 Diabetes Mellitus result in greater orthodontic tooth movement and increased osteoclasts as compared to normal subjects

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

To determine mean distortion score of mri at nine different sections of head and neck with dantauram metallic orthodontic brackets on the teeth

Magnetic Resonance Imaging [MRI] is a medical imaging technique used in radiology to visualize detailed internal structure. The presence of metallic sources, such as dental implants, orthodontic braces and metallic dental crowns may reduce the image quality of MRI in the maxillofacial region causing large magnetic field distortion and signal loss. Study was designed to evaluate the effects ofDantauram metallic orthodontic brackets on diagnostic quality of MRI image at nine craniofacial regions. A Cross sectional study was carried out on 30 patients visiting Department of Orthodontics, de' Montmorency College of Dentistry / Punjab Dental Hospital Lahore [tertiary health care center]. Patients with 18 years or above, of either sex and recently bonded with Dantauram metallic orthodontic brackets were included in the study. Duration of study was six months. Dantauram metallic brackets were bonded to all incisors, canine and premolars except molars. The mean distortion score of MRI at nine different sections of head and neck including tongue, body of mandible, hard palate, orbits /globes, nasopharynx, pituitary gland, frontal lobe, temporal lobe and brain stem with Dantauram metallic orthodontic brackets on the teeth was noted. The neu-roradiologist was requested to rank the images according to the distortion of these regions using a modified receiver operating characteristic method of distortion classification. The results of the current study revealed that 53.33% patients were between 18-30 years, 36.67% 31-40 years, and 10% patients with > 40 years age. Among these patients 76.67% were females and 23.33% males. The mean distortion score of MRI at nine different sections of head and neck with Dantauram metallic orthodontic brackets on the teeth of these patients was noted. It was observed that mean distortion score was 2.15 +/- 0.93 for tongue, body of mandible 2.79 +/- 0.88, hard plate 2.02 +/- 0.12, orbits/globes 2.32 +/- 0.38, nasopharynx 2.11 +/- 0.43, pituitary gland 1.96 +/- 0.23, frontal lobe 1.15 +/- 0.21, temporal lobe 1.75 +/- 0.76 and for brain stem was 0.78 +/- 0.53. It was concluded that mean distortion score of MRI at nine different sections of head and neck with Dantauram metallic orthodontic brackets on the teeth is <3 in all sections. This means that there is insignificant distortion of MRI at different craniofacial regions with Dantauram metallic orthodontic brackets on the teeth. However, more trials are required to confirm the findings and recommending for non-removal of brackets before MRI

Comparative study for evaluating the shear bond strength of metal reinforced ceramic and conventional ceramic bracket

Ceramic brackets were brought into orthodontics in an attempt to meet the rising requirement for added esthetic appliances. The objectives of this study were to assess and compare the shear bond strength and bond failure location of presently available clarity ceramic and Transcend brackets. This comparative study was conducted at Department of Orthodontics, de'Montmorency College of Dentistry Lahore and PCSIR, Lahore for one year from 10[th] June 2003 to 9[th] June 2004. Sixty brackets of each type were bonded to 120 extracted human 1[st] premolar teeth with the similar bonding system. Each bracket type was tested on a Schimadzu testing machine to find out the shear force levels necessary to debond these brackets. All the teeth were examined under an optical and stereo microscope to evaluate the Adhesive Remnant Index [ARI] at bond failure inter phase. The independent t-test performed for comparing the clarity and transcend 6000 ceramic brackets, indicated that there were no statistically significant difference between two brackets tested [P=0.256]. The Result of ARI scores indicated that there were no significant differences between the two brackets. [P=0.312]. Shear bond strength and ARI scores between the Clarity and Transcend 6000 ceramic brackets are insignificant

Posteroanterior cephalometric norms in Pakistani adults

Posteroanterior cephalometric [PAC] projections and relevant analyses constitute an important adjunct for qualitative and quantitative evaluation of the dentofacial region. PA cephalometric films can be used to evaluate vertical, transverse and sagittal dimensions. More over dentoalveolar/ facial asymmetries, dental / skeletal cross bites and functional mandibular displacement can also be assessed. PAC norms for different ethnic and racial groups have been established in many studies. The objective of present study was to determine the norms of postero-anterior cephalometric measurements in Pakistani adult population. 100 subjects including 47 males and 53 females [18-35 years] with skeletal class I were included in the study. PAC was taken in standardized conditions. 13 linear transverse skeletal and dental measurements were done for each radiograph. The data was processed using SPSS. For each variable mean and standard deviations were calculated by applying descriptive analysis. PA cephalometric norms for Pakistani adults are close to Rickett's Posteroanterior cephalometric norms. Clinically this will help orthodontists and maxillofacial surgeons to get more definite and predicted results in their treatment domains

Comparison of Jones JIG and distal jet molar distalizing appliances

The purpose of the present study was to evaluate and compare the effects of Jones jig and distal jet appliance during class-II molar correction with maxillary first molar distalization, its tipping, extrusion, rotation as well as anchorage loss at premolar-incisor unit. Sixty patients were selected from Orthodontics department de,Montmorency College of Dentistry, Lahore, Pakistan and pre and post distalization lateral cephalograms and study casts were used as evaluation tools. Distal jet group showed 3.88 mm space creation during 7.11 months, out of which 2.93 mm [75.52%] was molar distalization while 0.93 mm [24.48%] was premolar mesialization as anchorage loss. There was 3.41§ molar tipping with 0.20 mm extrusion and 7.33 § distal tipping with 0.90 mm second cuspid extrusion whereas incisors had 1.65 § labial tipping. Right and left upper molars showed 1.30° and 1.18° rotation respectively. In the Jones jig group, the maxillary first molars were distalized to 3.30 mm on each side and tipped 6.70° distally. The maxillary second premolars moved mesially 2.00 mm with tipping of 7.48°.Therefore a total space created between first molar and second premolar was 5.30 mm i.e. 62.26% from first molar distalization while 37.74% from second premolar mesialization. In addition maxillary first molar extruded 0.70 mm and second bicuspid extruded 1.58 mm. Both right and left first molars were also disto-palatally rotated by 2.00° and 2.55° respectively though upper incisors showed 2.25° proclination during distalization. Distal jet appliance was found to be a more effective and predictable method for themaxillary first molar distalization through bodily translation with minimum tipping, extrusion, and rotation as well as anchorage loss

Effects of distal jet appliance in class-II molar correction

This study was conducted on a sample of thirty patients selected from Orthodontics department de'Montmorency College of dentistry/ Punjab dental Hospital, Lahore. The purpose of study was to evaluate treatment effects of Distal Jet Appliance during Class-II molar correction with a focus on the magnitude of Maxillary first molar distalization, its tipping, extrusion, rotation as well as anchorage loss at premolar-incisor unit. Pre and post distalization lateral cephalogram and study cast were used as evaluation tools. Results showed that there was 3.88 mm space created during 7.11 months; out of which 2.93 mm [75.52%] showed molar distalization while 0.93 mm [24.48%] premolar mesialization as anchorage loss. There was 3.41% molar tipping with 0.20 mm extrusion and second premolar showed 7.33% distal tipping, 0.90 mm extrusion whereas Incisors showed 1.65% labial tipping

Prevalence of crossbite in orthodontic patients

The objective of the present study was to evaluate the prevalence of cross bite in patients reporting for orthodontic treatment. Pretreatment study casts of 100 patients were selected from the model store of the Orthodontics Department .Faculty of Dentistry, The University of Lahore. SPSS [10.0] was used to analyze the data. 24% of the patients had cross bite. Of these 25% were male patients while 75% were female patients

Co-relation between ANB angle, Wits value and SNP plane angle

ANB angle and Wits value are used to asses the Sagital pattern of the patient cephalometrically. The two variables are dependent on change in theAntero-posterior and vertical position of Point A. SNP plane angle determines the rotation change in position of Palatal plane with reference to SN plane. This rotational change might have an impact on the position of point A and thus the ANB angle and Wits value. Aim of the study was to establish correlation between ANB, Wits Value and SNP plane angle. Study was conducted on 60 subjects and following conclusions were drawn. 1. Statistically significant correlations was found between ANB angle and Wits Value 2. Statistically insignificant correlation was found between SNP plane angle and ANB and Wits Value suggesting that rotational change in this Palate with reference to SN plane has no impact on the sagital assessment parameters 3. Statistically significant correlations was found between

Orthodontic treatment need at de, Montmorency college of dentistry Lahore, using the aesthetic component of IOTN index

Although work has been done in Pakistan to determine the orthodontic treatment need of patients, but till now no study had been done to evaluate the orthodontic treatment need on aesthetic basis. Aesthetic Component [AC] of Index of Orthodontic Treatment Need [IOTN] was used on a sample of 100 pretreatment study casts of the patients at de'Montmorency College of Dentistry, Lahore Pakistan, to evaluate the aesthetic need for orthodontic treatment. The data was statistically analyzed by SPSS [8.0]. Overall it was found that 41% of the cases needed definite orthodontic treatment. 37% of female patients and 52% of male patients needed definite orthodontic treatment. 41% of the patients were classified as being in need of moderate orthodontic treatment, with 18% having no orthodontic treatment need. Aesthetic Component grade 8 was shown by 26% of cases. Results of the study showed a high number of patients in need of the orthodontic treatment

Bolton analysis for different sagital problem and its corelation with dental parameters

The clinician should be familiar with discrepancies in tooth size at the initial diagnosis and treatment planning stages if excellence in orthodontic finishing is to be achieved. Bolton's method of diagnosing tooth size discrepancies by analyzing the mesiodistal tooth size ratio between the maxillary and mandibular teeth has been widely used in scientific studies since its publication. Aim of my study was to calculate Bolton Ratio and Anterior Bolton Ratio [1][,][2] for Different Skeletal Malocclusions i.e. Skeletal Class I, II and III. The study was also aimed at establishing correlation between Bolton's anterior and overall ratios and dental parameters i.e. upper and lower incisor inclinations and Arch length Discrepancy. The study was conducted on 60 subjects with mean age 18.43+4.21. Study models and lateral Cephalogram were taken for each subject. Patients were categorized in to Skeletal Class I,II and III. Bolton Analyses, Anterior Bolton Analyses, Arch length discrepancy for maxilla and mandible, UI-SN and IMPA were calculated and analyzed using SPSS version 13.It was concluded from the results that 1.Bolton Ratio though slightly different but was statistically insignificantly different in Skeletal Class I, II and II patients 2. Anterior Bolton Ratio though slightly different but was statistically insignificantly different in Skeletal Class I, II and II patients 3. Incidence of Anterior Bolton Ratio was more in Skeletal Class III cases than in Skeletal Class I and II 4. Statistically significant correlations between Arch length Discrepancy in Maxilla and intermaxillary tooth size discrepancies were determined. Therefore, an orthodontist should be aware of such discrepancies and their probable effects on occlusion and dental relations when solving the malocclusion jigsaw

Prevalence of deep bite in orthodontic patients

The aim of the present study was to evaluate the deep bite status of orthodontic patients. Sample consisted of 100 pre-treatment study casts of patients at the Orthodontics department de, Mantmorency College of Dentistry, Lahore. The data was statistically analyzed by SPSS [8.0]. Overall, it was found that 7% patients had open bite. 17% showed normal value of incisor over bite, while 76% patients showed varying values of deep bite. Out of these 76 patients [76%], 28% were male and 72% were female patients. As far as the distribution of these 76 patients in different categories of deep bite is concerned. Maximum number of patients; 92% of these were having mild to moderate degree of deep bite while only 8% showed full coverage of lower incisor crowns

Co-relation between Bolton ratio, anterior Bolton ratio and different vertical growth patterns

Bolton's method of diagnosing tooth size discrepancies has been widely used in scientific studies since its publication. Aim of this study was to calculate Bolton Ratio and Anterior Bolton Ratio[1, 2, 3] for patients with different Vertical Growth Patterns and establishing correlation between Bolton's anterior and overall ratios and vertical growth pattern assessment parameters. Study models and lateral Cephalogram were taken for 60 subjects selected on the basis of selection criteria and Bolton Ratio, Anterior Bolton Ratio, SNM, MMA, SNP, Y-axis, SOFA, Jaraback ratio and Facial Ratio were calculated and analyzed using SPSS version 10.Rresults concluded that 1. Bolton Ratio and Anterior Bolton Ratio though slightly different in Normal Angle, High Angle and Low Angle Cases but the difference was statistically insignificant and 2. Statistically insignificant correlation occurs between Bolton Ratio, Anterior Bolton Ratio and vertical growth pattern assessment parameters

Corelaton of corrected ANB angle with other sagital discrepancy indicators

Sagital skeletal discrepancy is being evaluated Cephalometrically by using various parameters; ANB angle and the Wit's value[1.2] being the most commonly used. ANB angle is affected by various environmental factors including SN-GoMe [vertical pattern of patient] and SNA angle [antero -posterior / vertical position of nasion and point A] and Wits value is dependent on the assessment and inclination of occlusal plane, thus are not considered reliable sagital discrepancy assessment indicator. Corrected ANB angle was calculated using the formula: ANB = Original ANB angle + 0.5 x [81.5° -SNA angle] + 0.25 x [32°- SN-GoMe angle] which is considered independent of the above mentioned variables. Aim of this study was to assess the reliability of Corrected ANB angle and establishment of its correlation with ANB angle and wits value. Study was conducted using lateral cephalograms of 100 subjects age ranged 18-30 yrs and it was concluded that 1. High correlations exist among the three parameters used to assess the sagital jaw discrepancy i.e. Corrected ANB angle, ANB angle and Wits Appraisal showing that these sagital parameters could be used interchangeably, 2. Coefficient of correlation [r] confirmed ANB angle dependence on SN-GoMe and SNA and wits unpredictability. 3. Coefficient of correlation [r] confirmed that corrected ANB angle is statistically insignificantly related to SN-GoMe and SNA angle, thus is a better assessor of sagital discrepancy assessment indicator

Effectiveness of an oral hygiene program for patients undergoing fixed orthodontic treatment

The aim of the present study was to assess the effectiveness of an oral hygiene program for patients undergoing fixed orthodontic treatment. Main sample consisted of one hundred patients with an age range of 12-25 years, having a full complement of permanent dentition, reporting to the orthodontic department of the de, Montmorency College of Dentistry, Lahore. Community Periodontal Index was used to assess the periodontal status of these patients. From these 100 patients, 20 patients having good oral hygiene and in need of fixed orthodontic treatment were divided into experimental and control groups, and their periodontal status was assessed before and during fixed orthodontic treatment. Modified Bass toothbrushing technique and the relation between the fixed orthodontic appliances, plaque accumulation and gingival inflammation were explained to the experimental group. Data was analyzed by using SPSS [Version 8.0] in personal computer. Results showed although no significant differences were noted in the periodontal status of experimental and control groups, but as a group, control group patients showed more statistically significant deterioration of periodontal health as compared to the experimental group

Class- III - malocclusion: a cephalometric study in a Pakistani population sample

This study was carried out to evaluate the Cephalometric characteristics of class-III malocclusion in a sample of Pakistani population with age range 18-25 years visiting Orthodontics department, de' Montmorency college of Dentistry / Punjab dental hospital, Lahore. Lateral Cephalometric radiographs, Orthopentomograms, Study casts, extra oral and intra oral photographs were taken for every patient. Results indicate that regarding the Cephalometric characteristics of Pakistani patients with class III malocclusion, the Maxilla showed retrognathism in relation to cranial base both for angular and linear parameters in antero-posterior relationship while the Mandible showed prognathism in relation to cranial base both for angular and linear parameters in antero-posterior relationship. However the Dento-alveolar measurements showed maxillary incisors proclination and mandibular incisors retroclination, suggestive of dental compensation to skeletal discrepancy. Males showed comparatively horizontal while females exhibited vertical growth tendency

Effects of jones jig appliance in maxillary first molar distalization

The purpose of this study was to evaluate treatment effects of Jones jig appliance during class-II molar correction with a focus on the magnitude of maxillary first molar distalization, its tipping, extrusion and rotation as well as anchorage loss at premolar- incisor unit. A complete set of pre and post distalization records including history, clinical examination, Lateral cephalometric radiograph, Orthopentomogram, study casts and photographs was taken for each patient. Pre and post distalization lateral cephalometric radiographs were traced for evaluation of molar, premolar and incisors movements while models were used to find out molars rotation. Results showed that there was 5.30 mm space created between molar and premolar during 5.65 months; out of which 3.30 mm [62.26%] showed molar distalization and 2.00mm [37.74%] anchorage loss. There was 6.70° molar tipping with 0.70 mm extrusion while second premolar showed 7.58° tipping and 1.58 mm extrusion. Incisors exhibited an insignificant labial tipping of 0.75°. Both right and left molars showed 2.00° and 2.55° highly significant disto palatal rotation

Dental crowding and its relationship to tooth size and arch dimensions

Tooth size arch length discrepancy [TSALD] is a well defined means of assessing dental crowding. In previous literature conflicting evidence exists regarding the part played by tooth size and arch dimension in causing dental crowding. The objective of present study were to; examine the relationship between tooth size and arch dimension in crowded and non crowded arches, and to find out the major contributing factor in dental crowding of each. Eighty patients, 20 males and 20 female in crowded and non crowded group comprising of 40 patients each, with an age range of 14-18 years, reporting to outdoor of orthodontic department, was selected. All subject met the following criteria; 1] No cast with missing or impacted teeth. 2] No history of previous orthodontic treatment, 3] No cast showing any dental anomalies. The study included on clinical examination, crowding was assessed clinically in crowded arches with gross mal-alignment of teeth and non crowded arches showing no or mild crowding. Arch dimensions was measured from left to right First permanent molar at the inter section point of lingual groove with gingival margin on the dental cast and tooth size measurement were taken from the anatomatical contact points with the help of Vernier caliper. Similarly inter premolar width was measured. Inter canine width was recorded from canine tips. Arch length was taken with the help of Brass wire directly from the dental cast following the curve of occlusion from mesial marginal ridge of first permanent molar. Data was analyzed by using SPSS [version 10] in personal computer. Paired and independent t-test was used to find out the group differences in crowded and non crowded arches. Results showed that overall no significant differences [p>0.05] were found in tooth size between the non crowded and crowded arches, regardless of whether the tooth size was compared individually or collectively. Statistically significant differences [p<0.05] were observed when arch dimension of crowded and non crowded groups were measured particularly lingual arch width at the inter molar and inter premolar area. No statistically differences were found between the males and females comparison except that female showed smaller values as compared to males in every aspect of measurement

Assessment and comparison of dimensions of sella turcica in skeletal class I and skeletal class II Cases

The aim of this study was to assess and compare the dimensions of Sella Turcica in 90 subjects grouped as Group A [Skeletal Class I:ANB0-4°, Wits value -1 to 0.5 mm][1.4] and Group B [Skeletal Class II:ANB>4°, Wits value >0.5 mm] aged 14-30 years each having 45 subjects. For Group A Width [W] of Sella Turcica[10] is found to be 15.33 mm + 2.77 S.D, Depth [D] 6.43 mm + 1.45 S.D, Area [A] 66.05 mm[2] + 9.2 S.D, Specific Dimension [SDim] 99.5 mm[2] + 27.7 S.D and Interclinoid Distance [I] as 5.55 +2.12 S.D while for Group B Width [W] of Sella Turcica is found to be 14.55 mm+2.16S.D, Depth [D] 6.45 mm+0.9 S.D, Area [A] 60.35 mm[2]+7.96 S.D, Specific Dimension [SDim] 94.4 mm[2]+21.56 S.D and Interclinoid Distance [I] as 4.85 mm+0.93 S.D. When two groups were compared for Sellar Dimensions, Width, Area and Interclinoid Distance showed statistically significant difference between the Skeletal Class II and Skeletal Class I subjects [P<0.05] while Vertical Depth and Specific Dimension showed statistically insignificant difference [P>0.05]. Moreover these findings appear to indicate the greater likelihood of Sella Turcica bridging in Skeletal Class II patients