Comparison of dental and alveolar arch widths in class I and class II division 1 malocclusion

The objective of this study was to compare transverse dimensions of the dental arches and alveolar arches in the canine, premolar and molar regions of Class I and Class II div 1 malocclusion groups. This cross sectional study was performed at Lahore medical and dental college, from January 2011 to November 2011, using measurements on dental casts of 30 Class I and Class II div 1 adult female subjects. Twelve dental and alveolar arch width measurements were recorded from dental casts using a dial caliper. Descriptive analysis and paired sample t- test were carried out for significance [P < 0.05]. Statistically significant differences were found in two of the twelve measurements. Mandibular canine alveolar width and mandibular premolar alveolar width in Class II div 1 group were significantly narrower than Class I group. Rest of the variables did not show any significant difference. The results of our study suggest that Mandibular intercanine and interpremolar alveolar width measurements were narrower in Class II subjects and there is a tendency towards lingual cross bites in that malocclusion group

Lip morphology: a factor leading to bimaxillary dentoalveolar protrusion

The objective of this study was to see the effect of lip morphology in the study sample presenting with bimaxillary dentoalveolar protrusion on normal skeletal pattern. This cross sectional study comprised 50 subjects having bimaxillary dentoalveolar protrusion on class I skeletal pattern. Age of the subjects ranged from 18-25 years. The sampling comprised random selection of the subjects. The method involved Cephalometric analysis of skeletal, dental and soft tissues made on lateral cephalograms taken in natural head position of the subjects. A total of twenty variables were used in this study, comprising six skeletal, three dental and eleven soft tissue variables. Data were analyzed using SPSS version 10.00. Descriptive analysis and Independent t-test were carried out for significance [P<0.05]. Variables of the skeletal analysis were found within norms, whereas dental variables showed an increased value of Upper Incisor to Sella-Nasion plane [UI-SN] 115.120 [SD 5.500], Incisor Mandibular Plane Angle [IMPA] 102.700 [SD 3.400] and consequent decrease in Frankfort Mandibular Incisor Angle [FMIA] 55.500 [SD 5.490]. Soft tissue analysis determined full profile with greater vermilion of upper and lower lips, deficient lip strain and decreased length of upper and lower lips. Among six variables of skeletal analysis four were found very highly significant, among three variables of dental analysis only one was analyzed as significant and among eleven variables of soft tissue analysis four were found as very highly significant. This study concluded that the yielding effect of lips, because of relaxed orbicularis oris muscle and greater lip vermilion is the contributing factor in bimaxillary protrusion

Soft tissue facial profile analysis in patients with class I and class II skeletal pattern visiting children's hospital, Lahore

The soft tissues covering the face play an important role in facial aesthetics, speech and function. Detailed soft tissue analysis is an important component of comprehensive diagnosis and treatment planning. A balance between the dental and the perioral muscles must be achieved to attain stability of the treatment outcome. The aim of the study was to compare soft tissue facial profile between skeletal class I and class II subjects and to find out difference in soft tissues adaptation on the basis of gender. Non probability sampling technique was used. Eighty patients were selected with age ranging 14 to 18 years. For each patient a lateral cephalogram was taken and cephalometric analysis was performed. The study showed that patients with class II skeletal pattern have more convex profile. Both upper and lower lips are more protrusive than the normal and lower lip length in males is slightly greater than the normal

seven year study [2000 - 07] of the cleft proportions at the cleft clinic of the children's hospital, Lahore

The study assessed proportions of clefts in patients visiting orthodontic unit of Children's Hospital Lahore from 24-01-2000 to 24-01-2007. This observational descriptive study included 313 subjects comprising 189 males and 124 females with the age range of day one to 13 years. The method used for this study was Kernahan's modified double 'Y' with numeric coding. A total of 30 combinations were used to describe all types of clefts. The data was analyzed using SPSS 12. An increased proportion of the male patients [189] was examined compared to 124 females. The most common finding was complete bilateral cleft affecting 126 cases [40.3%]. The second common type was complete unilateral cleft seen in 95 patients [30.4%]. The clefts involving the left side were more common and were identified in 54 patients [17.3%]. The 3[rd] largest type was cleft involving median soft palate. An unusual finding of this study was complete unilateral and partial clefts of the opposite side found in 21 infants [6.7%]. The most common finding was complete bilateral cleft of the lip and palate. An unusual type of cleft was identified with Kernahan's double 'Y'

Molar distalization with modified palatal distalizer

The aim of the study was to introduce a modified palatal molar distalizer and evaluate its dental effects. 20 Adolescent and post adolescent patients [6 boys, 14 girls] with crowded upper arch and class II canine relationship were included in this study. The skeletal pattern of these patients was class I, II or bimaxillary hypoplasia. This study analyzed the maxillary first molar distalization with intervention device-The Modified Palatal Distalizer, its effects on the anchor teeth as well as on the maxillary second molars. The appliance was composed of four premolar bands, two first molar bands, wider Nance and 15mm Ni-Ti coil springs [0.012x0.032] applied on the palatal surface delivering 240gms of force. The period of appliance wear was 7.7months. Maxillary first molars were distalized bodily with minimal anchorage loss [11.1%] compared to 88.9% molar distal movement. An average of 5.39mm bodily distalization of the maxillary first molars was attained. The distal movement of maxillary second molars was recorded 4.35mm. Numerical data was statistically analyzed using paired t-test [SPSS version 12]. The modified palatal distalizer is an effective and reliable device producing bodily molar distalization, besides being cost effective

Linear photogrammetric analysis of the adult soft tissue facial profile

The objective of this study was to assess the soft tissue profiles and determine gender dimorphism in the young adult population of Pakistani origin, working in the Children Hospital in different capacities. This cross sectional descriptive study included 32 subjects including 16 males and 16 females. Age of these subjects ranged from 18-25 years. The sampling comprised random selection of the subjects. The method involved photogrammetric analysis with linear horizontal and vertical measurements made on standard photographic records taken in natural head position. Photocopies of the photographs with clearly identified landmarks were used for measurements. A total of21 variables were used in the study comprising 11 horizontal and 10 vertical linear measurements. Amongst horizontal linear measurements, gender dimorphism was seen in seven out of eleven variables. Out of the ten vertical variables only two variables showed sexual dimorphism. Facial depth, nasal depth, labial and chin areas showed sexual dimorphism in most of horizontal measurements. However length of the mid face, nose, upper and lower lips as well as height of the chin and nasal tip were found greater in females, reflecting vertical growth tendency

Proportions of oral clefts in patients visiting the cleft center of Children's Hospital and Institute of Child Health Lahore: a Five year study [2000 - 2005]

The objective of the study was to identify proportions of oral clefts in patients visiting Children's Hospital Institute of Child Health, Lahore during five year period from 24-01-2000 to 24-01-2005. This observational descriptive study included 128 subjects comprising 72 males and 56 females. Age of these patients ranged from one day old to 13 years. The method used for this study was Kernahan modified double [Y] with numeric coding system. A Total of 24 combinations were used to describe all types of clefts. The data was analyzed in SPSS 10 statistical package. Out of the whole sample size an increased number of male subjects [72] were examined as compared to female subjects [56]. The most common finding of this study was complete bilateral clefts affecting 54 patients [42.2%]. The next common type was complete unilateral cleft of the lip and palate, occurring in 27patients [21%]. Among these, clefts involving left side were more common and were seen in 19 patients [14.8%]. An unusual finding of this study was complete unilateral and partial clefts of the opposite side. Increased number of complete bilateral cleft of the lip and palate was because of referrals to the CH and ICH from various surrounding and remote localities for the tertiary level treatment of this particular deformity. The unusual type of the cleft was identified with Kernahan's modified double stem of the symbolic [Y]

Management of the cleft deformities at the cleft center of Children's Hospital Lahore during 5 years [2000-2005]

To describe management of cleft children during five year period from 24-1-2000 to 24-1-2005 at Orthodontic department of the Dental section CH and ICH Lahore, a tertiary level hospital. This quasi experimental study was conducted on 128 subjects comprising of 72 males and 56 females. Age of these subjects ranged from one day to thirteen years. These patients were classified with Kernahan's modified double Y system. Thirty six patients out of 54 [42.2% with complete bilateral cleft lip and palate] were treated with custom made orthopedic plate having anteriorly extending acrylic ring. The next common type of cleft seen was complete unilateral cleft lip and palate affecting 27 patients [21%]. An unusual finding was complete unilateral cleft lip and palate and partial opposite side cleft. Treatment given to unilateral cleft was pre-surgical infant orthopedic plate given in 30 patients. Supportive instructions were provided to 21 infants that included 10 neonates with Pierre Robin's sequence. 19 subjects out of the whole sample were given post surgical Obturators for the treatment of residual fistula or cleft following palatal closure. Ten patients were instructed on oral hygiene measures. Four patients were referred for surgical procedures. Three patients in early mixed dentition were provided custom made modified expansion device. One patient in mixed dentition was given Petit headgear after expanding maxilla with splinted hyrax while another one was given holding arch. Three patients, two in mixed dentition and one in permanent dentition were treated with comprehensive fixed mechanics followed by bone graft. In bilateral deformities PSIOP with anterior ring produced significant retraction of pre maxilla which made initial lip repair easy. In unilateral cases PROP served the purpose of obturator and improved the function while MED provided an effective substitute to splinted expanders