Lingual frenulum and malocclusion: An overlooked tissue or a minor issue.

Context: Tongue-tie (more formally known as ankyloglossia) is a congenital anomaly characterized by an abnormally short lingual frenulum, which may restrict mobility of the tongue tip impairing its ability to fulfill its functions. The clinical significance of ankyloglossia is varied; rarely symptomatic to a host of problems including infant feeding difficulties, speech disorders, malocclusions, and others. Aims: The need of this study was to evaluate the occurrence and severity of tongue-tie and its association with the type of malocclusions in two populations and also to correlate the various malocclusion traits with the grades of tongue-tie. Subjects and Methods: A total of 700 school children in the age group of 9–17 years were examined for the presence of tongue-tie, 350 from regular schools and 350 from special schools. The presence was evaluated, measured, and graded into Grades I–V according to Kotlow’s method. The malocclusion was assessed according to Angle’s classification. Severity of crowding was assessed by Little’s irregularity index in each case. Various other malocclusion traits were visually assessed, in relation to the positions of the teeth. Statistical Analysis Used: Spearman’s rank correlation method was used to test the relationship between type of malocclusions, grades of tongue-tie and severity of crowding. Significance was considered at the (P < 0.05) level. Results: Statistically significant differences were seen between grades of tongue-tie and Angle’s types of malocclusion and Spearman’s correlation between them showed negative correlation. The Spearman’s correlation showed a negative correlation between tongue-tie grades and severity of crowding. Conclusions: As the grade of tongue-tie increased, its association with Classes I and II malocclusion decreased. The lower grades of tongue-tie are associated with increased lower incisor crowding. Shorter, tight frenulums are more associated with maxillary constriction, anterior open bite, and spacing of the lower anteriors.

“Comparative evaluation of surface modified elastomeric ligatures for microbial colonization”: An in vivo study.

Introduction: Elastomeric ligatures are observed to reduce chair side time; however, they are also seen to have greater bacterial adhesion. Polymeric coating utilizing the Metafasix Technology and the OrthoShield Technology have been introduced in the Super Slick™* and Safe‑T‑Ties™** by TP Orthodontics, Ortho Organizers, respectively, to reduce bacterial adhesion. While each of the elastomers has been individually evaluated, no study compares the two elastomers manufactured by differing technologies together; hence the need for this study was felt. This in vivo study compared the Super Slick and Safe‑T‑Ties with their unmodified counterparts for bacterial adhesion. Materials and Methods: Thirty patients undergoing orthodontic treatment, between 12 and 25 years age group were selected and the modified, and the unmodified elastomers were randomly placed quadrant wise, on all the premolar brackets. After a period of 4 weeks, the elastomeric rings were removed and transported for culture on Mitis–Salivarius, Rogosa SL agar for Streptococcus mutans and Lactobacilli, respectively. The colonies were digitally counted (HiMedia) after 48 h of incubation at 37°C. Results: There was a significant difference in the S. mutans and Lactobacilli counts in both surface modified and unmodified elastomeric modules (P < 0.01). Unmodified elastomeric modules Mini Stix™*, Hand‑EE‑Lasts™** was associated with higher mean values of colony‑forming units/millimeter than the surface modified Super Slick™* and Safe‑T‑Ties™** ligatures. When compared pair‑wise, the surface modified elastomers showed less bacterial accumulations than the unmodified counterparts for both S. mutans and Lactobacillus, and the differences were statistically significant. Conclusion: Technological modifications of the elastomers using the Metafasix or OrthoShield Technology, is a definite improvement over the regular elastomers with regard to adhesion of S. mutans and Lactobacilli.

Frictional characteristics of the newer orthodontic elastomeric ligatures.

Introduction: Elastomeric ligatures reduce chairside time but increase friction. Polymeric coatings and 45° angulations have been introduced to the ligature modules to combat its disadvantages and reduce friction. This in vitro study compared the frictional characteristics of six different types of the most commonly used elastomeric modules. Materials and Methods: Thecoefficient of friction for six ligation methods: the non-coated Mini Stix† and coated Super Slick Mini Stix™ (TP Orthodontics), 45° angulated but non-coated Alastik Easy-To-Tie™ (3M Unitek) elastomerics and non-angulated non-coated Alastik QuiK-StiK * , 0.110'- and 0.120'-diameter elastomerics™ (Reliance Orthodontics) were measured in dry conditions utilizing a jig according to the protocol of Tidy. Results: A significant difference was observed between the various types of elastomeric ligatures (P<.01). Among the six types of elastomeric ligatures, the 45° angulated elastomeric ligatures produced the least friction, followed by the coated Super Slick† elastomers. No difference in the friction was noted when the diameter of the elastomeric ligatures was varied. Conclusions: Polymeric surface coatings and introduction of angulations into elastomeric ligatures reduce the friction during sliding; however, the diameter of the ligature made no difference to sliding friction.