Perception of Laypersons to Appearance of Orthodontic Appliances their Acceptance and Value for Money: A Questionnaire Study

Introduction: Orthodontic market has experienced remarkableevolution in the development and creation of orthodonticappliances that are designed to appeal the patients. With theadvent of newer technology like invention of CAD-CAMthe brackets travelled its life from a bulky metal appliance,to aesthetic brackets (ceramics and plastic brackets), lingualbracket systems and finally bracket-less approach (Invisalignand Clear Path). This, although enhanced the aesthetic aspect,but lost its dexterity to the common man due the increasingtreatment cost (Value). Study aimed at evaluation of Perceptionof Laypersons to Appearance of Orthodontic Appliances, theirAcceptance and value for money.Material and methods: A sample of 200 laypersons wereselected by simple random sampling. A questionnaire wasframed for evaluation of attractiveness, acceptability andvalue of orthodontic appliances as grouped from group 1 togroup 6 and distributed amongst laypersons. The statisticalanalysis was done using the Statistical Package for the SocialScience (SPSS version 22, Armonk, NY: IBM Corp) andDescriptive statistics were performed.Result: The attractiveness and acceptability of appliances goin favour of ceramic brackets with aesthetic arch wire andaesthetic ligature ties.Conclusion: But the practical acceptability of appliancesbased on three parameters conclusively favour ceramicbrackets with standard arch wire and metal ligature ties whichfulfils both the aesthetics and cost effectiveness.

Assessment and Comparison of the Head Posture and Craniofacial Growth in Vertical Dimension- A Cephalometric Study.

The aim of the present study was to examine as to whether any association can be found between the head posture and the craniofacial growth in the vertical direction.METHODSThe sample comprised of 150 subjects in the age group of 18 - 25 years and were further divided into three groups. These groups were classified into hypodivergent, normodivergent, and hyperdivergent according to the sella-nasion (SN) mandibular plane angle. The head posture was measured by calculating craniocervical and cervicohorizontal postural variables, recorded from the lateral cephalograms taken with the subjects standing with the head in the natural head position.RESULTSA clear pattern of association was found between the head posture and the vertical growth pattern. An extended head posture was seen in hyperdivergent group and flexion of the head was seen in hypodivergent group when compared to normodivergent cases (P<0.05, P<0.01). The findings were in agreement with the soft tissue stretching hypothesis according to which stronger forces are exerted on the facial skeleton whenever there is an increase in the tension in the soft tissue layer. When these forces are active for a long time during growth, they might restrict the growth of the maxilla and the mandible in forward direction and redirect it in a more caudal direction. Such a mechanism could explain the association between the extension of the head and the development of facial skeleton and in particular, the mandible.CONCLUSIONSThe cervical vertebral column area should be evaluated in routine cephalometric analysis and any deviation in the cervical column morphology and head posture should be registered. These registrations may prove useful when considering the diagnosis and evaluating the etiology, especially in patients with severe skeletal malocclusion and obstructive sleep apnea.

Evaluation of relationship between nutritional status and oral health related quality of life in complete denture wearers

The prevalence of malnutrition increases with old age, especially in developing countries like India, and it is the most common cause of morbidity and mortality, because of many factors out of which dentate status is one. Aim and Objective: The aim of this study is to evaluate and determine the effect of nutritional status and dietary intake on the oral health-related quality of life (OHRQOL) of elderly edentulous complete denture-wearing patients and to know whether elderly complete denture wearers have a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counseling during prosthodontic rehabilitation of elderly edentulous patients. Materials and Methods: A cross-sectional study was conducted among 200 elderly denture-wearing patients above 60 years of age from Nagpur, Maharashtra. Mini-Nutritional Assessment (MNA) questionnaire was used to assess nutritional status, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire was used to determine the OHRQOL of these patients. Descriptive statistics were used to analyze data using SPSS version 21 (SPSS Inc., Chicago, IL, USA). Results: Among the assessed participants, nearly 95% of them had total scores of GOHAI between 12 and 57 which require “needed dental care.” As per MNA, 10.5% had adequate nutrition, 70% were at risk of malnutrition, and remaining 19.5% of participants were malnourished. There was a significant correlation between GOHAI and MNA scores. Conclusion: Low nutritional status was associated with the poor OHRQOL among the elderly. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL. The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly. Dietary analysis and counseling should be strictly incorporated into geriatric treatment planning during prosthetic rehabilitation.

Effect of orthodontic pain on quality of life of patients undergoing orthodontic treatment

Introduction: Pain is an important aspect of oral health-related quality of life (OHRQOL). Understanding how patients' pain experiences during their treatment affect their quality of life (QOL) is important and the absence of pain/discomfort is important for achieving a high QOL. Aim and Objective: The objective of this study was to assess the relationship between pain and OHRQOL among patients wearing fixed orthodontic appliances and to evaluate whether patient motivation and counseling had an effect on the pain and discomfort. Materials and Methods: The McGill-Short-Form with visual analog scale and present pain intensity and Oral Health Impact Profile-14 indices were used to determine the intensity and severity of pain and to evaluate the QOL of 200 adolescents undergoing fixed orthodontic treatment during different phases of treatment. Results: There was a significant correlation found between pain and the QOL of patients undergoing orthodontic treatment. Overall score of OHRQOL increased significantly (mean 43.5 ± 10.9) in the initial phase of treatment where the incidence of severe to moderate pain was reported in 80% patients. Ninety-five percent patients felt pain or discomfort. After 1 day of appliance placement, more than 85% of patients experienced severe to mild pain whereas 9% of patients suffered very severe pain. Pain reduced over a week, and at the end of a month, 10.5% patients had moderate pain whereas majority, i.e., 58% of patients complained of only mild pain (P < 0.05). Conclusion: Pain is important sequelae of orthodontic treatment and has a significant effect on the QOL of orthodontic patients, especially during the initial phases of treatment. Patient motivation and counseling by the orthodontist have a profounding effect in reducing the pain and discomfort, improving the QOL, and an overall improvement in the patient compliance affecting the successful outcome of the treatment.

A comparative evaluation of the shear bond strength of five different orthodontic bonding agents polymerized using halogen and light-emitting diode curing lights: An in vitro investigation.

Purpose: With the introduction of photosensitive (light-activated) restorative materials in orthodontics, various methods have been suggested to enhance the polymerization of the materials used, including use of more powerful light curing devices. Bond strength is an important property and determines the amount of force delivered and the treatment duration. Many light-cured bonding materials have become popular but it is the need of the hour to determine the bonding agent that is the most efficient and has the desired bond strength. Aim: To evaluate and compare the shear bond strengths of five different orthodontic light cure bonding materials cured with traditional halogen light and low-intensity light-emitting diode (LED) light curing unit. Materials and Methods: 100 human maxillary premolar teeth, extracted for orthodontic purpose, were used to prepare the samples. 100 maxillary stainless steel bicuspid brackets of 0.018 slot of Roth prescription, manufactured by D-tech Company, were bonded to the prepared tooth surfaces of the mounted samples using five different orthodontic bracket bonding light-cured materials, namely, Enlight, Fuji Ortho LC (resin-modified glass ionomer cement), Orthobond LC, Relybond, and Transbond XT. The bond strength was tested on an Instron Universal testing machine (model no. 5582). Results: In Group 1 (halogen group), Enlight showed the highest shear bond strength (16.4 MPa) and Fuji Ortho LC showed the least bond strength (6.59 MPa) (P value 0.000). In Group 2 (LED group), Transbond showed the highest mean shear bond strength (14.6 MPa) and Orthobond LC showed the least mean shear bond strength (6.27 MPa) (P value 0.000). There was no statistically significant difference in the shear bond strength values of all samples cured using either halogen (mean 11.49 MPa) or LED (mean 11.20 MPa), as the P value was 0.713. Conclusion: Polymerization with both halogen and LED resulted in shear bond strength values which were above the clinically acceptable range given by Reynolds. The LED light curing units produced comparable shear bond strength to that of halogen curing units.

Influence of the processing technique on the flexural fatigue strength of denture base resins: An in vitro investigation.

Background : Though acrylic resins possess many desirable properties, denture fracture due to flexural fatigue or impact failure is a common problem. One major factor influencing the flexural fatigue strength of denture base resins is the processing technique used. Aim: To measure the flexural fatigue strength of denture base resins polymerized using short and long curing cycles using water bath, pressure cooker, and microwave polymerization techniques. Materials and Methods: Flexural fatigue strength of 60 samples (n=10) were measured using a cyclic 3-point loading method on a dynamic universal testing machine. Data were analyzed using a Student 't' test. Results : Comparative evaluation using Student's 't' test of mean flexural fatigue strength of samples processed by water bath processing (660.6) and the microwave technique (893.6) showed statistically significant (P <0.01) result with microwave processing being higher. Comparison of water bath (660.6) and pressure cooker (740.6) processing and microwave (893.6) and pressure cooker (740.6) processing using Student's 't' test was not statistically significant (P >0.05). In the intra-group analysis, it was found that there was statistically significant difference in samples processed using the short and long curing cycle, the latter being better in all groups, P-values being <0.05, <0.001, and <0.001 for water bath, microwave, and pressure cooker polymerization techniques, respectively. Conclusion : The polymerization procedure plays an important role in influencing the flexural fatigue strength of denture base resins, and the microwave long curing processing technique produced denture bases with highest flexural fatigue strength.