White spot lesions in orthodontic patients part I: frequency and pattern of distribution

To determine the frequency and pattern of white spot lesions developed during orthodontic therapy in a sample of orthodontic patients. This cross-sectional study was designed to compare pre-treatment and post-treatment digital photographs of patients having undergone orthodontic therapy to determine the presence or absence of enamel decalcification in the form of white spot lesions. The distribution of the white spot lesions was also recorded with reference to the tooth type, as well as its location on a particular tooth. Data were analysed using SPSS [version 11.5] where the means and frequencies were computed. The study sample consisted of 60 orthodontic patients. Out of these, 14 [23.3%] were males and 46 [76.7%] were females with male to female ratio of 1:3.3. The mean age was 14 years and 5 months and the mean fixed appliance treatment duration was 2years and 9 months. The frequency of White Spot Sessions according to the total number of patients affected was 75%, whereas according to the number of total teeth affected was 19%. The upper lateral incisors were the most commonly affected teeth [78.3%], followed by the lower 1st permanent molars [55%], the upper central incisors [43%] and upper canines [40%]. According to the type, the chalky-white White Spot Lessions were more common [76.2%] as compared to the brown lesions and cavitations. According to the site, the upper anterior teeth showed a more central occurrence as compared to the upper posterior and lower teeth, which were mostly affected in the gingival third of the crown. Out of 60 patients, 75% were affected by White Spot Sessions while the overall number of teeth affected was 19%. The most commonly affected teeth were upper lateral incisors [78.3%] while chalky white type White Spot Lessions were more common [76.2%]. Middle third of the crown of upper anterior teeth was the most commonly affected site

Soft tissue profile response in extraction versus non-extraction orthodontic treatment

To compare changes occurring in the soft tissue profile with orthodontic treatment in extraction versus nonextraction cases, and to determine the hard and soft tissue parameters that show significant correlations to understand the factors influencing the response to tooth movement. Quasi-experimental. Dental Section, The Aga Khan University Hospital, Karachi, from 2005 to 2008. Pre-and post-treatment lateral cephalographs of 34 subjects were assessed. For half of the patients [n=17], treatment included the extraction of 4 premolars, whereas the other half were treated by the non-extraction approach. Incisal and soft tissue effects of treatment were analyzed and compared between both groups using the independent sample t-test to assess the degree of change with orthodontic treatment. Pearson's correlation test was used to determine correlation. The extraction group finished with a statistically significant reduction in upper and lower lip procumbency [p=0.004 and 0.021], while the non-extraction group finished with a slight increase in lower lip procumbency [p=0.009] due to significant increase in IMPA [p=0.046]. Although the premolar extraction group showed greater soft tissue changes with treatment, post-treatment comparisons showed that both groups finished within the same soft tissue parameters. Pearson's correlation revealed statistically significant correlations between the upper and lower lips and upper and lower incisors [p<0.01]. The effects of the two types of orthodontic treatment on the facial soft tissues were very similar, indicating that treatment, involving the extraction of premolars, does not have a detrimental effect on facial aesthetics provided the decision to extract is on sound basis and the mechanics are controlled

Assessment of psychosocial impact of dental aesthetics

To assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' [PIDAQ] and self-rated Aesthetic Component [AC] of the Index of Orthodontic Treatment Need [IOTN]. Cross-sectional study. Dental Section, the Aga Khan University Hospital, Karachi, from August to September 2006. Adults with no prior orthodontic treatment were asked to complete a modified version of the 'Psychosocial Impact of Dental Aesthetics Questionnaire' [PIDAQ]. A total of four variables including 'Dental Self-confidence', 'Social impact', 'Psychological impact' and 'Perceived orthodontic treatment need' were assessed by a series of statements, whereas dental aesthetics were assessed by the respondents using the IOTN Aesthetic Component [self-rated IOTN-AC]. Kruskal-Walli's test was applied to determine significance. The respondents were 120 adults [70 females and 50 males; mean age 25.8 years], all four of the above mentioned variables measuring psychosocial impact showed positive and significant correlations with the perceived severity of malocclusion as depicted by the Aesthetic Component [AC] of Index of Orthodontic Treatment Need [IOTN], with p-value of less than 0.01 for all variables. The results indicate the strong psychosocial impact of altered dental aesthetics on the emotional state of an individual. The association between self-rated IOTN-AC grading with psychosocial well-being stands established, indicating that the perceived aesthetics of malocclusion may be as significant a factor in determining treatment need as the degree of malocclusion