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.

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.

Endovascular Balloon Occlusion Of The Aorta For Placenta Percreta During Cesarean Hysterectomy

The potential massive hemorrhage from placenta percreta requires large volumes of blood products to be transfused which are often not readily available for resuscitation and surgery, especially at rural centers. Multiple foreign case studies report the successful use of endovascular balloon occlusion of the aorta (EBOA) for the management of maternal hemorrhage. We present the first case of placenta percreta in India which was managed successfully by pre-operative placement of a balloon-tipped catheter in the aorta. Her hemodynamic status was well-controlled intraoperatively, and there were no post-operative complications. The surgical field was bloodless on balloon inflation allowing for surgical dissection and hemostasis; occult bleeders could be visualized and ligated by transiently deflating the balloon. Importantly, the transfusion requirements of this patient were drastically reduced. The authors propose that EBOA can be a staple modality in the pre-operative management of placenta percreta, especially in rural areas.