Early class III occlusal tendency in children and its selective management.

Class III malocclusion may develop in children as a result of an inherent growth abnormality, i.e., true class III malocclusion, or as a result of premature occlusal contacts causing forward functional shift of the mandible, which is known as pseudo class III malocclusion. These cases, if not treated at the initial stage of development, interfere with normal growth of the skeletal bases and may result in severe facial deformities. The treatment should be carried out as early as possible with the aim of permitting normal growth. This paper deals with the selection of an appropriate treatment approach from the various current options available for early intervention in children developing class III occlusal tendencies; the different clinical features are depicted in the three case reports.

Distribution of malocclusion types among thumb suckers seeking orthodontic treatment.

The present study was conducted to evaluate the influence of thumb sucking and its duration on the type of malocclusion. A total of 410 North Indian individuals between ages 12-30 years, 161 males and 249 females were examined. A specially designed proforma was used to record the detailed history of the individual. Among the etiological factors it was found that history of thumb sucking was present in 13.9% and significantly related to Class II div 1 malocclusion. When thumb sucking exceeded 18 months, it was found statistically significant (P < 0.1) in Class II skeletal malocclusion, in open bite (P < 0.1) and in extreme overjet (P < 0.5). CONCLUSION: If thumb sucking is not treated early, it can cause skeletal Class II malocclusion, anterior open bite and excessive overjet.

Is tongue thrust that develops during orthodontic treatment an unrecognized potential road block?

The role of tongue thrust has often been suspected, long debated and largely dispelled as a primary etiological factor of malocclusion. However, tongue thrust may contribute to poor occlusal intercuspation both during and after treatment. A tongue thrust may also develop during orthodontic mechanotherapy as a result of the transient creation of intra and interarch spaces and this little recognized phenomenon was found to occur in many randomly followed cases. In many instances, this seemingly adaptive and secondary response of the tongue posture and function may persist and thereafter impede the resolution of intra and interarch problems.

Effects of variation in the timing of palatal repair on sagittal craniofacial morphology in complete cleft lip and palate children.

The complete cleft lip and palate children, ranging from 6-14 years of age were studied to evaluate the effect of variation in the timing of palatal repair on craniofacial morphology and compared to the noncleft children. It was observed that all the groups early (8 to < or = 24 months), medium (> 24 to < or = 36 months) and late repair (> 36 to < or = 78 months) had significantly larger cranial base, retruded maxillomandibular relations, skeletodental and incisal relationships compared to the noncleft children. However, intercomparison among the cleft groups showed insignificant difference amongst them suggesting that the timing of palatal repairs does not effect the anterioposterior (sagittal) relationship.

Effects of variation of the timing of palatal repair on nasality of speech in complete cleft lip and palate children.

Nasality is related to factors like velopharyngeal closure and acoustic factors pertaining to cavities. The present investigation is a retrospective study aimed at evaluating the effects of variation in the timing of palatal repair on nasality during speech development in complete cleft lip and palate cases. It has been observed that the delay in palatal repair is associated with increase in nasality. Also, from the operated complete cleft lip and palate cases, it has been observed that the early and medium repair groups had almost similar effects on nasality of speech. (if they were operated before 36 months of age).

Effects of variation in timing of palatal repair on articulation skills in complete cleft lip and palate cases--a retrospective study.

The effects of variation in the timing of palatal repair on articulation skills in complete cleft lip and palate was evaluated from fifty subjects. The present study confirmed that development of articulation was similar in the groups operated upon before 24 months and between 24 to 36 months. The insignificant difference suggests that articulation was good irrespective of the early or medium timing of palatal repair.

Prevalence of malocclusion and abnormal oral habits in North Indian rural children.

This epidemiological investigation was conducted on a sample of 3164 rural children aged 6-15 years in Raipur Rani and Naraingarh blocks in the district of Ambala in Haryana. 29. 2 percent of rural children were found to have malocclusion whereas 70.8 per cent had normal occlusion. Class I malocclusion was found to be maximum in 14.4 per cent of children, while malocclusion with class II molar relationship was observed in 13.5 per cent of children. Malocclusion with Class III molar relationship was seen in 1.3 per cent of the population studied. Three per cent of rural children were found to have abnormal oral habits, predominantly tongue thrusting and thumb sucking. The frequency distribution of abnormal oral habits in children with malocclusion was found to be 10.3 per cent.

Non-familial cherubism--a case report.

A case of cherubism in a 9 year old boy with no familial history is presented. Clinical features, histologic appearance, radiographic findings, differential diagnosis and rationale for treatment is discussed.

Sagittal craniofacial morphology in repaired unilateral and bilateral complete cleft lip and palate cases.

Fifty repaired complete cleft lip and palate cases (38 UCLP and 12 BCLP) in the age of 6 to 14 years were evaluated for sagittal craniofacial morphology using lateral cephalograms. A total of twenty three measurements (19 angular and 4 linear) were used in the analysis to represent a comprehensive pattern of dento craniofacial morphology. The results of comparison between UCLP and BCLP revealed differences for only the skeletodental and interincisor sagittal relationship (greater retroclination in BCLP group).

Effect of timing of palatal repair on the transverse development of maxillary alveolar arch in complete-cleft cases.

Forty cleft cases in the age range of 5-12 years where the palatal repair had been performed at 16-24 months (17 cases), 24-36 months (15 cases) and 36-72 months (8 cases) were assessed retrospectively, for the status of maxillary arch and were segregated as acceptable and unacceptable. Plaster casts were prepared from alginate impressions and their graphical reproduction using Huddart's technique, were used to measure the alveolar arch. Anterior palatal measurement (C-C') and posterior palatal measurement (P-P') of the cleft subjects were compared with that in the non-cleft matched controls. The 16-24 month group showed 41.2% acceptable and 58.8% unacceptable arch cases. The 24-36 month group showed that 73.4% had acceptable arches and 26.6% had unacceptable arches. In the 36-72 months group the arch was acceptable in 62.5% cases and unacceptable in 37.5% cases. It was concluded that palatal repair performed before 24 months of age adversely affected the maxillary growth, whereas most favourable growth of maxillary arch occurred when the repair was done between 24-36 months.

Transverse and vertical asymmetry of bilateral craniofacial structures in repaired unilateral and bilateral complete cleft lip and palate cases.

Fifty repaired complete cleft lip and palate cases (38 UCLP and 12 BCLP) in the age range of 6 to 14 years were evaluated for transverse and vertical asymmetry using postero-anterior cephalograms. A total of nine bilateral landmarks, representing upper face, mid face and lower face were used. Results showed that asymmetry was not confined to any single plane of reference but manifested in both dimensions--transverse and vertical. The UCLP group had greater asymmetry of mid face than the BCLP group. Asymmetry was found to be extending to distant areas besides the contiguous structures.

Comparative evaluation of the role of NaF, APF & Duraphat topical fluoride applications in the prevention of dental caries--a 2 1/2 years study.

The study was conducted on 1251 6-12-year-old children, to evaluate the effect of topical application of NaF, APF and Duraphat given at six monthly interval assessed after 2.1/2 years revealed the percentage caries reduction with sodium fluoride to be in the range of 20-24 percent on base line teeth and 30-33 percent on teeth erupted during study, showing more effect on newly erupted teeth. In APF group, the caries reduction was 32-37 percent, in the DMFT and DMFS-slightly more on teeth erupted during study than on baseline teeth. The dental caries reduction with Duraphat (NaF varnish) was in the range of 70-75 percent-slightly more on newly erupted teeth. Equally high degree of efficacy was also noted on occlusal surfaces. Duraphat showed the greatest public health potential.