Proximity of Roots of Posterior Teeth to Maxillary Sinus in Different Facial Biotypes.

OBJECTIVE: To evaluate the relationship between maxillary posterior teeth roots to maxillary sinus floor (MSF) using three-dimensional imaging and to evaluate the correlation of vertical facial biotype, gender, and age to the proximity of posterior roots to the sinus. STUDY DESIGN: Observational, Cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Armed Forces Institute of Dentistry, Combined Military Hospital, Rawalpindi, from January 2021 to July 2022. METHODOLOGY: Three-dimensional CBCT scans of 100 patients aged between 13 to 43 years were evaluated and divided into three matching groups based on vertical face forms i.e. hyperdivergent, normodivergent, and hypodivergent. Root proximity to maxillary sinus was scored (0-3) for each scan. Nonparametric Wilcoxon Mann Whitney U test and Kruskal Wallis test were used to compare average tooth and patient scores to vertical face type, age, and gender. RESULTS: Out of 100 patients, 54 were males and 46 were females with 44% aged between 13-23 years, 27% between 24 to 33 years, and 29% between 34 to 43 years. Average patient and tooth scores were highest in the hyperdivergent face type (p<0.001). No statistically significant relation was found between gender and degree of root proximity to MSF (p>0.05). Age was negatively correlated to root sinus wall connection (p<0.001). CONCLUSION: Patients with hyperdivergent face forms are at greater risk of root resorption and prolonged orthodontic treatment due to the closer proximity of root apices to the maxillary sinus as compared to hypodivergent and normodivergent face forms. Moreover, roots were farther from the maxillary sinus wall with advanced age. KEY WORDS: Maxillary sinus, Cone beam computed tomography, Face.

Comparison of popular sagittal cephalometric analyses for validity and reliability.

BACKGROUND: The analysis of skeletal relationships of jaws in the sagittal plane is of utmost importance in orthodontic diagnosis for which numerous lateral cephalometric analyses have emerged. None of the analyses is without flaws. Current study compares ANB, Wits appraisal, Beta angle, Yen angle and W angle for their validity and reliability in diagnosis of skeletal classes. METHODS: Pretreatment cephalograph of 209 orthodontic patients comprised of 92 males and 117 females were selected from orthodontic archives. Radiographs were traced for ANB, Wits appraisal, Beta angle, W angle and Yen angle measurements. Patients were divided into three skeletal classes i.e. class I, II and III based on measurements and incisor classification and profile recorded from their files. ANOVA was applied to check the validity of performed analyses and Cramer's correlation was performed to find out the correlation between analyses and skeletal classes. RESULTS: All performed analyses showed statistically significant difference in the values for all three skeletal classes p < .05. All measured analyses were found equally reliable in diagnosis of skeletal discrepancies. CONCLUSION: All five-skeletal cephalometric sagittal analyses are reliable and can be used in orthodontic diagnosis as alternative to each other.

Canine Retraction Using a Closed Nickel Titanium Coil Spring and an Elastic Module.

OBJECTIVE: To compare the mean change of tooth movement in canine retraction between elastic module and Ni Ti coil spring. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Orthodontics Department, Armed Forces Institute of Dentistry, Rawalpindi, from May 2015 to January 2016. METHODOLOGY: Thirty-two patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed Ni Ti coil spring on one side of the maxillary arch and with active tie back on the other side. The distance between the lateral incisor and the canine was measured on both sides before starting canine retraction. The same measurements were recorded after four weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test. RESULTS: The study included 56% females and 43% males. The mean rate of tooth movement in Ni Ti coil group and in the elastomeric module group was 1.1 mm and 0.7 mm in one month, respectively (p=0.05). CONCLUSION: The rate of tooth movement is more rapid with Ni Ti coil spring than with the elastomeric module.

Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery.

OBJECTIVE: To determine the efficacy of intra-alveolar administration of chlorhexidine (CHX) gel in reducing the frequency of alveolar osteitis (AO) after impacted mandibular third molar surgery. STUDY DESIGN: A randomized control trial study. PLACE AND DURATION OF STUDY: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to December 2007. METHODOLOGY: One hundred patients including 65 males and 35 females with the age range 18-40 years were divided in two equal groups (50 each in the CHX and the control groups). Surgical removal of impacted mandibular third molar was carried out and after surgery CHX gel was placed into the alveolus of CHX group. Patients were followed at the first, second and third postoperative days. A proforma indicating presence or absence of pain, blood clot disintegration, halitosis and AO was filled for each patient. Frequencies and percentages were calculated for qualitative data. Chi-square test was applied to compare both subgroups. RESULTS: Eighteen patients (18%) were diagnosed with AO (11 males and 7 females). Out of these 18 cases, 14 (28%) were found in control group (9 males and 5 females), while 4 cases (8%) in the CHX group (2 males and 2 females). This was statistically significant p=0.017. CONCLUSION: Single application of CHX gel was effective in reducing frequency of AO following mandibular third molar surgery.