Effectiveness of metronidazole gel and mobile telephone short-message service reminders on gingivitis in orthodontic patients.

OBJECTIVES: To compare the effectiveness of metronidazole gel and mobile telephone short-message service (SMS) reminders on gingivitis in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: The trial was double blinded (patient and investigator), and only the clinical trial unit pharmacist was unblinded. Data were collected from patients undergoing fixed orthodontic treatment for at least 6 months. A total of 66 patients were randomly assigned to either 0.8% metronidazole gel (n = 22), SMS reminder and placebo gel (n = 22), or placebo (control) group only (n = 22). Gingival index (GI), bleeding index (BI), and orthodontic plaque index (OPI) were evaluated on several teeth at baseline (T0) and after 4 weeks (T1). Paired-sample t-tests were used to compare mean differences of indexes at T0 and T1 in the groups, and independent-sample t-tests were used to determine the effects of interventions compared with the controls. RESULTS: Data from 64 patients were analyzed; there were 2 dropouts. There were statistically significant (P < .05) reductions in GI, BI, and OPI scores from T0 to T1 for each intervention. However, there were no significant differences between each intervention and the control group. There were no adverse effects. CONCLUSIONS: The null hypothesis could not be rejected. There is no difference between interventions (application of 0.8% metronidazole gel and SMS reminder for reinforcing oral hygiene) in reducing gingival inflammation in orthodontic patients.

Application of New Biomedical Materials in Orthodontic Appliances.

This review article describes the application and characteristics of certain biomedical materials in orthodontic appliances. The elastic recoil of shape memory polymers, determination of the forces and moments experienced by the brackets and eventually by the tooth, reduction in treatment time by employing self-healing smart brackets and decreased enamel lost during debonding due to usage of biomimetic adhesives such as dihydroxyphenylalanine (DOPA) is discussed. Increased plaque retention and microbial attachment around brackets and teeth is of profound concern and by utilisation of hydrophobic properties of self-cleaning materials, this can be reduced significantly. Implantation of bioresorbable temporary anchorage devices, which resorb once their purpose is accomplished and increasing the concentration of fluoride in the oral environment to counter the deleterious consequences of orthodontic treatment such as white spot lesions and caries, are also discussed briefly.

Adjunctive surgical procedures enhancing treatment outcome - A literature review.

The face is the most expressive zone of the human body that communicates our feelings and thoughts. This may also influence the interaction between people. The aesthetic adjunctive procedures are life-changing. In contemporary orthodontic treatment, orthognathic surgeries are performed to correct the functional aspects of dento facial deformities. In cases where the aesthetic outcome is not improved, patient dissatisfaction is often encountered. Many adjunctive surgical procedures can be used to enhance the anaesthetics of orthodontic or orthognathic surgical cases. Dwelling not merely on the ideal occlusion, the results could be enhanced by analysing the whole-face to improve the overall treatment outcome.

Assessment of dental maturation on orthopantomograms among children with various dental malocclusions at a tertiary care hospital.

OBJECTIVE: To determine and compare the median dental age among males and females and in subjects with dental Class I, II and III malocclusions. METHODS: The retrospective study was conducted at Aga Khan University Hospital and comprised dental records of patients from July to December 2016 who were aged 9-16 years and had complete dentition excluding third molars. The sample was divided according to dental malocclusion which was further categorised according to chronological age groups. SPSS 21 was used for data analysis. RESULTS: Of the 270 sbjects whose radiographs were studied, 135(50%) each were males and females. Children aged 11-12 years showed a statistically significant difference (p=0.03) in the median dental age among genders. There was a strong positive correlation in the dental and chronological ages in the males (p<0.001) and females (p<0.001) sample. Median time of eruption of mandibular second permanent molar in different malocclusions was 11 years and 2 months. CONCLUSIONS: There was a strong positive correlation between chronological and dental ages for males and females. Females subjects were dentally advanced compared to the male subjects aged 11-12 years. ..

Concepts, protocol, variations and current trends in surgery first orthognathic approach: a literature review.

In the current era of expedited orthodontics, among many clinicians, tertiary care hospitals and patients, surgery first orthognathic approach (SFOA) has gained popularity. The advantages of SFOA (face first approach) are the reduced overall treatment duration and the early improvement in facial esthetics. In SFOA, the absence of a presurgical phase allows surgery to be performed first, followed by comprehensive orthodontic treatment to achieve the desired occlusion. The basic concepts of surgery early, surgery last, SFOA and Sendai SFOA technique along with its variations are reviewed in the present article. The recent advancement in SFOA in the context of preoperative preparation, surgical procedures and post-surgical orthodontics with pertinent literature survey are also discussed.

Correlation between the Atlas Morphology and the Maxillo-mandibular Divergence Pattern.

OBJECTIVE: To evaluate the correlation between atlas morphology and maxillo-mandibular divergence. STUDY DESIGN: Cross-sectional, analytic study. PLACE AND DURATION OF STUDY: Dental Clinics, The Aga Khan University Hospital, Karachi, Pakistan from February to August 2017. METHODOLOGY: Pretreatment lateral cephalograms of 208 subjects, aged 18 to 25 years, were evaluated. The atlas parameters were categorized into atlas dorsum, anteroposterior and ventrum, and measured on View Pro-X software. Various maxillary (FPPP, SNPP and FHPP angles) and mandibular (SNGoGn, saddle, articulare, gonial, sum of posterior and Y-axis angles) parameters were used to evaluate the divergence pattern of the individuals. Mann-Whitney U-test was used to compare atlas and maxillo-mandibular parameters between genders. Spearman correlation was used to correlate atlas and maxillo-mandibular parameters across genders. A p-value <0.05 was considered as statistically significant. RESULTS: Statistically significant differences were found between various atlas and maxillo-mandibular parameters between genders. With atlas dorsum, the saddle angle (r = -0.3) in males; whereas gonial (r = -0.2), Y-axis (r = 0.1) and SNPP (r = -0.2) angles in females showed significant weak correlation. With atlas anteroposterior, saddle (r = -0.2), articulare (r = 0.2), SNPP (r = -0.2) and FHPP (r = -0.3) angles in males showed significant weak correlation. However, only the SNPP angle (r = -0.2) in females showed a significant weak correlation with atlas ventrum. CONCLUSION: A weak correlation was found between atlas parameters and various maxillo-mandibular angular parameters in both genders. Therefore, atlas morphology cannot be regarded as a good predictor of future maxillo-mandibular divergence pattern.

Concepts, protocol, variations and current trends in surgery first orthognathic approach: a literature review

ABSTRACT In the current era of expedited orthodontics, among many clinicians, tertiary care hospitals and patients, surgery first orthognathic approach (SFOA) has gained popularity. The advantages of SFOA (face first approach) are the reduced overall treatment duration and the early improvement in facial esthetics. In SFOA, the absence of a presurgical phase allows surgery to be performed first, followed by comprehensive orthodontic treatment to achieve the desired occlusion. The basic concepts of surgery early, surgery last, SFOA and Sendai SFOA technique along with its variations are reviewed in the present article. The recent advancement in SFOA in the context of preoperative preparation, surgical procedures and post-surgical orthodontics with pertinent literature survey are also discussed.

RESUMO Na presente era da Ortodontia de resultados acelerados, a cirurgia ortognática com benefício antecipado (COBA) ganhou popularidade entre muitos clínicos, hospitais terciários e pacientes. A vantagem da COBA é a redução da duração total do tratamento, juntamente com a melhora precoce da estética facial. Na COBA, a ausência de uma fase pré-cirúrgica permite que a cirurgia seja realizada antes e, só então, venha o tratamento ortodôntico abrangente para se alcançar a oclusão desejada. Os conceitos básicos de cirurgia primeiro, cirurgia por último, COBA e a técnica COBA de Sendai, bem como suas variações, são aqui revistos. Também são discutidos no presente artigo, junto com a revisão da literatura pertinente, os recentes avanços da COBA no contexto do preparo pré-cirúrgico, dos procedimentos cirúrgicos e da Ortodontia pós-cirúrgica.

Association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity.

INTRODUCTION: Various methods have been proposed to evaluate a patient's developmental status. However, most of them lacked precision and failed to give a reliable estimate of skeletal maturity. The aims of this study were to evaluate the association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity and to determine its validity in assessing the different stages of the adolescent growth spurt. METHODS: A cross-sectional study was performed on the pretreatment lateral cephalograms of 252 subjects aged 8 to 21 years. The sample was divided into 6 groups based on the cervical vertebral maturation stages. The frontal sinus index was calculated by dividing the frontal sinus height and width, and the cervical stages were evaluated on the same radiograph. The Kruskal-Wallis test was applied to compare frontal sinus index values at different cervical stages, and the post hoc Dunnett T3 test was applied to compare frontal sinus index values between adjacent cervical stages for each sex. The Kendall tau-b values were computed to assess the correlation between the cervical stages and the sinus index. A P value of ≤0.05 was considered statistically significant. RESULTS: The height and width of the frontal sinus were significantly larger in the male subjects than in the females. A significant association was found between the frontal sinus height and width and cervical stages (P ≤0.001) in both sexes. However, the changes in the frontal sinus index across the different cervical stages were found to be significant (P ≤0.001) in male subjects only. Similarly, a weak negative correlation was found between the sinus index and the cervical stages in male subjects (tau-b = -0.271; P <0.001), whereas no correlation was found in female subjects (tau-b = -0.006; P <0.928). However, the post hoc analysis showed that the values of the sinus index were comparable between any 2 adjacent cervical stages. CONCLUSIONS: The frontal sinus index cannot be used to identify the prepubertal, pubertal, and postpubertal stages of the adolescent growth spurt. Therefore, it cannot be used as a reliable maturity indicator.