What are the intra-arch risk factors for palatally displaced maxillary canine? - Results of a case-control study.

INTRODUCTION: This study aimed to identify the intra-arch risk factors for palatally displaced canine by comparing the maxillary transverse dimensions, palatal depth (PD), and arch length (AL) of the subjects with and without impacted canine using cone-beam computed tomography (CBCT). METHODS: In this prospective case-control study, 79 CBCT images of gender- and skeletal feature-matched subjects (25 cases and 54 controls) were compared. Based on the CBCT images, maxillary transverse widths at four levels (molar basal, molar alveolar, premolar basal, and premolar alveolar), maxillary PD, and maxillary AL were measured. Group comparisons were assessed using analysis of variance (ANOVA), followed by post-hoc Scheffe's test, and risk factors were identified using univariate and multivariate logistic regression. RESULTS: The impacted canine group showed significantly smaller molar alveolar width, premolar alveolar width, PD, and greater AL compared to the control group (P = 0.046, P < 0.001, P = 0.003, and P = 0.001, respectively). No significant difference was observed in the molar and premolar basal width measurements between the two groups. Multivariate analysis showed that impacted maxillary canine was influenced by premolar alveolar width (odds ratio (OR): 0.669), PD (OR: 0.532), and AL (OR: 1.739). CONCLUSION: Intra-arch risk factors, such as reduced maxillary premolar transverse alveolar width, PD, and greater AL, are associated with palatally displaced canine.

What has changed in orthodontic patient care between the two surges of the COVID-19 pandemic? A thematic analysis.

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) has brought new challenges to every specialty and orthodontics is no exception. Currently, there seems no way other than to mitigate the risk and proceed with routine orthodontic treatment. The aim of the present study was to conduct a qualitative inquiry into the coping strategies, perceptions and anticipations of orthodontic patients and the challenges faced by orthodontists. METHODS: An in-depth telephone interview of 30 patients and/or their parents and orthodontists belonging to an Academic-based Residency Program and Private Practice was conducted regarding the challenges, opportunities and futuristic ways of coping with COVID-19. Inputs were recorded, transcripts were prepared and anonymised, and a thematic analysis was performed. RESULTS: Six themes and several sub-themes emerged from the detailed interviews and their transcripts. The initial fearful situation due to COVID-19 has gradually transformed into a certain 'new normal' in the lives of patients and caregivers, explaining why patients started seeking orthodontic treatment as usual or even preferring to begin treatment during this period. Orthodontists in the midst of uncertainty are delivering quality care and expecting future innovations and changes to combat such pandemics. CONCLUSION: Humans can adapt to any crisis that runs over a period of time. The new insights obtained will help to plan treatment and set up practice to cope with pandemics and crises that can affect orthodontic treatment in the future.

Maxillary Incisor Intrusion Using Two Conventional Intrusion Arches and Mini Implants: A Prospective Study.

AIM AND OBJECTIVE: This study aimed to compare cephalometrically the rate of maxillary incisor intrusion using mini implants, Connecticut intrusion arches, and segmental intrusion arches. MATERIALS AND METHODS: Thirty-two adult patients with deep bite were divided into three groups: 10 patients in mini implant and Connecticut intrusion arch group each and 12 patients in segmental intrusion arch group. Bilateral mini implants were used for intrusion in Group 1. Connecticut intrusion arch and Burstone's three-piece intrusion arch were used for intrusion in Group 2 and Group 3, respectively. Intrusion was carried out in all the patients for 4 months. Lateral cephalograms were taken just after alignment and leveling (T1) and after 4 months of intrusion (T2). RESULTS: The mean amount of intrusion observed was 1.7 mm (0.425 mm/month) in mini implant group, 1.4 mm (0.35 mm/month) in Connecticut intrusion arch group, and 1.66 mm (0.415 mm/month) in segmental intrusion arch group. No statistically significant difference was found in the extent of incisor intrusion in the three groups (p <0.05). CONCLUSION: The study failed to reject the null hypothesis, and there was no statistically significant difference in the amount and rate of incisor intrusion achieved among the three groups (p >0.05). CLINICAL SIGNIFICANCE: Significant amount of incisor intrusion was carried out by all the three methods. There was no statistically significant difference in the amount and rate of incisor intrusion achieved by the three methods. Clinically, mini implants can be considered superior to the conventional techniques as it provides absolute anchorage which eliminates unwanted effects of incisor intrusion.

Is Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) Valid for the Indian Population?-A Psychometric Study.

OBJECTIVES: A culturally adapted and validated Oral Health-Related Quality of Life (OHRQoL) inventory helps to reliably compare patient perceptions among different populations. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) evaluates the impact of dental aesthetics on OHRQoL. This study aimed to develop a regional version of PIDAQ (PIDAQMal) for the Indian population and to assess differences in perceptions due to malocclusion in different population groups. MATERIALS AND METHODS: PIDAQMal was derived through the translation process and pilot-tested to assess test-retest reliability. Psychometric properties were tested on 285 subjects (31.2% males, 68.8% females; age range 18-25 years). Normative treatment need was assessed using Index of Orthodontic Treatment Need (IOTN)-Dental Health Component and subjective assessment using IOTN-Aesthetic Component (AC) and Perception of Occlusion Scale (POS). PIDAQMal mean domain scores were compared with those of the previously validated versions to assess difference in perceptions. RESULTS: Internal consistency and test-retest reliability were good (Cronbach's α = 0.83-0.88; Intraclass Correlation Coefficient = 0.74-0.91). IOTN-AC and POS scores showed significant correlation with PIDAQMal scores ensuring convergent validity (P < 0.001). Discriminant validity was confirmed by statistically significant differences (P < 0.001) in PIDAQMal scores between subjects with no treatment need and moderate/definite need. Factor analysis derived four domains with one item showing cross-loading. Difference in mean domain scores among the previously validated versions of PIDAQ confirmed socio-cultural differences in perceptions due to malocclusion. CONCLUSION: PIDAQMal was found to be reliable and valid for the Indian subjects and can be used as a condition-specific OHRQoL measure. Socio-cultural differences in perceptions were brought to light using the translated scale.

Is There a Need to Increase Palatal Root Torque of Upper Incisors in Lingual Appliance? A Finite Element Analysis.

OBJECTIVES: To understand the effect of the biomechanical differences by assessing pre and post retraction torque, amount of retraction and arch width changes in both techniques. METHODOLOGY: A three-dimensional geometric model of maxilla with all upper teeth except first premolar was generated based on computed tomography radiograph of a dry skull using the computer program Hypermesh. 13.0. Virtual models of 0.022 "Roth labial brackets and 0.018 "ORMCO 7th generation lingual brackets; and for labial brackets 0.019 × 0.025" SS archwire and for lingual brackets 0.016 × 0.024" SS archwire were constructed. Sliding mechanics was used during en-masse retraction by applying a 300 g distal force on both sides of the dentition from canine to the second premolar brackets in the labial and lingual simulation. The finite element program ANSYS 12.1 was used to calculate the torque and displacement. RESULTS: The results stipulated that in transverse direction there was lingual tipping of anteriors, mild buccal flaring in second premolars and first molars and lingual tipping in second molar in lingual appliance. In the sagittal plane, the greater distal movement of posteriors and an up-righting tendency of molars were observed in lingual appliance. Extrusion of anterior teeth were observed in both appliances. Regarding the premolars and first molars, labial movements and relative intrusion were observed in lingual appliance compared to labial appliance. CONCLUSION: In lingual treatment, it is crucial to increase the lingual root torque. The amount of retraction and arch widening were more in lingual appliance compared to labial technique.

Ready to Use Norms for Arnett Bergman Soft-Tissue Cephalometric Analysis for South Indian Population.

CONTEXT: Variability of the soft-tissue drape in humans has complicated the accuracy of evaluating soft tissue profiles in diagnosis and treatment planning. AIMS: The objective of the present study is to establish soft-tissue cephalometric norms for South Indian population using Arnett Bergman Soft tissue analysis. SETTINGS AND DESIGN: This study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics. SUBJECTS AND METHODS: Lateral cephalograms of 60 individuals (30 males and 30 females), age ranging between 18 and 25 years, with orthognathic facial profiles were obtained in natural head position. True vertical line was drawn through subnasale parallel to the vertical reference plane. Measurements were done according to soft-tissue cephalometric analysis. STATISTICAL ANALYSIS USED: Student's t-test was used to compare the means between two groups. RESULTS: The results of the study showed significant gender dimorphism, with men having thicker soft-tissue structures, larger vertical dimensions, deep-set midface structures, more upright incisors, and deeper inferior labial sulci than women. When compared with the standard norms, the South Indian population had significantly protruded dentition, thinner soft-tissue drape, shorter vertical face heights, prominent forehead and midface with retusive lower facial thirds and convex profiles as compared to Caucasians. CONCLUSIONS: Significant gender dimorphism was evident in the local population suggesting the need for separate set of norms for males and females. Distinct ethnic differences were found between Caucasians and the Indian population that were statistically significant, highlighting the importance of defining separate set of norms for ethnic groups. The norms obtained should be used as reference when planning treatment of a specific ethnic group.