Assessment of dental malocclusion and soft-tissue features among children with special needs in the Western UP region: A cross-sectional study.

Aims: Assessment of dental malocclusion and soft-tissue features among children with special needs and their correlation with normal children. Subjects and Methods: A cross-sectional study was carried out among 128 children (63 special health-care needs children and 65 normal children), between 8 and 18 years of age. Two special schools (Vatsalya and Jeevandhara) were included in the study for case group and two local schools (one government and one private) were included in the study for control group. Index of Orthodontic Treatment Need was used to measure the malocclusion. To assess and compare various facial features, extra-oral photographs were taken from two different views (frontal and side). Statistical Analysis Used: Data were analyzed using ANOVA and Chi-square test, with keeping level of significance at P < 0.05. Results: The result of the present study demonstrated a significant difference between the study and control group with respect to overjet, caries, stains and calculus, soft-tissue facial profile, lip competency, and Korkhaus lip step. Soft-tissue comparison demonstrated facial asymmetry; lip incompetency was more prevalent in the study group compared to the control group. Overall, it was concluded that malocclusion was more prevalent in the study group compared to their counterparts. Conclusions: Malocclusion was more prevalent in children with disability compared to their counterparts. On clinical examination, a significant difference in relation to overjet, caries and stains, and calculus was observed, whereas a significant difference on soft-tissue examination was observed in facial profile, lip competency, and Korkhaus lip step in the study group compared to normal children.

Comparative analysis of craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders: a cross-sectional study.

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

Estimation of nickel and chromium in saliva of patients with fixed orthodontic appliances.

AIM: To examine whether orthodontic treatment induces an increase in salivary nickel and chromium concentration. METHODS: Ten new patients (7 females and 3 males) beginning fixed orthodontic treatment were included in the study. The mean age of the sample was 17.5 years (range 14 to 24 years). Three samples of stimulated saliva were collected from each orthodontic patient, 1 at each of the following times: before insertion of the fixed appliance (which served as a baseline/reference level for salivary nickel and chromium content), 1 week after insertion of the appliance, and 3 weeks after insertion of the appliance. These samples were analyzed for nickel and chromium content using the atomic absorption spectrometer and their values recorded in ng/mL. The Friedman test was used to test the statistical significance of differences in concentrations of each metal before and after insertion of orthodontic appliances. Post-hoc comparisons were performed using the Wilcoxon signed rank test and Mann-Whitney U test. RESULTS: This study showed that there was a statistically significant difference in salivary nickel and chromium concentrations before and 1 week and 3 weeks after insertion of fixed orthodontic appliances. The highest concentrations of nickel and chromium were found after 1 week. The salivary nickel and chromium concentrations tapered off 3 weeks after insertion but were significantly higher than baseline levels. CONCLUSION: The salivary nickel and chromium concentrations significantly increased after insertion of fixed orthodontic appliances as compared to baseline levels, with the maximum concentration seen in the first week after placement of fixed orthodontic appliances.

Biometric study of tooth size in normal, crowded, and spaced permanent dentitions.

INTRODUCTION: At present, there is a void in the orthodontist's armamentarium with regard to the assessment of malocclusion due, in part, to tooth size. A biometric study of tooth size was carried out to examine the extent to which tooth size contributes to dental crowding or spacing. METHODS: A sample of 240 orthodontic study casts was selected from a larger sample. These casts met the selection criteria. The sample was divided into crowded, spaced, and normal dentition groups with 80 casts in each group. The criterion of grouping was based on the tooth size-arch length discrepancy in the arch. Each group comprised 40 maxillary and 40 mandibular casts that were further divided equally by sex. The data were statistically analyzed. RESULTS: Mesiodistal crown dimensions of individual teeth, the sum of the incisors, and the sum of the canines and the premolars were uniformly larger in crowded arches than in normal and spaced dentition groups. Mesiodistal crown dimensions of individual teeth were smaller in the spaced arches compared with normal dental arches, but the difference was significant only in the combined mesiodistal crown dimensions of the mandibular incisors. Correlations of the combined mesiodistal crown dimensions of the incisors with the combined mesiodistal crown dimensions of the canines and the premolars were positive in all 3 groups. CONCLUSIONS: Mesiodistal tooth size is an important factor in the assessment of crowding or spacing and in orthodontic treatment planning.