Periodontal Lesions among Maxillary Sinus Mucosal Thickening Visiting the Department of Oral Medicine and Radiology of a Tertiary Care Centre.

Introduction: Maxillary sinus due to its proximity to posterior maxillary teeth could be affected by their pathology. Since cone beam computed tomography is the go-to for 3-D imaging in dental set-up. This study aimed to find out the prevalence of periodontal lesions among maxillary sinus mucosal thickening visiting the Department of Oral Medicine and Radiology of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in the Department of Oral Medicine and Radiology of a tertiary care centre from 01 February 2021 to 30 June 2021 after obtaining ethical approval from the Institutional Review Committee. The medical records from 01 January 2019 to 31 December 2019 were retrieved. The identification of maxillary sinus mucosal thickening of more than 3 mm, in cone beam computed tomography images, was registered separately for the right and left sinuses of each patient. The presence of periodontal lesions of posterior teeth was recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 195 maxillary sinus mucosal thickening, periodontal lesions were found in 74 (37.95%) (31.14-44.76, 95% Confidence Interval) maxillary sinuses of 46 patients. The mean age was 53.67±12.72 years and 30 (65.21%) were males. Conclusions: The prevalence of periodontal lesions among maxillary sinus mucosal thickening in CBCT images was similar to other studies done in similar settings. Keywords: cone beam computed tomography; maxillary sinus; periodontal disease; prevalence.

Cephalometric Analysis in Orthodontics Using Artificial Intelligence-A Comprehensive Review.

Artificial intelligence (AI) is a branch of science concerned with developing programs and computers that can gather data, reason about it, and then translate it into intelligent actions. AI is a broad area that includes reasoning, typical linguistic dispensation, machine learning, and planning. In the area of medicine and dentistry, machine learning is currently the most widely used AI application. This narrative review is aimed at giving an outline of cephalometric analysis in orthodontics using AI. Latest algorithms are developing rapidly, and computational resources are increasing, resulting in increased efficiency, accuracy, and reliability. Current techniques for completely automatic identification of cephalometric landmarks have considerably improved efficiency and growth prospects for their regular use. The primary considerations for effective orthodontic treatment are an accurate diagnosis, exceptional treatment planning, and good prognosis estimation. The main objective of the AI technique is to make dentists' work more precise and accurate. AI is increasingly being used in the area of orthodontic treatment. It has been evidenced to be a time-saving and reliable tool in many ways. AI is a promising tool for facilitating cephalometric tracing in routine clinical practice and analyzing large databases for research purposes.

Evaluation of fully automated cephalometric measurements obtained from web-based artificial intelligence driven platform.

BACKGROUND: Artificial Intelligence has created a huge impact in different areas of dentistry. Automated cephalometric analysis is one of the major applications of artificial intelligence in the field of orthodontics. Various automated cephalometric software have been developed which utilizes artificial intelligence and claim to be reliable. The purpose of this study was to compare the linear and angular cephalometric measurements obtained from web-based fully automated Artificial Intelligence (AI) driven platform "WebCeph"™ with that from manual tracing and evaluate the validity and reliability of automated cephalometric measurements obtained from "WebCeph"™. METHODS: Thirty pre-treatment lateral cephalograms of patients were randomly selected. For manual tracing, digital images of same cephalograms were printed using compatible X-ray printer. After calibration, a total of 18 landmarks was plotted and 12 measurements (8 angular and 4 linear) were obtained using standard protocols. The digital images of each cephalogram were uploaded to "WebCeph"™ server. After image calibration, the automated cephalometric measurements obtained through AI digitization were downloaded for each image. Intraclass correlation coefficient (ICC) was used to determine agreement between the measurements obtained from two methods. ICC value < 0.75 was considered as poor to moderate agreement while an ICC value between 0.75 and 0.90 was considered as good agreement. Agreement was rated as excellent when ICC value > 0.90 was obtained. RESULTS: All the measurements had ICC value above 0.75. A higher ICC value > 0.9 was obtained for seven parameters i.e. ANB, FMA, IMPA/L1 to MP (°), LL to E-line, L1 to NB (mm), L1 to NB (°), S-N to Go-Gn whereas five parameters i.e. UL to E-line, U1 to NA (mm), SNA, SNB, U1 to NA (°) showed ICC value between 0.75 and 0.90. CONCLUSION: A good agreement was found between the cephalometric measurements obtained from "WebCeph"™ and manual tracing.

Analysis of Lingual Arch Form in Dental Students of Nepal with Normal Occlusion.

BACKGROUND: The objectives of this study were to describe and classify lingual arch form in dental students with normal occlusion and explore the possibility to provide a lingual arch form template for Nepalese population. METHODS: The occlusion and arch form of 220 undergraduate dental students were analyzed and thirty-three subjects (14 males, 19 females) fulfilling the inclusion criteria were selected for the study. Reference points were drawn on the lingual surfaces of the teeth of study model using an indelible marker. A transparent ruled grid was used to obtain x and y coordinate values of the reference point. Following distances were measured with a digital caliper: inter-canine width, inter-molar width, inter-second molar width, canine depth, first molar depth, and second molar depth. Two-step cluster analysis was used to further classify the arch. The mean reference point values of each cluster were entered into the software (CurveExpert 1.4, Hymas developers). The curve finder tool of the software was used to obtain the curve which best described the arch forms. RESULTS: Two-step cluster analysis identified two distinguished clusters of lingual arch forms. Tenth degree polynomial was chosen as the best possible fit for lingual arch forms by using Curvefinder tool of the software CurveExpert 1.4. CONCLUSION: Two types of anatomical lingual arch forms derived from Nepalese dental students with normal occlusion have been described and templates for the same have been generated.

Effect of Hand and Rotary Instruments on the Fracture Resistance of Teeth: An In Vitro Study.

Objective: Endodontic treatment should be both conservative and effective. Endodontic instruments with a greater taper are used for coronal flaring, for proper debridement with efficient irrigation. However, increased taper of an instrument can remove a larger amount of pericervical dentin, compromising the strength of the tooth. The aim of this study was to determine the effect of hand files, ProTaper Universal, ProTaper Next, and V Taper rotary instrument systems on the fracture resistance of teeth. Materials and Methods: In total, 60 extracted human maxillary first premolars were divided into four groups-Group I (Hand Files; HF), Group II (ProTaper Universal; PT), group III (ProTaper Next; PTN) and Group IV (V Taper; VT) (N = 15). Each group was instrumented with the respective instrument system, irrigated, obturated, restored, and mounted in cold cure acrylic. A universal load-testing machine (Shimadzu, Japan) was used to apply a vertical compressive load. The maximum force was recorded in Newton. Analysis of variance (ANOVA) and Independent t-tests were applied to compare the maximum mean force required to fracture the tooth. Results: There was a statistically significant difference in fracture resistance between Group I (HF) and Group II (PT) and between Group II (PT) and Group IV (VT) (p < 0.001). Similarly, a significant difference was observed between Group II (PT) and Group III (PTN) (p < 0.01). Furthermore, a significant difference was observed between Group I (HF) and Group III (PTN), and between Group III (PTN) and Group IV (VT) (p < 0.05), too. However, there was no statistically significant difference between Group I (HF) and group IV (VT) (p > 0.05). Conclusion: Rotary files with more taper seem to remove more pericervical dentin than traditional manual and rotary files with less taper, thus altering the strength of the tooth.

A Retrospective Clinical Audit of Bracket Failure among Patients Undergoing Orthodontic Therapy.

OBJECTIVE: Bonding failure is a problem in orthodontic therapy and has been associated with orthodontic emergencies and delayed treatment time. The aim of this study is to determine the bracket failure rate among patients undergoing orthodontic therapy. MATERIALS AND METHODS: From the archives of posttreatment records, 200 total cases were selected, out of which 122 cases had detailed treatment records. Cases with incomplete records, large restorations, or enamel aberrations were excluded from the study. Descriptive statistics were applied to obtain sample characteristics, and a chi-square test was applied to compare the bracket failure between different categories. RESULT: Out of the 122 samples enrolled in the study, female and male patients comprised 71% and 29%, respectively. Class I malocclusions were the most common problem (56%), followed by Class II (41%) and Class III (3%). The bracket failure rate was 3.43%, and 32% of the patients had an incidence of bracket failure. There was no significant difference in bracket failure among genders (p=0.344), malocclusion types (p=0.191), or operators (p=0.188). The maxillary left quadrant was the most common site of bracket failure, followed by the mandibular right quadrant. CONCLUSION: Bracket failure is relatively uncommon. It is not affected by the gender or age of the patient or by malocclusion type. The maxillary left and mandibular right quadrants are the most common sites of bracket failure.

Analysis of Interarch Tooth Size Relationship in Nepalese Subjects with Normal Occlusion and Malocclusions.

INTRODUCTION: A proportional relationship between the maxillary and mandibular teeth size is required for achieving good finish with proper overjet and overbite postorthodontic treatment. The aims and objectives of this study were to determine the anterior and overall Bolton's ratio in Nepalese population, to compare Bolton's ratio between subjects with normal occlusion, Class I malocclusion, and Class II malocclusion, to compare these results with Bolton's norm, and to determine the frequency of clinically significant (beyond 2 SD) tooth size discrepancy compared to Bolton's norm. MATERIALS AND METHODS: The study models of the subjects with normal occlusion and Angle's Class I malocclusion and Class II malocclusion and fulfilling the inclusion criteria were retrieved from department archives. An electronic digital caliper was used to measure mesiodistal tooth size of the maxillary and mandibular teeth anterior to the second molars. The study sample of 120 study models consisted of the normal occlusion group (n = 31), Class I malocclusion group (n = 47), and Class II malocclusion group (n = 42). These measurements were then used to obtain Bolton's ratio in three groups of subjects. Bolton's ratio of study groups was compared with each other and with Bolton's original ratio. RESULTS: The differences in tooth size ratio of the study groups were not significant statistically, when the groups were compared on the basis of malocclusion or gender. Statistically significant differences were exclusively observed between the study groups and Bolton's original sample for the anterior ratio. The frequency of the clinically significant tooth size ratio discrepancy was lower for the overall ratio (9.1%) compared to the anterior ratio (22.5%). CONCLUSIONS: Bolton's analysis on the Nepalese population sample shows that there was no significant difference observed on the anterior and overall tooth size ratios when these were compared based on Angle's malocclusion classes or gender. The clinically significant anterior tooth size discrepancy was more prevalent than that of the overall ratio.

Nonsyndromic Bilateral Posterior Maxillary Supernumerary Teeth: A Report of Two Cases and Review.

Supernumerary tooth/hyperdontia is defined as those teeth which are present in excess of the usual distribution of twenty deciduous and thirty-two permanent teeth. It can be seen in both syndromic and nonsyndromic patients. In Nepalese population, prevalence of supernumerary tooth is documented to be 1.6%. To the best of our knowledge, no studies from Nepal have reported the incidence of bilateral maxillary paramolars or the combination of unilateral maxillary paramolar and distomolar till date. Hence, we are reporting these two cases with a brief review of literature to put emphasis on incidence, prevalence, proposed hypothesis for etiology, and management of supernumerary teeth.

Anticipated pain and pain experience among orthodontic patients: is there any difference?

BACKGROUND: Orthodontic treatment is taken as a painful procedure by most of the patients. The pain can be experienced during different procedures like separator placement, banding, bonding, extraction as well as arch wire activation and debonding. There are very few studies done on the anticipated pain and pain experienced among mentioned orthodontic procedures. OBJECTIVES: To compare the anticipated pain and pain experience among the patients going for comprehensive orthodontic treatment. METHODS: Total 45 patients going for comprehensive orthodontic therapy are enrolled into the study. They are given a 100mm Visual Analogue Scale (VAS) for pain. The anticipated pain as well as perceived pain after different orthodontic procedures are recorded on the VAS by patients and returned back to orthodontic office. The data are analyzed by SPSS 16.00 software by paired and independent t-test for the statistical significance. RESULTS: The result showed that there is significant difference between the anticipated pain before orthodontic treatment and the pain experienced following orthodontic treatment. It also showed that perception of pain between two sexes is significantly different. The comparison of anticipated pain among male and female does not show any significant difference, however the pain felt after separator placement as well as after orthodontic bonding is significantly different in two sexes. CONCLUSION: The level of anticipated pain before orthodontic treatment is higher than the real pain experienced after orthodontic procedures. So it is better to counsel and explain the patients about the orthodontic treatment and procedures.