Facial flow line and its effect on dental midline deviation on a female subject in an Asian population - A cross-sectional study.

INTRODUCTION: This study aims to understand the relationship between midline deviations and the inherent asymmetry that can be observed in a human face. MATERIALS AND METHODS: A cross-sectional study was conducted using a frontal smile photograph of a female which was altered on Adobe Photoshop software version 23.0 into eight different photographs by deviating the dental midlines by 2 mm, 4 mm, and 6 mm towards and away from the facial flow line (FFL). 4 mm of chin deviation was incorporated in all the pictures except for the first picture in which the midline and chin were kept symmetric. Orthodontic residents evaluated those photographs on an interrupted visual analogue scale (VAS) with 0 being the least attractive and 10 being the most. Simple linear regression was applied to observe factors associated with VAS score. RESULTS: Highest score was observed for picture with midline and chin on (MLCon) with a score of 9.4 ± 0.7, followed by picture with midline on and chin deviated (MLon) 8.7 ± 0.8. The deviations towards green zone received higher scores in comparison to deviations towards red zone. Linear regression revealed highly statistically significant differences between the constant and the rest of the pictures. CONCLUSIONS: The formation of green and red zones by the FFL influences the perception of midline deviation as judged by orthodontic residents. Midline when deviated towards the green zone, was judged to be more aesthetic than when shifted towards the red zones.

Imperceptible learners: Students' reasons for keeping webcams off and strategies to address students' challenges.

BACKGROUND: "Should students keep their webcams on or off during synchronous online classes?" is an unanswered question with educators' opinions divided on this aspect. Along with educators' perspectives, it is also important to unfold students' perspectives on this question. The objectives of this study were to determine the routine and opinion of students' regarding webcam usage and identification of students' reasons for not using webcams during online learning. MATERIALS AND METHODS: A cross-sectional study was carried out at Margalla Institute of Health Sciences, Rawalpindi, Pakistan. Census was done for data collection by including all dental students (n = 180) enrolled at the institute attending synchronous online preclinical and clinical operative dentistry classes. Data collection was carried out using a self-administrated questionnaire. Descriptive analysis was used to describe survey item responses. Pair-wise differences between demographic categories (female vs. male, and preclinical vs. clinical) were analyzed using the Pearson Chi-Square test. Correlation of routine and opinion with students' reasons were done using Spearman correlation. Ordinal regression analysis was done to associate routine and opinion with reasons. The level of significance (P value) was set at 0.05. RESULTS: Out of 180 students, 141 submitted the survey form, with a response rate of 77.47%. The majority of the students (n = 117, 83%) used to keep their webcams off during online classes and were (n = 69, 48.9%) of the opinion that webcams should be kept off during online classes. The most common reasons for keeping the webcam off during online classes were "comfort" (n = 87, 61.7%) and "distractions" (n = 84, 59.6%). A statistically significant association of gender was obtained, with females more likely than males due to distraction, self-consciousness, and appearance (P = 0.000, 0.003, and 0.016, respectively). The odds of gender highly influenced routine use of cameras, and this was statistically significant (OR: 3.478, P = 0.011). Students tended to keep their webcam off when they were inattentative during online classes (OR; 3.743, P < 0.001). CONCLUSION: The majority of the students did not agree to keep the webcam on during online synchronous learning. The main reasons for students' reluctance to keep the webcam on were self-consciousness, surrounding consciousness, distractions, and technological issues. Students can be encouraged to turn the webcam on by framing strategies according to students' concerns.

WITHDRAWN: Cephalometric predictors of optimal soft tissue profile outcomes in growing Asian skeletal class II subjects treated with twin-block appliance: a retrospective study.

Ahead of Print article withdrawn by publisher.

Association of hard and soft tissue factors with gingival recession in orthodontically treated patients: A retrospective study.

INTRODUCTION: Orthodontic treatment is thought as a contributory factor in the development of recession. The objective of this study was to determine the factors associated with a gingival recession in patients who underwent orthodontic mechano-therapy. MATERIAL AND METHODS: A retrospective chart review of 72 post-orthodontic cases done at the dental clinics of Aga Khan University hospital that were treated from 2009 to 2017. After evaluating dental records patients were recruited based on inclusion and exclusion criteria. Patients were divided into two groups based on the presence or absence of gingival recession on posttreatment photographs. Patients in each group were further assessed on the following factors: (1) Lower incisor inclination (IMPA). (2) Tissue thickness on the facio-lingual dimension. (3) Alveolar bone height. (4) Alveolar bone thickness. RESULTS: The mean age of patients at the start of treatment was 16.56±5.66years. Gingival recession was found in 40.3% of our patients while 59.7% of patients had no recession found after orthodontic treatment. Univariable logistic regression was applied for factors associated with a gingival recession following orthodontic treatment which showed that the odds ratio of gingival recession in thin gingival biotype are 14.4 times more than in thick gingival biotype. Multivariable regression analysis showed that the cases had 10.2 times more recession in thin biotype than those in the thick gingival biotype while adjusting for pre- and posttreatment alveolar heights following orthodontic treatment and with a confidence interval [95% CI=2.69 to 38.40]. CONCLUSIONS: It was concluded from this study that 40% of patients developed gingival recession in one or more teeth during orthodontic treatment. Among different factors pre-treatment, gingival biotype of patients and male gender were the factors that were more associated with the development of gingival recession.

Dental Characteristics Of Patients Suffering From Temporomandibular Disorders.

BACKGROUND: The role of malocclusion in the aetiology of TMDs has been discussed extensively in literature, however, the varied results from different studies have made it difficult to reach a consensus. The objective of this study was to determine the association of dental characteristics and temporomandibular disorders (TMDs). METHODS: This case-control study involved a total of 266 patients who were equally divided into 2 groups (TMD/Non-TMD) based on the score obtained from the Fonseca's questionnaire. Dental characteristics such as class of malocclusion, overjet, overbite, crossbite, and crowding were assessed. The Chi-square test was used to determine an association between each dental characteristic and TMD. Odds ratios were calculated using simple and multiple logistic regression. RESULTS: Significant associations were found between crowding, crossbites, and molar relationships in males. Simple logistic regression showed significant associations for class II malocclusion (OR=0.56, p=0.024) and crowding (OR=0.35, p<0.001) with TMD. Multiple logistic regression showed significant associations for crowding (p<0.001) and class III malocclusion (p=0.002). CONCLUSIONS: Male patients with dental characteristics such as improper molar relationships, crossbites, and crowding should seek orthodontic treatment to prevent the onset of TMDs. Higher odds of TMD were found in patients with Angle's class III malocclusion.

Dental age table for a sample of Pakistani children.

The aim of this study was to evaluate the applicability of Demirjian's dental age assessment table in a sample of Southern Pakistani population and, if not applicable, to formulate a separate dental age table for Pakistani males and females. The study was conducted on the dental pantomographs of a sample size of 882 subjects (427 males and 455 females) ranging in age from 7 to 14 years. A paired t-test was used to assess any difference between chronological age and dental age assessed according to Demirjian's method. Logit function was used to make the relationship between dental maturity and chronological age and linear regression analysis with the equation X = [Ln {y/100 - y} - a]/b was used to generate dental age tables for Pakistani males and females. Dental age assessed according to Demirjian's method for this male sample was over-predicted in the 7 year and 11-15 year age group (P < 0.05). In the female sample, there was an over-prediction in all the age groups (P < 0.05). Statistically significant differences were found in chronological and dental age assessed by Demirjian's method for Pakistani males and females and thus, a new table was generated to convert dental maturity calculated according to Demirjian's method into dental age for the population.

Dental maturity amongst various vertical and sagittal facial patterns.

OBJECTIVE: To compare the mean dental maturity amongst three vertical facial patterns (short, average and long anterior facial heights) and also amongst two sagittal facial patterns (skeletal class I and II) in orthodontic patients. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from August to October 2008. METHODOLOGY: Data was retrospectively retrieved from pretreatment orthodontic records of patients who visited the orthodontic clinic. The sample was divided into three vertical groups, namely short, average and long anterior facial types, and two sagittal groups, namely skeletal class I and II. Dental development was assessed using the Demirjian's system. One way ANOVA and independent sample t-test were used to find any difference in dental maturity amongst vertical and sagittal facial patterns, respectively. RESULTS: There was no statistically significant difference in dental maturity amongst the three vertical facial patterns (p=0.111) and also amongst the two sagittal groups (p=0.975). Statistically significant gender dimorphism (p < 0.001) was seen amongst boys and girls for dental maturity with girls being more advanced than boys in their dental development. CONCLUSION: Dental maturation in the three vertical and the two sagittal groups showed no statistically significant difference in our studied population sample and thus need no variations in treatment initiation timings. However, girls should be treated earlier as they are dentally more advanced than boys.

Correlation among chronologic age, skeletal maturity, and dental age.

AIM: To determine the correlation among chronologic age, skeletal maturity, and dental age in reference to both sexes. METHODS: In 380 subjects (147 males and 233 females) between 7 and 17 years of age, skeletal maturity was assessed using the cervical vertebral maturation stages described by Baccetti et al. Dental age was determined using the Demirjian method. The correlation between skeletal maturity and chronologic age on one side and between skeletal maturity and dental age on the other was assessed with Spearman rank correlation coefficients. Pearson correlation coefficients were used to assess the correlation between chronologic and dental age. RESULTS: For both sexes, significant correlations among chronologic age, skeletal maturity, and dental age were found. The mandibular first premolar had the highest correlation with skeletal maturation in both sexes. CONCLUSION: As skeletal maturity and dental age are significantly correlated, tooth development may be used to assess a patient's skeletal maturity at an early age.