Photographic Evaluation, Analysis and Comparison of Aesthetically Pleasing Smiles: A Prospective Study

Objective:To evaluate the differences in aesthetically pleasing smiles and compare the smile arc parameters in males and females by dental specialists using photographs.Methods:The study was conducted on 500 North Indian subjects (Indo-Aryan race; 212 males and 288 females) aged 17-25 years (mean age, males=21.1 years; females=23.4 years), with reasonably pleasing smiles. The facial photographs were taken using a DSLR camera. The standardized photographs were shown to 30 judges for evaluation and rated using the visual analog scale. The smiles were categorized into attractive, fair, and average. The quantification of the smile characteristics was done by using an objective method that involved identifying consonant and non-consonant smiles.Results:The association between smile arc and smile attractiveness was significant (p=0.018) in females. The buccal corridor width was higher among those with fair to attractive smiles as compared with those with an average smile (p=0.018). Most subjects with an attractive smile had a smile arc parallel to the upper lip as compared with most subjects with a fair or average smile who did not have the smile arc in parallel (p=0.006).Conclusion:Most females were in the fair to attractive category whereas most males were in the average to fair category. The buccal corridor width was found to be higher among those with a fair to attractive smile as compared with those with an average smile. There was an association between smile arc and smile attractiveness in females

Behaviour management during dental treatment!!!

Behavioral dentistry is an interdisciplinary science, which needs to be learned, practiced and reinforced in the context of clinical care and within the community oral health care system. The objective of this science is to develop in a dental practitioner an understanding of the interpersonal, intrapersonal, social forces that influence the patients’ behavior. The clinician must acquire knowledge to develop appropriate behavioral skills with an improved quality of communication and management of patients. Behavior dentistry also teaches to develop a recognition and understanding that the body and mind are not separate entities and focuses on patients’ social, emotional and physiological dental experiences. Behavior is an observable act. It is defined as any change observed in the functioning of an organism. Learning as related to behavior is a process in which experience or practice results in relatively permanent changes in an individual’s behavior. Self-perceptions of dental-facial appearance begin with aesthetic values shared within families and based generally on social norms, but that they may be strongly influenced by peer values and specific experiences of individual children, particularly those involving social responses. Theories incorporating concepts of social comparison and self-efficacy suggest that individuals evaluate themselves in comparison with others in their social environment. Children who perceive themselves to be attractive will reflect those perceptions in their behaviors and generally will receive confirming social responses. The comparison group may express an attractiveness norm that reflects negatively on the individual’s behavior. This, in turn, can affect the individual perceived sense of self-efficacy or adequacy within that group and lead to behaviors that reflect more negative beliefs about the self, thereby inviting still more negative social responses. Patient cooperation is the single most important factor every dentist must contend with. Major considerations are • Regularity in keeping appointments • Compliance in wearing removable appliances • Refraining from chewing hard and tenacious substances that are likely to distort or damage the teeth or crowns • Maintenance of oral hygiene. Laxity in following these instructions may lead not only to compromised treatment but also to slow progress of treatment, loss of chair time and frustration. What may be more interesting to the Dentist than the shaping of self-perceptions in the shaping of behavior that will ensure a successful result of treatment, that is, the patient’s adherence to prescribed routines for self-care and other regimens during Dental treatment. It is helpful in this regard to know that most patients expect improved dental-facial appearance as an outcome of treatment, but there is much more to know about factors influencing cooperation. Poor motivation can also contribute to non-compliance. The regulatory loop requires a motivational system to adjust behavior to coincide with the recommended regimen. A patient may recognize that the regimen is not being followed and yet simply not be motivated to correct the discrepancy. Poor motivation can also result from a lack of concern over the long-term health consequences of one’s behavior and/or a lack of belief in the treatment. Cognitive approaches that emphasize the personal relevance of the regimen or address misconceptions about the treatment may enhance motivation. Several approaches may be useful in treating poor compliance. Providing incentives or rewards for compliant behavior might be a useful strategy to enhance motivation. The cause of noncompliance is multifactorial and strategies to improve compliance must be tailored to fit each situation. Current Dental research focuses on a critical aspect of the feedback; specifically, the input received by the comparator that quantifies the actual amount of adherent behavior. Likewise, Patients, parents, and clinicians need a way to ascertain this information

How Condylar modifications occurs

Functional appliances used in correction of class II malocclusions are shown to modify the neuromuscular environment of dentition & associated bones. There are many studies related to the skeletal, dental and neuromuscular changes which are evaluated cephalometrically, clinically as well as with the recent diagnostic aids like MRI. The aim of this short communication was to highlight and discuss the different aspects of condylar modifications and its role in its growth. The Twin Block has higher effectiveness & comfort as compared to other removable functional appliances [1.2]. The action of Twin Block & Bionator is for 24 hours so effects are more with these appliances. Over the years, several theories have emerged attempting to shed light on condylar growth. One of the earliest theories, the genetic theory, suggests the condyle is under strong genetic control like an epiphysis that causes the entire mandible to grow downward and forward. Although this may be related more to development of the prenatal than postnatal condyle, the theory does indirectly question the effectiveness of orthopedic appliances in condylar growth as proposed by Brodie [3,4]. Several long-term investigations actually showed clinically insignificant condylar growth modification after continuous mandibular advancement with a reasonable retention period in human beings although the initial treatment results appeared encouraging. This leads to the conclusion that the general growth of the condyle appears relatively unalterable in long-term studies. A second hypothesis based on the earliest available acute and blind EMG monitoring technique, suggests that hyperactivity of the lateral pterygoid muscles (LPM) promotes condylar growth. Rees reported that other muscles and tendons, including those of the deep masseter and temporalis, also attach to the articular disk region. Attachments of the LPM to the condylar head or articular disk may be expected to cause condylar growth, but anatomic research has not found evidence that significant attachments actually exist [5,6]. The LPM tendon is observed attaching, however, to the anterior border of the fibrous capsule that in turn attaches to the fibrocartilage of the condylar head and neck anteriorly. At the same time, it is doubtful that initial hyperactivity could occur where the LPM muscle has been shortened by continuous mandibular displacement therapy. By using LPM myectomy in rats, which may have disrupted condylar blood supply, Whetten and Johnston found little evidence that LPM traction had any pronounced effect on condylar growth. More recently, permanently implanted longitudinal muscle monitoring techniques have found that the condylar growth is actually related to decrease postural and functional LPM activity. This notion was also supported in human studies by Auf der Maur, Pancherz and Anehus- Pancherz, and Ingervall and Bitsanis that reported decreased muscle activity. The LPM hyperactivity theory brought forward by Charlier et al. Petrovic, and later espoused by McNamara however, was important in prompting further investigations in muscle-bone interactions [7,8]. A third hypothesis, the functional matrix theory, postulates the principal control of bone growth is not the bone itself, but rather the growth of soft tissues directly associated with it. Although this was supported in part by investigations testing the different growth and developmental responses between the condyle and epiphysis, there has been no explanation as to exactly how condylar growth would be stimulated. Thus, this theory’s validity has been questioned. One of the reasons was that there was little explanation of the specific mechanism by which the condyle was stimulated to grow. Endow and Hans presented an excellent overall perspective suggesting that mandibular growth is a composite of regional forces and functional agents of growth control that interact in response to specific extra-condylar activating signals [9,10]

Fabrication of Lingual Retainer made easy

Direct bonding of a lingual retainer is challenging because it requires a long working time on the lingual aspect of the anterior teeth. Due to no direct vision there is a risk of contamination from saliva and moisture, which can cause bond failure; and it is difficult to apply the adhesive exactly where it is needed. The indirect method described in this article shows an easy way to increase better-quality bonding of the retaine

Impact of the COVID 19 Infodemic on Knowledge, Attitude and Social Behavior in India:A Mixed Method Survey

India, which has a growing base of 350 million social media users and large proportion of which are unaware about fact checking of the sources. This study aims to assess the impact of COVID-19 misconceptions on knowledge, attitude and preventive (KAP) practices in India using an online cross sectional survey and using semi-structured interviews. sThe 5 sections of the e-form collected the demographic profile, COVID-19 information profile, knowledge, preventive practices and attitude toward COVID-19. Also, this study aims to assess the impact of misinformation on individual and social behavior through 24 semi structured open ended interview questions and suggests mitigation measures. The misinformation question included “Coronavirus is airborne disease,” Frequent washing clothes can reduce spreading of COVID-19”, “Consuming herbal products, home cures and supplements can prevent COVID-19” and “Gargling with salt water or vinegar can prevent COVID-19.” Among the 520 responses, 44%, 51%, 44% and 32% agreed to these questions respectively. Binomial regression model was fitted to identify the predictors of KAP of COVID-19 prevention by taking the level of KAP separately and it revealed that the predictors for poor knowledge, negative attitude and noncompliance to preventive measures were associated with the misconceptions. The descriptive analysis in Tableau revealed that the trusted sources of information is majorly mass media. The content analysis of the interviews revealed that religious preventive methods, consumption of daily supplements, risk factors of the infection, disease statistics; treatments and conspiracy theory, are the subjective categories of the current outbreak. The consequences of misconceptions include stigma of discrimination, psychological distress and increased hygiene practices. The antidote to infodemics should include analyzing the information propagation and understanding the cognition and behavior of the population. In the era of the internet, health bodies can educate and address the people’s concern with the help of digital and e- health literacy.</p

Journal of Oral Health and Craniofacial Science

ABSTRACT Aim: To evaluate sexual dimorphism in horizontal lip position in adults with different skeletal patterns. Material and Methods: The sample comprised of 120 patients (Females 18 years and above, Males 21 years and above) with no history of previous orthodontic treatment or functional jaw orthopaedic treatment. They were divided into different groups based on the ANB angle and gender. Group I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0-4 degree). Group III and IV included 30 males and 30 females with skeletal class II malocclusion respectively (ANB above 4 degree). Results: When comparison between males and females (Class I+Class II) was done S-line (p&lt;0.001), B-line (p&lt;0.001), E-line (p&lt;0.001), Holdaways angle (p&lt;0.001) and Merrifi eld angle (p&lt;0.001) were found to be statistically signifi cant. S-line (p&lt;0.001), E-line (p&lt;0.001) and Holdaways angle (p&lt;0.001) were found to be statistically signifi cant when comparison was done between males and females (Class I). When comparison was done between males and females (Class II) only Holdaways angle (p&lt;0.001) showed a signifi cant statistical difference. Conclusion: Sexual dimorphism was found in various lip parameters. Signifi cant amount of differences were found between Class I and Class II (male and female) subjects

Evaluation of nasal proportions in adults with class I and class II skeletal patterns: A cephalometric study

Aim: The aim of this study was to evaluate sexual dimorphism in nasal proportions of Class I and Class II skeletal malocclusions in adults. Materials And Methods: The sample comprised 120 patients (females 18 years and above and males 21 years and above), with no history of previous orthodontic treatment or functional jaw orthopedic treatment. They were divided into different groups based on point A-Nasion-point B (ANB) angle and gender. Groups I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0–4 degrees). Groups III and IV included 30 males and 30 females with skeletal class II malocclusion, respectively (ANB above 4 degrees). Results: In regards to the comparison between males and females (Class I + Class II), nasal length (P < 0.001), nasal depth 1 (P < 0.001), nasal depth 2 (P < 0.001), nasobasal angle (P < 0.001), soft tissue convexity angle (P < 0.001), and nasal bone length (P < 0.008) were found to be statistically significant. Nasobasal angle was found to be significantly higher in females than in males (Class I) (P < 0.001). Nasolabial angle was prominent in class I males than in class I females (P < 0.001). Soft tissue convexity angle of Class I participants was significantly lower than that of Class II participants (P < 0.001), whereas nasobasal angle and nasomental angle of Class I participants were found to be significantly higher than that of Class II participants (P < 0.001). Conclusion: Sexual dimorphism was found in various nasal parameters. Significant amount of differences was found in the nasal proportions of Class I and Class II (male and female) participants

Evaluation of Horizontal Lip Position in Adults with Different Skeletal Patterns: A Cephalometric Study

Aim: To evaluate sexual dimorphism in horizontal lip position in adults with different skeletal patterns. Material and Methods: The sample comprised of 120 patients (Females 18 years and above, Males 21 years and above) with no history of previous orthodontic treatment or functional jaw orthopaedic treatment. They were divided into different groups based on the ANB angle and gender. Group I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0-4 degree). Group III and IV included 30 males and 30 females with skeletal class II malocclusion respectively (ANB above 4 degree). Results: When comparison between males and females (Class I+Class II) was done S-line (p&lt;0.001), B-line (p&lt;0.001), E-line (p&lt;0.001), Holdaways angle (p&lt;0.001) and Merrifield angle (p&lt;0.001) were found to be statistically significant. S-line (p&lt;0.001), E-line (p&lt;0.001) and Holdaways angle (p&lt;0.001) were found to be statistically significant when comparison was done between males and females (Class I). When comparison was done between males and females (Class II) only Holdaways angle (p&lt;0.001) showed a significant statistical difference. Conclusion: Sexual dimorphism was found in various lip parameters. Significant amount of differences were found between Class I and Class II (male and female) subjects

A comparative surface evaluation of orthodontic mini-implants before and after en masse retraction—A SEM study

OBJECTIVE: To evaluate the changes in surface morphology of two different types of mini-implants after clinical en masse retraction using scanning electron microscopy. MATERIAL AND METHODS: Fifty mini-implants of Dentos (Korea, Absoanchor, BH-1817-08) and Orlus (Korea, Yesanchor, C-1817) were inserted in patients in a split-mouth design who required en masse anterior retraction and absolute anchorage. Surface characteristics of mini-implants such as pitch (distance between consecutive threads), flank width (distance between root and crest), and taper were studied using scanning electron microscope (FEI nanosem450) before and after clinical use. RESULTS: Statistically significant difference (p value = 0.003) was found in a mean reduction of pitch dimension among the two groups with a mean difference of 25.000 μm. Also, a statistically significant difference was noted (p value = 0.001) in a mean reduction of flank width among Dentos implants as compared to Orlus implants. A statistically significant difference (p = 0.001) was seen in the mean reduction of taper dimension among Dentos group (0.0140 ± 0.02271) as compared to the Orlus group (0.0810 ± 0.05152). CONCLUSION: A marked reduction in surface morphology such as the pitch, flank width, and taper of both mini-implants after retrieval was observed. Dentos group of mini-implants displayed better dimensional stability post-retrieval as compared to the Orlus group of mini-implants. All the mini-screws showed milling defects in form of scratches on observation under scanning electron microscopy despite a smooth appearance to the naked eye

Assessment of Oral Hygiene awareness in Geriatric patients attending OPD at ESIC Dental College, Rohini, New Delhi

Aim: To assess and learn oral health awareness and hygiene practices among geriatric patients and also to identify important barriers in the establishment of oral health services, disease prevention and oral health promotion programmes for the same. Materials and Methods: A total of 500 patients in the age group of 50 years and above were selected using random sampling technique. A self‑administered structured questionnaire including 20 multiple choice questions was given to them. The results were analyzed using percentage. Results: The result of this study shows an acute lack of oral hygiene awareness and limited knowledge of oral hygiene practices. In Rohini, few people use tooth brush. Conclusions: Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about correct oral hygiene practices