Comparison of Dentoskeletal Changes, Esthetic, and Functional Efficacy of Conventional and Novel Esthetic Twin Block Appliances among Class II Growing Patients: A Pilot Study

Objective:A twin block appliance used for correction of skeletal Class II malocclusion suffers from undesirable dental effects and bulkiness. To overcome these limitations and the need for more esthetic appearance of this appliance, an esthetic twin block was designed and used in patients. This study aimed to compare dentoskeletal changes and esthetic and functional efficacy in patients treated with conventional and newly designed esthetic twin block (CTB and ETB) appliances using cephalometric measurements and a questionnaire.Methods:A pilot study with a 2-arm parallel-randomized double-blind clinical trial was conducted on 24 patients (20 males, 4 females) in the age group of 11-13 years. Subjects were treated with CTB (group 1 [G1]: n=12; mean age=11.67±0.49 years) and ETB (group 2 [G2]: n=12; mean age=11.75±0.62 years) appliances. A modified Pancherz analysis was performed to evaluate skeletal and dental changes. The esthetic and functional efficacy was evaluated by a questionnaire using Likert scale. Wilcoxon and Mann-Whitney U tests were employed for intra and intergroup comparisons respectively (p<0.05).Results:In G1, a significant increase in lower incisor inclination was observed (p<0.05) whereas it was insignificant in G2. The changes were predominantly skeletal in G2 whereas they were both skeletal and dental in G1. ETB was found to be esthetically and functionally acceptable in all the patients while CTB patients were esthetically conscious, lacked confidence and had discomfort and difficulty in eating, chewing and speaking.Conclusion:ETB had greater skeletal effects with a reduced tendency of lower incisor proclination, was esthetically acceptable, and functionally more comfortable than the CTB

Successful nonsurgical management of a large radicular cyst: A case report with review of literature

Radicular cyst is the most common of all jaw cysts comprising about 52-68% of the cysts affecting the human jaw. It is known to originate as a result of bacterial infection and necrosis of the dental pulp, which causes the proliferation of epithelial cells in a preexisting granuloma. Although a common entity, there still exists a dilemma regarding the management of this pathology. Some author reported that surgical intervention is necessary, whereas others recommends non-surgical management. This article is about successful management of a large radicular cyst following non-surgical endodontic treatment

LIFESTYLE FACTORS: AN ALARM TOWARDS HYPERTENSION

Cardiovascular disease is the number one cause of death worldwide in which hypertension is responsible for an annual death of 7.1 million. There exist a causal relationship between low levels of occupational and/or leisure-time Physical Activity and an increased risk of cardiovascular disease. An additional possible reasons may be reduced sleep duration/quality and individuals knowledge of their disease and its treatment. Objective: This study was conducted to assess the prevalence of hypertension and risk factors associated, concentrating on literacy status, physical exercise, occupation and sleep pattern in rural population. Method: It was a questionnaire based study carried out in two phases with Blood Pressure measurement. Result: The study results showed low literacy rate and maximum prevalence of hypertension in farmers and house wives, with a lifestyle devoid of routine physical exercises and with advancing age. Conclusion: The study concluded with the positive relationship between risk factors. Keywords: Hypertension, Physical Exercise, Literacy, Occupation, Risk Factors

Molar distalization with 2K appliance: one-year follow-up

Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angle's Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space

New generation of color bonding: A comparative in vitro study

Background: Newer available composite resin adhesives have chromatic agents that change their color during setting from pink to colorless. It has an advantage of easy flash removal thus reducing the amount of plaque accumulation and helping patients to maintain better hygiene. Aim: The aim of the present study was to compare shear bond strengths of light-cure orthodontic bonding agents, namely glass ionomer (FujiOrthoLC, GC Orthodontics), conventional composite resin (Transbond XT, 3M Unitek), and color-changing composite resin (Transbond Plus, 3M Unitek) with conventional etch and self-etch primer (Transbond PlusSEP, 3M Unitek). Materials and Methods: Maxillary premolars (n=300) were bonded on the facial surface in five groups. The INSTRON machine was used for shear bond strength testing. Statistical Analysis: Comparison of the mean rank among the groups was done by Kruskal-Wallis one-way analysis of variance (ANOVA). To determine the mean difference among groups, the Mann-Whitney test with Bon Ferroni adjustment was applied. Observations: It was observed that light-cure conventional composite resin with the conventional etchant group had the highest and glass ionomer resin adhesive had the lowest shear bond strength. There was no statistically significant difference between conventional composite used with conventional etchant and color-changing composite resin used with conventional etchant or with self-etch primer. Conclusion: Considering the advantages of a color-changing composite and self-etch primer especially in patients having high DMFT scores or physically and mentally compromised patients unable to maintain their hygiene properly, it was concluded in the present study that it would be the most suitable material for direct bonding

A comparative evaluation of skeletal, dental, and soft tissue changes with skeletal anchored and conventional facemask protraction therapy

Objective: To cephalometrically evaluate and compare the skeletal, dentoalveolar, and soft tissue changes after maxillary protraction with skeletally anchored and conventional facemask. Methods: The data for the study were collected from the pre- and post-treatment records of patients of maxillary retrusion treated with skeletally anchored and conventional facemask therapy. Twenty subjects were included in the study and were categorized into two groups, namely skeletal anchored maxillary protraction (SAMP) group with the mean age of 10.10 ± 1.1 years and conventional facemask maxillary protraction (CFMP) group with the mean age of 9.90 ± 1.1 years. Pre and post-treatment lateral cephalograms were assessed. Results: The data were analyzed by Mann-Whitney test and Wilcoxon signed-rank test. The mean duration of treatment in SAMP group and CFMP group was 5.8 months and 10 months, respectively. The mean forward displacement of the maxilla (vertical point A) was 3.40 ± 1.07 mm in SAMP group and 2.80 ± 0.79 mm in CFMP group. The mandible showed downward and backward rotation in both the groups with more rotation in CFMP group. A significant increase in maxillary incisor inclination was seen in CFMP group as compared to SAMP group. A significant decrease was found in mandibular incisor inclination in both the treatment groups. The soft tissue changes corresponded to underlying skeletal tissue. C onclusions: SAMP is proven to be a better treatment modality as compared to CFMP for achieving true skeletal changes and minimal dental changes in cases with developing skeletal Class III with maxillary retrusion

Separation and pain perception of Elastomeric, Kesling and Kansal separators

Abstract Introduction: Various types of separators have been advocated, but the ideal separator should produce optimum separation with minimal pain and discomfort. Objective: The objective of this study was to evaluate and compare the amount of separation achieved by three different types of separators (Elastomeric, Kesling and Kansal), and to assess the associated pain and discomfort. Methods: A random single-blind split-mouth study was conducted on 108 patients seeking fixed orthodontic treatment, in which two different separators were used on each side in both the arches for a single patient. After five days, the amount of separation was measured with a feeler gauge. Visual Analogue Scale (VAS) scoring was performed by the patient on each day, to evaluate pain perception. Discomfort was evaluated by questionnaire filled by the patient at the time of separator removal. Results: The greatest amount of separation was seen with the elastomeric separators, while the smallest separation was seen with Kansal separators. VAS scoring showed maximum pain at day 1 with all the three separator types. Highest pain was perceived in the Elastomeric separators group, followed by Kesling and Kansal separators, respectively. Statistically significant difference was found in VAS score of Elastomeric separators, when compared to both Kesling and Kansal, on day 1 and 2 (p= 0.001). Analysis of the questionnaires revealed that a greater number of patients experienced discomfort with elastomeric separators placement (69.4%), which was statistically significant (p< 0.01) when compared to the other two types of separators. Answers to the other questions were comparable, except for the need for medications, which was reportedly highest with elastomeric separators. Conclusion: Kesling separators produce adequate separation with minimal discomfort and pain, compared to Elastomeric and Kansal separators

Osteocalcin and serum insulin-like growth factor-1 as biochemical skeletal maturity indicators

Abstract Background With change in concepts of growth determination methods, there is a surge in the measurement of biomarkers for appraisal of growth status. Osteocalcin is a bone-specific protein and was observed to parallel the normal growth curve. Hence, the present study was intended to assess the levels of serum osteocalcin and serum insulin-like growth factor-1 (IGF-1) and compare them with cervical vertebral maturation index (CVMI) stages. Methods The cross-sectional study was performed on 150 subjects (75 males and 75 females) in the age group of 8–20 years and segregated into six CVMI stages. Serum osteocalcin and IGF-1 were estimated by ELISA. Mann-Whitney U test was used to compare the mean ranks of serum osteocalcin and serum IGF-1 with different CVMI stages. Spearman correlation was performed to find association between serum osteocalcin and serum IGF-1 across six CVMI stages. Results Peak serum IGF-1 levels were obtained at CVMI stages 4 and 3 for males and females, respectively, with insignificant difference between stages 3 and 4 in females. Peak serum osteocalcin levels were found at stage 5 and 3 for males and females with insignificant difference from other stages except stages 5 and 6 in males. A statistically significant correlation was seen between serum IGF-1 and serum osteocalcin across six CVMI stages (P < 0.01). Conclusions Osteocalcin followed IGF-1 across all CVMI stages but showed insignificant interstage differences