Purpose: To determine if biostimulation using a 810 nm diode laser was capable of affecting the rate of extraction space closure during orthodontic treatment. Materials and methods: Forty dental arches of patients above 17 years of age requiring bilateral first premolar extractions were exposed to a 810 nm diode laser with a power density of 3.97 W/cm² at 3 weeks intervals for total duration of 12 weeks during the space closure phase under direct anchorage using miniscrews. Space closure measurements were taken using digital calipers and the unpaired t-test was used to compare the differences between the experimental and control sides. Results: The rate of orthodontic tooth movement was greater on the experimental side and the difference between the two sides was statistically significant (p < 0.001). Conclusion: Biostimulation carried out using a 810 nm diode laser is capable of increasing the rate of extraction space closure in humans. Hence, it can be concluded that it is capable of increasing the rate of orthodontic tooth movement.

Introduction: The thickness of cortical bone is an important factor in the stability of mini-implants. Knowledge of cortical bone thickness, in various areas, can guide clinicians in selecting the placement site for microimplants and the proper placement protocol. In this study, we investigated the cortical bone thickness of every interdental area on buccal and lingual sides as an aid in planning microimplant placement. Aims and objectives: The study was undertaken to evaluate the cortical bone thickness in 20 maxillae and 20 mandibles in 27 healthy Indian subjects of age ranging 18 to 35 years (mean age: 25.5 ± 5.3 years), using computed tomography (CT) scan images that were already made previously. Materials and methods: Cortical bone thickness was measured interdentally at 2, 4, 6, 8 and 10 mm from the alveolar crest toward the apical region on buccal and lingual sides in maxilla and mandible respectively, using computer software. Results: Cortical bone is thickest between 2nd premolar and 1st molar at 8 mm level from the alveolar crest. It is thickest in mandible on lingual aspect and greater in males than in females. Conclusion: Mini-implants have gained considerable popularity due to their low cost, effectiveness, clinical management and stability. Among the factors related to microimplant stability, bone density and cortical bone thickness appear to be critical for successful placement. This study will provide knowledge of cortical bone thickness in various areas which can guide the clinicians in selecting the placement site.

Background: Bodily alignment of teeth that are blocked out of the arch such as a lingually placed lateral incisor, is often time consuming and difficult. Though several treatment methods are available for accomplishing this, these approaches have some drawbacks. Aim: To describe how Mollenhauer aligning auxiliary (MAA) can be adapted to bodily align lingually blocked-out lateral incisors in preadjusted edgewise appliance therapy and to present its application in three cases. Methods: This auxiliary in the form of rectangular boxes is made with 0.009 inch AJ. Wilcock Supreme Australian archwire, and is placed along with a stiff base archwire after sufficient space has been created for the blocked-out tooth. Conclusion: Mollenhauer aligning auxiliary can be effectively used for the bodily alignment of lingually placed lateral incisors in preadjusted edgewise appliance therapy as an alternative to torquing with rectangular wires.

Introduction: This study was done with the aim to examine the pain experienced by patient after the miniscrew implant placement and the dental anxiety that might influence the pain experience. Materials and methods: A total of 41 subjects (20 males and 21 females) with the age range of 12 to 30 years were recruited for this study, based on the need of skeletal anchorage for their orthodontic treatment. After 1 hour of the placement of the miniscrew implant patients were asked to indicate their level of pain on a 100 mm of visual analog scale (VAS). Dental anxiety was measured before placing the miniscrew implants using dental anxiety scale (DAS) consisting of seven questionnaires modified for orthodontic use. Results: The mean anxiety score DAS for the whole study sample was 16.31 ± 1.70. The mean VAS score for entire study group was 27.62 ± 1.12. Both the mean VAS and DAS score was found to be higher in females than males. There was a significant positive correlation between the dental anxiety and patient perception of pain with miniscrew implant placement as evident by Pearson correlation coefficient (r = 0.688). Conclusion: The study showed a positive linear relationship between dental anxiety and patient pain experience following miniscrew implants placement

Introduction: Orthodontic archwires are designed to move teeth with light continuous forces. Great strides have been accomplished and are continuously evolving to produce the 'perfect' wire through complete knowledge of their metallurgical properties. Advent of shape memory alloys in orthodontics has been phenomenal. This study addresses the need of basic understanding of its micrograin structure. Materials and methods: Nickel-titanium and titanium molybdenum; archwires were selected. Each of the samples was studied using following equipments: Scanning electron microscopy and energy dispersive X-ray spectroscopy. Results: Surface topography of nickel-titanium alloys showed a highly rough surface with pits along with phases of intermetallic compounds of TiNi, Ni₄Ti and Ti₂Ni while titanium molybdenum alloys showed a highly porous surface topography. Precipitates of stabilizing elements were seen at the grain boundaries in both the alloys. Nickel-titanium alloys showed equiatomic concentrations of nickel and titanium with titanium to be slightly more than nickel. High percentage of interstitial elements like carbon, oxygen, etc. were detected; while titanium molybdenum showed maximum percentage of titanium followed by beta stabilizer, molybdenum and low concentrations of interstitial elements. Conclusion: Metallurgists are continuously experimenting with alloying elements to improve titanium alloys with consistent and predictable properties.

Introduction: Dermatoglyphic and cheiloscopic analysis have been useful in understanding basic questions in biology, medicine, genetics, evolution and forensics. They are now beginning to prove themselves as an extremely useful tool for preliminary investigations into conditions with a suspected genetic basis. Materials and methods: Case-control type of study consisting of two groups of thirty parents each of cleft lip with/without palate, CL(P) affected children (Group A) and normal children (Group B). Study aims to determine the presence of any dermatoglyphic asymmetry and correlation between finger prints and lip pattern, among the two groups. Prints of all ten fingers were taken by Ink method and recorded on white paper. Lip patterns were obtained by direct photography of the subjects in natural head position. Results: Chi-square test was done to determine the significance of occurrence of different patterns among the two study groups. Increased dermatoglyphic asymmetry with higher ulnar loop patterns was seen in Group A. Whorl patterns were increased in Group B. An increase in type I (straight grooves) and II (branches) in Group A and type III (intersected lines) in Group B was seen in lip patterns. Conclusion: A highly significant correlation was observed in finger prints and lip patterns in parents with CL(P) affected children and hence can prove to be an extremely useful screening tool for CL(P) and other associated genetic anomalies.

Objective: The purpose of this study was to evaluate the anterior-posterior relationship of the maxillary central incisors to the soft tissue plane in young adults and to see if it could provide a useful guideline to determine the anterior-posterior position of maxillary incisor in patients seeking improved facial harmony. Materials and methods: The study sample consisted of 146 lateral profile photographs of young adults with a good facial harmony (control group) and 135 lateral profile photographs of young adult patients seeking orthodontic treatment (study group). The photographs were taken under standard conditions with the subjects in posed smile and the maxillary incisors clearly visible. The images were resized and the measurements were made using Image Tool version 3. The anterior-posterior position of the maxillary central incisors relative to the soft tissue plane was measured and the data was subjected to statistical analysis. Results: 86.1% of control group had maxillary central incisors located at or in front of the soft tissue plane (STP) and 13.9% had maxillary central incisors positioned behind STP in the control group. This was significantly different from the study group which had 67% located at or in front and 33% behind the STP. Conclusion: Maxillary central incisors were positioned more anteriorly relative to the forehead in males as compared to females. The position of maxillary central incisors in relation to the STP was not significantly different in males and females. The Soft tissue plane is useful landmark in assessing the position of the maxillary central incisors in young adult patients seeking improved facial harmony.

Thalassemia has a spectrum of varied manifestations and complications. Survival is associated with various multisystem complications primarily caused by chronic anemia, iron overload, adverse effects of chelation and transfusion associated infections. Thus, a disease that starts merely as hemolytic anemia attains the dimension of a chronic disease with multisystem involvement. The importance of thalassemia is masked by infections and nutritional deficiencies. Preventive strategies need to be developed, e.g. premarital screening, genetic counseling and antenatal diagnosis. Apart from early diagnosis, there is a need to increase the therapeutic facilities like blood transfusions, chelation therapy and bone marrow transplant. It is really a great challenge and needs an organized plan of action. This article reports the diagnosis and treatment consideration of a thalassemia patient.

Impaction of maxillary permanent incisor is not a frequent case in dental practice, but its treatment is challenging because of its importance to facial esthetics. Various local causes responsible for impaction, such as odontoma, supernumerary teeth and space loss supernumerary teeth are the main cause of impaction of upper incisor. We report a case of 15-year-old girl with bilaterally impacted supernumeraries in the premaxilla region associated with asymptomatic impacted developing supernumerary premolars in the mandibular arch. The supernumeraries of premaxilla region impeded the eruption of the permanent maxillary central incisors. The impacted supernumerary tooth was surgically removed and brackets bonded to the central incisors to apply orthodontic extrusive force which brought the central incisors down to their proper position in the dental arch.

Management of protruded premaxillary segment in bilateral cleft lip and palate cases is a challenge to clinicians, due to various factors, like collapsed lateral alveolar segments and disrupted muscular ring. It is in practice that, the protruding premaxilla is pinned to vomer using a K-wire. The wire is generally removed after 6 to 8 weeks. A 16-year-old female patient with bilateral cleft lip and palate reported for orthodontic treatment. Upon routine investigations, presence of a K-wire that was fixed when patient was around 6 months old, and now had migrated intracranially was made. As K-wire is notorious for its migration to distant places and, that any further impending migration, may in future present a serious problem, the wire was removed after necessary precautions. This case report should be an eye opener and post a caution to general, medical, surgical practitioners and orthodontists.

Tandem traction bow appliance (TTBA) promotes patient compliance, because it is more esthetic and comfortable than extraoral appliances. TTBA should be used only in case where maxillary deficiency and normal mandible is present. Advantages of it includes good oral hygiene, early treatment of any Class III malocclusion, optimal retention, distribution of the forces for protraction to all maxillary teeth, free mandibular movement. It can be used in conjunction with fixed appliances if necessary. This paper includes two case reports. The treatment results in both the cases demonstrated significant skeletal and dental response to TTBA therapy. Skeletal change was primarily a result of anterior movement of the maxilla.

Introduction: Obstructive sleep apnea (OSA) is part of the spectrum of sleep disordered breathing with severe social and life-threatening consequences. Case report: Female patient was diagnosed in orthodontic clinic with moderate OSA and confirmed by overnight polysomnography with apnea hypopnea index (AHI) of 77 per hour. A cost-effective oral appliance— mandibular advancement device (MAD) was custom fabricated as she was noncompliant to continuous positive airway pressure (CPAP). Results: AHI reduced from 77 to 27 with cessation of snoring and daytime sleepiness with improved quality of life with MAD. Conclusion: This case report highlights the role of oral appliances in the management of mild to moderate noncompliant OSA cases. CPAP continues to be the gold standard for conservative management of OSA though patient compliance still remains uncertain.

Successful treatment outcome go hand in hand with the appropriate use of elastics. Many patients find difficult to engage to and remove the elastics from the intraoral attachments/hooks. This task is often frustrating and in turn lead to poor compliance and inefficient settling. The present article describes a simple immediate approach for the fabrication of a user-friendly elastic placer.

The recording of natural head position lateral skull radiography has received much attention for many years and different methods have been presented for clinical purposes, most common being the use of fluid level device, it was decided to modify the way it is attached to make the use simpler.