Abrar Younus A

The goal of orthodontic treatment in a severely crowded malocclusion is to obtain a harmonious face with a well-balanced soft tissue profile, functional occlusion and a consonant smile. Etiology involving both genetic and non-genetic factors are associated with severe crowding. This case report is on correction of class I severely crowded malocclusion in a vertical grower treated with extraction of all first premolars. Intra oral, extra oral and radiographic examination revealed skeletal Class I with straight profile, hyper divergent growth pattern, increased overjet and severe crowding in maxillary and mandibular dentition, constricted arches, potentially competent lips with increased lip strain and a non-consonant smile arc, treated with extraction of all 1st premolars, significant improvement in patient's smile, profile and occlusion were obtained. The successful results were obtained due to correct case selection and proper treatment planning. The meticulous space analysis and management without anchorage loss is a result of proper anchorage planning prior to extractions. Keywords: Severe crowding, Constricted arches.

COVID 19 was originated from Wuhan city of Hubei Province in China in December 2019. It is a viral disease spread due to severe acute respiratory Syndrome Coronavirus virus. The virus has been spread extensively worldwide leading to a worldwide emergency. The strain of the virus is new and not been studied earlier. However the transmission of the virus is quick and immoderate. Efforts to contain the spread  of the disease have led to major disruptions forcing regional and in many cases national emergencies and lockdown, leaving only essential services to continue. Human transmission is predominantly through the respiratory track via droplets, respiratory secretions and or direct contact where the virus enters the mucous membrane of the mouth, nose and eyes. Although contact with symptomatic patients is the typical route of transmission, asymptomatic individuals or those within the viral incubation period may also be able to transmit COVID 2019. In many such efforts performing elective tasks including orthodontic treatment are required to be suspended on orders of the central, state and civic and public health regulatory bodies. Due to unpresented nature of this pandemic and the unknown length of time that mandatory suspension of elective treatment may be in effect in different regions, consolidated information and guidelines for the clinical orthodontic management of patients during the COVID-19 pandemic are lacking.  Keywords: COVID19, SARSCoV2, Pandemic, Emergency protocol, Orthodontics, Dentistry, Patient management.

Recent years, artificial intelligence technology has been a revolutionary tool in health care system, an increase in application of the technology noted significantly in Orthodontics as well. AI is an outstanding tool to help orthodontists as it can be utilized from the beginning to diagnose till the planning of the treatment. Along with speeding up the diagnosis and treatment processes, automation can cut labour expenses to zero.A well-trained AI model, which simulates human intelligence through machines, can aid in all kinds of linear, angular, and volumetric measurements in addition to helping identify landmarks, greatly reducing measurement time so that researchers can focus their efforts on discovering novel clinical insights. In this review article, artificial intelligence in orthodontics is discussed in relation to its use to clinical decision-making, diagnosis and treatment planning, estimation of growth and development, evaluating the facial proportion, prediction of cephalometric land mark and force system and also in analysing the soft tissue treatment outcomes.   Keywords: Artificial intelligence, Orthodontics

There has been significant growth and advancement since, the last few decades in the use of platelet and its derivatives in dentistry predominantly in oral surgery and periodontology. Very little is known about the same in orthodontics. There is emerging literature on the use of platelets and its derivatives in orthodontics. Platelets being the reservoir of cytokines and growth factors plays a crucial role in various regenerative processes. This review attempts to summarise the literature concerning to the application and role of platelet derived concentrates in orthodontics. The most commonly used platelet derived concentrates being the platelet-rich plasma (PRP) and Platelet-rich fibrin (PRF), their advancement and various roles and future opportunities of research have been described in this article.   Keywords: Platelet-rich plasma, Orthodontics

Background: In orthodontic therapy elastics and elastomeric chains are commonly used as an active component. These synthetic elastic materials are not supposed to be ideal, as they are sensitive to prolonged exposure to saliva, water, enzymes, temperature variations and external factors. The main disadvantage of elastomeric auxiliaries is their inability to sustain the delivered force for an extended period of time. Objective: The objective of this review is to determine the time taken by the elastomeric chains force to degrade after stretching and to assess oral environment and external factors affect the decay force of elastomeric chains. Data Source: Databases such as PubMed, Medline, and the Cochrane Library are searched electronically. Additional sources (Google Scholar, clinicaltrails.gov) were manually searched for additional trials or protocols until December 2021 Eligibility Criteria: Studies involving in vitro and in vivo exposure of elastomeric chains in various factors like, temperature, saliva, beverages, food, paste, mouthwash, etc were included. Result: 18 studies included primarily focused on the force decay in E-chains and also the associated external factors. The force decay of the Elastomeric chains was affected by time, temperature and environment. Conclusion: The force decay of the elastomeric chains was affected by time, temperature, and environment. The greatest effect on the elastomeric chain is shown by temperature. Force loss increased with increasing temperature, as expected of a viscoelastic material.    Keywords: Elastomeric Chains in orthodontics, Force decay of Elastomeric Chain, E-chain in orthodontics, Decay rate of E-chain

Background: Our purpose in this systematic review is to compare the lingual Vs labial orthodontic and overview the mental and physical outcomes in young boys and girls. Methodology: From 2012 to 2022, we conducted a literature search of publications that had been published in PubMed Medline, the Cochrane Library, and additional sources (Google Scholar, clinicaltrails.gov). We screened the main electronic databases. Due to the nature of the review, all sorts of studies were considered, including descriptive studies, surveys, reviews, commentaries, and editorials. In the current investigation, the recommended methodology was used to assess the risk of bias. Six distinct domains were addressed using the two-part technique. Result: The present systematic review yielded 1500 articles on initial search; first 715 duplicate publications were removed. After screening additional 590 articles were excluded and 124 full articles were assessed for the study. 14 studies concentrating upon the current status of the orthodontic study. 14 studies concentrating upon the current status of orthodontic Curriculum comparison of lingual and labial orthodontic patients were included in this systematic review. Conclusion: From the result, we can conclude that the lingual appliance group scored much higher than the buccal appliance group. During the first 2-4 weeks after lingual brackets were inserted, the majority of lingual patients saw gradual improvements in their oral impairment.   Keywords: Lingual vs labial, Orthodontic appliances, Systematic review.

Background: To assess and compare the accuracy of the second-generation TPS probe with the first-generation manual (Williams) probe for assessing pocket probing depth (PD). Materials and Methods: In this comparative investigation, 90 subjects were used. We categorized the teeth and groups of teeth. Patients were split into three groups—periodontally healthy, gingivitis-free, and periodontitis—based on pocket depth and gingival index. Two probes were used on Ramfjord teeth to measure the depth of the pockets. Result: Ramfjord teeth group wise, the manual probe's measured pocket depth was more than that of the TPS probe. Conclusion: In all groups, mean PD readings were deeper with the manual probe than with the TPS probe, with the periodontitis group showing the greatest difference, followed by gingivitis and the periodontally healthy groups.   Keywords: Probe, Gingival.

Aim: To compare the efficacy of active oxygen - containing mouthwash (BlueM) with chlorhexidine mouthwash (Hexidine) and its effect on plaque, calculus, and gingival inflammation. Materials and Methods: A double blind parallel study was done on 20 systemically healthy patients with the presence of generalized chronic gingivitis in the age group of 20-45 years. Each subject will rinse their mouth with the mouthrinse assigned to them, or twice daily for one minute in the morning and before going to bed. They will be instructed to swish it properly around the mouth and avoid its ingestion. Descriptive statistics was performed by calculating mean and standard deviation for the continuous variables. Intergroup and intragroup comparison between chlorhexidine and Blue M at baseline (To) and at the end of 3 weeks (T1) showing no statistical differences between the two groups. Conclusion: Blue M can be used as a safe alternative to chlorhexidine in reducing the microbial load. But when compared to each other there wasn't a significant change between them. Chlorhexidine has the edge in being very cheaper compared to Blue M. Further studies are required with conclusive evidence to be able to determine whether oxygen-enriched mouthwashes can replace chlorhexidine in the future.   Keywords: Mouthwashes, Chlorhexidine, Gingival irritation, Plaque, Calculus, BlueM.

In orthodontics, the most prevalent sagittal problem is Class II malocclusion, which affects one-third of the population. During active growth, myofunctional appliances are usually used to address sagittal discrepancies associated with the retruded mandible. Due to non-compliance with traditional myofunctional appliances, fixed functional appliances have been developed.Powerscope appliance is used to successfully manage the growing skeletal class II malocclusion for the correction of skeletal and dental parameters. The patient's profile dramatically showed improvement with the reduction in ANB angle by 4 degrees.   Keywords: Sagittal discrepancy, Myofunctional appliance, Powerscope.

Dermatoglyphics is a study of the unique pattern in the skin of fingers, palms, soles, and toes. These dermatoglyphics has played an important role in various fields like forensic medicine, genetics, and anthropology.Sir Francis Galton stated that an individual’s dermal pattern remained constant throughout their lifetime. Many studies have suggested the possible relation between dermatoglyphics and occlusion.Studies have suggested that dermatoglyphics could be used as a tool to identify the underlying skeletal malocclusion. As the dermal pattern and oral structures develop together, the genetic information in the dermal pattern could be used to assess the different types of skeletal malocclusions. Hence, the study was aimed to compare and evaluate the correlation between dermatoglyphics and class II skeletal malocclusion in horizontal and vertical growth patterns. The total of 50 samples were taken and divided into horizontal and vertical growth pattern consisting of 25 samples each. The dermatoglyphic pattern between the right and left hand and the pattern such as arches, loops, and whorls were evaluated. The data was analyzed by Kolmogorov – Smirnov and Shapiro Wilk test. There was a statistically significant association between class 2 malocclusion and the dermatoglyphic pattern.   Keywords: Class II skeletal malocclusion, Dermatoglyphics

Background: Fixed orthodontic treatment has a lot of benefits for the patients, but it is not without any potential risks. The most common side effect of orthodontic treatment with fixed appliances is in the form of incipient caries lesions around brackets and which is mainly due to limitation on self-cleansing mechanism. Objectives: To evaluate the effect of Er, Cr: YSGG laser irradiation and CPP-ACP paste used alone or in combination on the surface microhardness of enamel adjacent to orthodontic brackets. Materials and Methods: Initially starting with bonding brackets to each tooth and making acrylic resin blocks. Then LASER irradiation with appropriate settings was performed. Materials and Methods: 200 non-carious extracted human maxillary first premolars were bonded by metal brackets and were tested for microhardness on Vickers machine. They were randomly divided into 5 groups followed by treated with different caries prevention methods, then subjected to PH cycling model. All teeth were tested for surface microhardness in a 3mmx3mm area surrounding the orthodontic bracket. Results: The mean VHN value of all the groups were found to be highly statistically significant. The highest mean VHN value was found in the group 5 followed by group 2, group 3 and group 4 and least mean VHN in group 1. Combination of ER, CR:YSGG laser irradiation and CPP-ACP paste shows a highly effective preventive measure for white spot lesion. LASER irradiation with specific guidelines as followed m in this study is a more effective preventive measure as compared to CPP-ACP Paste application followed at regular intervals.   Keywords: CPP­ACP, Dental caries, Dental Laser, Fluorides, Microabrasion, White spot lesion

This article presents the evolution of dentistry and in particular orthodontics, in India and contribution of Indians to the field of orthodontics. We have come a long way since dental education was first introduced to us Indians, the wave of change brought about by the most esteemed and respectable pioneers of our profession, have led us to form a strong dental community in this world of tough competition. The pioneer of Indian dental education by Dr. H.D. Merchant, who gave first series of lectures in orthodontics. This article also prevents the work of great achievers of orthodontia, who have helped us raise the level of ‘Indian Orthodontics” and have enabled us to soar to greater heights.So, this review article presenting briefly on contributions of Indians to the field of orthodontics from the era of introducing orthodontics as a branch of specilisation of dentistry in India to recent achievements in this field.   Keywords: Indians to orthodontics, History

Advancements in the field of digital technology has vastly influenced various industries including dental practice. 3-D printing is one such development that has revolutionized the manufacturing industry and has become a subject of great interest in the field of dentistry. With the greatest advantage of 3-D printing being customization, it has become an important tool in delivering precise appliances and surgical guides. This article reviews the applications and incorporation of 3-D printing technology and recent advances applicable into dental practice, oral surgery and orthodontics.   Keywords: 3­D printing, Additive manufacturing, Digital work flow, Digital orthodontics.

Temporomandibular disorders (TMD) are a group of joint and muscular dysfunctions affecting the Cranio-orofacial area. Historically, TMDs were once believed to solely affect adults; however, recent studies have discovered an increased prevalence of TMD signs and symptoms in children and adolescents. The reported prevalence of these disorders in pediatric patients varies significantly due to methodological variations among studies; as a result, standardized diagnostic criteria for children are required. In this age group, TMDs can cause pain in the masticatory muscles and TMJs, as well as limited or asymmetric mouth opening and TMJ sounds. Rather than a single causative element, TMDs are produced by a combination of factors such as trauma, occlusion, systemic and developmental problems, and psychological disorders. A complete history and examination, which may include imaging, are essential to obtain a precise diagnosis and assure successful treatment of many disorders. For these issues, there is a range of therapeutic interventions available, although reversible treatments should be favored.   Keywords: Temporomandibular disorder, Children and adolescent, Diagnostic criteria.

The control of anchorage is essential in orthodontic treatment of adult patients. Complex tooth movements in lingual appliances and aligners require anchorage planning. Mini-screws enable the orthodontists to have good control over tooth movement in all three dimensions, while preserving the patient’s aesthetics. This article describes various clinical cases performed through aligners and lingual appliances by using mini-implants.   Keywords: Orthodontic, Extraoral.

Treatment of class II malocclusion requires accurate diagnosis and treatment planning. This case report outlines the successful management of a growing skeletal class II using Forsus fatigue resistant device for correction of skeletal parameters and premolar extractions for correction of dental parameters. The patient’s profile improved significantly with a 4° reduction in ANB angle. An ideal overjet, overbite and molar relation were also attained.   Keywords: Class II malocclusion, Forsus FRD, Extraction.

During orthodontic treatment it is crucial to prevent the unintentional movement of the anchorage unit whilst causing movement of other teeth. Conventional methods of anchorage control came along with many shortcomings. The introduction of skeletal anchorage in the form of temporary anchorage devices (TADs) or miniscrews has greatly benefited orthodontists in finding a way of anchorage control with minimum patient compliance and without a complicated clinical insertion and removal procedures. This review article outlines about the types of TADs, parts, techniques of insertion and removal and its clinical applications in orthodontics. Keywords: Temporary anchorage devices, Miniscrew, Anchorage.

The examination of Gingival crevicular fluid (GCF) may be considered an acceptable way to depict the biochemical changes occurring during orthodontic tooth movement. Correlating the changes taking place in GCF with different types of orthodontic forces, the patient can be managed based on individual patients’ tissue response. Thus, this can be an effective way of improving treatment efficiency and results. There is little evidence regarding which GCF biomarkers are associated with the growing phase. Most of the earlier reports provide information about correlation of GCF biomarkers with inflammation, bone remodeling and tissue damage and other processes associated with orthodontic tooth movement. This method is not being clinically used to its full diagnostic potential and requires further studies to provide additional data. Keywords: Biomarkers, Gingival crevicular fluid (GCF).

Background: This case report explores the treatment of a 13-year-old male patient with severe dental crowding and periodontal issues using non-extraction orthodontic treatment combined with a root coverage procedure. The patient presented with a skeletal class 1 base malocclusion, and multiple anterior crossbites, along with a compromised lower central incisor and gingival recession. Despite the option of extraction, the patient declined this approach, and the final goal was to achieve stable class 1 occlusion and an improved smile. Materials and Methods: The treatment plan utilized pre-adjusted edgewise appliance (MBT 0.022 inch slot), distalization of the canine, inversion of the maxillary right lateral bracket, and the cautious use of open coil spring in the upper and lower anterior segments. After alignment was completed, a root coverage procedure was performed on the lower right central incisor. The treatment lasted for 20 months, and the results showed successful alignment of both arches, canine protected occlusion, and improved periodontal health. Conclusion: Overall, this case report highlights the complex relationship between orthodontic treatment and periodontal health and the importance of careful treatment planning and patient communication to achieve successful and stable results. The non-extraction approach combined with root coverage procedure proved to be an effective treatment option for this patient, leading to an improved occlusion, smile, and periodontal health.   Keywords: Interdisciplinary approach, Crowding, Anterior cross bite, Gingival recession

Introduction : Compared to other fixed orthodontic appliances, orthodontic brackets have a substantial impact on enamel demineralization. This demineralization is a result of organic acid production by various microorganisms, primarily from Streptococcus mutans and Lactobacillus acidophilus. Preventing white spot lesions and caries during orthodontic treatment presents a considerable challenge for clinicians. Silver exhibits broad-spectrum antimicrobial activity against various microorganisms, including Gram-positive and Gram-negative bacteria, certain viruses, fungi, protozoa, and antibiotic-resistant strains. As such, the purpose of this research is to investigate the antibacterial properties of orthodontic brackets coated with silver nanoparticles against Streptococcus mutans and Lactobacillus acidophilus. Materials and Methods: The study involved 80 stainless steel orthodontic brackets, which were divided into four groups, each containing 20 brackets. In each group, there were uncoated brackets serving as the control group, and the experimental group consisted of brackets coated with silver dioxide. Coating was done by physical vapor deposition with the help of RF Magnetron sputtering unit. Surface morphology and material composition was analyzed by SEM and EDS unit. Afterward, the brackets underwent microbiological tests to evaluate their antibacterial efficacy against Streptococcus mutans and Lactobacillus acidophilus. Results: The study found that silver nanoparticle-coated stainless-steel brackets exhibited effective antibacterial properties against both Streptococcus mutans and Lactobacillus acidophilus when compared to the uncoated brackets. Silver nano particle coated SS brackets showed increased anti-bacterial effect towards S. mutans than L acidophilus. Conclusion: Using silver nanoparticles to coat orthodontic brackets represents an innovative and effective approach to prevent the formation of white spot lesions in patients receiving fixed orthodontic treatment. The antimicrobial properties of silver nanoparticles can combat bacteria like Streptococcus mutans and Lactobacillus acidophilus, responsible for enamel demineralization and the occurrence of white spot lesions. This advancement in bracket technology has the potential to significantly reduce the risk of enamel damage and improve overall oral health outcomes for orthodontic patients.   Keywords: White spot lesion, Antibacterial, Lactobacillus acidophilus: Streptococcus mutans

Introduction: Orthodontists use various dental records such as dental models or casts for diagnosis and treatment planning which includes making of dental impressions and study casts. Conventional alginate impressions are challenging for the patients with extreme gag reflex, irritation & discomfort. Recently 3D technology has led to development of scanning and digital models, but one major concern has been the accuracy. So this study was done to compare the accuracy, time and patient acceptance between intraoral scanner and conventional alginate impression technique. Materials and Methods: 15 patients were selected. Alginate impressions were made using zhermack neocolloid. The patients were subjected to digital scanning with Medit i500 intraoral scanner. Procedures were timed. After the impressions, each patient was asked to complete survey. Tooth width measurements were made using digital vernier caliper from stone models. In the second method digital images were measured using medit link software. Anterior and overall Bolton ratio was calculated to determine accuracy. Results: Digital impressions are accurate and comparable to conventional impressions as tooth width measurements did not differ significantly. Conventional impression consumed more time. Patients preferred digital impressions. Conclusion: Intraoral scanners are accepted by patients and they have comparable accuracy and time efficient compared to conventional impression.   Keywords: Digital impression, Medit i500, Conventional impression, Bolton ratio, Intraoral scanner, Patient preference

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks.A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.   Keywords: Zygomatic Implant, Molar Intrusion, Open Bite