Lishoy Rodrigues

Background: Fixed orthodontic components used in orthodontic treatment often act as a nidus for the retention of plaque and biofilm thereby resulting in Plaque associated gingivitis. This is because of the classic interplay of the host and the microbial ecosystem around the components. The common gingival changes in color, contour, texture, shape & size should alarm the patient and concerned orthodontist to prevent its further progression. The orthodontist and the patient should be made aware of the undesirable complications associated with the gingival response to the treatment. Materials and Methods: This Questionnaire study was performed to assess the common gingival problems faced by the patients undergoing fixed orthodontic therapy. Results: Our study revealed that the majority of patients of both groups were cautious in maintaining good oral hygiene. A small group of patients of both groups of treatment complained of food lodgment and also experienced pain, sometimes itchy and swollen gums with bleeding from the gums. Conclusion: Oral health lies majorly in the hands of the patient by ensuring correct, efficient and meticulous oral hygiene practices. Every orthodontic patient should be motivated and educated with regards to the changes that occur in the gingiva with respect to the orthodontic treatment and good oral hygiene practices. Keywords: Common gingival, Orthodontic treatment.

Background: Class II malocclusion is one of the most common problems around the globe affecting around one-third of the patients who come for orthodontic treatment Management of class II malocclusion in adolescent patients by growth modulation is one of the most debated topics in orthodontics. Noncompliance has been a major concern for orthodontists. Case Report: This case report describes the management of class II malocclusion in an 18 year old female patient using “Forsus” fixed functional appliance system to correct her class II malocclusion. The patient was well beyond her growing years, hence the fixed functional appliance bought more of dento-alveolar changes rather than much of skeletal changes. This appliance has several advantages, as it is an operator handled device and the patient cannot remove it. It acts on the teeth and jaws for 24 hours a day, patient compliance is not a problem, and hence treatment duration is shorter. Conclusion: The profile changes and treatment results were demonstrated. This case report illustrates that, fixed functional appliances have a significant role in the management of class II malocclusion by not only promoting growth modulation, but also encouraging dento-alveolar changes once growth has completed. Both growth modulation and dento-alveolar correction minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. With proper case selection and good patient cooperation, we can obtain a significant result with the Forsus Fixed appliance. Clinical significance: Fixed functional appliances have a significant role in the management of class II malocclusion. It eliminates the massive compliance needed in removable fixed appliance therapy. Nonetheless, the growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. Keywords: Forsus, Fixed functional appliance, Class II Malocclusion, Growth Modulation, Non-compliance therapy.

Introduction: Facial appearance has proved to play a key role in social and psychosocial settings. With the advances in Orthodontics, patients have become more aware about the possibility of correcting malocclusions via Braces. Adults however, face some roadblocks before making a confident decision. Understanding these concerns would help provide optimum treatment to such patients. Aim: To assess the knowledge and attitude of Adult patients towards Orthodontic treatment Materials and Methods: A sample of 205 participants was taken (155 Female and 50 Male) after assessing the sample size within the age group of 18 - 35 year of age. A Questionnaire was created on Google forms and circulated to participants using various social media platforms. The data of responses of participants was analyzed on Google forms application itself with the help of pie charts and graphs. Results : Majority of the participants, both with or without braces asserted that age was not a barrier in getting orthodontic treatment done. They also suggested that it was never too late to undergo Orthodontic treatment and that it could be carried out at any age. Majority of the participants, both treated and non-treated cases also believed that Orthodontic treatment improved function and enhanced the Facial appearance. Participants also believed that Orthodontic treatment would boost their confidence and in no way, would wearing braces affect them socially. Conclusion: This survey based questionnaire helped in assessing the attitude of the general adult population towards adult Orthodontic treatment as a whole. It concluded that age is not a barrier in today’s times for getting orthodontic treatment done. Moreover, Adult Orthodontics not only improved the function, but also the Aesthetics and Self Esteem of the Adult patient undergoing treatment thus eliminating the earlier notion that Braces can be worn only up till a particular age. Prolonged treatment time was one of the causes of reluctance in many participants; however, the other benefits outweighed the time related inconvenience caused by orthodontic treatment. Keywords: Adult Orthodontics, Questionnaire survey, Adult Attitude, Orthodontic Treatment.

Background: With orthodontic patient demographics expanding to involve more adults, the demand for esthetic appliances is greater and orthodontists are keen on offering their patients more discreet and even invisible options. Lingual orthodontics is a very viable field which offers all this, and it is noteworthy that more and more orthodontists in India are practicing the craft. Aim: This questionnaire based survey aims to assess the knowledge and application of Lingual Orthodontics among Orthodontists in their routine clinical practice in India. Methodology: A sample of 157 participants (orthodontists) was taken after assessing the sample size within the age group of 27 - 50 years of age. The participants comprised of orthodontists practicing in various parts of India. A Questionnaire was created on Google forms and circulated to participants using various social media platforms. The data of responses of participants were analyzed and evaluated with the help of pie charts. Results: This survey analyzed the knowledge and application of Lingual Orthodontics among Orthodontists in their routine clinical practice in India. The results highlighted certain key points ; Majority of the Orthodontists in India did not practice Lingual Orthodontics and if a patient demanded Lingual braces, majority of the Orthodontists convinced them for conventional braces. Majority of the Orthodontists also reported of not being comfortable practicing Lingual Orthodontics and were not even certified as trained Lingual Orthodontists. They reported of facing certain problems like long treatment duration, more frequent patient visits, increased appointment duration, increased breakages and increased patient discomfort. Most of the participants suggested that conventional braces were better than Lingual braces and they also felt that Lingual Orthodontics took up a lot of clinical chair side time. Maximum participants reported of frequently using conventional braces in their routine clinical practice. They also felt that there was a need to conduct increased awareness and training programs in lingual Orthodontics and a whopping majority also believed that Lingual Orthodontics had now become obsolete. Conclusion: This questionnaire based survey clearly helped in analyzing the knowledge and application of Lingual Orthodontics among Orthodontists in their routine clinical practice in India. Increased awareness and training programs in lingual Orthodontics need to be conducted in India as there were very few Orthodontic clinicians practicing lingual Orthodontics in routine practice. Keywords: Lingual Orthodontics, Knowledge and attitude Questionnaire, Survey, Clinical practice.

Magnets have been widely used in orthodontics, there have been concerns regarding their safety and possible harmful effects. Magnets are used in number of conditions like, Relocation of Unerupted teeth; Space closure with magnets; Molar intrusion and correction of anterior open bite; Molar distalization; Maxillary expansion; Functional appliances for correction of Class II malocclusion; Functional Appliances for Class III malocclusions; Treatment of obstructive sleep apnea, snoring; Extrusion of crown-root fractured teeth; Closure of mid-line diastema; Correction of hemifacial microsomia. At present the most promising clinical uses for these magnets are mainly confined to tooth movement for impacted teeth, and Class II and Class III malocclusions, as well as for treatment of open bite cases. In particular the long term effects of correction of open bite with magnetic appliances have to be evaluated. Keywords: Magnetic Appliances.

Background: The fight against the novel coronavirus and the disruption in our daily routine and practise due to lockdown has been mentally exhausting especially for ambitious students pursuing higher studies. The lockdown period came in suddenly giving no chance to be prepared for the worst. Post-graduate students of Orthodontics and Dentofacial Orthopedics could be badly hit by this lockdown period disrupting the entire treatment course of patients undergoing orthodontic treatment, which needs monthly visits to the orthodontist. Materials and Methods : To understand the concerns of the students pursuing MDS in Orthodontics and Dentofacial Orthopedics about their work, academics and the effect of the lockdown on their future, we performed a questionnaire study. The Questionnaire was circulated to 110 Post graduate students pursuing MDS in Orthodontics and Dentofacial Orthopedics who were currently in the 2nd year of their Post graduate training program. Results: In the present study it was found that around 61.3% of participants panicked about the workload of patients they possibly might have to deal with once college resumed and 29% students were worried about the risk of contracting the infection after resuming to work after the lockdown is lifted. Additionally, around 68.4 & 73.6% students were insecure about the completion of their undergoing cases and thesis till the end of the term respectively and around half of the students were worried that the patients may not turn up for the exam due to the lapse in treatment. A small proportion of students (15.8%) are apprehensive of being homesick after college resumes. Conclusion: Covid-19 lockdown has definitely affected post-graduate students creating a lot of confusion and apprehension in their minds regarding the pending cases and academic work. The uncertainty to cope with it, is still the question left unanswered. Keywords: COVID19, Orthodontics, 2 nd year Post graduate student concerns, MDS Orthodontics, Questionnaire survey.

This case report emphasizes on the management of a male patient having a Long Face Syndrome and a unique malocclusion with a Class III dental malocclusion over a Class II Skeletal Base. This patient showed the presence of an increased lower anterior facial height with the chin deviated slightly towards the left. The patient also complained of difficulty in breathing and presented with a history of Deviated Nasal septum and Nasal Polyps. This case was corrected non surgically merely by employing simple mechanics with the help of Fixed Orthodontic Mechanotherapy by extracting both the mandibular 1st premolars followed by retraction and closure of spaces. After Orthodontic treatment was completed, a Septoplasty was performed to correct the deviated nasal septum and the nasal polyp was excised thus addressing the difficulty in breathing experienced by the patient. Both Septoplasty and Polyp removal were performed using Non Invasive FESS (Functional Endoscopic Sinus Surgery). This was followed by Rhinoplasty for correction of nasal contour of the patient. Lastly, 2 types of Genioplasties were performed to correct the backwardly positioned chin, to reduce the vertical height of the chin and also to correct the deviated chin position. Following fixed orthodontic treatment and minor surgical procedures, marked improvement in patient’s smile, facial profile and lip competence were achieved and there was a remarkable increase in the patient’s confidence and quality of life The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy. The Long Face of the patient was corrected merely by minor elective surgical procedures, thus eliminating the need for a major surgery. Total treatment duration was 18 months. Keywords: Long Face Syndrome, Rhinoplasty, Septoplasty, Genioplasty, Fixed Orthodontic Mecanotherapy, Non surgical Correction, Class III Malocclusion on a Class II, Skeletal Jaw Base.

Maxillary midline diastema is one of the most frequently encountered esthetic problems in mixed and permanent dentition. Several causes have been attributed to the midline diastema, including developmental, pathologic or iatrogenic. It can also be seen as a transient malocclusion in which case any intervention is contraindicated. A wide range of possible treatments like restorative procedures, composite build up, surgeries (frenectomies) can be done, based on etiology. Thus, correct diagnosis of etiology and specific early intervention plays a major role in deciding the treatment plan. Class I malocclusion is one of the most common problems around the globe affecting around one-third of the patients who come for orthodontic treatment. This case report evaluates the management of Class I malocclusion with spaced dentition and a tongue thrusting habit in a male patient with the help of a single phase appliance therapy without the need for 2 phase correction, i.e, 1st the correction of tongue thrusting with the help of a habit breaking appliance followed by Fixed appliance therapy with braces. This modality not only saves time, but also promotes faster habit breaking as intervention is done in the earlier stages of life when the patient is still growing. Severe maxillar incisor proclination with a convex Orthognthic facial profile, increased mandibular plane angle, incompetent lips and increased overjet was observed on clinical and cephalometric analysis. Orthodontic treatment resulted in a marked improvement of the patient’s smile and a remarkable increase in self-confidence and quality of life. The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy. Keywords: Tongue thrust correction, Midline Diastema, Fixed Appliance Therapy, Class I malocclusion, Spaced dentition, Aesthetic Improvement, Habit breaking.

This case report evaluates the management of a Bimaxillary Dentoalveolar protrusion with a Class I malocclusion in a male patient with extraction of 1st premolars for correction of the prognathic profile of the patient. Clinical and cephalometric evaluation revealed skeletal Class I malocclusion with crowding with a convex facial profile, a Horizontal growth pattern, potentially incompetent lips, a posterior divergent face, average overjet and overbite. Following fixed orthodontic treatment by removal of 1st premolars in the upper and lower arch with retraction of anterior segment , a marked improvement in patient’s smile, facial profile and occlusion was achieved and there was a remarkable increase in the patient’s confidence and quality of life The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with Fixed appliance therapy. Keywords: Bimaxillary Dentoalveolar Protrusion, Class I malocclusion, Fixed Orthodontic treatment, 1 st Premolar Extraction, Orthodontic Camouflage.

This case report, aims to present a combined orthodontic and surgical approach in the treatment of an adult male patient with skeletal class III malocclusion with an Hapsburg jaw. The malocclusion was decompensated by pre-surgical orthodontic treatment and then normal jaw relationship was achieved by Bilateral Sagittal Split Osteotomy Setback followed by debonding after 4 months. The treatment lasted for over 14months, it improved facial esthetics and profile of the patient significantly and resulted in a normal occlusion, overjet, and overbite and a pleasant smile. Keywords: Hapsburg Jaw, Bilateral sagittal split osteotomy, BSSO, Prognathic lower jaw, Class III skeletal pattern, Decompensation, Orthognathic surgery.