Ashish Kamboj

All over the world Class II malocclusions affects twenty percent of the population and Class II division 1 malocclusion is thought to be the most recognized problem practiced in orthodontics. A wide range of functional appliances including the removal and fixed are available for the correction of Class II skeletal pattern. The fixed functional appliances eliminate the need for patient compliance and place the treatment outcome under the control of the orthodontist. Patients with Class II mandibular retrusion and those whose growth is about to finish are typically treated with fixed functional appliances, which require little maintenance. William Vogt, was the first to introduce the Forsus appliance. Fixed functional appliances in general and the Forsus (FRD) in particular considerably speed up the correction of Class II Division 1 malocclusions and shorten treatment time as they are used in conjunction with a fully bonded fixed orthodontic appliance. Forsus primarily achieves Class II correction through dentoalveolar effects, but if utilized by patients who are at or near pubertal growth, it can result in skeletal changes as well.In this article, the management of two young adult patients with Class II Division 1 malocclusion and mandibular retrognathism is discussed. Both patients received a two-phase therapy in which first phase involved alignment of the arches with fixed orthodontic pre-adjusted appliance and second phase involved using the Forsus fixed functional appliance for at least six months.   Keywords: Class II malocclusion, Patient compliance, Fixed functional appliance, Two­phase therapy

Osteomas are benign osteogenic lesions that result from the proliferation of mature bone. Three variants are known: central, peripheral, and extra skeletal. The peripheral variant is the most common and it most frequently affects the paranasal sinuses, rarely occurring in the jaws. Mostly peripheral osteomas are of small size and rarely requiring surgical treatment. Multiple osteomas occur in Gardner’s syndrome however isolated lesions are non-syndromic. Neoplastic, inflammatory, developmental and traumatic theories are given as etiologic causes. Here we have described a case of 66-year-old female patient who developed a giant peripheral osteoma in mandibular body region which was managed surgically and no recurrence noticed. Radiological evaluation portrayed a different picture and histopathology confirmed the diagnosis.   Keywords: Peripheral Osteoma, Bony growth, Surgical management.

Background: The bone split procedure is a unique technique used to increase the width of narrow ridge for possible simultaneous implant placement. Objective: We would present a case of horizontal ridge augmentation in this article, using an alveolar ridge expansion approach and simultaneous implant placement. Results: In this report, we have described a ridge split technique and immediate implant placement for a 40-year-old male patient with missing teeth in maxillary anterior tooth region who reported to us for implant treatment Conclusion:  A successful prosthetic rehabilitation was obtained following the healing phase. This approach leads to restoration of aesthetics, function and speech with a predictable outcome. Keywords: Alveolar ridge split technique, Alveolar bone atrophy, Immediate implant placement

Aim: The goal of this research is to see how effective virtual reality (VR) is in reducing discomfort during early fixed orthodontic operations. Materials and Methods: The research comprised 70 individuals, all of whom were between the ages of 15 to 18 years randomly divided into two groups- research group (n=35) and the control group (n=35). Patients in the experimental group received a virtual reality headset and watched interesting movies during orthodontic procedures, while those in the control group received regular care. The VR headgear was placed over the patient's eyes as the dental procedure began in the study group, whereas the controls group's eyes were kept open as they viewed the clinic and dental procedures going on around them. Result: After adopting virtual reality movies before and after dental treatments, there was a statistically significant difference in pain levels between the control and study groups. The mean pain ratings during orthodontic treatment were 8.6 and 6.3 in the control and study groups, respectively. Following orthodontic treatment, the control and study groups reported mean pain levels of 7.4 and 6.7, respectively. Conclusion: VR is found to be an effective method in pain alleviation during initial fixed orthodontic procedures.   Keywords: Virtual reality, Orthodontic pain, Anxiety

Cyst is defined as a pathological cavity which may or may not be lined by an epithelium and is usually filled with solid, semisolid or gaseous material. Dentigerous cyst is of odontogenic origin and is usually associated with an impacted tooth. Dentigerous cyst in maxillary antrum is often misdiagnosed in peripheral health care centers due to initial complaints mimicking maxillary sinusitis with patients reporting to general physicians/otolaryngologist for treatment. This article intends to report a case of infected dentigerous cyst initially managed as recurrent maxillary sinusitis in a peripheral rural health care center in high altitude region with limited health care facilities. Keywords: Cyst, Dentigerous cyst, Maxillary antrum

Class II malocclusion cases are of interest to orthodontists since they constitute a significant chunk of cases they treat. Still, they're one of the most grueling malocclusions to diagnose and treat.There lies a significant difference in the frequency of Class II malocclusion among various populations. The frequency of Class II malocclusion in India varies from 1.9% in Rajasthan to 8.37% in South India. Class II division 2 (Deckbiss) malocclusion is characterized by mandibular incisors positioned posterior to the cingulum of retroclined maxillary incisors. It usually presents with reduced overjet and increased overbite.The treatment approach of Class II division 2 malocclusion is different for different age groups. In growing cases, growth modulation with myofunctional appliances is recommended but in adult cases, orthodontic camouflage or orthognathic surgery is the recommended treatment modality. When orthodontic treatment alone is ineffective or when facial aesthetics is grossly undermined, orthognathic surgery is the choice of treatmentIn the present case series, two adult cases of severe Class II division 2 (Deckbiss) malocclusion were treated orthosurgically with BSSO. This case series demonstrates that treatment of Class II division 2 (Deckbiss) malocclusion in adult patients is a challenging task and a combined orthodontic-surgical approach can be used to obtain optimum aesthetics & functional efficiency.   Keywords: Deckbiss malocclusion, Deep bite, Orthosurgical, BSSO

Pulp canal obliteration (PCO) is defined as a deposition of hard tissue within the root canal space and a yellow discoloration of clinical crown. These tissues can eventually produce the radiographic appearance of a root canal space that has become partial or completely calcified. These teeth provide an endodontic treatment challenge. The critical management decision being whether to treat these teeth endodontically immediately upon detection of the pulpal obliteration or to wait until symptoms or signs of pulp or periapical disease occur. Success in root canal treatment is based on proper debridement, disinfection and obturation of the root canal system. However, this procedure may be difficult or even impossible to achieve if the pulpal space is calcified. The endodontic treatment performed under these circumstances pose the risk of root perforation, a complication that seriously affects the long-term prognosis of tooth. The present article discusses a series of cases of endodontic treatment in teeth with partially or completely PCO and methods for the clinical management of these cases using contemporary endodontic techniques. Keywords: Dental trauma, Discolouration, Pulp canal obliteration, Root canal treatment

Class II malocclusion cases are of interest to orthodontist since they constitute a significant percentage of cases they treat. However, they are one of the most challenging malocclusions to diagnose and treat.There lies a significant difference in prevalence of Class II malocclusion among various populations. Prevalence of Class II malocclusion in India varies from 1.9% in Rajasthan to 8.37% in South India.Class II malocclusions have dental or skeletal or combination entities. Success in the management of skeletal Class II cases especially in the adult cases relies on proper diagnosis and treatment planning. The treatment of severe dentofacial deformities in adult patients is a challenging task for both the orthodontist and the maxillofacial surgeon. In adults with severe discrepancy, combined orthosurgical approach is the ideal way to achieve acceptable results. This case report presents an adult male patient with severe Class II malocclusion in which mandibular advancement was carried out with BSSO. Post-treatment results showed improved facial esthetics and Class- I relationship of the skeletal jaw bases with optimal dental occlusion.   Keywords : Class­ II Malocclusion, Orthosurgical, BSSO, Mandibular Advancement

Palatoradicular groove is an important anatomic factor that presents accessibility problems and worsens the prognosis of periodontal disease. Palato-radicular groove is a rare developmental anomaly with prevalence rate of 2.8-8.5%. Most commonly affected tooth is the maxillary lateral incisor (93.8%). Palatoradicular groove may present as a radiolucent para pulpal line, radiographically. Treatment of radicular groove presents a clinical challenge to the operator. Removal of local predisposing factor is of prime importance. This case report presents the management of the periodontal defect associated with palatoradicular groove incorporating periodontal flap surgery with bone graft and GTR.   Keywords: Palatoradicular groove, Periodontal­endodontic lesion, Periodontal regeneration.

Anatomic variations of mandibular molars are documented in literature. Variations in the anatomy are not appreciated by a great number of general dental practitioners. One such variation is occurrence of radix entomolaris, a supernumerary root occurring on the disto-lingual aspect of mandibular molars. This anomaly is rarely known to occur in the Indian population. Literature has also shown that the knowledge about the variations in the distal root anatomy in mandibular molars is not commonly known. This case reports the occurrence of radix entomolaris in mandibular first molar with three roots and four root canals. The case report discusses the frequency of occurrence, diagnostic means and endodontic management of radix entomolaris. Keywords: Anatomic variations, Endodontic treatment, Mandibular first molar, Radix entomolaris

The effect of racial and ethnic variations of dental morphological traits on torque expression of preadjusted edgewise appliances has rarely been documented. This in vitro experiment was carried out with the aim to study the extent to which the anterior tooth morphology of a mixed Indian population affects torque expression of a preadjusted edgewise appliance. This study was conducted on extracted maxillary and mandibular anterior teeth of a mixed Indian population. These teeth were divided into two similar groups and were bonded with 0.018” Roth and MBT prescriptions. Full slot engagement was obtained using a 0.018” x 0.025” stainless steel wire to study how the variation in the tooth morphology affects the torque expression. Each tooth with the test wire engaged in the slot was radiographed using standardised procedures. The radiographs were photographed; images were transferred to a computer and enlarged 6 times. Printouts of the images were taken and the torque expression angle for each tooth of the two groups was measured. A wide range of torque expression was obtained reflecting the influence of tooth morphology on the expression of torque, suggestive of significant variations in the tooth morphology of the same tooth type. However, the mean torque expressions obtained in this study were comparable to the average values of torque prescribed for the two prescriptions.   Keywords: Torque Expression, Preadjusted Edgewise Appliance, ROTH, MBT, Anterior teeth, In­vitro

Edward H Angle first gave the classification for malocclusions into Classes I, II and III. Amongst these, Class II is the most prevalent and commonly treated at orthodontic clinics. Treatment of Class II malocclusion with mandibular deficiency in adult patients is usually managed with ortho-surgical treatment modality. In this article a case of Skeletal Class II malocclusion with vertical growth pattern is represented which was treated with BSSRO and mandibular advancement was carried out.   Keywords: Skeletal Class II, Bilateral Sagittal Split Ramus Osteotomy/BSSRO, Mandibular Advancement.

Mandibular retrusion is the most prevailing characteristic feature of Class II malocclusion. Removable Functional appliances and Fixed Functional Appliances (FFA) have been utilized for correction of Class II malocclusions in growing patients. This paper discusses the management of two young patients with Angles Class II Division 2 malocclusion with minimal growth remaining and with mandibular retrognathism who were treated with a two-phase therapy. The first phase involved alignment of arches with fixed Pre Adjusted Appliance (0.018”Roth). This was followed by a second phase involving application of Forsus fixed functional appliance for 6 months that resulted in unlocking of the mandible to Class I molar and canine relationship. Fixed Functional Appliances in general and the Forsus FRD in particular when used in conjunction with full bonded fixed appliance greatly facilitates the correction of Class II Division 2 malocclusions and the duration of the treatment is also reduced. Keywords: Retroclination, Forsus FRD.

Distalization is widely used as an effective method of gaining space with or without the need of extractions. Various Extra-oral and intra-oral appliances have been introduced over the years. The pendulum appliance and its modifications are specifically very popular among clinicians owing to their effectiveness. The present case series comprises of two cases that have been effectively treated using the pendulum appliance ensuing in aesthetically pleasing outcomes. Keywords: Distalization, Pendulum Appliance, Gaining space

Background: What is now known as a Class-III malocclusion was initially recognized by Pierre Fauchard. True Class-III malocclusion is a genetically based condition that manifests in childhood. As the youngster reaches the teenage growth spurt, it becomes more obvious. Typically, we will discover a parent or grandparent who is dealing with the same issue. Class-III malocclusion, however, is not a disease. The abnormality itself is a compensatory mechanism to make up for variation that has happened at some point during the course of the individual's development. Case Report: The case presented here demonstrates the importance of presurgical decompensation, surgical planning, including cephalometric predictions, and mock surgery in the management of severe skeletal Class-III malocclusion. The treatment included comprehensive orthodontic and surgical workup that included bilateral sagittal split osteotomy for mandibular setback of 3mm and LeFort-I osteotomy for maxillary advancement of 3mm. Results: Class-I jaw relationships with a pleasing profile and correctly aligned arches were attained after 2 years of detailed treatment. This led to an aesthetic improvement and a significant increase in the patient's confidence. Conclusion: Class-III skeletal malocclusions can be corrected surgically or through camouflage. However, an ortho-surgical approach may be necessary if the issue cannot be resolved with orthodontics alone. When done correctly, bi-jaw surgery has repeatedly been shown to be quite successful.   Keywords: Skeletal Class-III, Le Fort-I Osteotomy, Maxillary Advancement, Bilateral Sagittal Split Osteotomy/BSSO, Mandibular Setback

Background: What is now known as a Class-III malocclusion was initially recognized by Pierre Fauchard. True Class-III malocclusion is a genetically based condition that manifests in childhood. As the youngster reaches the teenage growth spurt, it becomes more obvious. Typically, we will discover a parent or grandparent who is dealing with the same issue. Class-III malocclusion, however, is not a disease. The abnormality itself is a compensatory mechanism to make up for variation that has happened at some point during the course of the individual's development. Case Report: The case presented here demonstrates the importance of presurgical decompensation, surgical planning, including cephalometric predictions, and mock surgery in the management of severe skeletal Class-III malocclusion. The treatment included comprehensive orthodontic and surgical workup that included bilateral sagittal split osteotomy for mandibular setback of 3mm and LeFort-I osteotomy for maxillary advancement of 3mm. Results: Class-I jaw relationships with a pleasing profile and correctly aligned arches were attained after 2 years of detailed treatment. This led to an aesthetic improvement and a significant increase in the patient's confidence. Conclusion: Class-III skeletal malocclusions can be corrected surgically or through camouflage. However, an ortho-surgical approach may be necessary if the issue cannot be resolved with orthodontics alone. When done correctly, bi-jaw surgery has repeatedly been shown to be quite successful.   Keywords: Skeletal Class-III, Le Fort-I Osteotomy, Maxillary Advancement, Bilateral Sagittal Split Osteotomy/BSSO, Mandibular Setback