Aim: The aim of this study was to assess the oral hygiene awareness among orthodontic patients. Objective: This research aims to find if patients undergoing orthodontic treatment are aware of the probable accumulation of dental plaque and the consequences of it, namely, bad breath, gum disease, and dental decay. Materials and Methods: The study was conducted on orthodontic patients from the Department of Orthodontics in Saveetha University. A self-assessed questionnaire was formulated to assess the oral hygiene awareness among orthodontic patients. The questionnaire was pretested to assess its reliability. It was distributed to 100 patients and only completely filled questionnaires were taken for analysis. Results: An average of 44% of the population are aware of the oral hygiene measures. The female population who underwent orthodontic treatment was more aware of the oral hygiene measures compared to men. Conclusion: There is a need to incorporate more oral hygiene programs in future. Extra attention should be given in educating and motivating the patients on oral hygiene practices during orthodontic treatment in a proper manner, which will be helpful to the patients in maintaining their oral hygiene.

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Objectives: To study the gingival biotype and its relation to maxillary and mandibular incisor inclination and its relation to dentopapillary complex. Materials and Methods: This cross-sectional study included 150 consecutive patients seeking orthodontic treatment at JSS Dental College, Mysore. Gingival biotype was assessed for maxillary and mandibular incisors using a digital vernier caliper. Maxillary and mandibular incisors' inclination and position were measured using cephalometric analysis. Parameters of dentopapillary complex were recorded from the dental casts. Results: The prevalence of thin gingival biotype was 42.66% for maxillary and 39.33% for mandibular incisors. A significant association was found between mandibular incisor inclination and thin gingival biotype, whereas there was no association between maxillary incisor inclination and gingival biotype. There was a significant correlation between gingival biotype and crown length, area of papilla, area of crown, and papilla length with P = 0.001 each. Conclusion: Mandibular incisor proclination is associated with thin gingival biotype, whereas no association is found in the maxilla. The correlation between gingival biotypes and dentopapillary complex is confirmed in this study. Evaluation of gingival biotype is of paramount importance during treatment planning for orthodontic patients.

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Introduction: The adhesion of brackets to the teeth throughout the period of orthodontic treatment is essential for achieving a timely and satisfactory treatment outcome. Bonding failure is therefore not desirable. Objective: To assess the prevalence of bonding failure among orthodontic patients at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Materials and Methods: Data were compiled from the files of all patients being managed with fixed orthodontic therapy at the orthodontic unit of a teaching hospital from August 2013 to December 2016. Results: A total of 42 patients comprising 26 (61.9%) females and 16 (38.1%) males with a mean age of 14.7 ± 7.8 years who were undergoing treatment were included in the study. Thirty-one patients (73.8%) experienced bracket failure. Male patients (81.2%) experienced this more than female patients (69.2%). Brackets bonded on the second premolars (46.8%) had the highest while maxillary anterior teeth (13%) had the least failure. Brackets on mandibular teeth had a higher failure rate (66.2%). There was a progressive decrease in bracket loss with age of the patient and duration of treatment. Conclusions: Bracket loss among patients treated at the hospital was found to be higher among males and younger patients. Brackets placed on mandibular premolars had the highest failure rate.

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Precise estimation of the stage of skeletal growth is essential for the formulation of accurate treatment planning and employing orthodontic intervention through functional orthopedic appliances for the shortest time possible yielding stable results. Along with clinical and radiological techniques, biochemical markers play an important role in the growth assessment for differential treatment application. Isolation and characterization of various systemic and local factors having a significant role in the growth process provided us the sight to tap their potential to be used as skeletal maturity indicators. Different methods for the assessment of biomarkers in use are enzyme-linked immunosorbent assay, radioimmunoassays, and immunoradiometric assays. These methods of assessment of biochemical markers are noninvasive and when interpreted correctly give useful information. This article presents an overview of various biomarkers under research for predicting skeletal growth.

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Dermatoglyphics is the study of fingerprints and skin patterns. These appear at the 12 ^th week of intrauterine life and are completely established by the 24 ^th week of intrauterine life. It is said that thereafter, these configurations remain constant throughout life. It is during the same embryonic period that finger and palm prints, the lip, alveolus, and palate develop. As a result, any factor causing changes in the lip, alveolus, and palate may also cause different patterns in the appearance of finger and palm prints. Hence, fingerprint patterns and other details of dermal ridges may offer distinct advantages and thus may be used as a screening tool, which is easily accessible, economical, and noninvasive marker to detect early malocclusion.

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Introduction: Deep bite correction in patients with convex profile and increased maxillary incisor visibility, and normal or increased vertical dimension necessitates the intrusion of maxillary incisors. Intrusion arches or miniscrews are commonly used for this purpose. The current study compares one of the prefabricated intrusion arches, the Connecticut intrusion arch (CIA), and the temporary anchorage devices (TADs) in their effectiveness for orthodontic intrusion. Materials and Methods: The present prospective study was done on 24 patients in the age group of 15–25 years undergoing fixed orthodontic treatment. In Group I, TADs were placed for intrusion while, in Group II, CIA was placed. Anchorage was reinforced in Group II using transpalatal arch. A paired t-test or a Wilcoxon signed-rank test was performed for the assessment of treatment changes within the groups, and an independent t-test or a Mann–Whitney U-test evaluated change between the groups. Results: Both TADs and CIA can bring about significant amount of true incisor intrusion with resultant decrease in incisor visibility. However, in the TAD group, in addition to intrusion, the incisors also proclined by 0.67 mm, but in CIA group, incisors retracted by 0.33 mm. There were nonsignificant mesial drift and significant extrusive movement of the maxillary first molars in the CIA group. The rate and amount of intrusion was greater in the TAD group. Conclusions: Both TADs and CIA can be effectively used for incisor intrusion which was, however, faster and greater in TAD group. Both the methods bring about associated unwanted tooth movements as well.

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Curiosity has its own reason for existing. For thousands of years, humanity has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors and is believed to create advances in the field of orthodontics to a great extent. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for humanity today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in the field of orthodontics.

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Artificial intelligence (AI) and machine learning (ML) are powerful tools that can be utilized to overcome some of the clinical problems that orthodontists face daily. With the availability of more data, better AI and ML systems should be expected to be developed that will help orthodontists to practise more efficiently and improve the quality of care. AI is a subfield of computer science concerned with developing computers and programs that have the ability to perceive information and reason, and ultimately, convert that information into intelligent actions. The future may be purely digitized, at the comforts of our home, with orthodontists developing neural programs with orthodontic decision markers to aid in developing AI for patients to take less visits, make more use of their time using orthodontic appliances, and enhance the quality of work. This article will briefly discuss the contributions AI and ML in orthodontics, its history and various uses in orthodontics in specific, and the possibility of development.

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Aim: The present study was aimed to investigate the variation of soft palate morphology and Need's ratio in various sagittal skeletal malocclusions. Materials and Methods: The study was conducted on 300 individuals (aged 15–25 years) who presented to the department of orthodontics for orthodontic treatment. The participants were divided into skeletal Class I, II, and III based on ANB angle on the lateral cephalogram. The soft palate morphology was examined and individuals were grouped into six types. The Need's ratio was calculated for all the participants by division of pharyngeal depth by soft palate length. The results were then subjected to statistical analysis to find the association between morphological variants of soft palate and skeletal malocclusions. Results: The most common type of soft palate was leaf shaped and the least common was S shaped. Leaf-shaped soft palate was the most common in males and rat tail-shaped soft palate was common in females. Individuals with skeletal Class I malocclusion were most frequently found to have leaf-shaped soft palate, skeletal Class II malocclusion had rat tail type, and skeletal Class III had leaf shape and crooked shape in equal proportions. Need's ratio was maximum in skeletal Class III and minimum in Class II malocclusions. Conclusions: There was a significant correlation between the variants of soft palate and the types of skeletal malocclusion in North Indian individuals. The knowledge of morphological variants of soft palate helps the clinician in etiological study of obstructive sleep apnea syndrome, snoring, and other conditions.

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Background: Finally, facial contours are determined by the soft tissues, and these can be altered by growth and orthodontic treatment. The position and the relationships among the facial structures can be affected by variation in thickness, length, and tonicity of soft tissues thereby affecting facial esthetics. Such variations between skeletal and soft tissues can cause a disassociation between the position of the underlying bony structures and the facial appearance that may shift treatment into the range of orthognathic and cosmetic surgery. Aims: This study was conducted to enumerate and compare soft tissue chin (STC) thickness in adult patients with various mandibular divergence pattern in Kodava population and to find the difference in STC thickness between men and women. Materials and Methods: A sample including eighty patients were stratified into four groups based on the divergence pattern defined by the mandibular plane (MP) to cranial base angle (MP/sella-nasion [SN]; average = 32° ± 5°). Low (L) = MP/SN ≤27°; medium-low (ML) = 27°<MP/SN ≤32°; medium-high (MH) = 32° <MP/SN <37°; and high (H), MP/SN ≥37°. The STC thickness was measured at three different levels: Pogonion (Pog)-Pog', gnathion (Gn)-Gn', menton (Me)-Me'. For statistical analysis Student's t-test, ANOVA were performed. Results: The STC thickness at Pog-Pog' and Me-Me' was the highest in ML followed by MH, low and was least in high. At Me-Me', the STC thickness was the highest in ML followed by low, MH and was least in high. Conclusions: STC thickness was greater in men than in women in all the groups except high mandibular divergence pattern.

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Aim: The purpose of this study is to compare the perceptions of orthodontists and other specialty dentists, regarding smile esthetics in the form of a questionnaire. Objectives: To determine whether there is any difference of opinion regarding the perception of smile between orthodontists and other specialty dentists and to compare the various factors that have a high impact on the perception of smile by orthodontists and other specialty dentists. Materials and Methods: This study is a questionnaire survey. Totally, 104 questionnaires were distributed, of which 52 patients were completed by the orthodontists and 52 patients were completed by other specialty dentists. Results: This study showed that the mean scores given by orthodontists are lesser than that of the nonorthodontists. The factors that had an impact on smile by nonorthodontists include crowding of lower anterior teeth and diastema of 3-4 mm. Among orthodontists, the various factors that had an impact include diastema, midline deviation, and reverse smile arc. Conclusions: Different parameters have an impact on the smile perception. Diastema, smile, and reverse smile were regarded as unattractive and received the lowest score in this survey. The presence of midline shift was not considered unaesthetic by nonorthodontists.

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Midline diastema is a space between the maxillary and/or mandibular central incisors. Midline diastema can be due to various causes such as genetic, environmental, and so on. Proper history taking and correct diagnosis of the etiology of the diastema is essential to ensure that the orthodontic correction is successful, and no future relapse takes place. The presence of diastema between the central incisors in the adult patient has esthetics and malocclusion concerns.

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Sterilization is a process by which an article, surface or medium is freed of all microorganisms either in vegetative or spore state. On a daily basis, the practicing dentist and his personal are at risk of being exposed to wide patients with blood borne diseases such as HIV/AIDS, hepatitis B, C, and airborne diseases such as tuberculosis. Infection can be directly transmitted by oral fluids, blood, contaminated instruments and surfaces, or through the respiratory system. Control of infection that spreads through various instruments and armamentarium used in the field of orthodontics and dentistry in general is of utmost importance as a preventive measure for cross infection. Considering the fact that the rate at which newer strains evolve with time and older strains develop resistance, it has become a constant challenge through time and in the years to come. This article tells about various methods of sterilization by focusing on the guidelines for an effective and efficient orthodontic practice.

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This case report describes the orthodontic treatment of an 18-year-old male patient who presented with the prognathic maxilla, deep bite, low mandibular plane angle, and proclined incisors. Modified three-piece base arch was used for the intrusion and retraction of maxillary incisor. En masse retraction was achieved in 6 months. Reduced time for retraction was attributed to a single stage of retraction, unlike burrstone three-piece intrusion base arch where canines are individually retracted followed by retraction of incisors. A modified utility arch was used in lower arch followed by a continuous archwire technique. The case was finished using bite settling elastics on a continuous archwire. The step between canine and premolar was corrected in the finishing phase of treatment. The final treatment outcomes were satisfactory, and true intrusion was achieved with proper selection of biomechanics.

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This study aimed to report a case of skeletal Class I adult with anterior open and transposed upper canines with premolars and lower right canine transposed with lateral incisor, retained upper deciduous C, B, and lower right C. With congenital missing upper right lateral incisor, upper spacing arch, and lower mild crowding arch, a patient complains about her smile esthetic. The case was treated using temporary anchorage devices and three-dimensional retraction loops designed primarily for upper canine transposition with an accepted esthetic reshaping of lower canine using composite restoration. The missing lateral had been implanted with smile makeover using microesthetic postorthodontic treatment. After 16 months of treatment, it was possible to see a significant improvement of the patient's facial profile, with overcorrection in overjet and preservation of the tissues and integrity of dental roots.

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Background: Retention is considered as an important phase at the end of any active orthodontic tooth movement. Aims: The purposes of this study were to compare compliance between Hawley retainer (HR) and vacuum formed retainers (VFRs) and to detect the reasons for noncompliance. Materials and Methods: Questionnaires were distributed to those who had an orthodontic treatment and currently have experience with the orthodontic retainer. Items included demographic information and questions pertaining to treatment satisfaction, perceived responsibility for retention, type of retainer prescribed, Likert scale to detect the reasons for discontinuing use of retainers, and relapse. Chi-square and t-test were used to compare the data. Results: Out of the 150 questionnaires distributed, 98 returned and seven were excluded from the study. The compliant groups were 40, whereas the noncompliant group were 51. Sixty-four (70.3%) of the participants were using HR, whereas 27 (29.7%) were using VFRs retainer. Seventeen percent (Hawley) and 15% (VFRs) of the participants who did not comply reported that they had lost their retainer. For both retainers, those participants who did not comply, the majority agreed that they do not wear their retainer because it affects their eating (84.3%), speech (56.9%), comfort (47.1%), and breath odour (43.1%). A statistically significant difference in compliance levels in relation to the length of time since debond was also found (P < 001). Conclusions: The participants were more compliant with Hawley's than VFRs retainers and a significant difference in compliance levels in relation to the length of time since debond was found.

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Introduction: Dermatoglyphics refers to the study of the intricate dermal ridge configuration on the skin covering the palmar and planter surfaces of the hands and feet. Dermal ridges are usually established by the 24^th week of intrauterine life, which remains constant throughout the life. The development of dentition and palate occurs during the same period and also genetically determined as dermatoglyphics. Hence, it can be assumed that hereditary and environmental factors leading to malocclusion may also influence normal fingerprint pattern. Thus, it was decided to assess the correlation between dermatoglyphics patterns and growth patterns in individuals with Skeletal Class I and Skeletal Class II malocclusion. Materials and Methods: Ninety individuals aged between 18 and 28 years were divided into Skeletal Class I (Group I n = 45) and Skeletal Class II (Group II n = 45) based on Tweed's and Steiner's analysis. Both the groups were further subdivided according to their growth pattern and named as A, B, and C, respectively, for horizontal, average, and vertical. Fingerprints of both hands were taken by the ink and stamp method. The patterns of Arches, Loops, and Whorls in fingerprints were assessed. The data collected were then statistically evaluated using the Chi-square test. Observations: In Skeletal Class I subjects, there was increased frequency of occurrence of whorl-pattern in thumb, plain-arches in little, index, and ring finger, and ulnar-loops in middle finger, whereas in Skeletal Class II subjects, radial-loops were more in number in ring and index finger, plain-arches in little finger, ulnar-loops in the middle finger, and whorl-pattern in the thumb same as Skeletal Class I. Conclusion: No significant correlation was observed between dermatoglyphics and various growth patterns. However, further studies must be conducted on large sample size to validate the findings.

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Objective: The purpose of the present study was carried out to establish whether the vertical and horizontal growth patterns influence the rate of dental and skeletal maturation as compared to normal growth patterns. Materials and Methods: This study comprised sixty samples divided into three groups. Group I normal grower (control), Group II-vertical growers, and Group III-horizontal growers. Each sample was assessed for skeletal and dental age using cervical vertebrae maturation index (CVMI), skeletal maturity indicator stages and canine calcification stages, respectively. All data in the groups were analyzed by analysis of variance test. Subgroup data and comparisons were analyzed by Dunnett D-test and -test. Results: Results showed that dental maturation was delayed in horizontal growers as compared to vertical growers with = 0.00 and 0.044. There was nonsignificant difference in dental maturation of male and females with >0.05. The comparison of skeletal maturation by hand-wrist radiograph showed significant variation in Group III with delayed skeletal maturation of horizontal growers than control group with P < 0.05. Dunnett D-test showed main skeletal age by CVMI was significant with = 0.00 which indicates that skeletal age of Group III to be lower in all groups. Rest was nonsignificant. Conclusion: Individuals with horizontal growth pattern showed delayed dental maturation when compared to vertical growers.

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Background: Smiling is the evident component of facial attractiveness. Midline diastema is considered in some cultures as unattractive and as a malocclusion, especially in Western countries while it is considered as a sign of beauty in Africa and Middle-East. Aim: The aim of this study is to compare the smile attractiveness perception of dental and nondental students toward anterior diastemas and to determine whether all spaces in the esthetic zone are considered unattractive as midline diastema. Materials and Methods: This is a descriptive cross-sectional study conducted among 156 dental and pharmacy students from the University of Medical Sciences and Technology, Sudan, from December 2015 to January 2016. A self-administered questionnaire was distributed to the participants and it consisted of two parts: part one – related to gender, faculty, educational level, and questions about dental diastema, and part two – containing four modified pictures of a young female's smile modified by photoediting software to create different spaces between anterior teeth (midline, Simian, Frush and Fisher, and Lombardi diastema). Participants were asked to rank the pictures according to attractiveness from the most to the least attractive using visual analog scale. Comparison between variables was made by Chi-square test with P < 0.05. Results: Smile attractiveness from the most to the least attractive was Simian > Frush and Fisher > midline > Lombardi among both dental and pharmacy students. Gender and presence of diastema had no relation with the student's perception (P > 0.05). There was a significant statistical difference between dental and pharmacy students regarding Frush and Fisher diastema (P = 0.034). Most of the students with diastema felt shy when smiling. Conclusions: The location and width of diastema had an important role on the attractiveness perception of dental diastemas. Midline diastema was not a gap with the most negative perception.

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Aim: It is not well documented which dental traits predominantly motivate patients to seek orthodontic therapy. This study was designed to recognize anterior occlusal traits that impact the perception of dental esthetics in patients with different types of malocclusion seeking orthodontic treatment. Materials and Methods: Forty-five pairs of intraoral photographs belonging to patients with various malocclusions were selected for this study. Each pair of photographs included a frontal view and a right-side view of the patient's occlusion at maximum intercuspation. A total of 60 laypersons (30 males and 30 females) were requested to rate the overall appearance of the dentition in the photographs, using a 100 mm line that served as a visual analog scale. The study models of the patients were evaluated by a single investigator to determine the amount of overjet, overbite, crowding, and midline deviation. A multiple linear regression analysis was employed to detect the dental features that predicted the overall attractiveness of the dentition. Results: The multiple linear regression analysis revealed that according to the judgment of female, male, and total female and male raters, overall dental attractiveness could be predicted by two features, the crowding of upper arch (P < 0.05) and overbite (P < 0.05). Conclusions: Dental attractiveness could be predicted by two main variables including upper anterior crowding and overbite. Sufficient priority should be accorded to these factors in orthodontic diagnosis and treatment planning to decrease the probability of misinterpretation of patients' expectation from treatment.

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Objective: The study aimed to evaluate the perception of facial attractiveness by the laypersons and the orthodontist using a series of silhouettes of varying lower facial vertical proportion. Materials and Methods: Sixty-three orthodontists and 63 laypersons judged the attractiveness of the series of seven silhouettes of the single person with the varying anterior lower facial height (LFH). The silhouettes were modified using the Corel software. The participants were asked to record their perception on a visual analog scale of 10 cm length. Independent t-test was performed to know the difference between the orthodontists and the laypersons, and the difference between female and male orthodontists and the lay persons. Results: Significant difference was noticed for different vertical height modifications. The master silhouette followed by the 2 mm decrease in the LFH followed by the 2 mm increase in the LFH was most preferred profiles by both the orthodontists and the laypersons. The modified silhouette with 6 mm increase or decrease was considered to be the most unattractive profile. There existed a significant difference between male and female laypersons for the lower face decreased by 4 mm and 6 mm silhouettes. Conclusion: The esthetic perception in relation to the vertical height by orthodontist and the laypersons in this particular population is similar, and the preferred profile is with average to the decreased LFH. It is recommended that the orthodontist keeps the LFH preference during the execution of the treatment.

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Aim: The aim of the study was to analyze and compare the cephalometric readings between manual tracings with digital software tracings using Steiner's analysis. Materials and Methods: The conventional lateral cephalograms of twenty participants were obtained. Six hard tissue landmarks were identified, and Steiner's analysis was carried out. The radiographs were manually traced, and the readings were recorded. Following this, the radiographs were uploaded in the FACAD digital software for digital tracing. Results: SNA, SNB, lower incisor to NB angle, and linear values show statistically significant differences. The remaining parameters do not show statistical difference. Conclusion: The results show a statistical difference between manual and digital tracing. The variation lies in the difference in identification of the hard tissue landmarks.

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Acupressure (acupuncture + pressure) is an alternative medicine technique derived from acupuncture. Here, physical pressure is applied to acupuncture points by the elbow, hand, or with various devices. There are literally thousands of acupressure points on the body. Many of the problems encountered in dental clinics can be curbed using these pressure techniques very easily and it is not an invasive process like acupuncture. The article provides a review of pressure techniques and its use (focusing on gaging, dental anxiety, and temporomandibular joint pain) in orthodontic as well as any other dental setup.

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Dental professionals are predisposed to a number of occupational hazards. These include exposure to ionizing radiation and nonionizing radiation. The current paper reviews the studies relating to occupational health problems in dental practice.

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Obstructive sleep apnea (OSA) is characterized by the cessation of air flow during sleep due to an obstruction in the nasopharyngeal/oropharyngeal region. Many episodes of apnea may take place within a span of minutes leading to arousal of the patient from his/her sleep in an attempt to increase the amount of air flow. Apart from inadequate hours of sleep, this also results in a deteriorated quality of sleep. Sleep apnea can be caused due to many factors and many treatment modalities have been employed to correct this disorder including mandibular advancement appliances, polysomnographs, and surgical intervention. Best results, however, have been seen with the use of the mandibular advancement appliances. This article highlights the role the orthodontist plays in the diagnosis and treatment planning of OSA patients.

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