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 shows the management of Angle's Class II division 1 Malocclusion with tooth size-arch length discrepancy of − 10 mm in maxillary arch and mandibular arches, proclined upper and lower anteriors, and crowding in relation to lower anteriors. Clinical evaluation revealed Class II dental and skeletal pattern, low mandibular plane angle, incompetent lips, increased overjet and overbite. Simultaneous intrusion and retraction of upper anterior teeth using Kalra Simultaneous Intrusion and Retraction arch was decided due unaesthetic excessive maxillary incisor showing at rest and to provide maximum space for the retraction of anterior teeth. Posttreatment changes were good and stable.

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Finishing is perhaps one of the most deceiving and difficult phases of orthodontic treatment. The finishing procedures are considered from the beginning stages of the treatment as a part of total scheme of treatment. The great deal of emphasis is placed on achieving perfect finishing and detailing of the orthodontic treatment, so that the results are pleasing to the eye and are more stable and conducive to improved function and health. Thus, the aim of this article is to provide comprehensive knowledge about different criteria about finishing and detailing in orthodontics.

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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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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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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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We often encounter deciduous teeth which are retained in the oral cavity beyond the age of its exfoliation. In most instances, we are posed with a question as to whether to consider retaining it further or to extract and substitute. The concept and clinical considerations for retaining deciduous teeth and substituting it for its permanent successors are projected through a case illustration in this clinical case report.

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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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Since 1930s Class II malocclusion benefits from functional appliances. These appliances alter the arrangement of various muscle groups to correct the position of mandible to grow out of the skeletal disharmony. These appliances have been broadly divided into removable and fixed functional appliances. Fixed functional appliances also known as “noncompliant Class II correctors” have gained significant ground in the last few years. With them in use, the treatment duration is reduced by 6 months. They are divided into rigid, flexible, and hybrid appliances. Rigid fixed functional appliances restrict the mandibular movements and flexible fixed functional appliances have frequency of breakage to a greater extent. To overcome these drawbacks, hybrid fixed functional (HFF) appliances have come into play. HFF appliances offer the advantages of previous ones, thus eliminating their pitfall. Recent advances have also lead to the improvisation with the use of HFF appliances. This review article provides the gist of different HFF appliances till date with their considerations in use, mode of action, biomechanical effects, and advances in this field.

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Orthodontic patients avoid many types of food, particularly fruits, raw vegetables, and other hard and tough foods, as they cannot chew these properly because of pressure sensitivity of the teeth in the initial 3–5 days period after routine. As a result, such individuals consume significantly less proteins and other key nutrients, fiber, calcium, nonhem iron, and some vitamins. This article presents an overview of the relationship between diet and orthodontic treatment. The nutritional guidelines to obtain good oral and general health in orthodontic patients are discussed.

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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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Bonding is the most published and researched procedure in orthodontics. Since its inception in 1954 by Buonocore, bonding material and technique have undergone major innovations and upgrading. Self-cured bonding materials were truly replaced with light cure ones, which provide an added advantage of controlled curing time and ease of operation. The light cure bonding material needs a specific light cure device for its curing. These devices have also undergone major changes in the past years. Halogen light cure devices were replaced by plasma arc, and recently, market is now flooded with light emitting diode light cure devices. However, literature search failed to reveal any review on this aspect. Hence, the author felt the need to review this untrodden topic. This article deals in detail with the various light cure devices used in orthodontics.

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Transverse maxillomandibular discrepancies are a major component of several malocclusions. Transverse maxillary discrepancies are routinely corrected in growing patients with appliances that separate the median palatal and associated maxillary sutures. This type of rapid palatal expansion (RPE) is not feasible in adults, however, because of the increasing resistance of the sutures. Surgically assisted RPE is an alternative method that reduces the resistance of the closed midpalatal suture to correct maxillary constriction in an adult. It allows clinicians to achieve effective maxillary expansion in a skeletally mature patient.

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During fixed orthodontic treatment, ligation method refers to the means by which an archwire is held inside the bracket. It can also be used to move the tooth in a particular direction depending on the type of ligature used and its method of ligation. Ligation can be done using stainless steel ligatures or elastomeric modules, or more recently, ligation methods have been designed and built directly into the bracket. Metal or elastic ligatures are used for this purpose, and the way they are tied affects tooth movement. Because of their design, twin brackets can be tied in a large variety of ways. Knowing how to use all the bracket's resources makes for better and faster treatment results. Elastic ligature may be a substitute for the wire ligatures in most situations. In various treatment mechanics, ligation ties are modified to accomplish variable tooth movement or to maintain arch form integrity during finishing of an orthodontic case. This article will highlight different ligation methods used in different bracket systems and their indications as well.

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Orthodontics is been at great service to mankind. Orthodontics is a field that has been around since the early 18^th century. Modern day orthodontists have generations of predecessors to learn their techniques. Technology used in orthodontic treatment continues to progress at an incredible pace. New discoveries and inventions have allowed orthodontists to bring better experiences to their patients with less of the hassle. If we want to continue providing fast, efficient, and effective treatment to our patients, we need to make sure that we stay up-to-date with changes in the field. Orthodontic brackets have evolved from Angle's era to the MBT brackets followed by lingual brackets. These brackets have made the life of the orthodontists much easier. As technology advances many more new materials and designs will be coming forward. The purpose of this article is to review the recent advancements in orthodontic brackets and how the science behind them helps the orthodontist in the day-to-day practice.

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A 10-year-old female presented with a skeletal Class II relation with 7 mm of overjet, 40% overbite, and bilateral posterior lingual crossbite. Two-phase therapy was planned to correct Class II skeletal relation, overjet, overbite, and to achieve lip competency. Phase I therapy was done with twin-block appliance to advance the retrognathic mandible. Phase II therapy was accomplished with fixed appliance for arch coordination to correct minor displacement and to finalize occlusion. Posttreatment, skeletal Class I relation was achieved. Incisors' inclination was improved, and ideal overjet and overbite with bilateral class I molar relationship was achieved. As the mandible advanced, lip competency, facial convexity, and mentolabial sulcus improved.

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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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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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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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A 13-year-old patient presented with Angle's Class II subdivision right malocclusion with anterior crowding, protruded lower incisors, and a lower arch that was skewed to the left. A morphological lower midline shift of 3 mm to the left was detected. Following extraction of the upper and lower first premolars, full-arch 0.022” MBT™ appliances were placed in both arches. A 0.018” × 0.025” stainless steel archwire was split into two posterior segments and an anterior segment from the right lateral incisor to the left canine including an open vertical helical loop extending apically toward the center of resistance of the consolidated anterior segment. Subsequently, a 0.017” × 0.025” titanium–molybdenum alloy cantilever spring from the right first molar auxiliary tube was bent buccally and connected to the loop with an elastomeric chain to achieve lower midline correction by translation. Midline correction with the use of segmented-wire technique and cantilever spring provides an effective method of incisor movement by translation with minimal side effects.

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Separation is an essential requirement to ease the placement of bands which requires an extra appointment; the article highlights a clinical pearl in the form of innovative use of Kesling separators as molar tubes to overcome the disadvantages of dislodgment and potential complications.

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Today many adult patients with periodontal disease demonstrate malocclusions that compromise their esthetics and ability to maintain oral hygiene. With adequate combined orthodontic.periodontal treatment it is possible to correct malocclusion and re.establish a healthy and well-functioning dentition. However, while orthodontic treatment can realign periodontally affected teeth, esthetic appearance may be compromised by gingival recession due to alveolar bone dehiscences or fenestrations in combination with a thin gingival biotype. This article reports an interdisciplinary. (orthodontic and periodontic) approach for the treatment of a periodontally compromised patient with spacing in anterior dental region. Periodontal therapy, including periodontal plastic surgery to obtain root coverage as well as orthodontic treatment by means of a fixed appliance was used to achieve stable periodontal conditions and successful esthetic and functional final results.

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A 15-year-old female presented unilateral Class II molar relation with 90% overbite, retroclined upper central incisors, and impacted lower right canine. Nonextraction treatment was planned to correct deep bite, retroclination of upper central incisors, and unilateral Class II molar relation. Intrusion arch was used to intrude and procline the upper central incisors. Correcting the axial inclination of retroclined incisors caused unlocking of the mandible. This, in turn, leads to simultaneous correction of class II molar relation. The vertical loop was used to disimpact canine. Posttreatment incisors inclination was corrected, bilateral Class I molar relation was achieved, and canine had erupted in its position. The smile arc was improved along with mentolabial sulcus and nasolabial angle.

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Impacted canine teeth are problems frequently encountered in dental practice. Maxillary canine teeth are the most commonly impacted teeth next to third molars. Incidence of palatal impaction is greater than labial impaction. Many etiological factors attributed for canine impaction. Timely diagnosis and interception provide a better management of impacted canine. There are various orthodontic auxiliaries used for disimpaction of canine. Ballista spring is one of the simplified orthodontic auxiliary spring developed by Harry Jacoby used for repositioning impacted teeth. It delivers light force, excellent biomechanics, simplicity of the design, patient comfort, and esthetics. This case report presents a case of orthodontic repositioning of palatally impacted canine in a 15-year-old using ballista's spring.

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