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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Cleft lip and palate (CLP) is the most commonly occurring congenital facial anomaly, in which Bilateral CLP is the least common among the different types of CLP. CLP correction requires a proper diagnosis and stage-wise treatment planning with a multidisciplinary approach which involves orthodontic and surgical correction of dental malocclusion and skeletal discrepancies, respectively. This case report emphasizes the need for multidisciplinary treatment which includes orthodontic treatment, orthognathic surgery, secondary lip revision and rhinoplasty performed in an 8-year-old patient with bilateral CLP to achieve a balanced and pleasing profile with good functional occlusion. The multidisciplinary approach performed by the orthodontists and oral surgeons brought stupendous results and showed good retention at 2-year posttreatment.

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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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Introduction and Objectives: The extraction versus nonextraction controversy is the oldest as well as the most enduring controversy and still remains a topic of debate in the field of orthodontics. The “American Board of Orthodontics” (ABO-1998) introduced an index called the objective grading system (OGS) which evaluates posttreatment dental casts and panoramic radiographs. It assesses the final occlusion in first, second, and third orders according to eight different occlusal components. The aim of the present study was to evaluate the treatment outcome of extraction and nonextraction cases in borderline cases by ABO-OGS system. Materials and Methods: Forty borderline orthodontic patients with Angle's Class I malocclusion with an age group of 13–20 years were selected and equally divided into two groups: twenty patients were treated by extraction of all first premolars and twenty patients with a nonextraction treatment protocol. MBT 0.022” slot prescription was used for all forty patients. With the aid of an ABO measuring gauge and panoramic radiographs, the total OGS scores between the two groups were calculated and compared using Student's t-test. Results: The mean OGS scores were significantly less negative in the extraction group (−22.0 ± 2.29) as compared to the nonextraction group (−26.80 ± 5.18, P < 0.005). Conclusion: According to this study, in the borderline cases, the final occlusion and radiographical characteristics were more acceptable in the patients treated with extraction than the nonextraction patients.

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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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Anterior crossbite is the most important concern in a patient with a Class III malocclusion. The current report demonstrates the use of a custom made removable appliance in a patient unwilling for fixed orthodontic therapy.

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Objective: The objective of this study is to evaluate and compare the level of receptor activator of nuclear kappa B ligand (RANKL) and osteoprotegerin (OPG) in gingival crevicular fluid (GCF) during canine retraction with nickel-titanium (NiTi) coil spring and elastomeric chain. Materials and Methods: Ten patients between the ages of 13–17 years requiring canine distalization after first premolar extraction were selected. NiTi coil spring was placed on one side and elastomeric chain on the contralateral side. GCF sampling was done at baseline, 1 h, 24 h, 168 h, 1 month from the distal site of the test teeth after the application of compressive force. RANKL and OPG concentration were detected by enzyme-linked immunosorbent assay. Results: In the NiTi coil spring side, the RANKL levels in GCF increased and OPG levels decreased in a time-dependent manner. Increase in RANKL and decrease in OPG were significant when compared with the baseline. In the elastomeric chain side, the RANKL levels were significantly higher and the OPG levels significantly lower at 24 h, the RANKL levels showed a significant decrease and OPG levels showed a significant increase from 24 h to 1 month time intervals. The RANKL and OPG levels in GCF when compared individually to the NiTi coil spring and elastomeric chain showed a significant difference at 24 h, 168 h, and 1 month after initiation of compressive force. Conclusion: The result suggests that RANKL and OPG expression during orthodontic tooth movement varies at different time intervals and according to the type of force delivery system.

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Introduction: To analyze the skeletal features of patients with maxillary canine impaction. Materials and Methods: Pretreatment lateral cephalograms of 30 patients in buccally displaced canine group (BDCG), 15 in palatally displaced canine group (PDCG), 30 in impacted canine group (ICG), and 50 in control reference sample (control group [CG]) were used to analyze the selected dentoskeletal characteristics. One-way analysis of variance was used to identify the differences in angles among the four groups (BDCG, PDCG, ICG, and CG). The differences in the relative distribution among the groups were tested by Pearson's Chi-square test. Independent samples t-test was used to test the significance of differences between the two groups. Results: In BDCG, retrognathic maxilla, tip up maxilla, retrognathic mandible, skeletal Class II, and horizontal growth pattern were the significant factors. In PDCG, skeletal Class II and hypodivergent were significant factors. In ICG, retrognathic maxilla, retrognathic mandible, hypodivergent relationships are poorly significant factors. The nasolabial angle and Steiner's S line were insignificant in all groups except the ICG where acute nasolabial angle is poorly significant. Conclusion: When compared to controls, canine impaction(s) revealed a trend toward retrognathic maxilla, retrognathic mandible, skeletal Class II, and hypodivergent skeletal relationship.

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