Introduction: To evaluate and compare the tongue pressure exerted on the acrylic button of variable size (10 mm and 14 mm) attached to the loop of trans palatal arch (TPA), placed at two different vertical heights (4 mm and 6 mm) from palatal mucosa during deglutition in hyperdivergent patients.Materials and Methods: Tongue pressure was measured in 20 hyperdivergent patients (9 males and 11 females; age range 16–19 years with mean age 18.2 years) using FSR (Force sensing resistor) pressure sensors attached to acrylic button of TPA. Readings were obtained on amplifier attached to another end of sensor. In each patient, the tongue pressure was measured at two different vertical heights of TPA (4 mm and 6 mm) from palatal mucosa. At each vertical height diameter of acrylic button was also varied (10 mm and 14 mm). Hence, a total of 4 variables for each patient were evaluated. Measurements were divided into two groups – Group I (acrylic button of 10 mm size) and Group II (acrylic button of 14 mm size). Groups were further divided into subgroups (A and B) – Group IA (acrylic button of 10 mm size at 4 mm height), Group IB (acrylic button of 10 mm size at 6 mm height), Group IIA (acrylic button of 14 mm size at 4 mm height), and Group IIB (acrylic button of 14 mm size at 6 mm height). Unpaired Student's t-test was used for adequate intra- and inter-group comparisons.Results: The mean tongue pressures for Group IIB was maximum (2.11 ± 0.228 N/cm²) > Group IB (1.81 ± 0.169 N/cm²) > Group IIA (1.57 ± 0.167 N/cm²) > Group IA (1.30 ± 0.109 N/cm²) and the difference was statistically significant (P < 0.001) for all the intergroup comparisions.Conclusion: The tongue pressure measured on acrylic button of TPA in our study was in the range of 247–400 g (1.30–2.11 N/cm²), which can be used to intrude molars in hyperdivergent individuals, thereby achieving counter-clockwise rotation of mandible.

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Over many decades, medical representatives, researchers, etc., are making an attempt to quantify the force/pressure put by the tongue within the oral cavity. Evaluation of the abovementioned may be done by qualitative or quantitative methods. The aim of this study was to assemble a review of literature regarding the devices to measure tongue strength used by different researchers over a period of time from everywhere the globe. A critical analysis regarding the devices custom-made or used to quantify tongue force was meted out in different words such as “tongue pressure,” “role of tongue,” and “malocclusion” in varied search engines using the Internet. The articles considered were over a period of 60 years approximately, i.e., 1956 dated up to March 2018. In addition, searches were also made within the references of the chosen articles. Every custom-made device has drawbacks in its own. In an overall view, most of the devices measure pressure in just one direction. However, tongue activity throughout the features entails a combination of dynamic and static forces because the tongue is oriented in a diffusion of various positions. The employment of quantitative ways to measure tongue force helps the skilled in the evaluation of orofacial physiology, making the diagnosis of tongue force more reliable, particularly in those subjects with a small strength deficit which are difficult to be noted by clinical evaluation.

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Class III malocclusion is exhibited either due to excessive mandibular growth, deficient maxillary growth, or both. Neither growth modification nor camouflage offers a solution for patients with severe Class III malocclusion. Surgery to realign the jaws or reposition dentoalveolar segments is the possible and stable treatment option. A combination of orthodontic and orthognathic phases offers remarkable results along with enhanced psychosocial acceptance. In this case report, Lefort I osteotomy was performed with maxillary inferior repositioning and advancement in a 25-year-old patient with skeletal Class III.

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Impaction of maxillary central incisors is not a common scenario seen in dental practice, and its treatment is often found to be challenging for a clinician as they are esthetically important. Parents are mostly apprehensive when the front teeth of their kids are missing. The causes for the impaction of maxillary central incisors are many, and one of the reasons is supernumerary teeth. A mesiodens is one common type which is a malformed, peg-like tooth that occurs between the maxillary central incisors. A bilateral tuberculate supernumerary tooth is a rare occurrence in the anterior premaxillary region, and if they occur, they fail to erupt into the oral cavity. They often cause impaction of the maxillary central incisors. This unique case report throws light on a rare case of palatally placed; tuberculate bilaterally impacted mesiodens along with impacted maxillary central incisors and its treatment procedures.

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This case reports the treatment of a 13-year-old male with Class II malocclusion, mandibular retrusion, lateral open bite, and crowded anterior teeth. Nonextraction approach was used for this patient. Ideal overbite and overjet were achieved. Leveling and aligning with fixed appliance and elastic was applied to correct this case. Rectangular loop was used to achieve mesial tipping and extrusion of the maxillary premolar.

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Alignment of malposed teeth is generally treated using coaxial wires, NiTi wires, or HANT wires. However, when canines which are ectopically erupted are tried to be aligned with NiTi wires, due to their bulky root structure, there is a risk of round tripping of adjacent teeth. This unnecessary round tipping creates load on the anchorage (leading to anchor loss) and prolongs the treatment duration. In this case, a unique approach to align buccally placed canine using a modified transpalatal arch (TPA) has been discussed. This case report describes a 20-year-old female, with a buccally placed left maxillary canine, being placed totally out of the arch. The first premolar was extracted to make space for the canine in the arch. The canine was brought into alignment using a palatal traction with the help of a modified TPA and an E-chain initially and later a closed coil spring attached to a palatal button on the canine.

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Objective: This study aimed to evaluate and compare shape variability of soft-tissue outline of skeletal Class II Division 1 patients with various vertical patterns (low, moderate, and high SN-MP angles) and skeletal normal Class I occlusion patients and to evaluate correlative skeletal and dental variables affecting soft-tissue thickness using cephalometric analysis. Materials and Methods: Sixty patients were selected with Class I normal occlusion and Class II Division 1 and divided into four groups based on horizontal and vertical skeletal pattern (SN-MP angles) on lateral cephalograms as Group I (normal occlusion), Group II-L (low angle <27°), Group II-N (normal angle 27°–36°), and Group II-H (high angle ≥ 37°). The correlation and multiple linear regression analysis were used to determine skeletal and dental variables influencing soft tissue characteristics. Results: The skeletal Class II patients with a high mandibular plane angle had significantly greater values than the skeletal Class II patients with a low mandibular plane angle for basic lower lip thickness and lower lip length. The measurements in perioral soft-tissue thickness were correlated with an inclination of the upper and lower incisors along with facial depth and facial length in skeletal Class II Division 1 patients. Conclusion: Lip strain, lip thickness, and dental inclination must be evaluated based on various skeletal patterns for balanced perioral muscle activity.

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A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review, current and future applications of stem cells (SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue (such as treatment of alveolar cleft) and soft tissue (such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.

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