A 21-year-old male presented with irregularily placed upper front teeth, skeletal Class II relation and also Class II molar relation with 100% overbite, retroclined upper central incisors, and proclined right lateral incisor. Nonextraction treatment was planned to correct the malccusion on the diagnosis and treatment planning. Intrusion arch was used to intrude and procline the upper central incisors. Correcting the axial inclination of retroclined incisors caused unlocking of the mandible, presurgical orthodontics was carried out. Followed by surgically correcting the posteriorily positioned mandible, bilateral sagittal split osteotomy mandibular advancement and genioplasty was proformed Posttreatment incisors inclination was corrected, bilateral Class I molar relation was achieved, and canine in its position by postsurgical orthodontics. The smile arc was improved along with mentolabial sulcus and facial profile.

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This review article presents various fixed functional appliances that have been developed all these years with the aim of correcting Class II malocclusion. Class II malocclusion though multifactorial in etiology, but the main cause is mandibular retrognathia. The treatment aims to modify the direction and amount of mandibular growth rather than restricting the development of the maxilla. Hence, the various appliances were developed removable and fixed with the aim to correct Class II malocclusion. Fixed functional appliances were developed with the aim to correct Class II malocclusion without the need of patient compliance, which was a major concern toward removable functional appliances.

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Introduction: As we witness the soft-tissue paradigm, treating the face becomes more important than just treating the hard tissue variables. Therefore, it becomes crucial to quantify the soft-tissue response to changes in the hard tissue following orthodontic treatment. Purpose of the Study: To determine lip morphology changes after first premolar extractions in patients with bimaxillary protrusion as ratios of hard and soft-tissue changes. Materials and Methods: The sample consisted of pretreatment and posttreatment lateral cephalograms of 15 subjects with Class I bimaxillary protrusion who had undergone orthodontic treatment with four first premolars extraction and retraction of upper and lower incisors. Pre- and post-treatment lateral cephalograms were traced and superimposed by using SN-7˚ plane. Sixteen linear measurements were made. Statistical analysis was performed to analyze the co-relation between the hard and soft tissue change by Pearson's correlation. Stepwise multiple regression were made to determine factors that related with lip changes. Results: Significant changes after treatment were found both in dental and lip analysis. The equations of upper and lower lip changes in sagittal and vertical dimensions were derived. Conclusion: Stepwise multiple regression analysis revealed that a 1 mm retraction of the maxillary incisor cervical point would produce a 0.59 mm retraction of upper lip and 1 mm retraction of the mandibular incisor cervical point would produce 0.89 mm retraction of the lower lip. The predictability of this study may be helpful for the clinician in predicting the amount of change in profile of the patient post treatment, thus aiding in planning the treatment.

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Traditional methods of distalization in maxillary arch require patient cooperation with headgear or elastics, which are awkward for the patient. Hence, numerous intraoral procedures have been offered to reduce patient discomfort. In continuance with such efforts, our aim is to present a successful method of unilateral en-masse distalization using miniplate. Treatment results were evaluated using lateral cephalogram and dental models. Findings suggested that miniplate is effective method of correcting unilateral Class II relationship.

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Introduction: Symmetry and balance in the facial morphology is an important factor determining facial attractiveness. Unilateral posterior crossbite is a common form of posterior crossbite that is usually associated with a functional mandibular shift which might, in the long run, lead to mandibular asymmetry. Thus, there was a need to study this malocclusion and its influence on the facial symmetry in young adults as any factor contributing to alteration in facial symmetry requires evaluation. The purpose of the study was to assess the condylar symmetry in patients with unilateral posterior crossbite. Materials and Methodology: The study was conducted on the pretreatment orthopantomograms (OPGs) of sixty cases, out of which thirty had unilateral posterior crossbite (crossbite group) and thirty had normal occlusion in the transverse plane (control group). The Condylar height(CH), Ramal height(RH), and Condylar + Ramal height(CH+RH) were compared within the groups, and their asymmetry indices were compared between the groups using ANOVA test. Results: The CH and CH + RH were significantly reduced on the crossbite side as compared to the normal side in the unilateral posterior crossbite group. The asymmetry indices were increased in the unilateral posterior crossbite group as compared to the control group. Discussion: OPGs can be used to evaluate vertical mandibular asymmetry. The condylar asymmetry index was increased in the group with unilateral posterior crossbite indicating a greater asymmetry between the two condyles in that group as compared to the control group. The finding was in concordance with a study done in the past. Conclusion: The unilateral posterior crossbite group showed reduced CH and CH + RH values on the crossbite side in comparison to the noncrossbite side. The same group showed a greater CH index (more than 3%) as compared to the control group, indicating that the patients with unilateral crossbite develop asymmetry in the mandibular condyle region.

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Objective: To evaluate the facial profile view perceived as most attractive and whether this attractiveness was influenced in a neutral and smiling face. Methodology: Sixty participants (20 each of laypersons, dentists, and orthodontists) were chosen for the study. Their facial photos were taken along with professional models' with normal occlusion. Participants were asked to rate self and model photos using the Visual Analog Scale (VAS) based on attractiveness; select most attractive face by looking at panels with 0°, 30°, 45°, 60°, and 90° rotated facial photos of neutral and smiling for models and self; select most attractive photo from the combination panels of neutral and smiling photos of self and model. Results: VAS scores by orthodontists for both neutral and smiling faces for both self and model were more or less similar. Dentists and laypersons found smiling photographs more attractive. The 45 angle was perceived most attractive in self and model for both the neutral and smiling categories separately by all three groups. In the combination category, orthodontist perceived the 0° smiling (model) as the most attractive followed by 45° smiling, whereas dentists and laypersons found 45° smiling photographs most attractive. Conclusion: The 45° profile view was most preferred by all three groups when assessing self as well as models. Smiling photographs of both self and model are considered more attractive than neutral photographs.

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Background: The aim of the study was to compare and evaluate the frictional resistance of clarity advanced ceramic brackets, metal insert ceramic bracket, and conventional metal brackets with Nickel–titanium wire and stainless-steel archwire of varying dimensions. Materials and Methods: The sample size with 80% power was 45. The samples were divided into three groups each group consisting of 15, Group 1 – Clarity Advanced Ceramic Brackets (3M Unitek). Group 2 – Metal insert Ceramic Brackets (3M Unitek). Group 3 – Conventional Metal Brackets, the control group (3M Unitek). The wires used for testing were 0.016” Niti, 0.017 ×× 0.025” Niti and 0.019 ×× 0.025” SS. Results: In the present study, it was found that wire material (nickel titanium) had an effect on friction. It was found that metal insert ceramic bracket exhibited similar frictional resistance when compared to metal brackets for 0.017 × ×0.025” Niti and 0.019 × 0.025” SS wires. The Clarity Advanced bracket had the highest frictional resistance followed by metal insert ceramic and least with the conventional metal. Conclusion: Clarity advanced can be the bracket of choice for the esthetically discerning patients who do not require extraction for orthodontic reasons, but the high frictional resistance in relation to larger rectangular Niti archwires should be considered. In adult patients who require extraction in the treatment plan, metal insert ceramic brackets are definitely a pleasing alternative when compared to metal brackets.

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This article compares the treatment outcome between two patients when en-masse intrusion and retraction of the maxillary anterior teeth were performed with mini-implants placed at different sites. Both the patients had a skeletal Class II malocclusion with Angle's Class I molar relation, Class I canine relation, proclination of upper and lower anterior teeth. In the first case, intrusion and retraction was done with conventional friction mechanics for space closure and an intrusive force from a mini-implant placed in the midline. In the second case, intrusion and retraction were done with the application of force from the anterior attachments to mini-implants placed between the second premolars and first permanent molar bilaterally. There was intrusion of the maxillary anterior teeth with both mechanics. However, the evaluation of treatment outcome at the end of space closure showed mesial movement of the maxillary first permanent molar in the first case. In the second case, distal movement and intrusion of the maxillary first permanent molar and decrease in the lower anterior facial height was noted. The mechanics in the first case can be applied for intrusion and retraction of maxillary anterior teeth when anchorage requirement is not critical. The mechanics described in the second case can be used for intrusion and retraction of maxillary anterior teeth in cases with a very high anchorage need and will be beneficial in patients with vertical growth pattern.

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