Ashok Kumar Jena

Effectiveness of twin-block and Mandibular Protraction Appliance-IV in the improvement of pharyngeal airway passage dimensions in Class II malocclusion subjects with a retrognathic mandible

OBJECTIVE To test the hypothesis that twin-block and Mandibular Protraction Appliance-IV (MPA-IV) are not effective in improving the pharyngeal airway passage (PAP) dimensions among Class II malocclusion subjects with a retrognathic mandible. MATERIALS AND METHODS Eighty-three subjects ranging in age from 8 to 14 years were divided into four groups. Group I included 30 Class I malocclusion subjects (healthy controls); group II consisted of 16 Class II malocclusion subjects (Class II controls); group III had 16 subjects in whom Class II malocclusion was treated by MPA-IV; and the remaining 21 subjects formed group IV, whose Class II malocclusions were corrected by twin-block appliance. Lateral cephalograms recorded at the beginning of orthodontic treatment in group I subjects and at the beginning and end of follow-up/treatment with functional appliance in group II, III, and IV subjects were analyzed to determine the PAP dimensions. Paired t-test, one-way analysis of variance, and Tukey tests were applied for statistical analysis, and a P-value .05 was considered statistically significant. RESULTS Soft palate length was decreased significantly in group III (P < .05) and group IV (P < .001) subjects. Soft palate thickness in group IV subjects was increased significantly as compared to group II (P < .05) and group III (P < .01) subjects. The improvement in soft palate inclination in group III and group IV subjects was significant (P < .01). The oropharynx depth was increased significantly in group III (P < .05) and group IV (P < .001) subjects. The depth of the hypopharynx was increased significantly (P < .01) in group IV subjects. CONCLUSIONS The twin-block appliance was more efficient than the MPA-IV in the improvement of PAP dimensions among Class II malocclusion subjects with retrognathic mandible.

Treatment Effects of Twin-Block and Mandibular Protraction Appliance-IV in the Correction of Class II Malocclusion

OBJECTIVE To evaluate the treatment effects of twin-block and Mandibular Protraction Appliance-IV (MPA-IV) in the treatment of Class II division 1 malocclusion. METHODS Fifty North Indian girls with Class II division 1 malocclusion, in the age range of 9-13 years, were chosen. The subjects were divided among a control group (n = 10), a twin-block group (n = 25), and an MPA group (n = 15). Pre-follow-up and post-follow-up lateral cephalograms of control subjects and pretreatment and posttreatment lateral cephalograms of the treatment subjects were traced manually and subjected to a pitchfork analysis. RESULTS Neither twin-block nor MPA-IV significantly restricted the forward growth of maxilla. Mandibular growth and improvement in the sagittal skeletal relation were significantly greater in the twin-block subjects. Distal movement of the maxillary dentition and mesial movement of the mandibular dentition were more prominent in the MPA-IV subjects. Molar correction and overjet reductions were significantly greater in the treatment subjects (P < .001). CONCLUSION Twin-block and MPA-IV were effective in correcting the molar relationships and reducing the overjet in Class II division 1 malocclusion subjects. However, twin-block contributed more skeletal effects than MPA-IV for the correction of Class II malocclusion.

Effects of twin-block appliance on the anatomy of pharyngeal airway passage (PAP) in class II malocclusion subjects

BackgroundThe use of functional appliances for the correction of retrognathic mandible is very common in orthodontics. Similar appliances known as oral appliances are also frequently used in adults for the treatment of mild to moderate obstructive sleep apnea (OSA). Many studies have reported improvement of pharyngeal airway passage (PAP) dimensions following functional appliance therapy in children and oral appliance therapy in adults. There is only one study in the literature that discussed the effect of oral appliance therapy on posterior pharyngeal wall thickness (PPWT) among subjects with OSA. The effect of functional appliance therapy on PPWT has never been investigated. Thus the present study was conducted to evaluate the effects of twin-block appliance on pharyngeal airway passage (PAP) dimensions and posterior pharyngeal wall thickness (PPWT) in class II malocclusion subjects with retrognathic mandibles.MethodsThirty-eight class II malocclusion subjects in the age range of 8 to 14 years with mandibular retrusion were divided into a treatment (n = 20) and control (n = 18) group. Mandibular retrusion in the treatment group subjects was corrected by twin-block appliance. The effect of twin-block appliance on PAP and PPWT dimensions were evaluated from lateral cephalograms recorded prior-to and after 6 months of appliance therapy in the treatment group subjects and the changes were compared with the changes in the control group subjects. Student’s t-test was used for statistical analysis; P-value of 0.05 was considered a statistically significant level.ResultsThe depth of the oropharynx was increased significantly in the treatment group subjects (P < 0.001) as compared to the control group subjects (P < 0.05). The depth of the hypopharynx increased significantly in treatment group subjects (P < 0.01). The PPWT at the level of the nasopharynx, oropharynx, and hypopharynx were maintained in the treatment group subjects; whereas in control group subjects, the PPWT was further reduced although the changes were not statistically significant.ConclusionsCorrection of mandibular retrusion by twin-block appliance in class II malocclusion subjects increased the PAP dimensions and maintained the pre-treatment thickness of posterior pharyngeal wall.

Hyoid bone position in subjects with different vertical jaw dysplasias.

OBJECTIVE To test the hypothesis that there is no difference in hyoid bone position among subjects with different vertical jaw dysplasias. MATERIALS AND METHODS Seventy-one North Indian adult male and female subjects in the age range of 15 to 25 years were selected for the study. Based on the vertical growth pattern of the face, subjects were divided into Group I (n = 24; subjects in whom both Frankfort mandibular plane angle [FMA] and basal plane angle measured 20 to 25 degrees), Group II (n = 17; subjects in whom both FMA and basal plane angle measured <15 degrees), and Group III (n = 30; subjects in whom both FMA and basal plane angle measured >30 degrees). Lateral cephalograms with the mandible in rest position were traced and analyzed manually for evaluation of hyoid bone position. RESULTS The anteroposterior position of the hyoid bone was significantly forward in subjects with short face syndrome compared with normal subjects (P < .05) and subjects with long face syndrome (P < .001). The vertical position of the hyoid bone was comparable among subjects with different vertical jaw dysplasias. The axial inclination of the hyoid bone was more oblique in subjects with long face syndrome than in those with short face syndrome (P < .01). CONCLUSION The anteroposterior position of the hyoid bone was more forward in subjects with short face syndrome. The vertical position of the hyoid bone was comparable among subjects with different vertical jaw dysplasias. The axial inclination of the hyoid bone closely followed the axial inclination of the mandible.

Comparison of risk indicators of dental caries in children with and without cleft lip and palate deformities

Objective: To test the hypothesis that there are no differences in various risk factors of dental caries among children with cleft lip and palate when compared to non-cleft high caries risk and non-cleft caries free children. Design: Seventy-three children in the age range of 4-9 years comprised three groups; Group-I (n = 23, children with cleft lip and palate), Group-II (n = 25, non-cleft high caries risk children) and Group-III (n = 25, non-cleft caries free children). Various risk factors for dental caries like type of oral hygiene practice, sugar exposures/day, developmental defects of enamel, caries activity, salivary streptococci mutans levels and lactobacilli levels were evaluated and compared among the three groups of children. Results: The mean deft score among Group-II children was significantly more (P < 0.01) as compared to the Group-I children. The mean deft + DMFT score among Group-I and Group-II children was comparable (P = 0.149). Developmental enamel defects were more among Group-I children as compared to Group-II and Group-III children (P < 0.01). Hypoplasia of the maxillary anterior teeth was more common among Group-I children as compared to Group-II (P < 0.05) and Group-III children (P < 0.001). The association between hypoplastic teeth and dental caries was significant (P < 0.05). The salivary acidogenic potential as evaluated by Snyder test was comparable among Group-I and Group-II children. The salivary streptococcus mutans levels in Group-I and Group-II children were higher when compared to lactobacillus counts. Conclusion: The risk factors of dental caries among children with cleft lip and palate were more as compared to non-cleft high caries risk and non-cleft caries free children.

Effects of sagittal maxillary growth hypoplasia severity on mandibular asymmetry in unilateral cleft lip and palate subjects

OBJECTIVE To test the hypothesis that sagittal maxillary growth hypoplasia has no effect on mandibular asymmetry among subjects with complete unilateral cleft lip and palate (UCLP). DESIGN A total of 86 subjects (normal noncleft, 42; UCLP, 44) in the age range of 15 to 25 years were chosen. Normal noncleft subjects were included in Group I. Based on the severity of sagittal maxillary growth hypoplasia, subjects with UCLP were divided into two groups. Subjects with UCLP in whom the SNM angle was ≥71 degrees and the M-point to Nasion perpendicular distance was ≤-10 mm were included in Group II. Group III consisted of subjects with UCLP in whom the SNM angle was <71 degrees and the M-point to Nasion perpendicular distance was >-10 mm. The mandibular asymmetry index (condylar, ramal, and condylar+ramal), gonial angle, and depth of the antigonial notch of three groups of subjects were examined on orthopantomograms (OPGs). RESULTS Among Group II subjects in whom sagittal maxillary growth was near normal, ramal and condylar+ramal heights were significantly less on the cleft side than on the normal side (P < .01). Condylar, ramal, and condylar+ramal asymmetry indices were significantly greater among Group II subjects. Mandibular asymmetry indices among Group III subjects were comparable with those in Group I subjects. CONCLUSION The hypothesis was rejected. The mandible was significantly asymmetrical among subjects with UCLP in whom sagittal maxillary growth was near normal, whereas the mandible was nearly symmetrical among subjects with UCLP in whom sagittal maxillary growth hypoplasia was very severe.

Efficacy of resin-modified glass ionomer cement varnish in the prevention of white spot lesions during comprehensive orthodontic treatment: a split-mouth study

AbstractObjective:To evaluate the efficacy of resin-modified glass ionomer cement varnish in the prevention of white spot lesions (WSLs) during early orthodontic treatment with fixed appliances.Materials and methods:A total of 480 maxillary and mandibular anterior teeth were studied. The varnish was applied to either the right or left side of the maxillary or mandibular anterior teeth on a random basis. For each experimental quadrant in each patient, the varnish was applied to the labial surfaces of incisors and canines, from the gingival surface of the bracket to the free gingival margin. White spot lesions were recorded on a standard pro forma before (T 0) and approximately 6 months following varnish application (T 1) by DIAGNOdent and direct visual inspection.Results:The DIAGNOdent score at T 1 was increased significantly in the control maxillary lateral and mandibular central (P < 0·05), and lateral incisors (P < 0·01). The visual scores in experimental maxillary lateral incisors and mandibular canine...OBJECTIVE To evaluate the efficacy of resin-modified glass ionomer cement varnish in the prevention of white spot lesions (WSLs) during early orthodontic treatment with fixed appliances. MATERIALS AND METHODS A total of 480 maxillary and mandibular anterior teeth were studied. The varnish was applied to either the right or left side of the maxillary or mandibular anterior teeth on a random basis. For each experimental quadrant in each patient, the varnish was applied to the labial surfaces of incisors and canines, from the gingival surface of the bracket to the free gingival margin. White spot lesions were recorded on a standard pro forma before (T(0)) and approximately 6 months following varnish application (T(1)) by DIAGNOdent and direct visual inspection. RESULTS The DIAGNOdent score at T(1) was increased significantly in the control maxillary lateral and mandibular central (P < 0·05), and lateral incisors (P < 0·01). The visual scores in experimental maxillary lateral incisors and mandibular canines were decreased significantly at T(1) (P < 0·05). The sidewise post-treatment (T(1)) comparisons of control and experimental teeth for visual scores revealed significant decreases for maxillary lateral incisors, maxillary canines and mandibular canines (P < 0·05). CONCLUSION Application of resin-modified glass ionomer cement varnish had a favourable effect in the prevention of WSLs during comprehensive orthodontic treatment.

Vanishing Mandible in a 7-year Old Child: Response to Radiation Therapy

Massive osteolysis in a 7-year old child is a rare condition. The etiology of massive osteolysis is unknown and it results in the progressive destruction of bony structures. There is no standard therapy available in the literature. Conservative treatment is often used for its management. Radiotherapy is considered as an accepted form of treatment with greater chance of success when it is used in the early course of disease. There are few case reports in the literature in which radiotherapy has been used for the treatment. This article highlights the literature update on various treatment modalities and a case managed by radiation therapy.

Atypical Bullous Lichen Planus in Palate

A 60-year old woman presented too dental OPD, All India Institute of Medical Sciences, Bhubaneswar, on 18.12.2014 with complaint of burning sensation to spicy food and a non-healing ulcer in the mouth for 1 year. Initially she developed vesicles in the palate which ruptured to give rise of ulcer. She developed itching on the skin few months after the development of oral symptoms without vesicle formation. On intra-oral examination, there was Y-shaped erythematous erosion in the palate

Second premolar extraction improves the angulation of developing third molars better than first premolar extraction among subjects undergoing comprehensive orthodontic treatment

Objective: To test the null hypothesis that premolar extraction had no favorable effect on the angulation of developing third molar among subjects undergoing comprehensive orthodontic treatment. Materials and Methods: Preand post-treatment orthopantomograms of 73 subjects in the age range of 13-24 years were divided into three groups to evaluate the effect of premolar extraction on the improvement of developing third molar angulation. Group-I (n=26) included subjects in whom all first premolars were extracted, Group-II (n=20) included subjects in whom all second premolars were extracted and Group-III (n=27) included subjects in whom non-extraction orthodontic treatment was carried out for the correction of their malocclusion. Descriptive statistics, paired t-test were used for the statistical analysis. The P-value of 0.05 was considered as level of significant. Results: The mean angulations of maxillary third molars were increased significantly following first and second premolars extraction treatment (P<0.01). The mean angulations of mandibular third molars were increased marginally following first premolars extraction treatment, however the mean angulations of the mandibular third molars were increased significantly following second premolars extraction treatment (P<0.05). The changes in the angulations of maxillary and mandibular third molars after non-extraction orthodontic treatment were very modest and statistically not-significant. Conclusions: Extraction of first and second premolars had favorable effect on the angulation of developing third molars. The favorable changes were more following the second premolars extraction as compared to the all first premolars extraction.