Narayan H Gandedkar

A new esthetic fiber-reinforced polymer composite resin archwire: a comparative atomic force microscope (AFM) and field-emission scanning electron microscope (FESEM) study

BackgroundFiber-reinforced polymer composite (FRPC) archwires could provide an esthetic solution to conventional orthodontic archwires. This study was carried out with the following aims: (1) to compare the sliding friction of FRPC archwire with nickel titanium archwire using various archwire-bracket combinations and (2) to determine the correlation between surface roughness and friction of the FRPC and NiTi archwires.MethodsFour different brackets (Gemini® (Gemini-3M Unitek, St. Paul, MN, USA), ICE® (ICE-Ormco- Orange, CA, USA), Clarity® (Clarity-3M Unitek, St. Paul, MN, USA), and SmartClip® (SmartClip-3M Unitek, St. Paul, MN, USA)) in combination with FRPC wires and NiTi wires (0.018 in) were studied for archwire friction with simulated wear and surface roughness using scanning electron microscope (SEM) and atomic force microscope (AFM), respectively. Statistical analysis of frictional wear generated and surface roughness between the various archwire and bracket groups was evaluated by one-way ANOVA at 5% level. Least significant difference (LSD) multiple comparisons were used to determine the archwire-bracket group difference.ResultsGemini®-FRPC group generated the highest frictional wear (mean, 313.10; SD, 802.59) and ICE®-FRPC group produced the highest roughness values among all the groups tested (Rau2009=u2009496.13xa0nm, RMSu2009=u2009635.49xa0nm). No correlation was found between frictional wear and surface roughness of the archwires of the various groups.ConclusionsFRPC archwire shows promise in its application as an esthetic aligning archwire. However, further research and refinement in its manufacture would be necessary to fully realize its potential as an esthetic archwire.

Double-loop technique using titanium molybdenum alloy wire for fabrication of nasal stents in nasoalveolar molding therapy for cleft lip and palate patients.

This article presents a technique for fabricating a modified nasoalveolar molding appliance using 0.032-inch titanium-molybdenum alloy wire for nasal stents incorporating a double loop. The nasal stents are included in the acrylic molding plate at the time the appliance is inserted. The acrylic retention button used in a conventional appliance is replaced by a simple retention hook fabricated using titanium-molybdenum alloy wire. This technique is an effective alternative to a conventional appliance, and it simplifies the appliance-modification process during follow-up visits.

Comparative Evaluation of the Pharyngeal Airway Space in Unilateral and Bilateral Cleft Lip and Palate Individuals With Noncleft Individuals: A Cone Beam Computed Tomography Study.

Objective To evaluate the pharyngeal airway space changes in complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) individuals, and compare with age and sex-matched noncleft (NC) control subjects. Design Retrospective study. Setting Cleft and Craniofacial Centre, KK Womens and Childrens Hospital, Singapore. Materials and Methods Twenty UCLP (mean age: 13.4 ± 0.5 years), 18 BCLP (mean age: 13.5 ± 0.5 years) and 20 skeletal Class I subjects (mean age: 13.4 ± 0.6 years) were included in the study. Cone beam computed tomography scans were assessed for pharyngeal airway space (PAS) (oropharyngeal, nasopharyngeal, total airway space volume), and compared with PAS of age and sex-matched skeletal Class I NC individuals. Results Pharyngeal airway space showed statistically significant differences in the UCLP, BCLP, and NC control subjects. Oropharyngeal (9338 ± 1108 mm3, P < .05), nasopharyngeal (2911 ± 401 mm3, P < .05), and total airway space (12 250 ± 1185 mm3, P < .05) volumes of BCLP individuals showed significant reduction in comparison to UCLP and NC. There were no gender differences of PAS in any of the groups tested (P > .05). Conclusion The pharyngeal airway space was significantly reduced in the BCLP group than were those in UCLP and control groups. This reduced PAS should be taken into account when planning treatment for these individuals.

Surgery-first orthognathic approach case series: Salient features and guidelines

Conventional orthognathic surgery treatment involves a prolonged period of orthodontic treatment (pre- and post-surgery), making the total treatment period of 3-4 years too exhaustive. Surgery-first orthognathic approach (SFOA) sees orthognathic surgery being carried out first, followed by orthodontic treatment to align the teeth and occlusion. Following orthognathic surgery, a period of rapid metabolic activity within tissues ensues is known as the regional acceleratory phenomenon (RAP). By performing surgery first, RAP can be harnessed to facilitate efficient orthodontic treatment. This phenomenon is believed to be a key factor in the notable reduction in treatment duration using SFOA. This article presents two cases treated with SFOA with emphasis on case selection, treatment strategy, merits, and limitations of SFOA. Further, salient features comparison of conventional orthognathic surgery and SFOA with an overview of author′s SFOA treatment protocol is enumerated.

A study of a novel aesthetic archwire on its frictional properties and its applications to orthodontics

Objectives: To compare sliding friction of prototype 0.018-inch fiber-reinforced polymer composite (FRPC) archwire with 0.018-inch nickel titanium archwire using various bracket-arch wire combinations. Materials and Methods: Two wires were tested against four different brackets (3M Gemini Twin bracket; 3M Clarity metal-reinforced ceramic bracket; Ormco Inspire ICE ceramic bracket; and 3M SmartClip) using the Universal testing machine to study and compare frictional characteristics. Results: There was no significant difference noted for the frictional wear generated between the various archwire and bracket groups ( P = 0.542). No statistical significance was detected within individual archwire-bracket groups. A multiple comparison of groups showed significant difference in frictional wear. Least significance difference multiple comparison revealed statistical significance ( P Conclusion: FRPC and NiTi wire show comparable frictional wear when used with ICE, Gemini, Clarity, and SmartClip brackets.

The immediate effect of alternate rapid maxillary expansions and constrictions on the alveolus: a retrospective cone beam computed tomography study

BackgroundRapid maxillary expansion reduced the expander’s anchor teeth buccal alveolar bone thickness. However, the effects of alternate rapid maxillary expansions and constrictions (Alt-RAMEC) on the expander’s anchor teeth alveolar thickness has not been assessed. The purpose of this retrospective study was to evaluate the effects of Alt-RAMEC on the alveolus surrounding the anchor teeth of a double-hinged expander.MethodsTwenty-six individuals, including 12 males (11.5u2009±u20091.00xa0years) and 14 females (11.5u2009±u20090.90xa0years), who had double-hinged expander for 7xa0weeks of Alt-RAMEC and then 3xa0months of maxillary protraction, were included. Their cone beam computed tomography (CBCT) images taken 3–6xa0months before treatment (T0) and after 7xa0week of Alt-RAMEC (T1), were studied for the buccal alveolar bone thickness (BABT) and palatal alveolar bone thickness (PABT) of the expander’s anchor teeth (first molars and first and second premolars) in four axial sections. The intra-class correlation coefficient, Dahlberg’s formula, and paired t tests were used to analyze the method errors, and the intra-group changes of the BABT and PABT at T0-T1 were analyzed by paired t test (pxa0<u20090.05).ResultsThe 7xa0weeks of Alt-RAMEC significantly reduced the BABT of the expander’s anterior anchor teethxa0(0.54~u200970xa0mm, pu2009<u20090.05) and at the cervical regionxa0(0.14~u20090.25xa0mm, pu2009<u20090.05), but not at the apical region of the expander’s posterior anchor teeth. The reduction of BABT by 7xa0weeks of Alt-RAMEC was within the scope of the initial BABT. On the opposite, the Alt-RAMEC significantly (pu2009<u20090.05) increased the PABT in the anterior anchor teeth and the cervical region of posterior anchor teeth.ConclusionsA 7-week protocol of Alt-RAMEC with double-hinged expander for maxillary protraction might reduce the buccal alveolar bone thickness of the expander’s anchor teeth, although the reduction is within the scope of initial alveolar thickness of the expander’s anchor teeth.

Influence of Bimaxillary Surgery on Pharyngeal Airway in Class III Deformities and Effect on Sleep Apnea: A STOP-BANG Questionnaire and Cone-Beam Computed Tomography Study

PURPOSEnTo evaluate pharyngeal airway space (PAS; nasopharyngeal, oropharyngeal, and total airway) volume and the correlation of an obstructive sleep apnea (OSA) and hypopnea syndrome screening questionnaire (STOP-BANG) with various mandibular setbacks during bimaxillary surgery and compare these findings with an age- and gender-matched skeletal Class I control group.nnnPATIENTS AND METHODSnThis retrospective cohort study was composed of patients with skeletal Class III discrepancy who underwent bimaxillary jaw surgery and were assessed with STOP-BANG score, cephalometry, and cone-beam computed tomography (of the PAS). The predictor variable was bimaxillary jaw surgery and included 4-, 6-, and 8-mm setbacks. The primary outcome variables were PAS volume, body mass index, and STOP-BANG score evaluated at 1xa0week before surgery and after comprehensive orthodontic treatment (11.25xa0±xa01.95xa0months). Other variables were grouped into the following categories: demographic and cephalometric parameters. Statistical intragroup and intergroup differences were assessed by paired t and independent t tests (Pxa0<xa0.05), respectively.nnnRESULTSnThe study sample was composed of 48 patients (18 to 25xa0yr old); group I received 4-mm setback (nxa0=xa016), group II received 6-mm setback (nxa0=xa016), and group III received 8-mm setback (nxa0=xa016) mandibular surgery, and all test groups received 4-mm maxillary advancement. The entire study group was compared with a skeletal Class I control group (nxa0=xa016). The total PAS volume after orthodontic treatment in groups I and II showed a significant decrease compared with the presurgical PAS (Pxa0<xa0.001), but the decrease was not less than that in the control group (Pxa0>xa0.05). In contrast, the total PAS volume in group III after orthodontic treatment (23,574xa0±xa01,394xa0mm3) was less than that in the control group (23,884xa0±xa01,543xa0mm3).nnnCONCLUSIONnAfter surgery, patients with Class III discrepancy exhibited a decrease in oropharynx volume; however, the STOP-BANG score showed no change in risk factors scores for OSA at 4- to 8-mm setback surgery of the mandible in bimaxillary jaw surgery.

Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics

Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery) are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the paper surgery to establish surgical-plan. Furthermore, the paper surgery is emulated in model surgery such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing paper surgery and an occlusion is set up during model surgery for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from treatment planning to execution for successful management of aforementioned dentofacial deformity.

Correction of an adult Class II division 2 individual using fixed functional appliance: A noncompliance approach

This case report describes the application of fixed functional appliance in the treatment of an adult female having Class II division 2 malocclusion with retroclination of upper incisors. Fixed functional appliance was used to correct the overjet after the uprighting of upper incisors. Fixed functional appliance was fitted on a rigid rectangular arch wire. Application of fixed functional appliance achieved a good Class I molar relationship along with Class I canine relationship with normal overjet and overbite. Fixed functional appliance is effective in the treatment of Class II malocclusions, even in adult patients, and can serve as an alternate choice of treatment instead of orthognathic surgery. This is a case; wherein, fixed functional appliance was successfully used to relieve deep bite and overjet that was ensued after leveling and aligning. We demonstrate that fixed functional appliance can act as a “noncompliant corrector” and use of Class II elastics can be avoided.

Presurgical nasoalveolar molding therapy in cleft lip and palate individuals: Case series and review

The nasoalveolar molding (NAM) therapy is advocated to reduce the severity of alveolar cleft and nasal deformity. NAM therapy has demonstrated to be an effective method for reducing cleft and improve nose anatomy. This paper presents a case report of three cleft lip and palate individuals treated with NAM therapy. Furthermore, the paper highlights the advantages of NAM therapy along with an enumeration of literature suggesting in favor of NAM therapy and otherwise. Regardless of controversies and divergent views involved with NAM therapy, the immediate success of NAM therapy facilitating primary lip repair surgery cannot be under-emphasized.