Pradeep Tandon

Dynamics of a smile in different age groups.

OBJECTIVE To evaluate smile in different age groups and to detect gender differences in smile. MATERIALS AND METHODS Digital videographic records of 241 randomly selected subjects were obtained for smile analysis. The subjects were divided into four groups by age (15-20 years, 21-30 years, 31-40 years, and 41-50 years). Each group was further subdivided by gender. After 41 subjects were excluded, the smile dimensions of 200 subjects were analyzed by two-way multivariate analysis of variance (MANOVA) with Duncans multiple range post hoc test. RESULTS All dynamic measurements (change in upper lip length, upper lip thickness, commissure height, and intercommissural width from rest to smile) decreased with age in both males and females. Changes in upper lip length and commissure height on smiling were greater in males as compared with females of the same age groups. Changes in intercommissural width on smiling were greater in females as compared with males in all age groups. CONCLUSION Smile changes with increase in age, and the changes differ between males and females. Females had a wider smile as compared with males of similar age groups.

A comparison of shear bond strength of orthodontic brackets bonded with four different orthodontic adhesives.

Objectives: The objective of this study is to compare the shear bond strength (SBS) of stainless steel (SS) orthodontic brackets bonded with four different orthodontic adhesives. Materials and Methods: Eighty newly extracted premolars were bonded to 0.022 SS brackets (Ormco, Scafati, Italy) and equally divided into four groups based on adhesive used: (1) Rely-a-Bond (self-cure adhesive, Reliance Orthodontic Product, Inc., Illinois, USA), (2) Transbond XT (light-cure adhesive, 3M Unitek, CA, USA), (3) Transbond Plus (sixth generation self-etch primer, 3M Unitek, CA, USA) with Transbond XT (4) Xeno V (seventh generation self-etch primer, Dentsply, Konstanz, Germany) with Xeno Ortho (light-cure adhesive, Dentsply, Konstanz, Germany) adhesive. Brackets were debonded with a universal testing machine (Model No. 3382 Instron Corp., Canton, Mass, USA). The adhesive remnant index (ARI) was recordedIn addition, the conditioned enamel surfaces were observed under a scanning electron microscope (SEM). Results: Transbond XT (15.49 MPa) attained the highest bond strength. Self-etching adhesives (Xeno V, 13.51 MPa; Transbond Plus, 11.57 MPa) showed clinically acceptable SBS values and almost clean enamel surface after debonding. The analysis of variance (F = 11.85, P < 0.0001) and Chi-square (χ2 = 18.16, P < 0.05) tests revealed significant differences among groups. The ARI score of 3 (i.e., All adhesives left on the tooth) to be the most prevalent in Transbond XT (40%), followed by Rely-a-Bond (30%), Transbond Plus with Transbond XT (15%), and Xeno V with Xeno Ortho (10%). Under SEM, enamel surfaces after debonding of the brackets appeared porous when an acid-etching process was performed on the surfaces of Rely-a-Bond and Transbond XT, whereas with self-etching primers enamel presented smooth and almost clean surfaces (Transbond Plus and Xeno V group). Conclusion: All adhesives yielded SBS values higher than the recommended bond strength (5.9-7–8 MPa), Seventh generation self-etching primer Xeno V with Xeno Ortho showed clinically acceptable SBS and the least amount of residual adhesive left on the enamel surface after debonding.

A correlative study of dental age and skeletal maturation

INTRODUCTION Skeletal age had been assessed by comparison between maturation of hand-wrist with stages of cervical vertebrae or canine calcification stages in past and this had been closely related to craniofacial growth. The importance of pubertal growth spurt in various types of orthodontic therapies is already established. AIMS AND OBJECTIVES Hence, this study was aimed to evaluate the relationship of skeletal maturity by hand-wrist with cervical vertebral maturation indicators and canine calcification stages. MATERIALS AND METHODS The study consisted of randomly selected 90 children from Lucknow population with 45 males (age range 10-13 years) and 45 females (age range 9-12 years). Lateral Cephalogram, hand-wrist x-ray, and periapical x-rays of maxillary and mandibular right canines were taken. STATISTICAL ANALYSIS Mean, standard deviation was calculated of different groups. Correlation was made among cervical vertebral maturation, hand wrist maturation, and canine calcification stages at various age groups. RESULTS There was strong correlation between skeletal maturation indicator and cervical vertebral maturation indicator for both male (0.849) and female (0.932), whereas correlation between skeletal maturation indicator and canine calcification was good for both male and female (0.635, 0.891). CONCLUSION It was concluded that cervical vertebral maturation indicator and canine calcification stages can also be used for assessing skeletal maturity.

Brodie bite with an extracted mandibular first molar in a young adult: A case report

Total buccal crossbites are rare, but, when they occur, they can be extremely difficult to correct, even with surgery and orthodontics. In most patients with in-locking crossbites, the maxillary teeth erupt past their mandibular antagonists, creating severe occlusal difficulties. This article presents an adult patient with scissors-bite or partial telescoping bite bilaterally in the posterior region and an extracted mandibular first molar on the right side. She was treated with expansion of the mandibular arch, and the subsequent open bite was closed with the help of masticatory muscle exercises and high-pull headgear. The second and third molars were uprighted and moved mesially to close the extraction spaces.

Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients

Introduction: The extraction of premolars as a practical form of orthodontic therapy has been accepted for many years, but there remains a controversy regarding the effect of premolar extraction to improve esthetics as well as dentoskeletal relationship. The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or non-extraction treatment, particularly in borderline patients. This cephalometric study was undertaken to compare the post-treatment soft-tissue profiles of successfully managed Class II, Division 1 malocclusions treated with either all first premolar extractions or treatment with a non-extraction therapy. Materials and Methods: The sample consisted of 100 post-pubertal female patients of Class II Division I malocclusion. Group 1, treated with four first premolar extractions, consisted of 50 female patients with a mean age of 14 years 1 month. Group 2, treated without extractions, consisted of 50 patients with a mean age of 13 years 5 months. Pre-treatment and post-treatment lateral cephalometric radiographs were evaluated. The pre-treatment to post-treatment stage comparison and the intergroup comparison of the treatment changes were conducted between extraction and non-extraction groups of Class II malocclusion samples with t-tests. Results: The soft-tissue facial profiles of the extraction and non-extraction samples were the same following active treatment except for a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction. Conclusions: The extraction or non-extraction decision, if based on sound diagnostic criteria, seems to have no systematic detrimental effects on the facial profile.

A comparative study of frictional resistance during simulated canine retraction on typodont model.

Objectives: Frictional resistance is an important counterforce to orthodontic tooth movement during sliding mechanics. This study was carried out to evaluate the effect of different bracket-archwire-ligation combinations on “resistance to sliding” during simulated canine retraction on typodont model. Materials and Methods: the frictional resistance was tested between three modern orthodontic brackets-stainless steel, ceramic, and ceramic with metal slot (0.022-inch), and seven different archwires (0.019 × 0.025-inch)-stainless steel, nickel-titanium, Teflon coated stainless steel, stainless steel with the reverse curve of spee (RCS), Teflon coated stainless steel with RCS, Teflon coated nickel-titanium and nickel-titanium with RCS ligated with stainless steel ligature wire and regular clear elastomeric modules. All tests were carried out in a dry state on an Instron universal testing machine (crosshead speed: 0.5 mm/min). 10 measurements were made from each bracket-archwire-ligature combinations. Results: The highest mean frictional resistance was found in ceramic brackets with nickel-titanium RCS archwire ligated with elastomeric modules while minimum frictional resistance was found in stainless steel brackets with Teflon coated stainless steel archwire ligated with stainless steel ligature. Metal slot ceramic brackets generated significantly lower frictional forces than ceramic brackets, but higher values than stainless steel brackets. Teflon coated archwires shows highly significant reduction of the frictional resistance than their corresponding uncoated archwires. Archwires with RCS had the higher frictional resistance than normal counterpart archwires. Conclusion: Ceramic brackets with metal slot and Teflon coated SS archwires seem to be a good alternative to conventional stainless steel brackets and archwires in space closure with sliding mechanics in patients with esthetic demands.

Cephalometric evaluation of hyoid bone position and pharyngeal spaces following treatment with Twin block appliance.

Objective: To evaluate the position of hyoid bone in the subjects treated with Twin block appliance. Materials and Methods: The sample consisted of 40 Angles Class II division 1 subjects treated with Twin block appliance. Lateral radiographs were taken before and after treatment. According to Schudys facial divergence angle (SN-MP), the subjects were classified in to three groups: group I (hypodivergent, SN-MP: <31° (27°-30°), n=15), group II (normodivergent, SN-MP: 31°-34°, n=15), and group III (hyperdivergent, SN-MP: >34° (35°−38°), n=10). Lateral cephalograms were traced and analyzed manually. After measurements of variables, Students t-test and one-way analysis of variance (ANOVA) were performed. Results: Post treatment with Twin block therapy, hyoid bone shifted significantly (P<0.01) forward in horizontal dimension in all three groups, although it was highest in group III. However, there was no significant difference amongst the groups. In vertical dimension, hyoid bone shifted in upward direction in all three groups; however, the shift was significant (P<0.01) only in group I and there was a significant difference between group I and rest of the two groups. Width of upper airway significantly (P<0.01) increased and ANB angle significantly (P<0.001) decreased in all three groups with forward movement of mandible. Conclusions: After treatment with Twin block appliance, significant changes occurred in horizontal dimension (anterior displacement), which resulted in significant increase in width of upper pharynx in all three groups.

An in vitro scanning electron microscope study to evaluate the efficacy of various root conditioning agents.

Aim: The purpose of present study was to investigate the scanning electron microscopic alterations produced on scaled and root planed dentin surfaces after application of different etching modalities namely citric acid, tetracycline hydrochloride and ethylenediaminetetraacetic acid (EDTA). Materials and Methods: Eighty specimens of teeth were collected and categorized into four groups. In group 1, control group specimens were treated with normal saline for 3 min, group 2 specimens were treated with citric acid, group 3 specimens were treated with tetracycline hydrochloride for 3 min and group 4 specimens were treated with 15% EDTA. Results: Opening of dentinal tubules was seen in all specimens except for control group that was treated with normal saline. The total number of tubules seen was highest in citric acid group as compared to tetracycline hydrochloride and EDTA Group. The total number of patent tubule opening was highest in citric acid as compared to EDTA and tetracycline. The diameter of patent dentinal tubules in citric acid group was more than EDTA and tetracycline. Conclusion: The study showed that all the three agents were effective in removing the smear layer however number of patent and wider diameter dentinal tubules was seen in vitro best in citric acid than EDTA and then in tetracycline hydrochloride. Hence, citric acid group is more efficient than EDTA and tetracycline HCl group in removing the smear layer and in opening of number of patent dentinal tubules.

A comparative clinico-radiographic study of guided tissue regeneration with bioresorbable membrane and a composite synthetic bone graft for the treatment of periodontal osseous defects

Aim: The aim was to evaluate the bonefill in periodontal osseous defects with the help of guided tissue regeneration, bioresorbable membrane (PerioCol) + bone graft (Grabio Glascera) in combination and with bonegraft (Grabio Glascera) alone. Materials and Methods: The study involved total 30 sites in systemically healthy 19 patients. The parameters for evaluation includes plaque index sulcus bleeding index with one or more periodontal osseous defects having (i) probing depth (PD) of ≥ 5 mm (ii) clinical attachment loss (CAL) of ≥ 5 mm and (iii) ≥3 mm of radiographic periodontal osseous defect (iv) bonefill (v) crestal bone loss (vi) defect resolution. The study involved the three wall and two wall defects which should be either located interproximally or involving the furcation area. The statistical analysis was done using Statistical Package for Social Sciences, the Wilcoxon signed rank statistic W + for Mann-Whitney U-test. Results: The net gain in PD and CAL after 6 months for Group I ([PerioCol] + [Grabio Glascera]) and Group II (Grabio Glascera) was 3.94 ± 1.81 mm, 3.57 ± 2.21 mm and 3.94 ± 1.81, 3.57 ± 2.21 mm, respectively. The results of the study for Group I and Group II with regards to mean net bonefill, was 3.25 ± 2.32 (58%) mm and 5.14 ± 3.84 (40.26 ± 19.14%) mm, crestal bone loss − 0.25 ± 0.68 mm and − 0.79 ± 1.19 mm. Defect resolution 3.50 ± 2.34 mm and 5.93 ± 4.01 mm, respectively. Conclusion: On comparing both the groups together after 6 months of therapy, the results were equally effective for combination of graft and membrane versus bone graft alone since no statistical significant difference was seen between above parameters for both the groups. Thus, both the treatment modalities are comparable and equally effective.

Early orthopedic correction of skeletal Class III malocclusion using combined reverse twin block and face mask therapy

A 6-year 8-month-old girl presented with a moderate Class III malocclusion characterized by mid-face deficiency and an anterior cross bite. In the first phase, the patient was treated with combination of reverse twin block and facemask therapy. In phase two, fixed appliances were placed in the permanent dentition. The post treatment results were good and a favorable growth tendency could be observed. The correction of the Class III malocclusion occurred by a combination of skeletal and dental improvements. This report shows successful correction of skeletal Class III malocclusion in the early transitional dentition using combination therapy.