Priyank Rai

Foreign body ingestion of orthodontic origin

Foreign bodies in the ear, nose, and throat are commonly seen in family medicine, usually in children. Occasionally, orthodontic appliances or parts of orthodontic appliances are accidentally swallowed and have caused problems with either the airway or the gastrointestinal tract. The purposes of this article were to describe the type of appliances most likely to cause problems and to discuss their clinical management. The case of a patient who swallowed a key for turning fixed expansion appliances is presented. The key became lodged in the patients pharynx but subsequently passed through the gastrointestinal tract. Suggestions are made to prevent the problems that were encountered in this case and others reported in the literature in orthodontic patients.

Evaluation of orthodontic mini-implant placement: a CBCT study

BackgroundOptimal positioning of orthodontic mini-implants is essential for a successful treatment with skeletal anchorage. This study aims to compare the accuracy of two-dimensional radiographs with a cone beam computed tomography (CBCT) for mini-implant placement.MethodsAn ideal site for mini-implant placement at the buccal interradicular space between the second premolar and the first molar was determined for 40 sites (in 13 patients aged 14 to 28 years) by using CBCT data. The mini-implant placement procedure was then divided into two groups. In CBCT group, mini-implants were placed at the sites determined from CBCT data. In RVG group, mini-implants were placed with the help of two-dimensional digital radiographs and a custom made guide. Postplacement CBCT scans were obtained to determine the accuracy of the mini-implant placement. The results were statistically analyzed with a Mann-Whitney test.ResultsA statistically significant difference (p value = 0.02) was observed between the two groups for deviation from an ideal height of placement of the mini-implants. Deviations in mesiodistal positioning and angular deviation showed a statistically non-significant difference. Three out of twenty mini-implants in the RVG group showed root contact in the mandibular arch that may be attributed to the narrower interradicular space and reduced accessibility in the mandibular posterior region.ConclusionsAlthough CBCT provides an accurate three-dimensional visualization of the interradicular space, the two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement. Considering the amount of radiation exposure and cost with the two techniques, it is recommended to use two-dimensional radiographs with a surgical guide for a routine mini-implant placement.

New generation of color bonding: A comparative in vitro study

BACKGROUND Newer available composite resin adhesives have chromatic agents that change their color during setting from pink to colorless. It has an advantage of easy flash removal thus reducing the amount of plaque accumulation and helping patients to maintain better hygiene. AIM The aim of the present study was to compare shear bond strengths of light-cure orthodontic bonding agents, namely glass ionomer (FujiOrthoLC, GC Orthodontics), conventional composite resin (Transbond XT, 3M Unitek), and color-changing composite resin (Transbond Plus, 3M Unitek) with conventional etch and self-etch primer (Transbond PlusSEP, 3M Unitek). MATERIALS AND METHODS Maxillary premolars (n=300) were bonded on the facial surface in five groups. The INSTRON machine was used for shear bond strength testing. STATISTICAL ANALYSIS Comparison of the mean rank among the groups was done by Kruskal-Wallis one-way analysis of variance (ANOVA). To determine the mean difference among groups, the Mann-Whitney test with Bon Ferroni adjustment was applied. OBSERVATIONS It was observed that light-cure conventional composite resin with the conventional etchant group had the highest and glass ionomer resin adhesive had the lowest shear bond strength. There was no statistically significant difference between conventional composite used with conventional etchant and color-changing composite resin used with conventional etchant or with self-etch primer. CONCLUSION Considering the advantages of a color-changing composite and self-etch primer especially in patients having high DMFT scores or physically and mentally compromised patients unable to maintain their hygiene properly, it was concluded in the present study that it would be the most suitable material for direct bonding.

A comparative evaluation of skeletal, dental, and soft tissue changes with skeletal anchored and conventional facemask protraction therapy.

Objective: To cephalometrically evaluate and compare the skeletal, dentoalveolar, and soft tissue changes after maxillary protraction with skeletally anchored and conventional facemask. Methods: The data for the study were collected from the pre- and post-treatment records of patients of maxillary retrusion treated with skeletally anchored and conventional facemask therapy. Twenty subjects were included in the study and were categorized into two groups, namely skeletal anchored maxillary protraction (SAMP) group with the mean age of 10.10 ± 1.1 years and conventional facemask maxillary protraction (CFMP) group with the mean age of 9.90 ± 1.1 years. Pre and post-treatment lateral cephalograms were assessed. Results: The data were analyzed by Mann-Whitney test and Wilcoxon signed-rank test. The mean duration of treatment in SAMP group and CFMP group was 5.8 months and 10 months, respectively. The mean forward displacement of the maxilla (vertical point A) was 3.40 ± 1.07 mm in SAMP group and 2.80 ± 0.79 mm in CFMP group. The mandible showed downward and backward rotation in both the groups with more rotation in CFMP group. A significant increase in maxillary incisor inclination was seen in CFMP group as compared to SAMP group. A significant decrease was found in mandibular incisor inclination in both the treatment groups. The soft tissue changes corresponded to underlying skeletal tissue. C onclusions: SAMP is proven to be a better treatment modality as compared to CFMP for achieving true skeletal changes and minimal dental changes in cases with developing skeletal Class III with maxillary retrusion.

Facilitated Eruption of an Impacted Premolar 8 Years Post-eruption Timing- Think before You Treat!!!

The treatment planning of impacted teeth usually involves surgical intervention for bringing about its eruption with traction. But a thoughtful analysis in such cases looking at the possible aetiology may save the complexity of therapy. The present case demonstrates the importance of correct diagnosis in resolving impaction wherein an impacted mandibular second premolar was made to erupt using a simple removable appliance 8 years after its normal range of eruption timing.

A Novel Minimally Invasive Technique of Using Tooth-Borne Hyrax Expansion Screw for Distraction Osteogenesis of Large Alveolar Cleft Defects (HYDIS-TB).

Because of the high failure rates, large alveolar cleft defects cannot be successfully closed with bone grafting. Vega introduced the use of the hyrax screw for the closure of such defects by distraction osteogenesis. However, his technique was more invasive with a difficult adaptation of the appliance at the surgical table. To overcome these limitations, a completely tooth-borne trifocal distraction appliance was devised and placed after osteotomy in a 22-year-old repaired group 3 cleft patient who had a 15-mm alveolar defect on the right side. The tooth-borne trifocal distraction appliance was successful in the controlled closure of a large alveolar cleft with minimal invasiveness and low costs making this procedure feasible for a greater number of patients.

Bone-specific alkaline phosphatase – a potential biomarker for skeletal growth assessment

Objective The present study was aimed to assess levels of serum Bone-specific alkaline phosphatase (BALP) and serum Insulin-like growth factor-1 (IGF-1) and comparing with cervical vertebral maturation index (CVMI) stages. Design Cross-sectional study. Setting Maulana Azad Institute of Dental Sciences, New Delhi, India. Participants 150 subjects (75 males and 75 females) in the age group of 8–20 years. Methods Subjects were divided into six CVMI stages. Enzyme-linked immunosorbant assay was performed for the estimation of serum BALP and serum IGF-1 levels. Mann–Whitney U test was performed to compare mean ranks of serum BALP and serum IGF-1 with different CVMI stages. Spearman correlation between serum BALP and serum IGF-1 was done across 6 CVMI stages. Results Peak serum IGF-1 levels were found at CVMI stages 4 and 3 for males and females respectively. Peak levels for serum BALP were found at stage 3 for both genders with significant differences from other stages. A statistically significant correlation was seen between serum IGF-1 and serum BALP from CVMI stages 1 to 3 and 4 to 6 (p < .01). Conclusions BALP showed promising results and can be employed as a potential biomarker for the estimation of growth status.

A custom made appliance for correction of anterior crossbite in Class III malocclusion

Anterior crossbite is the most important concern in a patient with a Class III malocclusion. The current report demonstrates the use of a custom made removable appliance in a patient unwilling for fixed orthodontic therapy.

Orthodontic management of dilacerated impacted maxillary central incisor using closed eruption technique

An impacted incisor with dilaceration poses a clinical dilemma because of its difficult position. This case report describes the orthodontic management of impacted dilacerated maxillary left central incisor. Based on esthetic demand and patient compliance, orthodontic traction involving closed eruption technique was performed to achieve alignment of central incisor in the arch. Prudent application of biomechanics and radiographic evaluation at regular interval assisted in achieving good esthetic and patient satisfaction.

Molar distalization with 2K appliance: one-year follow-up

Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angles Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space.