Orthodontic Journal of Nepal

Correction of Skeletal Class II Malocclusion in a Growing Child Using Standard Twin Block: A Case Report

2023-03-12T03:37:52+00:00

Mandibular defiiency in a Class II malocclusion is a frequently encountered condition that can be managed with myofunctional appliance in a growing child. An 11-year-old patient presented with a complaint of forwardly placed upper front teeth. The patient had a convex facial profie, acute naso-labial angle, deep mento-labial sulcus with lip trap. Clinically the patient showed positive VTO. The clinical fidings and cephalometric analysis indicated skeletal Class II jaw bases owing to prognathic maxilla and retrognathic mandible with Angle’s Class II division 1 malocclusion. CVMIshowed that the patient was in his growth phase. The treatment was done with a standard twin block appliance for 9 months followed by fied orthodontic treatment. The post functional phase showed correction of skeletal class II jaw base and marked improvement in the facial profie from convex to straight. It was later followed by fixed orthodontic treatment in the second phase upon completion of which bonded lingual retainer and wrap around retainers were given in the upper and lower arch. The total duration of the treatment was 23 months.

Evidence-Based Orthodontics

2023-10-08T09:16:55+00:00

A Correlative Study to Assess the Relationship among Ameloglyphics, Cheiloscopy, Rugoscopy in Skeletal and Dental Malocclusions

2023-03-28T09:06:59+00:00

Introduction: Benefits of preventive and interceptive orthodontic procedures can be availed by early prediction of malocclusion. Early diagnosis is achievable when parameters having similar embryological origin and development period, similar to that of the craniofacial structures are identified and studied. Few such parameters are the enamel rod end patterns, lip prints, and palatal rugae patterns. The intent of this study was to assess the correlation between ameloglyphics, cheiloscopy, rugoscopy and skeletal and dental malocclusions.

Materials and Method: A cross-sectional study with one hundred subjects were classified into 3 groups based on cephalometric analysis into skeletal class I, class II and class III malocclusion and were further divided into 4 dental malocclusion groups namely class I, class II division 1, class II division 2 and class III based on the Angle's classification of malocclusion. Ameloglyphics patterns, lip prints and palatal rugae patterns were recorded for each subject and statistically analyzed with chi-square test and Spearman correlation test.

Result: Class I malocclusion subjects revealed a predominant curve palatal rugae pattern, type II lip print pattern and wavybranched ameloglyphics patterns were observed with statistically significant association. In class II malocclusion, the predominant palatal rugae pattern observed was straight pattern, type I lip print pattern and linear branched ameloglyphics patterns were statistically significant. Subjects in class III malocclusion group were associated significantly with the annular pattern of palatal rugae, type I lip print pattern, and stem pattern of ameloglyphics.

Conclusion: A curve rugae pattern in class I malocclusion, a straight pattern in class II malocclusion, and an annular pattern in class III malocclusion were observed. For the Lip Prints, a highly statistically significant association was observed between class I malocclusion and type II lip print pattern. Ameloglyphics, revealed a statistically significant association between wavy branched pattern and class I malocclusion, linear branched pattern and class II malocclusion and stem pattern with class III malocclusion.

A Study of Bolton’s Analysis on Permanent Dentition of Nepalese Citizen of Lumbini Province

2023-06-10T03:29:47+00:00

Introduction: To achieve a good occlusion with satisfactory intercuspation of teeth and a correct overjet and overbite, the maxillary and mandibular teeth must be proportional in size. This cross-sectional study was conducted to assess the Bolton’s tooth size discrepancy in a sample of the Nepalese population of Lumbini Province.

Materials and Method: One hundred twenty-fie study casts (50 males and 75 females) were made after making impression of individuals with normal occlusion. Impression was made using alginate impression material, studycasts were made using dental stone type III, and bases were made using dental plaster type II. Individual mesiodistal width of the teeth were measured using a digital vernier caliper to the nearest 0.01mm for the calculation of Bolton’s anterior and overall ratio. The ratios were then compared between male and female.

Result: One hundred twenty-five study casts (50 males and 75 females) were made after making impression of individuals with normal occlusion. Impression was made using alginate impression material, study casts were made using dental stone type III, and bases were made using dental plaster type II. A statistically signifiant difference between the summed mesiodistal widths were found between males and females using Independent sample t-test. There was no sexual dimorphism concerning Bolton’s ratio in samples. The overall ratio and anterior ratio were 91.70 ± 1.28 and 77.09 ± 1.57 for males and 91.79 ± 1.34 and 77.29 ± 1.71 for females respectively. The combined overall ratio was 91.75 ± 1.32 and anterior ratio which was 77.21 ± 1.65. Individual mesiodistal width of the teeth were measured using a digital vernier caliper to the nearest 0.01mm for the calculation of Bolton’s anterior and overall ratio. The ratios were then compared between male and female.

Conclusion: The sum of mesiodistal dimensions of teeth were greater in males, however, no sexual dimorphism was found in the Bolton ratio. Further, statistically signifiant difference was found in the overall ratio from Nepalese population when compared to the original ratio by Bolton.

The prevalence of malocclusions in patients seeking orthodontic treatment at COMS from Chitwan District of Nepal

2023-04-30T08:58:36+00:00

Background: Malocclusion is the abnormal relation between maxillary and mandibular teeth which leads to various problems like esthetics, phonation, mastication, psychological and social problems. The prevalence of malocclusion is highly variable and its range is very wide and heterogeneous.

Aims and Objectives: To assess the prevalence of various malocclusion traits and to evaluate the orthodontic treatment need based on the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) among the patients visiting the College of Medical Sciences (COMS), Bharatpur, Chitwan.

Materials and Method: A total of 530 patients visiting dental OPD, College of Medical Sciences, Bharatpur, Chitwan were included in this study among which 288 were male and 242 were female patients. Out of the total 530 subjects, malocclusion was observed in 359 individuals. Therefore, all subsequent results and fidings reported in the study are based on these 359 subjects exclusively. Intraoral examination was carried out to assess malocclusion based on Angle’s classifiation, overjet, overbite, open bite, crowding, spacing, and crossbite. The statistical test employed in the study was the Chi-Square test, which was utilized to assess the presence of a signifiant difference.

Result: The present study showed that Class I (55.2%), malocclusion was most prevalent followed by Class II (40.9%) and then Class III (3.9%). Increased overjet (41.2%), deep overbite (40.7%), anterior crowding (70.8%), midline spacing (17.5%), and anterior crossbite (16.4%) were more prevalent occlusal traits. DHC (Dental Health Component) of IOTN (Index of Orthodontic Treatment Needs) showed more in grades 1 and 2 (61.88%) followed by grades 4 and 5 (26.03%).

Conclusion: Class I crowding was the most prevalent malocclusion in adolescents in Bharatpur, Chitwan. The majority of patients fall in grade 1 and 2 categories followed by grades 4 and 5 of DHC of IOTN grading.

Effects of thalassaemia major on components of the craniofacial complex- a cephalometric study in Andhra Pradesh population

2023-03-02T10:24:41+00:00

Introduction: The cephalometric study was conducted to evaluate the craniofacial effects of thalassaemia major on the Andhra Pradesh population.

Methods: A total of 32 thalassaemic patients (23 male, 9 female) were selected from the Thalassaemia and Sickle Cell Society and 32 controls (19 male, 13 female) from schools of Hyderabad city to eliminate any bias on the ethnic background. All 64 lateral cephalograms were taken under standard conditions with teeth in occlusion and lips in a relaxed position. Forty - two linear and angular cephalometric parameters defining craniofacial morphology (22 skeletal, 13 dentoalveolarand 7 softtissue) were selected.

Results: Everypatient with thalassaemia exhibited a skeletal base relationship of class II, accompanied by an average ANB angle of 4°. There was a significant increase in the length of the anterior cranial base. The length of the maxillary and mandibular base was significantly reduced, and the mandible appeared to be retruded in the face. Pronounced vertical growth was evident from linear and angular measurements. The dental deviations seen in thalassaemic patients were proclination, significant over-eruption of the maxillary anterior teeth and increased overjet. A marked increase in the convexity of the lower face, prominent upper lip, reduced nasolabial angle and increased inter-labial angle were evident from soft tissue measurements.

Conclusions: The reduced length of the maxillary and mandibular base could be due to chronic anaemia which causes retardation of growth in thalassaemic patients. An increase in the anterior cranial base length resulted in the posterior positioning of the mandible and an increase in anterior facial height led to a skeletal class II pattern.
Keywords: Anaemia; craniofacial growth; cephalometry; thalassaemia major.