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   Table of Contents - Current issue
Coverpage
October-December 2018
Volume 8 | Issue 4
Page Nos. 179-233

Online since Wednesday, December 26, 2018

Accessed 8,312 times.

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GUEST EDITORIAL  

Updates available!: Time for orthodontics' research approach to catch up with the rapidly evolving techniques and discoveries in molecular biology research ? p. 179
Priti Mulimani
DOI:10.4103/apos.apos_101_18  
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SPECIAL FEATURE Top

How did we get here ? p. 182
Allan R Thom
DOI:10.4103/apos.apos_100_18  
This is the transcript of the inspirational address delivered by Dr. Allan Thom, President-World Federation of Orthodontists to the Presidents of the APOS Affiliate Societies at the 11th APOC in Boracay, Phillipines in March, 2018.
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EXPERTS CORNER Top

Orthodontic finishing: Ten steps to success* Highly accessed article p. 184
Jose Nelson Mucha
DOI:10.4103/apos.apos_56_18  
An excellent orthodontic finishing is essential and involves a series of procedures such as a good diagnosis, appropriate treatment plan, and implementing the treatment plan. However, the most critical phase corresponds to finish properly or closely to the appliance removal. It is not enough only to say that it was a good finish. Specifically why, or what details are needed to be observed and obtained, and in what order to conclude that a great orthodontic finishing was done. In this article, I intend to discuss and propose procedures considered indispensable for the excellence in orthodontic finish. The goals are results with excellent oral health; facial, dental and smile harmony; functional occlusion; and especially long-term stability. In this matter, it is important to follow a series of procedures that can be summarized in 10 steps: (1) define clearly your goals; (2) have a checklist; (3) improve bracket placement; (4) repositioning of brackets; (5) make adjustments in the archwires; (6) look at the face, teeth and smile, not the appliance; (7) improve the functional occlusion; (8) reshape teeth anatomically; (9) plan the retention; and (10) plan the appliance removal. The conclusions are that following this steps and keeping in mind that in clinical orthodontic practice is necessary to clearly define the objectives, to know the basic and have technical domain; the result will be inevitable: Success.
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ORIGINAL ARTICLES Top

Enamel demineralization adjacent to orthodontic brackets bonded with ACTIVA BioACTIVE-RESTORATIVE p. 200
Kristin G Saunders, Gianina Mattevi, Kevin J Donly, Ravikumar Anthony
DOI:10.4103/apos.apos_48_18  
Introduction: Enamel demineralization adjacent to orthodontic brackets has been shown to be a consequence during orthodontic treatment. Fluoride-releasing resin-modified glass ionomer cements (RMGICs) have been shown to protect the enamel from white spot lesions, but their bond strength has been proven inadequate. The purpose of this study was to evaluate ACTIVA BioACTIVE-RESTORATIVE, a bioactive material with strength superior to RMGICs, for inhibition of enamel demineralization surrounding orthodontic brackets. Materials and Methods: Fifteen human teeth were sectioned and divided into two groups. One group was the control and had orthodontic brackets bonded with Transbond XT, while the second group had orthodontic brackets bonded with ACTIVA. The teeth were varnished within 2 mm of the bracket margins and immersed in an artificial caries solution for 3 days to create carious lesions. The teeth were sectioned and viewed under polarized light microscopy for the detection of enamel demineralization adjacent to the bracket, and then, the lesion areas were measured with a computer imaging system. Results: There was a statistically significant difference (P ≤ 0.001) that ACTIVA had less enamel demineralization adjacent to the bracket when compared to the control group. Conclusions: The results of this study have demonstrated that ACTIVA, a fluoride-releasing bioactive restorative material, inhibits demineralization of enamel adjacent to orthodontic brackets when compared to a nonfluoride-releasing control.
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Controlled molar inclination during maxillary dental expansion using a straight rectangular archwire p. 204
Chanchai Pattanaviriyapisan, Chairat Charoemratrote, Udom Thongudomporn
DOI:10.4103/apos.apos_70_18  
Purpose: The purpose of this study was to examine whether the amount of transversal dental expansion, controlled using a straight rectangular beta-titanium alloy (TMA®) wire, has an influence on changes in maxillary first molar inclination. Materials and Methods: Twenty patients requiring bilateral maxillary dental arch expansion were treated using a 0.018”-slot preadjusted edge-wise fixed appliance. Once leveled and aligned, the maxillary dental arches were expanded using a 0.016” × 0.022” straight TMA® wire. Changes in arch width and maxillary first molar inclination were assessed before (T0) and after (T1) expansion using three-dimensional scanned models. Mann–Whitney U-test, Wilcoxon signed-rank test, and Kruskal–Wallis test were used, where appropriate, to compare changes between and within groups. Results: Intermolar width expanded at a rate of 0.8 ± 0.3 mm/month, and first molar buccal crown tipping occurred at 2.1° ± 1.2° (P < 0.05). Changes in inclination between minor expansion (1.0–2.5 mm) and moderate expansion (2.6–4.0 mm) groups were not statistically significant (1.8 ± 0.5 vs. 2.2 ± 1.2; P > 0.05). Conclusions: Use of a straight rectangular TMA® wire in conjunction with a fixed orthodontic appliance successfully expanded the maxillary dental arch. The amount of expansion had no effect on molar inclination.
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Applicability of Bolton's analysis: A study on tibetan community p. 209
KK Sajal, Rishabh Gupta, Vikram Pai, Pooja Desai, Sudhir K Mishra, Jagadish Hosamani
DOI:10.4103/apos.apos_126_17  
Aim: This study aimed to evaluate the anterior and overall ratios of Tibetan population residing at Mundgod and to compare the obtained ratios to the ratios available from Bolton's study. Materials and Methods: The study consists of randomly selected 120 samples of Tibetan population ranging in age from 15 to 25 years, residing at Mundgod, Karnataka (60 males and 60 females). After measuring the width of each tooth, overall and anterior ratios were measured using formula proposed by Bolton. Statistical Analysis: Anterior and overall tooth ratios obtained from the study were compared to standard Bolton's ratio by one-sample t-test. The differences between males and females were compared by independent samples t-test. Results: The overall ratio was significantly lower for both males (P = 0.03) and females (P = 0.001) at 90.20 and 88.93, respectively, when compared to the Bolton's value of 91.3, whereas anterior ratio for males (P = 0.001) was significantly higher at 77.9 when compared to Bolton's value of 77.2. The combined values of males and females when compared to Bolton's value, i.e., the combined overall ratio (P = 0.001) was significantly lower at 89.5 and the combined anterior ratio (P = 0.016) was significantly higher at 78.7. Conclusion: In the present study, significant difference was observed between the overall and anterior ratios in Tibetan population as compared to the Bolton's value. Therefore, Bolton's original data cannot be applied for Tibetan population.
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Orthodontists and orthodontic residents' education: Effect on professional attitudes and behavior p. 213
Wasundhara Ashok Bhad
DOI:10.4103/apos.apos_78_18  
Introduction: Dental education aims at shaping the future professional behavior of their students, thus contributing to reduce oral health disparities and increasing care for the society. Objective: The objective of this study was to access the perception of the quality classroom-, clinic-, and community-based orthodontic postgraduate education devoted to the management of cleft lip palate cases, surgical orthodontic cases, and growth modification cases. Null Hypothesis: No relationship exists between the quality of postgraduate dental education and professional attitude and behavior in providing care to cleft lip palate cases, surgical orthodontic cases, and growth modification cases. Materials and Methods: A total of 200 active members were involved. The first group included approximately 100 residents of Central India and the second group consisted of approximately 100 active orthodontists of Central India. The questionnaire was given to each group about the different clinical condition. Answers were given on 5-point scale to access the professional attitude and behavior. Conclusions: The finding of this study challenges administrators about the postgraduate dental program in the specialty of orthodontics and reflects the degree to which this education contributes to the orthodontic health of the society.
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CASE REPORTS Top

Treating bimaxillary protrusion and crowding with the invisalign G6 first premolar extraction solution and invisalign aligners p. 219
Ronny KP Lie Ken Jie
DOI:10.4103/apos.apos_67_18  
In cases requiring extraction of four first premolars, ensuring maintenance of adequate posterior anchorage and proper inclination of the teeth adjacent to the extraction sites during space closure can be difficult. The Invisalign G6 first premolar extraction solution has been developed to specifically address these problems. This case report describes the treatment of a 30-year-old woman whose main concerns were related to her protrusive and malaligned anterior teeth. Clinical findings revealed, among others, bimaxillary anterior protrusion and moderate-to-severe anterior crowding. A treatment approach involving extraction of the four first premolars was chosen, followed by orthodontic treatment with the Invisalign G6 first premolar extraction solution and Invisalign aligners. At the completion of 19.5 months of aligner treatment, the patient's anterior teeth were retracted and uprighted, resulting in an improvement in her lip profile. Normal overjet and overbite were also achieved along with alleviation of the anterior crowding. The patient was extremely happy with the treatment results.
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Presurgical nasoalveolar molding in a 4-day-old infant with unilateral cleft lip, alveolus, and palate deformity p. 225
Abin Mathew, Sunil Muddaiah, Jayanth B Subrahmanya, Sanju Somaiah, Balakrishna Shetty, Goutham Reddy
DOI:10.4103/apos.apos_128_17  
Introduction: A four day old male infant was referred to our department. Infant's mother complained of an opening over lip and difficulty in feeding and desires to get it corrected. On clinical examination patient showed complete unilateral cleft lip, alveolus and palate deformity towards the left side. Methods: On the initial visit, lip taping using 1/4inch 3M Steri-strip was applied and instructions were given to parents about lip taping, and advised to continue lip taping for 2 weeks. Initial impressions were taken to fabricate the Presurgical nasoalveolar molding appliance. Intraoral molding plate was made to approximate the maxillary segments. Nasal stent was added to correct the nose deformity. Presurgical impressions were made. Results: Under this pre surgical treatment, the cleft alveolus reduced in size from 13mm to 3mm at the alveolar ridge and palate, respectively. The nasal wing was lifted considerably. Conclusion: Pre-surgical nasoalveolar moulding helped to reduce the cleft gap, improve the arch form, approximate lip segments and distinctly improve the morphology of the nose by correcting flattened nasal wings. This aforementioned correction not only enabled better aesthetic results after surgery but also reduced tissues tension and scar formation post-surgery. Introduction: A four day old male infant was referred to our department. Infant's mother complained of an opening over lip and difficulty in feeding and desires to get it corrected. On clinical examination patient showed complete unilateral cleft lip, alveolus and palate deformity towards the left side. Methods: On the initial visit, lip taping using 1/4inch 3M Steri-strip was applied and instructions were given to parents about lip taping, and advised to continue lip taping for 2 weeks. Initial impressions were taken to fabricate the Presurgical nasoalveolar molding appliance. Intraoral molding plate was made to approximate the maxillary segments. Nasal stent was added to correct the nose deformity. Presurgical impressions were made. Results: Under this pre-surgical treatment, the cleft edges moved closer by 13mm and 3 mm at the alveolar ridge and palate, respectively. The nasal wing was lifted considerably. Conclusion: Pre-surgical nasoalveolar moulding helped to reduce the cleft gap, improve the arch form, approximate lip segments and distinctly improve the morphology of the nose by correcting flattened nasal wings. This aforementioned correction not only enabled better aesthetic results after surgery but also reduced tissues tension and scar formation post-surgery.
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CLINICAL PEARL Top

The double-sided intrusion spring p. 230
Fatih Celebi
DOI:10.4103/apos.apos_101_17  
In deep bite cases, proper planning and practice are important in achieving the successful treatment outcomes. Bite opening is obtained with the aid of incisor intrusion, molar extrusion, or a combination of them. Pure incisor intrusion is a challenge for clinicians because incisor intrusion mechanics generally cause molar extrusion or incisor flaring. In the present article, a new technique that can be used for incisor intrusion without the mentioned handicaps was introduced.
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