Incisor-canine Region Research Articles

Clinical and Histological Comparison of Platelet-Rich Fibrin with Periodontal Dressing and Non-Eugenol Periodontal Dressing Alone on the Depigmented Gingival Epithelium

ABSTRACT Background: This study aims to assess and contrast the healing results, in terms of both histology and clinical appearance, after gingival depigmentation using diode laser application of the platelet-rich fibrin (PRF) membrane in contrast to non-eugenol periodontal dressing (Coe-Pak). Materials and Method: Thirty individuals in good health, aged between 18 and 50 years, were randomly divided into two groups, with each group consisting of 15 participants. One group underwent application of a PRF membrane along with periodontal dressing, while the other group received solely non-eugenol periodontal dressing. This procedure was performed in the intercanine region of the maxillary or mandibular arch for all participants. PRF was processed following the standardized procedure outlined by Choukroun. Patients underwent assessments for pain intensity using the visual analog scale (VAS) and for healing advancement using the Healing Index (HI) on the third and fifth days following treatment. Results: Statistically significant disparities were noted between the two study groups concerning the VAS, HI, epithelialization assessment, and histological observations. In the clinical assessment of epithelialization using toluidine blue, it was observed that areas treated with PRF+Coe-Pak showed significantly reduced staining, indicating enhanced wound healing compared to those treated with Coe-Pak alone. Conclusion: After depigmentation, the PRF+Coe-Pak group demonstrated enhanced patient comfort and facilitated an efficient wound-healing process.

Evaluation of maxillary dimensional changes in the mixed dentition: clear aligners vs acrylic expanders.

To compare changes in upper arch dimension and molar inclination between Invisalign First (IF) and removable acrylic expander (RE) treatments during the mixed dentition period. Seventeen patients meeting inclusion criteria underwent IF treatment and were age matched with a group that received treatment with a removable acrylic expander (RE). Intercanine width (ICW), intermolar width, arch depth, buccolingual inclination of the first molars (MI), surface area (SA) and volume (VAP) of the anterior palate, and expansion were compared before and after treatment. The predictability of expansion was calculated for the IF group. Analysis of variance and Kruskal-Wallis tests were used to assess differences. The ICW increased significantly by 2.14 mm in the IF group and 3.49 mm in the RE group, with no significant intergroup difference. Both groups exhibited significant increases in intermolar width (P < .05), except for intermolar distopalatal width in the IF group (P = .246). Mesiobuccal rotation of the first molar was observed with IF treatment. Although SA and VAP increased in both groups, the changes were not significant for the IF group (P > .05). The RE group exhibited significantly higher increases (P < .05), with an SA increase of 34.32 mm2 and VAP increase of 119.15 mm3. MI changes were in the opposite directions. The prediction accuracy of expansion was 70.28% for canines and 34.12% for first molars. Both appliances effectively expanded the intercanine region in growing patients. Expansion predictability was lower in first molars than in canines for the IF group. Removable acrylic expanders could be a choice of preference for expansion targeted to the molar region.

Variations of the Plaque Index in Four Timelines during 12 Months in Patients with Two Models of Fixed Retainers after Orthodontic Treatment is Finished

Background: Fixed retainers are retention tools bonded on the lingual side of the frontal teeth to prevent relapse after orthodontic treatment is finished. While stability remains the biggest concern, periodontal response remains the subject of discussion. This study aimed to compare plaque index (PI) levels on the lingual side of the lower dental arch in the inter-canine region after bonding two different models of fixed retainers.Methods and Results: The study included 60 subjects aged 16-25 who finished orthodontic treatment. Thirty subjects got flat fixed retainer (FFR), and 30 other subjects got round fixed retainer (RFR) bonded in the lower six frontal teeth on the lingual side. Adapted PI was recorded and photographed at four time points (3, 6, 9, and 12 months). Three months after the intervention, there were no significant differences between the FFR and RFR related to the PI value (P=0.363). PI was significantly lower in the FFR group than in the RFR group 6, 9, and 12 months after the intervention (P&lt;0.004, P=0.004 and P=0.001, respectively).Conclusion: Bonded fixed retainers, in general, cause increased plaque formation and make oral hygiene routines more difficult.

Comparative evaluation of arch form among the Nepalese population: A morphological study.

The study aims to identify sexual dimorphic features in the arch patterns based on tooth arrangement patterns and the maxillary and mandibular arches using Euclidean Distance Matrix Analysis (EDMA). A total of 96 Nepalese subjects, aged 18 to 25 were assessed using casts and photographs. Thirteen landmarks representing the most facial portions of the proximal contact areas on the maxillary and mandibular casts were digitised. Seventy-eight possible, Euclidean distances between the 13 landmarks were calculated using the Analysis ToolPak of Microsoft Excel®. The male-to-female ratios of the corresponding distances were computed and ratios were compared to evaluate the arch form for variation in the genders, among the Nepalese population. Microsoft Excel Analysis ToolPak and SPSS 20.0 (IBM Chicago) were used to perform EDMA and an independent t-test to compare the significant differences between the two genders. The maxillary arch's largest ratio (1.008179001) was discovered near the location of the right and left lateral incisors, indicating that the anterior region may have experienced the greatest change. The posterior-molar region is where the smallest ratio was discovered, suggesting less variation. At the intercanine region, female arches were wider than male ones; however, at the interpremolar and intermolar sections, they were similar in width. Females' maxillary arches were discovered to be bigger antero-posteriorly than those of males. The highest ratio (1.014336113) in the mandibular arch was discovered at the intermolar area, suggesting that males had a larger mandibular posterior arch morphology. At the intercanine area, the breadth of the arch form was greater in males and nearly the same in females at the interpremolar and intermolar regions. Female mandibular arch forms were also discovered to be longer than those of males from the anterior to the posterior. The male and female arches in the Nepalese population were inferred to be different in size and shape. With references to the landmarks demonstrating such a shift, the EDMA established objectively the presence of square arch forms in Nepali males and tapering arch forms in Nepalese females.

Managing an Odontoma Associated with Impacted Maxillary Incisor in Adult Patient: A Case Report

Background: Odontomas are known as the most common form of odontogenic tumour composed of mixed odontogenic origin. These are usually discovered accidentally during routine or diagnostic radiographic investigation. Compound odontomas often present themselves in the maxillary incisor-canine region while complex odontomas are found in the mandibular premolar-molar region. Odontoma though symptomless occasionally can interrupt the eruption of underlying teeth causing aesthetic and occlusal discord especially in the anterior maxilla region. Case: A 31-year-old female presented with pain and presence of an abnormally shaped tooth on her upper right anterior maxilla region. The tooth was diagnosed as compound odontoma and causes an impact of an underlying maxillary lateral incisor. Surgical assisted eruption of the impacted lateral incisor was done after removal of the odontoma, followed by exposure of the impacted tooth crown and gradual orthodontic-guided traction into occlusion. Conclusion: A combined (surgical-orthodontic) approach is deemed to have a higher prognostic value and optimal outcome for the impacted maxillary incisor associated with odontoma.

Split crest technique - an effective method in dental implantology for narrow ridges: A case report

Introduction. Implant placement with simultaneous bone augmentation presents procedure with high risk of complications. In those situations, one of the surgical procedures with promising outcomes is the split crest technique. Case report. A 69-year-old edentulous patient was referred to the Clinic of Oral Surgery, at the Faculty of Dentistry in Pancevo. The width of the mandibular alveolar ridge in the inter-canine region was 2 mm. For the ridge splitting and expansion, a special split and expansion kit was used (Esset KitR, Osstem, South Korea). The procedure started with crestal remover carbide cylindrical bur of 7 mm diameter for flattening of the alveolar ridge to the width of 4 mm. Then, a sharp lance drill was used to mark the places for implant osteotomies and placement. After that, 1.8 mm twist drill was used to prepare a bed of 10 mm depth, and a 13 mm saw was directed vertically. Set of expansion drills were used to expand the alveolar ridge gradually. Two implants 3.5x10 mm each (TSIII SAR, Osstem, South Korea) were inserted in the region of lower canines and the space between split buccal and lingual bone lamellae remained empty. Initial stability of inserted implants was assessed by implant stability quotient (ISQ). The values for implant stability were high for both inserted implants (98 and 93). After the surgical procedure, a control CBCT was done. The wound healed uneventfully. Conclusion. Split crest technique seems to be a predictable alternative for implant placement in narrow alveolar ridges.

Implant-supported overdenture- An alternate treatment option for severely resorbed mandibular ridge

Rehabilitation of the patient with resorbed ridge has been a challenging procedure. Replacement with complete dentures has been the most common traditional standard of care. But there were many drawbacks in the atrophic mandible which includes lack of comfort, retention, stability, and inability to masticate. To overcome this drawback implant-supported over-denture came into use. The advantage of implant-supported over-denture over other treatment modalities are as follows: decreased bone resorption, reduced prosthesis movement, better esthetics, improved tooth position, better occlusion, increased occlusal function, and maintenance of the occlusal vertical dimension. In this article, we discussed the placement of two implants in the inter-canine region of the mandibular ridge and providing a conventional denture. Three months later this complete denture was converted into implant-supported mandibular over denture.

Efficacy of fixed versus removal retianer post orthodontic treatment

The dearth of prolonged, prospective evaluation, the relative impact of fixed and the removable retainers eventualities can only be speculated upon. Hence in this study was to compare the stability of orthodontic outcomes with fixed and removable retainers over a period of at least 4 years. Of the 82 participants included in the previous RCT, data were obtained from 48 at 18-month follow up. Orthodontic stability was based chiefly on the irregularity of the mandibular incisors using Little’s Irregularity Index to assign a cumulative score for the contact point displacement in 4 the mandibular inter-canine region. Eighty-two participants were enrolled in the original RCT. After adjusting for confounders, the median between-groups difference was 1.64mm higher in those wearing vacuum-formed retainers (P= 0.02; 95% CI: 0.30, 2.98mm). No statistical difference was found between the treatment groups in terms of inter-canine (P= 0.52; 95% CI: -1.07, 0.55) and inter-molar widths (P= 0.55; 95% CI: -1.72, 0.93), arch length (P= 0.99; 95% CI: -1.15, 1.14) and extraction space opening (P= 0.84; 95% CI: -1.54, 1.86).

Odontogenic Keratocyst Is Frequently Misdiagnosed for a Lateral Periodontal Cyst in Premolar and Anterior Tooth-Bearing Areas

IntroductionRadiolucent lesions with gingival swelling found in the premolar and intercanine region can elicit a different clinical diagnosis than one confirmed by histologic findings. The purpose of the study is to identify and present the frequency of the unexpected microscopic diagnosis of odontogenic keratocyst (OKC) in a location preoperatively favoring a lateral periodontal cyst (LPC) with similar clinical and radiographic appearance. MethodsA retrospective analysis of biopsies received from 2011 and 2019 was performed, and the number of LPC and OKC cases was assessed. The alignment of clinical and radiographic diagnosis to histologic findings and anatomic location was analyzed, and the number of OKC cases preoperatively misdiagnosed as LPCs was identified. ResultsA total of 79,257 biopsies were received. Of those, 184 were diagnosed as LPCs and 742 as OKCs. For all preoperatively diagnosed LPCs, the clinical and histologic diagnosis aligned; however, 182 of 742 OKCs were submitted with a clinical misdiagnosis of LPCs. The location of these lesions with the unanticipated diagnosis overlapped with those for LPCs, specifically the maxillary and mandibular anterior and premolar regions. ConclusionsRadiolucent lesions with gingival swelling in the premolar and intercanine region are frequently clinically and radiographically misdiagnosed. A biopsy should be considered in all cases to establish the correct pathologic diagnosis and treatment course.

Comparison of commercially available preformed archwires with average natural arch forms.

To compare the dimensions of commercially available preformed archwires with natural arch forms of Pakistani subjects. The cross-sectional study was conducted at the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from September 2019 to February 2020, and comprised maxillary and mandibular dental casts of orthodontically untreated subjects that were evaluated to obtain arch dimensions at the canines and first molar levels with the help of digital Vernier calipers. Bracket-archwire assembly was constructed to accurately measure widths from bracket-slot points at both the canine and molar levels in an attempt to mimic clinical archwire-bracket interface. Canine and molar depths were also recorded for accurate estimation of the digitised archwire widths at the aforementioned levels. Data was analysed using SPSS 25. Of the 52 subjects, 26(50%) each were males and females with age ranging from 12years to 35 years. The archwires evaluated for maxilla were significantly wider at canines and first molars compared to the canine and molar dimensions of the dental casts obtained from the subjects (p<0.05). For mandible, significant differences were found at the canine level where archwires exhibited greater dimensions than mean intercanine widths of the subjects (p<0.05). Commercially obtainable preformed archwires were inconsistent with diverse arch forms manifested in subjects with almost ideal occlusion. Therefore, utilisation of these archwires may create unwarranted wider dimensions of the arch form, especially in the intercanine region which can influence post-treatment retention, stability and facial aesthetics.

Implant-to-nasal floor dimensions projected by panoramic radiographs in the maxillary incisor-canine region: implications for dental implant treatment.

To make a comparison of panoramic radiography (PAN) and cone-beam computed tomography (CBCT) determinations of implant-to-nasal floor dimensions (INFD) in the anterior maxillary region, and to assist in determining in which tooth regions additional radiation exposure involved in CBCT scans is justifiable. Data related to INFD by PAN (PAN-D) at implant-to-nasal floor sites (central incisor, lateral incisor, canine) were gathered using 141 implant sites from 119 adult patients. INFD was estimated employing the CBCT technique as a reference method. PAN analysis equations were created for estimation of INFD by CBCT (CBCT-D) specific to implant sites. For assessment of the agreement between the PAN and CBCT methodologies, the Bland-Altman approach was employed. There were robust and significant odds ratios that implants in the canine region would fall into the underestimation groups of > 0mm (4.5:1) (p = 0.003), > 0.5mm (6.2:1) (p < 0.001), and > 1mm (5.4:1) (p = 0.002). The root mean squared error (RMSE) and pure error (PE) were highest for the canine region (RMSE = 1.973mm, PE = 2.20mm). This research offers evidence of site-specific underestimations of available horizontal bone dimensions for implants when PAN is employed to assess the availability of vertical bone dimensions. The data suggest that it may be necessary to exclude canine regions when making assessment of INFD through PAN. Use of CBCT may, therefore, be recommended for all implant size and angulation estimations in this region.

Immediate Rehabilitation of the Severely Atrophic Maxilla Using Trans-Sinus Nasal Protocol and Extended Length Subcrestal Angulated Implants. Case Series With 1-Year Follow-Up.

Immediate fixed full-arch rehabilitation of the severely atrophic maxilla eliminates use of a tissue-supported prosthesis during the healing phase and maximizes patient comfort and quality of life. The surgical treatment options available for immediate rehabilitation of the severely atrophic maxilla are dependent on the location and availability of the residual alveolar ridge. When bone is only available in the intercanine region, a graftless approach using tilted distal implants may not provide adequate distance between implants for favorable biomechanics. Subsequently, zygomatic implants are the alternative to provide adequate posterior occlusal support. Use of extended length subcrestal angulated implants offers an additional implant option for the clinician to restore the severely atrophic maxilla immediately. The treatment protocol involves anchorage of the implant fixture to the lateral wall of the nasal bone. The distally tilted implant transverses an augmented sinus cavity and extends to the site of the first permanent molar. The novel implant subcrestal angulation and use of a multi-unit abutment promotes passivity of fit of a full-arch fixed immediate prosthesis. Five clinical case reports from private practice are presented that outline the clinical value of the novel implant design in the rehabilitation of the severely atrophic maxilla. In each case, the use of zygomatic implants would be the only alternative to provide an immediate fixed prosthesis due to the absence of residual alveolar bone in the maxilla premolar and molar regions. The use of extended-length subcrestal angulated (ELSA) implants with straight or angulated multiunit abutments have successfully restored the maxillary arch immediately.

Morphogenic correlation between facial form and intercanine width - an aid in forensic dentistry

Background: Forensic odontology is a branch of forensic dentistry that utilizes dental remains for personal identification. When facial recognition is not possible, the facial form of the person can be reconstructed with the help of teeth present and dental structures available. The teeth in the maxillary intercanine region play a vital role for the same. The intercanine width varies considerably between different populations and races and its relation with other facial parameters can be used in personal identification and even facial reconstruction. Aim: The aim of the present study is to assess the correlation between the tooth form and face form by correlating the intercanine width with other facial parameters such as interpupillary distance, interalar distance, interzygomatic distance, and intercanthus distance in the Ethnic Tamil population. Materials and Methods: The study was conducted on a sample of 100 patients aged between 20 and 40 years. Five parameters, namely the intercanine width, interpupillary width, interalar distance, interzygomatic distance, and intercanthus distance was measured using a digital Vernier caliper. The data obtained were tabulated and analyzed using SPSS statistical analysis software. Unpaired t-test was used to compare the mean values of the parameters among males and females. Pearson's correlation was run to assess the relationship between the parameters and P &lt; 0.05 was considered to be statistically significant. Results: Among 100 participants, 50 were male and 50 were female. The mean intercanine width of males (35.1 mm ± 3.8) and females (33.1 mm ± 3.1), mean interzygomatic distance of males (110.8 mm ± 12.3) and females (106.7 mm ± 8.1), and mean interalar distance of males (26.2 mm ± 5.8) and females (28.3 mm ± 4.5) were found to be statistically significant. There was a significant, moderate correlation (r = −0.3; P &lt; 0.05) between the intercanine and intercanthus width in males but not in females. Conclusion: In the present study, a weak correlation existed between intercanine distance and other facial parameters. Several parameters determine the facial form and a combination of these parameters have to be considered thereby reconstruction of the face is possible for future prospectus in forensic dentistry.

A firm mass of the maxillary gingiva

A firm mass of the maxillary gingiva

The stability of surgically assisted rapid maxillary expansion (SARME): A systematic review

BackgroundThis systematic review was conducted to determine the stability of surgically assisted rapid maxillary expansion (SARME) for correction of transverse maxillary deficiency, the effect of distractor type (tooth-borne vs. bone-borne) and the influence of a retainer on post-expansion stability. MethodsThe review was conducted applying the PICO criteria. Electronic database searches of published literature (MEDLINE via PubMed), Ovid via MEDLINE, the Cochrane Oral Health Group's Trial Register, Cochrane Central Register of Controlled Trials, (CENTRAL) and unpublished literature were accessed until January 2019. Search terms included SARME, ‘stability’, ‘relapse’, ‘surgery’, ‘expansion’ and ‘maxillary expansion’. ResultsFive hundred and ten studies were identified overall and 15 studies were included (3 RCTs, 2 prospective & 10 retrospective) following initial screening and data extraction of full texts. The quality of evidence was assessed using the Cochrane Risk of Bias tool for RCTs and the Newcastle–Ottawa Scale for prospective & retrospective studies. The heterogeneity of the retrieved articles prohibited quantitative analysis. Overall, the studies were either of high risk of bias or low quality. Qualitative analysis reveals SARPE to achieve expansion at the inter-canine region of 4–for inter 6 mm, inter-molar region of 6–8.9 mm, and skeletal level of 2.3–3.1 mm with relapse rates in the region of 0.1–2.3 mm (inter-canine), 0.2–3 mm (inter-molar) and 0–1.8 mm (skeletal) reported. ConclusionQualitative evaluation suggests SARPE results in significant expansion at the dental and skeletal level and that this appears to be stable. Existing literature is equivocal on the clinical benefits of a retention device or distractor type (bone-borne vs. tooth borne) on stability. This review has unearthed the need for high quality prospective RCTs to fully understand the stability of SARME, particularly with relation to varying distractor types and use of retention devices. As such, the inferences drawn should be considered with some discretion based on the quality of the available evidence.

Prevalence and Pattern of Hypodontia among Croatian Orthodontic Patients.

ObjectiveThe objective of this retrospective study was to assess the prevalence of hypodontia in the permanent dentition among Croatian orthodontic patients. The occurrence was evaluated concerning gender, specific missing teeth, the location, pattern of distribution in the maxillary and mandibular arches and sagittal and vertical skeletal pattern.Material and MethodsThe sample consisted of 194 patients (75 males and 119 females) from the Department of Orthodontics, Dental Clinic, Clinical Hospital Center Zagreb. Based on the severity of hypodontia the sample was divided into mild (1-2 missing teeth), moderate (3-5 missing teeth) and severe groups (6 or more missing teeth). The location of missing teeth was used to further divide the sample into anterior (intercanine region), posterior (premolars and molars) and anteroposterior groups. In addition, jaw localization of hypodontia was also considered.ResultsPermanent dentition hypodontia among Croatian orthodontic patients was found to be generally mild (80%), and a distribution was similar in the maxilla (39%) and the mandible (41%), as well as in the anterior and posterior segments of dental arch (44%). The number of missing teeth per person ranged from 1 to 12, with no significant difference between genders. The severity and location of hypodontia did not differ significantly between the genders, as well as in between the categories of sagittal and vertical skeletal patterns.ConclusionPresent results suggest that the treatment plan for patients with hypodontia in permanent dentition should be individualized and adjusted for each case.

Computed tomographic features of desmoplastic ameloblastoma of the jaw

Objective To retrospectively analyze the clinical and CT imaging features of desmoplastic ameloblastomas (DA) in comparison with other types of ameloblastomas. Methods Patients diagnosed with ameloblastoma histopathologically in Peking University School and Hospital of Stomatology from July 2000 to August 2017 were reviewed to analyze the constituent ratios and characteristics of DA. CT imaging features of DA (28 cases) were investigated in comparison with consecutive cases of solid/multicystic and unicystic ameloblastomas. The following imaging perspectives were analyzed: the border, internal structure, three-dimensional shape, tooth, the periodontium, the cortex and the expansion of the tumors. CT values were measured in the region of interest for quantitative analysis. Results Among the 1 269 cases of ameloblastomas, 50 (3.9%) were DA, which showed predilections for males (74.0%). The average age of DA was about 43.9 years old, which was higher than the other two types. The anterior incisorcanine region (62.0%) and premolar region (30.0%) were most frequently affected. The incidence rate of DA in mandibule was 56.0% (28/50), which was slightly higher than that of maxilla (44.0%). The DA characteristically showed scallop border and honeycomblike or soapbubble internal structure with bone formation on CT. The mean ratios of height to mesiodistal and buccal-lingual to mesio-distal distances were 0.76 and 0.63, which were higher than the other two types. According to the degree of internal bone formation, three subtypes of DA could be observed: densely ossifying type (I), honeycomb/soap bubble type (II) and sparsely ossifying type (III). The means and standard deviations of CT values of DA were significantly higher than those of the other two types, which were (488.8±164.0) HU (type I), (171.7±102.8) HU (type II), (42.1±8.8) HU (type III). Conclusion CT is helpful for diagnosis of DA, which shows as solid tumor with varying degrees of internal ossification.

ORAL MANIFESTATIONS IN LANGERHANS CELL HISTIOCYTOSIS. A CASE REPORT

We present a case of a 68-year-old woman diagnosed as having multisystem Langerhans cell histiocytosis (LCH) 8 years ago. She was treated with chemotherapy last year because systemic affectation; the patient has complained about intense pain and swelling of gums beginning 2 years ago. Intraoral examination reveals poor oral hygiene, gingival enlargement, and multiple necrotic ulcerations covered by pseudomembrane involving the upper buccal gingiva, the intercanine region, and the lower buccal and lingual gingiva of premolars, canines, and incisives. The orthopantomography reveals generalized alveolar bone loss. A biopsy was performed. The presence of a mixed inflammatory infiltration, and immunohistochemical staining positive for langerin and CD1 a confirms the diagnosis of the histiocytosis X. We proceed to the intralesional infiltration with triamcinolone acetonide 40 mg/mL once weekly for 4 weeks, and the complete cure of the oral lesions was achieved. Six months later no lesions were observed.

Does headgear treatment in young children affect the maxillary canine eruption path?

To test whether early headgear (HG) treatment and space conditions in the dental arch affect the eruption pathway of the maxillary canines in young children with mixed dentition. Data from two randomized controlled trials studying the effects of early HG treatment were pooled, yielding a study sample comprising 99 children (38 girls and 61 boys, mean age 7.6 years) with Angle Class II occlusion. Fifty-one children were treated with HG and 48 children served as an untreated control group (CG). Digital 3D models and panoramic radiographs were taken before (T0) and after (T1) treatment, and changes in the maxillary canine eruption angle and interdental spaces were measured at T0 and T1. A paired samples t-test was used to assess changes in maxillary canine angulation, and an independent samples t-test was used to evaluate the effect of HG treatment on spacing in the dental arch. Associations between intra-arch space conditions and changes in maxillary canine angulation were estimated with linear regression models. The eruption pattern of the permanent canine was significantly more vertical in the HG group than in the CG. The linear regression models showed a statistically significant association among the intercanine distance, crowding in the anterior part of the maxilla, and changes in the maxillary canine eruption angle. The maxillary canine eruption pattern changed significantly more to a vertical direction in spaced dental arches than in crowded dental arches in the HG group. This study shows that early HG treatment in children with Angle Class II occlusion may change the eruption pattern of permanent maxillary canines to a more vertical direction. This change appears to be related to space conditions in the maxillary arch, especially in the intercanine region, with more effect in children with spaced dental arches than in children with crowded dental arches.

Dental Arch Dimensions and Form in a Sudanese Sample

The size and shape of dental arches have significant implication in orthodontic diagnosis and treatment planning as it affects the space available, dental esthetics and stability of the occlusion. This study is a biometric analysis of dental casts of 50 adult Sudanese dental students (20 males, 30 females) aged between 19 to 22 years with normal occlusion. The study was conducted at the orthodontic clinics, Faculty of Dentistry, University of Khartoum. Each student was interviewed and written consent was given. The inclusion criteria were: complete permanent dentition fully erupted to the occlusal plane, no proximal caries or restorations, no attrition or dental anomalies, no extractions, no previous or ongoing orthodontic treatment and no fractures or jaw surgeries. Paired-test, ANOVA test, and Pearson's correlation were used for statistical analysis with a p-value set at 0.05. The result showed normal occlusion is higher in males than in females. Upper arch dimensions (width and length) found to be higher in males than females, inter canine width (ICW), males 36, and females 34.45; interpremolar width (IPmW) males 48.08, females 47.58; inter-molar width (IMW) males 53.04, females 52.4; the length for males 37.98 and for females was 37.09. Comparison of Lower arch dimensions between males and females showed ICW (27.08 and 26.86); IPmW (40.97 and 39.67); IMW (45.61 and 45.69); depth was (33.91 and 33.91) consequently. The ovoid-shaped arch form was more common in both genders. Length dimension showed the highest value with square arch form. The width dimensions increase with little change in the inter-canine region but appreciably more in the distal part of the arch. Men have a more massive arch form than females. The ovoid arch form dominates in the Sudanese population. Knowledge of arch dimensions that are associated with normal occlusion is helpful in determining treatment goals and proper diagnosis and treatment plan by choosing the right arch form for each race.