Lower Central Incisors Research Articles

Relación entre tipos de maloclusión en plano horizontal y hábitos orales en niños de 8 a 14 años de Montemorelos

La importancia de los hábitos orales en odontología es que estos pueden modificar la posición y la relación de los dientes, debido a la alteración en el desarrollo normal y el funcionamiento de los músculos de la ATM. Las consecuencias pueden ser observadas en la dentición de los niños como una alteración de esta. Por ello, es muy importante realizar un diagnóstico de los hábitos para eliminarlos y corregir las futuras alteraciones que estas puedan provocar realizando un correcto tratamiento. El objetivo del presente estudio es evaluar los efectos que produce la presencia de hábitos orales como succión digital y labial, succión de chupete, interposición lingual y respiración bucal en tipos de maloclusión en plano horizontal. Se realizó un estudio transversal sobre un análisis descriptivo de una base de datos obtenién- dose una muestra de 526 niños de 8 a 14 años de Montemorelos, Nuevo León. Se aplicó una encuesta y se les midió la distancia horizontal entre los incisivos centrales superiores e infe- riores a cada niño que nos pueda indicar la presencia de los tipos de maloclusión en plano horizontal. La recolección de datos se obtuvo mediante una encuesta que se realizó a los niños para el registro de los malos hábitos orales, y una exploración clínica para el registro de la medición de los tipos de maloclusión en plano horizontal. Los datos recopilados se analizaron mediante procesamiento y análisis estadístico de la información a través del programa estadís- tico SPSS (Statistical Package for Social Sciences). Se utilizó el análisis descriptivo, la prueba no paramétrica de independencia de chi-cuadrado para probar la asociación entre las variables. Este estudio encontró una relación relevante con la presencia de over jet con la edad y tipo de dentición, al igual que tipo de dentición con bis a bis, además se encontró significancia en el hábito de succión digital con over jet, los demás hábitos orales no tuvieron una asociación significativa. En este estudio se observó que existe una asociación significativa entre succión digital y over jet, con eso concluimos que de los hábitos orales estudiados en nuestra población el hábito de succión digital es un factor importante para el desarrollo de over jet específicamente. Debemos tomar importancia en la detección de los hábitos orales al momento de valorar pacientes pediá- tricos y al mismo tiempo educar a los pacientes y a los padres para eliminar el factor de riesgo para el desarrollo de maloclusión tipo over jet.

Comparison and Evaluation of Alveolar Bone Around Lower Central Incisors in Class III and Class I Patients

Objectives: The aim was to compare the alveolar bone support of mandibular central incisors in subjects with Class III and Class I skeletal patterns using cone-beam computed tomography (CBCT). Materials and Methods: Group 1 included 20 patients (mean age=19.78±2.80) with Class III malocclusion (mean ANB°=-2.77±3.69), mesofacial growth pattern (FMA°=27.03 ±5.11) and lingual-inclined mandibular incisors (IMPA°<85). Group 2 included 20 patients (mean age=20.85±3.97) with Class I malocclusion (mean ANB°=2.94 ±1.46), mesofacial growth pattern (FMA°=25.67±6.83) and normal inclined mandibular incisors (85<IMPA°<95). Vertical alveolar bone level and alveolar bone thickness (ABT) of total 80 mandibular central incisors (40 from each group) were evaluated. Buccal, lingual and total ABT were measured at the crestal, midroot, and apical levels. Buccal (BACH) and lingual (LACH) alveolar crestal heights were also evaluated. Mann-Whitney U, independent samples-t-tests, and Spearman’s rank correlation analysis were applied for statistical analysis. Results: The lingual ABT at the crestal and midroot level, buccal ABT at the apical level, and total ABT at all levels were significantly lower in Group 1 than Group 2 (p<0.05). There was a negative correlation between the buccal (r=-0.324; p=0.042) ABT at the apical level and mandibular plane angle. The change in mandibular incisor inclination was positively correlated with buccal ABT at the apical level (r=0.463; p=0.003) and lingual ABT at the crestal level (r=0.550;p<0.001). BACH was significantly higher in Group 1 (2.21±1.48 mm) compared to Group 2 (1.42±0.17 mm) (p < 0.05). Conclusions: In subjects with Class III deformities, mandibular central incisors have less bone support especially at the buccal side of the alveolar bone at the apical level and lingual side of the alveolar bone at the crestal and midroot levels. Rate of change in mandibular incisor inclination and mandibular plane angle can be thought as significant factors that may influence alveolar bone thickness.

Knowledge, Beliefs and Practices Associated with Teething Among Mothers in Mangalore Taluk, South India

Background: To assess mother’s knowledge and beliefs about teething signs and symptoms, to evaluate their experience during the teething of their youngest child and to assess the practices undertaken by mothers to relieve the teething symptoms. Methods: Random number of anganvadis, 5 from the rural and 5 from the urban areas of Mangalore were selected. A cross sectional survey was conducted using a self administered questionnaire. The questionnaire form included three sections eliciting demographic characteristics and assessing parent's knowledge, and beliefs regarding teething of their youngest child. Result: The majority of the respondents were in the age group of 28 – 37 years of age and had only primary level of education . Almost about 93% of the mothers knew that the tooth eruption starts around 6 – 7 months of age and the first tooth to erupt is the lower central incisors. About 85 % of the mothers said that the primary tooth eruption gets completed by 2 years of age. Almost 90 % parents attributed fever and diarrhea to teething. Almost 55 % of the parents consulted a doctor for fever and diarrhea. There is no statistically significant difference between the rural and urban mothers about teething knowledge and its associated symptoms. Conclusion: This study identified mother’s conceptions about teething signs and symptoms. Health care providers must review and dispel long held cultural myths and beliefs about teething, acknowledge and share the evidence that tooth eruption is not strongly associated with significant symptoms.

Effects of anterior tooth crown inclination on occlusal relationship—A study in three-dimensional reconstruction

ObjectiveThis study aims to analyze the relationship between the central incisor crown inclination and occlusal relationship via three-dimensional study. MethodsTen Chinese volunteers with normal occlusion were selected from physical examination of college students. Lateral cephalograms and CT scans were taken, and the CT data were imported into Simplant pro 11.04 to reconstruct three-dimensional model. In the three-dimensional model, every tooth was separated independently. The upper and lower central incisors were moved labial inclination(up) or lingual inclination(down) and then the upper and lower tooth were aligned based on the central incisor’s position according to the principles of Andrew’s six keys. Four groups were set up with different changes of central incisors. The upper and the lower arch were aligned again based on the moved central incisors. After every motion, the mesio-distal distances of upper and lower canines and first molars were recorded. All data were analyzed using t-test via SPSS19.0, and the significance level was set at 5%. ResultsThe results showed that the mesio-distal distances of occlusal relationship were different from normal occlusal relations, when either upper incisor crown inclination or lower incisor crown inclination was changed, and both upper and lower incisor crown inclination were moved in same or opposite direction. According to the statistical analysis, there was no significant difference when the changes of U1-L1 were no more than 10° (P > 0.05). But there was statistically significant difference (P < 0.05) when changes of U1-L1 were more than 20°. ConclusionsThe incisor crown inclination has influence on the establishment of occlusal relationships. The bigger difference upper and lower incisor crown inclination has, the more deviations from the normal occlusal relationship exist.

Evaluation of eggshell powder as an experimental direct pulp capping material

Aimis to histopathologically evaluate dental pulp response to eggshell powder as a direct pulp capping material and compare it to Calcium Hydroxide as regard to inflammation, calcific bridge formation and fibrosis. Material and methods30-New Zealand rabbits were selected in this study and divided into 3 groups according to the time of sacrifice after pulp capping procedure (1, 2 and 4weeks). The two lower central incisors were used, where the pulp was exposed and capped directly by one of the two materials used in this study; Calcium Hydroxide (Dycal) or eggshell powder. The cavities were then sealed by glass ionomer cement (Fuji IX). Animals were sacrificed at each time interval and teeth were collected for histopathological evaluation. ResultsEggshell group showed significantly less inflammation, less fibrosis and thicker calcific bridge formation than Calcium hydroxide group. When the effect of time was considered, inflammation significantly decreased from 1 to 4 weeks while calcific bridge significantly increased for both materials. Also fibrosis increased significantly from 1week to 4 weeks. ConclusionsEggshell powder should be considered as a direct pulp capping material as it led to a better calcific bridge formation than calcium hydroxide with less inflammation and fibrosis.

Rapid urease test (RUT) for evaluation of urease activity in oral bacteria in vitro and in supragingival dental plaque ex vivo

BackgroundUrease is an enzyme produced by plaque bacteria hydrolysing urea from saliva and gingival exudate into ammonia in order to regulate the pH in the dental biofilm. The aim of this study was to assess the urease activity among oral bacterial species by using the rapid urease test (RUT) in a micro-plate format and to examine whether this test could be used for measuring the urease activity in site-specific supragingival dental plaque samples ex vivo.MethodsThe RUT test is based on 2% urea in peptone broth solution and with phenol red at pH 6.0. Oral bacterial species were tested for their urease activity using 100 μl of RUT test solution in the well of a micro-plate to which a 1 μl amount of cells collected after growth on blood agar plates or in broth, were added. The color change was determined after 15, 30 min, and 1 and 2 h. The reaction was graded in a 4-graded scale (none, weak, medium, strong). Ex vivo evaluation of dental plaque urease activity was tested in supragingival 1 μl plaque samples collected from 4 interproximal sites of front teeth and molars in 18 adult volunteers. The color reaction was read after 1 h in room temperature and scored as in the in vitro test.ResultsThe strongest activity was registered for Staphylococcus epidermidis, Helicobacter pylori, Campylobacter ureolyticus and some strains of Haemophilus parainfluenzae, while known ureolytic species such as Streptococcus salivarius and Actinomyces naeslundii showed a weaker, variable and strain-dependent activity. Temperature had minor influence on the RUT reaction. The interproximal supragingival dental plaque between the lower central incisors (site 31/41) showed significantly higher scores compared to between the upper central incisors (site 11/21), between the upper left first molar and second premolar (site 26/25) and between the lower right second premolar and molar (site 45/46).ConclusionThe rapid urease test (RUT) in a micro-plate format can be used as a simple and rapid method to test urease activity in bacterial strains in vitro and as a chair-side method for testing urease activity in site-specific supragingival plaque samples ex vivo.

Anesthetic Efficacy of 4% Articaine Versus 2% Lidocaine in Lower Central Incisors - A Comparative Study

Anesthetic Efficacy of 4% Articaine Versus 2% Lidocaine in Lower Central Incisors - A Comparative Study

Coordinating bracket torque and incisor inclination

To determine the reproducibility and statistical measures of the torque coordination angle (TCA). Atotal of 107 final cephalograms and corresponding casts were included, all reflecting treatment outcomes that met high qualitative standards, one of them being aPeer Assessment Rating (PAR) score of ≤3. Based on these records, the TCA was measured as aparameter to identify differences related to tooth morphology and bracket position between the torque-relevant reference plane at the bracket base and the long axis of atooth. All measurements were performed on upper and lower central incisors (U1 and L1). Several reproducibility assessments for the TCA measurements yielded good results, including objectivity at 1.26 ± 0.81° (U1) or 1.41 ± 1.18° (L1), examiner reliability at 1.30 ± 0.97° (U1) or 1.25 ± 0.82° (L1), and method reliability at 1.80 ± 1.13° (U1) or 1.53 ± 1.07° (L1). The statistical measures revealed ahigh degree of interindividual variability. With bracket placement 4.5 mm (U1) or 4.0 mm (L1) above the incisal edge, the differences between the maximum and minimum TCA values were similarly large in both jaws (21.0° for U1 or 20.0° for L1), given mean TCA values of 24.6 ± 3.6° (U1) or 22.9 ± 4.3° (L1). Moving the bracket placement from 3.5 to 5.5 mm (U1) or from 3.0 to 5.0 mm (L1) changed the mean TCA values by 4.5° (U1) or 3.2° (L1). The TCA is asuitable cephalometric parameter to identify differences related to tooth morphology and bracket placement. Given its high interindividual variability, the fixed torque value of aspecific bracket system should not be expected to produce the same incisor inclinations across patients.

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Objective: To analyze the chronology of first deciduous tooth eruption in children with microcephaly associated with presumed or confirmed Zika virus. Methods: A longitudinal study was developed with 74 children of both sexes. Data on prematurity, gestational age (in weeks), anthropometric characteristics at birth [length (cm), weight (g) and cephalic perimeter (cm)] and dental eruption (chronological age and corrected age for prematurity in months) were collected and presented through descriptive statistics. Results: The majority of children were female (54.1%) and 14.9% were born premature. The mean gestational age was 38.2 (± 1.9) weeks, while length, weight and cephalic perimeter at birth were 45.6 (± 3.1) cm, 2750 (± 526.6) and 30 (± 2.3) cm, respectively. The eruption of the first tooth occurred on average at 12.3 (± 3.0) months of chronological age and at 11.1 (± 2.3) months of corrected age. The first erupted teeth were the lower deciduous central incisors (82.4%). The mean age for dental eruption in males was 12.5 months (± 3.0) and in females 12.0 months (± 3.1) among full-term children. For premature infants, the mean corrected age of dental eruption was 11.5 months (± 3.4) for boys and 11 months (± 1.7) for girls. Conclusion: In this group of children with microcephaly, the first tooth to erupt was the lower central incisor around the first year of life. Girls had lower average eruption time when compared to boys in both chronological age and age corrected for prematurity.

Direct Measurements of Root Canal Length in Primary Anterior Teeth for Educational and Clinical Purposes

Background: The root canal length (RCL) estimates is an essential step for total endodontic therapy procedures. The aim of this study was to measure the RCL in a sample of extracted primary anterior teeth and compare the data obtained with the literature for educational and clinical purposes. Materials and methods: Seventy extracted primary anterior upper and lower teeth were selected according to the following inclusion criteria: absence of root resorption and/or internal root canal anatomy complications, and no previous root canal manipulation. The teeth were assigned to six groups: upper central incisors (UCI; n = 15), upper lateral incisors (ULI; n = 13), upper canines (UC; n = 20), lower central incisors (LCI; n = 6), lower lateral incisors (LLI; n = 3), and lower canines (LC; n = 13). RCL was measured by the direct method after insertion of a #15 K-file with a silicone stopper in the root canal until the root apex and measuring with a millimetre rule. Results: Mean RCL values (mm) obtained were UCI = 14.33 ± 1.69; ULI = 14.00 ± 1.63; UC = 16.07 ± 2.43; LCI = 15.41 ± 3.20; LLI = 15.00 ± 1.73; and LC = 16.38 ± 1.51. Conclusions:The RCL direct measurement method and the results obtained were in accordance with the literature reports and can be useful for educational purposes aiming at knowledge of dental anatomy and the clinical determination of root canal treatment viability and treatment of primary teeth, as RCL is one of the parameters for the indication/contra-indication of this therapy.

Aesthetic perception of the smile related to the vertical position of the lower anterior teeth by afro-descendent laypeople

Introduction: To evaluate the influence of the vertical position of the lower anterior teeth in the aesthetic perception of the smile of Afro-descendent laypeople from different age groups. Materials and Methods: A standard smile was constructed from intraoral photographs of an afro-descendent individual. The vertical position of the lower anterior teeth was gradually changed by moving the teeth up and down within the lip frame in 0.5 mm increments ranging from -1.5 mm to 2.0 mm, regarding point zero. Using a visual analog scale, 150 Afro-descendent Brazilian lay individuals from three different age groups (15-19, 35-44 and 65-74) rated the attractiveness in relation to 8 smiles with altered gingival exposure. Results: There were no significant differences (p>0.05) between male and female raters for the three groups. All the age groups assigned higher scores for the smiles with 0.5 mm coverage of the lower lip on the lower central incisors. However, for the less attractive smiles, there were differences in the opinions of the age groups (p<0,05).Conclusions: the age groups shared similar preferences regarding the most pleasant smile regarding the vertical positions of the lower anterior teeth.

Chemical oral burn cum erosive gingival lesion arising from self-medication for toothache

Chemical burn of the oral mucosa occurring as a result of a noxious agent placed in direct contact with the mucosa either by the patient or a dentist is frequently associated with gingival erosion. The objective of this study was to report a case of chemical oral burn with erosive gingival lesion due to self medication with nonsteroid anti inflammatory drug topically in patient with acute apical abscess. We report a case of 63-year-old male public servant with health insurance that presented to the periodontology clinic with chemical oral burns and erosive gingival lesion due to topical application of nonsteroidal anti-inflammatory drug for relief of toothache from apical abscess of lower left central incisor (tooth 31). The patient was advised to discontinue topical application of Anacin. Full-mouth scaling was done, oral hygiene instructions given, warm saline mouthrinse therapy prescribed, and patient referredb to the conservative clinic where root canal treatment. Increased public awareness is required regarding chemical injuries that can result from topical self-medication. Dentists must recognize the local effects of topically applied aspirin as well as other medications on the oral mucosa and incorporate them into the treatment plan to prevent complications.

Autopercepción estética de la sonrisa en adultos Cuenca-Ecuador

El objetivo de este estudio fue analizar la Autopercepción de la Estética de la sonrisa en pacientes que acudieron a la atención Odontológica de la Universidad Católica de Cuenca. Fue un estudio descriptivo de corte transversal actual, se aplicó una encuesta a 250 pacientes de 18 a 70 años de ambos sexos que asistieron a la consulta odontológica de la clínica docente de la Universidad Católica de Cuenca en el periodo Marzo – Julio del 2017, misma que consto de 11 preguntas relacionadas a la estética dental. Se obtuvo como resultado que la autopercepción de la estética dental fue mayor para el sexo femenino en un 12% más al comparar con el sexo masculino, en donde los factores de mayor afección fueron el color de dientes, posición en la que se encuentran, tamaño y forma en un 41,29%, 29,03% y 22,58% respectivamente, los de menor afección fueron diastemas y edentulismo; las piezas dentales más relacionadas a la autopercepción de la estética de la sonrisa fueron los incisivos centrales superiores e inferiores. Así podemos decir que todos los pacientes examinados autopercibieron al menos un factor que afectó la estética de la sonrisa.

Timing and sequence of emergence of permanent teeth in Syrian schoolchildren.

The aim of the present study was to investigate the timing and sequence of the eruption of permanent teeth in Syrian schoolchildren. A total of 1211 children aged 5-13years were included. Every permanent tooth was scored according to its clinical stage of eruption. The significance of difference was tested using t test. The mean number of erupted teeth in children aged 5-6years was 2.41±2.68, and reached to 24.48±3.60 in those ages between 12 and 13years. Mandibular teeth erupted earlier than maxillary opposing teeth in both sexes, except upper premolars. The eruption significantly proceeded in girls when compared to boys. Differences were significant for numbers 11 (P=.003), 21 (P=.035), 13 (P=.013), 42 (P=.038), 33 (P=.009), and 45 (P=.012). There was no significant difference between contralateral teeth (right and left) in the mean age of eruption in both arches. Lower central incisors and first molars were the earliest teeth to emerge in both sexes. Second molars were the last teeth to emerge in boys (maxilla: 11.68years, mandible: 11.15years) and girls (maxilla: 11.2years, mandible 10.99years). Findings could be used as Syrian standards of eruption when health professionals assess normal occlusion and need to determine the correct timing for preventive or corrective procedures.

Measurement of anterior teeth widths in 236 Uygur teenagers

In order to provide reference for orthodontic and esthetic dentistry, we measured anterior teeth widths, and analyzed the ratio between the teeth in 236 Uygur teenagers. Two hundred and thirty-six samples were selected from Uygur population,Vernier calipers was used to measure the widths of the anterior teeth. SPSS21.0 software package was used for independent sample t test, paired t test and REG regression. Except for mandibular lateral incisors, significant difference was observed in anterior teeth widths between males and females, the ratio between the upper and lower central incisors in males was nearly 1.618; the ratio between upper central incisor and lower central incisor, upper central incisor and lower lateral incisor, upper canine and lower lateral incisor in females was not approaching 1.618, i.e. There was no "golden proportion". There was significant correlation between anterior teeth of Ugyur teenagers. No "golden proportion" was found in anterior teeth widths of Ugyur teenagers, but a specific ratio exists.

Influence of olive oil on alveolar bone response during orthodontic retention period: rabbit model study

Objectives: This study attempted to evaluate clinically and histologically the effects of olive oil (Ol) consumption on orthodontic relapse after the retention period.Design: Thirty apparently healthy female albino rabbits, weight more than 1000 g each was used in this study. The animals were grouped randomly into six groups of five animals each: two control and four experimental groups. In control groups, the relapse was estimated either at zero day, or at the end of the fourth week after orthodontic retention period. In the experimental groups, the animals' groups received Ol, 7.7, or 15.4 ml/kg b.w. per day during the orthodontic retention period. The relapse was estimated either at zero day, or at the end of the fourth week after orthodontic retention period for each concentration.Modified fixed orthodontic appliances were attached to the rabbits’ lower central incisors. Each rabbit received orthodontic intervention for one week, followed by six weeks retention period. At the end of the experiments, the clinical and histological investigations were conducted. Data analyses were performed at the level of p < .05 for the statistically significant difference.Results: Clinically, Ol high concentration four weeks group showed a significantly lower relapse tendency than control four weeks group. Histologically, Ol low concentration zero time group showed significantly higher osteoblasts numbers than control zero time group. Olive oil low and high concentrations four weeks group showed significantly lower fibroblasts count. Moreover, Ol high concentration four weeks group revealed significantly higher bone mineralization, osteoblasts and osteocytes counts than control four weeks study group.Conclusions: Supplementation with Ol during an orthodontic retention period, especially at 15.4 ml/kg b.w. per day concentration, clinically reduced orthodontic relapse on rabbit model. Histologically, Ol increased osteoblasts and osteocytes counts and the relative amount of bone mineralization of connective tissue layer forming alveolar bone (AB) at the end of four weeks after the orthodontic retention period.

Audiological Diagnostics and Treatment of Craniofacial Abnormalities in Cleidocranial Dysplasia CCD

Introduction: Cleidocranial dysplasia CCD is a rare genetic disorder connected with mutation in the gene RUNX2. The characteristic feature of this syndrome is a triad of symptoms: hypoplasia or aplasia of clavicles, cranial defects, persistent decidous teeth and multiple supernumerary teeth with consecutive failure in succedaneous teeth eruption. Objective: The aim of the study is to present a CCD patient, in which during orthodontic treatment there was performed a comprehensive hearing test. Case report: The paper presents a 15-year-old patient in whom intraorally there were stated only 4 first permanent molars and 1 lower central incisor while all the remaining teeth were decidous. The CBCT showed 11 impacted supernumerary teeth. Treatment started by surgical exposure and orthodontic traction of the upper incisors into the arch. The introduced fixed appliance seems to be a good solution to pull down impacted anterior teeth. An audiological examination of the patient with CCD revealed normal hearing on the border of norm, however tympanometry may suggest a defect of the auditory ossicles. Conclusion: Active long-term treatment that requires cooperation of many specialists is the correct procedure in CCD cases.

The influence of orthodontic non-extraction treatment on the change in the inclination and position of incisors in the Europoid race.

To detect post-treatment change in the inclination and position of incisors in cases treated with orthodontic non- extraction therapy. The group consisted of 102 patients without extractions in lower and upper dental arch during orthodontic treatment. Cephalogram examination evaluated the position of the lower incisor to point A by Downs-pogonion line (-1 to APo) and inclination of the lower incisor to mandibular line (-1 to ML), position of the upper incisor to nasion-pogonion line (+1 to NPo), inclination of the upper incisor to nasion-sella line (+1 to NS) and the size of the inter-incisival angle between upper and central lower incisor (-1 to +1). In 58 % of cases, the difference in post-treatment and pre-treatment changes in the position of the (-1 to Apo) was within ± 2 mm, which we considered stable. Statistically significantly higher values after treatment were in unstable rather than in stable cases with values (-1 to Apo), (-1 to ML), (+1 to NPo). Statistically significantly lower value after the treatment was measured in unstable cases rather than in stable cases with a value (-1 to +1). There was no statistically significantly different value in stable and unstable cases after treatment in values (+1 to NS). The number of stable post-treatment cases was only 16 % higher than the number of unstable cases. With the increasing value (-1 to Apo), the value (-1 to ML) and (+1 to NPo) increased, the value (+1 to -1) decreased. The value (-1 to NS) not after treatment was not statistically significantly different in stable and unstable cases (Tab. 6, Fig. 4, Ref. 27).

Optimization of periodontal tissue through orthodontic dental movement

Case report of: a patient with severe inactive periodontitis, bone loss in the upper and lower anterior segments, supra-eruption of the upper and lower central incisors and spacing. Objective: To increase alveolar bone volume in the anterior segments, level and align the dental arches, upright incisors, close spaces and improve stability, function and esthetics. Method: Orthodontic appliances were bonded, both dental arches were leveled and aligned; the incisors were intruded and their inclination corrected. Results: Alveolar bone volume was increased in the anterior segments thus reducing the bony defect between upper central incisors. Stability, function and aesthetics were improved. Conclusions: The orthoperio relationship has been well established, and the benefits of this relationship help the orthodontist to achieve contemporary treatment objectives.

“Light wand-guided nasotracheal intubation in patients with limited mouth opening: a comparison with blind nasal intubation”

Background and objectives: Approximately 1–3% of surgical patients have difficult airways, which accounts for the most important cause of anaesthesia-related morbidity and mortality. The fibreoptic bronchoscope is considered the gold standard for the management of difficult airways. However, blind nasal intubation remains a basic technique in developing countries, especially in remote areas where a Fiberoptic bronchoscope is not always available. The light wand is a simple, cost effective device, and has become a tool widely accepted in airway management under various clinical scenarios, including difficult airways. The study was conducted to evaluate the efficacy of light wand-guided nasotracheal intubation over blind nasal intubation. Methods: A total of 60 ASA Grade I & II patients of age 18-60 yrs of Body mass index between 18-25 kg/m2 with limited mouth opening (distance between upper and lower central incisors < 3.0 cm) posted for elective surgeries were divided into two equal groups in a randomized, double-blind fashion. Blind nasal group 30 patients Light wand Group: 30 patients Results: The first attempt and overall success rate of light wand guided nasotracheal intubation was 80% and 90% respectively, significantly higher than blind nasal intubation i.e. 50% and 66.66% respectively (p