Type Of Malocclusion Research Articles

Is Apical Root Resorption Greater When Using Clear Aligners as Compared to Conventional Fixed Appliances in Adult Patients Following Orthodontic Treatment? A literature Review

Background: Apical root resorption has been identified as a potential risk/adverse effect of conventional orthodontic treatment, however, with changing dental demand and increasing patient preference for clear aligners therapy, the availability of evidence-based information on its incidence/severity following treatment with either clear aligners or fixed appliance is of relevance to clinical practice in providing guidance on orthodontic treatment risk to patients and therefore contributing to the process of obtaining valid informed consent. Objectives: The aim of this study is to undertake a literature review to establish whether apical root resorption following orthodontic treatment is greater in adult patients treated with clear aligners as compared to conventional fixed appliances, to analyse and appraise the data, to make appropriate recommendations relevant to orthodontic practice and is widely referenced by orthodontists. Search Methods: A systematic literature search of three databases (Medline, Embase, Web of science), Google scholar and a hand search of relevant journals was done. Selection Criteria: Primary research studies high in the hierarchy of evidence that investigated/compared apical root resorption following extraction/non-extraction based orthodontic treatment with fixed appliance or clear aligners in adult patients equal to or greater than 18 years between January 2010 and December 2021 were selected for this systematic review. Data Collection and Analysis: Studies were accessed, duplicates eliminated, data extracted with the use of a customized data extraction form, and quality assessed using a critical appraisals skills programme tool. Results: A total of 67 studies were identified, and after the elimination of duplicates and quality assessment, six studies were selected for review. The Cochrane Rob 2 bias tool was used to assess the risk of bias of the selected studies. Apical root resorption prevalence/severity was measured using two different radiographic methods: 3-Dimesional (CBCT-scan) and 2-Dimensional (panoramic/periapical radiographs). Conclusions: The majority of the studies showed that the severity/prevalence of apical root resorption is less in clear aligners compared to fixed appliance treated patients, however, they are characterized by different baseline malocclusion/treatment duration/modalities, study design flaw, inconsistency in outcome measurement/calculation. Due to these limitations, it is difficult to arrive at a conclusion and make recommendations applicable to everyday clinical practice. The clinician should take into consideration factors that increase the risk of apical root resorption such as genetic predisposition, treatment duration, force application (types and location), types of tooth movement, initial malocclusion and extraction/ non-extraction-based treatment in deciding on the orthodontic treatment option and gaining patient consent.Limitations: The current evidence has a number of limitations including the lack of robust prospective studies on apical root resorption, different methods of outcome measurement and calculation, different baseline malocclusions, the evaluation of apical root resorption in only one treatment modality and short treatment duration which may influence the validity of the study conclusions. A meta-analysis could not be performed due to the heterogeneous outcome recording methods. Further research is recommended

An Evaluation of the Ramus Mandibular Asymmetry on the Panoramic Radiography

This study is intended to focus on the evaluation of posterior vertical mandibular asymmetry by calculating the mandibular asymmetry index on the panoramic radiography in different types of malocclusions, considering the sexual dimorphism in children and adolescent patients and performing a comparative analysis between these groups. In this context, a cross-sectional study was conducted for a group of 214 patients (134 females and 80 males with a mean age of 9.5 ± 2 years). The asymmetry index was calculated for each patient according to the Habets method. The results were analyzed by using the independent Student t-test, ANOVA and Mann–Whitney U-test at the 95% confidence level (p < 0.05). The results of the analyses showed a statistically significant difference between males and females at the level of the condylar index (p = 0.023) and a significant difference in the unilateral posterior crossbite in the Mann–Whitney U test (p = 0.01). No statistically significant differences were found between males and females in the index of the mandibular ramus and condyle-plus-ramus. The highest value of the asymmetry index was recorded at the level of the condyle. We found higher values of asymmetry in Angle Class I malocclusions in all groups and in Class II/1 in the group of females.

CORRELATION OF MOUTH BREATHING HABITS TO DENTAL MALOCCLUSIONS

Introduction: one of the malocclusion’s etiology is bad habits such as mouth breathing habit. The purpose of this study was to determine the relationship between the mouth breathing habit through with the type of malocclusion. Materials and Method: the sampling method used was purposive sampling obtained from giving questionnaires to parents and clinical examination of the oral cavity of students at SDN 17 Dauh Puri Denpasar. The number of samples with mouth breathing habit were 50 samples. Classification of dentition malocclusion in students was assessed using a modified Dewey Angle Classification. Data analysis used the chi-square test. Results and Discussion: the results of this study were that the mouth breathing habit was more dominant in the Class I Angle type 2 Dewey malocclusion with a total of 25 students (50%) and in the Class I Angle type 4 Dewey malocclusion with a total of 14 students (28%). Conclusion: the conclusion of this study is that there is a significant relationship between the mouth breathing habit and the type of malocclusion.

Correlation of dermatoglyphics and Class II skeletal malocclusion – Original research

Dermatoglyphics is a study of the unique pattern in the skin of fingers, palms, soles, and toes. These dermatoglyphics has played an important role in various fields like forensic medicine, genetics, and anthropology.Sir Francis Galton stated that an individual’s dermal pattern remained constant throughout their lifetime. Many studies have suggested the possible relation between dermatoglyphics and occlusion.Studies have suggested that dermatoglyphics could be used as a tool to identify the underlying skeletal malocclusion. As the dermal pattern and oral structures develop together, the genetic information in the dermal pattern could be used to assess the different types of skeletal malocclusions. Hence, the study was aimed to compare and evaluate the correlation between dermatoglyphics and class II skeletal malocclusion in horizontal and vertical growth patterns. The total of 50 samples were taken and divided into horizontal and vertical growth pattern consisting of 25 samples each. The dermatoglyphic pattern between the right and left hand and the pattern such as arches, loops, and whorls were evaluated. The data was analyzed by Kolmogorov – Smirnov and Shapiro Wilk test. There was a statistically significant association between class 2 malocclusion and the dermatoglyphic pattern.

Tridimensional assessment of the mandibular angle in patients with different skeletal patterns by cone-beam computed tomography scans: a retrospective study

BackgroundSince the muscles of chewing are involved in the region of the mandibular angle, important structures in surgical and orthodontic procedures, to study its morphological aspects and the possible influence of different patterns of skeletal development would be of interest. Thus, this study aimed to assess the influence of patient characteristics - such as sex, skeletal malocclusion (Class I, Class II, and Class III) and facial type (brachycephalic, mesocephalic, and dolichocephalic) - on the width, height, thickness, and volume of the mandibular angle, using cone-beam computed tomography (CBCT) scans.MethodsCBCT scans were assessed − 144 men and 154 women, total of 298 - and classified according to skeletal patterns (skeletal malocclusions and facial types). Width, height, and thickness of the mandibular angle were measured using OnDemand 3D software. The volumetric measures of the mandibular angle were obtained using the ITK-SNAP software. Analysis of Variance (multiway ANOVA) with Tukey’s post-hoc test compared the data, with a 5% significance level.ResultsAmong the factors studied, sex significantly influenced all the analyzed variables (height, width, thickness, and volume of the mandibular angle) (p < 0.05); in general, male individuals presented higher values than females. In some cases, the skeletal malocclusion and facial type factors influenced only the width and height variables (p < 0.05); in general, the Class III and dolichocephalic individuals presented higher values in relation to the other types of skeletal malocclusions and facial types.ConclusionsVariations in the craniofacial growth pattern, considering the different skeletal malocclusions and facial types, had some influence in the width and height dimensions of the mandibular angle. Furthermore, sex influenced all the studied variables.

Linear and Angular Mandibular Measurements: Comparison Between Panoramic Radiography (Orthopentomogram) And Lateral Cephalogram

Invention of lateral cephalogram by Hofrath in Germany and Broadbent in United States provided a clinical tool for assessment of skeletal disparities. But lateral cephalogram is not effective in measuring bilateral cranial structures independently. In orthodontic practice, panoramic radiographs are frequently obtained for information about maturation period of teeth with surrounding tissues and their axial inclination. Objective: To determine the use of orthopantomogram, whether it’s a substitute of lateral cephalogram for the linear and angular measurement of mandible. Methods: This was a Prospective Cohort study. Study was conducted at Nishtar Institute of Dentistry, Multan form January 2021 to December 2021 in one year duration. A total of 75 patients were found to be eligible for the study. Gonial angle of patients with malocclusion type I was measured with lateral cephalogram and orthopantomogram. In orthopantomogram, measurement of gonial angle was made by drawing a tangent line to the lower border of mandible and other tangent line to the distal border of ramus and both sides of condyle. In lateral cephalogram it was measured at intersection point of mandibular plane and ramus plane. Results: Overall, 75 patients were included in our study. The average age of the patients was 16.43±4.06 years. The mean difference between cephalogram and OPG was statistically significant, (p&lt;0.001). Conclusions: Gonial angle can be measured on OPG as accurately as on lateral cephalogram but linear measurements are taken accurately by the help of orthopentomogram.

Relapse after Orthodontic-Surgical Treatment: A Retrospective Longitudinal Study

Long-term stability is a crucial point in order to keep the patient’s aesthetic and functional balance. The aim of this study was to evaluate dental and skeletal relapse in patients who underwent orthodontic-surgical treatment. This retrospective study included 25 patients who corrected their dentofacial deformity through orthodontics and orthognathic surgery. The dental casts and lateral cephalograms were evaluated prior to orthodontic treatment (T0), final of orthodontic-surgical treatment (T1) and long-term retention phase (T2). The Wilcoxon test with p-value corrected by the Benjamini–Hochberg method was used to assess differences between the groups. The influence of retention duration was assessed using the Kruskal–Wallis method. The association of nominal variables and differences between quantitative variables were assessed using the Fisher and Mann–Whitney tests, respectively. No dental or skeletal variable presented statistically significant differences between the final orthodontic-surgical treatment and the long-term retention phase. Eight patients presented dental relapse (32–95% CI [12.4%; 51.7%]), but no skeletal relapse was observed in any of the 25 individuals. The type of malocclusion did not influence the relapse rate of orthodontic-surgical treatment (Fisher, p = 0.202). No differences were found between the different retention times, sex and age at the end of treatment. Orthodontic-surgical treatment showed long-term stability in the present study group.

Cephalometric evaluation of posterior airway space in Chinese and Egyptian races

Objectives: The aim of this study was to evaluate the size of posterior airway space (PAS) and hyoid bone position in Chinese and Egyptian races in both genders using cephalometry. Material and Methods: Lateral Cephalometric X-ray were collected from 195 healthy young adults (96 Chinese subjects and 99 Egyptian subjects). Twenty cephalometric measurements (linear and angular) of the nasopharynx, oropharynx, hypopharynx, tongue, and hyoid bone were recorded. Considering gender, according to the ANB angle, the subjects were classified into three types of skeletal malocclusion: class I (1° ≤ ANB ≤ 3°), class II (ANB &gt; 3°), and class III (ANB &lt; 1°). Probability (P) ≤ 0.05 was considered statistically significant. Confident intervals of 95% were used and P &lt; 0.05 was considered to represent statistically significant differences. Results: Significant differences were founded in (PNS-V) (P ≤ 0.01), (TT-V) (P ≤ 0.05), ([Hy-Me-MP] [P ≤ 0.01] [Hyoid–MP-Prep] [P ≤ 0.05] [Hy-C3] [P ≤ 0.01] and [Hy-S] [P ≤ 0.05]), and (PNS-U) between Class II and Class III (P ≤ 0.05) in Chinese group. Significant differences were founded in (TT_FH) (P &lt; 0.001), (Hy_RGn) (P &lt; 0.001), Hyoid bone and C3 (Hy_C3) (P &lt; 0.05), (DeepPharyxatPog) (P &lt; 0.05), and (Hy_C3) between Class I and Class II (P &lt; 0.05) in Egyptian group. Conclusion: There is no direct clinical implication of this study. However, the study shows a reference of the average size of PAS in both genders of Egyptian and Chinese races. Gender showed a significant influence on the PAS dimensions in both Chinese and Egyptian individuals. Sexual dimorphism may account for larger airway dimensions and hyoid bone geometry in both Chinese and Egyptian males.

The Perceptions of Dental Professionals and Laypeople to Facial Aesthetics and Mal-Occlusion in Central India Population.

Dental professionals play an important role in an individual's appearance which can affect the perception of others that can vary greatly depending on their educational and socioeconomic background. The purpose of this study was to determine an insight of recognizing ability of dental professionals and laypersons toward facial aesthetics with different types of orthodontic malocclusion. A questionnaire-based study was conducted on 90 dental professionals and 90 laypersons. The perceptions differences between groups were assessed using visual analogue scale on 11 photographs. Kolmolgorov-Smirnov was used for normality test. The perceptions of facial aesthetics showing various malocclusions were significantly different between dental professionals and laypersons. The dental professionals and layperson perceptions regarding the facial particularly in central Indian population are significantly different for most of the malocclusion types.

Maxillary and Mandibular Interarch Width Among Different Malocclusions

Objective: To determine the association of maxillary and mandibular interarch width among different malocclusions. Material and Methods: This cross-sectional study was done at the Department of Orthodontics of the Dr. Ishrat Ul Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, during a period of one year from January 2017 to December 2017. Individuals with a Class I canine and molar relationship with minor crowding, normal growth and development, and mal-aligned upper and lower dental arches. Class II molar and canine relationship on at least one side, Class II division 1 or 2 groups, bilateral Class III molar relationship in centric occlusion, Class III permanent canine relationship with excessive negative overjet, good facial symmetry, and participants had to have all their permanent teeth present except for their third molars were included. Readings were obtained by measuring the interarch width using a vernier gauge caliper. The calibration of the vernier caliper was checked daily using the standard technique. The intercanine arch width was measured from the cusp tip of one canine to the contralateral canine. Intermolar width was assessed as the distance between the central fossae of the left and right first molars. The readings were taken by a single examiner, and the measurement was repeated three times with an interval of two minutes between each measurement to reduce the possibility of errors. To assess the reliability of the measurements, the intra-examiner reliability was determined using the intraclass correlation coefficient (ICC). The collected data was analyzed using statistical software, SPSS version 26. Results: The study examined the maxillary and mandibular interarch widths of participants with different types of malocclusions. Class I had the highest maxillary intercanine width, and Class III had the highest maxillary intermolar width. Class III had the highest mandibular intercanine and intermolar width. Class II Division 2 had the lowest intercanine and intermolar width in both arches. Significant differences were observed in the mean intermolar width in the mandibular arch between Class II Division 2 and Class III malocclusions and in the maxillary intercanine width between Class I and Class II Division 2 malocclusions. No significant difference was found in other width measurements among the different types of malocclusions. Conclusion: It has been concluded that patients with Class III malocclusion had narrower upper width measurements compared to the normal occlusion sample. Keywords: Maxillary, mandibular, interarch width, malocclusion

Transverse Malocclusions: Etiology, Development, Diagnosis and Treatment

Malocclusions that involve the transverse dimension are very common in the orthodontic office. They can be as simple as a crossbite of the posterior teeth or as severe as a Class III malocclusion with a mandibular asymmetry. Transverse malocclusions can vary from being a simple dento-alveolar problem to a more complex challenge as represented by a skeletal asymmetry that has developed after puberty and causing temporomandibular disorder (TMD) problems. In this review we shall address the most common types of transverse malocclusions and review their etiology and development. The most typical etiology of transverse anomalies will be discussed, and we will suggest diagnostic criteria to differentiate the individual malocclusions. We shall also introduce a frontal cephalometric analysis that relates to the anterior part of the face helping to differentiate between dento-alveolar and skeletal transverse malocclusions as well as determine the presence of dento-alveolar compensations. Furthermore, we shall suggest possible treatment approaches and the best timing of treatment for the most common types of transverse malocclusion. Finally, we shall present several cases with more unusual etiology including a case with mandibular asymmetry due to an anterior disc displacement of temporomandibular joint. A case with Class III malocclusion with mandibular overjet caused by maxillary stenosis will also be presented. Furthermore, we will show an example of a late developing mandibular asymmetry which is not an uncommon problem and document a case of excess mandibular growth with mandibular asymmetry and Class III malocclusion combined with posterior crossbite. This review will also address considerations that may affect the post treatment stability.

Comparison of the Mesiodistal Angulations of Canine and Molar Teeth in Different Types of Orthodontic Malocclusions: A Retrospective Study

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower-upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t-test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t-test and one-way ANOVA were used for normally distributed data, while the Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula.

ORTHODONTIC-SURGICAL TREATMENT OF CLASS III MALOCCLUSION WITH MANDIBULAR ASYMMETRY: A CASE REPORT

Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone shift may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 19 years with Class III skeletal malocclusion, having narrow maxilla, bilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the mandibulary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patients final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.

THE POSITION OF THE TONGUE AND VOLUME OF THE UPPER RESPIRATORY TRACT IN PATIENTS WITH MALOCCLUSION

This study is a fragment of the planned research work "Features of rehabilitation of orthodontic patients in various ages" state registration No. 022U201229.&#x0D; Malocclusion and functional disorders that accompany them are not only a health problem, but also a rather important aspect in the process of personality formation and adaptation in society. To increase the effectiveness at the beginning of orthodontic treatment and stability in the retention period, it is important to take into account the etiological factor that led to the occurrence of malocclusion.&#x0D; In order to study and evaluate the position of the tongue in patients with malocclusion, to identify the influence and relationship on the patency of the upper respiratory tract, the volume of the oropharyngeal area was measured according to the McNamara’s method, the size and position of the tongue on cone-beam computer tomograms of orthodontic patients on the Donders’s residual space.&#x0D; The average indicators of the volume of the upper respiratory tract in patients with class I are 10.103±1.27 cm3, in patients with class II by 0.8 cm3 less 9.3±0.706 cm3.&#x0D; In patients with class I, the average parameters of the space of Donders are 4.4379±0.8077 mm. In patients with class II, the average values were lower 2.6667±0.3609 mm (р˂0.5). The distribution of patients by gender shows that in men the position of the tongue (space of Donders) had average indicators of 2.411±0.318 mm, in women the average indicators were almost 2 times higher and amounted to 4.603±0.754 mm, which is typical for the displacement of the tongue to the bottom, i.e. lower position of the tongue (р˂0.01). That is, the volume of the respiratory tract depends on the skeletal structure of the pathology, in other words, the morphology of the thoracic duct in the sagittal plane.&#x0D; Cephalometric analysis of the interaction of the airways and the tongue in orthodontic patients on TRG is quite limited compared to the CBCT image, as the CBCT enables a three-dimensional study of the shape and volume of the upper respiratory tract, the position of the tongue at rest.&#x0D; The position of the tongue has a rather insignificant effect on the type of malocclusion in the sagittal plane, but it has a rather large effect on the formation of the pathology in the vertical plane, which is the subject of research in future works.

Upper airway dimensions and the skeletal parameters in orthodontic patients who developed moderate-severe COVID-19 symptoms during the pandemic.

Large airway dimensions are associated with a rapid decline in the lung function and a higher risk of hospitalization. Therefore, the airway dimensions of healthy subjects who tested positive for coronavirus disease 2019 (COVID-19) may be associated with the severity of COVID-19 symptoms. The objectives of this study were to measure the upper airway dimensions and the craniofacial skeletal parameters in patients who tested positive for COVID-19, to compare the upper airway dimensions and the craniofacial skeletal parameters between patients who developed no/mild symptoms and those with moderate-severe COVID-19 symptoms, and to assess any association of the skeletal relationships (anteroposterior (AP) and vertical) and the upper airway dimensions with the severity of COVID-19 symptoms in adult subjects. A total of 204 orthodontic patients who tested positive for COVID-19 were evaluated. Of these, only 137 met the inclusion criteria. The sample was further subdivided into 2 groups based on the severity of symptoms: cases (moderate-severe symptoms; n = 56); and controls (asymptomatic/ mild symptoms; n = 81). The upper airway dimensions and the skeletal parameters were measured on lateral cephalograms. The nonparametric Mann-Whitney U test was used to detect differences between the cases and the controls. Binary logistic regression analysis was used to evaluate the association between the studied variables and the severity of symptoms. The cases had a reduced lower face height (LFH) and a reduced perpendicular distance from the hyoid bone to the line connecting the anteroinferior limit of the 3rd cervical vertebra (C3) and the retrognathion point (RGN) (HH1) as compared to the controls. Regression analysis revealed a significant association of LFH (p = 0.013), the vertical airway length (VAL) (p = 0.002) and HH1 (p = 0.021) with the severity of COVID-19 symptoms. The types of malocclusion were similar in the cases and the controls. Patients with reduced LFH and VAL, and a superiorly positioned hyoid bone in relation to the mandible developed more severe COVID-19 symptoms.

Assessment of Size, Shape, and Position of Palatal Rugae and their Association to Types of Malocclusions in Taif City, Saudi Arabia: A Retrospective Cast-Based Study

Objectives: 1) Study the predominant palatal rugae characteristics in Angles classes of malocclusions. 2) Statistically relate the major palatal rugae characteristics with Angles classes of malocclusions and thereby study the probability of employing it in forecasting malocclusions. Materials and Methods: The data for classifying malocclusion was obtained from the patients’ clinical records. Study casts of the palate of 100 healthy orthodontic patients were included as Class 1, Class 2 and Class 3 respectively. Palatal rugae characteristics for all groups were recorded and Class 2 was compared with Classes 2, and 3 according to angles classification and analyzed. Distribution of 100 study casts for the study- 34 Class 1; 34 Class 2 and 32 Class 3. Inclusion Criteria: 1) The casts were categorized into class 1, 2 and 3 based on the ANB angle of 0-4 degrees for class 1, more than 4 degrees for class 2 and less than 0 degrees for class 3. 2) No previous orthodontics treatment. 3) No anomalies. Exclusion Criteria: 1) Study casts of inferior quality. 2) Records of any patient having history of previous anomalies affecting the maxilla rugae. Statistics: Predominant palatal rugae data of groups was entered in SPSS (version 10.0) software and statistically analyzed using ANOVA test to assess the differences between Class 1, 2 and 3 malocclusions study casts for the palatal rugae. Palatal rugae size (length) and number analysis shall be using Krukas-wallis test. The Pattern (Shape) and orientation (Position) of the palatal rugae shall be assessed using chi-square test. Results: Wavy and complex rugae were prevalent in Class 1 and 3 malocclusions and showed statistically significant difference between Class 1, 2 and 3 malocclusions (p=0.00, 0.014 and 0.016 respectively). The wavy pattern was higher in Class 1 and horizontal and complex higher in Class 3. Conclusions: Predominant palatal rugae can be considered on vaticination of malocclusions, still, clinical correlation is must. Further studies could be accepted to develop digital styles to identify predominant palatal rugae and prognosticate malocclusion.

Parafunctional Oral Habits: Frequency and Association with Malocclusion Traits in Adolescents

OBJECTIVE: To determine the frequency of parafunctional oral habits and their association with types of malocclusions in all three planes among the adolescents. METHODOLOGY: This cross-sectional study involved 610 students studying in 8 different schools of Raiwind, Lahore. Ethical approval for the study was obtained from Sharif Medical and Dental College, Lahore. Data was collected by the primary researcher and recorded in predesigned proforma. Each student was inspected while seated in an upright position in natural day light, using disposable wooden blades to retract the cheek to record posterior dental relationships and to retract lips to record anterior dental relationships. Data was scrutinized using SPSS and chi-square test was used to find the statistical significance of the association between various parafunctional oral habits and types of malocclusions. RESULTS: The frequency of parafunctional oral habits was 57.3% among 610 adolescent students, being more prevalent in females (72.9%) than males (52.3%). The most common oral parafunctional habit was bruxism (18.0%) and least frequent was thumb sucking (8.4%). Association between oral parafunctional habits and malocclusion in all three planes was found to be significant (p=0.0). CONCLUSION: The parafunctional oral habits such as bruxism, tongue thrusting, nail biting, mouth breathing and thumb sucking are very commonly found among adolescents in the same descending order. Most common malocclusions found to be associated with parafunctional oral habits are exaggerated over-jet, open bite and deep bite. Parafunctional oral habits have a strong influence on developing malocclusion traits in all three dimensions. KEYWORDS: Parafunctional oral habits, malocclusion, thumb sucking, tongue thrusting, mouth breathing, bruxism, nail biting.

Assessment of Dentoalveolar Changes Following Leveling and Alignment of Severely Crowded Upper Anterior Teeth Using Self-Ligating Brackets Alone or With Flapless Piezocision Compared to Traditional Brackets: A Randomized Controlled Clinical Trial.

Introduction Dental crowding is one of the most common types of malocclusions. It can be treated with or without extraction, depending on the severity of the crowding. Extraction-based orthodontic treatments are the preferred treatment option in cases of severe crowding, but they take longer than non-extraction cases. Objective This study aimed to evaluate the dentoalveolar changes following the orthodontic treatment of severely crowded maxillary anterior teeth in adults using self-ligating brackets alone or combined with flapless piezocision. Materials and methods The participants in this study were 63 patients (46 females and 17 males; mean age SD: 19.71 ± 2.74 years) who attended the Department of Orthodontics at the University of Damascus from January 2020 to December 2021. The participants were divided into three groups at random: Group (1): traditional brackets group, Group (2): self-ligating brackets group; and Group (3): self-ligating brackets with flapless piezocision group. Little's Irregularity Index (LII) was measured at five assessment times: before the onset of orthodontic treatment (T0), after one month (T1), after two months (T2), after three months (T3), and at the end of the leveling and alignment phase (T4). The intercanine width (lingual), the intercanine width (cusp), and the canine rotation angle were measured at two assessment times: before the onset of orthodontic treatment (T0) and at the end of the leveling and alignment phase (T4). Results The three studied groups had statistically significant differences in terms of LII during the first three months, and the most significant improvement of LII was in the self-ligating brackets with the piezocision group (P < 0.001). In addition, the intercanine width (cusp) at the end of the leveling and aligning phase revealed greater mean values in both self-ligating brackets groups compared to the traditional brackets group, and the differences were statistically significant (P < 0.001). Otherwise, no statistically significant differences were found at the end of the leveling and aligning phase in the intercanine width (lingual) or the canine rotation angle between the three studied groups (P > 0.05). Conclusion Using self-ligating brackets with flapless piezocision revealed more significant results concerning LII as compared to other groups. Thus, combining these two acceleration methods could get more effective results in aligning severely crowded teeth. Self-ligating brackets, whether used alone or with flapless piezocision, resulted in greater intercanine width at the cusplevel. The type of brackets (traditional or self-ligating) did not affect the canine rotation angle.

Alveolar bone defects around mandibular anterior teeth in Class I, II, and III malocclusions: a retrospective CBCT evaluation

Background: The aim of this study was to quantitatively and qualitatively evaluate alveolar defects of mandibular anterior alveolar bone in three different types of malocclusion with cone-beam computed tomography (CBCT) by an observational cross-sectional study.

Associations between skeletal discrepancies, breathing pattern, and upper airway obstruction in Class III malocclusions.

To verify the associations between sagittal and vertical skeletal discrepancies, changes in upper airways, and breathing pattern in children and adolescents with Angle Class III and Class III subdivision malocclusions. Eighty-five children and adolescents with a mean age of 9.5±1.74 years were selected. Cephalometry assessed the sagittal relationship (AO-BO measurement), facial types (Ricketts VERT index), nasopharynx, and oropharynx. An otorhinolaryngologist analyzed the breathing pattern and upper airway obstruction during anamnesis, physical examination, anterior rhinoscopy, and nasofibroscopy. Medical records were also reviewed. For statistical analysis, ordinary one-way ANOVA, Kruskal-Wallis (Tukey's post-hoc), unpaired t-test, Pearson's correlation, chi-square, and Fisher's exact tests (p<0.05) were used. The nasopharyngeal cephalometric dimension and pharyngeal tonsil hypertrophy were associated, whereas the oropharyngeal cephalometric dimension and palatine tonsils hypertrophy were not. Sagittal discrepancies were associated with septum deviation, while facial type was associated with inferior turbinate and palatine tonsils hypertrophy. However, facial type was not associated with breathing pattern, septum deviation, and pharyngeal tonsils hypertrophy. Sagittal discrepancies and type of malocclusion were not associated with breathing pattern and changes in upper airways, except for the severity of septum deviation and Class III malocclusions, which were associated with large sagittal discrepancies. Although the facial types analyzed presented signs of airway obstruction, the highest prevalence of inferior turbinate and palatine tonsils hypertrophy were found in patients with dolichofacial type.