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Introduction: Hard tissue analysis, such as cephalometric analysis for orthognathic surgery (COGS), defines the nature of existing skeletal discrepancies but is incomplete in providing information concerning the facial form and proportions of the patient. The soft tissue cephalometric analysis (STCA) accounts for the soft tissue drape, which, however, is subject to significant individual, gender, and age variation. Aims and Objectives: The purpose of the study was to evaluate the conformance of the diagnostic inferences derived from two cephalometric analyses, COGS and STCA, to the clinical diagnosis of experienced clinicians. Material and Methods: Lateral cephalograms of 120 patients were traced for parameters previously diagnosed by an oral surgeon and an orthodontist. Corresponding variables were taken from two analyses, COGS and STCA, defining the (1) position of the maxilla, (2) position of the mandible, (3) growth pattern, (4) upper and lower lip prominence, (5) severity of skeletal malocclusion, and (6) need for surgical intervention. The inferences derived cephalometrically were compared to the clinical diagnosis. Results: Kappa analysis was used to compare the agreement of inferences derived from COGS and STCA with clinical diagnosis. A p ‐value less than 0.016 was considered significant. The agreement of both analyses with clinical diagnosis was significant and fair when the position of the mandible and intermaxillary jaw relationship was considered. COGS showed better agreement for both. COGS additionally showed fair agreement with clinical diagnosis for growth patterns too. STCA showed fair agreement with clinical diagnosis when the need for surgical intervention was evaluated. For all other parameters, the agreement was poor for both analyses. Conclusion: COGS proved to have better diagnostic accuracy than STCA, except in predicting the need for a surgical treatment plan, where STCA appeared better. Clinical Significance: The findings provide significant insights that may improve the accuracy of diagnosis and decision‐making in orthodontic and surgical interventions, ultimately aiding clinicians in selecting the most appropriate treatment protocols.

Introduction: Whitening of teeth is a popular choice among dental clinicians and patients. However, the changes in enamel structure and composition induced by the bleaching agents cause a decrease in the shear bond strength of brackets leading to premature bracket debonding. Among several methods to overcome this, the most common is delaying bonding by 2-4 weeks. This waiting period can be eliminated by applying an antioxidant (sodium ascorbate) which causes a reversal in the reduction of bond strength. Aim: This study aims to compare the efficacy of a naturally occurring antioxidant (gooseberry) and sodium ascorbate in normalizing the bond strength of enamel to prebleached levels. Materials and Methods: Seventy-two extracted premolars were divided into 4 equal groups; 1st group - control group - unbleached teeth, bonded directly, 2nd group - bleached with 16% carbamide peroxide (8 h for 1 week), then bonded. 3rd and 4th group - similarly bleached, followed by application of 10% sodium ascorbate and gooseberry extract (3 h respectively), then bonded. Bond strength was checked using Instron Universal Testing Machine. Results: The bond strength of the control group was the highest and that of the carbamide group was drastically reduced. Considerable increase in the bond strength was seen after treatment with sodium ascorbate with negligible difference between sodium ascorbate and control group (P > 0.05). Conclusion: Treatment with gooseberry extract did improve the bond strength but was not as effective as sodium ascorbate postbleaching.

Introduction: Sella turcica is an important cephalometric structure and attempts have been made in the past to correlate its dimensions to the malocclusion. However, no study has so far compared the size of sella to the jaw bases that determine the type of malocclusion. The present study was undertaken to find out any such correlation if it exists. Materials and Methods: Lateral cephalograms of 110 adults consisting of 40 Class I, 40 Class II, and 30 Class III patients were assessed for the measurement of sella length, width, height, and area. The maxillary length, mandibular ramus height, and body length were also measured. The sella dimensions were compared among three malocclusion types by one-way ANOVA. Pearson correlation was calculated between the jaw size and sella dimensions. Furthermore, the ratio of jaw base lengths and sella area were calculated. Results and Conclusion: Mean sella length, width and area were found to be greatest in Class III, followed by Class I and least in Class II though the results were not statistically significant. 3 out of 4 measured dimensions of sella, correlated significantly with mandibular ramus and body length each. However, only one dimension of sella showed significant correlation with maxilla. The mandibular ramus and body length show a nearly constant ratio to sella area (0.83-0.85, 0.64-0.65, respectively) in all the three malocclusions. Thus, mandible has a definite and better correlation to the size of sella turcica.

Introduction: The hyoid bone and its relation with the pharyngeal space in health and disease has been an intriguing subject for years. Aim: This study attempts to evaluate the hyoid bone position and to ascertain any correlations with pharyngeal airway space in skeletal class I, II, and III malocclusions. Materials and Methods: McNamara's airway analysis was carried out to assess the upper and lower airway widths and Hyoid triangle analysis by Bibby and Preston was carried out to determine the position of the hyoid bone. Conclusion: A positive correlation was found between the lower airway and horizontal distance from the hyoid bone to the retrognathion in class I skeletal pattern with average growth pattern.

Background: There is always a need to assess whether small changes in bracket prescription can lead to visually detectable differences in tooth positions. However, with little clinical evidence to show advantages of any of the popularly used bracket systems, orthodontists are forced to make clinical decisions with little scientific guidance. Aim: To compare the orthodontic cases finished with Roth and MBT prescription using American Board of Orthodontics-Objective Grading System (ABO-OGS). Settings and Design: Department of Orthodontics, Post-graduate dental college, retrospective cross-sectional study. Materials and Methods: Forty patients selected were divided into two groups of 20 patients each finished with straight wire appliance using Roth and MBT prescription, respectively. The examiner ability was assessed and calibrated by one of the ABO certified clinician to grade cases using the OGS. Statistical Analysis: Unpaired student t-test was used and P < 0.05 was accepted as significant. Results and Conclusions: MBT bracket group had a lower score of 2.60 points in buccolingual inclination and lower score of 1.10 points in occlusal contact category that was statistically significant when compared with Roth group. The difference in total ABO-OGS score was 2.65 points showing that the outcome for the MBT prescription was better than that of the Roth prescription, which is statistically significant, but with little or no clinical significance. It can be concluded that use of either one of the Roth and MBT bracket prescriptions have no impact to the overall clinical outcome and quality of treatment entirely depends on clinician judgment and experience.

Hyperdontia amounts to an odontostomatologic anomaly wherein, there is an increase in tooth number irrespective of the location. This case report represents a form of hyperdontia characterized by bilateral multiple supernumerary teeth in both the jaws without any evident familial history.

Objectives To examine and compare the stability of buccal shelf mini-screws using self-drilling and pre-drilling implant placement techniques. Methodology It was a split-mouth, randomized controlled trial comprising of 7 patients, each receiving two buccal shelf bone screws. The screws were placed using a self-drilling protocol in one quadrant and a pre-drilling protocol in the opposing quadrant decided via coin toss randomization. Stability was examined at the time of placement and 1,2, 3 and 4 months thereafter, using the Resonance Frequency Analysis method with the Osstell Beacon TM device. The Implant Stability Quotient (ISQ) obtained was then compared and assessed between both quadrants. Friedman’s Two-Way Analysis of Variance and the Wilcoxon signed rank test were utilized for the intergroup comparison. A statistically significant result was defined as one with a p-value of less than 0.05. Results A statistically significant difference between the mean ISQ reading in the pre-drilling and self-drilling group was observed, indicating higher stability of bone screws placed with the pre-drilling protocol. The primary stability of the buccal shelf screws decreased after placement, but the secondary stability remained stable. Conclusion Buccal shelf bone screws placed with a pre-drilling protocol depicted greater primary and secondary stability as compared to the self-drilling protocol, as depicted by the ISQ readings obtained. Resonance Frequency Analysis can be used as a valuable tool to assess the stability of buccal shelf bone screws. Clinical relevance The use of buccal shelf screws has increased tremendously over the past few years due to their myriad applications and have now become an essential part of an orthodontist’s armamentarium. It is therefore essential for clinicians to be well-informed about all aspects of their use including insertion techniques. The results of this trial indicate that the pre-drilling protocol provides better stability and therefore treatment outcomes.

Microimplants are widely used to provide absolute anchorage in cases with bimaxillary dentoalveolar protrusion especially in those that require simultaneous retraction and intrusion of anterior teeth. The position of the microimplant significantly affects the build up of stress in the alveolar bone as well as the incisor inclinations, and is therefore a critical factor in treatment plannning. Keeping this in mind, this finite element method(FEM) study was taken up to identify the most suitable combination of implant placement sites for cases in which en-masse anterior retraction is done along with intrusion. The geometric model was constructed from a CBCT scan of the maxilla of an adult patient with full permanent dentition.The images were saved as DICOM files and were later exported to the 3D image processing software (Mimics,version 17). The center of resistance for the 6 anterior teeth was 9 mm superiorly and 13.5 mm posteriorly from the midpoint of crown tip of central incisors. The working archwires were assumed to be 0.019 / 0.025-in stainless steel. The three mini-implant placement sites compared were – S1- Midline micro implant between the maxillary central incisors with two placed posteriorly between maxillary 2nd premolar 1st molar roots. S2 – Micro implant placed between the lateral incisor and canine along with posterior mini implants as above. S3- Micro implant placed high up between the maxillary second premolar and first molar roots. The amount of tooth displacement after finite element analysis was compared with central and lateral incisor and canine axis graphs. For the system S1, intrusive components were seen on the archwire mainly in the anterior region with maximum displacement between central incisors and gradually decreasing away from point of force application. In S2, the intrusive component of force was more evenly distributed. In S3, pattern of intrusive component was similar to S2 but the maximum displacement was slightly lower. Greatest value of minimal principal stress was seen on cervical and apical third of central incisors as well as apical third of lateral incisors in S1; and cervical third of lateral incisors and apical and cervical third of canines in S2. Maximum retraction of anterior teeth was seen in S3. In all of the three systems of force application, tooth inclinations were maintained. Maxillary anterior teeth showed more tendency towards retraction in the case where two micro implants were placed posteriorly high up above the roots of maxillary premolars and molars such that the force is directed diagonally having both horizontal and vertical components, and hence eliminating the need for anterior implants. Greater intrusion tendency was seen when implants were placed between the roots of maxillary central incisors.

Sella turcica is an important cephalometric structure and attempts have been made in the past to correlate its dimensions to the malocclusion. However, no study has so far compared the size of sella to the jaw bases that determine the type of malocclusion. The present study was undertaken to find out any such correlation if it exists. Lateral cephalograms of 110 adults consisting of 40 Class I, 40 Class II, and 30 Class III patients were assessed for the measurement of sella length, width, height, and area. The maxillary length, mandibular ramus height, and body length were also measured. The sella dimensions were compared among three malocclusion types by one-way ANOVA. Pearson correlation was calculated between the jaw size and sella dimensions. Furthermore, the ratio of jaw base lengths and sella area were calculated. Mean sella length, width and area were found to be greatest in Class III, followed by Class I and least in Class II though the results were not statistically significant. 3 out of 4 measured dimensions of sella, correlated significantly with mandibular ramus and body length each. However, only one dimension of sella showed significant correlation with maxilla. The mandibular ramus and body length show a nearly constant ratio to sella area (0.83-0.85, 0.64-0.65, respectively) in all the three malocclusions. Thus, mandible has a definite and better correlation to the size of sella turcica.