Dimensional Changes in Dental Arches after Complete Dentures Rehabilitation of a Patient with Hypohidrotic Ectodermal Dysplasia: A Case Report with 18-Year Follow-Up

Background: This case report presents the dimensional changes in dental arches in a patient with hypohidrotic ectodermal dysplasia (HED) after complete denture rehabilitation, with an 18-year follow-up period. Case report: The patient had complete anodontia and was successfully rehabilitated with conventional complete dentures at 3, 4, 5, 7, 9, 12, 16, and 21 years of age. Each successive denture was larger and contained more and larger teeth so as to accommodate for the increase in the size of the developing jaw. A series of diagnostic casts were used to measure the dimensional changes in the arch length and width of the alveolar ridge. Cast analysis revealed that there was an increase in arch length and width in both the maxilla and mandible over time. Cephalometric analysis of craniofacial development was performed at 21 years of age, and suggested protrusion of the maxilla and mandible. Conclusions: The absence of teeth due to HED did not affect the dimensional changes in dental arches after complete denture rehabilitation from childhood to adulthood. The prosthetic treatment improved the patient’s social integration and enabled the development of normal dietary habits, speech, and facial esthetics, which in turn led to improved quality of life.

Unilateral Scissor Bite Managed with Prefabricated Functional Appliances in Primary Dentition—A New Interceptive Orthodontic Protocol

A unilateral scissor bite is a type of severe malocclusion in primary dentition that can influence the development of the mandible and face. The present case report describes an interceptive treatment on a 4-year-old girl with a unilateral scissor bite combined with an anterior crossbite, increased reverse overjet, and overbite on a skeletal Class III base. The patient was treated with a new Prefabricated Functional Appliance (PFA) which was modified from a Frankel-III appliance to induce a mandible to move backwards and relieve an occlusion discrepancy of the dental arch, and a functional dental rehabilitation with resin and myofunctional exercises with a PFA which was modified from an oral screen appliance were performed during the treatment. The total treatment time was 11 months and a satisfactory improvement of occlusion and facial esthetics was achieved. This case report presents a new PFA system and treatment protocol in primary dentition which results in a favorable outcome, and the clinical effectiveness of this appliance system warrants further investigation.

Relative Frequency of OCD in People with Malocclusion Class I Requiring Orthodontic Treatment

Introduction: The Malocclusion or misalignment of teeth affects not only oral function but also facial esthetics and the psychological well-being of patients. In addition, obsessive-compulsive disorder is a psychological disorder associated with anxiety involving 2-2.5% of the population during their life. This study aimed to assess the severity of obsessive-compulsive disorder in patients having class I malocclusion with crowding. Materials & Methods: In this case-control trial, Using the Yale-Brown questionnaire, female patients with 18-22 years old of ages having class I crowding malocclusion and referring to orthodontic department of Azad Dental school enrolled in the trial as the case group (n = 60). The participants with similar malocclusion without reference for orthodontic treatments followed up as the control group (n = 60). The obtained data by Yale-Brown questionnaire classified the obsessive-compulsive disorder in the participants into four groups of mild, fairly mild, moderate and severe levels. The results of the two groups were analyzed using the Chi-square test (p value < 0.05). Results: In malocclusion patients referring for orthodontic treatments, 19 (31.7%) had mild OCD; 7 (11.7%) had fairly mild OCD; 23 (38.3%) had moderate OCD and 11 (18.3%) showed severe OCD. These values were 28 (46.7%); 12 (20.0%); 15 (25.0%) and 5 (8.3%) for malocclusion patients not referring for orthodontic patients respectively. No significant differences were found among 2 groups regarding severity of OCD (p value = 0.07). Conclusion: In terms of the severity of OCD, there were no significant variations between malocclusion patients with and without referring for orthodontic treatments.

Mandibular Fractures: Diagnosis and Management

Accurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.

Orthognathic Surgery of the Mandible

Orthognathic surgery performed in conjunction with orthodontic treatment is commonly performed to correct skeletal irregularities and realign the maxillomandibular relationship to improve occlusal function and facial esthetics. A thorough understanding of soft tissue esthetics, skeletal and occlusal relationships, and surgical techniques is required to obtain successful results. Surgical techniques have evolved greatly throughout history, as technological advances such as virtual surgical planning have become available and widely used to obtain predictable movements with minimized complications. The aim of this article is to review the orthognathic surgical procedures of the mandible, with particular attention to the indications, contraindications, preoperative assessment, surgical technique, and possible complications encountered.

Comparison of commercially available preformed archwires with average natural arch forms

Objective: The research was carried out to compare the dimensions of commercially available preformed archwires with natural arch forms of Pakistani subjects. Methods: An observational study that lasted for 6 months was conducted at AFID, Rawalpindi. Fifty-two maxillary and mandibular dental casts of orthodontically untreated subjects (26 males and 26 females) 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 (BS) 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 digitized archwire widths at the aforementioned levels. Results: The archwires evaluated for maxilla were significantly wider at canines (42.16 ±1.84mm, p = 0.000) and first molars (58.45 ± 1.33mm, p = 0.014) compared to the canine and molar dimensions of the dental casts obtained from subjects (37.61 ± 3.75mm, 55.68 ± 4.05mm respectively). For mandible, statistically significant differences were found at the canine level where archwires (34.75 ± 1.66mm, p = 0.000) exhibited greater dimensions than mean intercanine widths (29.33 ± 3.35mm) of the subjects. Conclusion: At present, commercially obtainable preformed archwires are inconsistent with the diverse arch forms manifested in a group of subjects with almost ideal occlusion. Therefore; utilization 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 esthetics. Continuous..

Dental-Facial Midline: An Esthetic Based Classification

Background: The facial midline and dental midline play an important role in facial esthetics, cosmetic dentistry, facial plastic surgery, and anthropologic studies. Objective: This study studied the dental-facial midline in Nepalese subjects and to classify the midline. Methods: The study was conducted in 150 Nepalese subjects, mostly consisting of University students (80 males and 70 females). After obtaining ethical approval, facial and dental midlines were analyzed using a scale. Results: It showed 26 (18%) study subjects showed the coincidence of the facial midline with the maxillary and mandibular dental midlines. It showed that only 44 (30%) subjects showed the coincidence of facial midline with only maxillary dental midline, and 26 (17%) subjects showed the facial midline coincidence with only mandibular dental midline. The dental midline discrepancy was more prevalent in the maxillary arch and more prevalent on the right side. Midline discrepancy is seen more in males compared to females. The majority of the deviation showed 1 mm, followed by 2 mm, and 3 mm. Conclusion: The coincidence of the facial midline with both the maxillary and mandibular dental midlines is uncommon. Midline discrepancy is seen more in males compared to females. The majority of the subjects show a mild discrepancy of 1 mm. The midline discrepancy was more seen on the right side and in the maxillary arch.

A combined Surgical-Orthodontic treatment in skeletal Class II malocclusion patients

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.

Modified TPA appliance for severely proclined central incisors

The esthetic appearance of teeth forms a part of an overall picture, interacting closely with facial esthetics. The patient’s esthetic expectations were successfully met through a comprehensive approach of severe proclination by tipping the maxillary central incisors. Here, we are showing a novel approach to bring about uncontrolled tipping to decrease the inclination of severely proclined teeth.