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In spite of the tremendous improvements in technology that allow for fewer patients to require extractions, there are always patients who have significant enough crowding that ultimately necessitate the removal of premolars. Alleviating the lower anterior crowding prior to placement of the fixed appliances shortens the time in braces, and allows self correction by natural drift. One such treatment strategy which allows all this is Driftodontics.This paper is intended to bring forth the clinical advantages of driftodontics by showing some of our cases which achieved efficient results.

Introduction: Continuing dental education (CDE) has undergone enormous changes in recent years regarding its methodologies used, intellectual base, and the anticipation of what it should convey. Objectives: Do contemporary educational interventions based on general practice change doctors' behavior, and improve patient outcomes? It has become a more critical concern for governments and patients as well as dental practitioners. As reaccreditation and quality assurance scientific programs have become more widespread, the effectiveness of continuing dental education in changing clinical practice has come under closer inspection. There is a definite need to focus on the role of CDE during the COVID-19 Pandemic and how to implement CDE programs related to awareness of COVID-19. Results: In this review, we intend to describe various methods of educating dentists that improve patient outcomes, to examine the effectiveness of continuing dental education in clinical practice in particular, and some key points for ensuring success. Specifically, we focused on the role of CDE in the prevention and control of the COVID-19 Pandemic and various education methods that were efficient in attaining knowledge, attitude, and practical skills during the COVID-19 era.

COVID-19, the current pandemic has created a fearful scenario for health-care professionals. Being the frontline warriors, we need to have sound knowledge about the transmission of SARS-CoV-2 and protect ourselves during this pandemic. According to the published literature, ins pite of following possible precautionary measures against transmission of disease, there is an increased number of infected health-care workers with COVID-19. The purpose of this review is to provide the information for the postgraduates, faculties, orthodontic practitioners, and to some extent, guidance on possible transmission routes, patient assessment, laboratory investigations, various radiographic imaging techniques, proper disinfectant protocol in handling the patients, orthodontic emergency management, and elective orthodontic treatment.

AIMS The purpose of this study was to evaluate the effect of fluoride-releasing elastomeric modules in the control of Streptococcus mutans levels in the oral cavity. MATERIALS AND METHODS The study consisted of 30 patients, with two experimental periods of three weeks and a three-week washout period between experimental periods. At the first visit, fluoridated modules were placed around brackets on 12 11 33 and non-fluoridated ones on 21 22 43. During the 2nd visit, the modules were removed and sent for a microbiological analysis. Non-fluoridated modules were placed on all brackets for one visit to allow for a washout period. At the 3rd visit, fluoridated elastomeric modules were placed around brackets on 21 22 43 and non-fluoridated on 12 11 33. At the 4th visit, the procedures at the 2nd visit were repeated. RESULTS A mean comparison between bacterial counts of fluoride-releasing and non-fluoridated elastomeric modules in both the trials were done by the Mann-Whitney U test, which showed the result to be significant (p < 0.001). The mean comparison of bacterial counts between fluoride-releasing and non-fluoridated elastomeric modules in a specific area was done by the Wilcoxon signed rank test, which showed the result to be significant (p < 0.001). A comparison between bacterial counts of fluoride-releasing elastomeric modules in both trials were done by the Mann-Whitney U test, which also showed a significant result (p < 0.001). CONCLUSION The sustained-release fluoridated elastomeric modules are effective in reducing the levels of Streptococcus mutans in dental plaque around the brackets for a time period of 21 days. CLINICAL SIGNIFICANCE The sustained-release fluoridated modules were effective in reducing the CFU of S. mutans and are also stable at the end of 21 days of the experimental period. But the action of fluoride released from the modules is localized, temporary, and requires constant maintenance of these modules over the brackets throughout the treatment period.

Objectives: The objective of this study was to evaluate the mechanical properties and surface characteristics of coated superelastic Ni–Ti archwires of three companies with different coatings before and after clinical use. Materials and Methods: Coated 0.016 inch mandibular archwires of three different companies with different coatings (G & H – epoxy coated on all sides, Rocky Mountain Orthodontics (RMO) – Teflon coated on labial surface, and American Orthodontics (AO) – Teflon coated on all sides) were used in this study. Twenty wires from each company, 10 as received and 10 retrieved from patients after 4 weeks of clinical use, were tested for load deflection and surface roughness. An independent sample t-test was done to compare surface roughness and load-deflection characteristics and one-way ANOVA analysis to compare between groups. Results: Both retrieved and as-received G & H wires showed less force levels during loading and unloading compared to RMO and AO wires (P < 0.05). In both test and control groups, G & H wires produced slightly higher surface roughness values compared to AO and RMO. In all the three company wires, roughness values increased significantly before and after clinical use. Conclusion: Retrieved coated archwires of all the three companies produced lower loading and unloading force values compared to as-received coated archwires. Surface roughness of coated archwires increased after use.

The purpose of this study was to evaluate the effect of fluoride-releasing elastomeric modules in the control ofThe study consisted of 30 patients, with two experimental periods of three weeks and a three-week washout period between experimental periods. At the first visit, fluoridated modules were placed around brackets on 12 11 33 and non-fluoridated ones on 21 22 43. During the 2nd visit, the modules were removed and sent for a microbiological analysis. Non-fluoridated modules were placed on all brackets for one visit to allow for a washout period. At the 3rd visit, fluoridated elastomeric modules were placed around brackets on 21 22 43 and non-fluoridated on 12 11 33. At the 4th visit, the procedures at the 2nd visit were repeated.A mean comparison between bacterial counts of fluoride-releasing and non-fluoridated elastomeric modules in both the trials were done by the Mann-WhitneyThe sustained-release fluoridated elastomeric modules are effective in reducing the levels ofThe sustained-release fluoridated modules were effective in reducing the CFU of

Most of the skeletal malocclusions which require orthognathic surgeries are treated by traditional approach which requires time-consuming and unesthetic presurgical orthodontic phase. Surgery first approach (SFA) avoids these disadvantages of the traditional approach. A 24-year-old female patient with skeletal and dental class II malocclusion due to retrognathic mandible was treated with SFA. Bilateral sagittal split osteotomy with mandibular advancement was done immediately after initial alignment and closure of the existing spaces in the maxillary arch. Angle's class I molar and canine relation was achieved after surgery. Bonding of the mandibular arch was done after 1 month of orthognathic surgery and treatment was completed within 13 months. A wrap-around retainer was placed in upper arch, and bonded lingual retainer was given in the lower arch.

Treating impacted teeth is very challenging for an orthodontist. Although canine impactions are common, second molar impactions are also encountered in orthodontics. The fate of impacted second molar depends on various factors such as the degree of its inclination and position of third molars. A case of molar uprighting using a 0.017″ × 0.025″ titanium molybdenum alloy uprighting spring is discussed in this case report. Treatment included surgical exposure and crown lengthening along with orthodontically assisted eruption.

Deep bite management and retention are cumbersome as the stability is questionable, especially when the correction is achieved by posterior extrusion in nongrowing patients. Hence, it is advisable to intrude the anteriors; however, as conventional methods of anterior intrusion tax the anchorage, choosing biomechanics which ensure stable anchorage is our goal. The use of mini-implants has revolutionized biomechanics in orthodontics with better results as far as anchorage is concerned. This case report supports the literature regarding the implant-supported anchorage for true intrusion.

Objectives: To investigate the influence of orthodontic treatment on pharyngeal airway size and position of hyoid bone in patients treated with extraction of all first premolars. Materials and Methods: Pre- and post-treatment lateral cephalograms of twenty patients were obtained, and cephalometric analysis was done to assess skeletal and dental changes, airway dimensions, and hyoid bone position using 17 linear and 4 angular measurements. Results: All the readings were statistically analyzed using paired t -test. Change in nasopharyngeal airway size was not statistically significant. However, airway size was reduced significantly at soft palate (SPP-SPPW) by 7.4%, at uvula (U-MPW) by 19.2%, at tongue (TB-TPPW) by 20.8%, and at the base of tongue (V-LPW) by 13.2%. The analyzed linear measurements showed relocation of hyoid bone in an inferior direction. Simple linear correlation analysis revealed positive correlation between incisor retraction and airway size. Conclusions: There was a significant narrowing of pharyngeal airway behind soft palate, uvula, and at the base of the tongue following retraction. There is a change in the position of the hyoid bone in an inferior direction as an adaptation preventing an encroachment of the tongue into the pharyngeal airway.

Background: Friction plays a very crucial role in our daily life and orthodontics is no exception. Various materials possess friction of varying intensity, which ultimately affects tooth movement. Aim: The aim was to compare the frictional resistance (FR) between various bracket types and archwire materials when ligated with low-friction and conventional elastic ligatures so as to obtain best bracket-archwire combination possessing least FR for clinicians in achieving optimal mechanotherapy. Materials and Methods: Study consisted of three types of preadjusted edgewise brackets including ceramic, stainless steel (SS) and self-ligating brackets (0.022" slot, MBT prescription), two types of archwire materials, 0.019 × 0.025" SS and 0.019 × 0.025" Teflon coated (TC) and two types of ligatures including low-friction and conventional elastic ligature. A total of 10 combinations were formed with the above mentioned material. Each combination was tested 10 times on universal testing machine for FR. The data was statistically analyzed using one-way ANOVA and unpaired t-tests. Results: Self-ligating brackets exhibited least FR (2.35 ± 0.15N) followed by metal brackets. Ceramic brackets showed the highest FR (7.32 ± 0.10N). In general, the mean value for TC wire was less than that of SS wire indicating low FR possessed by TC wires. Results also showed that low-friction ligatures produce lower-friction when compared with conventional elastic module (P > 0.05). Conclusion: The study demonstrated that self-ligating brackets with TC wire showed the least FR and ceramic brackets with SS wire when ligated with conventional elastic ligature showed the highest FR.

Edentulous spaces can be closed with dental implants, prosthesis, and orthodontic space closure. As mandibular bone is dense, protraction of molars is time taking and challenging. Temporary anchorage devices play a vital role in providing anchorage. Translation of molars can be achieved with power arms which are placed near to the centre of resistance. This is a case with bilaterally missing mandibular first molars and lower central incisor. Ridge defect is seen in molar region on right side. Class II molar relation was achieved bilaterally with second molar moving into first molar space followed by the third molar. Translation was achieved bilaterally and 10mm of space closure was done with the help of TAD’s and power arms.

Aim To evaluate and compare the frictional resistance produced by Super Slick modules during sliding with four different types of brackets and four ligature types both in conventional and figure-of-8 ligation method with saliva as lubricant. Materials and methods The frictional resistance was evaluated by using four different ligatures on 0.019” × 0.025” stainless steel (SS) archwires using four different brackets using an universal testing machine with unstimulated saliva as a lubricant. Mean and SD values were calculated. Data was statistically analyzed using analysis of variance ANOVA with post hoc test. Results The results showed that self-ligating brackets produced least frictional forces. Among all other tested combinations, Teflon-coated SS ligatures in ceramic with metal slot brackets produced least coefficient of static and kinetic friction and full ceramic brackets ligated with Super Slick elastomeric modules demonstrated the highest, with other combinations falling in between. Conclusion Super Slick elastomeric modules, produced highest coefficient of both static and kinetic friction with the conventional and figure-of-8 ligation technique even in wet conditions using natural fresh human saliva. Clinical significance Both static and kinetic frictional resistance play an important role during sliding mechanics. Various factors have been attributed for friction. However, bracket type, archwire material, type of ligature and method of ligation are important variables. Recently polymeric coated slick elastomeric modules were introduced with the claim that they produce very low frictional forces in wet condition. Contrary to the claim made by the manufacturers of Super Slick elastomeric modules, they produced highest coefficient of both static and kinetic friction with the conventional and figure-of-8 ligation technique. How to cite this article Pattan SK, Peddu R, Bandaru SK, Lanka D, Mallavarapu K, Pathan AB. Efficacy of Super Slick Elastomeric Modules in reducing Friction during Sliding: A Comparative in vitro Study. J Contemp Dent Pract. 2014; 15(5):543-551.

Adult patients with severe skeletal malocclusions require orthognathic surgeries. Two case reports with skeletal Class II malocclusion due to retrognathic mandible discussed in this article were treated by bilateral sagittal split osteotomy mandibular advancement. Treatment results showed good improvement in facial profile, Angle Class I molar and canine relation, good occlusion after surgery for both the cases.

Impaction of maxillary lateral incisor with odontome and retained deciduous tooth is not often seen in regular dental practice. Impaction of anterior teeth cause generalized spacing which affects the esthetics of the face. Here we report a case of an 18-year-old patient with horizontally impacted dilacerated lateral incisor, which was bought into occlusion with the help of orthodontic tooth movement within a span of 18 months.

Introduction: Rapid palatal expansion of the midpalatal suture is an effective method for the correction of transverse malocclusions. This study was conducted to compare the reaction of circum-maxillary sutures and center of resistance of molar to the Hyrax appliance with different degrees of activations and the Spring jet appliance using laser holography on a freshly macerated skull. Materials and methods: A freshly macerated skull with well-aligned teeth and intact dental arches was used as the experimental model. The Hyrax appliance and Spring jet appliances were fabricated and analyzed qualitatively and quantitatively by using double exposure hologram. Hyrax was activated two 1⁄4 turns, four 1⁄4 turns and eight 1⁄4 turns. The Spring jet is activated and double exposure hologram was recorded. Results: Results were obtained qualitatively by observing the fringes, and quantitatively by counting the number of fringes. The Spring jet showed fringes only in the first molar area, whereas the Hyrax showed fringes along the circum-maxillary sutures and the first molar area; and the number of fringes increased with the number of turns. Conclusion: Hyrax appliance activation produced mechanical reactions on the teeth, alveolar bone, maxilla and the circum-maxillary bones and sutures. The displacement and fringes increased progressively with two, four and eight turns activation of hyrax. The pattern of the fringes was more circular around the nasomaxillary complex and zygomaticomaxillary sutures, suggesting rotational displacement of the maxilla. The number and pattern of fringes produced by the Spring jet appliances suggest that it produces only dentoalveolar changes and minimal orthopedic affects.

Extraction versus nonextraction debate is still continuing since 1900s. Some cases demand extraction of premolars, but the decision making is difficult in the border line cases with good facial esthetics. Lower incisor extraction becomes a therapeutic alternative to premolar extractions in lower anterior crowding cases with good facial esthetics and well occluded posterior teeth. Diagnostic setup reveals the posttreatment occlusal possibilities and hence the most important step in the diagnosis and treatment planning of these cases. Lower incisor extraction decision would be a better option in cases with anterior Bolton′s discrepancy. Two cases treated with single lower incisor extraction, indications, contraindications and measures to attain posttreatment stability are discussed in this presentation.

Adult orthodontics in today's contemporary world is focused mainly on esthetics. Lingual orthodontics has evolved as an adjunct while exploring esthetics. Assuring esthetics and functional balance is the current concept of invisible orthodontics. It is almost as successful as labial orthodontics and has good three-dimensional control over the dentition. As the brackets are placed near to the center of resistance of the tooth, anchorage value is higher in lingual orthodontics than labial orthodontics. With the appliance in mouth, the patient overcomes the social barriers of appearing in public and augments his own level of confidence. Proper knowledge on biomechanics ensures success with lingual appliance. The following case report presents the usage of lingual technique in closing generalized spaces by following proper biomechanics in achieving ideal occlusion and thus enhancing esthetics.

Background: The cephalograms are invaluable in diagnosis, treatment planning, and evaluation of treatment results. Digital cephalograms have several advantages. Conventional cephalograms can be converted to digital format by scanning on a flatbed scanner. More recently it was reported that conventional cephalograms photographed with a digital camera can be used for doing cephalometric analysis. However, the accuracy of the measurements is not very clear. Aim: To compare the accuracy of angular and linear measurements obtained from scanned and photographed images of conventional cephalograms with that of manually traced original cephalograms. Materials and Methods: Twenty cephalograms of patients taken in natural head position (NHP) were converted to digital format by scanning on a flatbed scanner and also were photographed with a high resolution digital camera. Both images were digitized with Vista Dent OC Imaging TM cephalometric software. Customized cephalometric analysis was performed on both images, and the measurements were recorded. Results: Statistical analysis was done using paired Student's t-test and intraclass correlation coefficient tests. The results showed that; 1. There was significant distortion when analog cephalograms were converted to digital format by photographing. 2. Scanned images were more comparable to the original cephalograms than photographed images. 3. Among the linear and angular measurements, linear measurements showed significant variation than angular measurements. Conclusion: It is acceptable to use digital photographs of cephalograms if angular measurements are primarily required. However, these images might not be acceptable if linear measurements are needed.