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From a periodontal point of view, various factors contribute to facial aesthetics. In the recent past, studies have revealed that excessive gingival display is a factor that influences an individual’ smile line. Some literature exists to support that more than excessive gingival display of more than 3mm is considered unaesthetic and termed a ‘gummy smile’ (GS). The prevalence of 'gummy smile’ has been 10% and to be more common in females. Gingival hyperplasia altered passive eruption, vertical maxillary excess, and upper-lip hypermobility can all result in excessive gingival display when a patient smile.To select the correct treatment protocol, accurate diagnosis is essential. Various techniques have been used to treat gummy smile which includes surgical and non-surgical methods. Recently a non-surgical method using Botulinum toxin gained popularity considering that the method is minimally invasive.

Objective: This study compared the biofilm formation pattern on Polytetrafluoroethylene (PTFE) coated orthodontic brackets with that of uncoated ones. Methods: Fifteen teen aged patients were enrolled for eight weeks with their second premolar symmetrically bonded with uncoated and PTFE-coated orthodontic brackets. Upon completion, the elastomeric ligatures were deboned and removed. Rutherford backscattering detection (RBSD) method was adopted and the RBSD photographs were validated. Results: Analysis showed a total surface area of 21.7 ± 0.7 mm2 per bracket. The biofilm formation was noticed in 4.0 ± 3.6 % (0.9 ± 0.8 mm2) of the bracket surface in case of PTFE-coated brackets versus 22.2 ± 5.4 per cent (4.8 ± 1.2 mm2) on uncoated brackets and in case of PTFE-coated brackets highest amount of biofilm formation was evident in ‘mesial surfaces’ (6.58 ± 4.4 %) and the lowest on the occlusal surfaces (1.29 ± 1.2 %). The comparisons of the 2 interventions/procedures showed significant differences in all the 5 views (p=0.001 for all). Conclusion: The research findings suggest that coating the brackets with PTFE reduces biofilm adhesion to a larger extent and minimizes iatrogenic side effects. Key words: Biofilm formation, Polytetrafluoroethylene coating, Orthodontic brackets, RBSD photographs.

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.

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.

Orthodontic therapy is no longer restricted only for healthy patients. With the better management of serious medical problems and increased quality of life expectations, medically compromised individuals are now regular visitors to the orthodontic clinics in every part of the world. As such, there is no absolute contraindication of orthodontic treatment in most of these conditions. A slight modification of the normal orthodontic treatment protocol is obligatory in such patients according to their medical condition. This article reviews and suggests the orthodontic treatment protocol for some common medical conditions. Key Words: Medically Compromised; Orthodontic patients; Treatment protocol DOI: 10.3126/ajms.v1i2.2937Asian Journal of Medical Sciences 1 (2010) 68-74

Objectives: The objective was to estimate the level of alkaline phosphatase (ALP) in gingival crevicular fluid (GCF) during en-masse retraction stage of orthodontic tooth movement. Materials and Methods: 10 patients in the age group of 15-20 years participated in this study. GCF was sampled from the distal surface of the canine and mesial surface of the second premolar on day 0, 1, 7, 14, 21, and 28 postorthodontic treatment. Results: A marked fall in the level of ALP was evident following force application. A progressive decreasing trend in ALP activity on both distal aspect of canine and mesial aspect of the second premolar was observed. The fall in ALP was more on distal aspect canine when compared to the mesial aspect of the second premolar. Conclusions: Measure of ALP activity in GCF could be an indicator of the biochemical and cellular alterations in bone turnover and hence rate the amount of tooth movement following orthodontic force application.

Introduction: The main reason for seeking orthodontic treatment for Class II malocclusions is aesthetic improvement. Growth modification treatment procedures offer better results for a patient with significant potential growth. Aim: The aim of this cephalometric clinical study was to distinguish skeletal and dental corrections on skeletal class II division I growing subjects with Twin Block therapy (TB) and the changes were assessed using SO-analysis by Pancherz. Materials and Methods: Strict diagnostic protocol viz. growing individuals with horizontal growth pattern, skeletal class II due to retrognathic mandible with positive VTO, bilateral class II molar relation, minimal crowding in either arch or overjet more than 5mm was used. Out of 28 selected cases,17 patients received TB therapy and 11 patients were maintained as control group. Standard removable TB appliances with lower incisor capping were delivered to treatment group. The horizontal advancement was about 8mm and 2-3mm vertical opening between the upper and lower central incisors were maintained for all the cases. The mean time interval between the initial (T1)and post treatment (T2) cephalograms of Twin-Block group was 11 month,with a range of 8 month to 13 month. In the control group, the mean time interval between the first (C1)and second (C2) cephalometric films was 12 month,with a range of 10 month to 14 month. T1and T2 cephalograms were traced and S-O analysis was used to segregate dental and skeletal effects. Statistical Analysis: SPSS software was used for statistical analysis. Results: Skeletal Changes: In this study, the mean movement of maxilla was 0.67mm which represents significant restriction of forward maxillary growth in contrast to control groups. Dental Changes: In this study the maxillary molars appear to move distally with a mean value of 0.13mm. Comparing this to the movement of maxillary jaw base itself, maxillary distal movement of molar is less. But still it contributes to Class II correction. Conclusion: The overjet reduction and molar relation correction are more skeletal in nature.