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This review aims to collate and analyze the existing evidence on the comparison of external apical root resorption (EARR) in subjects treated with clear aligners (CAs) and fixed appliances (FA). An electronic search was conducted in six databases for articles published in all languages until July 2023. Studies that evaluated EARR in subjects treated with CAs and FAs were included. The RoB 2 tool for RCTs and the ROBINS-I tool for non-randomized studies were used to analyze the risk of bias (ROB). A random effects meta-analysis was performed to assess EARR extent in maxillary and mandibular anterior teeth for subjects treated with CAs and FAs. Ten studies (eight retrospective, one RCT, and one CCT) were included in this review, out of which six studies reported a moderate ROB, one reported a serious ROB, and three reported a low ROB on qualitative analysis. The quantitative analysis of six studies revealed a significant intergroup difference (P <0.05)> P <0.00001)> P =0.01) with a moderate heterogeneity (I2=56%), as well as the mandibular central incisors (SMD=-0.27, P =0.04) with high heterogeneity (I2=79%). EARR was lower in subjects treated with CAs than FAs. A moderate quality of the available evidence suggests that EARR was less evident in subjects treated with CAs when compared with FAs. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Anterior‑posterior discrepancy assessment is a crucial component of orthodontic diagnosis and is often carried out using hard tissue cephalometric analysis. The purpose of this study was to compare the photographic Frankfort plane subnasale pogonion (FSA) angle with established cephalometric parameters to determine the accuracy of the angle in determining maxillomandibular anteroposterior discrepancies. MATERIALS AND METHODS: In this prospective study, a total of 60 subjects, 20 in each skeletal sagittal malocclusion, were included in the final sample based on the selection criteria. Both photographic and cephalometric records were taken, and the parameters assessed were the beta angle, Steiner’s analysis, the ANB (A point‑ Nasion‑ B point) angle in the cephalograms, and the FSA angle in the profile photographs. Statistical analysis was done with SPSS software. The correlation between the measured parameters was assessed using Pearson’s correlation test. RESULTS: A high positive and significant correlation between the FSA angle and beta angle (r = 0.793) was noted, and a high negative and significant correlation between the FSA angle and ANB angle (r = ‑0.848) was noted. CONCLUSION: The photographic FSA angle can be used as a reliable parameter to diagnose anteroposterior discrepancies. [ABSTRACT FROM AUTHOR]

Buccolingual position of teeth could affect the prevalence of alveolar bone defects. Presence of alveolar defects may have a deleterious effect on orthodontic treatment. Aim: The aim was to assess the prevalence and extent of dehiscence and fenestration in Class I hyperdivergent subjects and correlate it with buccolingual inclinations(BL) of maxillary first molar teeth. Methods: This retrospective study involved 80 CBCTs of class I hyperdivergent subjects divided into two groups - group A (n=33) buccolingual inclination >9º and group B (n=47) buccolingual inclination <9º. Prevalence and extent of alveolar bone dehiscence and fenestrations were measured in CBCTs using OSIRIX Lite software. Descriptive statistics, Mann Whitney U test and Spearman correlation were done for evaluating intergroup differences and correlation with Buccolingual inclination. Results: Overall prevalence of dehiscence and fenestration in maxillary first molars was 60.95% and 5% respectively. In the buccal alveolar bone, prevalence of dehiscence was highest in group A (84.6%) for 16 and in the lingual alveolar bone prevalence of dehiscence was highest in group B (71.4%) for 26 . On intergroup comparison, the extent of lingual alveolar bone dehiscence (26) in group B was significantly higher (p value <0.05) than in group A. No significant correlation between the extent of dehiscence and fenestration with buccolingual inclination of molar teeth was noted. Conclusion: Molar teeth with BL inclinations of more than 9º had higher prevalence of dehiscence on the buccal side and molar teeth with BL inclinations less than 9 degrees had more dehiscence on the lingual side. But no significant correlation of BL inclination with prevalence and extent of dehiscence and fenestration was noted. [ABSTRACT FROM AUTHOR]

Introduction: T-scan III is used in clinical practice for a digital assessment of occlusal force distribution and other occlusal parameters. The present study was proposed to do an assessment of occlusal contacts and forces using T-scan III in subjects with class II division II malocclusion and compare it to subjects with class I malocclusion requiring fixed orthodontic treatment. Materials and Methods: This prospective study included 70 subjects - 33 in group A (Angle's class II division II malocclusion) and 37 in group B (Angle's class I malocclusion). Occlusal analysis was done with T-scan III, and parameters like occlusal force distribution (OFD), occlusion time (OT), and disocclusion time (DT) were recorded. Statistical analysis was done with SPSS software. Independent t-test for intergroup comparisons and paired t-tests for intra group comparisons were done. Results: A Significant intergroup difference in OFD between left/right, posterior/anterior regions (P < 0.05) was noted between groups. OT and DT (left lateral excursive) were also significantly higher (P < 0.05) in group A. On intergroup comparison, the L/R bite force ratio was higher in group B males (P < 0.05) and the P/A bite force ratio was higher in group B females (P < 0.05). Conclusion: In subjects with class II division II malocclusion, anterior teeth were subjected to greater occlusal loading when compared to class I subjects and had higher occlusion and disocclusion times. [ABSTRACT FROM AUTHOR]

Introduction: Trajectories of force determines the trabecular pattern of bone. In transverse malocclusions, force trajectories are altered which can affect the trabecular pattern. Hence, it is important to study the trabecular pattern associated with transverse malocclusions. Aim: Assessment of trabecular pattern changes on Intraoral Periapical Radiographs (IOPA) in subjects with dental crossbites using fractal analysis. Materials and Methods: This cross-sectional study was conducted in Department of Orthodontics at Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India, from October 2021 to December 2021. The study involved 30 IOPAs in 15 patients with unilateral first mandibular molar teeth in crossbite. The sample was divided into two groups. Group A has 15 IOPAs of mandibular molars in crossbite side, group B has 15 IOPAs of mandibular molars not in crossbite. A region of interest (ROI) of 256×256 pixels were selected between the roots of the premolar and mandibular molars and converted into an 8-bit image with image J software. Fractal dimensional analysis with box counting was used to assess trabecular perimeter and the trabecular number. Normality of the data was assessed by Shapiro-Wilk test and an Independent t-test was carried out to find intergroup differences. Results: Shapiro-wilk tests p-values were not significant (p-value >0.05) for both groups ensuring normality of data. The mean fractal dimensions measured were 0.867 (group A) and 1.213 (group B). The mean trabecular perimeter in group A was 86.37±29.31 whereas in group B it was 194.62±43.26 and the intergroup difference was significant (p-value<0.001). Conclusion: Fractal analysis of IOPAs revealed that the alveolar bone surrounding the teeth in crossbite presented with significant reduction in the trabecular perimeter and number when compared with teeth not in crossbite. [ABSTRACT FROM AUTHOR]

Aim: To assess and compare 1-year treatment stability after correction of lower anterior crowding with nonextraction approach using passive self-ligation appliance and lower incisor extraction protocol with conventional ligation approach. Materials and Methods: This retrospective study included total 32 subjects. The inclusion criteria of the study were adult subjects with class I skeletal and dental malocclusion with mild-to-moderate mandibular anterior crowding of 4-6 mm. Subjects were divided into two groups: Group A treated with passive self-ligation nonextraction protocol (n = 15) and Group B treated with conventional ligation lower incisor extraction protocol (n = 17). The primary outcomes were the changes in arch dimension and dental crowding at three time points. Changes in intermolar width (IMW), intercanine width (ICW), little's irregularity index, and mandibular incisor inclination at T0 (pretreatment), T1 (postdebonding), and T2 (1-year postdebonding) were evaluated. Descriptive statistics, normality tests, and intergroup comparison (independent t test) were performed. Results: Change in IMW was similar in both groups with no significant difference at T1 and T2. Change in ICW at T1 was significantly higher in Group A (2.01 mm) than Group B where ICW decreased by 0.94 mm. The relapse in ICW was significantly more in Group A. Difference in relapse of lower incisor crowding and inclination was significant between groups and it was more in Group A (P < .05). Conclusion: Orthodontic treatment with lower incisor extraction protocol with conventionally ligated approach has stable treatment outcomes than with nonextraction approach using passive selfligation appliance Class I cases with moderate-to-severe mandibular anterior crowding. [ABSTRACT FROM AUTHOR]

The use of skeletal anchorage with fixed functional appliances (FFA) has been proposed by various authors to produce skeletal changes and reduce lower incisor proclination. To compare the skeletal and dentoalveolar effects of Forsus Fatigue Resistant Device (FFRD) with or without skeletal anchorage (miniplates and mini‐implants). The electronic database PubMed, Cochrane Library, Medline, Embase and Google Scholar along with a manual search of orthodontic journals till the year 2019. Only randomized control trials (RCTs) were included in the systematic review. One controlled clinical trial (CCT) which involved FFRD was included in the review since it was a continuation of an RCT which was expanded to a CCT. Skeletal and dentoalveolar outcome data were extracted to collect study characteristics. After evaluating risk of bias, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Three RCTs and one prospective CCT were evaluated. The analysis included data from 116 Class II subjects [(58) treated with FFA along with skeletal anchorage and (58) treated with FFA]. There were no significant difference between the two groups with respect to mandibular length changes (P value =.10) and SNB angle changes (P value =.22). With respect to lower incisor inclination however, there was a significant difference between the two groups (P value =.005) signifying better results with respect to skeletal anchorage. The studies reviewed provide insufficient evidence to form a conclusion regarding the effects of the use of skeletal anchorage with FFRD. The available weak evidence suggests that the use of skeletal anchorage with FFRD has no superior skeletal effects but is able to reduce proclination of the lower incisors. Control of lower incisor proclination remains the most significant advantage of skeletal reinforcement, and miniplate‐anchored FFRD showed more promising results in preventing lower incisor proclination than miniscrew‐anchored FFRD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the soft tissue upper lip thickness of subjects with different skeletal malocclusions. Lateral cephalograms of 30 patients (control group : skeletal malocclusion I - 10, Case group : skeletal malocclusion II - 10, skeletal malocclusion III - 10) were selected randomly from orthodontic records of subjects who reported to the Department of Orthodontics in Saveetha Dental College. All cephalograms were traced and upper lip thickness was measured using FACAD software. One way - ANOVA test was done, soft tissue upper lip thickness was found to be statistically significant (p<0.05) among different skeletal malocclusions. Post hoc test (Tukey HSD) was performed to find out the differences between each skeletal class, the upper lip thickness was found to be comparatively high in Class III compared to Class I and Class II (p<0.001). This study concluded that soft tissue upper lip thickness was found to be greater in skeletal class III malocclusion compared to other skeletal class I and II malocclusion. [ABSTRACT FROM AUTHOR]

Crowding of teeth is one of the most common malocclusion. Determination of etiology of crowding could have significant effects on treatment planning and prognosis of class II malocclusion. Growth pattern might affect the amount of crowding in class II malocclusion. Aim of this study was to evaluate the relationship between lower dental arch crowding and various growth patterns in class II subjects. Pretreatment lateral cephalograms and dental occlusal view mandibular arch photographs for class II subjects were collected for the study. Lateral cephalograms were traced and the subjects were divided into different growth patterns (n=60) (horizontal =20, vertical = 20, average = 20) on the basis of gonial angle. Crowding in each growth pattern was assessed from the records of patients visiting the dental hospital. From the results,15% of the vertical growers showed very severe crowding, 20% of the vertical growers showed severe crowding, 40% showed moderate crowding, 5% had mild crowding. 10 % of the horizontal growers showed severe crowding, 25% had moderate crowding, 40% showed mild crowding. 35 % of the average growers had moderate crowding, 30% had mild crowding. Results were statistically significant.(p<0.05). Significant association was found between vertical growth patterns and severity of the mandibular arch crowding as compared to horizontal or average growth patterns. No association between crowding and gender. Hence, it can be concluded that the Class II subjects with Vertical growth patterns have severe lower dental arch crowding as compared to the subjects with horizontal and average growth patterns. [ABSTRACT FROM AUTHOR]

Malocclusion is a very common dental disorder in a large proportion of children and adolescents. Determining the need and treating it at an early stage can reduce the severity of malocclusion and treatment time in permanent dentition. Thus this study was focused on orthodontic treatment needed in children with early permanent dentition. The study was aimed to determine the orthodontic treatment need in children with early permanent dentition reporting to a university hospital setup. A retrospective cross sectional study was conducted by including the records of patients who visited a university dental hospital between June 2019 August 2019. Demographic data like age, gender were recorded. Children were selected by simple random sampling between the age group of 12-15 yrs. Orthodontic treatment need was evaluated using the IOTN index and then subjected to statistical analysis. Orthodontic treatment need was higher in 12-14 yrs age group (63%) compared to 14-16 yrs(37%) and orthodontic treatment need was more in males (55%) compared to females (45%). The association of age and gender with orthodontic treatment need was not statistically significant (p>0.005). Within the limits of the study, the overall orthodontic treatment need was moderate to severe in subjects reporting to the author's institution and there was no significant association between age, gender with orthodontic treatment need. [ABSTRACT FROM AUTHOR]

Crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral malalignment of the dental arches. This two part questionnaire survey was undertaken in Chennai, Tamil Nadu, India. The participant groups consisted of one hundred and fifty orthodontic practitioners and eighty seven patients who reported to the department of orthodontics for correction of their malocclusion. Responses were recorded both on online survey platforms and manually; they were further subjected to statistical analysis. The results of this survey indicate that a majority of orthodontic practitioners prefer to treat crossbites in patients with deciduous and early mixed dentition as early as possible to avoid deleterious effects to the maxilla, mandible and adjoining dentofacial structures, both hard and soft tissues. Furthermore a strong association was established between Orthodontist's and Patient's need for management of crossbite (P value < 0.035) and between the type of crossbite and the respondent's (Orthodontists and Patients) perception of treating the same (p value <0.000). The improved patient awareness and specific aesthetic demands of the patients reporting for orthodontic treatment has necessitated early intervention of anterior crossbites. [ABSTRACT FROM AUTHOR]

and diagnosis. Materials and Methods: Pre-operative study casts and the photographs of 100 patients were taken. The measurements for facial width and height were taken for calculating facial form. The palatal height is measured from the deepest point near the molar region on the midpalatine raphe in the study casts. Results: From the clinical study, there was a strong correlation between the palatal depth and the facial form of the individuals which can be used as an indicator to detect malocclusions and photographs can be used as an alternative communication among the orthodontists regarding the treatment planning. Discussion: There is no significant correlation between the palatal depth and facial form. As the facial height increases, there is no increase in the palatal form which does not result in the narrowing of arches. Conclusion: Thus, the facial form cannot be also used as an indicator for identifying the probability of malocclusion and its related strategies with the irregularities of teeth alignment. [ABSTRACT FROM AUTHOR]

Background: Orthodontic treatment is usually provided to the individuals with malocclusion that may negatively influence psychosocial well-being or oral dysfunction. The most important motivating factor is a strong subjective dissatisfaction with the appearance of the teeth. Hence, it is essential to understand teenager's subjective motives for undergoing orthodontic treatment. Aim and Objective: The aim of the study is to describe and to analyze the thoughts of the teenager's decision to undergo orthodontic treatment. Result: From the analyzed data, it is evident that the need for orthodontic treatment was about 61% but the awareness about malocclusion among the teenagers was about 40%, and this proves that the teenagers were unaware of the malocclusion and the orthodontic treatments available for the malocclusion, they are afraid to visit the orthodontist for the treatment. Conclusion: This study shows that awareness toward the correction of malocclusion should be increased among the teenagers and their problems toward the orthodontic treatment should be rectified. [ABSTRACT FROM AUTHOR]