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Extraction versus nonextraction debate is still continuing since 1900s. Some cases demand extraction of premolars, but the decision making is diffi cult 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. [ABSTRACT FROM AUTHOR]

Aim: The objective of the present study was to evaluate in vitro, the influence of different ligatures, archwire material and archwire sizes on static frictional resistance. Methods: The frictional resistance was evaluated by using different ligatures Gray, Purple, Alastic, Teflon coated stainless steel ligature and 0.009"Stainless steel ligatures on 0.017"×0.025" and 0.019"×0.025" TMAand SS archwires using standard edgewise brackets with zero degree tip and torque mounted on Perspex blocks using an universal testing machine with a cross head speed of 5mm/min with unstimulated saliva as a lubricant. Results: Mean and SD values were calculated. Data was statistically analyzed using three way analysis of variance (ANOVA), pair wise comparison by Tukeys multiple post hoc test and multiple regression analysis to calculate coefficient of static friction. The results showed that irrespective of wire size and wire material combination Teflon coated SS ligatures produced the least frictional resistance while Gray elastomeric modules produced the highest with Alastic, SS ligature and purple falling in between. Multiple linear regression analysis of static friction revealed that only arch wire size has significant influence on static friction with groups and archwire composition showing negligible influence. Interpretation and conclusion: (a)Teflon coated stainless steel ligatures produced lowest frictional forces with all wire, material contributions followed by Alastic, Stainless steel, Purple and gray elastomeric modules. (b)Increase in arch wire dimension has increased the frictional resistance, whereas archwire composition has minimal effect on frictional resistance. [ABSTRACT FROM AUTHOR]

Aim: The present case report describes the importance of interdisciplinary approach and gives an understanding on management of an adolescent with unilateral cleft lip and palate., Background: Failure of fusion between medial nasal process and maxillary process or between the palatal process leads to the formation of clefts. Clefts are result of genetic or environmental factors or a combination of both. Common dental problems associated with clefts includes anterior and posterior crossbites, hypodontia, malformation and abnormal eruption pattern., Case Report: A girl, aged 15 years reported with a chief complaint of unesthetic appearance of her maxillary anterior teeth. She had unilateral cleft lip and palate and had received cheiloplasty and palatoplasty when she was in young age and rhinoplasty when she was 14 years of age. At pretreatment evaluation, she had concave profile with maxillary arch constriction and oroantral fistula and mesially tipped maxillary left canine., Conclusion: This patient's treatment was unconventional, but it was successful in significantly improving her masticatory function and smile, along with favorable dental and facial results. Generalized esthetics and function were significantly improved in this patient without orthognathic surgery, and treatment results were stable 3 years after the appliance removal. Clinical considerations, sequencing of treatment phases as shown in this case report can be utilized while treating an adolescent with cleft lip and palate., Clinical Significance: If the skeletal discrepancy is mild and esthetic concerns are minimal, dental compensation by orthodontic treatment alone might be recommended. The cephalometric analysis and prediction tracings provide further information for deciding whether a patient can be treated by orthodontics alone, or by orthodontics and an orthognathic surgical procedure. A change in axial inclination of the teeth can camouflage the skeletal relationship adequately. However, one should be cautious in a growing patient, because he or she might outgrow the dental correction so that ultimately skeletal surgery would be indicated.

Aim: The present case report describes the importance of understanding of biomechanical and clinical considerations in application of Forsus appliance in correction of class II skeletal malocclusion., Background: Angle's class II malocclusion is one of the most prevailing that may be either skeletal or dental presenting with different clinical manifestations. There are number of appliances to treat such a malocclusion in a growing child. Fixed functional appliances are indicated for class II corrections in patients who report late with minimal residual growth left., Case Description: A case of class II skeletal and dental malocclusion treated with preadjusted edgewise appliance supplemented with Forsus Fatigue Resistant Device (FRD) (3M Unitek Corp, California, USA) is reported., Conclusion: Forsus device is an effective alternative in treating moderate skeletal class II malocclusion. The Forsus FRD (3M Unitek Corp, California, USA) can be used instead of class II elastics in mild cases and in place of Herbst appliance in severe cases. Alteration of force vector by modifying the archwire as shown in this case report while applying Forsus and incorporation of 10 degree labial root torque in lower archwire will minimize the effects on dentition. Engaging modules or tubing on to the pushrod and leaving 1 to 2 mm clearance between distal end of the upper tube and L-pin as shown in this case report will significantly improve the patient compliance., Clinical Significance: Much emphasis should be given to biomechanical considerations which were discussed in this article while treating patients with Forsus to prevent the unwanted effects. Clinical considerations and certain modifications advised in this case report should be utilized while treating class II skeletal malocclusions with Forsus appliance to eliminate the patient cooperation factor and make treatment time estimates much more accurate.