Orthodontic traction of an impacted dilacerated maxillary central incisor is clinically challenging and often results in a long treatment duration. A case of an unusual dilacerated central incisor with a 90° crown-root angulation and palatally displaced crown is presented herein. Using a single stage open window exposure of the crown on the palatal aspect with light orthodontic traction force, the impacted dilacerated central incisor crown was successfully positioned in alignment with the contralateral incisor.

OBJECTIVE: To evaluate the effect of different surface treatments and bonding modalities on the shear bond strength (SBS) between metallic orthodontic brackets and zirconia crowns. MATERIALS AND METHODS: Sixty zirconia specimens were computer-aided design/computer-aided manufacturing milled, sintered, glazed, and embedded in acrylic resin. The specimens were divided into three groups according to the surface treatment applied: C: no surface treatment (control), S: sandblasted with 50 μm Al₂O₃, and D: Sof-Lex disc roughening. Each group was further subdivided into two subgroups according to the resin cement used: P: Clearfil Ceramic Primer + Panavia F2.0 (Kuraray) and R: RelyX U200 (3M/ESPE). Metallic orthodontic brackets were bonded to the labial surface of the specimens. All specimens underwent thermocycling. SBS test was applied using a universal test machine at a cross head speed of 1 mm/min. Data were analyzed using Mann–Whitney test (α = 0.05). RESULTS: Subgroup SP showed the highest SBS (20.8 ± 4.8 MPa), followed by subgroups SR (16.7 ± 4.6 MPa), DP (12.3 ± 2.8 MPa), and DR (11.6 ± 3 MPa). However, all specimens in the control group underwent debonding during thermocycling. The different surface treatment groups showed highly significant differences (P < 0.05), whereas the resin cement subgroups showed no significant differences (P > 0.05). CONCLUSION: SBS between glazed zirconia crowns and metallic brackets strongly depended on the surface treatment applied. Sandblasting achieved the highest SBS. Roughening with Sof-Lex disc proved to be a reliable surface treatment modality for glazed zirconia. Bonding to untreated glazed zirconia surfaces led to bond failure. Both resin cements yielded strong SBS results.

OBJECTIVE: Using the cast-radiograph evaluation (CRE) score of the American Board of Orthodontics (ABO), the purpose of this study was 1) to find the post-treatment discrepancies that contributed to low-quality outcomes and 2) to identify if there might be any correlation between cephalometric changes and post-treatment discrepancies. MATERIALS AND METHODS: About 200 records submitted for the Thai Board of Orthodontics examination were analyzed. Overall, 23 parameters of the CRE scores and 12 cephalometric changes were collected. Based on the total CRE score, the cases were classified into three categories: pass (score <20), undetermined (score 20–30), and fail (score >30). Kruskall–Wallis was used to analyze the differences of mean CRE scores among these three categories. In addition, the cases were further classified into fixed appliance, two-phase and orthognathic surgery groups. Correlation tests were carried out to determine if there might be any association between cephalometric changes and CRE parameters. RESULTS: Significant differences of mean CRE scores were found for all CRE components except interproximal contacts. Significant correlation coefficients with the total CRE scores were found for all parameters except interproximal contacts. Significant moderate association was found between lower incisor changes and CRE scores in the two-phase and orthognathic surgery group. CONCLUSIONS: In order to improve treatment outcome quality, the top four parameters that orthodontists should pay attention to are occlusal contacts, occlusal relationship, marginal ridges, and alignment and rotations. Cephalometric changes were not suitable as weighting factors for total CRE scores.

OBJECTIVE: To determine the prevalence of malocclusion and orthodontic treatment need in a sample of Omani adolescents aged 11–16 years. MATERIALS AND METHODS: The total sample included 854 adolescents with 387 boys and 467 girls between the age of 11 and 16 years with no previous orthodontic treatment history. The study design was cross-sectional. The parameters studied were skeletal relationship, lip competency, teeth impactions, missing teeth, contact point displacement, crowding, spacing, incisors and molars classification, overjet, overbite, crossbite, oral hygiene and caries. The Index of Orthodontic Treatment Need (IOTN) was used to study the need for orthodontic treatment for the total sample. RESULTS: There was a high prevalence of Class I jaw relationship (86.2%). About 81.6% of the sample studied had Class I molar relationship and 73.8% had Class I incisors relationship. About 61.4% of the sample had no contact displacement, while 5.2% had contact displacement >4 mm. Severe crowding in the maxilla was found in 2.3% while spacing was found in 24.2%. Around 11% of the sample studied had Class II div 1 incisors relationship, 13.5% Class III and only 1.8% had Class II div 2 incisors relationship. Only 8.6% of the sample studied had an overjet >6 mm while 16.3% had a deep bite and 0.2% had anterior open bite of >4 mm. Teeth impaction was found in 11.7% while permanent missing teeth was present in 1.8%. The results showed that 13.9% had a very great need for treatment while 43.2% of the sample did not need any treatment. CONCLUSION: Among the Omani adolescents, there was a high prevalence of Class I jaw relations and Class I molar relationship. The prevalence of malocclusion and treatment need in Omanis shows some variation when compared to other ethnicities.

OBJECTIVES: To evaluate the possible change in teeth lengths as an indicator of orthodontically induced tooth root resorption (OITRR) after high-frequency mechanical vibration (HFV) treatment concurrent with Invisalign Smart Track® aligners as evaluated by cone beam computed tomography (CBCT). MATERIALS AND METHODS: The sample, composed of 30 patients with an average age of 26 ± 11 years and Class I malocclusion with an initial anterior crowding ranging from 3 to 5 mm, was divided equally into two groups; Group I received adjunctive high-frequency mechanical vibration (HFV); Group II, the control, did not receive adjunctive mechanical treatment. The maxillary incisor's teeth lengths were measured using Mimics software before (T1) and after (T2) treatment. All data were analyzed using Student's t-test. Reliability testing was completed by randomly selecting 10 patients' CBCTs, and their teeth lengths were measured twice by the same investigator over a 15-day interval and compared confirming intra-operator accuracy. RESULTS: The control group showed a statistically significant decrease in tooth lengths compared to the HFV group which showed nonstatistically significant change of tooth lengths. CONCLUSION: Patients treated with HFV showed minimum tooth length changes after treatment, which may indicate that HFV can reduce OITRR with treatment using clear aligners.

OBJECTIVE: To our knowledge, no study has compared the facial and dental morphology of adult Latin and Japanese populations. The purpose of this study was to assess differences in the facial and dental morphology between adult Spanish and Japanese women with Class I malocclusion using lateral cephalograms. MATERIALS AND METHODS: The lateral cephalograms of 33 adult Spanish and 33 adult Japanese women were traced and digitized by a single investigator. All patients satisfied the following criteria: female sex; age 18–35 years; skeletal Class I malocclusion (ANB angle, 2°–5°; angle Class I malocclusion; arch length discrepancy, −10 to + 10 mm; overjet, 1–5 mm; overbite, 1–5 mm); absence of congenital anomalies, significant facial asymmetry, or congenitally missing teeth, with the exception of the third molars; significant temporomandibular joint problems; severe crowding; and no history of orthodontic treatment. RESULTS: Eleven and six angular measurements for the skeletal and dental hard tissues, respectively, were computed in accordance with previous studies. The results showed that Japanese women had significant maxillary and mandibular protrusion, clockwise mandibular rotation, greater labial tipping of incisors, and a smaller interincisal angle compared with Spanish women. CONCLUSION: At the time of orthodontic treatment planning, it is important to consider the facial and dental morphological characteristics of individual ethnic groups to achieve satisfactory outcomes and retention. The findings of this study provide valuable information that will aid in orthodontic treatment planning for adult Spanish and Japanese women.

OBJECTIVE: To determine the mean soft tissue facial profile for Circassian adults as determined by Legan–Burstone cephalometric analysis. MATERIALS AND METHODS: 71 lateral cephalometric radiographs for nongrowing Circassian adults with normal occlusion were traced and accurately measured. RESULTS: With regard to facial form analysis, Circassian adults showed higher facial convexity angle, retruded mandible, and obtuse lower face–throat angle. When compared with lip form norms, Circassians showed increased nasolabial angle, deeper mentolabial sulcus, and increased maxillary incisor exposure. Comparison between men and women showed that mentolabial sulcus depth was significantly increased in Circassian men compared with Circassian women. CONCLUSION: The results of this study showed that soft tissue facial profiles for Circassians and Caucasians are different in certain values. Such differences should be taken into account when formulating a treatment plan for Circassian patients seeking orthodontic treatment and orthognathic surgery.

CONTEXT: The purpose of this study was to evaluate the accuracy and reliability of tooth length measurements using conventional and cone-beam computed tomography (CBCT) imaging techniques. AIM: The aim of this study was to assess the accuracy and reliability of various tooth length measurements made on CBCT scans and conventional imaging techniques [intraoral periapical radiograph (IOPA) and orthopantomogram (OPG)]. SETTINGS AND DESIGN: This is an in-vitro comparative study. SUBJECTS AND METHODS: In total, 50 extracted single-rooted premolar teeth were mounted on the dry human mandible. For each extracted tooth, measurements for tooth length, crown length, and root lengths were taken with a Vernier caliper and using three imaging modalities: CBCT, OPG, and IOPA radiographs. The measurements were compared with the gold standard (Vernier caliper). STATISTICAL ANALYSIS USED: One-way analysis of variance was used to compare mean values between the groups that are Vernier caliper, CBCT, IOPA, and OPG. The multiple comparisons of means of tooth length, root length, and crown length were done by Bonferroni test. RESULTS: A significant difference in the tooth length measurements was seen between the measurements taken by CBCT and IOPA and between IOPA and OPG. But, no significant difference was seen between any other groups. The highly significant difference was seen between the root length measurements taken by IOPA and OPG and by CBCT and OPG. However, no significant difference was seen between any other groups. No significant difference was seen in between the crown length measurements taken by Vernier caliper and CBCT and between IOPA and OPG. However, a significant difference was seen between all the groups. CONCLUSIONS: Among the radiographic techniques, CBCT was found to be the most accurate in measuring the tooth, root, and crown lengths.

OBJECTIVE: This study was carried to study the prevalence of dental anomalies and treatment modalities/planning among the orthodontic patients. MATERIALS AND METHODS: A total of 370 orthodontic records including their pre-treatment orthopantomographs (OPG) and study models of orthodontic patients in permanent dentition who attended dental clinic were assessed for impaction, hypodontia, supernumerary, supraocclusion, infraocclusion, and any other anomalies excluding the third molars. The association of anomalies with gender status and racial status was analyzed using Pearson's Chi-square test. A P value of <0.05 is considered as significant. The confidence interval at 95% (CI) was set. RESULTS: Among the 370 subjects, 105 (28.4%) presented with at least one anomaly. Eighty-five (23%) demonstrated a single anomaly and 20 (5.4%) with more than one anomaly. The most prevalent anomaly was impaction (14.32%), followed by hypodontia (7.03%). The less common anomalies were microdontia (1.08%), dilacerations (0.27%), and generalised enamel hypoplasia (0.27%). Maxillary right lateral incisors and canines were the most common affected teeth and these are located on the maxillary right quadrant. It was evident that dental anomalies were statistically dependant on race (P = 0.025), but independent of gender. The most common treatment planned for these patients was fixed appliance. CONCLUSIONS: Impaction was predominant among 28.4% subjects observed with anomaly and most patients with anomaly are treated with fixed appliances (49%). CLINICAL RELEVANCE: These anomalies play a great role in occlusion and alignment in treatment planning and relapse for orthodontic treatment.

BACKGROUND: The association between maxillary development and vector relationships is used in the field of plastic surgery, but the validity of this principle has not been tested yet. AIM: The aim of this study is to determine whether visual classification of anterior malar projection using vector relationships is supported by cephalometric analysis. MATERIALS AND METHODS: Normal, healthy 40 subjects aged 10–15 years with no history of orthodontic treatment, craniofacial syndromes, or trauma formed the study group. These subjects based on the visual assessment of vector relationship (positive and negative) were divided into 2 groups (Group A and Group B), consisting of 20 subjects each. Vectors were drawn on the profile photographs. Sella–Nasion–Orbitale (SNO) angle were traced using the Nemoceph software. The relationship of anterior malar projection obtained from profile photograph and lateral cephalogram were compared. The data obtained were subjected to statistical analysis. RESULTS: Skeletal differences between the positive and negative vector groups based on SNO angles were statistically significant (P < 0.001). SNO angulations in the negative vector group were smaller than the positive vector group by an average of 5.9°. CONCLUSIONS: Visual assessment of vector relationship can be effectively used to classify anterior malar projection. This also helps in diagnosing maxillary hypoplasia and executes different treatment modalities.

AIM: The value of gonial angle indicates the range of steepness as well as the direction of mandibular growth. Exact measurement of right (R) and left (L) gonial angles from a lateral cephalometric radiograph is challenging due to the superimposition of both sides. Thus, the aim of the present study was to assess the potential of determining accurate measurement of R and L gonial angles by employing orthopantomographs (OPGs) and to compare the findings with the measurements obtained from lateral cephalometric radiographs. MATERIALS AND METHODS: A total of 125 standardized panoramic as well as lateral cephalometric radiographs of Libyan subjects were obtained from the orthodontic clinical records (36 males and 89 females). Mandibular inclination was computed by averaging the R and L gonial angles produced by drawing tangents to the inferior border of the mandible and to the distal aspect of the ascending ramus and the condylon on each OPG. Moreover, similar steps were followed to extract the gonial angle from the cephalometric radiographs. RESULTS: Student's paired t-tests revealed no significant discrepancies between the R and L gonial angle values extracted from the OPG (123.88° ± 6.53° and 123.27° ± 6.55°) at P = 0.0.070. The mean values of the gonial angle (average of the R and L mean values) extracted from the OPG (123.58° ± 6.38°) and cephalometric radiographs (125.14° ± 6.23°) were not significantly different (P = 0.084). Furthermore, Pearson's correlation coefficient revealed strong correlation between the value of the gonial angle measured in the cephalometric radiograph and the mean value extracted from the OPG (r = 0.897 at P < 0.001). CONCLUSION: OPGs are as useful as lateral cephalometric radiographs in the assessment of mandibular inclination and steepness in Libyan subjects. They have the added advantage of reducing patient exposure to radiation by cutting the number of radiographs required during diagnosis.

OBJECTIVES: This study was designed to explore whether force magnitude would influence incisor torque control and the overall outcome in patients with bimaxillary protrusion who need mass incisor retraction. MATERIALS AND METHODS: Forty-one female patients (aged > 15 years) with bimaxillary protrusion requiring mass incisor retraction were selected. Two sliding mechanics were utilized, with the elastic group receiving a light force of ~100 g by wearing elastics and the power chain group receiving a moderate force of ~250 g by power chain. Lateral cephalograms obtained before and after treatment were traced and measured. RESULTS: Patients in both groups displayed maxillary protrusion with a similar skeletal class II tendency. A longer treatment time was found in the elastic group. No difference in the distance of incisor tip movement was observed between the two groups; however, a larger inclination of upper incisors was found in the elastic group, indicating less loss of torque. In addition, larger reduction in Sella-Nasion-A and A-Nasion-B angle was observed in the elastic group, which was accompanied by a larger ratio of upper lip retraction to upper incisor retraction as well as more upper lip retraction. CONCLUSIONS: Sliding mechanics with elastics to generate light forces can achieve better torque control with more reduction in skeletal and soft tissue protrusion.

OBJECTIVES: The objective of this study was to compare the shear bond strength (SBS) of new and rebounded orthodontic brackets bonded to the buccal sound and cleaned enamel surfaces using two orthodontic adhesives: resin-modified glass-ionomer (RMGI) and resin-composite. MATERIALS AND METHODS: Forty premolars were randomly allocated into four groups, 10 teeth/group. New and rebonded brackets were bonded to sound and cleaned enamel surface, and then were subjected to thermocycling. The bond strength was determined using a universal testing machine at a crosshead speed of 1 mm/min. Remaining adhesives on enamel after bracket debonding was scored independently by two investigators who were not aware of the four different groups, using adhesive remnant index (ARI). RESULTS: There was a statistical significant difference in SBS of the four groups (P = 0.005). SBS values were significantly higher with cleaned enamel surfaces after adhesive removal compared to sound enamel. SBS was significantly higher for rebonded brackets, when compared with the new brackets. No significant difference was found between the two adhesives types. The level of agreement between the two raters was higher toward the classification of higher categories of ARI (scores 5 and 6) with agreement percentage 91.7% and 100%, respectively. There was more adhesive remained among resin-composite groups. CONCLUSIONS: The bond strength of debonded sandblasted stainless-steel brackets was higher than new brackets. Resin-composite and RMGI orthodontic adhesives used in this study exhibited sufficient SBS values for bonding brackets to sound and cleaned enamel and comparable to each other.

OBJECTIVES: The purpose of this pilot study was to evaluate the root lengths of upper incisors as an indication of the degree of orthodontically-induced apical root resorption following treatment with Smart Track® aligners and compare it with two different fixed orthodontic appliances – regular and Damon brackets – using cone-beam computerized tomography (CBCT). MATERIALS AND METHODS: The sample comprised 33 patients with class I malocclusion and 4–6 mm crowding divided in 3 groups; Group I: 11 patients treated with Smart Track® aligners, group II: 11 patients treated with Damon brackets, and group III: 11 patients with regular brackets. Maxillary incisors teeth lengths were assessed using Dolphin imaging software before and after treatment. All data were analyzed using analysis of variance and t-test. RESULTS: All groups showed statistically significant root resorption, 0–1.4 mm for clear aligners, 0.1–2.3 mm for Damon, and 0–2.5 mm for regular brackets group. However, cases treated with fixed appliance in general showed significantly higher resorption than those treated with Smart Track® aligners (P < 0.05). CONCLUSION: Orthodontically-induced root resorption, as evaluated by root length, is an inevitable drawback with different orthodontic techniques. However, the use of Smart Track® aligners showed less root resorption relative to regular fixed appliances.

OBJECTIVE: To assess and compare the changes in pharyngeal airway space dimensions following orthodontic treatment of skeletal class II and class III facial deformities with premolar extraction. MATERIALS AND METHODS: Sixty pre and posttreatment lateral cephalometric radiographs of patients who underwent fixed orthodontic treatment with premolar extraction were collected. The sample was divided into two groups – 32 patients with skeletal class II and 28 patients with skeletal class III malocclusion. Both groups were subdivided into growing patients (<16 years old) and adults (>16 years old). Nasopharyngeal, palatopharyngeal, and glossopharyngeal airway space dimensions were measured in the pretreatment (T0) and posttreatment (T1) cephalometric radiographs using Dolphin Imaging 11.7 software. Two-way, repeated-measures analysis of variance was used to assess the in-treatment changes. RESULTS: Nasopharyngeal airway dimension showed similar significant increase in class II (P = 0.042) and class III (P = 0.049) patients from T0 to T1, whereas palatopharyngeal and glossopharyngeal dimensions were insignificantly decreased in both groups. However, both malocclusions followed the same pattern of changes in relation to airway dimensions. In addition, no significant statistical difference was found in the airway spaces between growing and adult patients. CONCLUSIONS: Extraction of premolars did not affect the pharyngeal dimensions except those of the nasopharynx, which showed a significant increase after extraction in both groups.

OBJECTIVE: To assess the knowledge of, demand for, and need for the orthodontic specialty in comparison to other dental fields in a sample of Saudi males. MATERIALS AND METHODS: A multiple choice questionnaire was designed to assess participants' knowledge interest, demand, and need for treatment in the following dental specialties: orthodontics, periodontics, prosthodontics, endodontics, and restorative dentistry. Subjects desiring clinical examination underwent further assessment to document their actual needs. In addition to the subjects' age, the frequencies of tooth brushing, dental pain, treatment seeking, and routine checkup were collected. Descriptive statistics and Pearson's Chi-square test were applied to compare the percentages of the knowledge of, demand for, and need for each dental discipline. The significance level was set at P < 0.05. RESULTS: A total of 1566 Saudi males completed the initial survey of dental knowledge, and 1406 subjects then completed the needs checklist. For the assessment of treatment needed, a total of 177 Saudi males were examined. The average age was 31.25 years (±13.44) and 30.61 years (±10.21) for the surveyed and examined groups, respectively. Subjects' interest in orthodontic knowledge (25%) and demand (27.6%) were not significantly different (P = 0.113), unlike the highly significant difference in the need counterpart (62.5%, P < 0.001). Highly significant differences (P < 0.001) were detected between the three outcome frequencies (knowledge interest, demand, and need) within all dental disciplines, except for the endodontic group where there was no significant difference detected (P = 0.625). Further analysis for the differences between each possible pairing of the three outcomes is highlighted. CONCLUSIONS: Subjects' knowledge of orthodontics approximated their treatment demand. However, orthodontic need was significantly much higher. Different patterns of distinction for other dental specialties were detected and described.

Children with an overjet of more than 6 mm are three times more likely to receive trauma to their upper incisors than children with an average overjet. This could be complicated with avulsion of permanent incisor and with space loss for the tooth. Functional appliances are usually used to treat Class II skeletal pattern and increased overjet in growing patients. The following is a case in which the Twin Block functional appliance was used, while its classic design was modified to treat a Class II skeletal problem and to open a space for a missing maxillary central incisor.

INTRODUCTION: The purpose of this study is to evaluate the validity of a free-access software package (ITK-SNAP) in segmenting and measuring the volume of upper airway spaces secondary to rapid maxillary expansion (RME). MATERIALS AND METHODS: Sixteen participants who required RME were recruited for this study. Preoperative (T1) and 6-month postoperative (T2) cone-beam computed tomographic scans of all participants were analyzed. OnDemand3D software packages was used for superimposition and orientation of the images, while ITK-SNAP software was used to measure the volume of airway spaces. At week one (W1), all volumetric measurements were carried out by one examiner and repeated after 1 week (W2). Paired t-test, the interclass correlation coefficient, and Dahlberg coefficients of reliability were used to assess the reproducibility. RESULTS: Student's t-test showed no significant difference between the W1 and W2 set of measurements (P > 0.05). Coefficients of reliability were above 95% and intraclass correlation coefficient ranged from 0.99 to 1.000, which altogether confirmed the satisfactory reproducibility of the measurements. CONCLUSIONS: ITK-SNAP software package is a reliable and cost-effective method to segment and measure upper airway changes subsequent to RME.

INTRODUCTION: It has been reported that Class II, division 2 maxillary central incisors frequently demonstrate increased collum angles, which indicates an excessive palatal “bend” of the crown. However, evidence supporting such observation is mostly derived from radiographic studies. OBJECTIVE: The objective of this study was to evaluate and compare the collum angle of maxillary central incisors in Class I, Class II, division 1, and Class II, division 2 cases using cone-beam computed tomography. MATERIALS AND METHODS: Forty-eight consecutive orthodontic cases (16 Class I, 16 Class II, division 1, and 16 Class II, division 2 malocclusion) with cone-beam computed tomography as part of their initial diagnostic records were evaluated. Cross-sections including maxillary right and left central incisors were used to calculate the angulation between the crown and root long axes (collum angle). Comparisons between groups were performed using analysis of variance for multiple and post-hoc Tukey for paired analyses. RESULTS: Mean collum angle observed in Class II, division 2 cases was significantly larger (5.2 ± 1.3°) than the ones obtained for Class I (1.1 ± 4.2°) (P = 0.034) or Class II, division 1 cases (0.1 ± 0.7°) (P = 0.014). CONCLUSIONS: Our findings suggest that Class II, division 2 individuals demonstrate accentuated lingual inclination of the maxillary central incisor crown compared to the other types of malocclusion studied here. Such morphological feature indicates the need for better tooth movement planning, especially in regard to root palatal torqueing of the maxillary central incisors.

OBJECTIVE: The aim of this systematic review and meta-analysis is to quantitatively compare previous studies that evaluated skeletal and dentoalveolar effects of the Forsus^TM Fatigue Resistance Device (FRD) in the treatment of Class II malocclusion with a matched untreated control group. MATERIALS AND METHODS: Four electronic searches PubMed, Web of Science, Cochrane Library, and Science Direct that were limited to articles on human studies comparing the effect of Forsus appliance with a matched control group in the treatment of Class II malocclusion from the year (2000–2017). An additional manual search was carried out by examining the references of the included articles, SEARCH terms included; Forsus and Class II malocclusion. The quality of the included studies was assessed using the modified methodological score for clinical trials. The data were analyzed using Michael Borenstein's Comprehensive Meta-Analysis Software (V3.3.070, Biostat, Inc., US). RESULTS: Seven studies were included comprising 273 participants (Forsus group = 142; control group = 131). The results indicated a statistical significant skeletal effect of the Forsus appliance on increasing the occlusal plane only (P < 0.001). The results also indicated a statistical significant (P < 0.001) dentoalveolar effects of the Forsus appliance on the following outcomes; protruding, proclining, and intruding lower incisors; retroclining upper incisors, distalizing and intruding upper molars, as well as reducing overjet and overbite. CONCLUSIONS: The Forsus^TM showed positive effects on the maxillary incisors and first molars as well as overjet and overbite. However, multiple negative effects were reported on the occlusal plane and lower incisors that need to be considered when using such appliance in treating Class II malocclusion.

AIM OF THE STUDY: The main objective of the present study was to investigate the level of job satisfaction among professional orthodontists in relation to some significant intrinsic and extrinsic factors that generally affect their performance. MATERIALS AND METHODS: A cross-sectional study was conducted among orthodontists working in the Kingdom of Saudi Arabia using an online survey questionnaire through Survey Monkey. A total of 161 responses were received; among those, 57.8% of the respondents were Saudi and 42.2% were non-Saudi. RESULTS: On an overall satisfaction basis, a majority of orthodontists (80.7%) were satisfied with orthodontics as their profession irrespective of their gender. Only 4.4% showed dissatisfaction, whereas the remaining 14.9% were moderately satisfied with orthodontics as a profession. In-depth analysis revealed that a majority of the respondents (56.2%) showed reservations over having ample time for their family life. 52.8% of the respondents strongly agreed that they are assigned significant paperwork. Likewise, 66.5% of the orthodontists showed moderate to dissatisfaction over time adherence by the patients. CONCLUSION: The findings of the present investigations depicted a higher level of passion and commitment among the male and female respondents for the profession in spite of the fact that they do not have adequate time for their personal life. The working efficiency of orthodontists may be significantly enhanced by sparing them from too much paperwork and ensuring that their patients appear on time.

OBJECTIVES: The aim of the study was to assess the association and correlation between the overjet and muscle activity (the masseter and temporalis muscles) in patient with Class II malocclusion in different genders using surface electromyography (sEMG). MATERIALS AND METHODS: The overjet (measured clinically) and electromyographical activity (rest, chew, post chew rest, clench and post clench rest) of the masseter and temporalis muscle of class II malocclusion patient were assessed in 18 patients (3 males and 15 females) from the School of Dental Science, Hospital University Sains Malaysia. RESULTS: The results were compared by simple linear regression test to evaluate the association between overjet and muscle activity in different genders. Class II malocclusion patients with increased overjet group showed significant association with masseter muscle activity on chewing stage (P = 0.005, F = 6.081 and adj-R² = 0.473). Left temporalis muscle in class II malocclusion showed a significant linear association (P = 0.014, F = 0.812 and adj-R²= −0.034) with gender during clench. CONCLUSION: In conclusion, class II malocclusion patient with increased overjet can affect masticatory muscle function and as well as clench force may differ in gender.

OBJECTIVES: A skeletal anterior open-bite is a challenging malocclusion for the orthodontist due to the difficulty and instability of correction. Treatment options for the adult patient include extractions, anterior extrusion with intermaxillary elastics, posterior intrusion using skeletal anchorage, occlusal adjustment, and orthognathic surgery. Patient compliance plays a key role in posttreatment stability. The present case report demonstrates the orthodontic treatment of an adult patient who presented with a complex open-bite malocclusion. MATERIALS AND METHODS: Treatment involved the placement of four miniscrews to assist intrusion of maxillary molars by applying posterior vertical maxillary elastics and extrusion of the anterior segments using anterior vertical interarch elastics. RESULTS: Ideal intercuspation was successfully achieved and good stability was maintained during 3 years following treatment. CONCLUSION: The intrusion of the maxillary molars with miniscrews is an interesting option in selected cases of skeletal anterior open bite. The retention protocol should be specific in these cases.

OBJECTIVES: The objective of this study was to evaluate the use of survival analysis in cyclic fatigue testing in orthodontic bracket bonding. MATERIALS AND METHODS: We used 100 extracted bovine lower incisors (50 orthodontic brackets and 50 eyelet brackets). Each set of brackets was further divided by etching technique (25 total-etch and 25 self-etch). Cyclic fatigue testing was performed at a crosshead speed of 2 mm/min using an up-and-down method. Kaplan–Meier survival data analyses and Cox regression analyses were performed. RESULTS: Survival analysis proved to be a simple methodology and revealed that the etching technique was not a statistically significant predictor for survival of orthodontic bracket bonding with either tensile or shear cyclic forces at P > 0.05. In tensile cyclic loading, high mechanical loading after controlling for the etching technique is a statistically significant predictor for lower survival of the orthodontic bracket bond at P < 0.001. CONCLUSIONS: Both etching techniques (total-etch and self-etch) are equally efficient in bonding orthodontic brackets. High mechanical loading is an important predictor of bond failure when applying tensile cyclic forces. Finally, survival analysis is a simpler alternative method to analyze orthodontic bracket bonding subjected to cyclic tensile and shear forces and gives similar results to other complicated methods.