BACKGROUND AND PURPOSE: The soft-tissue layer and facial skeleton influence the harmony and equilibrium of the face. The evaluation of the patient's structural and soft-tissue features is one of the most crucial steps in preparing for the diagnosis and treatment of oral-maxillofacial orthodontics. Clinicians can intervene with the proper treatment at the proper time to achieve the best results by being aware of the traits and variations of soft tissue at various developmental stages and in various races. To obtain a consistent treatment result in terms of function and aesthetically pleasing results, patients, and forecast, the growth that may take place after the orthopedic therapy has concluded. OBJECTIVE: To examine the soft-tissue features of the oral-maxillofacial area in Vietnamese adults (aged 18–25 years) by evaluating cephalometric radiographs. MATERIALS AND METHODS: In a cross-sectional descriptive study, 85 students from Can Tho University of Medicine and Pharmacy took part. Students' lateral cephalograms were taken in compliance with the sample requirements. RESULTS: Men's lip protrusion (4.30 ± 0.71) was higher than women's (3.88 ± 0.97) (P = 0.024 <.05) and men's (-4.88 ± 0.93) chin lip groove depth was higher than women's (-4.24 ± 0.93) (P = 0.002), both with a P value of. 05. CONCLUSIONS: The study identified a statistically significant difference in the protrusion of the top lip and the depth of the cleft lip between the male and female, demonstrating that the soft-tissue features of Vietnamese students were distinct from those of other races.

AIM: This study aimed to assess Iraqi university students' oral health-related quality of life (OHRQoL) according to sociodemographic variables and compare dental and non-dental students. METHODS: A cross-sectional study was carried out for students in multiple Iraqi universities from June 15, 2022, to July 15, 2022. A total of 771 individuals participated in the study using an online questionnaire. A pre-tested and validated Arabic version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was adopted as an evaluation tool. A P value of less than 0.05 was considered statistically significant. Reliability analysis was conducted using Cronbach's alpha. RESULT: Cronbach's alpha score for the overall scales was 0.942, indicating excellent internal consistency. There were 69.8% (n = 538) dental students in the total sample. A significant difference was found between dental and non-dental students in the total PIDAQ scores and other subscale domains (P < 0.05). Statistically significant differences in means were also noted in the residency (P = 0.005) and household income of students (P = 0.000). CONCLUSIONS: This study shows the reliability of the PIDAQ scale for assessing the psychological impact of dental aesthetics on undergraduate Iraqis. It was found that the perception of OHRQoL varies between dental and non-dental university students, and according to socioeconomic status and residency.

OBJECTIVES: The study aims to measure the mandibular condylar height (CH), ramus height (RH), total height (CH+RH), asymmetry index, and condylar volume (Cvol) in individuals with different anteroposterior and vertical skeletal discrepancies. MATERIALS AND METHODS: The study sample consisted of 131 subjects (60 females and 71 males) with a mean age of 35.06 ± 12.79 years. Pre-existing CBCT images were divided into groups according to the anteroposterior and vertical skeletal discrepancies. The investigator analyzed the data using t-tests to assess the mandibular bilateral sides of the individuals and gender differences. The mean difference between groups was determined using a one-way analysis of variance (ANOVA). The Chi-square test was used to study the association between the asymmetry index and groups. RESULTS: Each individual's bilateral sides exhibited statistically significant differences in CH, RH, and Cvol (P = 0.033, P = 0.039, P = 0.005, respectively), but not in CH+RH (P = 0.458). There were, however, statistically significant gender differences in CH+RH (P < 0.001). Skeletal Class III and hypodivergent groups revealed the highest linear and volumetric values compared to other groups. The asymmetry index was increased in CH (P = 0.006) and Cvol (P = 0.002) in skeletal Class II subjects. CONCLUSIONS: Significant differences in CH, RH, and Cvol were found on the right and left sides of the same individual. This study found increased linear and volumetric values in males, skeletal Class III, and hypodivergent subjects. Class II individuals had an increased CH and Cvol asymmetry index. This study highlights in-depth knowledge of mandibular asymmetry, which is extremely important to achieve an accurate diagnosis and provide the best treatment outcome.

OBJECTIVES: To evaluate the level of oral hygiene awareness and practice among orthodontic patients that have fixed appliances and investigate the differences in awareness as per age, gender, and education qualification. MATERIALS AND METHODS: A cross-sectional study with 250 patients was included. A questionnaire was used to collect information regarding the patient's oral hygiene. RESULTS: The level of awareness and oral hygiene practice was significantly higher among females, with a consistent stepwise increase toward older ages. Also, increased with higher education level, longer duration since getting the appliance, and receiving instructions from the orthodontist. CONCLUSIONS: Oral hygiene instructions received by the orthodontist play an important role in the patient's awareness level. Also, many predictors have a significant effect on the patient's cooperation in practicing oral hygiene measures.

OBJECTIVE: The shortage of health care professionals in rural areas contributes toward discriminatory health care delivery. The present study was planned with a similar intent and aimed to evaluate the perception of dental students regarding their future in rural areas. MATERIALS AND METHODS: The present study was designed as a cross-sectional study comprising of a 30-item questionnaire survey instrument distributed among a total of 550 dental students while the results obtained were subjected to statistical analysis. Statistical analysis was done using SPSS version 12.0 (SPSS Inc., Chicago, IL, USA). Independent student's t-test and one-way analysis of variance (ANOVA) were used for comparison among the variables while the Chi-square test was used to determine the association between the variables. P < 0.05 was considered statistically significant. RESULTS: No significant difference was observed in the attitude based on gender (P = 0.43), although, a statistically significant difference was observed in the attitude of students based on the year of their education with a positive attitude toward rural dental practice generally noted in the first year Bachelor of Dental Surgery (BDS) students which significantly declined with the increasing level of education (P = 0.01). CONCLUSIONS: Dental students were more influenced by the negative aspects of rural dental practice though they had, in their mind, a positive approach for the same at the beginning of their education, but this significantly declined with the increasing level of their education.

OBJECTIVES: The objectives of the study was to assess and compare the cranial base morphology in long face and short face. METHODOLOGY: The study comprises 64 individuals (32 in each group). Group I consists of individual's with long face and group II comprises individuals with short face. Individuals were classified into groups with the help of lateral cephalometric parameters like Gonial Angle, Anterior facial height, Posterior facial height, Jarabak's Ratio, and Y-axis. Linear and angular measurement in the cranial base was taken. RESULT: The results showed statistically significant difference in Sella-Nasion, Sella-Basion and Nasion-Sella-Basion between the two groups. Sella-Spinoethmoidal suture, Nasion-Spinoethmoidal suture, Spinoethmoidal suture-Sella-Basion, Frankfurt Horizontal-Sella-Nasion, Frankfurt horizontal-Sella-Basion, Frankfurt horizontal-Sella-Spinoethmoidal suture showed no statistically significant difference among the groups. CONCLUSION: The study concluded that individuals with long face have a greater Sella-Nasion, Sella-Basion, Nasion-Sella-Basion compared to individuals with short face.

OBJECTIVES: This study aimed to investigate the correlation of gonial angle and three linear measurements on OPG and lateral cephalograms and their effects on the different facial patterns using the OneCeph android app. METHOD: About 90 pre-treatment digital lateral cephalograms and OPGs of 90 patients were selected and divided into 3 categories, based on their growth patterns. The OPGs and lateral cephalograms were uploaded on the OneCeph android app. After calibrating using One linear measurement i.e. length of extracted premolar for OPG and ruler in radiograph for lateral cephalogram, Gonial angle (Ar- Go-Me), ANS-Me (LAFH), U1-NF, L1-MP were measured. The data were collected, tabulated, and subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS: Values for parameters were highest in the vertical growth pattern followed by average and horizontal in both cephalogram and OPG. Upon comparison of lateral cephalogram and OPG, no significant difference was observed in gonial angle and a significant difference in LAFH and L1-MP in all three growth patterns with OPG scores greater than cephalometric tracing. The interclass coefficient test indicated almost perfect agreement for the gonial angle between the two methods. A substantial agreement was seen for U1-NF on lateral cephalogram and OPG in the vertical group. Also, a fair agreement in the vertical and horizontal group was observed in Lower anterior mandibular height. CONCLUSION: Vertical parameters such as gonial angle and maxillary anterior dental height can be accurately determined on an OPG by the OneCeph application.

AIM AND OBJECTIVE: To evaluate and compare the position of the tongue from rest to centric occlusion in subjects with skeletal class II division 1 and skeletal class II division 2 malocclusions with subjects of skeletal class II normal occlusion. MATERIAL AND METHODS: The study was conducted on 30 individuals equally divided into three groups of skeletal class II division (div) 1, skeletal class II div 2, and skeletal class I normal occlusion. The study was conducted on two lateral cephalograms for each subject: one taken at rest and one in centric occlusion. RESULTS: On evaluation of tongue posture, a statistically significant difference was observed at the middle portion of the tongue in class II div 1 malocclusion, and at the posteromedial portion of the dorsum of the tongue in class II div 2 skeletal malocclusions as the tongue moved from rest to centric occlusion. While statistically significant differences were found between class II div 2 malocclusion and class I normal occlusion, no statistically significant differences were observed between class II div 1 and class II div 2 malocclusions. CONCLUSION: Tongue position was observed to be the same in both class II div 1 and class II div 2 malocclusions, with no statistically significant differences. However, a great change was seen in the tongue position from rest to centric occlusion.

AIMS AND OBJECTIVES: To derive a new horizontal plane which can be a suitable alternative to Frankfurt horizontal plane (FH plane). MATERIALS AND METHODS: 200 pre-treatment lateral roentogenic cephalograms from patient records in the department of orthodontics and dentofacial orthopaedics were traced. The landmarks were identified and marked and the measurements were carried out. Patients with all skeletal relationships were included in the study. The angle formed between the lines connecting anatomic porion, orbitale and machine porion was measured and tabulated. Dimorphism between the genders if any was also evaluated. RESULTS: The mean angulation between the planes from the anatomic porion to orbitale to machine porion (PoA-Or-PoM) in our sample is 3.14 ± 2.17°. PoA to Or to PoM angulation for males is 2.57° and for females is 3.4°. CONCLUSIONS: SIDS plane also called as derived FH plane given here is a reliable and easily reproducible alternative to the FH plane.

INTRODUCTION: To evaluate the effect of orthodontic retraction force on thick and thin gingival biotypes of anterior teeth having grade I and II gingival recession with D1 and D2 alveolar bone densities by assessing the displacement of teeth and deformation in gingival tissue, along with evaluating the amount of equivalent stress on teeth and gingiva in finite element model. MATERIALS AND METHOD: Based on cone-beam computed tomography datasets, eight models (LC01–LC08) of maxilla with appliance assembly were created. A retraction load of 150 gm was applied on each model during the finite element analysis (FEA), and then values of teeth displacement, gingival deformation, and von Mises stress were evaluated. RESULT: All the models with D1 bone density (LC01–04) were showing gingival deformation, whereas models with D2 bone quality (LC05–08) give no significant outcome. The amount of von Mises stress for teeth and gingival tissue in each model was the same for both central and lateral incisors. CONCLUSION: All the models having D1 bone quality showed greater gingival deformation after applying retraction force, whereas in models with D2 bone density, deformation was not significant. Changes in gingival tissue are brought about by orthodontic treatment, which also helps to correct the periodontal defects; however, bone density plays a significant role in improving gingival recession.

OBJECTIVES: To compare nickel-titanium (NiTi) wires and clear aligners in the management of mandibular incisor crowding. METHODS: Seventy-two participants were arbitrarily alienated into two groups with 36 samples in each. Group I participants were treated with NiTi arch wires and group II participants with clear aligners. Malocclusion was evaluated using Little's irregularity index. A questionnaire was applied to record the discomfort levels. Patients were recalled regularly at four weeks, eight weeks, and twelve weeks. RESULTS: At baseline, the mean score was 2.91 mm and 2.72 mm; at 4 weeks, it was 1.64 mm and1.48 mm; at 8 weeks, it was 0.98 mm and1.0 mm; and at 12 weeks, it was 0.68 mm and 0.52 mm in groups I and II, respectively. The mean change in Little's irregularity index score at 4 weeks was 1.27 mm and 1.24 mm; at 8 weeks, it was 0.66 mm and 0.48 mm; and at 12 weeks, it was 0.30 mm and 0.48 mm in groups I and II, respectively. The disparity was not-considerable (p > 0.05). The mean discomfort score at baseline was 2.8 and 2.5; at 4 weeks, it was 2.4 and 2.0; at 8 weeks, it was 1.8 and 1.4; and at 12 weeks, it was 1.3 and 1.0 for groups I and II correspondingly. The disparity was non-significant (p > 0.05). CONCLUSION: From the present study, it was found that both NiTi wires and clear aligners were equally effective in managing mandibular anterior crowding cases.

OBJECTIVES: To evaluate and compare the shear bond strength of stainless-steel brackets using three different light curing units MATERIAL AND METHODS: Using three LED curing units (3M ESPE Elipar, Ivoclar bluephase, and Woodpecker I LED light cure), 120 precoated metal brackets (Gemini series, 3M Unitek) were cured. The shear bond strength was recorded using a universal testing machine. RESULT: The shear strength of the bracket in different light-curing systems was examined with ANOVA test. The mean shear strength of group A, group B, and group C were 16.03 ± 14.30 MPA, 16.86 ± 11.89 MPA, and 20.51 ± 19.40, respectively. The result of the analysis shows that there is a major difference in shear bond strength of these three different light-curing systems with F value = 3.94 and P value 0.04 CONCLUSION: We used three LED light-curing units with different intensities and manufacturing companies. The result showed that woodpecker I LED light had significantly highest mean SBS than the other two (Elipar LED curing light and 3M ESPE, Ivoclar bluephase).

OBJECTIVE: This study aimed to evaluate the clinical and histological administration of magnesium oxide (MgO) supplementation on orthodontic relapse and bone remodeling. MATERIALS AND METHODS: Twenty male albino rabbits were classified into four groups (five animals for each as two control (positive and negative), plus two experimental (low dose 40 mg/kg) and (high dose 80 mg/kg)/b.w. daily). An orthodontic force was applied (40 gm) to the lower incisors using modified orthodontic appliance adapted on the lower central incisors. During the period of retention, MgO was given orally. Relapse was estimated after appliance removal. A digital Calliper was used to compete the space between incisors' mesial tips of rabbits at six successive time points (0, 3, 7, 10, 15, and 21 days). Histologically, osteoblast, osteoclast, and osteocyte account were assessed. Data analyses were performed by SPSS using ANOVA and Tukay HSD (P ≤ 0.05) for statistically significant differences between groups. RESULTS: The high dose group had a lower relapse rate than the low dose and control groups. Histologically, the high dose group had more osteoblasts and osteocytes than low dose and control groups. While osteoclasts were significantly lower than the control group in low and high dose groups. CONCLUSIONS: MgO supplementation during an orthodontic retention phase, particularly at a level of high dose, clinically decreased orthodontic relapse in a rabbit model. Histologically, MgO has a significant effect on alveolar bone after the orthodontic retention period.

OBJECTIVE: The aim of this study was to investigate the stresses on mini-implant, cortical bone, and cancellous bone for maxillary molar distalization using an orthodontic implant in a finite element model for different angulations and depths of insertion. METHODS: A three-dimensional finite element method was used to simulate overall orthodontic tooth movements by using ANSYS software. The maxillary bone and the molars were reproduced using CT scan images and conversion of the same into STL file was done. Finite element model was generated and the effect of forces was studied on the model for different depths and angulations of mini-implant insertions. The distalization force was exerted by an open-coil spring and the direct skeletal anchorage was provided by a mini-implant. Mini-implants were placed in depths of 5 mm, 7 mm, and 9 mm inside the bone and insertion angles of 30°, 60°, and 90°. Stresses on mini-implant and extent of stress on the surrounding bone were assessed by the software. RESULTS: 1. Least stress was found when the mini-implant was inserted at an angle of 30°, as it is nearer to the stronger cortical bone. 2. As the length of the mini-implant increases, accompanied by the increase in the depth of insertion, a decrease in stress in the mini-implant, cortical bone, and cancellous bone was noticed. CONCLUSION: An increase in the insertion angle from 30° to 90° increases the stresses on both the implant and the cortical bone. A higher depth of thread in the bone helps in reducing the stress on the implant, cortical bone, and cancellous bone. This helps in improving the primary stability of the mini-implant and its life.

OBJECTIVES: The purpose of the study is as follows:

• To evaluate the dental and skeletal changes of the AdvanSync 2 appliance.
• To evaluate the soft tissue changes of the AdvanSync 2 appliance using photometric analysis.

METHODS: The sample size consisted of 15 patients who reported to the Department of Orthodontics, seeking fixed orthodontic treatment. The effects of the AdvanSync 2 appliance were measured at two intervals. RESULTS: After the nine months, P values were observed to be less than 0.5, therefore statistically significant for parameters such as Sella-Nasion-Point A (SNA), Condylion-Point A (CO-A), University of Witwatersrand, Condylion-Gnathion (C0-Gn), point A-Nasion-Point B (ANB), Upper incisor-Point A (UI-A) (degree), LI-B (mm), Lower lip to Esthetic plane (LL-E plane), nasolabial angle, mentolabial angle, facial angle, and L lip to the chin. P values were however observed to be greater than 0.5, therefore statistically insignificant for parameters such as sella-Nasion-Point B (SNB), Condylion –gonion (C0-Go), UI A (mm), LI B (mm), UL-EPL, H LINE, Frankfurt mandibular plane (FMA), nose tip angle, nasofrontal angle, nasomental angle, upper lip angle, and U lip to the chin. CONCLUSIONS: AdvanSync 2 appliance brought about a change in Class II malocclusions through Co-Gn, Co-Go, ANB, FMA, UI-A (degree), UI A (linear) LI B (linear), Upper lip to Esthetic plane, LL-E plane, Holdaway LINE, nose tip angle, nasolabial angle, mentolabial angle, nasofrontal angle, nasomental angle, facial angle, upper lip angle, U lip to chin, L lip to the chin after nine months of appliance delivery. MAIN POINTS:

1. AdvanSync 2 normalized class II by an increase in the length and body of the mandible.
2. AdvanSync 2 has a restraining effect on the growth of the maxilla.
3. AdvanSync 2 brings about positive soft tissue changes.
4. The major disadvantage is the proclination of the lower incisors.

OBJECTIVE: This study aimed to evaluate the effect of the local injection of injectable platelet-rich fibrin (i-PRF) on the eruption rate of the teeth and evaluation of the effect of i-PRF on the number of odontoblast, cementoblast, osteoblast, osteocyte, and osteoclast cells. MATERIALS AND METHODS: The samples consisted of 20 male albino rabbits and were divided randomly into the control group (5 rabbits) and i-PRF groups (15 rabbits) sub-divided into week 1, week 2, and week 3 sub-groups. The labial surface of lower right incisors was marked by drilling a hole at the level of the free gingival margin in the mid-line of each tooth with a small round bur, and the eruption rates were measured by measuring the distance from the most apical point of the free gingival margin and the center of the hole with a digital caliper. i-PRF was prepared by centrifuging autologous blood of each rabbit at 1000 rpm for 5 minutes; then the i-PRF layer was collected. The control group received no treatment, whereas i-PRF groups received i-PRF in the following manner: For week 1 groups, a single dose was given at 0 day; for week 2 groups, double doses were given at 0 and 7 days; and for week 3 groups, three doses were given at 0, 7, and 14 days. At the end of experiments for each group, animal scarification was performed, and histological steps were performed. RESULTS: There was a significant increase in the rate of tooth eruption in i-PRF groups when compared to the control group, and the eruption rate was increased in 107.3%, 144.7%, and 167.5% for week 1, week 2, and week 3, respectively. Concerning the histological finding, the i-PRF groups gave rise to a higher number of odontoblast, cementoblast, osteoblast, osteocyte, and osteoclast cells with a significant difference when compared to the control groups (P ≤ 0.05). CONCLUSIONS: Applying i-PRF significantly increased the rate of teeth eruption at all-time intervals. Platelet-rich fibrin injection can be an effective method for acceleration of teeth eruption.

OBJECTIVE: To evaluate the changes in surface morphology of two different types of mini-implants after clinical en masse retraction using scanning electron microscopy. MATERIAL AND METHODS: Fifty mini-implants of Dentos (Korea, Absoanchor, BH-1817-08) and Orlus (Korea, Yesanchor, C-1817) were inserted in patients in a split-mouth design who required en masse anterior retraction and absolute anchorage. Surface characteristics of mini-implants such as pitch (distance between consecutive threads), flank width (distance between root and crest), and taper were studied using scanning electron microscope (FEI nanosem450) before and after clinical use. RESULTS: Statistically significant difference (p value = 0.003) was found in a mean reduction of pitch dimension among the two groups with a mean difference of 25.000 μm. Also, a statistically significant difference was noted (p value = 0.001) in a mean reduction of flank width among Dentos implants as compared to Orlus implants. A statistically significant difference (p = 0.001) was seen in the mean reduction of taper dimension among Dentos group (0.0140 ± 0.02271) as compared to the Orlus group (0.0810 ± 0.05152). CONCLUSION: A marked reduction in surface morphology such as the pitch, flank width, and taper of both mini-implants after retrieval was observed. Dentos group of mini-implants displayed better dimensional stability post-retrieval as compared to the Orlus group of mini-implants. All the mini-screws showed milling defects in form of scratches on observation under scanning electron microscopy despite a smooth appearance to the naked eye.

OBJECTIVE: To assess the optimal intervals of exposure of low-level LASER therapy (LLLT) that would optimally accelerate orthodontic tooth movement. Second objective was to quantitatively analyze the difference in the time taken for alignment of anterior teeth with and without the application of LASER. MATERIALS AND METHODS: PROSPERO database registry was done (CRD42020196472) and review was conducted based on PRISMA guidelines. A search was systematically conducted in five major electronic databases without restrictions up to June 2020 along with a hand search of selected journals. The quality of evidence was assessed using the Grading of Recommended Assessment, Development, and Evaluation tool, risk of bias using Cochrane risk of bias tool, and meta-analysis was carried out using RevMan 5.4 software. RESULTS: Ten randomized controlled trials which met the inclusion criteria were evaluated and tabulated. A random-effects meta-analysis demonstrated that there is a statistically significant increase in the orthodontic tooth movement when patients were exposed to minimum of four intervals of LLLT in the first month, at P =0.03 by a standard mean difference of 0.46 mm with an overall heterogeneity of I² = 0% at 95% confidence interval. There was a statistically highly significant reduction in the number of days taken for alignment of anterior teeth with the application of LASER (P < .00001). CONCLUSION: Application of LLLT for minimum of four irradiations in the first month has yielded better results in accelerating orthodontic tooth movement than application of LLLT once a month.

OBJECTIVE: To determine the prevalence of dilaceration in a sample of patients presenting for initial orthodontic care. METHODS: Examining radiographs from a random sample of orthopantomogram images was used to acquire the data. In all, 2,801 dental records were evaluated at Oman Dental College (ODC), Oman. A dental X-ray processing software was utilized to view the images. A tooth was classified as having a mesial/distal dilaceration if its long axis exhibited an angle of 90 degrees or greater. Dilacerated roots in the buccal/lingual direction were diagnosed by observing the appearance of a spherical opaque area with a dark shadow in its central region, projected by the apical foramen, which gave the root canal a “bull's-eye” appearance. RESULTS: Dilacerations were found in 17.32% of the records examined. The maxillary second molars (22.71%) were the most commonly affected, followed by the mandibular third molars and mandibular lateral incisors (21.90% and 17.23%, respectively). The central incisors and canines were the least affected, with dilaceration affecting less than 0.2% of the teeth. The mandible was found to have more dilacerations than the maxilla (53.78% and 46.22%, respectively). 61.03% of dilacerations occurred in molars, 43.12% of which occurred in third molars. CONCLUSION: Dilaceration is a notable dental anomaly that can affect any tooth, with some teeth being more affected than others. Dilaceration in maxillary second molars and mandibular lateral incisors is more common in the population of this study than in other populations reported in the literature. Recognizing the condition will allow for more effective orthodontic treatment.

OBJECTIVES: The objective of the study is to test whether the local injection of i-PRF may affect osteoblast, blood vessels and new bone formation in surgically expanded mid palatal suture using maxillary skeletal expander. MATERIALS AND METHODS: Eighteen adult male local breed dogs were divided randomly into three groups: group I (control), includes the expansion with maxillary skeletal expander that was done without corticotomy and i-PRF. Group II, involves the expansion that was done with mid palatal corticotomy but without i-PRF injection. Group III, has the expansion that was done with mid palatal corticotomy and has injection with 2 ml of i-PRF. Each group consisted of 6 dogs which were subdivided into 3 dogs. Three dogs were sacrificed after 15 days and the other 3 dogs were sacrificed after 45 days. The number of osteoblast, blood vessels and new bone formation percentage were statistically analyzed using Sigma plot platform. Mean and standard error, ANOVA and Duncan were performed among the different groups. Values of P ≤ 0.05 were considered significant. RESULTS: After expansion, the i-PRF group demonstrated a considerable increase in the amount of new bone in the mid-palatal suture at 15 and 45 days compared with other 2 groups which were indicated by highest percentages of new bone formation (29.30% of 15 days and 76.55% at 45 days) if compared to control group which were (7.72% at 15 days and 22.30% at 45 days). The corticotomy groups were in between, 15.33% and 46.84% respectively. Moreover the number of osteoblasts was higher in corticotomy with i-PRF group on 15 days and decreased on 45 days than the other two groups, while the blood vessels were highest in this group than the other two groups both on 15 and 45 days. CONCLUSION: I-PRF enhanced the production of osteoblast, blood vessels, and new bone in the surgically expanded mid palatal suture.

OBJECTIVE: A novel technique, named the MH setup (MH is an abbreviation for the author's name), was developed to provide an accurate yet simplified method to produce custom-made brackets without bonding errors. This setup aimed to simplify the treatment and eliminate the finishing phase, so that the orthodontist was able to provide better care with less time and lower costs. MATERIALS AND METHODS: The setup was performed in two major steps: direct bonding on the cast followed by cutting and setting the teeth into precise positions using brackets. The first set of brackets, bonded directly onto casts, oriented the teeth by setting them ideally into wax rims with full control over first-, second-, and third-order bends. The fully engaged archwire used allowed for precise control over the arch symmetry and form. Setting teeth in wax allowed the clinician to refine the occlusion and correct any minor errors that arose during the initial bonding. The second set of brackets, mounted on the fully engaged archwire, featured custom-made composite bases. The transfer tray combined the benefits of its soft inner and hard outer layers, providing control over bonding and later ease of peeling from the brackets. RESULTS: The patient was satisfied with a full bonding procedure lasting 15 min that remained simple without unnecessary stress. The clinician was confident that the procedure allowed the precise positioning of brackets and simple bonding for all teeth in the arch, combined with the elimination of the finishing phase. CONCLUSION: The MH technique offered a simple, precise, and inexpensive improvement to the Kesling wax setup. The process allowed for precise bonding without errors or expensive armamentarium. The brackets were transformed into custom-made prescriptions and could be used with labial or lingual techniques. The method allowed for teeth addition, trimming, or overcorrection according to the clinician's preferences. The MH setup facilitated visualization of the treatment objectives with precise locations and the opportunity to revise the treatment plan or to discuss further options with the patient.

OBJECTIVES: To understand the impact of the COVID-19 pandemic on orthodontic clinical services in Jordan. MATERIALS AND METHODS: Google Forms electronic questionnaires were distributed between March and June 2021 using the WhatsApp platform of the Jordanian Orthodontic Society and via direct WhatsApp messages. The survey was identical and contemporaneous to that used in the United Kingdom.^[9] RESULTS: The survey yielded 127 unique responses, giving a response rate of 53.1%. The factors that had the greatest impact on service delivery were government guidance (78%), patients' fear of attending (70.1%), and increased cross-infection measures (65.4%). The survey revealed that there had been a perceived deterioration in oral hygiene (60.3%) and levels of compliance (61.9%) in patients in active treatment even though patients in treatment were prioritized during the pandemic. Also, 56.8% of respondents felt clinical staff should be vaccinated and undergo regular testing for COVID-19. Orthodontists within Jordan were optimistic regarding the speed at which clinical services would return to pre-pandemic levels of activity with 32.5% anticipating this would take less than 6 months. CONCLUSIONS: Patients in active orthodontic treatment, during COVID-19, have been prioritized but at the expense of new and review patients. Respondents in Jordan felt COVID-19 would have ongoing effects on clinical care, professional practice, and society. Most respondents supported the vaccination of orthodontic staff and were optimistic about the effect of a vaccination program on restoring clinical services.

OBJECTIVE: The aim of this 2-arm parallel study was to evaluate the alignment efficiency of heat-activated nickel-titanium (NiTi-TE) and superelastic nickel titanium (NiTi-PSE) archwires over the first 3 months of orthodontic treatment and compare these groups. SETTING AND SAMPLE POPULATION: Randomized, double-blind, controlled, single-center trial in 52 patients with fixed orthodontic appliances from an orthodontic graduate program in the permanent dentition and moderate crowding in the lower arch. MATERIAL AND METHODS: Patients were randomly allocated to one of two interventions: NiTi-TE and NiTi-PSE archwires, 0.014-inch (3M Unitek™, CA, USA) with a follow-up period of 3 months. The primary outcome was the alignment efficiency determined by the reduction in Little's irregularity index (mm), measured in three points, T0: before the start of orthodontic treatment, T1: 1 month later, T2: 2 months later, T3: 3 months later. Data were analyzed using independent sample t tests and repeated measures ANOVA. RESULTS: 52 patients (NiTi-TE n = 26; NiTi-PSE n = 26) were randomized and analyzed (average age: 21.73; standard deviation (SD): 6.07; average lower anterior irregularity: 5.20; SD: 0.76) for intention-to-treat (ITT) analysis. No statistically significant differences between the groups were found (mean of the differences: T1: 0.20; 95% CI: –0.558; 0.958; T2: 0.49: 95% CI: –0.339; 1.319; T3: 0.33; 95% CI: –0.308; 0.968). The resolution of crowding with each of the wires was significant (P < 0.0001) at all times. Twelve participants (2 treated with NiTi-TE and 10 treated with NiTi-PSE) lost follow-up due to face-to-face dental-procedures restrictions during the COVID-19 pandemic, the missing data was imputed. CONCLUSIONS: NiTi-TE and NiTi-PSE wires of 0.014-inch were similar in their clinical efficiency for the resolution of crowding during the first 3 months of orthodontic treatment. REGISTRATION: Clinical Trials NCT03256279.

OBJECTIVES: The study aimed to compare the effects of quadhelix and nickel-titanium (NiTi) expander appliances on lower facial height, to quantify, and evaluate dentoalveolar and orthopedic changes in transverse plane, respectively, to estimate the difference in changes between these two appliances. MATERIALS AND METHODS: Twenty patients, ten for the quadhelix and NiTi expander in the two-appliance group, respectively, participated in this study. A total of 8 readings, 1 for clinical facial height, 2 for model analysis, and 5 for posteroanterior cephalometric analysis were recorded. The statistical tests used were, Student's unpaired and paired t-tests. RESULTS: Both appliances individually, produced statistically highly significant (p < 0.01) expansion every month in both premolar and molar areas with more uniform expansion for quadhelix and less expansion in NiTi palatal expander in the premolar region initially. The skeletal to dental change ratio showed that there was more dental change than skeletal with no inter-appliance differences statistically while assessing the PA cephalometric readings. CONCLUSIONS: This study infers that both appliances are equally efficacious maxillary expanders, which are primarily dentoalveolar and not skeletal (p < 0.05).

AIM: The aim of this in-vitro study was to observe and analyze the various enamel surface changes that occur due to laser debonding of metal and ceramic brackets, done by means of Er, Cr:YSGG laser. MATERIALS AND METHODS: 90 extracted premolars were randomly allocated into one of six groups with 15 teeth each. The groups represent metal brackets (Groups A1, A2, A3) and ceramic brackets (Groups B1, B2, B3). Each sub-group represents the mode of debonding used in the study. Debonded teeth were analyzed under scanning electron microscopy (SEM) at 80X and at 1000X magnification at three sites. The adhesive remnant index (ARI) scores were analyzed and the presence of enamel damage was observed. RESULT: ARI showed high score in Groups A1 and B1. SEM images of large composite remnants at the site of bracket in Groups A1 and B1 at the site of bracket and multiple enamel microcracks and fractures at interface and enamel adjacent to bracket in Groups A1 and B1. SEM images of minimal composite remnants at the site of bracket in Groups A2, A3, B2, and B3 and little to no presence of enamel microcracks or fractures at interface and enamel adjacent to bracket in Groups A2, A3, B2, and B3. CONCLUSION: The use of Er, Cr:YSGG laser in orthodontic practice, especially in the debonding procedures of orthodontic brackets provide quality care to patient with minimal post-treatment damages.

AIMS: This study aimed to evaluate the bond strength of light- and chemical-cure adhesive systems over six months. MATERIALS AND METHODS: A total of 144 sound human maxillary first and second premolars were randomly divided into six groups according to the adhesive type (i.e., Transbond XT and Unite) and evaluation time. The groups were T0 (24-h group without thermocycling), T1 (24-h group with thermocycling), T2 (1-month group), T3 (2-month group), T4 (4-month group), and T5 (6-month group). The bond strength was then measured and the data were analyzed by SPSS software (version 23) through the independent t-test and one-way ANOVA. A P value less than 0.05 was considered statistically significant. RESULTS: The results of this study showed that shear bond strength of chemical-cure orthodontic adhesive (Unite, 15.37 MPa) at all-time points was significantly 1.37 times higher than that of the Transbond XT light-cure adhesive (11.15 MPa). Moreover, shear bond strength of self-cure adhesive (Unite) 1 month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.002), 24-h group with thermocycling (P = 0.008), and 6-month group (P = 0.016). The highest shear bond strength in both adhesives was observed at one month. Furthermore, the shear bond strength of Transbond XT light-cure adhesive one month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.000) and 24-h group with thermocycling (P = 0.000), as well as with the 2-month (P = 0.008), 4-month (P = 0.000), and 6-month groups (P = 0.016). CONCLUSION: Unite self-cure adhesive compared to Transbond XT light-cure adhesive has higher bond strength and is recommended for rebonding brackets in patients with multiple rebonds.

BACKGROUND: Maxillary canine is the second most common tooth that gets impacted after III molars. Early pre-eruptive inclination changes of first premolar and its associative changes with canine inclination are an important factor that predicts the fate of maxillary canines. Hence, a cross-sectional study was planned to evaluate the normal pre-eruptive mesiodistal inclinations of maxillary permanent canine, first premolar, and lateral incisor in children aged 6–14 years using orthopantomogram. MATERIALS AND METHODS: The total number of participants was 296. Each group of boys and girls consisted of 37 participants in each of the age groups 6–8 years, 8–10 years, 10–12 years, and 13–14 years, making up a total of 148 boys and 148 girls. Routine clinical examination was conducted, and orthopantomograph was taken for radiographic examination. Orthopantomographs of all these participants were collected. Inclination of lateral incisor, inclination of canine, and inclination of premolar with midline were measured on the orthopantomogram. Also, the angles between the canine with lateral incisor and canine with first premolar were measured. Pearson correlation was also evaluated between the movement of canine with lateral incisor and canine with first premolar. RESULTS: All the mean angles related to lateral incisor, canine, and first premolar with midline were recorded. Also, the angles between the canine with lateral incisor and the canine with first premolar were recorded. The movements between lateral incisor, canine, and first premolar were moderately correlated from 6 to 12 years of age. CONCLUSION: The eruption of canine from the floor of the nose till it erupts has its synchronized influence on the lateral incisor and the first premolar.

OBJECTIVES: To assess the oropharyngeal airway in Iranian female young adults with different skeletal patterns using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This descriptive, cross-sectional study evaluated 105 CBCT scans of female patients between 18 and 35 years retrieved from the archives of a radiology clinic. The images were evaluated in axial, sagittal, and frontal sections. In the axial plane, the maximum and minimum cross-sectional area (CSA) of the airways at the oropharynx, minimum width (anteroposteriorly), and minimum depth (laterally) were measured using Mimics Medical software. The oropharyngeal volume was measured by NemoFAB software. The values were compared among the groups with different sagittal, vertical, and transverse patterns. The correlation of indices with airway measurements was analyzed using Monte Carlo Chi-square and Pearson's correlation coefficient. RESULTS: No significant difference was noted in oropharyngeal airway dimensions and volume among cases with different skeletal sagittal, vertical, and transverse patterns (P > 0.05) except for class III patients with normal transverse pattern in whom maximum CSA in low-angle group was larger than that in normal-angle group (P < 0.05) and class I normal-angle patients in whom maximum CSA in transverse normal group was smaller than that in constriction group (P < 0.05). CONCLUSIONS: Oropharyngeal dimensions were not significantly different in Iranian female young adults with different skeletal patterns.

OBJECTIVE: To evaluate in-vitro surface characteristics and frictional properties of orthodontic stainless steel and beta-titanium archwires after surface modification with different concentrations and coating time of titanium oxide (TiO₂) nanoparticles by Sol-gel dip coating method. MATERIALS AND METHODS: The experiment was carried out with 4 different concentrations (1:2, 1:4, 1:6, and 1:8) and three different dipping durations (24 hours, 48 hours, and 72 hours) over ten main test groups of SS and TMA archwires with uncoated wires acting as control in both dry and wet conditions. Phase analysis and surface characterization of TiO₂ was analyzed by X-ray Diffractometry, surface evaluation with the help of scanning electron microscopy (SEM), and frictional characteristics were evaluated. RESULTS: Among all the concentrations 1:6 ratio with 48 hours of dipping duration showed better surface characteristics. A statistically significant difference in frictional coefficient was observed in both SS and TMA wires than their respective controls (p = 0.001). Intragroup comparison among SS and TMA groups showed that groups with 1:6 ratio and 48 hours dipping duration had least frictional coefficient in both dry and wet conditions (p = 0.001). Intergroup comparison between SS and TMA showed that SS group had significantly reduced friction than TMA (p = 0.001) except in few groups. CONCLUSION: TiO₂ nanoparticle with a concentration ratio of 1:6 and 48 hours dipping duration is recommended for surface modification of orthodontic archwires.

OBJECTIVE: The Brodie bite (BRB) is a rare posterior crossbite affecting the transverse occlusal relationship with the palatal cusps of the upper molars, biting into the vestibule and outside the buccal cusps of the lower molar teeth. The BRB is a highly challenging orthodontic problem and is an extreme form of scissors bite. Patients with this problem present with facial deformity and inability to chew on the affected side. The problem is usually not identified until it becomes severe. This study aimed to identify the prevalence of BRB among untreated orthodontic patients in two geo-political zones in Nigeria. METHODS: A total of 1,041 untreated orthodontic patients who presented to two different orthodontic centres located in two geo-political zones (South/South-Benin City and North Central-Abuja, Nigeria) over a 3-year period were evaluated for the presence of BRB. The transverse dimension of the occlusion was examined for the presence of a crossbite or scissors bite. The molar teeth were used as the reference point for occlusion with Angle's classification of malocclusion. Four groups were identified, namely, teeth in occlusion (TIO) (Angle's Classes I, II or III malocclusion served as the control group), scissors or lingual crossbite (LCB), buccal crossbite (BCB) and BRB. A posterior crossbite was confirmed when the upper molar teeth were biting outside the buccal groove of the lower molar teeth either lingually or buccally. A BRB was identified when the palatal cusps of the upper molars were biting into the buccal vestibule of the lower jaw, with the deviation of the face to that side. Statistical analyses were performed using SPSS version 21; frequencies were determined for the variables, and cross-tabulations between the variables were established. P values < 0.05 were considered significant. RESULTS: The overall prevalence of BRB in this study was 0.6% (six patients). The values in the South/South (Benin City) were 997 untreated orthodontic patients, with a prevalence of 0.5% (five patients). The North Central (Abuja) zone had a total of 44 untreated orthodontic patients, with a prevalence of 2.3% (one patient). Unilateral BRB was seen in five patients (80%), and bilateral BRB was seen in one patient (20%). The condition was more prevalent among women (four patients, 80%) and on the right side (three patients, 60%). Angle's relationship in Classes I, II and III (TIO or control group) was seen in 911 patients (87.5%). The LCB and BCB groups comprised 39 (3.8%) and 85 patients (8.1%), respectively. Posterior crossbite was seen in 130 patients (12.5%). CONCLUSION: The prevalence of BRB in this study was found to be 0.6%, with the condition being more prevalent in women and on the right side.