The management of cleft lip and palate (CLP) requires an interdisciplinary team providing comprehensive care. The present report presents an interdisciplinary approach for the care of a cleft patient. A 17-year-old male patient presented with a a chief complaint of "unpleasant appearance of my teeth" and a history of surgical repair of unilateral CLP on the left side. He presented with Class III molar relationships, Class II canine relationships, crossbite related to maxillary right first premolar and lateral incisor, severe maxillary and mandibular crowding, maxillary anterior tooth size deficiency, congenitally missing upper left lateral incisor. Patient was treated with a pre-adjusted edgewise appliance in conjunction with extraction of multiple teeth and distalization of the lower right first molar using a temporary anchorage device. In addition, alveolar bone graft and implant were placed to restore the missing upper left lateral incisor and a final esthetic work was performed for anterior teeth. The case was finished with Class I molar and canine relationships, minimal overjet and overbite. Total treatment time was about 31 months with satisfactory results. Post-treatment evaluation after 8 months showed stable results.

Background: An important stage at the very beginning of orthodontic therapy is the separation of teeth where space is created for banding of the molars. A dislodged separator may create problems if ingested or it may get wedged between the adjacent teeth causing acute localized periodontitis. In order to overcome these shortcomings of conventional separators, the Kansal Separator was conceptualized. This separator has been designed as a single device that acts simultaneously on both mesial and distal aspects of tooth, causing adequate separation. In addition to separator's independent 2 in 1 action, the self-locking connecting bar prevents the premature dislodgement of the separator. Aim: To determine the force vectors produced by Kansal separator. Materials and Methods: A prototype model was created to study the forces produced. Results: The separator's unique design is based on sound biomechanical principles that explicate the proof of concept and allows the separator to be distinctly effective and effi cient in variable clinical situations, thus amplifying its uniqueness. Discussion: The Kansal Separator, a 2 in 1 orthodontic tooth separator, has a unique design enabling the device to simultaneously separate the teeth on the mesial and distal aspect of the tooth to be banded. Conclusion: Kansal Separator's unique design is based on sound biomechanical principles that explicate the proof of concept and allows the separator to be distinctly effective and efficient in variable clinical situations, thus amplifying its uniqueness.

Background: To compare changes in the amount and distribution of dental plaque associated with placement of elastomeric modules over a self-ligating bracket during orthodontic treatment and to relate these changes to the periodontal inflammation. Materials and Methods: A cross-arch randomization trial was carried out at Bristol Dental School, United Kingdom. Clinical measurements of periodontal inflammation and plaque accumulation and microbiological test were done on 24 patients aged 11-14 years [Mean (SD) age = 12.6 (1.01) years] wearing fixed appliances (Damon 2 brackets, Ormco, Orange, CA, USA) at the start and 3 months into fixed orthodontic treatment. Results: In the first 3 months of treatment there was no statistically significant difference in bleeding on probing between incisors with and without elastomeric modules (P = 0.125 and 0.508, respectively). The difference in plaque accumulation was not statistically significant (P = 0.78). The difference in probing depths between the incisors was not statistically significant (P = 0.84). The microbiological analysis showed no difference. Conclusions: Based on this preliminary 3 months study, elastomeric modules were not significantly associated with any increased risk during treatment when compared to self-ligating brackets. The longer term studies are needed to further confirm the findings of the present study.

Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions.