The treatment of Angle Class I malocclusion by atypical extraction is rather challenging. The extraction of four first premolars often manages it. However, in cases of compromised and non-restorable teeth, the extraction decision may be altered, making the anchorage and the treatment mechanics more challenging. This article reports the clinical case of a 16-year-old patient from Sudan who presented with a chief complaint “My teeth are crooked and sticking out.” He had Angle Class I malocclusion with a bimaxillary dentoalveolar protrusion. He had severe crowding in both arches and localized marginal gingivitis related to an ectopically erupted upper right canine (UR3) and lower right first premolar (LR4). The patient had a provisional restoration in the lower right first molar (LR6). Extraction of three first premolars and one first molar was the alternative of choice for this treatment, which restored function, providing improved periodontal health, achieved the desired facial esthetics, and allowed finishing with a stable and balanced occlusion. Management of angle class I malocclusion with atypical extraction patterns should be performed with careful mechanics and anchorage planning to obtain good results.

OBJECTIVES: To analyze the craniofacial morphology in child patients and adolescents by evaluating the skeletal cephalometric profile of the HIV infected patients in this age group and comparing them with the HIV-negative controls. MATERIALS AND METHODS: The present study was a planned case-control study which included 25 HIV-positive adolescent patients aged between 10 and 18 years (the study group) who were compared with 25 age- and sex-matched HIV-negative adolescent controls (the control group). All the patients had been HIV infected via a vertical transmission with positive serology confirmed in two different tests and had been kept on HAART since they were born. The diagnostic aids used for orthodontic documentation included facial photographs, digital orthopantomographs, lateral teleradiographs, and study models. RESULTS: With reference to the methodologies used for taking the cephalometric values, all the methods used were in strong agreement with each other for almost all the variables studied and had high intra-class correlation coefficient values except Co-A, SN.ANSPNS, and SNB which, too, had a good agreement of 60%. Nevertheless, the agreement was positive for these variables, too, since the P values obtained were found to be statistically significant (P < 0.05). CONCLUSION: Most of the measurements in the HIV-infected adolescents were found to be similar to the ones obtained for the HIV-negative controls, although, the study results highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis in longitudinal studies to have an idea of the exact changes observed and their pattern in the included groups.

OBJECTIVES: To evaluate the perception of esthetics and the attractiveness of the smile, in frontal view, with mandibular asymmetry, through the eye-tracking. MATERIALS AND METHODS: OGAMA software and The Eye Tribe Tracker hardware were used to obtain eye tracking in certain areas of interest on the face. To simulate asymmetry, Photoshop® image editing software was used to create a vertical reference line to the midline of the face and make it symmetrical with control of the angulation relative to another horizontal reference line passing through the vertices. Then, the lower third of the face added asymmetries or deviations, starting from zero, with increments of 2 by 2 degrees up to 6 degrees. The study included 60 laypeople, 30 males and 30 females, without any knowledge about the study, showing good vision, and not having used drugs with the possibility of influencing cognitive or motor skills. RESULTS: From the heat map in cases of mandibular asymmetry, it is possible to visualize that for both sexes the evaluators evaluated with a certain degree of similarity mainly when the deviations presented with 6 degrees. The trajectory of the male and female gaze in cases with asymmetry shows that in cases with a magnitude of 6 degrees, the raters traced mainly in the region of the mouth with little transition in the eye region and mainly in the areas of interest considered as “other.” In the images presented with a magnitude of up to 4 degrees, they were traced in the general image. CONCLUSIONS: The perception of laypeople from mandibular asymmetry to the right in females presented a higher perception when compared to males with mandible asymmetry to the left.

OBJECTIVES: To assess the effect of malocclusion on the self-esteem of adolescents. MATERIALS AND METHODS: This cross-sectional study evaluated 496 student aged between 12 and 14 tears old living in Shiraz city. The level of self-esteem was determined using the Rosenberg self-esteem scale (RSES). To assess the degree of malocclusion, Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC) was used. The Spearman's correlation coefficient was calculated to assess the correlation of malocclusion and self-esteem. The mean of IOTN-DHC and total score of RSES in different age groups were analyzed using the Kruskal–Wallis test. The mean IOTN-DHC and total score of RSES were compared between the two municipal districts and males and females using the Wilcoxon test and independent t-test, respectively. RESULTS: A significant but weak correlation was noted between IOTN-DHC and self-esteem (r = 115/0, P = 04/0), while IOTN-DHC subscale: space shortage, dental missing, overjet, overbite, and crossbite had nonsignificant correlation with self-esteem. The socioeconomic status of adolescents significantly affected their self-esteem (P < 0.001). CONCLUSIONS: Weakly significant correlation between mild malocclusion and dental self-esteem.