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A questionnaire study about oral hygiene awareness among orthodontic patients
Shristi Nadar, SP Saravana Dinesh
July-September 2016, 7(3):97-100
Aim: The aim of this study was to assess the oral hygiene awareness among orthodontic patients. Objective: This research aims to find if patients undergoing orthodontic treatment are aware of the probable accumulation of dental plaque and the consequences of it, namely, bad breath, gum disease, and dental decay. Materials and Methods: The study was conducted on orthodontic patients from the Department of Orthodontics in Saveetha University. A self-assessed questionnaire was formulated to assess the oral hygiene awareness among orthodontic patients. The questionnaire was pretested to assess its reliability. It was distributed to 100 patients and only completely filled questionnaires were taken for analysis. Results: An average of 44% of the population are aware of the oral hygiene measures. The female population who underwent orthodontic treatment was more aware of the oral hygiene measures compared to men. Conclusion: There is a need to incorporate more oral hygiene programs in future. Extra attention should be given in educating and motivating the patients on oral hygiene practices during orthodontic treatment in a proper manner, which will be helpful to the patients in maintaining their oral hygiene.
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Sterilization and orthodontics: A literature review
Jeevan M Khatri, Manjusha M Jadhav, Gaurav H Tated
October-December 2017, 8(4):141-146
Sterilization is a process by which an article, surface or medium is freed of all microorganisms either in vegetative or spore state. On a daily basis, the practicing dentist and his personal are at risk of being exposed to wide patients with blood borne diseases such as HIV/AIDS, hepatitis B, C, and airborne diseases such as tuberculosis. Infection can be directly transmitted by oral fluids, blood, contaminated instruments and surfaces, or through the respiratory system. Control of infection that spreads through various instruments and armamentarium used in the field of orthodontics and dentistry in general is of utmost importance as a preventive measure for cross infection. Considering the fact that the rate at which newer strains evolve with time and older strains develop resistance, it has become a constant challenge through time and in the years to come. This article tells about various methods of sterilization by focusing on the guidelines for an effective and efficient orthodontic practice.
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Midline diastema
M Ketaki Kamath, AV Arun
July-September 2016, 7(3):101-104
Midline diastema is a space between the maxillary and/or mandibular central incisors. Midline diastema can be due to various causes such as genetic, environmental, and so on. Proper history taking and correct diagnosis of the etiology of the diastema is essential to ensure that the orthodontic correction is successful, and no future relapse takes place. The presence of diastema between the central incisors in the adult patient has esthetics and malocclusion concerns.
  2,591 417 -
Biochemical markers as skeletal maturity indicators
T Tripathi, P Gupta, P Rai
April-June 2017, 8(2):60-66
Precise estimation of the stage of skeletal growth is essential for the formulation of accurate treatment planning and employing orthodontic intervention through functional orthopedic appliances for the shortest time possible yielding stable results. Along with clinical and radiological techniques, biochemical markers play an important role in the growth assessment for differential treatment application. Isolation and characterization of various systemic and local factors having a significant role in the growth process provided us the sight to tap their potential to be used as skeletal maturity indicators. Different methods for the assessment of biomarkers in use are enzyme-linked immunosorbent assay, radioimmunoassays, and immunoradiometric assays. These methods of assessment of biochemical markers are noninvasive and when interpreted correctly give useful information. This article presents an overview of various biomarkers under research for predicting skeletal growth.
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Skeletal Class II division 1 malocclusion treated with twin-block appliance
Pratik Patel, Ravi Shanthraj, Nekta Garg, Anisha Vallakati
January-March 2017, 8(1):31-37
A 10-year-old female presented with a skeletal Class II relation with 7 mm of overjet, 40% overbite, and bilateral posterior lingual crossbite. Two-phase therapy was planned to correct Class II skeletal relation, overjet, overbite, and to achieve lip competency. Phase I therapy was done with twin-block appliance to advance the retrognathic mandible. Phase II therapy was accomplished with fixed appliance for arch coordination to correct minor displacement and to finalize occlusion. Posttreatment, skeletal Class I relation was achieved. Incisors' inclination was improved, and ideal overjet and overbite with bilateral class I molar relationship was achieved. As the mandible advanced, lip competency, facial convexity, and mentolabial sulcus improved.
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A comparative evaluation of bite opening by temporary anchorage devices and Connecticut intrusion arch: An in vivo study
Neha Gupta, Tulika Tripathi, Priyank Rai, Anup Kanase, Neha
October-December 2017, 8(4):129-135
Introduction: Deep bite correction in patients with convex profile and increased maxillary incisor visibility, and normal or increased vertical dimension necessitates the intrusion of maxillary incisors. Intrusion arches or miniscrews are commonly used for this purpose. The current study compares one of the prefabricated intrusion arches, the Connecticut intrusion arch (CIA), and the temporary anchorage devices (TADs) in their effectiveness for orthodontic intrusion. Materials and Methods: The present prospective study was done on 24 patients in the age group of 15–25 years undergoing fixed orthodontic treatment. In Group I, TADs were placed for intrusion while, in Group II, CIA was placed. Anchorage was reinforced in Group II using transpalatal arch. A paired t-test or a Wilcoxon signed-rank test was performed for the assessment of treatment changes within the groups, and an independent t-test or a Mann–Whitney U-test evaluated change between the groups. Results: Both TADs and CIA can bring about significant amount of true incisor intrusion with resultant decrease in incisor visibility. However, in the TAD group, in addition to intrusion, the incisors also proclined by 0.67 mm, but in CIA group, incisors retracted by 0.33 mm. There were nonsignificant mesial drift and significant extrusive movement of the maxillary first molars in the CIA group. The rate and amount of intrusion was greater in the TAD group. Conclusions: Both TADs and CIA can be effectively used for incisor intrusion which was, however, faster and greater in TAD group. Both the methods bring about associated unwanted tooth movements as well.
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Obstructive sleep apnea in orthodontics: An overview
Rohit Kulshrestha, Ragni Tandon, Saniya Kinger, Abhimanyu Rohmetra, Raahat Vikram Singh
July-September 2016, 7(3):115-118
Obstructive sleep apnea (OSA) is characterized by the cessation of air flow during sleep due to an obstruction in the nasopharyngeal/oropharyngeal region. Many episodes of apnea may take place within a span of minutes leading to arousal of the patient from his/her sleep in an attempt to increase the amount of air flow. Apart from inadequate hours of sleep, this also results in a deteriorated quality of sleep. Sleep apnea can be caused due to many factors and many treatment modalities have been employed to correct this disorder including mandibular advancement appliances, polysomnographs, and surgical intervention. Best results, however, have been seen with the use of the mandibular advancement appliances. This article highlights the role the orthodontist plays in the diagnosis and treatment planning of OSA patients.
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A modified three-piece base arch for en masse retraction and intrusion in a Class II Division 1 subdivision case
Dhaval Ranjitbhai Lekhadia, Gautham Hegde, K Sindhuja
April-June 2017, 8(2):81-89
This case report describes the orthodontic treatment of an 18-year-old male patient who presented with the prognathic maxilla, deep bite, low mandibular plane angle, and proclined incisors. Modified three-piece base arch was used for the intrusion and retraction of maxillary incisor. En masse retraction was achieved in 6 months. Reduced time for retraction was attributed to a single stage of retraction, unlike burrstone three-piece intrusion base arch where canines are individually retracted followed by retraction of incisors. A modified utility arch was used in lower arch followed by a continuous archwire technique. The case was finished using bite settling elastics on a continuous archwire. The step between canine and premolar was corrected in the finishing phase of treatment. The final treatment outcomes were satisfactory, and true intrusion was achieved with proper selection of biomechanics.
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Accurate bracket positioning as a prerequisite for ideal orthodontic finishing
Raed H Alrbata
January-March 2017, 8(1):3-4
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Treatment of Class II division 2 malocclusion with impacted lower canine
Pratik Patel, Ravi Shanthraj, Nekta Garg, Anisha Vallakati, B Ashwini
October-December 2016, 7(4):148-153
A 15-year-old female presented unilateral Class II molar relation with 90% overbite, retroclined upper central incisors, and impacted lower right canine. Nonextraction treatment was planned to correct deep bite, retroclination of upper central incisors, and unilateral Class II molar relation. Intrusion arch was used to intrude and procline the upper central incisors. Correcting the axial inclination of retroclined incisors caused unlocking of the mandible. This, in turn, leads to simultaneous correction of class II molar relation. The vertical loop was used to disimpact canine. Posttreatment incisors inclination was corrected, bilateral Class I molar relation was achieved, and canine had erupted in its position. The smile arc was improved along with mentolabial sulcus and nasolabial angle.
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Tempo blocks
Khushbu Dinesh Agrawal, Suresh K Kangane, Anand Ambekar
October-December 2017, 8(4):161-163
Bite opening is often required to achieve clearance for correction of certain malocclusions such as crossbites or deep overbites. The present article introduces “tempo blocks” which are easy to fabricate and use and can be used along with the fixed orthodontic appliance in place.
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Clinical considerations for retaining the over-retained deciduous tooth: A rare case report
Ratna Parameswaran, Terry Thomas Edathotty, Anoop Mathew
January-March 2018, 9(1):27-31
We often encounter deciduous teeth which are retained in the oral cavity beyond the age of its exfoliation. In most instances, we are posed with a question as to whether to consider retaining it further or to extract and substitute. The concept and clinical considerations for retaining deciduous teeth and substituting it for its permanent successors are projected through a case illustration in this clinical case report.
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Surgically assisted rapid palatal expansion: A way to treat transverse maxillary deficiency
Rohit Kumar Maheshwari, Harsh Harani, Savan Joshi, Amit Tiwari
July-September 2018, 9(3):107-112
Transverse maxillomandibular discrepancies are a major component of several malocclusions. Transverse maxillary discrepancies are routinely corrected in growing patients with appliances that separate the median palatal and associated maxillary sutures. This type of rapid palatal expansion (RPE) is not feasible in adults, however, because of the increasing resistance of the sutures. Surgically assisted RPE is an alternative method that reduces the resistance of the closed midpalatal suture to correct maxillary constriction in an adult. It allows clinicians to achieve effective maxillary expansion in a skeletally mature patient.
  1,603 221 -
Camouflage treatment of Angle's Class III malocclusion in a young adult
Zeeshan Iqbal Bhat
October-December 2017, 8(4):154-158
A case report is presented of a class III malocclusion with a class III skeletal pattern with prognathic maxilla and mandible in relation to cranium and prognathic mandible in relation to maxilla. The smile was unesthetic as there was a generalised spacing and the maxillary teeth were retroclined and mandibular proclined with more exposure of mandibular teeth. Camouflage treatment was carried out by closure of all the spaces and correcting anterior crossbite.
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Dermatoglyphics and orthodontics
S Achalli, M Patla, USK Nayak, CR Soans
October-December 2016, 7(4):144-147
Dermatoglyphics is the study of fingerprints and skin patterns. These appear at the 12 th week of intrauterine life and are completely established by the 24 th week of intrauterine life. It is said that thereafter, these configurations remain constant throughout life. It is during the same embryonic period that finger and palm prints, the lip, alveolus, and palate develop. As a result, any factor causing changes in the lip, alveolus, and palate may also cause different patterns in the appearance of finger and palm prints. Hence, fingerprint patterns and other details of dermal ridges may offer distinct advantages and thus may be used as a screening tool, which is easily accessible, economical, and noninvasive marker to detect early malocclusion.
  1,497 293 -
Cephalometric and computed tomography evaluation of dentoalveolar/soft-tissue change and alteration in condyle-glenoid fossa relationship using the PowerScope: A new fixed functional appliance for Class II correction –A clinical study
B Nishanth, Adusumilli Gopinath, Sameer Ahmed, Neelakantha Patil, K Srinivas, ASK Chaitanya
April-June 2017, 8(2):41-50
Background and Objectives: Among various interarch appliances for the correction of Class II malocclusion, PowerScope is one of the latest appliances used in the clinical practice of orthodontics. This clinical study was conducted to evaluate the clinical efficiency of PowerScope appliance by assessing skeletal, dentoalveolar, and soft-tissue changes and condyle-glenoid fossa relationship after using the appliance. The null hypothesis of this research is that there is a significant difference between dentoalveolar and soft-tissue changes alone. Methodology: Ten patients of age between 11 and 16 years, 4 males and 6 females, who reported to the Department of Orthodontics and Dentofacial Orthopedics, have been treated for Class II malocclusion (nonextraction) were selected for the study. Inclusion criteria included convex profile, retrognathic/deficient mandible, growing patient at least pubertal growth period, minimal crowding, and positive visual treatment objective. Exclusion criteria included patients with neuromuscular disease, temporomandibular joint problem, and skeletal open bite. Statistical Analysis: Statistical analysis is performed using Wilcoxon signed-rank test. Results: The study revealed the following findings. There are statistically significant changes in dentoalveolar and soft-tissue parameters after using PowerScope appliance. Statistical significant changes are seen in the anterior and posterior joint spaces relationship after using PowerScope appliance. Interpretation and Conclusion: Thus, PowerScope was clinically efficient in the correction of Class II malocclusion in noncompliant patients. Although there were changes in the skeletal parameters, they are not statistically significant. Hence, based on this clinical study, we can conclude that the Class II correction with PowerScope occurred almost entirely by dentoalveolar movement.
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Renaissance in orthodontics: Nanotechnology
Navaneetha Nambi, NR Shrinivaasan, L Xavier Dhayananth, Vishal G Chajallani, Ashwin Mathew George
October-December 2016, 7(4):139-143
Curiosity has its own reason for existing. For thousands of years, humanity has been harnessing its curiosity into inquiry and the process of scientific methodology. If we consider technology as an engine, then science is its fuel. Science of miniaturization (nanotechnology) is manipulating matter at nanometer level and the application of the same to medicine is called nanomedicine. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors and is believed to create advances in the field of orthodontics to a great extent. When we gain access to hold the nanorobots, we will be able to treat very rapidly a number of diseases that are a continuous threat for humanity today. The present article aims to provide an early glimpse on the impact and future implication of nanotechnology in dentistry, especially in the field of orthodontics.
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Acupressure therapy in orthodontics: A review
Abhimanyu Rohmetra, Ragni Tandon, Kamlesh Singh, Ankita Jaiswal
January-March 2017, 8(1):26-30
Acupressure (acupuncture + pressure) is an alternative medicine technique derived from acupuncture. Here, physical pressure is applied to acupuncture points by the elbow, hand, or with various devices. There are literally thousands of acupressure points on the body. Many of the problems encountered in dental clinics can be curbed using these pressure techniques very easily and it is not an invasive process like acupuncture. The article provides a review of pressure techniques and its use (focusing on gaging, dental anxiety, and temporomandibular joint pain) in orthodontic as well as any other dental setup.
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An in vitro comparison of shear bond strength using different bonding techniques in amelogenesis imperfecta cases
Megha Shankar Chougule, Rajesh Bajranglal Kuril, Jyotirmayee Batkishor Dalai, Sanjeet Bechanram Maurya
April-June 2018, 9(2):64-71
Introduction: The objective of this study is to assess and compare shear bond strength (SBS) using different bonding techniques in amelogenesis imperfecta (AI) cases. Materials and Methods: Totally 30 extracted premolars from AI cases and 10 premolars from normal cases were obtained. The first group of (10) normal samples was treated with 37% orthophosphoric acid (H3PO4), second group (10) of AI cases was treated with conventional technique (37% H3PO4), third group (10) with sodium hypochlorite (5% NaOCl), and fourth group (10) with 2% sodium fluoride (2% NaF). Brackets were bonded using Transbond XT light curing adhesive and SBS was measured using the Instron universal testing machine. Results: Statistically highly significant difference observed between the strengths of all four groups (P < 0.01) with the mean highest for control group followed by NaF conditioning and NaOCl conditioning and least for conventional bonding procedure in AI cases. On pairwise comparison using Tukey's post hoc test, statistically highly significant difference was observed between the mean SBS for control group versus Group 2, Group 3, and Group 4, Group 2 versus Group 3, and Group 2 versus Group 4. Conclusion: Brackets bonded by conventional technique showed lower SBS as compared to NaOCl and NaF in AI cases. The application of 2% NaF gel for 4 min before acid etching of hypomineralized tooth surface shows significantly higher SBS as compared to conventional and NaOCl group in AI cases.
  1,397 150 -
Evaluation and prediction of impacted mandibular third molars by panoramic radiography: A retrospective study
Anubha Verma, Payal Sharma, Shalaj Bhatnagar
July-September 2017, 8(3):101-107
Aim: The aim of this study was to evaluate the factors associated with impaction of mandibular third molars and to find a method for predicting eruption of the third molars using panoramic radiographs. Materials and Methods: Ninety pretreatment panoramic radiographs of patients with a full complement of teeth were selected. The mandibular third molars were divided into two groups depending on their eruption status: Group 1: erupted and Group 2: impacted molars. Various angular and linear measurements were made on the panoramic radiographs. Results: Shapiro–Wilk test showed that the data were not normally distributed. Mann–Whitney U-test showed that mean rank of angulation between third molar and second molar (M3M2), gonial angle (GoA), and mesiodistal width of third molar (MDW3M) of impacted group was significantly higher than the erupted group. Spearman's correlation coefficient showed positive correlation between angulation of third molar with mandibular plane (M3MP) and retromolar space (RS) with eruption of mandibular third molar. M3M2, GoA, and MDW3M were found to have negative correlation with eruption of mandibular third molar. Conclusions: Increased RS and M3MP were strongly associated with eruption of the mandibular third molar. An increase in the M3M2 and MDW3M predisposed impaction of third molar. GoA was smaller and mandibular length was larger in the erupted group although both had a weak correlation.
  1,332 203 -
Evaluation of factors affecting dental esthetics in patients seeking orthodontic treatment
Farzin Heravi, Farzaneh Ahrari, Roozbeh Rashed, Parya Heravi, Negin Ghaffari, Arezou Habibirad
July-September 2016, 7(3):79-84
Aim: It is not well documented which dental traits predominantly motivate patients to seek orthodontic therapy. This study was designed to recognize anterior occlusal traits that impact the perception of dental esthetics in patients with different types of malocclusion seeking orthodontic treatment. Materials and Methods: Forty-five pairs of intraoral photographs belonging to patients with various malocclusions were selected for this study. Each pair of photographs included a frontal view and a right-side view of the patient's occlusion at maximum intercuspation. A total of 60 laypersons (30 males and 30 females) were requested to rate the overall appearance of the dentition in the photographs, using a 100 mm line that served as a visual analog scale. The study models of the patients were evaluated by a single investigator to determine the amount of overjet, overbite, crowding, and midline deviation. A multiple linear regression analysis was employed to detect the dental features that predicted the overall attractiveness of the dentition. Results: The multiple linear regression analysis revealed that according to the judgment of female, male, and total female and male raters, overall dental attractiveness could be predicted by two features, the crowding of upper arch (P < 0.05) and overbite (P < 0.05). Conclusions: Dental attractiveness could be predicted by two main variables including upper anterior crowding and overbite. Sufficient priority should be accorded to these factors in orthodontic diagnosis and treatment planning to decrease the probability of misinterpretation of patients' expectation from treatment.
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Comparison of perception of smile by orthodontists and other specialty dentists: A questionnaire study
Swetha Sridharan, Christine Samantha
July-September 2016, 7(3):92-96
Aim: The purpose of this study is to compare the perceptions of orthodontists and other specialty dentists, regarding smile esthetics in the form of a questionnaire. Objectives: To determine whether there is any difference of opinion regarding the perception of smile between orthodontists and other specialty dentists and to compare the various factors that have a high impact on the perception of smile by orthodontists and other specialty dentists. Materials and Methods: This study is a questionnaire survey. Totally, 104 questionnaires were distributed, of which 52 patients were completed by the orthodontists and 52 patients were completed by other specialty dentists. Results: This study showed that the mean scores given by orthodontists are lesser than that of the nonorthodontists. The factors that had an impact on smile by nonorthodontists include crowding of lower anterior teeth and diastema of 3-4 mm. Among orthodontists, the various factors that had an impact include diastema, midline deviation, and reverse smile arc. Conclusions: Different parameters have an impact on the smile perception. Diastema, smile, and reverse smile were regarded as unattractive and received the lowest score in this survey. The presence of midline shift was not considered unaesthetic by nonorthodontists.
  1,277 171 -
Extraction Versus Non-Extraction: A Retrospective Study
Mrudul Vaidya, H Jyothikiran, N Raghunath, Pratham Pai
January-March 2018, 9(1):23-26
Introduction and Objectives: The extraction versus nonextraction controversy is the oldest as well as the most enduring controversy and still remains a topic of debate in the field of orthodontics. The “American Board of Orthodontics” (ABO-1998) introduced an index called the objective grading system (OGS) which evaluates posttreatment dental casts and panoramic radiographs. It assesses the final occlusion in first, second, and third orders according to eight different occlusal components. The aim of the present study was to evaluate the treatment outcome of extraction and nonextraction cases in borderline cases by ABO-OGS system. Materials and Methods: Forty borderline orthodontic patients with Angle's Class I malocclusion with an age group of 13–20 years were selected and equally divided into two groups: twenty patients were treated by extraction of all first premolars and twenty patients with a nonextraction treatment protocol. MBT 0.022” slot prescription was used for all forty patients. With the aid of an ABO measuring gauge and panoramic radiographs, the total OGS scores between the two groups were calculated and compared using Student's t-test. Results: The mean OGS scores were significantly less negative in the extraction group (−22.0 ± 2.29) as compared to the nonextraction group (−26.80 ± 5.18, P < 0.005). Conclusion: According to this study, in the borderline cases, the final occlusion and radiographical characteristics were more acceptable in the patients treated with extraction than the nonextraction patients.
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Craniofacial anthropometric measurements of adult Indians in Angles Class I malocclusion
SA Shinde, RB Sable, AS Patil
October-December 2016, 7(4):130-134
Context: The study was done on Adult Indians ranging from an age group of 18-25 years inhibiting Angles Class I malocclusion. Aims: The objective of the study was to establish the craniofacial anthropometric norms for the young adult (18-28 years) Indians. Subjects and Methods: The study group consisted of 150 healthy volunteers with equal number of male and female subjects who had no history of mixed racial parentage. Twenty-one linear measurements were studied from 28 landmarks over six craniofacial regions by two different operators. Statistical Analysis Used: Sample t-test was used to study the significance of the difference of each average level of all craniofacial parameters between male and female groups. Chi-square test was used to study the statistical significance of difference of the craniofacial indices between males and females. Results: The minimum measurements were contributed by female subjects in most of the craniofacial parameters, except for the eye fissure height (ps-pi) and nose prominence (sn-prn). There is a gender difference in all the measurements except the eye fissure width and nose prominence (independent t-test; P < 0.05). The Indians exhibit some North American White Caucasians (NAWC) features in all regions. Conclusions: This study establishes the craniofacial anthropometric norms of the Indians over 21 parameters. Males, in general, have a significantly higher measurement than females in most of the craniofacial parameters. The Indians do exhibit some NAWC like features.
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Cone beam computed tomography: A newer avenue in orthodontic diagnosis and treatment planning
N Tilekar, VD Swami, AV Sabane, SA Shinde, RB Sable
April-June 2017, 8(2):67-73
Cone beam computed tomography (CBCT)-three-dimensional (3D) imaging technique has shown tremendous progress since its introduction in dentistry and reformed the efficiency and effectiveness of orthodontic care. There has been a great revolution from its use as a predominantly diagnostic tool to an imaging method now used for predicting treatment outcomes and planning treatment. The conventional imaging techniques are basically two-dimensional (2D) representations of 3D objects and hence, they have many limitations. Malocclusion results from discrepancies in three planes of space and hence, 2D imaging cannot be used to achieve ideal imaging goals in orthodontics. It is an excellent tool for diagnosis, treatment planning, patient management and education, improved treatment outcome, and patient satisfaction. A cone beam examination is recommended in the detection of assessing shape and growth of mandible, localization of impacted canines, evaluation of root resorption repair, for the placement of temporary anchorage device, airway analysis in growing patients with maxillary constriction treated with rapid palatal expansion, etc, This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic diagnosis and treatment planning.
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