A proposal to formulate an orthodontic index specific for the Indian Board of Orthodontics (IBO) to determine the acceptability and degree of difficulty of a cases submitted for the phase III examination was discussed at the College of Diplomates meet (CDIBO). To ascertain the degree of difficulty of a case is very subjective; therefore, the need to quantify the complexity of a case in a standard format is required. To develop a Discrepancy Index for the IBO, 20 Dental and Cephalometric components of a malocclusion and 20 intraoral frontal photographs would have to be evaluated and a weightage score for each component would be assigned. Components such as upper and lower anterior proclination, commonly seen in our Asian population which have been omitted in the commonly used indices such as PAR (Peer Assessment Review) IOTN (Index of Orthodontic Treatment Need) and the ICON (Index of Complexity,Outcome and Need) have been included. The proposed IBO Index would add uniformity and standardization in assessing the degree of difficulty and also the degree of improvement of a case, which would be a beneficial tool for a fair evaluation.

A new orthodontic index was proposed by the College of Diplomates to assess the degree of difficulty of cases submitted for the Indian Board of Orthodontics Phase III clinical examinations. This article is the continuation of the part 1 article which gave a brief insight into the need and the methodology undertaken to formulate this index. A weightage score grading the degree of severity of a case was obtained for dental, cephalometric, and miscellaneous components based on the results of a survey taken from the Diplomates of the Indian Board of Orthodontics. An aesthetic component was also developed using photographs and the relative aesthetic score for every photograph was graded. This index would help to categorize the malocclusion based on the severity, in a single, linear, and transparent manner.

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Aim: The aim of this study is to critically review the studies that studied the effect of Chlorhexidine varnish and fluoride varnish on White Spot Lesion (WSL) in patients undergoing orthodontic treatment. Materials and Methods: The electronic database PubMed, The Cochrane Library, Medline, Embase, Google Scholar, Web of Knowledge along with a complimentary manual search of all orthodontic journals till the first week of December 2019 was searched. English language study performed on humans, randomized or nonrandomized clinical trials, comparing the effect of fluoride and chlorhexidine varnish on WSL was included in the review. Quality assessment of included studies was performed. Clinical Significance: The need for an adjunct oral hygiene aid to reduce the incidence and prevalence of white spot lesions in orthodontic patients is necessary. The use of these varnishes will aid in the same and thus make the adverse effects of fixed orthodontic treatment negligible. Review of Literature: Enamel demineralization is a significant risk associated with orthodontic treatment when oral hygiene is poor. Prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians despite modern advances in caries prevention. The development of White Spot Lesions (WSLs) is attributed to prolonged plaque accumulation around the brackets. Results: The search identified a total of 3 studies that were included in this review. One study had Low risk of bias and the remaining 2 studies had moderate overall risk. Results showed that there was a reduction in the incidence of white spot lesions in orthodontic patients after application of chlorhexidine and Fluoride varnish. Conclusion: Low level evidence is available to conclude that the use of chlorhexidine varnishes and fluoride varnishes reduces the prevalence of white spot lesions in patients undergoing fixed orthodontic treatment. Due to its limitations, the results of this systematic review should be handled with caution and further well-planned Randomized Clinical Trial (RCT) are needed to provide a discrete conclusion.

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