The scope of orthodontics has widened to include not only children and adolescents but also adults, thereby abolishing the upper age limit. With growing esthetic conscience among the society, a great number of young adults are seeking orthodontic treatment primarily for esthetic reasons. They undergo comprehensive orthodontic treatment involving major occlusal changes to get the utmost esthetically pleasing face. The older adults with poor dental conditions requiring perio-restorative treatment undergo adjunctive orthodontic treatment to attain a long-term prognosis. The orthodontist faces challenges to practice adult orthodontics due to various issues being under considerations, which are quite different than routine orthodontic treatment oriented to children and adolescents. This article highlights the difficulties and limitations faced by the orthodontist while practicing adult orthodontics with remedies to overcome them.

Background MicroRNAs (miRNAs) are non-coding short, single-stranded RNA molecules that may serve as biomarkers for various inflammatory and molecular mechanisms underlying bone and tissue remodeling consequent to orthodontic force application. Methods A thorough literature search in major databases was conducted in March 2021 to generate evidence for miRNAs in orthodontics, with prior PROSPERO registration. The initial search revealed 920 articles, subjected to strict selection criteria according to PRISMA, and resulted in final inclusion of four studies. Quality assessment by QUADAS-2 classified three studies as unclear risk-of-bias while the applicability was high. Further, bioinformatic analysis was performed to identify the target genes from the miRNA database (miRDB) and TargetScan databases and their protein-protein interaction pathways with the STRING analysis. Results Multiple miRNAs in gingival crevicular fluid (GCF) of orthodontic patients were seen, including miRNA-21, 27(a/b), 29(a/b/c), 34,146(a/b), 101, and 214 along with matrix metalloproteinases (MMPs)-1, 2, 3, 8, 9, 14 in one study. A statistically significant increase in expression of miRNA-29a/b/c,101, 21 from pre-treatment (before initiation of retraction) was seen to reach a peak at 4–6 weeks (wk) of retraction. On the contrary, miRNA-34a showed downregulation from the 1 day to 4 wk of retraction and also, negatively correlated with MMPs-2,9,14 levels at the same observation times. The distance of canine movement showed mild correlation with miRNA-27a/b, 214 at 2 wk of retraction. Bioinformatics revealed 1213 mutual target genes which were analyzed for inter-relational pathways using Cytoscape plugin, MCODE. Further, 894 prominent protein interactions were identified from the STRING database and SMAD4, IGF1, ADAMTS6, COL4A1, COL1A1, COL3A1, FGFR1, COL19A1, FBN1, COL5A1, MGAT4A, LTBP1, MSR1, COL11A1, and COL5A3 were recognized as the hub genes. Their interactions were able to isolate multiple miRNAs: hsa-miR-34a-5p, hsa-miR-29b-2-5p, hsa-miR-29b-3p, hsa-miR-34a-3p, hsa-miR-27a-5p, hsa-miR-29a-5p, hsa-miR-29b-1-5p, hsa-miR-29c-3p, hsa-miR-214-5p, hsa-miR-27a-3p, hsa-miR-29a-3p, hsamiR-146-5p, which were found promising as biomarkers for tooth movement. Conclusions Our results support using miRNAs as biomarkers in varied orthodontic study designs and for inter-relationships with pathological settings like periodontal disease, pre-malignancies, or conditions like obesity or metabolic irregularities, etc. The identified target genes and their protein interaction pathways can be used to propose precision therapies, focusing on ideal tooth movement with minimal iatrogenic side-effects.

Introduction The subject of beauty has been the topic of much debate throughout history, and methods for the evaluation of beauty have been the focus of many research projects. The evaluation of beauty is influenced by factors which include various linear measurements, angles, ratios, and proportions. We evaluated several ratios in Indian Population after locating various landmarks on beautiful Indian faces. Aims and Objectives The aim of the present study was to evaluate various facial proportions of Indian beauties using their frontal photographs in natural head position to establish anthropometric norms in beautiful Indian females. To evaluate whether these values satisfy golden and silver proportions. To compare these values with Caucasian anthropometric norms. Materials and Methods Frontal photographs of 30 female celebrities were downloaded from the internet. Photographs of only those Indian beauties that have been declared winners of either national or international beauty contests by a designated panel of judges were included in this study. Hardcopy of these photographs was taken in 5 inch by 3.5 inch format, all the measurements done and ratios calculated. Results Measurements were tabulated and values for various ratios were calculated to establish norms. Coefficient of variation was also evaluated. Conclusion All the ratios were found to be consistent than others which made it possible to assess beauty objectively rather than arbitrarily. Most of the values did not match the golden and silver proportion. In comparison with Caucasian population, we found that there is significant difference in most of the values.

Aim and Objectives To assess the reliability of orthopantomograms (OPGs) in detecting facial asymmetry. Materials and Methods The OPGs and posteroanterior cephalograms for 10 patients with facial asymmetry were obtained from the outpatient department of the dental college. These radiographs were traced and analyzed. Six measurements (four linear and two angular measurements) were made on both sides. Asymmetry was defined by subtracting the right and the left side measurements. The differences from OPG were compared to those obtained from posteroanterior cephalograms. The kappa statistics and intra-class correlation coefficient (ICC) were used to calculate the differences. Results The ICC was calculated between OPGs and posteroanterior cephalograms difference measurements. The class interval for all measurements was noted between 0.61 and 0.84. The ICC was 0.7861, which shows strong correlation between the values (P < 0.0005) by probability 10−5, within 95%, coefficient correlation lies between 0.61 and 0.84. Kappa test gives a value of 0.64, which shows strong agreement between the measurements. Conclusion Individually, the measurements from OPGs may not be reliable but the obtained difference between the values of the OPGs and the posteroanterior cephalograms are comparable in nature and show strong correlation and can be used to detect facial asymmetry.

Objective: To evaluate the accuracy of measurements obtained with a digital cephalometric software program. Materials and methods: Digital photographs of 32 cephalograms were imported into the Nemotec digital imaging software. Digital measurements of 41 hard and soft tissue variables generated by the software were compared to those obtained by manual tracings. Reproducibility for each method was assessed using Pearson's correlation coefficient by repeating measurements of all radiographs at an interval of 3 months. A paired t-test was used to detect differences between the manual and digital methods. Results: Both the methods demonstrated a high correlation (r > 0.7) between the first and second measurements indicating good reproducibility. SN-Occ, anterior cranial base length, posterior cranial base length, nasolabial angle, facial height and lower lip length showed clinically significant differences between the measurements obtained from digital and manual methods. Conclusion: Digital measurements obtained with the Nemotec digital imaging software using digital photographs of analog cephalograms were found to be reproducible and comparable to the manual method for most of the variables used in clinical practice except a few which could not be measured accurately with the digital method.