Objectives Due to the constant battle regarding the controversial topic of orthodontic extraction, this study aims to assess the changes in vertical dimensions of patients treated with premolar extractions compared with nonextraction orthodontic patients. Materials and Methods A sample of 60 borderline patients were recruited and divided into extraction and nonextraction groups. Eleven pretreatment cephalometric measurements were recorded using WebCeph and patients were followed-up until the completion of treatment. Statistical Analysis Intragroup and intergroup comparisons were made using paired t-test and two-sample independent t-test, respectively. The joint significance of differences was measured using F-tests. Results The intragroup comparison revealed that in the extraction group, the vertical dimension was significantly increased posttreatment for four cephalometric measurements, that is, mandibular plane angle (p < 0.05), palatal plane angle (p < 0.05), Frankfort mandibular plane angle (p < 0.05), and y-axis (p < 0.05). In the comparison of the posttreatment values of both groups, the mean differences of the posttreatment values for sella nasion (SN)-gonion (Go)-gnathion (Gn) angle (p = 0.008), the total anterior (p = 0.050), and lower anterior facial heights (AFH; p = 0.011) were significantly higher. At the same time, the Jarabak ratio was significantly (p = 0.006) lower in the extraction group than in the nonextraction group. Conclusion The increase in vertical dimension is significantly higher in the extraction group than in the nonextraction group which indicates a significant impact of orthodontic extraction on the vertical dimensions.

Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance. Materials and Methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups. Statitical Analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation. Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group. Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.

Background and Objective: Dental study casts play a vital role in the diagnosis and treatment planning of various orthodontic cases. This study was carried out to compare the tooth widths, arch widths, and arch lengths in Class-I normal dentition to those in Class-I and Class-II crowded dentition in an effort to improve treatment planning and to eventually reduce treatment duration. Methods: Total 170 patients, 12 to 40 years of age with a complete set of permanent teeth till 1st molars; who presented to the Orthodontics Department at Armed Forces Institute of Dentistry (A.F.I.D), Rawalpindi from Sep 2019 to Feb 2020, were included in the study. Non-probability purposive method of sampling was used. The dental casts obtained were used to measure tooth widths, arch widths, and arch lengths. Subjects were classified into Class-I normal and Class-I and Class-II crowded occlusion and comparison of the sum of tooth widths, arch widths, and arch length discrepancies were determined among the three occlusion groups. Data was analyzed in SPSS version 21 and independent samples t-test was used to differentiate the variables of interest. Results: Out of 170 subjects, 73 (42.9%) subjects had Class-I normal occlusion while 97 (57%) had Class-I and Class-II crowded occlusions. No statistical difference was found between the occlusal groups with regard to the sum of tooth widths, inter-canine widths, inter-first premolar widths, inter-second premolar widths and inter-molar widths. However, a remarkable difference was observed between the occlusal groups with respect to arch perimeters and arch length discrepancies (p = 0.000 and 0.000 respectively). Conclusions: Results of the current study indicate that crowding of teeth occurs as a consequence of decreased arch perimeters which may lead to increased arch length discrepancies. However, no prominent difference was noticed in the sum of tooth widths and arch widths among different occlusal groups. doi: https://doi.org/10.12669/pjms.37.2.3240 How to cite this:Shafique HZ, Zaheer R, Jan A, Fazal A. Comparison of Tooth Widths, Arch Widths and Arch Lengths in Class-I Normal Dentition to Class-I and II Crowded Dentitions. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3240 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Background: Cephalometric analysis has been used as one of the main diagnostic tools for orthodontic diagnosis and treatment planning. The analysis can be performed manually on acetate tracing sheets, digitally by manual selection of landmarks or by recently introduced Artificial Intelligence (AI)-driven tools or softwares that automatically detect landmarks and analyze them. The use of AI-driven tools is expected to avoid errors and make it less time consuming with effective evaluation and high reproducibility. Objective: To conduct intra- and inter-group comparisons of the accuracy and reliability of cephalometric tracing and evaluation done manually and with AI-driven tools including WebCeph and CephX softwares. Methods: Digital and manual tracing for cephalometric analyses was conducted for 54 patients. 18 cephalometric parameters were assessed on each radiograph by manual method and by using 2 softwares (Webceph and Ceph X). Each parameter was assessed by two investigators using these three methods. SPSS software was then used to assess the differences in values of cephalometric variables between investigators, between softwares, between human investigator means and software means. ICC and paired T test were used for intra-group comparisons while ANOVA and post-hoc were used for inter-group comparisons. Results: · Twelve out of eighteen variables had high intra-group correlation and significant ICC p-values, 5 variables had relatively lower values and only one variable (SNO) had significantly low ICC value. · Fifteen out of eighteen variables had minimal detection error using fully-automatic method of cephalometric analysis. Only three variables had lowest detection error using semi-automatic method of cephalometric analysis. · Inter-group comparison revealed significant difference between three methods for eight variables; Witts, NLA, SNGoGn, Y-Axis, Jaraback, SNO, MMA and McNamara to Point A. Conclusion: There is a lack of significant difference in the majority of variables among the manual, semi automatic and fully automatic methods of cephalometric tracing and analysis. The mean detection errors were the highest for manual analysis and lowest for fully automatic method. Hence the fully automatic AI software has the most reproducible and accurate results.