The loss of maxillary central incisors at an early age has psychological, esthetic, and functional implications. Multiple treatment options are available for replacing missing central incisors. The management demands a multidisciplinary approach involving the orthodontist, prosthodontist, and periodontist. Treatment planning requires consideration of a variety of clinical and nonclinical factors. This clinical report attempts to demonstrate different strategies for the management of unilaterally and bilaterally missing central incisors.

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.

Aim:The study analyzed plaque microflora to compare the growth of periodontopathogens-Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella nigrescens and Campylobacter rectus in patients undergoing fixed orthodontic treatment. Materials and Methods: Samples of plaque microflora from gingival crevices from incisors, and molars were collected by sterile periodontal probe at four different time periods-first was taken before placement of fixed appliances (T0) considered to be control group, then at 1 week (T1), 1 month (T2), and 5 months of starting fixed treatment (T3). The samples were transported to the laboratory and processed within 24 hr using the polymerase chain reaction technique. Results: The statistical significance of intragroup comparisons was done using test RMNOVA. The colony-forming units at different follow-up intervals showed a significant increase in all tested periodontopathogens except A. actinomycetemcomitans which showed no significant increase. Conclusion: Fixed orthodontic treatment can interfere in normal oral hygiene which can initiate plaque accumulation further leading to inflammation due to increase in periodontopathogens. Therefore, oral hygiene should be constantly monitored for plaque control.

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