Objective: To investigate stress distribution in the roots of maxillary central incisors bearing various types of root morphologies with regard to application of different types of orthodontic forces using the finite element model (FEM). Materials and Methods: FEMs of maxillary central incisors with different root morphologies (normal, short, blunt, dilacerated, and pipette) were constructed, and orthodontic forces in various directions (intrusion, extrusion, tipping, and rotational) were applied to the tooth axis at the bracket level.Result: On application of various forces, significantly increased stress was seen at the apex of the root with dilacerated morphology and at the cervical one-third region of the tooth with the short root. Increased stress was observed at the middle one-third region in the tooth with the pipette-shaped root during intrusion and extrusion. Conclusions: In the present study, the stress distribution pattern indicates that the maxillary central incisors with deviated root morphology are at higher risk of root resorption. (Angle Orthod. 2012;82:799-805.)

Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO) was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.

BACKGROUND The Forsus fatigue resistant device (FFRD) appliance is known to correct Class II malocclusion. The disadvantage of it are labial flaring of lower incisors, distalisation and extrusion of maxillary molars, difficulty in procuring the appliances in remote areas and cost. No research has documented the comparison of patient’s experience with FFRD and Sharma’s Class II corrector appliance. Therefore, a questionnaire survey was conducted. METHODS 40 patients having Class II Division 1 malocclusion were included and were divided into two groups- FFRD appliance (group 1, 20 patients) and Sharma’s Class II corrector (group 2, 20 patients). A questionnaire was framed that consisted of 15 questions. Descriptive and analytical statistics was done using SPSS software. The difference in proportions was calculated by chi-square test. The level of significance was set at P < 0.05. RESULTS 30 % of cases in group 2 indicated that the Sharma’s Class II corrector looks good (Q1) as compared to 15 % in group 1. (P = 0.630) 5 % indicated it was not aesthetic in group 2 as compared to 10 % in group 1. 30 % of cases in group 1 indicated that there were problems associated with speech as compared to 0 % in group 2. (P < 0.05). Values were statistically significant. CONCLUSIONS Sharma’s Class II corrector has similar patient acceptance as compared to FFRD appliance with the additional benefit of cost effectiveness. Hence, this can be considered as a better option in treating Class II malocclusion with fixed therapy. KEY WORDS FFRD, Fixed Function Appliance, Economic Orthodontics, Growth Modification, Sharma’s Class II Corrector

Objective To evaluate and compare articular disk position, condylar position, and joint spaces in Class II vertical, Class II horizontal, and Class I cases. The purpose was to assess the potential for development of temporomandibular disorders (TMDs) in the three groups. Materials and Methods A sample of 75 cases, 25 cases in each group of Class I, Class II vertical, and Class II horizontal, were selected based on inclusion and exclusion criteria. Magnetic resonance imaging (MRI) assessments were made with a 1.5-Tesla basic system with a closed-mouth technique for evaluating articular disk position in the sagittal and transverse planes, condylar position, and joint spaces in the sagittal plane. Philips 3.0 software was used to analyze the MR images. Results There was evidence of alterations in the temporomandibular joint (TMJ) morphology in both Class II vertical and Class II horizontal cases, with maximum discrepancy in Class II vertical cases. MRI evaluation suggested a tendency for antero-medial disk displacement with anteriorly positioned condyles in Class II vertical cases. The discrepancy was milder in the Class II horizontal group. Conclusions Class II vertical cases are more susceptible to the development of TMDs and should be subjected to TMJ evaluation before starting any orthodontic treatment to intercept and prevent a mild asymptomatic TMD from developing into a more severe form. Class II vertical cases should be subjected to MRI evaluation before starting any orthodontic treatment.

BACKGROUND Skeletal class II division 1 malocclusion is an antero posterior discrepancy between maxilla and mandible which is usually treated by functional appliances when the patient is in the growing phase. It has been shown that these functional orthodontic appliances may lead to pressure on the oral mucosa, soft tissue tension, oral constriction, toothache and pain. They may also lead to fatigue or to functional speech and respiratory disorders, and they may affect the appearance of the face. All of these undesired consequences affect the patients’ degree of compliance in a negative manner, and may in turn affect the patients’ perception towards the treatment. This study was conducted to investigate patient perception of treatment need, appliance acceptance, expectations of treatment influence on oral health, value of dental aesthetics and information concerning treatment procedures. METHODS Total 30 samples were selected 15 samples were cases treated with twin block appliance and other 15 samples were treated with clear block appliance. After 8 months of treatment, a questionnaire survey was conducted assessing discomfort, expectations and experiences of all patients being treated with clear block appliance and twin block appliance. RESULTS Clear block seemed to be better with regard to all the parameters used in the study but on statistical analysis the difference between the two groups was insignificant. CONCLUSIONS Clear block appliance was designed to increase the compliance of the patient. However, clear block and twin block appliance have similar effects. KEY WORDS Class II, Clear Block, Twin Block