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Objective:To evaluate the upper airway dimensions in adolescents treated for bimaxillary proclination with first premolar extraction.Materials and Methods:A retrospective cephalometric evaluation was carried out on the available pre and post orthodontic treatment records of 150 patients (12-18 years of age) who had bimaxillary proclination and were treated with fixed orthodontic therapy. Cephalometric landmarks for sagittal airway measurements and hyoid bone were identified; linear and angular measurements were obtained. Descriptive statistics using paired t-test was used to assess changes in pre and post treatment values and Pearson's correlation coefficient was calculated to evaluate the reliability of observations. The method error calculations were performed using the Dahlberg formula.Results:It was observed that the mean values of nasopharyngeal dimension and Total Airway Length (TAL) showed no statistically significant difference in pre and post treatment groups. All other airway and hyoid parameters showed statistically significant difference. Pearson's correlation coefficient showed statistically significant correlations in all the airway and hyoid parameters.Conclusions:In the present study, the nasopharyngeal dimension and TAL were not found to be directly affected by the retraction of anterior teeth, This can be attributed to the fact that nasopharyngeal dimension and TAL are not under direct influence of tongue position. The other findings also indicated direct correlation of tongue position to oropharynx and hypopharynx. Consequently, we emphasize clinically relevant anatomic risk factors that should be given prime importance and serious consideration on the decision whether to extract or not in growing patients.

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.