Introduction Class II malocclusion due to mandibular retrognathism presents a treatment challenge in postpubertal patients with limited remaining growth potential. Traditional two-phase treatment approaches are time-consuming and require high patient compliance. Case Description This case report presents the treatment of a 16-year-old patient with skeletal Class II malocclusion characterized by mandibular retrognathism, increased overjet (8 mm), and Class II division malocclusion. Treatment utilized interradicular mini-implants (1.8 × 8 mm) placed in both arches to deliver forces through Class II elastic traction, combined with simultaneous fixed mechanotherapy using passive self-ligating brackets. Results Within 14 months of active treatment, significant skeletal and dental improvements were achieved. SNB angle increased from 78° to 81°, ANB reduced from 5° to 2°, and effective mandibular length (Co-Gn) increased from 90 mm to 93 mm. Class I molar and canine relationships were established bilaterally. The facial profile improved from convex to straight, with enhanced smile esthetics and increased lower pharyngeal airway space. Conclusion Interradicular mini-implant-assisted Class II elastic traction combined with fixed mechanotherapy offers an efficient single-phase approach for skeletal Class II correction in postpubertal patients. This technique effectively utilizes residual growth potential, minimizes undesirable dental side effects, and reduces treatment duration, achieving predictable skeletal and dental outcomes.
Background Cleft lip and/or palate (CL/P) is a common congenital craniofacial malformation with marked geographic variation. No epidemiological data were available for Zanzibar. Objectives To estimate the hospital-based presentation rate of CL/P, describe its pattern by type and laterality, assess sex distribution, and determine age at presentation among patients treated at Mnazi Mmoja Hospital (MMH) from 2020 to 2024. Methods A retrospective cross-sectional study was conducted on the medical records of patients diagnosed with CL/P at MMH over a 5-year period. Data on age at diagnosis, sex, cleft type, laterality, and age at time of intervention were collected and analyzed. Results A total of 200 cases were included, yielding a hospital-based presentation rate of 0.66 per 1,000 live births. Females accounted for 52% of cases and males 48%. Unilateral cleft palate (CP) was the most common type (53.5%), followed by unilateral cleft lip (CL) (25.5%). Most cases were unilateral (98.5%). The association between males and isolated CL showed a trend but did not reach statistical significance (OR = 1.45, 95% CI: 0.77-2.75). The most common age of presentation was 1 month to 1 year (45.5%). Most procedures were performed at ages 1.5 to 3 years (32.5%). Conclusions CL/P in Zanzibar is characterized by a predominance of isolated CP and a slight female majority. The observed hospital-based presentation rate likely underestimates the true prevalence, highlighting gaps in early detection and access to care. Strengthening early diagnosis, establishing a cleft registry, improving multidisciplinary management, and ensuring timely surgical intervention are essential to enhance outcomes.
Aim This research focuses on assessing oral health-related quality of life (OHRQoL) through the application of the Oral Health Impact Profile (OHIP)-14 and the Index of Orthodontic Treatment Need (IOTN). It specifically explored the link between clinician-assessed malocclusion severity and how adolescents and young adults seeking orthodontic treatment perceive their own dental health. Methods A cohort of 120 orthodontic outpatients (77 females and 43 males; age range: 15-30 years; mean age: 22.07 ± 4.71 years) was selected via consecutive convenience sampling. To capture both clinical and patient-centered perspectives, OHRQoL was assessed using the self-reported OHIP-14 and the AC-IOTN indices, whereas a single operator evaluated normative treatment needs using the Dental Health Component (DHC)-IOTN. Statistical distribution analysis with the Shapiro–Wilk test confirmed that the data were non-normally distributed ( P < .05). Consequently, we utilized the non-parametric Mann–Whitney U test to compare differences between genders and Spearman’s rho ( ρ ) to explore correlation patterns. High examiner consistency on the DHC was verified by an almost perfect intra-rater Cohen’s kappa of 0.966. Results A majority of participants (74.16%) of the sample were clinically categorized as having a “Great Need” for treatment (DHC); clinical severity did not significantly correlate with quality of life (QoL) ( P = .398). In contrast, the patient’s own aesthetic perception showed a significant but weak positive correlation with poorer OHRQoL ( P = .030). Females reported significantly higher negative impacts on QoL ( P = .012) and higher aesthetic concern ( P = .014) than males, despite having statistically similar clinical severity ( P = .590). The total median OHIP-14 score was 10.0 (interquartile ranges: 4.0-15.5). The results showed a weak correlation between AC and OHIP-14. Conclusion This study identifies a significant “clinical-perceptual gap,” demonstrating that patient-centered AC is a more reliable predictor of OHRQoL impact than objective clinical indices (DHC). Females in this demographic exhibit a heightened subjective awareness of malocclusion, experiencing a greater negative impact on their QoL than males for the same degree of clinical severity. These findings underscore the need to prioritize patient-reported outcomes when planning orthodontic services in public health settings.
Objectives To evaluate and compare the shear bond strength (SBS) of orthodontic brackets by employing a conventional composite bonding agent and an alternative self-cure acrylic resin for bonding orthodontic attachments to three different provisional crown materials. Methods A total of 42 material specimens were prepared: 14 discs, each made of provisional crown materials, namely, bis-acryl composite, self-cure acrylic resin, and heat-cure acrylic resin. These 14 discs of each provisional crown material were randomly allocated into two groups: the first group of 7 was bonded using the conventional bonding technique, and the other group of 7 was bonded with self-cure acrylic resin as the bonding agent. SBS was measured using a Hounsfield universal testing machine, and the Adhesive Remnant Index (ARI) was evaluated. A post hoc power analysis was performed to validate the statistical findings. Results One-way analysis of variance revealed significant differences ( P < .001). Self-cure acrylic resin demonstrated the highest mean SBS when bonded to self-cure acrylic crowns (13.48 MPa). The lowest SBS was observed in heat-cure acrylic crowns bonded with composite resin (6.14 MPa). Conclusion Bonding brackets to self-cure acrylic provisional crowns using self-cure acrylic resin results in the highest SBS. While all groups met clinically acceptable thresholds, the alternative self-cure protocol provided superior bond strength compared to the conventional method across all tested materials.
Introduction Cephalometric norms are often population-specific due to ethnic and environmental influences. The Shimla Hills region of Himachal Pradesh, India, represents a distinct population influenced by high-altitude and cold climatic conditions, which are known to affect craniofacial morphology. This study aimed to establish McNamara cephalometric norms for this population and evaluate their deviation from Caucasian standards. Materials and Methods Digital lateral cephalograms of 200 adult subjects (18-29 years) native to the Shimla region, with Class I occlusion, were analyzed. Skeletal, dental, and airway parameters were measured and compared with Caucasian norms and regional Indian data. Results The Shimla population exhibited a distinct craniofacial pattern. Maxillary and mandibular positions were significantly more retrusive compared to Caucasians. Mandibular length (Co-Gn) was significantly shorter, mirroring South Indian trends more closely than Maratha (Central India) or Caucasian standards. Vertical analysis showed reduced anterior facial height but a steeper mandibular plane angle. Pharyngeal airway dimensions were significantly narrower when compared to Caucasians. Sexual dimorphism was evident, with males generally exhibiting a proportionately larger skeletal framework and females showing slightly more dental proclination. Conclusion McNamara’s Caucasian norms are not directly applicable to the Shimla population. The established population-specific norms reflect a unique phenotype of bimaxillary retrusion and reduced airway space, emphasizing the need for individualized diagnostic standards in orthodontic and orthognathic planning for this region.
