Background. Friction at the bracket–archwire interface reduces the efficiency of sliding mechanics during space closure. Silver nanoparticle (AgNP) coating may reduce friction and accelerate tooth movement. Objective. To compare the rate of space closure using AgNP-coated versus non-coated stainless steel archwires in metal and ceramic bracket systems. Methods. A split-mouth randomized controlled trial was conducted on 20 patients (aged 18–25 years) undergoing fixed orthodontic treatment with bilateral first premolar extractions. Stainless steel 0.019 × 0.025-inch archwires were half-coated with AgNPs using PVD–DC magnetron sputtering. In each patient, coated and non-coated segments were randomly allocated to contralateral quadrants with MBT metal or ceramic brackets. NiTi closed-coil springs (150 g) were used for retraction. Space closure was measured from baseline (T0) and at monthly intervals for 3 months (T1, T2, T3) on dental casts. Results. Over 3 months, coated wires demonstrated significantly greater space closure than non-coated wires in the metal bracket group (maxilla: 3.21 ± 0.12 mm vs. 2.61 ± 0.14 mm; mandible: 2.61 ± 0.15 mm vs. 2.02 ± 0.13 mm; both p < 0.001). Monthly closure was consistently higher with coated wires (maxilla: 1.05-1.08 mm/month vs. 0.86-0.89 mm/month; mandible: 0.87 mm/month vs. 0.66-0.69 mm/month). No significant differences were observed in ceramic brackets across the 3-month period (p > 0.05). The maxillary arch showed faster closure than the mandible irrespective of wire coating (p < 0.001). Conclusions. Silver nanoparticle coating significantly enhanced the rate of orthodontic space closure when used with metal brackets but showed no benefit with ceramic brackets. AgNP-coated archwires may offer a clinically relevant reduction in treatment duration in metal systems. Larger, longer-duration trials are recommended to confirm durability and clinical applicability.

Objectives: To evaluate the influence of crown morphology and collum angle of maxillary incisors on torque expression at common bracket-bonding landmarks using cone-beam computed tomography (CBCT). Methods: Twenty CBCT scans of individuals aged 18–27 years were analyzed. For each central and lateral incisor, the height of maximum labial contour (HMC), height of the labial anatomic (LA) point, collum angle (CA), and alpha angle at both HMC (αc) and LA (αLA) were measured. Stone casts confirmed LA points. Independent and paired t-tests assessed inter- and intra-tooth differences (α = 0.05). Results: The HMC was located 2.6 ± 0.3 mm (centrals) and 1.3 ± 0.5 mm (laterals) incisal to the LA point (p < 0.001). LA-point bracket placement reduced torque by 6.9° (centrals) and 5.7° (laterals). Conclusions: The LA point underestimates the true height of contour, potentially compromising torque delivery. CBCT-guided crown morphology analysis may improve bracket positioning in fixed and aligner treatments.

OBJECTIVE:To evaluate the load-deflection characteristics of Damon™ Ultima (0.014×0.0275") wires compared with heat-activated nickel-titanium (HANT, 0.014×0.025") wires across different passive self-ligating brackets (PSLBs). MATERIAL AND METHODS:One hundred eight bracket-wire assemblies were allocated into six groups based on three PSLB systems (Damon™ Ultima, Damon™ Q, Unitek™ Gemini SL) and two wire types. A modified ISO 15841 three-point bending test was performed at 37̊C using an Instron machine, with deflections recorded at 0.5mm steps from 3.0 to 0.5mm. A supplementary wet-after-thermocycling protocol (5000 cycles; artificial saliva) assessed ecological validity. Statistical analysis (SPSS v23) included t-tests, one-way ANOVA/Kruskal-Wallis tests, and effect-size estimation (Cohen's d, Hedges' g) with 95% confidence intervals; multiple comparisons were adjusted using the Holm-Bonferroni method. RESULTS:Damon™ Ultima wires produced significantly lower deactivation forces than HANT wires across PSLBs at 1.0- and 1.5-mm deflections (P<0.001). Activation differences were bracket-dependent, with significant reductions observed mainly in Damon™ Ultima brackets. Wet-after-thermocycling reduced deactivation forces by 23-37% at 1.0-1.5mm, with large paired effect sizes (Hedges'g ≈-1.5 to-1.9). Force delivery remained light and consistent despite the larger 0.0275″ cross-section. CONCLUSION:Within the limits of this bench study, Damon™ Ultima wires exhibited lower unloading forces at clinically relevant deflections across PSLBs, potentially facilitating earlier bracket engagement and rotational efficiency. However, rotational control was not directly measured, and clinical trials are warranted to validate these findings.

Obstructive Sleep Apnea (OSA) remains underdiagnosed despite its high prevalence and health risks. With increasing patient reliance on artificial intelligence (AI) for health guidance, this study aimed to evaluate the accuracy, comprehensiveness, and empathy of responses generated by large language models (LLMs) to OSA-related queries, as judged by orthodontists. Ten commonly asked OSA-related patient questions were posed to five LLMs (ChatGPT-3.4, ChatGPT-4.0, LLaMA, Bing, and Gemini). Responses were collected and anonymized, then evaluated by 20 orthodontists with over ten years of clinical experience. Ratings were assigned using a standardized 4-point scale (accuracy, comprehensiveness, empathy, and clinical relevance). Statistical analysis was conducted using the Kruskal–Wallis test with Bonferroni post hoc correction. Significant differences were observed across models (p < 0.05). LLaMA consistently outperformed other models, offering comprehensive, empathetic, and clinically relevant responses. Bing was valued for citation-based outputs, while Gemini was appreciated for its disclaimers. ChatGPT models performed less favourably across multiple domains. LLaMA demonstrated superior response quality in OSA-related interactions; however, AI tools should be considered complementary resources rather than substitutes for professional diagnosis and care. Integration with clinician oversight remains essential for patient safety.

Objective:The objective of the present study was to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on pain during the debonding procedure.Methods:A placebo-controlled, randomized split - mouth study was conducted on 30 orthodontic patients. The right and left anterior teeth in the maxilla and mandible were randomly allocated to the control and experimental groups (EG) and were stimulated. TENS application was made through a modified electrode probe that was used from an ammeter. The control group (CG) received the mechanical application of the device with no current, whereas the EG received progressively increasing current from 0.1 mA to the point where the patient experienced a mild tingling sensation for 60 s for each tooth. This was followed by a debonding procedure using an orthodontic debonding plier. Pain perception was recorded on a numerical rating scale after debonding each tooth.Results:The mean pain score was higher in the CG than in the EG, and the difference between the two groups was significant (p=0.001). The pain score was higher in the mandibular teeth than in the maxillary teeth, and the difference between the two groups was also significant (p=0.021). Pain score was higher in female subjects than in male subjects, and the difference between the two groups was significant (p=0.015).Conclusion:The application of TENS therapy results in pain reduction during the debonding procedure. The female subjects experienced more pain. Higher pain scores were recorded for the mandibular anterior teeth than for the maxillary teeth.

AIM: The present study was undertaken to evaluate and compare muscle activity after the treatment with rigid and flexible fixed functional appliance. MATERIAL AND METHOD: The study was conducted on 14 skeletal Class II malocclusion patients in the age group of 13–17 years, divided into two groups comprising 7 patients in each group. Group I was treated with a rigid fixed functional appliance (MPA IV), and Group II was treated with a flexible fixed functional appliance (Churro Jumper). Masseter and anterior temporalis muscle activities were recorded using needle electromyography (EMG) at postural rest, saliva swallowing, and clenching during five intervals (T0 to T4) during fixed functional appliance treatment. Unpaired t-test, Mann–Whitney U, and Wilcoxon sign rank test were applied for statistical analysis, and a P value of <.05 was considered statistically significant. RESULTS: Group I (MPA IV) showed a significant increase in EMG activity during postural rest position (P = 0.003, P = 0.001), swallowing (P = 0.013, P = 0.005), and clenching (P = 0.001, P = 0.002) in masseter and anterior temporalis muscle, respectively. Group II (Churro jumper) also showed a significant increase in EMG activity during postural rest position (P = 0.000, P = 0.000), swallowing (P = 0.001, P = 0.000), and clenching (P = 0.001, P = 0.000) in masseter and anterior temporalis muscle, respectively. CONCLUSION: Both rigid (MPA IV) and flexible (Churro Jumper) fixed functional appliances caused a significant increase in EMG activity of masseter and anterior temporalis muscle during postural rest position, swallowing, and clenching in 6 months of the observation period, but the flexible appliance (Churro Jumper) showed more significant increase.

: To evaluate force decay of elastics of different dimensions and different force values over 48-hours.Steps included extension and immersion of elastics in artificial saliva and measurement of force levels at a specified point of time. A model with vertical pins placed at in the oral cavity. The initial force measurement was done using Universal testing machine before the elastics were engaged onto the pins 37⁰C in artificial saliva. The reading was taken after this in the Universal testing machine for the samples. The elastics were then placed back into the static simulation for the next 23 hours and again into the dynamic simulation for the next 1 hour. Statistically significant difference (P<0.05) was observed between force depreciation between rest and maximum stretch of the elastic. Statistically significant difference was observed in force depreciation with varying time intervals of a particular elastic sample. Lumen size and pre-determined force values affect the overall force decrease pattern of elastics. Elastics with higher force and smaller lumen size show comparatively higher loss of force than the lighter elastics with larger internal diameter. The maximum force loss of a particular elastic happens within the first 24 hours of elastic stretch. The study would help provide information about how an elastic's lumen size and initial force are interdependent, giving clinicians a better understanding of how to prescribe the right elastics for the force they need to apply for treatment.

Background:The aim of this study was to compare skeletal and dentoalveolar dimensions in subjects with maxillary unilateral impacted palatal canines versus the unaffected contralateral side using CBCT.Material and Methods:Skeletal and dentoalveolar variables (Anterior alveolar ridge height, Anterior dentoalveolar height , nasal cavity width, basal nasal width, Lateral angulation of long axis of the incisors and canines with respect to the nasal horizontal plane, premolar to median raphe width, dimensions of lateral incisor and canine, root resorption of lateral incisors, crown-root angulation of lateral incisor, and sector classification of canine) were compared between the impacted and the contralateral sides. As the data had normal distribution, means were compared using students t test. The significance was set at p<0.05. The root resorption in lateral incisor was compared using Chi square test.Results:Lateral angulation of long axis of canines, nasal cavity width, basal lateral width, and premolar to median raphe width were found to be significantly different. Maximum number fell in sector 4 (n = 23, 38.3%) in sector classification. Root resorption of lateral incisor on impacted side was insignificant.Conclusions:Skeletal and dento-alveolar dimensions vary between the impacted and non-impacted sides in unilateral palatal canine impaction cases. Canines on the impacted side were more mesially angulated compared to the non-impacted side. The nasal cavity width, basal lateral width and premolar to median raphe width were significantly less on the impacted side compared to the non- impacted side. Key words:Impacted canine, CBCT, skeletal dimensions, diagnosis, orthodontic treatment.

Purpose: The present study aimed to assess the accuracy and reproducibility of laser-scanned digital models compared to plaster models. Materials and Methods: A total of 50 plaster models were scanned using the 3M ESPE Lava scan ST scanner to construct digital models. Various measurements, encompassing intra-arch and inter-arch from scans and plaster models, were estimated. The plaster models were measured using digital calipers and digital models using MiniMagics 3.0 software. Descriptive statistics were calculated, and the mean difference of the parameters between the two groups was tested by paired t-test. Results: No significant difference was detected between the digital and manual measurements in the majority of the parameters, and the values for the parameters showed significant differences that were not clinically applicable. The digital method showed good reproducibility for all the measurements (r > 0.7). Overbite showed a marked variation between the manual and digital measurements due to overlapping tooth structures in digital models with respect to ideal occlusion. Bolton's analysis did not show a significant difference between the manual and digital methods. Conclusions: Digital models could be compared to the gold standard plaster models.

Extractions are commonly used to alleviate moderate to severe crowding, retract protrusive incisors, or correct anteroposterior inconsistencies in the maxillomandibular area. The choice of which teeth to be extracted requires a thorough assessment of the dentition of the patient, taking into account treatment objectives, dental and periodontal properties as well as ease of mechanics with minimum iatrogenic effects. This case report discusses the successful treatment with myofunctional appliance of a growing patient with skeletal Class II malocclusion followed by fixed mechanotherapy involving atypical teeth extraction.

OBJECTIVE: To evaluate the efficacy of non-aerosol producing restorative self-etching primers (SEPs) as a substitute for conventional orthodontic bonding primers and to analyze the extent of residual composite on the tooth post-debonding. MATERIALS AND METHODS: Eighty-four extracted human premolars were randomly divided into seven groups based on the adhesive and the bonding protocol used. The study comprised Prime and Bond one select (Dentsply), G-Premio Bond (GC), which were each divided into three subgroups based on the method used for moisture control and the control group (Transbond XT conventional total etch). The three methods for moisture control in study groups were: without drying, air-drying with the use of a three-way syringe, and with the use of blotting paper. Shear bond strength (SBS) was tested using a universal testing machine (UTM), and after debonding, the enamel surface of each tooth was examined under 10× magnification to evaluate adhesive remaining index (ARI) scores. RESULTS: Groups 2A (Prime and Bond; without drying) & 1 (Transbond XT) had the lowest and highest SBS values, respectively (P = 0.001). Comparison of ARI between the control group and group 2b (Prime and Bond; air-drying with 3 in 1) showed a significant difference (P = 0.041). Comparison of ARI between control group and group 2c (Prime and Bond; blotting paper) showed a significant difference (P = 0.017). Rest all other comparisons were non-significant. CONCLUSIONS: Transbond XT had SBS values higher than the self-etch groups. Among the self-etch groups, G-Premio Bond had higher SBS values when the traditional methods of air-drying were followed. Use of blotting paper for drying that produced variable SBS values can be an effective alternative method. G-Premio Bond with its adequate bond strength under manufacturer's instruction seems promising in this regard.

The purpose of this case report is to present a multidisсiрlinаry treatment of an adult patient with maxillary hyрoplаsia secondary to a cleft lip and palate using a segmentаl maxillary distrаctiоn osteogenesis (MSD) system. Dentаl-аnchоred Hyrаx deviсe wаs usеd tо bring аbоut the distаctiоn tо incrеаse the uрреr jаw length withоut аltering spеeсh, with аdеquаte аnd stаble occlusiоn. Dental implants were placed in a recently created bone to replace missing teeth. For patients with maxillary hypoplasia, AMSD is a successful treatment option. It preserves velорhаryngeal function and is a stаble therаpy that keeps the overjet achieved with distraction osteogenesis without damaging the posterior occlusiоn. During the consolidation phase, intermаxillary elаstiсs can solve the open bite caused by tooth-borne devices. At a reasonable cost, the mоdified Hyrаx system allows the maxillary arch to be extended and pushed forward.

Purpose:To compare skeletal and dentoalveolar measurements of subjects with unilateral impacted canine versus the non-impacted contralateral side using cone beam computed tomography (CBCT).Materials and methods:30 CBCTs with unilaterally impacted maxillary canines (Buccal=15, Palatal=15) were selected. Skeletal and dentoalveolar variables (alveolar ridge height of incisors, dentoalveolar height, angulations of incisors and canines, basal lateral width and premolar width) were compared between the impacted and the contralateral sides. Independent t-test was used to compare the variables.Results:There was a significant difference in the mean basal lateral width between the impacted (28.25±1.83 mm) and non-impacted (31.64±2.18 mm) sides. Premolar width was significantly lower on the impacted side (p<0.05). The canines exhibited significantly greater angulations on the impacted side compared to the nonimpacted side. The basal lateral width was significantly higher in the buccal subgroup (29.03±1.65mm) compared to palatal (27.48±1.70mm) on the impacted side. The intra-operator reliability was found to be high (0.99%).Conclusion:Significant differences were seen in canine angulation, premolar width and basal lateral width between impacted vs. non impacted sides. Basal lateral width was higher in buccal impacted cases compared to palatal.

Background: The most common ulcer in adults, recurrent aphthous ulcers affect roughly 25% of them. The purpose of this study was to see how beneficial probiotics are at treating it. Materials and Procedures: 160 people in total were split into two groups. Bacillus coagulans (Sporolac) and Tetracycline capsules 250 mg (Tetrastar) were given twice daily to 80 patients in Group 1 for 7 days. In Group 2, 80 patients received just Tetracycline capsules 250 mg (Tetrastar) twice a day for 7 days. At the beginning, fourth, and seventh days of the ulcer, discomfort, size, and average duration were recorded. In order to compare the parameters between the two groups, the Mann-Whitney U test was performed. Results: Over the course of just four days, all of the metrics for the Probiotic group dropped substantially. Conclusion: RAS can be treated and managed with probiotics as adjuvant therapy.

Aim: To evaluate and compare the efficacy of Ozonated Olive Oil Gel, Chlorhexidine gel, and Amflor (Fluoridated) mouthwash on reducing the count of Streptococcus mutans and Lactobacillus in patients undergoing fixed orthodontic therapy evaluated at different time intervals. Methods: Sixty patients undergoing orthodontic treatment were randomly divided into three groups (n = 20) based on antimicrobial agents used (Group 1: Ozonated olive oil gel; Group 2: Chlorhexidine gel; Group 3: Fluoridated mouthwash). Elastomeric modules from brackets were collected at T0 (Fresh samples) and T1 (2nd week) and T2 (4th week) for assessment of the microbial growth. These collected modules were cultured and evaluated for the presence of Streptococcus Mutans and Lactobacilli and numbers of colonies were counted at each interval. Data obtained was subjected to statistical analysis using SPSS software (Version 20.0). Level of significance was kept at 5%. Intra-group and inter-group comparison between pretreatment, 2nd week and 4th week was done for each group using Wilcoxon signed rank test and Mann–Whitney U test. Results: There was presence of Streptococcus Mutans and Lactobacilli during orthodontic treatment which progressively increased from To to T1 and then declined from T1 to T2. The colony counts were maximum for Fluoridated mouthwash and least for Chlorhexidine and the results were statistically significant (P < 0.05). Conclusion: All three antimicrobial agents used were effective against Streptococcus mutans and Lactobacillus. Chlorhexidine proved to be more efficacious whereas Fluoridated mouthwash proved to be least effective against both Streptococcus mutans and Lactobacillus bacteria.

Failure of eruption of maxillary incisors requires careful diagnosis and treatment planning. The cause of impaction may vary from physical obstruction in the path of eruption, tooth material arch length discrepancy to malformation of the tooth. General principles of management of the condition include removal of physical obstruction, creation of space, and surgical exposure with or without traction. The treatment of an unerupted tooth depends upon its age, position, etiology, and amount of space in the dental arch. This case series elaborates on three different cases of incisor impaction with different etiologies and varying ranges of complexity. Three-dimensional radiography was utilized in all cases to accurately visualize the impacted tooth and its relation to adjacent structures. All the cases required different approaches and were completed in varying time durations. Meticulous treatment planning resulted in well-aligned satisfactory functional and esthetic results. How to cite this article: Jain S, Raza M, Sharma P, et al. Unraveling Impacted Maxillary Incisors: The Why, When, and How. Int J Clin Pediatr Dent 2021;14(1):149-157.

OBJECTIVE: The purpose of this split-mouth single-centered, parallel-group, randomized clinical trial was to evaluate the efficiency of corticotomy-facilitated orthodontics in rapid canine retraction.METHODS: The sample consisted of 10 patients (15–25 years old) requiring extraction of the maxillary first premolars with subsequent canine retraction. The patients' right sides were randomly assigned to either the corticotomy (experimental) or control groups. Corticotomy cuts and perforations were performed and canine retraction was initiated bilaterally with closed-coil nickel-titanium springs that applied 150 g of force. The following variables were examined till the end of canine retraction on both sides: Rate of canine retraction, canine root resorption, and patient perception of the procedure. The rate of canine retraction was assessed every month using study models while root resorption was evaluated using CBCT. Patient's perception was evaluated using a 100 mm VAS.RESULT: Mean time taken for full completion of canine retraction: 5.7 months (test) and 7.1 months (control). Mean root resorption: 0.53 ± 0.10 (control) and 0.24 mm ± 0.10 (test). Mean VAS scores: 16 ± 3.94 (24 hours) and 2 ± 2.58 (1 week) at control side and 46.50 ± 6.69 (24 hours) and 2 ± 2.58 (1 week) at test.CONCLUSION: There was an overall reduction in the time taken for canine retraction with corticotomy; however, an increase in the rate of canine retraction in the corticotomy-facilitated method was evident only for the first four months, compared to the conventional method. Less root resorption was observed in corticotomy-facilitated method than conventional method. Pain perception was more for corticotomy-facilitated method than conventional method at 24 hours, but similar after one week.

Background and Objective: The Coronavirus 2 syndrome (SARS CoV 2) or COVID-19 pandemic's rapid and widespread reach has become a major cause of concern to the dental health-care profession. The goal of this study was to assess the knowledge among dental students and professionals about COVID-19 disease and related infection management practices in the region of Delhi-National Capital Region, India. Materials and Methods: An online questionnaire was created, and it was divided into six sections to assess the awareness with respect to the facts, diagnostic aspects of the disease, and its importance in dental treatment. Convenient sampling method was used for data collection. Comparison was done among the following four groups: Bachelor of Dental Surgery (BDS) students, Master of Dental Surgery (MDS) students, academicians (teaching in a dental college), and academicians + practitioners (teaching/not teaching but working in a private dental clinic) over a total of 500 responses for a period of 10 days. The data were coded, entered, and analyzed using SPSS 20.0 version. Descriptive statistics, frequencies, and percentages were used to summarize the data. ANOVA test was used to determine the association of study disciplines among BDS, MDS, practitioners, and academicians and practitioners. P < 0.05 was considered statistically significant. Results: The average correct responses among various sections among all groups came out to be 60.64%, with the highest score being 64.91% among academicians + practitioners and the lowest score being 57.45% among BDS students. Among the sections, 72.4% was highest (section 1: what is coronavirus) and 41.2% was lowest (section 5: diagnosis/tests). Comparison of the overall sections among various groups showed a nonsignificant result although some individual questions showed a statistically significant result. Conclusion: Dental health professionals need regular educational activities and training programs on infection prevention practices with respect to COVID-19 infection to serve not just their own practice but also to help the health-care sector in case the demand arises.