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A. Arif Yezdani ¹

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, BharathInstitute of Higher Education and Research (BIHER), Chennai, IN

Abstract

The purpose of this narrative review was to analyze publications that assessed the accuracy and efficiency of the Invisalign® system. A search strategy to identify articles that referenced Invisalign®, which were published between 2001 and 2019 was adopted and the relevant articles were segregated and perused to evaluate the accuracy of Invisalign technology in achieving predicted tooth positions with respect to direction of tooth movement and tooth type as also its indications, limitations, advantages & disadvantages. It could also be surmised that in comparison with the traditional fixed appliances, patients treated with Invisalign had a better periodontal health but the results achieved with it were not as accurate as thoseachieved by treatment with fixed appliances.

Keywords

Invisible Orthodontics, Invisalign, Clear Aligners.

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S. Vaibava Keerthana ¹, A. Arif Yezdani ¹, M. S. Kannan ²

Affiliations
1 Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, IN
2 Department of Orthodontics & Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, IN

Abstract

Bone mineral metabolism helps in understanding the sequence of boneloss and bone remodeling and in identifying those persons at risk from osteoporosis. One of the approaches that has yielded useful information is the examination of the role of collagenous and noncollagenous bone proteins in bone mineral metabolism. Osteoblasts are the cells responsible for new bone formation, and osteoclasts the cells for resorption. Osteocytes are derived from osteoblasts but their function although not precisely established probably involves calcium homeostasis and bone cell destruction comparable to osteoclastosis. The term remodeling or bone turnover refers to the sequential processes of resorption and subsequent formation for maintenance of mineral homeostasis. In normal man this remodeling cycle occurs at a particular site about every 3 months. The osteoclasts and osteoblasts which are responsible for remodeling appear to be anatomically linked or coupled in equilibrium. Osteocalcin (OC) acts as a regulator of bone mineralization. It also regulates osteoblast and osteoclast activity. This review article lays emphasis on the structure and interaction of OC with various other molecules; its skeletal effects and therapeutic applications.

Keywords

Osteocalcin, Remodeling, Bone Turnover, Osteoclasts, Osteoblasts.

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R. Padmavati ¹, A. Arif Yezdani ²

Affiliations
1 Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN
2 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN

Abstract

The success of mini implants depends on primary stability followed by secondary stabilization. Resonance frequency analysis has been used to assess the primary stability of implants used in dentistry. There is a paucity in the literature regarding its use in orthodontics. This review attempts to showcase the efficiency and reliability of resonance frequency analysis for assessing stability of orthodontic implants.

Keywords

Mini Implants, Resonance Frequency Analysis, Primary Stability.

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A. Arif Yezdani ¹, S. Kishore Kumar ¹, Kesavaram Padmavathy ¹

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN

Abstract

Knowledge of timing and duration of the adolescent growth spurt is essential to treat skeletal jaw discrepancies in the growing child. The purpose of this review of literature was to evaluate the validity and reliability of the maturational stages of the cervical vertebrae C2, C3 & C4 as seen on lateral cephalograms in the prediction of peak pubertal growth spurt.Literature review purported that cervical vertebral maturity indicators were effective in assessing the circumpubertal growth spurt. The drawbacks of this method of assessment was that it evaluated the skeletal maturity at one point of time and that it failed to pinpoint the peak in mandibular growth. It also did not specify the intensity and amount of residual growth left,factors deemed importantfor implementing orthopedic therapy.

Keywords

Lateral Cephalograms, Cervical Vertebrae, Adolescent Growth Spurt, Mandibular Growth, Dentofacial Orthopedics.

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A. Arif Yezdani ¹, Priya Chatterjee ¹, S. Kishore Kumar ¹, Kesavaram Padmavathy ²

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN
2 Department of Microbiology, Research Laboratory for Oral-Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN

Abstract

Introduction: This case report describes the treatment of a Class II skeletal malocclusion with a prognathic maxilla and retrognathic mandible with severely proclined maxillary incisors and lingually blocked mandibular right lateral incisor withentire maxillary arch distalization and use ofinfra-zygomatic crest bone screws devoid of extraction of premolars.

Method: Treatment involved strap-up of a pre-adjusted edgewise appliance, MBT technique (0.022 X 0.028 - inch slot). A non-extraction approach was recommended despite the case warranted premolar extractions. Infra-zygomatic bone screws of length 14mm and diameter 2mm was used for the distalization of the entire maxillary arch. The case was assessed at start of orthodontic treatment (T1) and end of orthodontic treatment (T2).

Results: At T2, the severe pre-maxillary prognathism and mandibular anterior crowding with lingually locked right lateral incisor was corrected with the canines and molars finished in Class I relationship. Normal overbite and overjet with a pleasing soft tissue profile was satisfactorily achieved.

Conclusion: Infra-zygomatic bone screws can be effectively used as absolute skeletal anchorage to correct Class II skeletal discrepancy with maxillary prognathism and severe proclination of maxillary incisorsdevoid of premolar extractions.

Keywords

Infra-Zygomatic Bone Screw, Skeletal Class Ii Discrepancy, Maxillary Arch Distalization, Skeletal Anchorage.

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R. Rajesh Murugan ¹, A. Arif Yezdani ¹

Affiliations
1 Dept. of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN

Abstract

Background: Intentional injury to the periodontium by either corticotomy, piezocision or microosteoperforations triggers increased alveolar bone remodelling due to the regional acceleratory phenomena leading to accelerated tooth movement. Periodontal augmentation with bone graft provides structural integrity to the periodontium minimising occurrence of tell-tale relapse. Selective decortication and bone autograft augmentation were the procedures advocated for the accelerated correction of the skeletal maxillary bilateral posterior crossbite and open bite malocclusion in the case reported.

A -18 - year-old female patient presented with a mild skeletal Class III malocclusion with increased bimaxillary dento-alveolar protrusion, anterior open bite, forward tongue posture and imbricated and rotated mandibular incisors with maxillary bilateral posterior crossbite. A nonextraction treatment plan was recommended.

Method: A week subsequent to strapping of pre-adjusted edgewise appliance, MBT prescription (0.022 x 0.028-inch slot) and Hyrax device, full thickness mucoperiosteal flaps were reflected in the maxillary buccal regions. Decortication was done with surgical perforations and augmented with bone autograft taken from the symphyseal region of the patient. Two weeks later activation of the Hyrax device was done twice daily with the other orthodontic adjustments performed fortnightly untill completion of treatment.

Results: Rapid correction of the skeletal maxillary bilateral posterior crossbite was achieved in 2.5 months and the complete malocclusion was treated in 7 months.

Conclusion: The accelerated correction of the malocclusion could be attributed to the regional acceleratory phenomenon triggered by the intentional surgical insult effected by the decortication procedure and the stable result thus observed was attributed to the periodontal augmentation by the bone autograft.

Keywords

Skeletal Maxillary Bilateral Posterior Crossbite, Anterior Open Bite, Bone Autograft.

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A. Arif Yezdani ¹, Prashanth Sreenivasan ¹, R. Padmavati ¹, S. Kishore Kumar ¹, Kesavaram Padmavathy ²

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, BIHER, Chennai, IN
2 Department of Microbiology, Research Laboratory for Oral-Systemic Health, Sree Balaji Dental College and Hospital, BIHER, Chennai, IN

Abstract

Introduction: This case report describes the treatment of a skeletal Class II malocclusion with an orthognathic maxilla and retrognathic mandible with severely proclined maxillary incisors, imbricated mandibular incisors, deep bite, convex profile and horizontal mandibular growth pattern treated with the Herbst appliance.

Method: Visual treatment objective was initially done to confirm the effectiveness of the use of a functional appliance. Treatment involved the use of a fixedfunctional appliance namely, Herbst appliance to advance the mandible forwards. The case was assessed at T1 and T2 of the initial orthopedic phase of treatment.

Results: At T2, the retrognathism of the mandible was adequately addressed and the facial convexity reduced dramatically. The molars attained a Class I relation and the facial soft tissue profile improved drastically with elimination of lower lip trap.

Conclusion: Functional retrusion of the mandible can be effectively treated in the pubertal period of growth spurt with the judicious use of a fixed functional bite jumping appliance such as the Herbst.

Keywords

Pubertal Growth Spurt, Skeletal Class II Jaw Discrepancy, Retrognathic Mandible, Herbst Appliance.

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A. Arif Yezdani ¹, Mansi Giri ¹

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharat Institute of Higher Education and Research, Chennai, Tamilnadu, IN

Abstract

Orthodontic force application causes an inflammatory event in the periodontium resulting in bone resorption and subsequent orthodontic tooth movement (OTM). The release of inflammatory mediators like prostaglandins E₂ and Interleukin-1β act as potent stimulators of bone resorption. Application of heavy force results in pain and to relieve the same non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed. These NSAIDs negate the inflammatory reactions by interfering with the synthesis of prostaglandins(PG), thus inhibiting orthodontic tooth movement. The purpose of this mini-review of literature was to highlight the effects of the two commonly used drugs, namely acetaminophen and ibuprofen on their pain relieving ability and effect on OTM. It was concluded that acetaminophen was a potent analgesic that could be used to relieve the discomfort associated with orthodontic treatment as its effect was at the central nervous system level and not at the cell membrane level as also since it inhibited the PG synthesis very slightlyits inhibitory effect on OTM was not a matter of concern. On the other hand, Ibuprofen served as a mild analgesic as also inhibited OTM with its anti-inflammatory effect.

Keywords

Acetaminophen, Ibuprofen, Prostaglandins, Orthodontic Tooth Movement.

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A. Arif Yezdani ¹, S. Kishore Kumar ², Kesavaram Padmavathy ³

Affiliations
1 Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN
2 Department of Orthodontics and Dentofacial Orthopedics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN
3 Department of Microbiology, Research Laboratory for Oral-Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, IN

Abstract

In orthodontic treatment planning decisions assessment of growth status plays a vital role and that the adolescent growth spurt is considered an ideal time to mete out growth modification therapy. Various radiologic and non-radiologic skeletal maturity indicators have been in use with its attendant advantages and disadvantages. Insulin like Growth Factor-1 (IGF-1) is one such non-radiologic biomarker that could be used to estimate the amount of available growth present to help treat jaw discrepancies in the circumpubertal period of growth as the mean levels of it has been reported to be high during cicumpubertal growth. Internationally peer reviewed and valid indexed reference articles pertaining to IGF-1 and its predictive usefulness in estimating the peak pubertal growth spurt used alone or in combination with the other radiologic skeletal maturity indicators was segregated and diligently perused. Information gleaned from the literature review revealed that IGF-1 was indeed effective in assessing the circumpubertal growth spurt. It had a high correlation with the cervical stages C3 and C4 as seen on lateral cephalograms as also with the stages pertaining to peak pubertal growth as seen on handwrist radiographs and middle phalanx 3 (MP3) on periapical x-rays. IGF-1 was an effective and alternative biomarker for estimation of peak pubertal growth spurt used alone or in combination with the other radiologic biomarkers.

Keywords

Insulin Like Growth Factor-1, Growth Hormone, Pubertal Growth Spurt, Skeletal Maturation.

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