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Background The minimal important difference (MID) is defined as the smallest difference that the patient perceives as important. Furthermore, the smallest worthwhile effect (SWE) is the important change measured with the benefit-harm trade-off method. The aim of this study was to evaluate the MID in orthodontic treatment duration to inform the decision regarding seeking procedures to accelerate orthodontic tooth movement and reduce treatment duration. Methods We constructed a survey eliciting views of the MID from adult participants from four countries undergoing orthodontic treatment. Ten questions addressed reduction in the treatment duration for both durations 12 and 24 months, and four questions were related to the reduction in treatment duration that the patients would require to undergo surgical or non-surgical adjunctive procedures. We applied a univariable random effects logistic regression model to examine the association between the participants' characteristics and the MID. Then, we fitted a multivariable logistic random effects regression including significant predictors. Results Four hundred and fifty adults, with a median age of 21 (interquartile range: 19–24), undergoing orthodontic treatment participated in the survey. Of the respondents, 60% considered 15 days as a trivial reduction from 12 months duration of therapy and 70% considered 15 days a trivial reduction from 24 months. Of the respondents, 48% considered the period of 2 months a moderate reduction from 12 months, and 60% considered 2 months a moderate reduction from 24 months. From these results, we inferred that patients considered reductions of approximately 1 month as the MID in the treatment duration for both 12 and 24 months. However, SWE was considerably more than the MID for most of the participants to decide undergoing surgical adjunctive procedures to reduce the time of therapy. The participants required smaller SWE to undergo non-surgical procedures compared to surgical procedures. Conclusion The MID in the treatment duration is one month for both treatment durations 12 and 24 months. Patients require a greater SWE than the MID to undergo adjunctive procedures to shorten the duration, particularly for surgical procedures. [ABSTRACT FROM AUTHOR]

Introduction: The research for finding the most effective teaching method is still on. The aim of current study was to find out the perceptions of dental interns after a problem based learning (PBL) sessions on a topic of orthodontic case planning. Study Design: Experimental, Quasi study. Setting: Orthodontic Dental Section, Faisalabad Medical University. Period: 15.8.2017 to 5.2.2018. Materials & Methods: Thirty two dental interns were selected at Orthodontic Dental Section, Faisalabad Medical University. On initial case planning sessions, baseline theoretical knowledge was provided on the topic of 'Premolar extractions'. In between the sessions dental interns were asked to answer five multiple choice questions relative to one orthodontic case (OPG, Lateral cephalograms, Photographs) they were given. On a final case planning sessions, orthodontic case discussion case took place with an expert orthodontist, at the end of which dental interns were asked to rate their experiences about PBL session by filling questionnaire anonymously. Results: Results showed that dental interns perceived PBL to stimulate their attentiveness, interest, and interactivity with fellow interns, motivation for additional case study and learning efficacy. Conclusion: Perceptions of dental interns were positive after a problem based learning attempt on a topic of orthodontic case planning. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To compare the different smile variables amongst patients with varying vertical skeletal patterns, and to find whether there is a correlation between the dynamic contributing factors and the vertical smile parameters. METHODS: This cross-sectional study was conducted at department of Orthodontics, Nishtar Institute of Dentistry, Multan, Pakistan from 01-10-2020 to 01-04-2021. The posed smiles of 120 participants, aging 15-25 years, having well-aligned dental arches were videotaped for objective measurements and comparisons with their underlying vertical skeletal growth patterns. RESULTS: The evaluation of smile parameters showed a significantly decreased inter-labial gap in patients with skeletal low angle in males (8.92±3.6mm) and females (9.44±2.58 mm) [p<0.004]. Upper lip length was significantly decreased in low angle (16.23±1.59 mm) cases for males as compared to vertically high (18.57±1.47 mm) and normal angle (18.24±2.08 mm) cases. Inter commissural width was increased significantly in the low angle cases (63.39±8.14 mm) when compared with the high angle cases (58.24±5.44 mm) in females. Maximal Incisal Display was significantly increased in high angle cases (9.03±1.31 mm) p<0.001 as compared to the low angle cases (7.64±1.98 mm). A 65.8% (n=79) of the sample showed a flat smile arc with 26.7% (n=32) having consonant smiles while 7.5% (n=9) showed a reverse smile arc. CONCLUSION: Smile dynamics are influenced by underlying skeletal patterns. Individuals with skeletally high angles showed an increased incisal display and an increased upper lip elevation upon smiling. While the low angle patterns displayed a decreased inter-labial gap and majority showed a flat smile arc. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To find the different etiological factors underlying a midline diastema which will help in effective orthodontic correction by enabling the practitioner to adopt the most appropriate mechanics. METHODS: This descriptive cross-sectional study was conducted at the Department of Orthodontics, Nishtar Institute of Dentistry, Multan, from 01-08-2020 to 01-02-2021. A sample of 165 patients was analyzed according to age, gender, presenting various occlusal traits, and relevant diastema findings to assess the underlying etiology of the maxillary midline diastema. Cases with a midline diastema of >0.5 mm were documented with examination including clinical intra-oral examination and orthopantomograms and upper occlusal radiographs. Examinations were done by the same observer to reduce human error and were cross-checked by a superior to minimize the possibility of error. The data was analyzed using SPSS version 20.0. RESULTS: Dental anomalies (n=113, 68.6%) was the most frequent cause of maxillary midline diastema. Dental anomalies were observed in both females (n=77/112; 68.8%) and males (n=36/53; 67.9%). Common dental anomalies included tooth/arch size discrepancies (n=58, 51.3%), abnormal occlusal patterns (n=37; 32.7%) and missing teeth (n=18 15.9%). Other contributing factors for maxillary midline diastema observed were abnormal maxillary arch structure (n=30; 18%), physical impediments (n=18; 11%), muscular imbalances (n=3; 1.8%) and pernicious habits (n=1; 0.6%). Common causes of physical impediments were fleshy labial frenum 10/18; 55.6%) and supernumerary tooth (n=8/18; 44.4%). CONCLUSION: Maxillary midline diastema was common in both genders and was associated with multiple etiologies of which dental anomalies, abnormal maxillary arch structure and physical impediments were highly prevalent. [ABSTRACT FROM AUTHOR]

The biologic aspects of facial growth are fundamentally important in dentofacial orthopedics. The beginning, intensity, onset, and duration of the pubertal peak of facial growth have great variations among patients. The aim of the present study was to find the puberty growth spurt age in local population for diagnostic and optimum treatment planning issues. Hand- wrist radiographs of 200 patients were evaluated according to Bjork's method of assessment to determine the puberty growth spurt age. The spearman rank correlation between chronologic age and skeletal maturation intervals was 0.731 (P<.001) for both the genders combined. The mean chronological age of females in accelerating, peak and decelerating growth spurt was less than male subjects. [ABSTRACT FROM AUTHOR]

Anterior open bite is defined as the absence of vertical overlap between the upper and the lower incisors when posterior teeth are in centric occlusion. The causes of anterior open bite depend upon multiple factors and can be attributed to environmental and genetic traits, reflected in pathologic (muscular dystrophy and cleft lip/palate) and developmental factors. The aim of this study was to determine the prevalence of anterior open bite in the permanent dentition in a sample of patients visiting Out Patient Department(OPD) of the Nishtar Institute of Dentistry, Multan. Research data was acquired by clinical examination of 249 patients (124 males and 125 females) having ages between 14-33 years with a mean age of 22.7±4.5 years. Detailed history and clinical examination measurements were made for anterior open bite. An edge-to-edge incisor relationship was recorded if the maxillary and mandibular incisors occluded on their incisal edges. Statistical Package for Social Sciences (SPSS) p rogram (version 20.0) was used for descriptive analysis of data. Overall the prevalence of Anterior open bite was present in 19(7.6%) patients while in females (8%) was found to be slightly higher than males(7.2%) having a ratio of 1.138:1. Out of these, 9(3.6%) patients had dental open bite while 10(4.0%) patients had skeletal open bite. Less severe open bite (<1mm) was more common, as observed in 16(6.4%) patients, than severe (>1mm) as observed in 3(1.2%) patients. [ABSTRACT FROM AUTHOR]

As generally accepted mean value of FH-SN angle is 7°. Many previously done studies have shown that fluctuation in FN-SN plane angle exists that might be due to racial or geographic variations. Study was conducted in Nishtar Institute of Dentistry, Multan in February 2019. Lateral cephalogram of 114 orthodontic patients were drawn using 3H pencil and FH-SN plane angle was measured and documented. Lateral cephalogram were ordered into different growth patterns (class I, class II and class III) using wits value. Average FH- SN angle was 7.79º±2.38º. Greatest angle was found in Class III patients. There is significant difference among the different skeletal patterns according to ANO-VA test. Average FH-SN angle among patients from Multan was 7.79°±2.38º. There is no significant difference among Class I, Class II and Class III orthodontic patients. [ABSTRACT FROM AUTHOR]

Cranial base growth effects the growth and rotation of entire viscreocranium. The cranial base through its articulation with maxilla and mandible is thought to have an impact on anteroposterior jaw positions.Although Scientific literature indicates a relation between deflection of cranial base and skeletal discrepancies, various studies done on effect of cranial base growth on facial complex seems to show conflicting results depicting both positive and negative correlation between the the two entities.The aim and purpose of this study, therefore, was to evaluate and assess the relationship and correlation (if there is any ) between various skeletal malocclusion and angle of cranial base.Cranial base angles (N-S-Ar)(N-S-Ba) were traced measured on lateral cephalograms of 100 patients with different horizontal skeletal dysplasias.In this study no differences were recorded between cranial base deflection angles (NSAr and NSBa) and three malocclusions groups I.e. Class I ,II and III. This study did not find/record any correla-tionship between cranial base angle and various skeletal dysplasias. [ABSTRACT FROM AUTHOR]