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Background/Aim. An impacted tooth is a tooth that could not erupt and take its place in the dental row. Impacted maxillary canines are a very frequent problem in orthodontic practices. They are the second most impacted teeth, right after the third molars. The aim of this cross-sectional study was to evaluate the two-dimensional and three-dimensional position of the impacted maxillary canines and make a descriptive study analysis of possible indicators of the impaction difficulty and risk factors for adjacent tooth root resorption. Methods. In this study, 94 subjects with 116 diagnosed maxillary canine impaction were included. The two-dimensional position of the impacted canines (IC) was evaluated on the panoramic projection of the cone beam computed tomography (CBCT) images. Canine position (CP) to the X, Y, and Z-axis was measured and scored using the novel classification system that incorporates three-dimensional information of CBCT imaging – the KPG index. Based on the KPG index value, impaction was defined as easy, moderate, difficult, and extremely difficult. In order to determine indicators of impaction difficulty and risk factors of root resorption of adjacent teeth, qualitative variables (gender, side of impaction, etc.) and quantitative variables [age, canine distance to the occlusal plane (OccP), etc.] were tested with multiple logistic regression. Results. The mean age of the sub-jects was 19.8 ± 5.2 years. The impactions were twice as prevalent in females compared to males. Most (71.4%) impactions were unilateral in palatal position of the canines. Adjacent root resorption was present in 27.3% of cases of impaction, and the central incisor was mostly affected. More than half of the impactions were of moderate level. In univariable analysis, canine distance to sagittal medial line (SML), angle between canine and SML, OccP, and first premolar, respectively, were significant in impaction difficulty prediction. Multivariable analysis showed that angle between canine and the first premolar could be a risk factor for adjacent root resorption. Conclusion. Most impacted maxillary canines were in the palatal position, with a KPG index value of moderate difficulty. Besides the position to the OccP and SML, angle between canine and the first premolar should be estimated, as a part of diagnostic procedures, to evaluate the risk of adjacent root resorption, prevent resorption, and decide on the treatment plan.

Introduction/Objective. Hypodontia is a common dental anomaly that occurs either in a non-syndromic form or as a part of various syndromes. It is considered a multifactorial condition with genetic, epigenetic, and environmental influences, the interplay of which can lead to various anomalies in tooth size and number. The aim of this study was to assess mesiodistal tooth dimensions in Serbian hypodontia orthodontic patients and compare them to healthy controls using digital study models. Methods. Fifty subjects (30 females, 20 males) divided into two groups – 25 with hypodontia (15 females, 10 males) and 25 sex-matched controls (15 females, 10 males) – were included in the study. Alginate impressions were taken and plaster models poured, digitized, and imported into software where mesiodistal dimensions were obtained. Results. Intra-operator reliability was high. All teeth in the hypodontia group had smaller mesiodistal dimensions compared to controls. Statistical significance was noted for all teeth except for upper canines. No statistically significant differences were found between males and females in neither the hypodontia nor the control group, except for lower canines, which were significantly smaller in both hypodontia and control females. The most commonly missing teeth were upper lateral incisors, and lower and upper premolars. Conclusion. Hypodontia group presented with smaller mesiodistal dimensions compared to controls. The greatest difference in mesiodistal dimensions was found in upper lateral incisors and lower first molars. Lower canines were significantly larger in males compared to females in both groups.

Background/Aim: This investigation aimed to evaluate the intensity of self-reported pain and frequency of self-medication with analgesics during the initial phase of orthodontic treatment with fixed appliances and to compare possible differences between the maxillary and mandibular teeth. Material and Methods: In this observational clinical trial 68 patients had similar orthodontic forces (the same bracket-slot and prescription, archwire size and material, and treatment plan) applied on maxillary and mandibular teeth. The patients recorded pain intensity and use of analgesics for the first seven days of treatment. Comparisons between maxillary and mandibular teeth regarding the pain intensity and self-medication frequency were performed by Wilcoxson Signed Ranks Test and McNamara Test for Matched Pairs, respectively. Results: The patients reported moderate pain in both jaws which decreased significantly with each day of treatment. Still, during the initial three days of treatment intensity of pain for maxillary teeth was significantly lower compared to the mandibular teeth. Patients reported analgesics consumption for both jaws, without a statistically significant difference between them. Conclusions: The patients have reported orthodontic pain of higher intensity in the mandibular arch compared to the maxillary arch during the initial phase of orthodontic treatment with fixed appliances.

Introduction/Objective. This study aimed to translate the original disease-specific Malocclusion Impact Questionnaire (MIQ) into Serbian and validate the new version in the cohort of young Serbian orthodontic patients. Methods. At the university clinic, 154 patients filled out the MIQ in Serbian before the start of the orthodontic treatment; 112 participants filled out the same questionnaire four weeks later. The Index of Orthodontic Treatment Need – Dental Health Component (IOTN-DHC) and Peer Assessment Rating (PAR) pretreatment scores were recorded. Descriptive statistic, Cronbach’s α, Spearman’s ρ, and exploratory factor analysis, followed by parallel analysis for factor reduction, were calculated and analyzed. Results. One hundred forty-eight patients with no missing responses (51 male, 97 female), of the average age of 13.3 ± 2 years, had MIQ total scores mean of 10.14 ± 7.451. Internal reliability (α = 0.913), external reliability (ρ = 0.906; p = 0.000), construct validity tested by MIQ total scores and two global question scores’ correlations (ρ = 0.682; p = 0.000 and ρ = 0.366; p = 0.000), as well as clinical validity tested by correlations of MIQ total scores with PAR pretreatment scores (ρ = 0.181; p < 0.05), and IOTN-DHC scores (ρ = 0.192; p < 0.05) were positive and statistically significant. One item factor was extracted and it explained a large part of the cumulative variance. Conclusion. Reliability and validity of the translated and cross-culturally adapted MIQ in Serbian is satisfactory. It could be used for malocclusion-related quality of life assessments in young Serbian orthodontic patients.

The objective of this study was to assess pre-treatment quality of life and the relevant clinical variables in adult patients with malocclusion in order to improve orthodontic treatment strategies.

The impaction of maxillary canines is one of the biggest challenges in orthodontics practice. This case report describes successful surgical and orthodontic approach to the treatment of palatally impacted maxillary canine in a 14-year-old boy. Intraoral clinical examination revealed an absence of the upper right canine, an ectopic position of the upper left canine and crowding in the maxillary arch. The impaction of right maxillary canine and class II malocclusion were confirmed by lateral cephalogram, orthopantomogram and cone beam computed tomography. In the first phase, a transpalatal arch to the upper first molar teeth was applied, first premolars were extracted, and brackets were placed on all teeth and nickel-titanium arch wire was applied. The initial orthodontic phase was soon thereafter followed by the surgical exposure and orthodontic traction of the impacted canine using ligature wire attached from the button with chain to the open coil on the arch wire. The orthodontic treatment took two years with satisfactory aesthetic and functional results at the end. This clinical case has shown that adequate treatment of impacted maxillary canine can be achieved by using combined surgical technique and appropriate orthodontic approach.

Introduction/Objective. After an orthodontic brackets debonding procedure it is necessary to remove any residual adhesive from the tooth surface, as this is a common cause of enamel damage. The aim of this study is to evaluate the enamel surface after the application of six different methods of adhesive removal following brackets debonding, as well as to compare the duration of these procedures. Methods. For the purpose of this study, 245 human premolars were extracted as part of the orthodontic treatment. Metal brackets were bonded to 210 human premolars with the Aspire adhesive system. After the debonding of brackets, the samples were divided into six groups according to the adhesive removal method applied: tapered fissure tungsten carbide bur, round tungsten carbide bur, composite bur, abrasive disc, adhesive removing pliers, and ultrasonic scaler. Out of 245 premolars, 35 served as a control group. The duration of adhesive removal was recorded. Enamel damages were estimated according to the enamel surface index on the scanning electron microscopy images. Results. Maximum preservation of the enamel surface was accomplished by using a composite bur (1.08). The application of abrasive disc was significantly less time-consuming in comparison to the application of a composite bur (p < 0.01) and an ultrasonic scaler (p < 0.01). Conclusion. The most harmful for the enamel surface was the use of an ultrasonic scaler as well as a round tungsten carbide bur. Adhesive removal done by an abrasive disc thus proved one of the least damaging and the least time-consuming methods.

Introduction/Objective. Rapid developments in information technologies lead to the wider use of digital representations of dental study models in orthodontics. Most popular way of digitizing the models is to use a 3D scanner and then perform measurements on 3D models, which requires additional and expensive hardware and software resources. In this paper we present an alternative approach based on the use of photogrammetry in the newly developed OrthoPhoto4D software that calculates and corrects perspective distortion errors. Methods. We measured individual tooth width for 24 teeth, 12 two-teeth segments as well as inter-molar and inter-canine distances on 50 models. Measurements are performed in OrthoPhoto4D software that uses four photographs of each model for measurements, uses QR codes for automation, calculates the camera position and corrects perspective distortion-caused errors in measurements. Obtained measurements are compared to ones obtained from models generated by structured light 3D scanner. Results. Statistical analysis strongly indicates that there is no significant difference between the two methods. The recorded differences also have no clinical impact as they have mean values of 0.2 mm for individual tooth widths, approximately 0.2 mm for two teeth segments, and under 0.3 mm for both intercanine and inter-molar distances. All recorded differences fall within the expected measurement error. Conclusion. We concluded that the described photogrammetry measurements performed in OrthoPhoto4D can be used in diagnosis and therapy planning.

Backrgound/Aim. Researchers in the field of dentistry have been conducting research into modelling and defining dental arches equitations. Nowadays, when 3D digital modelling is commonly utilized in dentistry, the approach to modelling, analysis and synthesis has changed. Clinical researches are related to aesthetic and functional analysis. The aim of this study was to increase repeatability and accuracy of defining and determining the coordinate system of the jaw as well as to defining mathematical criteria for monitoring and evaluating orthodontic treatment. Methods. In this study, we used the plaster models of the jaw, optical scanner with structured light, 3D digital models, computer aided design (CAD) engineering tools adjusting the coordinate system, spline fitting of 3rd, 4th, 5th, 6th, 7th and 8th degrees. Results. Splines of 3rd, 4th, 5th, 6th, 7th and 8th degrees were fitted from the initial state (K0) in all 10 successive controls (K1, K2, K3,…, K10). All splines were fitted through 12 points, from the right to the left side of the jaw: 6-5-4-3-2-1-1-2-3-4-5-6. Tabular and graphic presentations of the maximum and average deviation of dental arch fitting curves in successive controls were given. Conclusion. The parameters of the maximum and average errors of fitting curves converge the dental arch values that are lower than the accuracy of the used optical scanners. The average error of fitting provides a general picture of the entire dental arch at each stage of treatment. Maximum error fitting points at a specified tooth where the largest deviation. This article has been corrected. Link to the correction 10.2298/VSP190515051E

Tooth agenesis is common dentofacial malformation in humans. Its etiology is still not clear. Hypodontia has been regarded as a multifactorial condition influenced by gene function, environmental interaction and developmental timing. More than 300 genes have been related with patterning, morphogenesis and cell differentiation in teeth. According to data WNT10A gene is considered to have an important role in odontogonesis. The aim of this study was to show mutation status in WNT10A gene in a family with two members with diagnosis of hypodontia/oligodontia. In the reported family (father, mother, son, daughter) children were diagnosed with congenital tooth agenesis (son-2 teeth, daughter-11 teeth), while parents negated congenital absence of teeth. We identified a heterozygous missense mutation, c.682T>A (p.Phe228Ile) within the exon 3 of WNT10A in mother and father and the same homozygous mutation was detected in the same region of WNT10A gene in daughter and son. Observed differences in our study, from no symptoms to mild/severe hypodontia, could be the consequence of genetic influence of c.682T>A(p.Phe228Ile) mutation, but also the contribution of many environmental factors during odontogenesis.

Introduction Lundstrom segmental analysis is often used analysis in orthodontic diagnosis. It includes measurements of available and needed space in the arch in order to determine whether there is a lack or excess of space for proper teeth alignment. Measurements are traditionally performed on plaster study models, but with recent developments of computer-based systems, there is an increase in use of digital models in measuring process. The aim of this study was to present a photogrammetry based measurement approach that requires no specialized and expensive hardware and compare results with ones obtained on 3D scanned models. Material and method On 50 plaster study models measurements of 24 teeth, widths of 12 segments and Lundstrom segmental analysis were performed. 3D scanned study models were analyzed in the photogrammetry software OrthoPhoto4D on the set of four photographs of the study model in custom made measurement apparatus. The software corrects for finite distance of the camera and corrects errors due to perspective distortion. Results Statistical analysis performed on obtained measurements provided Bland-Altman plots that strongly suggested high degree of correspondence between the two measurements methods. Discrepancies for maxilla for individual segments were under 0.25 mm with standard deviation of up to 0.16 mm, and less than 1 mm and deviation of up to 0.4 mm for complete arch. For mandible the differences were up to 0.27 mm for segments with 0.15 mm deviation and 0.6 mm for complete arch with up to 0.24 mm deviation. Correlation coefficient was over 0.985 in all cases. Conclusions Both analyzed methods can be equally used in clinical practice.

Introduction/Objective. Class II malocclusions are sagittal malocclusions characterized by a distal relationship of posterior teeth. Depending on the underlying problem, class II can be skeletal or dentoalveolar. Class II treatment modality will depend on the cause, severity and age. Growth modification is the best treatment option in skeletal Class II growing patients. The aim of this study was to establish and compare sagittal and vertical skeletal and dental changes in patients treated with the “M block” appliance, the Fränkel functional regulator and the Balters’ Bionator. Methods. The sample consisted of 70 patients diagnosed with skeletal class II (ANB > 4°) and mandibular retrognathism (SNB < 80°). Patients were divided into 3 groups according to the type of appliance. All patients went through the standard diagnostic procedure (anamnesis, clinical and functional analysis, study model, panoramic radiograph and cephalometric analysis) and dental and skeletal age was determined. Treatment effects were analyzed on study models and cephalograms at the end of treatment. Results. All appliances led to significant mandibular anterior movement and sagittal growth, which reduced ANB values. All three groups of patients presented with neutral growth pattern, upper incisor retrusion and lower incisor protrusion at the end of treatment. Conclusion. Results of this study indicate efficacy of all three appliances in skeletal class II treatment.

Background: 3D modelling in orthodontics is becoming an increasingly widespread technique in practice. One of the significant questions already being asked is related to determining the precision of the scanner used for generating surfaces on a 3D model of the jaw.

Introduction/Objective. Digital 3D modeling is slowly becoming an everyday orthodontic practice, and after two decades of research and development it is a basic element of e-orthodontics. The aim of this study was development and use of geometric entities on 3D digital models for diagnosing, planning and monitoring of orthodontic therapy, by using CAD (computer aided design) systems. Methods. Statistical analysis and synthesis of 54 orthodontic parameters (28 in the upper and 26 in the lower jaw), defining three hypotheses and their testing, the application of the t-test. Results. All three hypotheses are confirmed, convenience of using geometric entities, higher accuracy of 3D digital models, and more substantial displacement of teeth in the first six months of therapy (Student’s t-test). After the first six months, distances in the x–y plane (occlusal plane) were bigger in both the upper and the lower jaw; additionally, the distances in the y–z plane (medial plane) decreased on the left and right side, so we can say that the first phase of therapy had success and that both jaws are wider. At the next four controls, parameters showed slight progress that was not statistically significant. Overall, after 11 months of therapy, there was a considerable improvement in the x–y plane, while changes in distances of clinical crown heights were very small. This could be explained by the fact that, during therapy, by using different arches, upper molars were pushed inside, toward the palate. Analyzing 3D computer models, we could notice that in this plane displacement of the upper left first molar was larger. Conclusion. The use of geometric entities for defining orthodontic parameters gives us new possibilities for accurate and reliable analysis of patient’s orthodontic condition.

Introduction. Orthodontic diagnosis includes the interpretation of the relations between the craniofacial and cervical system, given the potential impact of the irregularities from one system to another. Objective. The aim of this study was to examine morphological characteristics of the cervical spine, depending on the parameters of the vertical craniofacial growth and gender in adult subjects. Methods. The sample comprised lateral cephalograms of 120 subjects with different vertical facial growth, aged 17.5-35 years. Measured parameters were the following: anterior and posterior vertebral body height (ABHC2-C5, PBHC2-C5), anterior and posterior intervertebral space (AISC2-C5, PISC2-C5), distance between vertebrae and point sella (SC2, SC3, SC4), pterygomaxillare (PmC2), gonion (GoC2) and basion (BaC4); cervical spine angulation (OPT/CVT) and inclination (OPT/HOR, CVT/HOR). Results. Results showed that subjects with anterior facial growth rotation have greater values for BaC4, OPT/HOR, CVT/HOR, OPT/CVT, anterior and posterior vertebral body heights and intervertebral spaces, and lower values for GoC2 and PmC2. Higher values in males were found for anterior and posterior vertebral body heights, distances SC2, SC3, SC4, and BaC4. In females, the greater values were found for GoC2 and ОРТ/СVT. Conclusion. Subjects with anterior facial growth rotation have greater cervical spine inclination and angulation, higher cervical vertebrae and intervertebral spaces, longer upper cervical spines and shorter distances GoC2 and PmC2. Males show smaller cervical column curvature, but higher cervical vertebrae and greater length of the upper cervical spine.

Class III malocclusion is orthodontic anomaly where mandibular arch is in mesial position to maxillary arch. Reasons for Class III malocclusion can be found in mandibular prognathism, maxillar retrognathism or combination of these two. In most cases of mandibular prognathism, it is necessary to postpone the treatment until the growth ceases. However, if certain conditions are accomplished it is possible to start early treatment of class III malocclusion to improve occlusal relations and provide more favorable environment for future growth. The aim of this study was to present treatment of two patients with Class III maloclussion in early mixed dentition, using two different appliances: Delaire mask and Frankel functional regulator type 3. The treatment with Delaire mask resulted in rotation of maxilla downward and forward due to the angle of extraoral part of the mask to the occlusal plane that was modified to be almost 45°. At the end of the treatment facial esthetics was significantly improved. Moving maxilla forward resulted in straight profile, whereas moving maxilla downward lead to coordination of upper, middle and lower facial third. The result of the treatment in patient who used Frankel functional regulator was correction of anterior crossbite by premaxilla development and incisors protrusion. Significant differences in SNA, SNB and ANB angle values at the beginning and at the end of the treatment were not found suggesting that most changes were dental but not skeletal.

Introduction. During growth, proportions of craniofacial and cervical structures are changed. Craniofacial and cervicovertebral structures are morphologically and functionally connected, but their each other’s influence is still unknown. Objective. The aim of this study was to determine the changes in cervical lordosis and cervicovertebral morphology in different age periods and the possibility of estimating skeletal maturity, based on the percentage of anterior cervical vertebrae body height sum in the total anterior C2-C5 height. Methods. The study included lateral radiographs of 120 patients of both sexes, divided into three different age groups: eight, 12-13 and 17-18 years of age. Five craniofacial and 15 cervical parameters were measured and analyzed. Results. The results showed significant correlation between cervical lordosis angle and age, gender, anterior and posterior body height of C3, C4, C5, anterior C4-C5 and posterior C2-C3, C3-C4, C4-C5 intervertebral space, anterior body height of C2-C5. Overall values of all cervical body heights were more present in the total height of the spine in females, while all intervertebral spaces were more present in males. The percentage of anterior and posterior C2, C3, C4, C5 body height sum compared to total C2-C5 height increases with age. Conclusion. The cervical lordosis becomes more curved and vertebral bodies occupy more space in females, while intervertebral spaces occupy more in males. Skeletal maturity could be estimated following vertebral percentage distribution in the total anterior C2-C5 part.

Introduction. Forces generated in orthodontic treatment with fixed appliances create tension and compression zones in the periodontal ligament resulting in a painful experience for patients. In the first phase of orthodontic treatment, when leveling of teeth is needed, nickel-titanium (NiTi) archwires can be completely engaged in brackets, even in the cases of extreme crowding, exerting small forces. There is a great individual variation in the pain perception related to the application of orthodontic forces. Objective. The aim of this study was to investigate the pain perception among patients with dental crowding after insertion of six different NiTi orthodontic archwires as a part of fixed appliances in the first stage of orthodontic treatment. Methods. The study was conducted on a sample of 189 orthodontic patients receiving one of six different either superelastic or heat activated NiTi archwires, in the first phase of orthodontic treatment. Pain perception was evaluated in groups of patients with different degree of crowding. The modified McGill Pain Questionnaire with Visual Analogue Scale was used to evaluate the quality and intensity of pain. Statistical analysis was performed using simple descriptive statistics, and Pearson`s chi-square test with statistical significance of p

Introduction. Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surrounding tissues, bones and muscles. These changes may also affect the dimensions of the pharyngeal airways (PA). Objective. The aim of this study was to evaluate and compare three-dimensional PA changes in patients treated by a combination mandibular set-back/maxillary advancement versus patients that had bimaxillary advancement with genioplasty. Methods. The sample consisted of 7 patients treated by combined mandibular set-back/maxillary advancement and 7 patients treated with bimaxillary advancement surgery. Nasopharyngeal (NP) volume, oropharyngeal (OP) volume and the area of maximum constriction (AMC) in the OP were measured on CBCT scans (2 mA/120 kV/12’’ FOV) taken before (T1) and 3 months after surgery (T2). Paired samples t-test was used for analyzing statistical significance of changes (p≤0.05). Results. OP volume and AMC increase after bimaxillary advancement was statistically significant, while for the mandibular set-back group the increase was non-significant. NP volume was not reduced in any of the two groups. No significant differences in PA dimensions were found between groups at neither T1 nor T2 time points. Conclusion. Results suggest that the combination of mandibular set-back/maxillary advancement did not reduce airway dimensions, while bimaxillary advancement surgery led to a statistically significant increase in the OP dimensions.

Introduction. The placement of fixed orthodontic appliances may lead to increased plaque accumulation and changes in subgingival microflora. Objective. The aim of this study was to examine the changes in frequency of subgingival microflora that occur after placement and removal of fixed orthodontic appliance using polymerase chain reaction (PCR). Methods. This study included 33 orthodontic patients, who were divided into two groups. Subgingival plaque samples were collected from the right upper incisor (U1) and right upper first molar (U6). In group A, the samples were taken three times: before placement appliance (T1), after one month (T2), and after 3 months (T3). In group B the samples were also taken three times: before appliance removal (T1), after one month (T2), and after three months (T3). PCR method was used to determine the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythia, and P. intermedia. Results. In group A the frequency of P. gingivalis showed statistically significant decrease at U1 (p=0.049) and U6 (p=0.008), from T1 to T2, and at U1 (p=0.048) from T1 to T3. In group B only the frequency of T. forsythia showed a statistically significant decrease, at U6 (T1 vs. T2, p=0.004; T1 vs. T3, p=0.0003). Regarding other analyzed bacteria, changes in the presence were noticed but no statistical significance was found. Conclusion. Placement of fixed appliances may have an impact on subgingival microflora, but in the first months after the placement and removal of the appliance changes were not significant, probably due to good oral hygiene. [Projekat Ministarstva nauke Republike Srbije, br. 175075]

3D modeling is often used in orthodontics. Most commonly used software today is problem- oriented CAD system (OrthoCAD and others), as well as general CAD software for engineering modeling. Both methods require definition and use of various geometric entities to describe and monitor orthodontic status, but still there have been more than one approach to definition of geometric entities that characterize orthodontic parameters. The aim of this study was to define the referent geometric entities (RGE) on 3D models, perform their classification and provide examples of their application. For defining and monitoring orthodontic parameters the following RGE groups are used: (a) basic geometric entities (point, line, straight line, plane, curve, curved surface); (b) derived geometric entities (coordinate origin, coordinate system, coordinate plane, axis, edge, perspective); and (c) anatomical geometric entities (surfaces, points). In this study, using 11 examples is shown how orthodontic parameters can be modeled over three classification groups RGE. Presented analysis and RGE examples indicate that RGE give interdisciplinary and systematic approach to computer modeling in orthodontics, and create a basis for development and implementation of methods of anatomical features in orthodontics which can be used to set up an integrated orthodontic parameter.

Introduction. Anthropological studies show craniofacial changes with a reduction in teeth size during evolution of the human population. Objective. The objective was to measure and compare the sizes of teeth in the population of the Mesolithic-Neolithic sites in the Iron Gate Gorge and the population from the Early Bronze Age site of Mokrin. Methods. The study included teeth without advanced wear near the pulp. The material was divided according to the site of the skeletal population in two groups. Group 1 comprised 107 teeth from the Mesolithic-Neolithic sites Lepenski Vir and Vlasac. Group 2 included 158 teeth from the Mokrin graveyard dated in the Early Bronze Age. The mesio-distal diameter was measured in all teeth, while the vestibulo-oral diameter was measured in the molars only. Using the two-factor analysis of variance, the influence of sex, site and their interaction on the size of the teeth were investigated. Results. The vestibulo-oral diameter of the upper third molar was significantly higher in males compared to females. The comparison between the groups showed that the vestibulooral diameter of the lower first molar was significantly higher in group 1. Conclusion. The present difference in teeth size indicates the existence of reduction during the prehistoric times. However, the time period between the populations studied is probably too short to be manifested on a large number of teeth.

Introduction. Therapy with fixed orthodontic appliances starts with bracket bonding and ends with debonding of brackets, leaving enamel surface varied. Objective. The aim of this pilot study was to examine enamel surface before and after debonding of orthodontic brackets by the use of scanning electron microscopy (SEM). Methods. Epoxy replicas of four patients’ premolars indicated for therapy with fixed orthodontic appliances were made and brackets were bonded to their teeth with a different adhesives (Enlight, No-mix, Fuji Ortho LC and Heliosit Orthodontic) (n=4). Two months later, brackets on premolars were debonded and amounts of adhesive left on the tooth surfaces and the bracket bases were evaluated with the adhesive remnant index (ARI). After resin removal, epoxy replicas were made and the surface of premolars was evaluated with the enamel surface index (ESI). All replicas of premolars (n=32) were prepared for SEM examination and compared under different magnifications. Tooth damage was estimated based on correlation between ARItooth and ESI. Results. Pearson’s χ2 test showed no significant differences between ARItooth and ARIbracket of four materials used. Nonparametric correlations showed significant differences between ARItooth and ARIbracket, ESI and ARItooth, and between ESI and ARIbracket. Increasing of ARItooth is followed with the descent of ARIbracket and the ascent of ESI. Multivariate regression analysis showed a significant correlation between ESI and ARItooth. Conclusion. Most bond failures took place at enamel-adhesive interface. ARItooth was a predictor to enamel surface damage. The type of material did not affect enamel surface damage.

Introduction. A successful treatment outcome in dentofacial deformity patients commonly requires combined orthodontic-surgical therapy. This enables us to overcome functional, aesthetic and psychological problems. Since most patients state aesthetics as the primary motive for seeking therapy, cephalometric predictions of treatment outcome have become the essential part of treatment planning, especially in combined orthodontic-surgical cases. Objective. The aim of this study was to evaluate the validity and reliability of computerized orthognathic surgery outcome predictions generated using the Nemotec Dental Studio NX 2005 software. Methods. The sample of the study consisted of 31 patients diagnosed with mandibular prognathism who were surgically treated at the Hospital for Maxillofacial Surgery in Belgrade. Investigation was done on lateral cephalograms made before and after surgical treatment. Cephalograms were digitized and analyzed using computer software. According to measurements made on superimposed pre- and postsurgical cephalograms, the patients were retreated within the software and the predictions were assessed by measuring seven angular and three linear parameters. Prediction measurements were then compared with the actual outcome. Results. Results showed statistically significant changes between posttreatment and predicted values for parameters referring to lower lip and mentolabial sulcus position. Conclusion. Computerized cephalometric predictions for hard-tissue structures in the sagittal and vertical planes, as well as the VTO parameters, generated using the Nemotec Dental Studio NX 2005 software are reliable, while lower lip and mentolabial sulcus position predictions are not reliable enough.

Background/Aim. Occlusal indices are quantitative diagnostic indicators of malocclusion severity, orthodontic treatment need, complexity and outcome. The aim of this study was to determine correlations and agreement among three occlusal indices: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON) in evaluating orthodontic treatment need. Methods. A total eighty study models of patients referred to the Department of Orthodontics, School of Dentistry, Belgrade, were assessed in this retrospective study. Malocclusions of various types and severity in the permanent dentition were included. Results. The Aesthetic and the Dental Health Component of IOTN determined orthodontic treatment need in 25% and 51% of the patients, respectively. PAR determined orthodontic treatment need in 59% and ICON in 53% of patients. The Aesthetic Component of IOTN and ICON had the highest correlation (Spearman's correlation coefficient 0.95, p < 0.01). Correlations between indices were 0.44 to 0.61 with statistical significance (p < 0.01). The agreement between indices, calculated using Kappa statistics, was 0.22 to 0.63. Conclusion. The most critical in malocclusion assessment was PAR. The Aesthetic Component of IOTN and ICON correlated highly (p < 0.01). Correlations between other pairs of indices were moderate (p < 0.01). The Aesthetic Component of IOTN and ICON had substantial agreement, whereas agreement between other indices was fair or moderate. ICON could replace PAR and IOTN. Application of occlusal indices enables objective evaluation of orthodontic treatment need and easier determination of the treatment priorities.

Background/Aim. Functional appliances can be used effectively in the treatment of skeletal Class II/1 malocclusions. The best treatment results are obtained during active period of facial growth when skeletal, as well as dentoalveolar, changes occur. In comparison with removable functional appliances, such as activator, that are effective only during adolescent period of growth, the Herbst fixed appliance is also successful at the end of the growth period. It also offers a shorter treatment time and a patient compliance is not necessary. The aim of this study was to analyze and compare dentoalveolar changes in the group of young adult patients with Class II/1 malocclusion treated with the Herbst appliance and an activator. Methods. The sample for this study consisted of 50 patients of both sexes, 14-21 years of age with Class II/1 malocclusion. For estimating the effect of functional appliances used, the following cephalometrics parameters were determined: inclination of the upper and lower incisors, interincisal angle, antero-posterior molars relationships, overjet and overbite. The results obtained were statistically tested. Results. The cephalometric findings after the treatment indicated retroinclination of upper incisors (average value of 9°) and proclination of lower incisors (average value of 7°), mostly expressed in the patients treated by Herbst appliance (p < 0.001). Increased overjet and distocclusion were completely corrected in the group of patients treated with the Herbst appliance, while the correction of malocclusion in the activator group was only partially accomplished. No changes in the overbite were noticed at the end of the treatment in both groups. Conclusion. The results of this study revealed that the Herbst appliance is more effective in the treatment of Class II/1 malocclusion in young adults in comparison with the activator.

Background. Inheritance is most casual etiological factor of Class II division 2 malocclusion. This kind of malocclusion is very difficult for treatment specially in older patients. Case report. In the female patient, 20 years old, at the beginning of the treatment at the School of Dentistry in Belgrade, lateral cephalogram showed skeletal and dentoalveolar Class II division 2 malocclusion. She was in the Herbst treatment for 8 months and 12 months more with a fixed multibracket appliance. The measurements were performed on lateral cephalograms before and after the treatment: ii, is, mi, ms, Pg and ss. The distance from these points to occlusal perpendicular line (Olp) were measured and compared from cephalogram before to cephalogram after the treatment. Temporomandibular joint (TMJ) tomograms were compared from before and after the treatment by superimposition. Correction was found in molar and incisor relation, overjet and overbite. There were found sagital skeletal changes and soft tissue profile improvement. Conclusion. Herbst appliance is effective in the treatment of Class II malocclusions, even in adult patients. Dental and skeletal changes as a result of Herbst treatment could be good choice instead of camouflage orthodontics or surgical decision.

Introduction. Occlusal indices were designed to improve diagnostic criteria and to enable an objective assessment of malocclusion severity. The aim of this study was to present the most frequently used occlusal indices in orthodontic practice and to determine their reliability when applied to dental models. Material and Methods. Three occlusal indices were selected for analysis: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON). Twenty dental models of patients referred to Department of Orthodontics, School of Dentistry, Belgrade, with malocclusions of different type and severity were used in this study. All dental models were measured by three afore mentioned indices twice, two months apart, in order to determine intraexaminer reliability. Results. The results showed that three indices had good reliability. Weighted Kappa was calculated for IOTN (0.72 and 0.79 for the aesthetic and the dental health component, respectively) and root mean square error was calculated for PAR and ICON (2.1 and 4.5, respectively). There was no statistically significant difference in scores between two measurements of these two indices (p

Treatment plan in contemporary orthodontics cannot be imagine without analyzing soft tissue facial characteristics besides assessment of jaw and dental relationships. Aim. Using a questionnaire, we aimed this study at establishing facial characteristics, in relation to sagittal and vertical facial ratios, which are considered aesthetically acceptable, and which could be altered by the means orthodontic treatment. Material and Method. The research was conducted in persons from 23 to 30 years of age whose photographs were taken in standard conditions. Photographs of three patients with different facial profiles were chosen (Class I, Class II and Class III). Every photo was modified in six new profiles by changing facial features. This included mesial and distal shift of maxilla and mandible, as well as increase and decrease of lower facial height. Results. The results showed that straight profile, which is most often present in normal jaw relationships, is considered the most beautiful, furthermore slightly convex profiles are also considered very attractive. Convex profile is connected with distal jaw relationship and its intensity affects facial attractiveness. Concave profile in patients with mesial jaw relationship is aesthetically the least acceptable.

The aim of this study was to examine the efects of Delair`s mask on facial skeleton in patients with Class III antero-posterior jaw relationship. Two groups of children were evaluated. The first group of 34 children with Class III was treated with Delair`s mask. The second group of 46 children with Class III did not receive any orthodontic treatment and was presented as a control group. In the first group pretreatment and post treatment radiographic tracing was done while second tracing in the control group was done a year after diagnostic radiographic tracing. Analysis of the skeletal facial profile was done measuring SNA, SNB and ANB angles. Rotation of the maxillary base (NS/SpP), rotation of the mandibular base (NS/MP) and vertical relationship between jaws (SpP/MP) were also measured. The results were statisticaly analysed using T test, descriptive statistics and Wilcoxon`s test. The results of this study showed changes in facial skeleton in children treated with Delair`s mask compared to the control group. In the first group of children SNA and ANB angles were increased and the SNB angle was decreased.

The aim of this investigation was to assess the craniofacial morphology of five male individuals with 46,XX chromosomal constitution, and to compare them with normal male individuals (46,XY) and normal female participates (46,XX). The investigation was carried out on the lateral cephalomestic radiographs of five male individuals with sex reverse syndrome (46,XX chromosomal constitution), 62 normal female (46,XX) and 31 normal male (46,XY chromosomal constitution) participants. The following angular variables were measured: SNA, SNB, ANB, SN/SpP, SN/MP and SpP/MP. For each variable the mean value and standard deviation were calculated. The Student t-test was used to compare the result obtained between the group of patients with sex reverse syndrome and group of normal male, as well as of normal female participants. The male individuals with 46, XX chromosomal constitution showed slight bimaxillary retrognathism, and class III sagittal jaw relationship. Due to decreased inclination of the upper jaw to the anterior cranial base, the angle of vertical jaw relationship slightly increased in the group of patients with sex reverse syndrome, compared to normal male and female participants.