Orthodontic Journal of Nepal 2022-02-22T00:00:00+00:00 Dr Manish Bajracharya Open Journal Systems <p>The official journal of the Orthodontic and Dentofacial Orthopedic Association of Nepal (ODOAN). The Orthodontic Journal of Nepal is a peer reviewed journal published biannually with an open access and dealing with the applied as well as theoretical researches in the field of orthodontics. The journal does not charge article processing fees or submission charges.</p> <p>From August 2018, the journal is accepting online submissions. Please register and follow the 5 step submission process.</p> Comparison of anteroposterior lip positions of the most preferred facial profiles of the Nepalese people 2022-02-20T13:41:48+00:00 Manish Bajracharya Umesh Parajuli Abhilasha Khanal Neesha Shrestha Ujjwal Pyakurel <p><strong>Introduction:</strong> Though cephalometric analysis of both hard and soft tissue has been done extensively for the treatment planning in orthodontics and orthognathic surgery in Nepalese people for years, they are all based on the norms for the Caucasians. No research has been done to establish the most favored profile amongst the Nepalese. The purpose of this study was to find out the most preferred well balanced or most favored facial profile from a series of 13 silhouettes with varying position of anteroposterior lip position by a group of Nepalese lay persons and general dental surgeons.</p> <p><strong>Materials and Methods:</strong> Average profile for male and female were constructed from the profile of 50 Nepalese males and females with normal occlusions and without history of orthodontic and prosthetic replacement. The lips were then protruded or retruded in 1-mm increments and a series of 13 silhouettes were constructed for each male and female with the average profile in the center. The silhouettes were then given to 500 dental surgeons and lay persons each and were asked to rank the 3 most preferred facial profiles in order of preferences.</p> <p><strong>Result:</strong> Both the general dental surgeons and the lay persons tend to prefer flatter profile than average for both the sexes. Both the groups preferred more flat profile for women compared to males. The least favored profile was the most protrusive one for both the groups.</p> <p><strong>Conclusion:</strong> This research shows that lay persons and the general dental surgeons preferred retruded profile than the average profile though prior research show that Nepalese people have an average profile convex</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Correlation of vertical dimension with lip position, nasolabial angle and incisal display at rest and at smile in young adults 2022-02-20T13:54:44+00:00 Jahamgeer Badusha S Purva Joneja Anshu Agarwal Deepak Singh Choudhary <p><strong>Introduction:</strong> Photography has been given a great importance in diagnosis in orthodontics, the study of certain aesthic parameter on digitilzed photographs can provide an additional diagnostic tool. This study is designed to compare facial parameters and various photographic parameters among patients with long, average, short faces in central Indian population. Also an alternative method to cephalometric analysis needs to be worked upon which is reliable, easily assessable and convenient for multiple usage by the orthodontist to direct his/her treatment.</p> <p><strong>Materials and Methods:</strong> 150 subjects (75 males and 75 females) selected and examined by two methods clinical examination and photographic examination by using ImageJ software.</p> <p><strong>Results:</strong> The results of this study shows there is significant correlation between vertical dimension, incisal display upper lip length, lower lip length and nasolabial angle and there is no significant difference between clinical examination and photographic examination done with Image J software.</p> <p><strong>Conclusion:</strong> This study concluded that the vertical proportions of facial soft tissue follow the underlying vertical skeletal pattern, high vertical dimension is associated with short upper lip, more incisal display and high clinical FMA. The low vertical dimension is associated with acute nasolabial angle and low clinical FMA. Photogrammetry was found to be a quick easy, cost effective and reliable diagnostic tool which can reduce radiation exposure and reduce the number of cephalograms during treatment</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Assessment of Palatal Height Index and palatal form in different malocclusions in adult patients visiting Nishtar Institute of Dentistry, Multan 2022-02-20T14:23:40+00:00 Asia Khalid Faisal Rasheed Zubair H. Awaisi <p><strong>Introduction:</strong> This study was conducted to evaluate the palatal height index in different malocclusion because of appearance of variable palatal heights &amp; palatal forms</p> <p><strong>Materials &amp; Method:</strong> In this study 108 adult subjects (41 males, 67 females), age ranges from 13-28yrs, were randomly selected from Orthodontic Department In Nishtar Institute of Dentistry Multan. Their impressions were taken by the Alginate and dental casts were formed and lateral cephalograms were collected. One sample t test was used to calculate the results.</p> <p><strong>Result:</strong> Descriptive statistics showed mean palatal index of 60.95% in skeletal class I, 48.31% in skeletal class II, whereas 61.26% in skeletal class III. Frequency distribution in different skeletal patterns showed 100% high palate in class I and class III whereas skeletal class II showed variety in palatal form with 82.3% high palate, 11.3% medium palate and remaining 6.3% was low palate. major portion of the sample had high palate.</p> <p><strong>Conclusion:</strong> Mean index in Skeletal Class I is 60.95 %, 48.31% in skeletal class II, 61.26% in skeletal class III. Mean palatal height index in females is significantly higher than in males. Skeletal class II has variety of palatal form with high prevalence of high palate. Most common palatal form is high palate.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Lip length and its correlation among different age group and gender in Nepalese Population 2022-02-20T14:30:40+00:00 Binam Sapkota Ujjwal Rimal <p><strong>Introduction:</strong> The Dentofacial composition includes the lips and the smile as they relate to the face which provide the valuable information to the clinician when evaluating smile esthetics.</p> <p><strong>Aims and objectives:</strong> To determine the relation of lip length and incisor visibility during rest and smile among different age groups and gender.</p> <p><strong>Materials and Method:</strong> A cross sectional study was done in 158 participants of age group between 19-40 years and above. They were seated in an upright position at rest. Then the lip length was recorded with a calibrated digital caliper measuring from subnasale to stomion superius and categorized into short, normal and long lips. Similarly maxillary incisor visibility was observed on rest and during full smile. The data obtained were then analyzed with SPSS software (version 22) and student- t test and ANOVA test was used to compare the measurements.</p> <p><strong>Results:</strong> It has been found that there is no significant of lip length in relation to gender and different age groups. Whereas average lip length has been found to be 21.2±2.3mm in male and 19.4±1.9mm in female. On the other hand significant difference is found in incisor visibility in different age groups and gender during smile.</p> <p><strong>Conclusion:</strong> Within the limitation of the study, a significant difference has been found in the incisor visibility when compared between gender and age groups in full smile whereas there is no difference in the lip length in male and female group.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Association of pain between elastomeric and the kesling sparators in the orthodontic patients 2022-02-20T14:40:01+00:00 Abhilasha Khanal Manish Bajracharya Neesha Shrestha <p><strong>Introduction:</strong> Pain may be experienced during the first 3-4 days of fixed Orthodontic appliance activation. The lesser the pain perceived by a patient, better the treatment outcome and the patient compliance. The post separator placement pain increases as soon as 4 hours and gradually increases over the next 24 hours which is worst at the day 2-4. The Aim of the study is to find out the association of post separator placement pain in our population. Also, the study focuses on the use of dose Paracetamol 500gms, by our patients in case of pain.</p> <p><strong>Materials and Method:</strong> Elastomeric separator was placed mesially and distally to the upper right first permanent molar(16) and the kesling separator was placed to the left first permanent molar(26) in 100 orthodontic patients . Patients were given a questionnaire that documented perceived pain, pain on chewing, pain affecting the daily life activities. The patient documented the intake of medication to reduce the pain, if at all. Two different Pain rating scales (PRS) along a line will be used to depict the pain perception. The subjects were asked to circle a spot on the line that they believed best represented the pain they perceived at that time. The evaluation of pain and documentation started on the 4th hour, 24th hrs, 2nd day, 3rd day, 4th day, 5th day, 6th day and the 7th day. Scores 1-3 will be considered as mild pain; 4-6 will be moderate pain and 7-10 is considered to be the severe pain. At every time slot, the pain was documented, there was a spot where the patient has mentioned if he / she used the medication prescribed by the orthodontist.</p> <p><strong>Results:</strong> No association of Kesling separators with Pain on chewing , pain perception and pain affecting life at 4th hour, 24th hour, 2nd day, 3rd day, 4th day, 5th day, 6th day, 7th day post separator placement. Association of Medication with the post separator placement pain also is not significant.</p> <p>Significant association of elastomeric separators with pain perception and pain affecting life at 4th hour (p= 0.002 &amp; p=0.005), 24th hour (p= 0.002). Significant Association of Medication with the post separator placement pain also is significant at 4th (p=0.00) and 24th hour (p=0.02) of post separator placement.</p> <p><strong>Conclusion:</strong> There is a significant association of elastomeric separators with pain perception and pain affecting life at 4th hour, 24th hour. Significant Association of Medication with the post separator placement pain also is significant at 4th and 24th hour of post separator placement</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Patient’s expectation of orthodontic treatment attending tertiary care dental hospital in Kathmandu 2022-02-20T14:48:27+00:00 Bikash Veer Shrestha Anshu Piya Anju Khapung Prakash Bhattarai <p><strong>Introduction:</strong> Understanding of patient’s expectation and attitude towards orthodontic treatment plays an important<br />role towards a successful treatment outcome and behavioral management.</p> <p><strong>Materials and Method:</strong> All the patients (270) attending department of Orthodontics in Nepal Medical College for the first time were included in the study. The descriptive study is done. A structured questionnaire was used to obtain the socio-demographic information and responses to questions on their expectation of orthodontic treatment.</p> <p><strong>Results:</strong> Majority of the respondents had higher expectations on aesthetic outcome of orthodontic treatment than the functional outcomes. They expected to have better smile, teeth straightened and have confidence socially. The lowest mean scores were obtained in the domains of improvement in career and making speech easier. Females had significant higher scores than male participants in all domains explored with the mean highest score in the domain of better smiles; while the highest male mean score was in the domain of straightened teeth.</p> <p><strong>Conclusion:</strong> To achieve successful orthodontic treatment result, patient cooperation is necessary. Agreeing with the patient on realistic expected treatment outcomes by the orthodontist before the treatment is required so that they are not disappointed with the final appearance.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Reproducibility and speed of cephalometric tracing between manual versus digital method 2022-02-20T15:01:15+00:00 Sanjay Prasad Gupta Samarika Dahal Shristi Rauniyar <p><strong>Introduction:</strong> Cephalometric tracing is an indispensable method for the evaluation of the growth and development of the facial skeleton. The clinical implication of the tracing may be utilized in many branches of dentistry for diagnosis and treatment planning. The research based cephalometric tracing has been widely used over a period of time by various specialist. The purpose of this study was to compare the cephalometric tracing method between manual and the digital method.</p> <p><strong>Materials and Method:</strong> Lateral cephalometric radiographs of 120 patients who came for orthodontic treatment during Jan 2020 to Dec 2020 were randomly selected from Tribhuvan University Dental Teaching Hospital and one orthodontic center. Only the cephalograms with clarity and without artefacts were selected. The samples were randomly selected without any discremation of gender, occlusal type or skeletal pattern. The two methods were compared in terms of reproducibility and the speed of cephalometric tracing. The cephalograms were compared using both the manual and the digital method using Vistadent OC 1.1 software program (GAC International Inc, Bohemia, New York, USA). The mean tracing time for each method was also estimated. Paired t –test was used to compare the differences in individual measurement between the two methods. Intraclass correlation coefficients were used to measure the repeatability of the measurements.</p> <p><strong>Results:</strong> On comparing two methods, 3 out of 20 measurements showed statistically significant difference while others showed no statistically significant difference. The mean time needed to perform cephalometric analysis by the digital method (4.61±0.63 minutes) was significantly less as compared to the manual method (11.23±0.71 minutes) and the difference of performance duration were statistically significant (&lt;0.05). Intraclass correlation coefficient showed strong correlation (0.86 to 0.99) for each repeated cephalometric measurements carried out by both manual and digital methods.</p> <p><strong>Conclusion:</strong> Both conventional manual and digital cephalometry methods showed good reproducibility with strong correlation for repeated measurements. The digital method exhibited significant reduction in time compared to manual method. Incorporation of digital methods by the clinicians can increase their efficiency</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Dental age estimation and accuracy assessment by Demirjian, Nolla and Willems methods in Nepalese children for predicting the chronological age 2022-02-20T15:09:33+00:00 Senchhema Limbu Parajeeta Dikshit Manisha Malla Ujwal Gautam <p><strong>Introduction:</strong> Dental age estimation has been performed by numerous methods worldwide. This study was done to evaluate and compare the validity and accuracy of dental age estimation by Demirjian, Nolla and Willems methods in Nepalese children.</p> <p><strong>Materials and Method:</strong> A comparative cross sectional study was conducted on 280 orthopantomography of Nepalese children aged 5-14 years in Kantipur Dental College from December 2020 to September 2021. Dental age was calculated by three methods and difference with chronological age was examined. Descriptive statistics were presented as mean ± SD and median (range). Differences in paired data of chronological and dental ages were examined using Wilcoxon signed rank test. Spearman’s correlation coefficient was used for comparing chronological and dental ages. Regression analysis was performed to derive equation for predicting chronological age from dental age.</p> <p><strong>Results:</strong> An underestimation of dental age was observed with Demirjian (-1.17 years), Nolla (-1.06 years) and Willems (-1.32 years) methods which was statistically significant and also across both genders (p&lt;0.001). However, chronological age was found to be highly correlated with dental ages estimated using Demirjian (σ=0.930; p&lt;0.001), Nolla (σ=0.939; p&lt;0.001) and Willems (σ=0.947; p&lt;0.001) methods. Linear regression analysis conducted to predict chronological age showed total variance of 80.8%, 87.7% and 89.5% in boys and 81.7%, 87.7% and 88.4% in girls by Demirjian, Nolla and Willems methods respectively.</p> <p><strong>Conclusion:</strong> This study revealed Demirjian, Nolla and Willems methods can be a valid measure for age estimation among Nepalese children and precise prediction of chronological age can be made from different dental age estimation techniques.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Estimation of Dental Age by Demirjian and Willems Method In a Tertiary Care Hospital of Nepal 2022-02-20T15:33:57+00:00 Sumita Upadhyay Sijan Poudyal Prashant Khatiwada Bibardha Khanal Rasna Shrestha <p><strong>Introduction:</strong> Dental age estimation using orthopantomogram is very useful in pediatric dentistry, orthodontics inclinical diagnosis and treatment planning and also has forensic application. The objectives of this study were to estimate the dental age of children in a specific population of Nepal by Demirjian and Willems method, compare them with the chronological age and assess their applicability.</p> <p><strong>Materials and Method:</strong> Digital orthopantomograms of 5 to 14 years of children were used to estimate the dental age by Demirjian’s 7- teeth method and Willems method. Descriptive statistics was used and mean with standard deviation was calculated for gender and age of the samples. Paired t-test was used for comparison of chronological age with dental age. P &lt; 0.05 was considered as statistically significant. Pearson correlation was used to assess the correlation between chronological and dental age in both the genders.</p> <p><strong>Result:</strong> By Demirjian method, there was an underestimation of 0.276 years in males and 0.194 in females and by Willems method, 0.652 in males and 0.847 in females which were statistically significant. There was an underestimation of dental age in all the age groups except in the age group of 5,7 and 14 for Demirjian age which was statistically nonsignificant. Pearson correlation demonstrated strong positive correlation between chronological age and dental age.</p> <p><strong>Conclusion:</strong> The underestimation of dental age was more by Willems method as compared to Demirjian method. There was a strong positive relationship between chronological age and dental age in both the genders. Demirjian’s 7- teeth method was more applicable as compared to Willems method when tested in selected Nepalese children population</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Assessment of prevalence of dental pulp stones in patients undergoing orthodontic treatment 2022-02-20T15:41:12+00:00 Vivek Bikram Thapa Swikriti Rana Niroj Bhattarai <p><strong>Introduction:</strong> Pulp stones are foci of calcification in the dental pulp. During the orthodontic tooth movement, a complex series of tissue reaction occurs. Studies show that the orthodontic force application may cause pulpal changes like pulpal calcifications. Hence; we assessed the prevalence of prevalence of dental pulp stones in patients undergoing orthodontic treatment.</p> <p><strong>Materials and Method:</strong> A total of 50 patients who were scheduled to undergo non-extraction orthodontic treatment were included. Pre-treatment and Post-treatment radiographs were taken in all the patients. Evaluation of the permanent molars (maxillary and mandibular) was done, both pre-treatment and post-treatment. Interpretation of the radiographs was done by skilled and experienced oral radiologists. Diagnosis of pulp stones was done when definite radiopaque bodies as dental pulp stones were noted as present or absent. All the results were recorded in Microsoft excel sheet.</p> <p><strong>Results:</strong> At pre-treatment time, prevalence of pulp stones was found to be 26 percent, while at post-treatment time, the overall prevalence of pulp stones was found to be 48 percent. Significant results were obtained while comparing the pretreatment and post-treatment prevalence of pulp stones.</p> <p><strong>Conclusion:</strong> Formation of pulp stones might be triggered under the effect of orthodontic trea</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Treatment of generalized spacing with clear aligner therapy: Report of a case 2022-02-20T15:50:15+00:00 Dashrath Kafle Ravi Kumar Mahato Abhisek Giri Sanjiv Luintel Arjun Karki <p>Clear Aligners are becoming popular among patients in recent years because of its invisible nature , comfort to wear, less orthodontic emergencies and better hygiene control. However proper case selection is vital for the success. With the better understanding of aligner biomechanics and improvement in aligner materials and attachment design, more complex teeth movement is also possible with clear aligners. As there is always controversy on whether aligners cause tipping or bodily tooth movement, In this case report, a skeletal class I patient with generalized spacing in maxilla and mandible is presented which is treated effectively by bodily movement of incisors.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal A Chronicle Overview of Cephalometric Parameters for assessing Sagittal Jaw Disparity 2022-02-20T16:00:41+00:00 Jaina Dubey Amitabh Kallury Rajesh Kumar Balani Chandni Bharti Chandrika Dubey <p><strong>Introduction:</strong> Assessment of sagittal jaws relation is a vital procedure in establishing a good diagnosis for all orthodontic cases. Various analyses have been introduced over the years with varying degrees of reliability and validity. Orthodontist should be aware of a range of analyses to be used in diagnosing different cases. This review provides a brief information about the various cephalometrics parameters i.e angular &amp; linear which are used for assessing sagittal jaw discrepancy in their chronologic order.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal A century of Hawley retainer 2022-02-20T16:07:07+00:00 Samikshya Paudel Rabindra Man Shrestha Sristi Napit <p><strong>Introduction:</strong> The use of Hawley retainer has crossed a century with same basic principles incorporated one hundred years back accompanying little improvisation in material. The innovation of Hawley retainer was a simple orthodontic appliance yet innovative device of retention of that period of time. The primitive appliance is still continuing over a century; is an achievement in itself. This clearly reflects the intense invention of an inquisitive mind of its creator, Dr. Charles Augustus Hawley. The present article reviews the chronological events of the life of Dr. Charles Augustus Hawley and his contributions to the profession. Special emphasis has been laid on the evolution, development and clinical aspects of Hawley retainer commemorating its completion of a century.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Late upper airway constriction and its prevention by interceptive functional appliance therapy- A review 2022-02-20T16:15:16+00:00 Nida Nayyer Ashok Kumar Jena Jitendra Sharan <p><strong>Introduction:</strong> Sleep-disordered breathing (SDB) is one of the poorly diagnosed disorders which affects the quality of life of patients. The SDB is a spectrum of problems ranging from simple snoring to obstructive sleep apnoea (OSA) which involves complete collapse of the pharyngeal airway passage during sleep resulting in airflow cessation and consequent arousals. A noteworthy etiological factor of OSA is mandibular retrognathism. Imaging studies on craniofacial structures in OSA patients have shown decreased oropharyngeal and hypopharyngeal depth, elongated soft palate, altered tongue posture, and increased hyoid bone-to-mandible distance. The management modalities of OSA are positive airway pressure (PAP) and oral appliance therapy. The modus operandi of mandibular advancement devices (MADs) is the same as of myofunctional therapy instituted by orthodontists for the treatment of skeletal Class II malocclusions with mandibular retrusion in growing patients. By virtue of the increase in the mandibular length and advancement in mandibular position, pharyngeal airway space is enlarged along with favorable changes in the soft palate, tongue posture, and hyoid bone position. The focus of the present review is to consolidate the available literature on the long-term effects of functional appliance treatment. It is hypothesized that interceptive functional appliance therapy in the growing stage could be a viable strategy for the prevention of OSA development during adulthood. The review also highlights the importance of the need for more studies emphasizing the long-term impact of functional treatment to establish the role of the same in reducing the OSA treatment burden during adulthood.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal Orthodontic workforce for the next 10 years 2022-02-20T13:28:09+00:00 Dashrath Kafle <p>No abstract available.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Orthodontic & Dentofacial Orthopedic Association of Nepal