Original Research

Year : 2026 | Volume : 17 | Issue : 2 | Page : 58-71

Perspectives Of Indian Orthodontists on Clear Aligner Therapy Versus Fixed Appliances: A Questionnaire Study

Adheena Nambiar- 1, K.M. Shahul Hameed Faizee- 2, D. Hemamalini- 3, L. Xavier Dhayananth- 4

1- Postgraduate Resident, 2- Professor & Head, 3- Assistant Professor, 4- Associate Professor, Department of Orthodontics, Sathyabama Dental College & General Hospital, Chennai, India.

Address for Correspondence:

Dr Adheena Nambiar

Postgraduate Resident,

Department of Orthodontics,

Sathyabama Dental College & General Hospital, Chennai, India.

Mobile: +91 7619637810

ABSTRACT

OBJECTIVE: The aim of the present study was to assess the perceptions, treatment preferences, and decision-making approaches of Indian orthodontists on the use of clear aligners and fixed orthodontic appliance therapy in various types of malocclusion cases.

METHODS: A cross-sectional questionnaire survey was conducted among practicing orthodontists across India using a convenience-based voluntary response sampling method. A total of 378 responses were received via an online survey platform and were statistically analyzed. Descriptive statistics were calculated to summarize the variables, and the Chi-square test was used to find out the association between the variables.

RESULTS: It was observed that 92.9% of the orthodontists currently use clear aligners in routine clinical practice. Clear aligners were predominantly preferred by 84.1% orthodontists to treat mild to moderate malocclusions mainly due to better aesthetic appeal and patient compliance and better oral hygiene maintenance. Fixed appliances were predominantly preferred to treat more complex malocclusions like extraction cases, open bites, class III malocclusions and orthognathic surgery cases due to better biomechanical control and ability of achieving finishing. Majority (52.4%) orthodontists were inclined towards a combination of treatment approach in complicated cases with an aligner and fixed appliance therapy being combined. Most respondents perceived clear aligners to be associated with better periodontal health and a lower incidence of white spot lesions, whereas fixed appliances were perceived to provide superior anchorage control, torque control, and finishing outcomes.

CONCLUSION: Clear aligner therapy has become an integral part of present orthodontic practice and is preferred for treatment of mild to moderate malocclusions, but for managing complex orthodontic tooth movements, especially with regards to anchorage control and for finer tooth movements fixed appliances are preferred. However, there is an increasing number of orthodontists who favor a combination of both treatment approaches.

KEYWORDS: Clear aligners; Fixed appliances; Orthodontists; Treatment preference; Malocclusion.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Adheena Nambiar, K.M. Shahul Hameed Faizee, D. Hemamalini, L. Xavier Dhayananth. Perspectives Of Indian Orthodontists on Clear Aligner Therapy Versus Fixed Appliances: A Questionnaire Study. Int J Orthod Rehabil 2026; 17 (2): 58-71.

Doi: 10.56501/Intjorthodrehabil.172.ijor0087

Original Research

Year : 2026 | Volume : 17 | Issue : 2 | Page : 43-57

Dermatoglyphics, Palatal Rugoscopy, and Cheiloscopy as Markers for Angle’s Class I, II, and III Malocclusions: A Cross-Sectional Study

Sathish Elangovan-1, Pavithranand Ammayappan-2, Sithra P-3, Shaick Ashiq-3, Shivashankar Kengadaran-4

1-Postgraduate Resident, 2-Professor and Head, 3-Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics, Sri Balaji Vidyapeeth University, Puducherry, India, 4-Associate Professor, Department of Public Health Dentistry, Sri Balaji Vidyapeeth University, Puducherry, India.

Address for Correspondence:

Dr Pavithranand Ammayappan MDS FDSRCS (England)

Professor and Head,

Department of Orthodontics and Dentofacial Orthopedics,

Sri Balaji Vidyapeeth University, Puducherry, India.

Mobile: +91 9443183590

Email: docanandpavi@gmail.com

ABSTRACT

BACKGROUND AND AIM: Early detection of malocclusion is key to providing effective orthodontic treatment. The non-invasive indicators dermatoglyphics, palatal rugoscopy, and cheiloscopy, which have similar embryonic development to the craniofacial structure, could play a role in the early detection of malocclusions. This study examines the correlation between the three indicators and malocclusions such as Angle’s Class I, II, and III in a South Indian population.

MATERIALS AND METHODS: The cross-sectional study was carried out among 120 subjects within the age range of 13 to 25 years, equally divided into three categories of malocclusion (each comprising n = 40 subjects). Impressions of fingerprints were taken by the ink impression method, and the classification was done based on whether the pattern is arch, loop, or whorl. The lip prints were taken using the lipstick-cellophane method, which classified them using the Suzuki-Tsuchihashi classification. The palatal rugae prints were taken using the dental cast, and their classification involved straight, curved, wavy, or circular forms. Statistical analysis included chi-square tests and multinomial logistic regression, with significance set at p<0.05.

RESULTS: Dermatoglyphics analysis showed associations between Class III cases and left thumb (p = 0.019), right index finger (p < 0.001). Patterns of arch had higher incidence among the members of Class III (30% versus 12.5 to 15%). The cheiloscopy pattern was statistically different (p = 0.008), with branched pattern being the most common pattern in Class I (60%), while vertical pattern was more common in Class II and Class III (37.5% each). Multinomial regression showed that lip prints were good predictors. The right rugae 1 and left rugae 4 showed significant differences (p = 0.001 & p < 0.001, respectively). Rugae 5 was not present bilaterally in Class III.

CONCLUSION: Notable correlations were observed between dermatoglyphics, cheiloscopy, and palatal rugoscopy and the classification of Angle’s malocclusions. These findings suggest that these modalities may serve as valuable adjunctive, non-invasive screening tools in orthodontic practice.

KEYWORDS: Dermatoglyphics, cheiloscopy, Palatal rugoscopy, Angle's malocclusion, Orthodontic screening

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Sathish Elangovan, Pavithranand Ammayappan, Sithra P, Shaick Ashiq, Shivashankar Kengadaran. Dermatoglyphics, Palatal Rugoscopy, and Cheiloscopy as Markers for Angle’s Class I, II, and III Malocclusions: A Cross-Sectional Study. Int J Orthod Rehabil 2026; 17 (2): 43-57.

Doi: 10.56501/Intjorthodrehabil.172.ijor0089

Original Research

Year : 2026 | Volume : 17 | Issue : 2 | Page : 29-42

Comparison of Heat-Activated Copper Nickel-Titanium and Multistranded Stainless Steel Archwires on Pain Perception and Alignment Efficiency: A Randomized Clinical Trial

Sobitha Obili-1, Gowri Sankar Singaraju-2, Venkatesh Nettam-3, Ravindra Vangala-4, Prasad Mandava-5

1-Postgraduate Resident, 2-Professor, 3-Associate Professor, Department of Orthodontics, Narayana Dental College, Nellore, 4-Professor and Head, Gitam Dental College and Hospital, Visakhapatnam, Andhra Pradesh , 5-Professor and Head, Department of Orthodontics, Narayana Dental College , Nellore, Andhra Pradesh, India -524003.

Address for Correspondence:

Dr Prasad Mandava

Professor and Head,

Department  of Orthodontics, Narayana Dental College,

Nellore, Andhra Pradesh, India -524003.

Email :mandavabruno9@gmail.com

ORCID ID:0000-0003-3024-544X

ABSTRACT

BACKGROUND: The initial archwires during the alignment phase must be effective and cause as little pain as possible for the patient. There is limited information that compares heat-activated copper nickel-titanium (CuNiTi) and multistranded stainless steel archwires.

OBJECTIVES: This study aims to compare the impact of 0.016-inch copper-nickel-titanium (CuNiTi) archwires and 0.0175-inch multistranded stainless steel archwires on alignment efficiency, changes in transverse dimensions, and pain perception during the initial phase of treatment.

METHODS: This randomized clinical trial included 48 subjects, of whom 32 completed the study. Participants were allocated to receive either 0.016-inch CuNiTi or 0.0175-inch multistranded stainless steel archwires. Alignment was assessed using Little’s Irregularity Index, and transverse dimensions were measured on dental casts at baseline (T0) and 6 weeks (T6). Pain was evaluated using a 10-point visual analogue scale at T1 (4 h), T2 (24 h), T3 (3 d), T4 (7 d), T5 (30 d), and T6 (6 wks.). Statistical analysis included independent paired t-tests, Mann–Whitney U test, and Friedman test.

RESULTS:  CuNiTi archwires demonstrated greater alignment reduction at 6 weeks (3.55 ± 0.39 mm vs 2.55 ± 0.78 mm; p = 0.0001), while intercanine width increased more with multistranded SS (0.84 ± 0.26 mm vs 0.64 ± 0.11 mm; p = 0.0105). Regarding pain, CuNiTi caused higher scores at 4 hours (4.19 ± 1.67 vs 2.44 ± 0.79; p = 0.001).

CONCLUSION: Within the limitations of this short-term study, CuNiTi showed greater early alignment reduction, while pain differences were transient. Both archwire systems are clinically useful, and selection should be guided by crowding severity, patient comfort, and cost-effectiveness.

CLINICAL TRIAL REGISTRATION: CTRI/2021/02/031065

KEYWORDS: Orthodontic Wires; Nickel-Titanium Alloys; Multistranded; Pain; Alignment

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Sobitha Obili, Gowri Sankar Singaraju, Venkatesh Nettam, Ravindra Vangala, Prasad Mandava. Comparison of Heat-Activated Copper Nickel-Titanium and Multistranded Stainless Steel Archwires on Pain Perception and Alignment Efficiency: A Randomized Clinical Trial. Int J Orthod Rehabil 2026; 17 (2): 29-42.

Doi: 10.56501/Intjorthodrehabil.172.ijor0096

Original Research

Year : 2026 | Volume : 17 | Issue : 2 | Page : 17-28

Microbial Contamination Of New Orthodontic Clear Aligners: Comparing Disinfection With Chlorhexidine Solution Versus No Treatment

Chintan S Shetty-1, Amarnath B C-2, Akshai Shetty K R-2, Dharma R M-2, Prashanth C S-2, Navya Siddalingaiah-3

1-Postgraduate Resident, 2-Professor, 3-Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics, DAPM RV Dental College, Affiliated to Rajiv Gandhi University of Applied Sciences, 24th Main Road, JP Nagar 1st phase, Bangalore-560078

Address for Correspondence:

Dr. Chintan S Shetty

Post Graduate Student,

Department of Orthodontics and Dentofacial Orthopedics

DAPM RV Dental College, Affiliated to Rajiv Gandhi University of Applied Sciences,

24th Main Road, JP Nagar 1st phase, Bangalore-560078

Email id: chintanshetty98@gmail.com

ABSTRACT

BACKGROUND: The growing demand of invisible orthodontics in all the age groups has increased the treatment of malocclusion with clear aligners. While the aligners are in direct contact with the oral tissues for 22/24 hrs, any lack of complete sterilization could result in causing harm to the patient during this timeframe.

OBJECTIVES: To examine the microbial presence on aligners as received from manufacturers and to evaluate efficacy of chlorhexidine decontamination in 2 different concentrations (0.01% and 2%).

METHODS:  A total of 20 aligner samples were collected from four different companies (80 samples in total) as received from the manufacturers. The samples were divided into four groups (A, B, C, and D). They were incubated in brain heart infusion (BHI) broth to assess bacterial growth. The streak plate technique on blood agar, along with biochemical tests, was performed to identify microbial contaminants (catalase, coagulase, oxidase, and sugar fermentation assays). Contaminated aligners underwent disinfection with 0.01% chlorhexidine for 5 minutes and were then tested for sterility. Those that remained contaminated were re-treated with 2% chlorhexidine, and the effectiveness of the higher concentration was subsequently evaluated for complete microbial decontamination.

RESULTS: Microbial contamination was detected on aligners of all the four groups.80% of aligners samples in Group C showed microbial contamination , followed by Group D (65%), and followed by Group B (55%) whereas Group A had the least percentage of microbial contamination (30%)] Upon disinfection with 0.01% chlorhexidine solution, Group A displayed complete decontamination, while all aligners in the other groups exhibited complete decontamination with 2% chlorhexidine.

CONCLUSION:  Orthodontic aligners received from four manufacturers showed high bacterial contamination after going through biochemical test. Disinfecting ability of 2% chlorhexidine proved highly effective in destroying both gram-positive and gram-negative bacteria
KEYWORDS: Contamination, Disinfection, Microbiology,Chlorhexidine, Product packaging.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Chintan S Shetty, Amarnath B C, Akshai Shetty K R, Dharma R M, Prashanth C S, Navya Siddalingaiah. Microbial Contamination Of New Orthodontic Clear Aligners: Comparing Disinfection With Chlorhexidine Solution Versus No Treatment.Int J Orthod Rehabil 2026; 17 (2): 17-28.

Doi: 10.56501/Intjorthodrehabil.172.ijor0004

Original Research

Year : 2026 | Volume : 17 | Issue : 2 | Page : 1-16

Assessment of Mandibular Molar Inclination and Buccal Bone Thickness in Different Facial Patterns of Class II Division 1 Malocclusion using the WALA Ridge: A CBCT Based Cross-Sectional Study

Poongodhai S 1, Thirunavukkarasu Ramanathan 2, Sola Rajan 3, Tamizhmani 4, Harini Abilasha K 3

1-Postgraduate Resident, 2-Professor and Head, 3-Senior Lecturer, 4-Reader, Department of Orthodontics & Dentofacial Orthopaedics, Karpaga Vinayaga Institute Of Dental Sciences, Madhuranthagam, Kanchipuram, TamilNadu, India-603308.

Address for Correspondence:

Dr. Thirunavukkarasu Ramanathan, MDS

Professor and Head, Department of Orthodontics and Dentofacial Orthopedics

Karpaga Vinayaga Institute Of Dental Sciences,

TamilNadu, India- 603308.

Email.id: tringortho.tr@gmail.com

ABSTRACT

Background: Orthodontic treatment planning in the mandibular posteriors requires careful consideration of alveolar bone limits to ensure biologically safe tooth movement and long term stability. The WALA ridge, described as the most prominent contour of the buccal alveolar mucosa at the level of the mucogingival junction, has been proposed as a stable landmark, closely associated with the basal bone of the mandible.

Aim: To assess and compare mandibular molar inclination and buccal bone thickness in patients with Class II Division 1 malocclusion across different facial patterns using the WALA ridge as a reference landmark on CBCT scans.

Materials & Methods: This was a cross-sectional observational study conducted retrospectively on pre-treatment CBCT scans from Class II Division 1 malocclusion patients (n=66, age 18-35 yrs), obtained from patient records at the Department of Orthodontics from January to December 2025. Ethical approval (IEC: KIDS/IEC/2026/I/015) and informed consent from study subjects (obtained at CBCT imaging) were secured. Subjects were grouped into euryprosopic (≤80.9), mesoprosopic (81.0-85.4), and leptoprosopic (≥85.5) facial patterns by facial index (Martin & Saller 1957). Molar inclination was measured as the angle between the tooth long axis and a vertical reference line parallel to midsagittal plane. Buccal bone thickness at various mandibular tooth sites (from canine to molar region) on both sides was measured in relation to WALA ridge level on axial sections using Carestream software. Data were analyzed in SPSS software. P<0.05 was considered statistically significant.

Results: Molar inclination differed significantly among facial patterns (P<0.0001). Euryprosopic subjects showed greater buccal crown tipping (14.18 ± 2.32° for 36; 13.05 ± 1.96° for 46) than leptoprosopic subjects (9.31 ± 1.08° for 36; 9.32 ± 1.36° for 46). BBT showed a significant anterior-to-posterior increase (P<0.05) across sites, with 0.00 mm at canine/first premolar regions in all groups. Euryprosopic subjects showed greatest posterior thickness, first molar distal (1.78 ± 0.42 mm), second molar distal (6.20 ± 1.43 mm), vs. leptoprosopic (first molar distal: 0.56 ± 0.48 mm).

Conclusion: Facial pattern influences mandibular molar inclination and buccal bone thickness at the WALA ridge level, supporting individualized transverse planning to reduce periodontal risk.

Keywords: WALA ridge; facial pattern; BBT ( buccal bone thickness); molar inclination; CBCT; Class II Division I.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Poongodhai S, Thirunavukkarasu Ramanathan, Sola Rajan, Tamizhmani, Harini Abilasha K. Assessment of Mandibular Molar Inclination and Buccal Bone Thickness in Different Facial Patterns of Class II Division I Malocclusion using the WALA Ridge: A CBCT Based Cross-Sectional Study.

Int J Orthod Rehabil 2026; 17 (2): 1-16.

Doi: 10.56501/Intjorthodrehabil.172.ijor0079

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 83-96

WALA Ridge changes in Orthodontic Patients treated with Conventional Fixed Appliances and Damon Self-Ligating Appliances

Sohel Rana 1, Bhadrinath Srinivasan 2, Sridevi Padmanabhan 3

1-Postgraduate Resident, 2-Associate Professor, 3-Professor, Associate Dean Research, Department of Orthodontics & Dentofacial Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

Address for Correspondence:

Dr. Sridevi Padmanabhan

Professor, Department of Orthodontics & Dentofacial Orthopaedics

Associate Dean Research,

Sri Ramachandra Institute of Higher Education and Research

Chennai, India

Email: sridevipadmanabhan@sriramachandra.edu.in

ABSTRACT

Objectives: To evaluate and compare the changes in the WALA ridge and the distance from the FA point to the WALA ridge in the mandibular arch of patients treated with a conventional fixed appliance and a Damon self-ligating appliance.

Materials and Methods: The investigation included pre- and post-treatment mandibular study models of 63 subjects, with 33 subjects in Group I (MBT prescription) and 30 subjects in  Group 2 (Damon Self-Ligating appliance). Reference planes were generated on the maxillary study model and the WALA ridge, and FA points were marked on the mandibular models. Scanning of models was performed using a 3-dimensional laser scanner. The changes in WALA ridge position and the distances between the FA point and the WALA ridge were assessed using a dental cast analysis software.

Results: There was a significantly greater increase in WALA ridge dimensions in Group 2 (P<0.001) relative to Group 1. Intergroup comparison of changes in FA-WALA distances revealed buccal movement of all teeth in Group 1, except for the central incisor and first premolar. In contrast, buccal movement was noted only in the first molar region in Group 2. However, this variation among the groups was not statistically significant (P>0.05).

Conclusions: There was a significant increase in WALA ridge dimensions with the Damon self-ligating appliance relative to the conventional fixed appliance, demonstrating that the WALA ridge is not immutable.
Keywords: WALA ridge; Self-ligating appliance; Damon self-ligating appliance.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Sohel Rana, Bhadrinath Srinivasan, Sridevi Padmanabhan. WALA Ridge changes in Orthodontic Patients treated with Conventional Fixed Appliances and Damon Self-Ligating Appliances.

Int J Orthod Rehabil 2026; 17 (1): 83-96.

Doi: 10.56501/Intjorthodrehabil.171.ijor0078

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 72-82

Comparative Evaluation of the Effect of Lyophilised Platelet-rich Plasma and Micro Osteoperforation on the Rate of Orthodontic Tooth Movement in Class I Bimaxillary Protrusion Patients: A Split Mouth Study

Mohamed Shafi Nalla Mohamed 1, S.D. Milling Tania 2, Bevin Shaga 3, S. Veerasankar 3, A. Jebilla Pringle 4, Mary Sheloni Missier 4, C. Priyadharshini 4

1-Postgraduate Resident, 2-Professor, 3-Reader, 4-Senior Lecturer, Department of Orthodontics, Rajas Dental College and Hospital, Kavalkinaru, Tamil Nadu - 627105.

Address for Correspondence:

Mohamed Shafi Nalla Mohamed

Postgraduate Resident,

Department of Orthodontics

Rajas Dental College and Hospital, Kavalkinaru

Tamil Nadu - 627105.

ABSTRACT

BACKGROUND: Orthodontic tooth movement is often time-consuming and can cause patient discomfort. Various techniques to accelerate tooth movement such as micro-osteoperforation and platelet-rich plasma (PRP) have been extensively researched. PRP is an autologous component rich in growth factors and mediators that promote cell proliferation and differentiation, essential for orthodontic tooth movement. Freeze-drying PRP enhances its shelf life and clinical applicability.

AIM: The present study aims to evaluate the efficacy of lyophilised platelet-rich plasma (LPRP) and micro-osteoperforation (MOP) in accelerating canine retraction in patients with class I bimaxillary protrusion undergoing fixed orthodontic treatment.

MATERIALS AND METHODS: This randomized split-mouth clinical trial was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, Rajas Dental College and Hospitals, Tirunelveli. Nine patients with Class I bimaxillary protrusion were randomly assigned to receive either MOP or LPRP on the contralateral side. Tooth movement was assessed at one- and two-months post-intervention using dental cast. Statistical analysis of the data was performed, with a p-value of < 0.05 considered statistically significant.

RESULTS: The mean age of the participants was 21.00 ± 1.94 years with a total of 9 participants with 4 males and 5 females. It can be observed that in both the groups, the rate of canine retraction at three different time interval was highly significant (p<0.001) but minimal differences was seen between LPRP and MOP groups which was not statistically significant.

CONCLUSION: This study demonstrated that both MOP and LPRP showed accelerated tooth movement over the course of two months ,while the difference  between the two groups was not statistically significant. Future studies to further validate these findings with larger sample sizes are recommended.
KEYWORDS: Malocclusion; Orthodontics; Micro-osteoperforation; Platelet-rich plasma; Regional acceleratory phenomenon.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Mohamed Shafi Nalla Mohamed, S.D. Milling Tania, Bevin Shaga, S. Veerasankar, A. Jebilla Pringle, Mary Sheloni Missier, C. Priyadharshini. Comparative Evaluation of the Effect of Lyophilised Platelet-rich Plasma and Micro-Osteoperforation on the Rate of Orthodontic Tooth Movement in Class I Bimaxillary Protrusion Patients: A Split Mouth Study.

Int J Orthod Rehabil 2026; 17 (1): 72-82.

Doi: 10.56501/Intjorthodrehabil.171.ijor0054

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 60-71

Comparison of Two Smart Phone Based 3D Facial Scanning Applications for Soft Tissue Anthropometric Measurements: A Prospective Study

Rahul Narendran 1, Amarnath B.C 2, Dharma R.M 2, Prashanth C.S 3, Narayan Gandedkar 4, Akshai Shetty 5

1-Post Graduate, 2-Professor, 3-Dean and Professor, Department of Orthodontics, D A Pandu Memorial RV Dental College, Bengaluru, Karnataka-560078, 4-Program Director, DClinDent, Post-Graduate Studies (Orthodontics), Discipline of Orthodontics & Paediatric Dentistry. The University of Sydney, School of Dentistry, NSW, 2006, 5-Professor and Head, Department of Orthodontics, D A Pandu Memorial RV Dental College, Bengaluru, Karnataka-560078.

Address for Correspondence:

Dr Akshai Shetty, MDS, M.Orth (RCSEd)

Professor and Head,

Department of Orthodontics,

D A Pandu Memorial RV Dental College,

Bengaluru, Karnataka 560078.

Email: Akshaishettyortho@gmail.com

ABSTRACT

Introduction: Recent developments have transformed dentistry from traditional workflow to a digital workflow. Face scan is one such advancement to study the facial soft tissues. This study was done to compare facial measurements obtained using two smart phone-based 3D facial scan applications with clinical measurements.

Methodology: In this prospective study, forty participants meeting the inclusion and exclusion criteria were selected. Three-dimensional facial reconstructions were captured for each participant in the digital group utilising dual-structured light facial scanners (Bellus3D and Face App). Clinical measurements were taken using Digital callipers. Using open-source software, inter landmark measurements were taken (Meshlab). Measurement differences were evaluated by comparing the direct measurement with the two digital measurements.

Results: Measurements made with Bellus 3D were closer to the clinical values, for five parameters. (mean nose height (P=.04), the mean nasal bridge length (P=.04), the mean mouth width (P=.001), the mean distance between glabella – sub-nasale (P=.02), the mean distance between pro-nasale – menton. (P=.002)

Conclusion: Bellus 3D app produced measurements comparable to the clinical measurements in comparison to Face app.

Keywords: Face scan; Bellus 3D; Face App; Facial mapping; soft tissue landmarks.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Rahul Narendran, Amarnath B.C, Dharma R.M, Prashanth C.S, Narayan Gandedkar, Akshai Shetty. Comparison of Two Smart Phone Based 3D Facial Scanning Applications for Soft Tissue Anthropometric Measurements: A Prospective Study.

Int J Orthod Rehabil 2026; 17 (1): 60-71.

Doi: 10.56501/Intjorthodrehabil.171.ijor0076

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 39-59

Retention Protocols and Relapse Management Strategies Used by Orthodontists in Türkiye: A National Cross-Sectional Survey

İpek Savkan1, Osman Bilal Kandaz2, Evren Öztas3

1-Assistant Professor, 2-PhD Student, 3-Professor, Istanbul Kent University, Faculty of Dentistry, Department of Orthodontics, Istanbul, Turkey

Address for Correspondence:

Dr Osman Bilal Kandaz

Ph. D Student, Istanbul Kent University,

Faculty of Dentistry, Department of Orthodontics, İstanbul, Turkey

Cihangir, Sıraselviler Cd. No:71, 34433 Beyoğlu/İstanbul

Phone: +90 539 318 20 21

Email: bikandaz@gmail.com

ABSTRACT

Background: Orthodontic relapse is a common clinical challenge following orthodontic treatment and may occur due to biological factors such as periodontal reorganization, soft-tissue pressures, and craniofacial growth changes. Although various retention protocols are widely used, there is still no universal consensus regarding the most effective retention strategy.

Aim: The aim of this study was to investigate the retention protocols and relapse management strategies preferred by orthodontists in Türkiye following orthodontic treatment.

Materials and Methods: A national cross-sectional survey consisting of 33 multiple-choice questions was distributed electronically to members of the Turkish Orthodontic Society using an online survey platform. A total of 100 orthodontists responded, corresponding to a 10% response rate. Statistical analyses were performed using Chi-square and Fisher’s exact tests to evaluate differences according to professional experience.

Results: Retention protocols were applied to all patients by 94% of orthodontists, and 74% recommended lifelong retention. Vacuum-formed retainers and bonded retainers were the most commonly used appliances in maxillary and mandibular arches, respectively. Less experienced orthodontists showed a significantly higher tendency to prefer removable retainers in non-extraction Class I crowding cases (p = 0.015). Overall, 87% of orthodontists reported encountering relapse in their clinical practice, most frequently in tooth rotation and anterior open-bite cases (p = 0.006, p = 0.034, respectively). Retreatment was reported in ≤25% of patients in 73% of relapse cases.

Conclusions: Orthodontists in Türkiye widely recognize the importance of retention; however, substantial variability exists in retention protocols and relapse management strategies. Professional experience appears to influence certain clinical decisions, highlighting the need for standardized evidence-based retention guidelines.
Keywords:Orthodontic Retention, Orthodontic Relapse, Orthodontists, Retainers, Surveys and Questionnaires.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: İpek Savkan, Osman Bilal Kandaz, Evren Öztas. Retention Protocols and Relapse Management Strategies Used by Orthodontists in Türkiye: A National Cross-Sectional Survey.

Int J Orthod Rehabil 2026; 17 (1): 39-59.

Doi: 10.56501/Intjorthodrehabil.171.ijor0064

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 27-38

Prevalence of Moyer’s Class II malocclusion subtypes in Dravidian Population: A Cephalometric Study

Rishika Singla 1, Ravindra Kumar Jain 2, Swati Singh 3

1-Resident, 2-Professor, Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600077, India, 3-Assistant Professor, Department of Orthodontics, Kalinga Institute of Dental Sciences, KIIT university, Campus-5 Bhubaneswar, Odisha, India – 751024

Address for Correspondence:

Dr Ravindra Kumar Jain

Professor and Head,

Department of Orthodontics, Saveetha Dental College and Hospitals,

Saveetha Institute of Medical and Technical Sciences,

Chennai, India.

E-mail: ravindrakumar@saveetha.com

ABSTRACT

Background: Class II malocclusion exhibits considerable skeletal and dental heterogeneity that is often inadequately described by Angle’s dental classification. Moyers’ cephalometric subclassification, based on horizontal and vertical skeletal–dental relationships, provides a more biologically meaningful framework for understanding Class II patterns. Population-specific evaluation of these subtypes is essential, as craniofacial morphology varies across ethnic groups.

Aim: To determine the prevalence and distribution of Moyers’ horizontal and vertical Class II malocclusion subtypes in a Dravidian population and to evaluate their association with age and gender using cephalometric analysis.

Materials and Methods: This retrospective study analyzed 455 pretreatment lateral cephalograms of Dravidian subjects diagnosed with Class II malocclusion. Cephalometric assessment was performed digitally using FACAD software with Steiner’s, McNamara’s, Wits, and Rakosi analyses. Each case was classified into Moyers’ horizontal (A–F) and vertical (1–5) subtypes by calibrated examiners. Frequency distribution was calculated, and Chi-square tests were used to assess associations of subtypes with age and gender.

Results: Horizontal Subtype F was the most prevalent pattern, while Vertical Subtype 2 predominated among vertical patterns. A statistically significant association was observed between age and horizontal subtypes (p = 0.02), and between gender and horizontal subtypes (p = 0.04). No significant association was found between age or gender and vertical subtypes. Angle’s dental classification showed variable overlap with Moyers’ skeletal subtypes.

Conclusion: The Dravidian population demonstrated a distinct distribution of Moyers’ Class II subtypes, emphasizing the influence of ethnic craniofacial characteristics. Moyers’ cephalometric classification provides superior diagnostic insight compared to Angle’s system and facilitates more individualized treatment planning.
Keywords:Class II malocclusion, Moyers classification, Cephalometric analysis, Dravidian population, Horizontal subtypes, Vertical subtypes, Orthodontic diagnosis.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Rishika Singla, Ravindra Kumar Jain, Swati Singh. Prevalence of Moyer’s Class II malocclusion Subtypes in Dravidian Population: A Cephalometric Study. Int J Orthod Rehabil 2026; 17 (1): 27-38.

Doi: 10.56501/Intjorthodrehabil.171.ijor0077

Original Research

Year : 2026 | Volume : 17 | Issue : 1 | Page : 12-26

Comparison of Maxillary Canine Characteristics between Buccal and Palatal Impactions in South Indian Population- A Preliminary Observational CBCT Study

R. Prenetha1 , A. Sumathi Felicita2

1-Resident, 2-Professor, Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600077, India.

Address for Correspondence:

Dr. A. Sumathi Felicita,

Professor, Department of Orthodontics,

Saveetha Dental College and Hospitals,

Saveetha Institute of Medical and Technical Sciences, Saveetha University

Chennai, Tamil Nadu, India -600077

Email ID: sumifeli@hotmail.com

ABSTRACT     

AIM: To evaluate and compare the various general, morphologic and positional factors that influence the dis-impaction of maxillary buccal and palatal canine impactions in humans belonging to the South Indian population.
MATERIALS AND METHODS: The sample involving 14 subjects was divided into two groups, based on the position of the impacted maxillary canine. G1 consisting of eight patients with palatal canine impaction and G2 consisting of six patients with buccal canine impaction was conducted.The general, morphologic and positional factors were compared between the two groups, G1 and G2. Several angular and linear measurements were made to determine the canine position in the maxilla and were compared between the groups. Mann Whitney U test and Chi Square test was performed Binary logistic regression was done to predict an association between the various parameters and a favourable outcome following dis-impaction.

RESULTS: The difference in frequency of canine impaction was statistically significant between G1 and G2 with unilateral impactions present in four samples in both the groups and bilateral impactions present in four samples in G1 and two samples in G2 [p = 0.5]. A statistically significant existed between the groups with respect to the position of the impacted canine with the adjacent teeth with the crown of the canine located on the palatal or distal aspect of the anterior teeth in G1 compared to the palatal, buccal and distal aspect in G2 [p=0.04]. Other parameters did not have a statistically significant difference between the two groups.

CONCLUSION: There was no difference between buccal and palatal impactions with respect to the general, morphologic and positional factors for most of the parameters except for the of frequency of canine impaction and the position of tip of crown to the adjacent tooth.
KEYWORDS: impaction, canine, buccal, palatal, human, gender.

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: R. Prenetha, A. Sumathi Felicita. Comparison of Maxillary Canine Characteristics between Buccal and Palatal Impactions in South Indian Population- A Preliminary Observational CBCT Study. Int J Orthod Rehabil 2026; 17 (1): 12-26.

Doi: 10.56501/Intjorthodrehabil.171.ijor0072

Review Article

Year : 2026 | Volume : 17 | Issue : 1 | Page : 1-11

Dental Pulp Response and Tooth Discoloration after Orthognathic Procedures: A Systematic Review & Meta-Analysis

Haytham Jaha1 , Ibraheem K Bamaga2

1-Associate Professor and Consultant in Endodontics, Endodontic Division, Department of Restorative Dentistry, Faculty of Dental Medicine, 2-Associate Professor and Consultant in Orthodontics, Department of Basic and Clinical Oral Science, Faculty of Dental Medicine, Umm AI-Qura University, Makkah, Saudi Arabia

Address for Correspondence:

Dr. Haytham Jaha

Associate Professor and Consultant in Endodontics,

Endodontic Division, Department of Restorative Dentistry,

Faculty of Dental Medicine, Umm Al-Qura University,

Makkah, Saudi Arabia

Email: haythamjaha@gmail.com

ABSTRACT     

Background: Orthognathic surgery, including procedures such as Le Fort I osteotomy and genioplasty, is performed to correct craniofacial discrepancies and malocclusions. However, these procedures may lead to complications such as changes in dental pulp response and tooth discoloration.

Objective: This systematic review aims to evaluate the evidence regarding the dental pulp response and the incidence of discoloration following orthognathic procedures.

Materials & Methods: Relevant studies investigating pulp blood flow, pulp sensitivity, and dental discoloration after orthognathic surgery were reviewed. Observational studies, case reports, and clinical investigations on pulp response and discoloration in patients undergoing procedures such as Le Fort I osteotomy were included.

Results: Pulp blood flow in anterior teeth significantly drops immediately after surgery, often leading to negative pulp sensitivity tests in the first days and weeks post-operatively. Recovery of pulp sensitivity occurs gradually, with some teeth regaining a positive response within three months. Dental discoloration occurs in approximately 3.5-5% of cases after orthognathic procedures, mainly due to vascular impairment or mechanical injury to the apical region. Discoloration may present early, sometimes as a dark pink hue, and is often reversible; however, persistent discoloration combined with loss of pulp sensitivity may indicate pulpal necrosis, warranting root canal therapy and non-vital bleaching as effective management. Patients should be informed of these potential complications preoperatively.

Conclusion: Orthognathic surgery can acutely affect pulp vitality and pose a risk of dental discoloration via vascular or mechanical trauma. Most cases resolve with conservative dental management. Awareness and monitoring are critical for early identification and appropriate treatment to ensure satisfactory esthetic and functional outcomes.

Keywords:Orthognathic surgery; Dental pulp response; Pulp vitality; Pulp sensitivity: Pulp blood flow; Tooth discoloration; Le Fort I osteotomy; Genioplasty

CONFLICT OF INTEREST AND FUNDING

Nil

How to cite this article: Haytham Jaha, Ibraheem K Bamaga. Dental Pulp Response and Tooth Discoloration after Orthognathic Procedures: A Systematic Review & Meta-analysis. Int J Orthod Rehabil 2026; 17 (1): 1-11.

Doi: 10.56501/Intjorthodrehabil.171.ijor0067

Original Research

Year : 2025 | Volume : 16 | Issue : 4 | Page : 91-101

Prediction Of Torque Expression Of Upper Central Incisor Using Different Auxiliaries In Clear Aligners - A FEM Study

Shifo Savio1, Srirengalakshmi Muthuswamy Pandian2, Muskan Chanduka1, Aravind Kumar Subramanian3,

Nikhillesh Vaiid4

1Post Graduate Resident, 2Associate Professor, 3Professor, 4Adjunct Professor, Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai-77, India

Address for Correspondence:

Dr. Srirengalakshmi Muthuswamy Pandian

Associate Professor, Department of Orthodontics and Dentofacial Orthopaedics

Saveetha Dental College and Hospitals

SIMATS University

Email: rengalakshmi1910@gmail.com

ABSTRACT

BACKGROUND: Torque control of maxillary incisors remains a biomechanical limitation of clear aligner therapy. Auxiliaries such as attachments and power ridges have been proposed to enhance torque expression; however, quantitative evidence comparing their isolated biomechanical effects is limited. This finite element method (FEM) study aimed to predict and compare torque expression of the maxillary central incisor using clear aligners without auxiliaries, with vertical rectangular attachments, and with power ridges.

MATERIALS AND METHODOLOGY: A three-dimensional FEM model was constructed from CBCT and intraoral scan data of a patient with normal occlusion. Three models were analyzed: Group I (aligner without attachment), Group II (aligner with vertical rectangular attachment), and Group III (aligner with power ridge). A palatal force of 1.89 N was applied to simulate incisor torque. Displacement patterns along x, y, and z axes and stress distribution within the periodontal ligament (PDL) and alveolar bone were evaluated.

RESULTS: Vertical displacement was minimal and clinically insignificant in all groups. Labio-lingual displacement differed markedly: Group III demonstrated the greatest palatal crown and root displacement, indicating superior torque expression, followed by Group II, while Group I showed inadequate root control. Peak PDL stress was highest in the power ridge model (19.62 MPa), moderate with rectangular attachments (14.67 MPa), and lowest without attachments (13.48 MPa).

CONCLUSION: Power ridges significantly enhance torque expression of maxillary central incisors and have significant biomechanical advantage and force transmission compared with rectangular attachments or no attachment designs. Vertical rectangular attachments offer limited torque improvement, whereas aligners without auxiliaries are biomechanically insufficient for effective torque control.

KEYWORDS: Clear aligners; Torque expression; Power ridge; Auxillaries; Finite element analysis.

CONFLICT OF INTEREST AND FUNDING

Nil
How to cite this article: Shifo Savio, Srirengalakshmi Muthuswamy Pandian, Muskan Chanduka, Aravind Kumar Subramanian, Nikhillesh Vaiid. Prediction Of Torque Expression Of Upper Central Incisor Using Different Auxiliaries In Clear Aligners - A FEM Study. Int J Orthod Rehabil 2025;16 (4): 91-99.

Original Research

Year : 2025 | Volume : 16 | Issue : 4 | Page : 77-90

A Comparison of Cervical Spine Postural Changes following Fixed and Removable Functional Appliance Therapy in Growing Class II Subjects

Bhargavi Ganesan1, Vignesh Kailasam2, Sridevi Padmanabhan3

1-Post Graduate Resident, 2-Professor, 3-Professor and Head,  Associate Dean Research, Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, 600116, India

Address for Correspondence:

Dr. Vignesh Kailasam

Professor and Head, Department of Orthodontics and Dentofacial Orthopaedics,

Sri Ramachandra Institute of Higher Education and Research (SRIHER)

Chennai, 600116, India

Email: vignesh.k@sriramachandra.edu.in

ABSTRACT     

Introduction: The objective was to compare the cervical spine postural changes after treatment with fixed and removable functional appliances.

Methods and Analysis: A retrospective study with pre and post lateral cephalograms of 60 patients was planned. They were divided into three groups- fixed functional appliance, removable functional appliance and a control group which involved camouflage mechanics. Cervical spine posture and airway were assessed. The craniocervical angulation changes were correlated to changes in ANB, mandibular parameters and airway.

Results: Amongst the cervical spine postural variables, only the sella-nasion to odontoid process tangent (SN-OPT) showed significant changes (Twin block/control, p=0.041). Removable and fixed functional appliances brought about a reduction in the SN-OPT. However, this was not statistically significant (Herbst/control=0.184; Herbst/Twin block, p=0.761). Control group revealed an increase in the SN-OPT and this difference was significant between Twin block and control group (p=0.041). There were significant variations in the SNB (p=0.000) and ANB (Herbst/control, p=0.003; Twin block/control, p=0.001) between both Herbst and Twin block groups when compared with control group. However, there were no significant differences between the Herbst and Twin block groups (SNB, p=0.333;ANB,p=0.974). There were no significant differences in the mandibular length and the mandibular plane angle between the three groups (mandibular length, p=0.206; mandibular plane angle, p=0.788). Changes in superior, middle and inferior pharyngeal airway were not significantly different between the three groups (p=.537; p=.354; p=.110 respectively).

Conclusion: The functional appliances did not affect significant changes in the cervical spine posture. There were no significant differences between fixed and removable functional appliances.
Keywords: Cervical spine posture; Orthodontic appliances; Fixed functional appliances; Removable functional appliances.

FUNDING STATEMENT

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

COMPETING INTERESTS

No competing interests

RESEARCH ETHICAL APPROVAL

Ethical approval from the Institutional Ethics Committee was obtained. CSP/20/OCT/86/172

How to cite this article: Bhargavi Ganesan, Vignesh Kailasam, Sridevi Padmanabhan. A Comparison of Cervical Spine Postural Changes following Fixed and Removable Functional Appliance Therapy in Growing Class II Subjects. Int J Orthod Rehabil 2025; 16 (4): 77-90.

Review Article

Year : 2025 | Volume : 16 | Issue : 4 | Page : 63-76

Comparison of Efficacy between Tooth Borne and Bone Borne Mini Implant Assisted Rapid Palatal Expansion with Conventional Palatal Expansion – A Systematic Review

Anjusha Divakar1, Ashwin Mathew George2, Prasanna Arvind T.R.3, Deepika Katyal4

1-Post Graduate Resident, 2-Professor, 3-Assistant Professor, Department of Orthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai-77, India, 4-Assistant Professor, Department of Orthodontics, Sree Balaji Dental College and Hospitals, Chennai-77, India

Address for Correspondence:

Dr.Ashwin Mathew George

Professor, Department of Orthodontics and Dentofacial Orthopaedics

Saveetha Dental College and Hospitals

SIMATS University

Email: ashwin.george10@gmail.com

ABSTRACT

Background: Transverse maxillary discrepancies often develop due to altered skeletal growth patterns influenced by prolonged oral habits and impaired orofacial muscle function. Traditional methods like Rapid Maxillary Expansion (RME) and Slow Maxillary Expansion (SME), have been widely used, particularly in younger patients. MARPE is a minimally invasive, micro-implant–supported expansion technique designed to achieve skeletal maxillary widening in adolescents and adults. The objective of this review was to critically appraise and synthesize the evidence comparing mini-screw–assisted rapid palatal expansion (MARPE) with conventional rapid palatal expansion (RPE) in terms of skeletal expansion, dentoalveolar changes, and periodontal effects.

Materials and Methods: Electronic and manual searches were performed based on predefined PICO eligibility parameters. Risk of bias was assessed using the ROB-2 tool for randomized controlled trials and the ROBINS-I tool for non-randomized studies. The evidence was then synthesized narratively to evaluate skeletal, dentoalveolar, and periodontal outcomes.

Results: Six studies were included, most with low to moderate risk of bias. MARPE showed higher skeletal effectiveness, with midpalatal suture opening rates of 84–100% and consistently greater increases in nasal width compared with conventional RPE. Dentoalveolar changes were smaller with MARPE, with molar inclination ranging from 1.3° lingual to 3.9° buccal, lower than in tooth-borne expanders. Periodontal findings also favored MARPE, with studies reporting less buccal bone and alveolar height loss, indicating improved preservation of supporting structures.

Conclusion: The review indicates that MARPE is an effective non-surgical option for maxillary expansion in late adolescents, offering greater skeletal expansion with fewer dentoalveolar and periodontal side effects than conventional expanders. However, the predominance of studies with moderate risk of bias underscores the need for higher-quality research to confirm these findings.
Keywords: MARPE, Rapid Palatal Expansion, Maxillary Constriction, Skeletal Expansion, Dentoalveolar Effects, Systematic Review

CONFLICT OF INTEREST

The authors have no conflict of interests to declare.

FUNDING

Nil.

How to cite this article: Anjusha Divakar, Ashwin Mathew George, Prasanna Arvind T.R., Deepika Katyal. Comparison of Efficacy between Tooth Borne and Bone Borne Mini Implant Assisted Rapid Palatal Expansion with Conventional Palatal Expansion – A Systematic Review. Int J OrthodRehabil 2025; 16 (4): 63-76.

Original Research

Year : 2025 | Volume : 16 | Issue : 4 | Page : 52-62

Orthodontists’ Experiences with Clear-Aligner Treatment Discontinuation: A Cross-Sectional Survey.

Pervin Bilginer1, Merve Kurnaz2, Osman Bilal Kandaz3, Sibel Biren4

1Private Practice, 2Assistant Professor, 3PhD Student, 4Professor, Istanbul Kent University, Faculty of Dentistry, Department of Orthodontics, Istanbul, Turkey.

Address for Correspondence:

Dr Osman Bilal Kandaz

PhD Student, Istanbul Kent University

Faculty of Dentistry, Department of Orthodontics, İstanbul, Turkey

Cihangir, Sıraselviler Cd. No:71, 34433 Beyoğlu/İstanbul

Phone: +90 539 318 20 21

E-mail: bikandaz@gmail.com

ABSTRACT

Background: The aim of this study was to evaluate orthodontists’ reported experiences with clear aligner therapy and fixed appliances, with particular emphasis on treatment discontinuation, compliance, and conversion to alternative treatment modalities. By analyzing the collected responses, the study seeks to clarify the key contributors to patient discontinuation.

Methodology: A cross-sectional survey was distributed to orthodontists in Türkiye who actively provided clear aligner therapy. Eligibility required orthodontic training and clinical practice in Türkiye. A priori power analysis determined a sample size of 134 respondents. Clinicians reported aligner-related outcomes based on clinical records. Data was analyzed using descriptive statistics and Chi-square tests (SPSS v25, p < 0.05).

Results: Among the orthodontists, 31.34% (42/134) with more than 10 years of experience reported having over 100 ongoing cases, and 9.70% (13/134) had completed more than 100 clear aligner (CAT) treatments. Treatment discontinuation was predominantly attributed to patient abandonment (63.43%, 85/134), while 31.34% (42/134) of patients transitioned to alternative fixed appliance therapy. Additionally, 5.22% (7/134) of patients who discontinued aligner therapy completed their treatment through restorative dental procedures. 46.27% (62/134) of patients who discontinued treatment had exhibited poor oral hygiene, non-compliance, or motivational issues prior to withdrawal. Among surveyed orthodontists, 45.52% (61/134) reported challenges with CAT planning, while 58.96% (79/134) handled the planning independently. Significant correlation was found between limited clinical experience (1–5 years) and higher discontinuation rates (9.68%, 13/134; p = 0.006). Strong correlation was identified between orthodontists treating 1–10 patients and having more than five discontinuations (3.13%, 4/134; p = 0.009). Discontinuation rates were notably higher among patients under 18 years (65%, 87/134).

Conclusions: Orthodontists reported higher discontinuation and conversion rates in clear aligner therapy, emphasizing the importance of realistic treatment planning, regular monitoring, and continued professional education. Standardized tracking systems may provide more precise insights into factors associated with treatment discontinuation.
Keywords: Clear aligners, Patient compliance, Orthodontic treatment

CONFLICT OF INTEREST

The authors have no conflict of interests to declare.

FUNDING

Nil.
How to cite this article: Pervin Bilginer, Merve Kurnaz, Osman Bilal Kandaz, Sibel Biren. Orthodontists’ Experiences with Clear-Aligner Treatment Discontinuation: A Cross-Sectional Survey.

Int J Orthod Rehabil 2025; 16 (4): 52-62.

Original Research

Year : 2025 | Volume : 16 | Issue : 4 | Page : 39-51

Comparison of Efficacy and Rate of Alignment using Three Different Arch wires: A Randomized Clinical Trial

 B Edward Giftson Noah1, S.D. Milling Tania2, S. Veerasankar3, Bevin Shaga3, Jebilla Pringle4, Razick Nishadh M4, Shahina Juneith4

 1Postgraduate Resident, 2Professor, 3Associate Professor, 4Assistant Professor, Department of Orthodontics, Rajas Dental College, Rajas Dental College And Hospital, Thirurajapuram, Kavalkinaru Jn, Tirunelveli - 627 105

Address for Correspondence:

Dr. S.D. Milling Tania,

Professor and HOD,
Rajas Dental College And Hospital

Thirurajapuram, Kavalkinaru Jn, Tirunelveli - 627 105
Email ID - drtania_d@yahoo.co.in

ABSTRACT

Aim: To compare the rate and efficiency of Niobium-Titanium-Tantalum Zirconium archwire (Gummetal), Copper Nickel Titanium archwire (CuNiTi) and conventional nickel titanium archwire (NiTi) on initial alignment.

Materials And Methods: A single-center randomized controlled clinical trial was conducted in 33 fully erupted dentition patients and Little’s Irregularity Index (LII) >2 mm. Patients were randomly assigned to three groups (n=11 each) treated with 0.014-inch NiTi, CuNiTi, or Gummetal archwires. Impressions were taken at baseline (T0) and at 3-week intervals for 4 times (T1–T4). LII, Intercanine width (ICW) and intermolar width (IMW) were measured and analyzed using SPSS v20.0 with Repeated Measures ANOVA, Bonferroni post-hoc, and Chi-square tests with p value <0.05 as statistical significance.

Results: All groups showed statistically significant reduction in LII from T0 to T4 (p<0.001). Group 1 showed a decrease from 3.76±0.75 to 1.02±0.53, Group 2 from 3.74±0.64 to 0.90±0.25, and Group 3 from 3.04±0.59 to 1.33±0.66. ICW increased significantly in all groups: Group 1 from 25.93±2.86 to 26.58±2.78 (p<0.001), Group 2 from 25.59±2.68 to 26.64±2.76 (p < 0.001), and Group 3 from 25.79±2.86 to 26.52±2.83 (p=0.008). IMW changes were significant in Group 2 (40.76±2.66 to 41.11±2.63, p<0.001) and Group 3 (40.95±2.61 to 41.11±2.63, p<0.001), but not in Group 1 (41.01±2.64 to 41.08±2.62, p=0.136). Intergroup comparison revealed no statistically significant difference in LII, ICW, or IMW (p≥0.051).

Conclusions: CuNiTi and NiTi archwires were more effective in initial alignment and mild arch expansion than Gummetal, making them preferable for early orthodontic correction.

Keywords: Archwires, Copper NiTi, Gummetal, Intercanine arch width

CONFLICT OF INTEREST

The authors have no conflict of interests to declare.

FUNDING

Nil.
How to cite this article: B Edward Giftson Noah, S.D. Milling Tania, S. Veerasankar, Bevin Shaga, Jebilla Pringle, Razick Nishadh M, Shahina Juneith.Comparison of Efficacy and Rate of Alignment using Three Different Arch wires: A Randomized Clinical Trial. Int J Orthod Rehabil 2025; 16 (4): 39-51.

Review Article

Year : 2025 | Volume : 16 | Issue : 4 | Page : 14-38

Antimicrobial, Biocompatibility, and Durability Outcomes of Nanoparticle-Coated Orthodontic Materials: A Systematic Review of In Vivo Evidence

Avula Samata1, Gowri Sankar Singaraju2, Prasad Mandava2, P V Sravya Silpa1

1-Postgraduate Resident, 2-Professor, Department of Orthodontics, Narayana Dental College, Nellore, Andhra Pradesh, India-524003
Address for Correspondence:

Dr. Prasad Mandava,

Professor and Head, Department of Orthodontics,

Narayana Dental College,

Nellore, Andhra Pradesh, India -524003.

Email ID: mandavabruno9@gmail.com

ABSTRACT

Objective: To systematically review available in vivo evidence from animal and human studies evaluating the antimicrobial efficacy, biocompatibility, and durability of metallic nanoparticle-coated orthodontic materials, excluding all in vitro research.

Methods: Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Ovid, and ClinicalTrials.gov for studies published from January 2015 to August 2025, supplemented by manual and grey-literature searches. Eligible studies included in vivo animal or human investigations assessing surface coatings of orthodontic components—brackets, archwires, ligatures, elastomeric modules, or aligners—with metallic or metal-oxide nanoparticles (Ag, TiN, TiO₂, N-TiO₂, ZnO, Au). Primary outcomes were antimicrobial efficacy (CFU, qPCR, or biofilm indices); secondary outcomes included biocompatibility (ion release, cytotoxicity, mucosal response) and coating durability. Quality appraisal used SYRCLE, RoB 2, and ROBINS-I tools; evidence certainty was graded using GRADE. Registration: OSF (https://doi.org/10.17605/OSF.IO/5CZSG).

Results: Of 1,499 records, eight in vivo studies met the inclusion criteria—six human and two animal. Nanoparticles evaluated were Ag, TiN, TiO₂, N-TiO₂, ZnO, and Au. All demonstrated reduced Streptococcus mutans or related bacterial loads compared with uncoated controls. Silver coatings produced early antibacterial effects but released trace Ag⁺ (0.16–0.35 ppb). TiO₂ and TiN coatings reduced bacterial adhesion up to four weeks but showed partial delamination (~60%). N-doped TiO₂ extended efficacy to 60 days, while ZnO coatings-maintained suppression and enamel protection for 12 months despite early surface degradation. Gold nanoclusters exhibited short-term antibacterial and excellent biocompatibility in animal models. Biocompatibility was acceptable across studies, but durability and long-term stability were inconsistently assessed. Meta-analysis was precluded by heterogeneity of outcomes and timepoints. Overall risk of bias ranged from low to serious; certainty of evidence was low to moderate.

Conclusions: In vivo data indicate short-term antibacterial and biocompatible benefits of metallic nanoparticle coatings on orthodontic materials; however, evidence for coating durability and long-term safety is limited. Well-designed randomized clinical trials with standardized microbial, biocompatibility, and durability outcomes are essential for clinical translation.
Keywords: Metallic nanoparticles; Orthodontic materials; Antimicrobial; Biocompatibility; Durability; In vivo; Systematic review.

CONFLICT OF INTEREST

The authors have no conflict of interests to declare.

FUNDING

Nil.
How to cite this article: Avula Samata, Gowri Sankar Singaraju, Prasad Mandava, P V Sravya Silpa. Antimicrobial, Biocompatibility, and Durability Outcomes of Nanoparticle-Coated Orthodontic Materials: A Systematic Review of In Vivo Evidence. Int J Orthod Rehabil 2025; 16 (4): 14-38.

Original Research

Year : 2025 | Volume : 16 | Issue : 4 | Page : 1-13

Antimicrobial Potential Of Pycnogenol® Coated Orthodontic Modules Against Oral Pathogens: An Invitro Study

Divya Devraj,1 Ratna Parameswaran,2 Monikaa Marappan,1 Seerab Husain,3

1-Postgraduate Resident, 2-Professor, 3-Assistant Professor, Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India

Address for Correspondence:

Dr. Ratna Parameswaran

Department of Orthodontics, Meenakshi Ammal Dental College and Hospital

Meenakshi Academy of Higher Education and Research (Deemed to be University)

Alapakkam Main Road, Chennai – 600 095

Tamil Nadu, India

Email ID: drratna.ortho@madch.edu.in

ABSTRACT

Introduction: Fixed orthodontic treatment increases the oral microbial count, leading to a series of oral health problem. Incorporating products containing antimicrobial effects into the orthodontic materials reduces the escalation of harmful effects of these pathogens. Pycnogenol ®, an extract from the bark of French pine tree (Pinus pinaster Aiton) is a major constituent of over 1000 dietary supplements and variety of other products worldwide, used for treating various illness. However, its potential in orthodontics remains to be explored.

Materials and Methods: Pycnogenol ® extract was prepared and coated onto the orthodontic modules. Drug loading and drug release kinetics was studied using UV visual spectrometry. The coated modules were subjected to antimicrobial testing against common oral pathogens. SEM imaging was done to analyse the surface coating of the orthodontic modules.

Results: The antimicrobial activity for S. mutans, E. coli, and S. aureus were studied at 1, 8, and 24 hours. The mean rank obtained from MIC showed that there is a highly significant difference between the bacterial groups in all the time duration. Direct agar diffusion test showed profound zone of inhibition of 20 mm for S. mutans. Additionally, Pycnogenol ® coated modules also demonstrates antimicrobial activity against E. coli and S. aureus.

Conclusion: Increased microbial adhesion to orthodontic appliances and modules causes a sequelae of oral health problems. Pycnogenol® is a potent antioxidant possessing antimicrobial and anti-inflammatory properties. The study exhibits the release of the Pycnogenol® from the modules after coating and the coated modules also demonstrate antimicrobial activity.

Keywords: Fixed Orthodontic Appliances, Pycnogenol, antioxidant, reactive oxygen species, ROS, Antimicrobial, Oral Pathogens, Modules.

FUNDING

This study was funded by Meenakshi Academy of Higher Education and Research (Deemed to be University), Chennai. Ref: MADC/IEC/041/2021

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest in this study.

How to cite this article: Divya Devraj, Ratna Parameswaran, Monikaa Marappan, Seerab Husain. Antimicrobial Potential Of Pycnogenol® Coated Orthodontic Modules Against Oral Pathogens: An Invitro Study. Int J Orthod Rehabil 2025; 16 (4): 1-13.

Original Research

Year : 2025 | Volume : 16 | Issue : 3 | Page : 82-92

Assessment Of the Correlation Between Cephalometric Measurements and Facial Attractiveness

Udit Chaudhary,1 Monis Raza,2 Achint Juneja,3 Ridhi Kothari,4 Tanvi Gupta,5

 1-Postgraduate Resident, 2-Associate Professor, 3-Professor, 4-Assistant Professor, Department of Orthodontics & Dentofacial Orthopaedics, Institute of Dental Studies and Technologies (IDST), Modinagar, Uttar Pradesh, India, 5-Postgraduate Resident, Department of Orthodontics, Himachal Institute of Dental Sciences, India

Address for Correspondence:

Dr. Monis Raza
Associate Professor,

Department of Orthodontics & Dentofacial Orthopaedics
Institute of Dental Studies and Technologies (IDST),

Modinagar, Uttar Pradesh, India
Email: monis8raza@gmail.com

ABSTRACT

Aim: This study aimed to evaluate both linear and nonlinear (quadratic) correlations between cephalometric variables and facial attractiveness in North Indian adults.

Methods: Pretreatment frontal and profile photographs and lateral cephalograms of 30 adults (10 Class I, 10 Class II, 10 Class III) were analysed. Attractiveness was rated on a 10-cm visual analog scale by 40 evaluators (orthodontists, prosthodontists, general dentists, and laypersons). Cephalometric variables were traced using Nemoceph software and correlated with attractiveness scores through linear and quadratic regression analyses.

Results: No significant differences in attractiveness were observed among malocclusion groups (p = 0.120). Only the glabella-to-true vertical line (G′-TVL) distance showed a significant quadratic correlation with profile attractiveness (r = 0.63, p = 0.010).

Conclusion: In North Indian adults, malocclusion class was not associated with perceived facial attractiveness. Glabella position relative to the true vertical line showed a quadratic association, suggesting that forehead morphology may influence esthetic perception.
Keywords: Cephalometry; Facial Aesthetics; Orthodontics; India; Soft Tissue

 SOURCE OF FUNDING

Nil

CONFLICTS OF INTEREST

Nil

How to cite this article: Udit Chaudhary, Monis Raza, Achint Juneja, Ridhi Kothari, Tanvi Gupta. Assessment Of the Correlation Between Cephalometric Measurements and Facial Attractiveness. Int J Orthod Rehabil 2025; 16 (3): 82-92.