Vinay Kumar Chugh

Aim: To explore changes in salivary biomarkers and rate of tooth movement during en-masse retraction into recent and healed extraction sites. Methods: A total of 20 patients with prominent anterior maxillary teeth requiring en-masse retraction were randomly allocated into two groups. First premolar extractions were carried out either at the start of orthodontic treatment (healed extraction group) or immediately before the commencement of en-masse retraction (recent extraction group). Unstimulated saliva samples and study models were collected at five time points: before the start of orthodontic treatment; after alignment and levelling; and at 2, 8 and 12 weeks after the initiation of retraction. Changes in concentrations of salivary biomarkers were assessed as primary outcomes. Rate of tooth movement was evaluated as a secondary outcome. A mixed analysis of variance was used to evaluate changes in salivary biomarker concentrations over time and between groups. The rate of tooth movement was compared between groups using an independent t -test. Results: Both groups demonstrated an increase in salivary receptor activator of nuclear factor kappa-B ligand (RANKL) levels and a decrease in osteoprotegerin (OPG) levels during the 12-week retraction period. Significant time and group interaction was observed for the RANKL:OPG ratio ( P < 0.05). Between-group differences at individual time points were not statistically significant after correction for multiple comparisons. A statistically significantly higher rate of tooth movement was found in the recent extraction group (mean difference: 0.07 mm/week, 95% confidence interval 0.04–0.09; P < 0.05), although this difference is probably not clinically significant. Conclusions: The RANKL:OPG ratio may reflect the biological activity during orthodontic tooth movement better than individual biomarker concentrations and extraction timing may influence the rate of space closure. Trial registry: Trial was prospectively registered with the Clinical Trials Registry India ( https://ctri.nic.in/Clinicaltrials ) CTRI/2020/12/029660 and approved by the Institutional Ethics Committee of All India Institute of Medical Sciences, Jodhpur (AIIMS/IEC/2019-20/977), Rajasthan, India.

The aim was to compare the reliability of cephalometric analysis using a smartphone-based application with conventional computer-based imaging software. Pre-treatment cephalometric radiographs of 50 subjects (26 males, 24 females; mean age, 19.2 years; ±4.2) were traced using the OneCeph® application and Dolphin imaging software®. Two independent observers identified seventeen landmarks and measured fourteen cephalometric measurements at an interval of. Interobserver and intraobserver reliability were evaluated using the intraclass correlation coefficient. Student's t-test was used to compare the means of two measurement methods for observer 1 and observer 2. Additionally, the time taken to complete the cephalometric measurements was also compared between the two methods. Good (ICC 0.75-0.90) to excellent (ICC 0.90-1.00) interobserver and intraobserver reliability was observed for all hard and soft tissue measurements with both methods. No significant differences were found between the two measurement methods for both observers (p<0.05). OneCeph application took significantly more time to complete the analysis than Dolphin imaging software (p<0.001). Cephalometric measurements made through a smartphone-based application showed good to excellent interobserver and intraobserver reliability and are comparable with the computer-based software. Therefore, it can be recommended for clinical use. The time taken to complete the cephalometric measurements was more with a smartphone-based application (OneCeph application) compared to computer-based software (Dolphin imaging software).

Objective: To compare rate and anchorage loss during en‐masse retraction of anterior maxillary teeth between friction mechanics (FM) and frictionless mechanics (FLM).Setting and Sample Population: Thirty‐eight patients requiring en‐masse retraction of protruded anterior maxillary teeth were randomly allocated into FM and FLM groups.Methods: En‐masse retraction with sliding mechanics (FM) using an elastomeric chain was compared with continuous mushroom loop archwire mechanics (FLM). Study models and lateral cephalograms were taken before (T1) and immediately after retraction (T2). The primary outcome was the rate of en‐masse retraction. Anchorage loss was the secondary outcome. Intergroup comparison was performed using an independent t test (P < .05).Results: Baseline characteristics were similar between groups. Thirty‐six patients completed the trial. Two patients were lost to follow‐up in the FLM group. The rate of en‐masse retraction did not differ significantly (P = .625) between FM (0.7 mm/mo) and FLM (0.8 mm/mo) groups. The intragroup comparison showed significant anchorage loss in FM (2.28 mm) and FLM (1.13 mm) groups; however, the intergroup comparison showed no statistically significant difference (P = .093). Maxillary first molar showed a statistically significant change in angulation between the two mechanic groups (P < .001). Vertical movement of the maxillary incisor and first molar showed no significant difference between FM and FLM groups (P = .143, P = .546, respectively).Conclusions: The rate of en‐masse retraction and anchorage loss was comparable between the FM and FLM groups. Significant anchorage loss was seen with both mechanics. The result suggests that both the mechanic group require external reinforcement to prevent anchorage loss.

Objective: To compare alignment efficiency and root resorption between nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi) archwires after complete alignment in mandibular anterior region. Methods: In this two-arm parallel single-blind randomized controlled trial, forty-four patients with Class I malocclusion with mandibular anterior crowding were recruited form orthodontic clinic of All India Institute of Medical Sciences (Jodhpur, India). Patients were randomly allocated into NiTi and CuNiTi groups, with a 1:1 allocation. Alignment was performed using 0.014-in, 0.016-in, 0.018-in, 0.019x0.025-in archwire sequence in the respective groups, which terminated in 0.019 x 0.025-in stainless-steel working archwire. The primary outcome was alignment efficiency, measured on study models from baseline (T0) to the first, second, third, fourth and fifth-month (T5). Secondary outcome was root resorption, measured from CBCT scans taken at T0 and T5. Mixed-factorial ANOVA was used to compare Little’s Irregularity Index (LII). For assessing the proportion of patients with complete alignment at the end of each month, Kaplan-Meier survival curve was built and time to treatment completion was compared between groups using log rank test. Paired t-test was used to assess external apical root resorption (EARR) within groups, whereas independent t-test was used to evaluate LII and EARR between the groups. Results: Twenty-two patients were recruited in each group. One patient was lost to follow-up in the CuNiTi group. No statistically significant differences were observed in alignment efficiency between the groups (p>0.05). Intergroup comparison revealed that the changes in root measurement in three-dimensions were not statistically significant (p>0.05), except for mandibular right central incisor, which showed increased resorption at root apex in NiTi group (p<0.01). Conclusion: The two alignment archwires showed similar rate of alignment at all time points. Root resorption measurement did not differ between the NiTi and CuNiTi groups, except for the mandibular right central incisor, which showed more resorption in NiTi group.