Nonextraction Management of Severe Crowding in a Growing Patient with Borderline Malocclusion: Case Report Devaki Vijayalakshmi, Ratna Parameswaran, Ahana S Rajan, Balaji Rajkumar International Journal of Clinical Pediatric Dentistry, 2024 A borderline case presents with mild skeletal disharmony or orthodontic problems due to arch length discrepancy and migration of teeth or a combination of these but is masked by a balanced soft tissue relationship. This case report describes one such borderline case of a 13-year-old girl who complained of irregularly placed upper and lower front teeth. Extraoral examination revealed balanced soft tissue with a mild convex profile, competent lips, and an average nasolabial angle. Intraorally, she had mixed dentition with flush terminal in primary molars and a class I relation in the permanent molars, severe crowding in the lower anterior, and congenitally missing permanent right laterals. A nonextraction protocol was followed, harnessing the pubertal growth spurt to alleviate the crowding and thereby preserving the soft tissue harmony. How to cite this article Rajan AS, Parameswaran R, Rajkumar B, et al. Nonextraction Management of Severe Crowding in a Growing Patient with Borderline Malocclusion: Case Report. Int J Clin Pediatr Dent 2024;17(4):472-478.
Evaluation of pharyngeal airway volume three-dimensionally in various sagittal skeletal patterns - Systematic review B. Rajkumar, Ratna Parameswaran, Mary Sanjana, Srinivasan Boovaraghavan, Devaki Vijayalakshmi Indian Journal of Dental Research, 2023 To investigate the pharyngeal airway volume in different anteroposterior skeletal malocclusions. This study was prepared according to the Cochrane criteria for creating a systematic review and meta-analysis and confirms the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. This search was conducted to answer the patient/population, intervention, comparison and outcomes (PICO) question: To evaluate (outcome) and compare (comparison) whether there is a difference in airway volume in patients (participants) with different skeletal malocclusions diagnosed using 3D data (intervention).The first two authors extracted the data from the included studies and assessed the risk of bias in the individual studies using the Newcastle-Ottawa scale. Meta-analysis was done using STATA version 16, which compared various three-dimensional pharyngeal airway parameters in skeletal Class II and skeletal Class III malocclusions with that of skeletal class I malocclusion. Out of 370 articles from the initial search, 17 articles were included in the systematic review. Out of 17 studies, 12 eligible studies were included in the quantitative synthesis. The nasopharynx, oropharynx, hypopharynx, and total airway volume were increased in skeletal Class I malocclusion compared to that of skeletal Class II malocclusion and decreased in comparison to skeletal Class III malocclusion. The moderate quality of evidence indicates the total airway volume, oropharynx, and hypopharynx are largest in skeletal Class III compared to Class I and Class II skeletal malocclusion.
ENHANCEMENT OF SMILE ESTHETICS WITH TOTAL MAXILLARY ARCH INTRUSION USING TEMPORARY SKELETAL ANCHORAGE DEVICE – A CASE REPORT Manoj R Sekar, Ratna Parameswaran, Dr.Balaji Rajkumar, Dr. Srinivasan Boovaraghavan, Dr. Devaki Vijayalakshmi International Journal of Orthodontic Rehabilitation, 2022 Smile esthetics is a prime concern in contemporary orthodontic therapy. This case report is about a growing female patient with the inability to close the lips, vertical maxillary excess and hyperdivergent class II skeletal pattern. To enhance skeletal therapy benefits , differential intrusion of segments in the upper arch was required. Bilateral Bollard type miniplates were inserted on the infrazygomatic crest . The technique employed helped this patient avoid orthognathic surgery by allowing a complete upper arch intrusion, treating lip incompetence and causing counterclockwise movement of the mandible.
Evaluation of volume change in oral cavity proper before and after mandibular advancement: A retrospective volumetric study Balaji Rajkumar, Ratna Parameswaran, Anantanarayanan Parameswaran, Devaki Vijayalakshmi Angle Orthodontist, 2021 Objectives To evaluate the tongue and oral cavity proper volume in pre- and post-bilateral sagittal split osteotomy (BSSO) patients, and to establish whether there was a correlation between them. Materials and Methods A retrospective study that evaluated 12 patients' pre- and post-surgical computed tomography records satisfying the inclusion criteria. Borders were defined for measurement of tongue and oral cavity proper volume. The volume assessment was carried out using 3D slice software. Results The mean difference of tongue volume was 5.7 ± 1.7 cm3, which showed high statistical significance. The mean difference of oral cavity proper volume (OCVP) was 6.9 ± 3.4 cm3 and indicated high statistical significance. A very strong positive correlation existed between pre- and post-surgical tongue volume. Positive correlation was also evident between pre and post - surgical OCVP. Medium positive correlation was noted when the difference between pre- and post-surgical tongue and OCVP were assessed. Conclusions There was a significant change in volume of tongue and oral cavity proper after BSSO advancement surgery. The space around the tongue, position of tongue, and maxillary and mandibular relationship influence the volume of tongue and oral cavity proper.
