International Journal of Clinical Pediatric Dentistry

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2017 | July-September | Volume 10 | Issue 3

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Nelamakanahalli K Suma

Effect of Dentin Disinfection with 2% Chlorhexidine Gluconate and 0.3% Iodine on Dentin Bond Strength: An in vitro Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:223 - 228]

   DOI: 10.5005/jp-journals-10005-1440  |  Open Access |  How to cite  | 


Objective: Cavity preparation is a surgical procedure that attempts to remove all infected dentin.1 Bacteria left beneath the filling material is greatest threat to the pulp. To reduce the potential for residual caries development and sensitivity, an antibacterial solution with the ability to disinfect the prepared tooth surface would be of help.2 So this study was conducted to evaluate and compare the effect of dentin disinfection with 2% chlorhexidine gluconate (Consepsis) and 0.3% iodine (Ora5) on shear bond strength (SBS) of self-etch adhesives to dentin. Materials and methods: Buccal surfaces of 36 caries-free permanent third molars were ground to expose dentin. All specimens were mounted on acrylic block, divided randomly into three groups, namely group I (control), group II (Consepsis), and group III (Ora5). After the application of cavity disinfectant and bonding procedures as per manufacturer's instructions, composite cylinders were built. Then SBS was measured using universal testing machine. Results: Statistical analysis of the measurements were made using one-way analysis of variance (ANOVA), which showed that when cavity disinfectants (Consepsis and Ora5) were used there was significant reduction in SBS of composite to dentin when compared with that of control group. Interpretation and conclusion: The results indicate that the use of commercially available cavity disinfectants, Consepsis containing 2% chlorhexidine gluconate and Ora5 containing 0.3% iodine and 0.15% potassium iodide with self-etch adhesive (Adper Prompt), would significantly lower SBS of composite to dentin.



Yahya B Nakhjavani, Farid B Nakhjavani, Ahmad Jafari

Mesial Stripping of Mandibular Deciduous Canines for Correction of Permanent Lateral Incisors

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:229 - 233]

   DOI: 10.5005/jp-journals-10005-1441  |  Open Access |  How to cite  | 


Aim: Stripping is a technique of creating space for correction of crowding by interproximal enamel reduction. This study sought to assess the efficacy of mesial stripping of mandibular deciduous canines for correction of rotated and lingually erupted lateral incisors. Materials and methods: This clinical trial was performed on 42 patients with ≤3 mm mandibular anterior crowding. The required space was determined using the Moyers' method and 3 mm of canine mesial surfaces was removed using a bur. Alginate impressions were made and the correction of crowding was evaluated until 5 months after the treatment. Data were analyzed using Fisher's exact, Kruskal—Wallis, and Mann—Whitney U tests. Results: Mesial stripping of canines completely removed the crowding of anterior teeth; however; in a few cases, this correction was not complete, in which, the amount of space required was calculated to be near zero. Patient gender and occlusal relations had no significant effect on the correction of crowding; however, the amount of space required was significantly affected by the position of left lateral incisors (p < 0.001). Conclusion: Mesial stripping of deciduous canines is an effective technique to remove ≤3 mm crowding of buccally and lingually erupted permanent lateral incisors. Thus, stripping is recommended for space regaining and crowding correction.



Sneha Thakur, Rishika Habib

Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:234 - 239]

   DOI: 10.5005/jp-journals-10005-1442  |  Open Access |  How to cite  | 


Introduction: With greater awareness worldwide, the use of herbs and herbal products has increased to a large extent. Objective: To evaluate and compare the antimicrobial efficacy of green tea, garlic with lime, and 0.05% sodium fluoride (NaF) mouth rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans. Materials and methods: A total of 45 children aged 4 to 6 years with severe early childhood caries (S-ECC; based on decayed extracted filled [defs] score) were selected. Children were divided randomly into three equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and postrinsing nonstimulated whole salivary sample (2 mL) was collected and tested for the number of colony-forming units (CFUs). The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software with one-way analysis of variance (ANOVA) and Tukey's post hoc test. Results: A statistically significant fall in colony count was found with the three mouth rinses in S. mutans (p < 0.001, p < 0.001) and Lactobacilli spp. (p < 0.001, p < 0.001), but not against C. albicans (p = 0.264, p = 0.264). On comparison, no statistically significant difference was found against S. mutans (p = 1, p = 0.554, p = 0.572), lactobacilli spp. (p = 0.884, p = 0.999, p = 0.819), and C. albicans (p = 0.999, p = 0.958, p = 0.983). Conclusion: The findings of this study indicate that green tea and garlic with lime mouth rinse can be an economical alternative to NaF mouth rinse both for prevention and therapeutics.



Ravigna Peddi, B Sunitha, P Tarasingh

Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:240 - 244]

   DOI: 10.5005/jp-journals-10005-1443  |  Open Access |  How to cite  | 


Background: The medicament formocresol (FC) used for pulpotomy in primary teeth has great concerns regarding its toxicity due to one of its constituent formaldehyde which acts by tissue fixation. Therefore, new medicaments were introduced which claimed preservation and regeneration of pulp. Aim: The present study is aimed to compare and evaluate the clinical and radiographic success of FC, pulpotec, mineral trioxide aggregate (MTA), and emdogain (EMD) as pulpotomy medicaments in human primary molars. Design: A sample of 21 patients with 84 teeth were selected. All the patients have at least four teeth eligible for pulpotomy according to selection criteria. In each mouth, the teeth selected were randomly allocated into four groups with 21 each. Results: After 24 months of follow-up, the clinical success rates were FC (94%), pulpotec (94%), MTA (100%), and EMD (83%) and radiographically FC (88%), pulpotec (83%), MTA (94%), and EMD (72%), which were statistically not significant (p ≥ 0.05). Conclusion: The outcome of this study demonstrates MTA has a high success rate compared with FC, pulpotec, and EMD as pulpotomy agent. In addition, MTA, pulpotec, and EMD can be considered as alternatives to FC as pulpotomy agent.



Sandeep S Mayall, Telegi Ravishankar

Comparison of Dermatoglyphic Pattern among Cleft and Noncleft Children: A Cross-sectional Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:245 - 249]

   DOI: 10.5005/jp-journals-10005-1444  |  Open Access |  How to cite  | 


Background: Oral clefts are among the common congenital birth defects with a broad phenotypic gamut. Since the epidermal ridges of the fingers and palms as well as the facial structures like lip, alveolus, and palate are formed from the same embryonic tissues during the same embryonic period, the genetic and environmental factors responsible for causing cleft lip and palate might also affect dermatoglyphic patterns. Aim: Thus, study was undertaken to compare the dermatoglyphic pattern of children with orofacial clefts and normal children and to determine the correlation of dermatoglyphics with orofacial clefts. Materials and methods: Total study sample consisted of 120 children in the age group of 3 to 16 years being divided into study and control groups. Dermatoglyphic data obtained from both control and study groups were then subjected to statistical analysis. Results: Statistically no significant difference was found in the dermatoglyphic pattern and atd angle for both the groups. Conclusion: It was observed that dermatoglyphics in orofacial clefts may not be distinctive. Further, large-scale studies are recommended to confirm the same.



Deepesh Prajapati, Rashmi Nayak, Deepika Pai, Nagraj Upadhya, Vipin K Bhaskar, Pujan Kamath

Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:7] [Pages No:250 - 256]

   DOI: 10.5005/jp-journals-10005-1445  |  Open Access |  How to cite  | 


Aim: To evaluate the effectiveness of resin infiltration on artificial caries lesion by assessing the depth of resin penetration and the change in microhardness of lesion postinfiltration. Materials and methods: Totally 45 human extracted premolars were used to create an artificial demineralized lesion in enamel using demineralizing solution. A total of 15 samples (group I) were infiltrated with resin. The depth of resin penetration was studied using scanning electron microscope (SEM). Other half (n = 30) of samples was equally divided into three subgroups and Vickers hardness number (VHN) values were obtained to measure the surface microhardness as group IIa—before demineralization, IIb—after demineralization, IIc—postresin infiltration. Results: Mean depth of penetration in group I was 516.8 µm. There was statistically significant increase in VHN values of demineralized lesion postresin infiltration (independent Student's t-test, p < 0.001). Conclusion: Penetration depth of the resin infiltrant was deep enough to render beneficial effects, while significant increase in microhardness was observed postresin infiltration. Clinical significance: Infiltrant used can be considered as a valid treatment option for noncavitated lesions.


Original Article

Azhar Malik, Sumit Sabharwal, Aina Kumar, Praveen Singh Samant, Abishek Singh, Vineet Kumar Pandey

Implementation of Game-based Oral Health Education vs Conventional Oral Health Education on Children's Oral Health-related Knowledge and Oral Hygiene Status

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:4] [Pages No:257 - 260]

Keywords: Game-based oral health education, Oral health knowledge, Plaque scores

   DOI: 10.5005/jp-journals-10005-1446  |  Open Access |  How to cite  | 


Introduction: For the prevention of oral health problems, health education of schoolchildren has a vital role. The oral health status of the children can be improved if health promotion in schools is conducted in a comprehensive and interesting manner Objective: Effectivity of game-based oral health education over conventional on the oral health-related knowledge and oral hygiene status among 8- to 12-year-old schoolchildren. Materials and methods: A total of 150 children aged 8 to 12 years were divided into two groups. A pretest evaluation of their knowledge regarding oral health and the estimation of plaque index was carried out. Children in group I were given oral health education through PowerPoint presentation once daily for 7 days. Children in group II were educated through the play method (i.e., crosswords and quiz with PowerPoint presentation). The evaluations regarding oral health-related knowledge and plaque scores were recorded on postintervention 1 and 3 months. Results: In group II, high knowledge scores of 10.32 and 9.98 were obtained by the on postintervention 1 and 3 months respectively. In both the groups, there was a significant increase in good oral hygiene scores and a significant decrease in plaque scores on postintervention 1 and 3 months follow-up, but much better scores were seen in group II compared to group I at both the follow-ups. Conclusion: Implementation of crossword game-based oral health education program is an easy and effective aid for teaching oral health instructions and preventing oral diseases in children as the knowledge scores of children increased considerably when the game-based teaching intervention was used.



Iqra Chaudhary

Effect of Casein Phosphopeptide–amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Artificial Carious Lesions: An in vitro Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:261 - 266]

   DOI: 10.5005/jp-journals-10005-1447  |  Open Access |  How to cite  | 


Aim: To compare new remineralizing agents calcium sodium phosphosilicate paste and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) paste with that of fluoridated toothpaste in remineralization of early carious lesions using scanning electron microscopy and energy-dispersive X-ray (SEM-EDX) analysis. Materials and methods: Sixty sound extracted premolars were collected and placed in demineralizing solution for 4 days to produce artificial carious lesions. All specimens were evaluated for any loss of mineral content using SEM-EDX analysis. Samples were randomly assigned to three groups: Group I: Fluoridated toothpaste (control), group II: CPP-ACP paste, and group III: Calcium sodium phosphosilicate paste. Specimens were then treated with above-mentioned remineralizing agents and again measured for mineral content using SEM-EDX analysis. Results: Group III (calcium sodium phosphosilicate paste) showed highest significant difference followed in descending order by group II (CPP-ACP paste) and group I (fluoridated toothpaste). Conclusion: Calcium sodium phosphosilicate paste showed maximum remineralizing potential compared with CPP-ACP and fluoridated toothpastes.



Debasmita Das, PV Samir, Rajnish K Verma, Nipa Singh

Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:267 - 271]

   DOI: 10.5005/jp-journals-10005-1448  |  Open Access |  How to cite  | 


Introduction: Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. Aim: To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution. Materials and methods: A total of 48 nonvital primary teeth were included in this study. After access opening first microbiological sample (s1) was collected by using absorbent paper point introducing into canal. Second microbilogical sample (s2) was taken following chemomechanical preparation and the teeth were divided into four groups: Group I: calcium hydroxide (CH) powder with distilled water; group II: CH with 2% chlorhexidine solution; group III: triple antibiotic powder with distilled water; group IV: triple antibiotic paste with 2% chlorhexidine solution. Then the canals were filled with any one group of the medicament and cavity was temporarily sealed with zinc oxide eugenol. After 1 week, a postmedication sample (s3) was collected. Then the canal was filled with Metapex, restored with glass ionomer cement. Conclusion: From the experiments carried out in this study, with the limitations, an inference can be drawn that a combination of antimicrobial agent used as intracanal medicament is definitely better than single agent like Ca(OH)2.



Sayaka Komori, Kousuke Matsumoto, Kenji Matsuo, Hiroaki Suzuki, Takahide Komori

Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:272 - 277]

   DOI: 10.5005/jp-journals-10005-1449  |  Open Access |  How to cite  | 


Aim: To suggest regarding the timing of oral surgery and laser treatment for frenulum abnormalities in the pediatric population. Materials and methods: We investigated the sex, age, frenulum site, reason for consultation, treatment method, and prognosis of 35 patients aged 15 years or younger and who were examined at our hospital for the chief complaint of frenulum abnormality. Results: A total of 21 (mean age, 6.0 years) of the 35 patients underwent frenectomy using a carbon dioxide (CO2) laser. Of these, 7 patients (mean age, 2.8 years) underwent the procedure with general anesthesia and 14 patients (mean age, 7.6 years) underwent the procedure with local anesthesia. The surgical site was the lingual frenulum in 15 patients and the maxillary labial frenulum in 6 patients. No adverse events were intraoperatively reported in any of the patients, and the procedure was quickly and safely performed. The mean postoperative follow-up period was 4.6 months, and readhesion was noted in one patient (4.8%). The most common reason cited for not undergoing frenectomy in the 14 patients (mean age, 3.4 years) was the young age of the child. Conclusion: Retrospective study of pediatric patients with frenulum abnormalities demonstrated the usefulness of the CO2 laser in performing frenectomy and offered suggestions regarding the timing of this procedure. Clinical significance: Frenectomy performed using a CO2 laser for pediatric patients is a useful, simple, and safe treatment method.



Neha Verma, Arpana Bansal, Parimala Tyagi, Ankur Jain, Utkarsh Tiwari, Ruchika Gupta

Eruption Chronology in Children: A Cross-sectional Study

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:278 - 282]

   DOI: 10.5005/jp-journals-10005-1450  |  Open Access |  How to cite  | 


Aims and objectives: The purpose of this study is to determine the appropriate reference standard for eruption timing of primary teeth in infants and preschool children of Bhopal city and to determine the role of various factors affecting the eruption of primary dentition. Materials and methods: A cross-sectional study was conducted among the infants and preschool children (4–36 months) attending the local government or private hospitals, and vaccination centers. Prior to the study, Institutional Ethical Committee clearance and informed written consent from the parents were obtained. The data were collected from fullterm infants and preschool children of 4 to 36 months from Bhopal city. Oral examination was done under adequate natural light by a single examiner using mouth mirror and probe. Teeth present in the oral cavity were noted by using Federation Dentaire Internationale system of nomenclature in the preformed proforma. The teeth were considered as erupted, when any part of its crown had penetrated the gingiva and was visible in the oral cavity. Height, weight, birth weight, and other close-ended questions in questionnaire were asked from parents. Results and conclusion: The data collected were statistically analyzed and it was observed that significant relation exists between tooth eruption and birth weight, feeding habits, socioeconomic status, and body mass index (BMI). Based on the findings, it may be concluded that Indian children experienced delayed eruption of primary teeth when compared with children of different countries and standard norms.


Original Article

Shivayogi Hugar, Punit M Patel, Laresh Mistry, Neha Dhariwal

An in vitro Comparative Evaluation of Efficacy of Disinfecting Ability of Garlic Oil, Neem Oil, Clove Oil, and Tulsi Oil with autoclaving on Endodontic K Files tested against Enterococcus faecalis

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:283 - 288]

Keywords: Autoclave, Clove oil, Disinfection, Enterococcus faecalis, Garlic oil, Neem oil, Tulsi oil

   DOI: 10.5005/jp-journals-10005-1451  |  Open Access |  How to cite  | 


Aim: To comparatively evaluate the efficacy of disinfecting ability of garlic oil, neem oil, clove oil, and tulsi oil with autoclaving on endodontic K files tested against Enterococcus faecalis. Materials and methods: Fifty endodontic K files were exposed to the test micro-organism and checked for its disinfecting ability using three different methods. Result: Garlic oil, clove oil, tulsi oil and autoclave showed considerable effectiveness against E. faecalis except neem oil. Conclusion: Garlic oil, clove oil and tulsi oil are an effective disinfectant and can be used as an alternative to autoclaving against the test micro-organism. Clinical Significance: Herbs and herbal extracts are a natural and harmless way of controlling infection. These products are readily available and comparable to gold standard, thus can have its applications in rural India.



Punya Sekhri, Meera Sandhu

Emerging Understanding of Emotional Intelligence of Teenagers

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:4] [Pages No:289 - 292]

   DOI: 10.5005/jp-journals-10005-1452  |  Open Access |  How to cite  | 


Aim: Emotional intelligence (EI) is the ability to use emotions effectively and productively. It is becoming increasingly clear that these skills are one of the primary foundations for better performance of students in classrooms and in the society as well and EI provides the basis for competencies important “in almost every job.” So we accessed the EI of teenagers as a guide of their academic score. Study design: We analyzed the correlation of academic score to the EI of teenagers in regular schools and part-time unconventional coaching institute using the Bar-On Emotional Quotient questionnaire. Results and conclusion: The results of our study showed that empathy and self-actualization were highly developed in students of regular conventional school than those attending part-time unconventional coaching institute. The academic score had a significantly positive correlation with empathy, whereas a significantly negative correlation with interpersonal relations. Empathy, interpersonal relation, and impulsive control were significantly higher in females than males. Therefore by inculcating and working toward development of EI in the young generation, we can hope to achieve a more positive environment.



Mariana A Nemezio, Katharina MH De Oliveira, Priscilla C Romualdo, Alexandra M Queiroz, Francisco WG Paula-e-Silva, Erika C Küchler

Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:6] [Pages No:293 - 298]

   DOI: 10.5005/jp-journals-10005-1453  |  Open Access |  How to cite  | 


Aim: To perform a systematic review and meta-analysis to establish if fever is associated with primary tooth eruption. Materials and methods: Literature searches involved Pubmed, MEDLINE, Web of Science, Scopus and Cochrane. The potentially relevant studies had the full text analyzed. Only studies concerning fever during eruption period of primary tooth in humans were included. Papers in non-English language, and papers that included syndromic patients or patients with any disease were excluded. The meta-analyses were performed with Review Manager (version 5.3). Only studies that reported the results as dichotomous data were analyzed with Cochran– Mantel–Haenszel test in meta-analysis function of Review Manager 5.3. The fixed-effects model was used to evaluate the association between tooth eruption and fever. Results: Search identified 83 potential studies. After exclusion of the duplicated studies, or were not related to the criteria of inclusion only 6 studies were selected for the systematic review. In the overall meta-analysis, no association was found [OR = 1.32 (0.88–1.96)] between fever and primary tooth eruption. However, in the subgroup analysis, when the method used to measure fever was the rectal temperature there was an association [OR = 2.82 (1.55–5.14)] between fever and primary tooth eruption. Conclusion: There are few suitable studies in the literature regarding the association between primary tooth eruption and fever. However, our study found an association between fever and primary tooth eruption only when rectal temperature was performed



Anuradha Rawat

Distalization of Maxillary First Permanent Molar by Pendulum Appliance in Mixed Dentition Period

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:3] [Pages No:299 - 301]

   DOI: 10.5005/jp-journals-10005-1454  |  Open Access |  How to cite  | 


Introduction: Mesial drifting of molar teeth in maxillary arch is corrected by movement of the molars distally. In addition to traditional distal movement techniques, such as extraoral force application and removable appliances, various intra-arch devices have been introduced since 1980s. These intra-arch appliances have nearly eliminated the need for patient cooperation. Case report: The purpose of this paper is to report a case of 10-year-old male patient with loss of space in maxillary molar teeth treated by intra-arch appliance–pendulum appliance by distalization of maxillary first permanent molar teeth. Distalization of the permanent molar teeth helped in proper eruption of second premolar teeth without any extensive treatment procedures. Conclusion: In the present case report, the treatment of developing malocclusion was corrected by utilizing the concept of interceptive orthodontics. Hence, correction of space loss in mixed dentition period using pendulum appliance can eliminate the fixed orthodontic therapy.



Paul Chalakkal, Amanda N Ferreira, Godwin C Da Costa

Functional Lingual Arch with Hinge-type Lockable Dentulous Component

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:7] [Pages No:302 - 308]

   DOI: 10.5005/jp-journals-10005-1455  |  Open Access |  How to cite  | 


The conventional lingual arch is a nonfunctional fixed space maintainer used in the mandibular arch to maintain arch length by the prevention of mesial movement of the permanent first molars. This study highlights a functional lingual arch with a hinge-type lockable dentulous component that incorporates molar tubes, with various advantages over the conventional lingual arch.



Shweta S Jajoo

Primary Maxillary Bilateral Central Incisors with Two Roots

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:4] [Pages No:309 - 312]

   DOI: 10.5005/jp-journals-10005-1456  |  Open Access |  How to cite  | 


A rare case of birooted primary maxillary central incisor is reported. A 5-year-old male patient reported with carious maxillary primary anterior teeth. Radiographic examination incidentally revealed root bifurcation in primary maxillary central incisors bilaterally. This represents a rare finding. There are few cases that have reported birooted permanent incisors, but there is no case reported till date with birooted primary incisors. This report discusses the findings in the context of the available literature. The possible etiology and the need for careful assessment prior to root canal therapy are highlighted.



C Munish Reddy, Divya Joshi, Shalu Jain

Treatment of Maxillary Impacted Canine using Ballista Spring and Orthodontic Wire Traction

[Year:2017] [Month:July-September] [Volume:10] [Number:3] [Pages:5] [Pages No:313 - 317]

   DOI: 10.5005/jp-journals-10005-1457  |  Open Access |  How to cite  | 


In orthodontic practice, impaction of maxillary permanent canines is a frequently encountered clinical problem. After the third molar, the canine is the most frequently impacted tooth. For functional occlusion, bringing the impacted canine into occlusion is important to achieve final esthetic in orthodontic practice. This article illustrates a distinct case in which the three permanent canines maintained their unerupted status till the age of 18 years. The three impacted canines were surgically exposed, attachment bonded, traction given with ballista spring for vertical and labial movement, and ideally positioned with fixed orthodontic mechanotherapy.


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