mohammad behnaz

Considering the importance of skeletal anchorage in orthodontic treatment, this study aimed to assess the frequency and pattern of skeletal anchorage usage by Iranian orthodontists.

In this cross-sectional study, 301 Iranian orthodontists filled out a questionnaire consisting of 10 questions, 5 about miniscrews and 5 about miniplate usage. It also asked for the demographic information of the participants. The relationship between the participants' demographic information and their responses to the questions was also analyzed. Statistical analysis was conducted by the Chi-square test, one-way ANOVA, t-test, and Mann-Whitney test (alpha=0.05). 

There were 46.7% males and 53.3% females with a mean age of 38.9 years and a mean work experience of 8.95 years. Of all, 89.7% of the participants used miniscrews and 16.3% of them used miniscrews and miniplates. Generally, participants not using skeletal anchorage were significantly older (P=0.002) and had a significantly longer work experience (P=0.000). Also, there was no significant association between gender and skeletal anchorage usage (P=0.204). From the perspective of the orthodontists, the main indication of anchorage devices was to provide optimal anchorage.

The results showed that a high percentage of Iranian orthodontists used different types of skeletal anchorage devices. They preferred to use miniscrews more frequently than miniplates, mostly due to difficulties associated with their surgical insertion. Also, it was observed that older orthodontists used skeletal anchorage less frequently than younger orthodontists.

This research sought to assess how fluoride varnish affects the shear bond strength (SBS) and adhesive remnant index (ARI) of ceramic brackets used in orthodontics.

Forty-eight freshly extracted premolars were randomly assigned to four groups(N=12each). Groups 1, 2, and 3 were treated with 5% sodium fluoride varnish 1, 7, and 14 days before ceramic bracket bonding, respectively. Group 4 as the control group received no pretreatment. The SBS of the brackets was measured using a Universal Testing Machine, while the adhesive remnant on the tooth surfaces wasassessed based on the ARI. The SBS and ARI were analyzed statistically using one-way ANOVA and Kruskal-Wallis tests, respectivelyat a significance level of 0.05.

Group 2 exhibited significantly lower SBS than that of group 1 (P=0.001). Group 1 displayed higher SBS than that of the control group (P=0.016). Additionally, group 3 exhibited greater SBS than group 2 (P=0.020). However, none of the groups showed an SBS lower than the standard value of 6 MPa. Regarding ARI, a significant difference was found only between Groups 1 and 2, with Group 2 showing a higher ARI than Group 1 (P=0.025).

The application of fluoride varnish at 1, 7, and 14 days prior to bonding ceramic brackets in orthodontics does not decrease SBS and does not significantly affect ARI compared to the control group

 This study assessed the correlation of tongue posture with dental arch characteristics in sagittal and vertical skeletal patterns using cone-beam computed tomography (CBCT).

 This cross-sectional study evaluated 225 CBCT scans of sagittal Class I, II, and III patients. Class I and II groups were subdivided into high-angle, normal, and low-angle vertical subgroups. Palatal length, width, and height, maxillary width (Wmax), mandibular width (Wman), tongue posture according to the Graber’s analysis, tongue length (TGL), and tongue height (TGH) were three-dimensionally measured. Statistical analyses were conducted using one-way and two-way ANOVA, and Pearson and Spearman tests (alpha=0.05).

 All dental arch parameters were significantly greater in Class III, compared with Class I and II groups (P<0.05), except for) Wman, palatal length, and palatal height( . Palatal height was significantly greater in Class II and III, than Class I group (P<0.05). Wmax was lower in high-angle than low-angle, and palatal length was lower in high-angle than low-angle and normal groups (P<0.05). In Class I normal-angle patients, Wmax had a positive correlation with TGL. In Class I low-angle patients, Wmax had a moderate positive correlation with TGH.

 Significant differences were found in Wmax and palatal length among the vertical groups. In different skeletal patterns Wmax, Wman had a low to moderate positive correlations with D4, D5, D5ʹ, TGL and TGH. Wmax in Class I was significantly lower than that in Class III; this variable in Class II was significantly lower than that in Class III

The present study aimed to investigate the patients’psychological status, level of awareness, and attitude toward the coronavirus disease 2019 (COVID-19) pandemicand itseffects on the process of orthodontic treatment in patients at the School of Dentistry, Shahid Beheshti University of Medical Sciences, and three private clinics in the city of Tehran in 2021-2022.

A questionnaire with fourpartswas designed. The participant’s general information and the information regarding orthodontic treatments were collected in the first part, and the patient’s knowledge and attitude in confronting COVID-19 were collected in the next two parts. In the last part, the patient’s psychological status was assessed using Kessler’s Psychological Distress Scale (K10). A total of 300questionnaires were distributed among the patients in fourclinics. Spearman’s correlation coefficients, the t-test,and U Mann-Whitney statistical test were used ata significance level of 0.05.

A total of 209 patients undergoing fixed orthodontic treatment participated in the present study. The mean score of the K10 questionnaire among the participants was 11.93.30.14% of the participants could not attend their orthodontic appointments at least once during 6 months.59.8% of the participants reported much concern about going to the dental office and contracting a disease.25.8%of patientswere worried about falling brackets, loosening bands, and breaking wires during the outbreak. On the other hand, 69.8% had no problem incontacting their orthodontist.

Most patients had no missed orthodontic appointments during 6 months, and more than a quarter believed that COVID-19 had affected their orthodontic treatments. The patients’psychological status was not suitableespeciallyin women. In general, with highereducational level, the awareness of COVID-19 increased,and the psychological status worsened.

The present study aimed at evaluating the onset and duration of the pubertal growth spurt in skeletal class I and II individuals, utilizing the cervical vertebral maturation (CVM) method.

A total of 132 Iranian individuals (class I=68, class II=64) were evaluated retrospectively in this cross-sectional study. Subjects were between 9 and 16 years old and had never undergone orthodontic treatment. Lateral cephalograms of the subjects were independently traced by two examiners to determine their skeletal class, employing Steiner and Wits analyses. Baccetti's CVM method was employed to assess skeletal maturation. The onset and duration of the pubertal growth spurt (CS3-CS4 interval) was analyzed among the two classes and genders using the Independent Samples t-Test.

The duration of the pubertal growth spurt equaled 1.62 (±1.33) years in skeletal class I subjects and 1.34 (±1.21) years in skeletal class II subjects. The difference in duration between the two classes, with an average of 0.28 years (3.36 months), was statistically significant (p<0.001). The average onset age of growth spurt was estimated to be 11.91 (±1.32) years in class I subjects and 11.41 (±1.19) years in class II subjects, but this difference was insignificant (p=0.110). The onset and termination of the pubertal growth spurt occurred later by 1.49 years (p<0.001) and 1.27 years (p<0.001), respectively, in male subjects.

Class I and II subjects had similar growth spurt onset ages, but class II spurt duration was shorter by 3.36 months. Females experienced longer and earlier growth spurts compared to males.

This study aimed to assess the relationship of upper pharyngeal airway volume with tongue position in different sagittal and vertical skeletal patterns using cone-beam computed tomography (CBCT).

CBCT images of 225 participants (149 females, 76 males) over 18 years of age were evaluated in three groups with sagittal Class I, II, and III skeletal patterns. Class I and II individuals were subdivided into three vertical subgroups high angle, normal, and low angle. The CBCT scans were evaluated three-dimensionally, and the volume of the lower nasopharynx (LNP), oropharynx (ORP), and velopharynx (VLP) was calculated in addition to the total upper pharyngeal airway volume (TV). The tongue position (according to Graber’s analysis and D1-D5 and D1’-D5’ lines) was determined, and the tongue height (TGH) was measured. Data were analyzed by one-way and two-way ANOVA, Tukey’s test, and Pearson’s and Spearman’s correlation tests (a=0.05).

The volume of the LNP was significantly larger in Class II than in Class III patients (P<0.05). VLP volume (r>0.5, P<0.05) and TV (r>0.5, P<0.05) in Class I high angle participants had a significant correlation with D1.

The present results showed greater LNP volume in Class II than in Class III individuals. In some variables (VLP, ORP, TV, intraoral airway volume) no significant difference was observed between different sagittal and vertical groups. Most of the airway variables (TV, VLP, ORP) had no correlations with some tongue variables (TGH, D1, D3, D4, D4’, D5, intraoral airway volume) in different skeletal patterns.

Objectives:

 Health workers are considered as an important part of society and a role model for service recipients. Quality of life related to oral health is a common concept to assess the impact of oral conditions and the impact of dental interventions that affect people in many aspects such as physical, mental, social and ability to perform daily activities of life.The aim of this cross-sectional study was to assess the quality of life related to oral health among the staff of Shahid BeheshtiDental School.

Methods:

This study was performed on 85 employees of Shahid Beheshti Dental School in 2021. The Participants completed the OHIP-49 (Oral health impact profile-49) questionnaire. Independent t-test, and one way ANOVA were used for data analyzing by SPSS 21 statistical software.

Results :

The mean total score of OHIP was 13.86 with a standard deviation of 12.44. The most problematic subscalewasphysical pain (20.65±14.01). The psychological disability and social disability subscales were significantly associated with female gender (p<0.05), and there was no relationship between the mean OHIP scores and the rest of measured demographic variables, including age, marital status, level of education, and chronic disease.

Conclusion:

 The results of the study showed that the quality of life related to oral health in dental staff was acceptable. On other hand, the Persian version of OHIP-49 questionnaire was validated to be used in Iran.

Orthodontics is a significant part of general dentistry education. Yet, many general dentistry graduates seldom practice orthodontics. This study assesses the desire of last-year dental students at Shahid Beheshti Dental School towards orthodontic treatments in their future career.

A questionnaire was validated by ten dental specialists. For reliability, it was re-administered to ten students after ten days. Descriptive statistics were used for results presentation. The Mann-Whitney test compared ranked responses, and the Kruskal-Wallis test compared grade point average (GPA) variations. The comparison of mean opinions based on age, gender, and academic term was conducted with the t-test independent samples and based on GPA status with a one-way ANOVA. Analyses were done using SPSS 25, with a significance level of 0.05.

In this study, 58 last-year students were questioned in line with the research objectives. More than half of the students believe that the hours dedicated to teaching orthodontic courses at university are insufficient (65%), the quality of theoretical teaching is low (55%), practical teaching hours and presence in the department are inadequate (48%). Only 15 percent of students declared they have the necessary confidence to diagnose and conduct orthodontic treatments after graduation. About half of the students express an interest in attending supplementary orthodontics courses after graduation (39%).

According to approximately half of the students’ opinions, the quality of teaching theoretical and conceptual orthodontics courses is low. Additionally, students lack the necessary confidence and desire to diagnose, plan, and perform treatments after graduation.

Identifying and developing superior talents doubles the importanceof educational planning.The purpose of this plan is to find laws in the field of superior talent that are incompatible with the logic of following educational justice in academic environments and to suggestfor reform have been presented.

This qualitative study was conducted in 2022using the content analysis method. Targeted interview sessions were held with assistants and students who were members and non-members of gifted students offices as well as the heads of these offices in major universities of medical sciences. Primary conceptual codes were extracted after data analysis, and after continuous review and assessing similar codes, summarization, and removal of duplicate codes, four main categories and 14 subcategories were identified.

Students emphasized the need to change the conditions of membership in gifted students offices and to identify talents during their studies according to their efforts and scientific and research abilities.While requesting coordination between the educational and executive institutions of the country, they inquired forcreatinga stronger foundation for the officials of the ministries, so that they could have a greater impact on the scientific and cultural promotion of the country.

Senior educational managers should pay attention to solving the structural problems of the units and revising the regulations, motivational inducers, and the social and cultural needs of talented students. While requesting the generalization and changes of the statements mentioned in related regulations, the students agreed with establishment of elite assessment centers in metropolitan areas with the same guideline. It is suggested that the Office of Elites and Talented Students of the relevant ministry, be in charge of forming specialized groups of talented students from medical sciences universitiesin cooperation with one of the leading educational institutions in the country; so that these students have closer contact with the relevant ministryofficials and participate more actively in solving educational, research-related and executive problems.

Today, academic stress and subsequent test anxiety is one of the most important problems for the last year of high school students. In addition to systemic effects, stress can affect the level of oral health by disrupting oral health behaviors. The aim of this study was to investigate the relationship between stress and variables related to oral health in the final year of high school students prior to University entrance exam.

In this descriptive-analytical study, the level of stress and variables related to oral health in 180 students of the final year of high school in Tehran, in three time periods during the academic year 2018-2019, were measured by a questionnaire and one clinical examination. Data were analyzed by Friedman, Bonferroni and Generalized Estimating Equations using SPSS software.

As the exam approaches, some variables related to the oral health, such as toothbrush usage pattern, daily sleep, fast food frequency, and sweet snack consumption, changed (P<0.05). Daily sleep changes were significantly associated with the stress changes (P=0.022). According to the results of the Repeated Measures Analysis, significant changes were observed between the average score of the "Cognitive Error" aspect of three times (P<0.001). Also, according to the results of the Bonferroni Test, significant changes related to the difference in the average score of "cognitive error" 6 months and 3 months before the entrance exam (P<0.001), 6 months and 1 month before the entrance exam (P<0.001), and 3 months and 1 month before the entrance exam (P<0.001) were observed. In all three cases, as the time of the entrance exam approaches, the score of "cognitive error" had decreased significantly. Considering that the lower score in this index indicates a higher level of test anxiety, the closer we get to the entrance exam, the higher the level of test anxiety in the "cognitive error" dimension

The academic stress of the national university entrance exam can affect some oral health variables such as daily sleep, however, it is not related to other variables.

Multiple sclerosis (MS) is an inflammatory disease that destroys neurons and exerts detrimental effects on oral health, apart from its negative physical and psychological consequences. Although there is a bulk of research on oral health in patients with MS, no study has evaluated the quality of life associated with oral health in these patients. Therefore, the current study aimed to assess oral health-related quality of life in patients with MS.

This case-control study was conducted on 103 patients with MS and 103 healthy participants. The subjects in both groups completed standardized Oral Health Impact Profile (OHIP) questionnaires and assessments of indicators related to oral health behavior. Caries index was also measured and recorded for the subjects in both groups. Finally, the data were analyzed in SPSS software using linear regression, T-test, Mann-Whitney tests.

The oral health-related quality of life was statistically significantly lower in patients with MS, as compared to that in the control group (P=0.032). Moreover, the caries index score was significantly higher in patients with MS (P=0.025).

As evidenced by the obtained results, oral health-related quality of life in patients with MS, who have more dental caries, is not significantly different from that in healthy individuals. Further qualitative studies are needed to shed more light on the problems posed to these patients.

 Exams are an inseparable part of education, and they are the main tool to evaluate the results of educational process. If based on scientific rules, exams can show the level of achievement to educational goals.

 This study aimed to evaluate the quality of orthodontic exams in Shahid Beheshti Dental School, Iran.

 In this cross-sectional study, the quality of all written and multiple-choice questions (MCQ) exams of orthodontic department in 2014 - 2015 were evaluated in terms of content validity, structural rules, discrimination index, difficulty index, and taxonomy. To collect the data, the Millman checklist, content analysis table, and standard formula were used. SPSS software version 21 was used to analyze the data. T-test, chi square, and independent sample test were used for statistical analysis.

 Our results showed that 86.55% of exams were in MCQ form and 13.5% in written form. Content validity was considered in 94.8% of exams. Standard structural rules were observed in 93.61% of questions. Discriminative index and difficulty index were estimated to be 41.6 and 68.8%, respectively. Also, 43.7% of questions were categorized as taxonomy I, 44.38% as taxonomy II, and 11.58% as taxonomy III.

 Exams held in Shahid Beheshti Dental School in the 2014 - 2015 academic year were acceptable considering their content validity, structural rules, and difficulty index. However, their discrimination index was low, and they were in poor conditions in terms of taxonomy.

Obstructive sleep apnea (OSA) is a relatively common sleep disorder, which leads to multiple sleep arousals and hypoxemia. We aimed to assess the knowledge and attitude of students and faculty members of Shahid Beheshti Dental School, Tehran, Iran about OSA.

We conducted a cross-sectional study on undergraduate and postgraduate students and faculty members of oral and maxillofacial (OMF) surgery, orthodontics, and oral medicine departments of Shahid Beheshti Dental School. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) questionnaire was used to obtain information. We used the Chi-square, Kruskal Wallis, and Mann-Whitney U tests for statistical analysis. The data were analyzed by SPSS 22.0 (α <0.05).

One hundred ninety-seven participants, including 43 dental students, 68 postgraduate students, and 64 faculty members filled out the questionnaire. The mean knowledge score among all participants was 10.69±3.133. Overall, OMF medicine and OMF surgery faculty members had significantly higher correct answer choices in the knowledge section than fifth and sixth-year dental students (P<0.001). There was no significant difference among other groups (P>0.05). About attitude, 91% of respondents reported that OSA is an important or extremely important disorder. However, only 10.2% and 16.9% felt confident about the ability to manage patients with OSA and identifying patients at risk of OSA, respectively. Overall, gender and educational level were correlated with the mean attitude score (P<0.05).

All participants had poor knowledge but a positive attitude towards OSA. This shows the necessity of better education about OSA.

 Development of white spot lesions (WSLs) in the course of orthodontic treatment would compromise the satisfaction of patients and clinicians. One suggested preventive strategy is to incorporate antimicrobial agents into orthodontic adhesive systems or to coat brackets with them. Several clinical and experimental studies have evaluated the effect of antimicrobial agents, but no consensus has been reached on the best preventive approach. Thus, the aim of this narrative review was to assess the clinical and experimental studies on the effect of incorporation of antimicrobial agents in orthodontic adhesives and brackets.

 PubMed (Medline), Scopus, and Google Scholar were searched for related articles published from 1990 to 2020. Both clinical and experimental studies were included in this review.

 Different antimicrobial agents can be added to adhesive systems to control the formation of WSLs, and also preserve the bond strength of adhesives. Same as adhesive systems, coating of brackets with antibacterial agents can be performed to control bacterial proliferation and demineralization of enamel.

 Antimicrobial agents incorporated in bonding systems or used for coating of brackets can confer antimicrobial properties with no significant negative effect on bonding properties. However, clinical and long-term studies are required to confirm their effectiveness and absence of side effects.

 Thalassemic patients commonly present malocclusions, which require both orthognathic treatments and surgury. This study aimed to assess prioritizing the surgery over orthodontic treatment.

Case report: 

Surgery-first method was performed to treat severe gummy smile and mild retrognathic mandible and prognathic maxilla in a 24-year-old Iranian girl with major β-thalassemia. Brackets and Ni-Ti wires were adjusted on all teeth to align their levels for one month. Then, the patient underwent the surgery, and the soft tissue was excised for Lefort dissection by two cutting lines, followed by osteotomy. Afterwards, down fracture and bilateral septoplasty were carried out, and excessive bones were removed.  The surgery retruded the maxilla by 10 mm.

 The 2-year follow-up revealed no overgrowth of the maxilla or malocclusion.

 Surgery-first method can be successfully used for treatment of malocclusions in patients with major thalassemia.

Floating teeth is a condition when teeth lose their supporting alveolar bone as a result of a destructive process, which is most frequently occur in the molar/ premolar region of both jaws. The aim of this study was to review the common conditions associated with floating teeth.

We used general search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus to find relevant studies by using keywords such as "jaw lesion", "jaw disease", "floating tooth", “floating teeth”, "tooth mobility", and “tooth loss”. About 100 articles were found, of which approximately 80 were broadly relevant to the topic, and finally 30 articles closely related to the above topic were chosen.

When the data were compiled, the following 9 lesions were found to have more relationship with floating teeth appearance: Aggressive periodontitis, Langerhans histiocytosis, Burkitt’s lymphoma, multiple myeloma, Metastatic tumors, Primary intraosseous carcinoma (intraosseous squamous cell carcinoma), Ewing’s sarcoma, Hyperparathyroidism, and Cherubism.

When clinicians encounter a lesion associated with floating teeth, they should consider these entities especially malignant disorders in differential diagnosis to make more accurate diagnoses and develop better treatment plans according to patients’ imagings.

Evaluation is an integral part of educational programs and undoubtedly conducting an appropriate evaluation for the clinical courses of the medical and dental students, who have the burden of training professional experts, can improve the quality of education. The study endeavors to examine the evaluations of clinical general dentistry courses from Shahid Beheshti University studentschr('39') view in the academic years2017-2018.

This descriptive-analytic study was carried out on all 10th and 11th semester students (totally 50 persons) of Shahid Beheshti dental school. The data-gathering tool was a self-made questionnaire and its collection method was fieldwork. After designing the three-option Likert questionnaire in three areas, its validity and reliability were confirmed and calculated. After collecting the questionnaires analytic tests of one-way ANOVA, Tukey and Kruskal-Wallis test, was done.

From the perspective of the target group, the OSCE evaluation method was intermediate to weak (0. 69 ± 0. 44), the method of evaluating course requirements was intermediate (0. 99 ± 0. 50) and the general quality of evaluation methods for clinical courses was moderate (1. 20 ± 0. 32). However, dissatisfaction in some cases, such as feedback, the appropriateness of the OSCE evaluation method for assessing clinical dentistry skills, and the use of similar benchmarks for scoring by faculty members was seen among the students.

According to the studentschr('39') viewpoint, which evaluated the overall evaluations of clinical courses as intermediate in general, it can be concluded that the methods for evaluating clinical courses and the quality of clinical assessments at Shahid Beheshti dentistry faculty needs to be revised.

Lesion description has a key role in correct diagnosis and timely treatment. The aim of this study was to review of morphological descriptive terms, which are used in oral lesion description.

An electronic search of the literature was conducted in various database including: Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus databases, for relevant articles using the following keywords: “oral lesion”, “terminology”, “semiology”, ”glossary”, ”morphology”, “primary lesion”, “basic lesion”, “dermatology” ,“oral medicine”, and “stomatology”. About 60 articles were found; out of which, 45 were relevant to our topic of interest. Finally, we included 22 articles that were closely related to the topic of interest. In addition, 4 text books were also used in this study.

After data collection, the following 20 descriptive morphological terms were found. These terms divided into two groups as primary and secondary lesions: (1) Primary lesion: macule, patch, papule, plaque, nodule, tumor, weal (or hive), vesicle, bullae, pustule, abscess, cyst, purpura (petechia & ecchymosis), and hematoma. (2) Secondary lesion: erosion, ulcer, sinus, fistula, and scar.

The correct and updated descriptive terminology should be considered by dentists in oral examination.

 Since the determination of skeletal maturation by surveying concavity on lower surface of cervical vertebrae and evaluating shape of vertebrae is a subjective and quantitative study, this systematic review was performed to evaluate new quantitative and objective methods by using cervical vertebrae for determining skeletal maturation.

 Related keywords were searched in Pubmed and Cochran database in order to find studies that were published in English from January 2000 to January 2019 and evaluated skeletal maturation based on cervical vertebrae by modern methods. Also, the references of the included studies were search for other related studies.

 From overall 1371 titles, 27 were selected by initial screening. Evaluation of the full texts resulted in inclusion of 13 articles. Among articles included in this review, three studies used CBCT images and another studies used lateral cephalogram. One study performed evaluation cervical vertebrae in the axial view of CBCT images while another evaluation was on sagittal view. Most of the studies used a regression model in order to determine bone age of vertebrae and then compared it with skeletal age obtained from hand wrist radiography.

 As the methods and measurements were different in the included studies it was not possible to reach a decisive conclusion regarding method for determining skeletal age based on cervical vertebrae. It is suggested to use a combination of maturation signs along with development stages of cervical vertebrae in order to determine skeletal maturation until a quantitative and valid method is presented.

Objectives Use of a reliable method to determine the degree of skeletal development of the mid-palatal suture is important in the choice of treatment between orthopedic maxillary expansion and surgical expansion in adolescents and young adults. The aim of this study was to review the new methods for evaluation of mid-palatal suture maturation. Methods Electronic search was conducted in PubMed and Scopus databases using the following key words: (“mid-palatal suture maturation” OR “mid-palatal suture ossification”) AND (“orthopedic treatment” OR “maxillary expansion” OR “orthodontic*”) to find studies published from 1990 to December 2018 in English that evaluated the mid-palatal suture maturation stage. Results Of 127 papers found, 28 articles met the inclusion criteria and their full texts were reviewed. Finally, 8 met the inclusion criteria. Five studies used cone-beam computed tomography (CBCT) as the imaging modality and examined the quality of the mid-palatal suture maturation and assessed the morphology of the suture. Two studies used bone density and one study used fractal dimensions. Conclusion Since all the innovative methods lack a gold standard and valid histological references, it is not possible to reach a comprehensive conclusion. It is therefore important that the clinicians use several diagnostic criteria for thorough evaluation of the development of mid-palatal suture and decide on the appropriate therapeutic modality.

Impaction of maxillary central incisors is not common. Treatment of an impacted central incisor is challenging as it relates to facial esthetics and dental function.
Although impaction of permanent teeth is rarely diagnosed in mixed dentition period, an impacted central incisor is usually diagnosed when there is a delay in the eruption of tooth.
Tooth impaction may result from a number of local etiological factors such as lack of space for eruption, presence of supernumerary teeth, disturbances in the path of eruption and presence of pathological cysts. Management options for such teeth include (1) surgical extraction and moving the lateral incisor to replace the central incisor and changing the anatomy of other teeth, (2) extraction of the impacted tooth followed by bridge or implant placement, (3) surgical repositioning of the impacted tooth, and (4) orthodontic correction of the impacted tooth.
The purpose of this article was to describe surgical exposure and orthodontic treatment of a horizontally impacted permanent maxillary central incisor, parallel to the occlusal plane in a 9-year-old girl. The impacted tooth was surgically exposed and traction was done with orthodontic intervention.
Keywords: