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Open access

Mirjana Umićević Davidović, Marijana Arapović Savić and Adriana Arbutina


Introduction Need for orthodontic treatment is determined by the severity of specific malocclusion. Orthodontic indices are used to objectively present treatment needs. The most commonly used is the Index of Orthodontic Treatment Need (IOTN). The aim of this study was to determine the need for orthodontic therapy in 11 to 13 years old schoolchildren in Republika Srpska.

Material and Methods 1377 patients, 11 to 13 years old, were included in this study. The examinations were performed in elementary schools, using daylight, flat mirror and two-dimensional orthodontic caliper. Patients were ranked into 5 grades according to the Dental Health Component (DHC) and graded on a scale 1 to 10 for the Aesthetic Component (AC) of the IOTN index.

Results According to the Dental Health Component (DHC), 79.23% of patients needed orthodontic treatment. Little and borderline orthodontic need was present in 27.74% and 24.83% children, respectively, while severe need was present in 19.98% and 6.68% respectively. 20.77% of subjects did not need orthodontic treatment. In regards to the Aesthetic Component (AC) (face appearance related to orthodontic need) little or no treatment was needed in 91.42% of subjects while 6.42% were borderline and 2.16% of subjects had severe relation between orthodontic need and facial appearance.

Conclusion Due to the wide presence of orthodontic irregularities in schoolchildren 11-13 years old in Republika Srpska, it is important to introduce orthodontic indices in clinical practice in order to determine orthodontic treatment needs.

Open access

Adriana Arbutina, Marijana Arapović Savić, Mirjana Umićević Davidović and Irena Kuzmanović Radman


Introduction In order to establish an accurate diagnosis and proper therapy planning in orthodontics, it is necessary to perform the analysis of transverse and sagittal dental arch development in relation to the facial type of the patient. The aim of this study was to determine sagittal and transverse parameters of dental arches in the population of Republika Srpska (Bosnia and Herzegovina) based on Schwarz analysis.

Material and Methods Facial type was determined in 300 patients of both genders, aged 18 to 25, with class I occlusion. After taking impressions of the upper and lower jaw, cast study models were poured and used to determine basic sagittal and transverse parameters of dental arches. The obtained values were compared with the values defined by Schwarz in order to determine the existence of certain variations.

Results Out of 300 subjects, 50.33% were dolichofacial, 30.76% were mesofacial and 19.00% were brachyfacial. The average values of anterior width, posterior width and height of dental arch in patients with all three types of face showed lower range of values compared to the values defined by Schwarz, who determined his values by examining the same parameters in the population of Vienna. These parameters did not show linear proportional increase with the increase of the sum of upper incisors, what is the case with the values defined by Schwarz.

Conclusion The results of this study showed significant differences compared to Schwarz’s values. Modification of the size and shape of dental arch leads to changes in the appearance of patient’s face. Therefore, an individual approach during orthodontic diagnosis and treatment planning must be present despite the great importance of biometric standards.

Open access

Marijana Arapović-Savić, Mirjana Umićević-Davidović, Adriana Arbutina and Mihajlo Savić


Introduction Clinical extraoral examination prior to orthodontic treatment includes face analysis (front and profile). Development of computer technology has increased efficacy and simplified this process through automating several steps of the analysis. The aim of this paper was to examine the possibility of automatic determining of linear measurements based on the facial image of a patient.

Material and Methods Based on the set of 20 patients in NHP (Natural Head Position) position, three sets of measurements were conducted. Trained orthodontist performed positioning of predefined points on the image of the patient two times with one week apart, after which the points were automatically determined using customized computer software. Based on the position of the points, measurements for bizygomatic distance, upper and lower facial height and full facial height were computed. Three sets of measurements were compared and statistically analyzed.

Results showed that computer software produced measurements comparable to measurements obtained by a trained orthodontist. Statistical analysis included calculating mean values and standard deviations, as well as paired two‑tailed T‑test. Differences between measurements ranged from 0.03% to 0.6% suggesting that automatic method can be successfully used.

Conclusions The results of this research suggest that it is possible to ease, accelerate and automate work of the orthodontist on the image analysis using suitable software without significant differences in measured values.

Open access

Adriana Arbutina, Marijana Arapović-Savić, Mirjana Umićević-Davidović, Irena Kuzmanović Radman and Saša Marin


Introduction After the completion of treatment with fixed orthodontic appliances, it is necessary to remove the brackets and bands from teeth using an appropriate method. The aim of this study was to determine the most common way of bond failure between teeth and metal brackets, as well as to compare bond failure between the brackets and upper and lower premolars. Material and Method Metal brackets were bonded with Aspire composite material on 154 human premolars, extracted for orthodontic purposes. After debonding, the surface of remaining adhesive on the teeth and brackets was measured. Adhesive Remnant Index (ARI) was used to estimate bond failure between teeth and metal brackets. Results The average size of remaining adhesive surface after removing brackets from the upper premolars was 12.06 mm2, while it was 9.32 mm2 on the lower premolars. The average size of the remaining adhesive surface area on the brackets removed from the upper premolars was 0.37 mm2, while it was 2.08 mm2 on the brackets removed from lower premolars. A statistically significant difference was found between these values. The most common score of ARIteeth was 3 (85.71%) and the most frequent score of ARIbrackets was 0 (85.71%). Conclusion The most common way of bond failure between teeth and metal brackets was between the bracket base and adhesive surface. A statistically significant difference was found between the values of the size of residual adhesive surface on the upper and lower premolars as well as on the brackets debonded from them.

Open access

Marijana Arapović-Savić, Mihajlo Savić, Mirjana Umićević-Davidović, Adriana Arbutina, Nenad Nedeljković and Branislav Glišić


Introduction Lundstrom segmental analysis is often used analysis in orthodontic diagnosis. It includes measurements of available and needed space in the arch in order to determine whether there is a lack or excess of space for proper teeth alignment. Measurements are traditionally performed on plaster study models, but with recent developments of computer-based systems, there is an increase in use of digital models in measuring process. The aim of this study was to present a photogrammetry based measurement approach that requires no specialized and expensive hardware and compare results with ones obtained on 3D scanned models.

Material and method On 50 plaster study models measurements of 24 teeth, widths of 12 segments and Lundstrom segmental analysis were performed. 3D scanned study models were analyzed in the photogrammetry software Ortho-Photo4D on the set of four photographs of the study model in custom made measurement apparatus. The software corrects for finite distance of the camera and corrects errors due to perspective distortion.

Results Statistical analysis performed on obtained measurements provided Bland-Altman plots that strongly suggested high degree of correspondence between the two measurements methods. Discrepancies for maxilla for individual segments were under 0.25 mm with standard deviation of up to 0.16 mm, and less than 1 mm and deviation of up to 0.4 mm for complete arch. For mandible the differences were up to 0.27 mm for segments with 0.15 mm deviation and 0.6 mm for complete arch with up to 0.24 mm deviation. Correlation coefficient was over 0.985 in all cases.

Conclusions Both analyzed methods can be equally used in clinical practice.