Success of miniscrews used as anchorage for orthodontic treatment: analysis of different factors

ObjectivesTo examine factors involved in clinical success of miniscrew implants used for orthodontic anchorage in the upper jaw.Materials and methodsOne hundred and forty-four patients (93 females and 51 males) were fitted with a total of 324 miniscrew implants of two different morphologies (cylindrical and conical), and of different lengths and diameters. The clinical factors examined were screw length, side of insertion, miniscrew shape and diameter, bone quality, skeletal type, and relationship between bone quality and skeletal type and patient age.ResultsThe mean overall success rate of the implants was 91.4%. The length and shape of the miniscrews significantly influenced the success rate, whereas side of insertion (left or right), screw diameter and skeletal type showed no significant effects. Poor (soft) bone quality and good (hard) bone quality are risk factors for miniscrew failure, with the best results obtained when the screws are inserted into bone of medium quality (10-15 Ncm).ConclusionIn the posterior areas of the upper jaw, long, conical miniscrews showed a significantly greater success rate. An insertion torque of 10 Ncm to 15 Ncm is also a significant index of higher success rate.     

Influence of miniscrew dental root proximity on its degree of late stability

Purpose of this study was to evaluate the influence of miniscrew dental root proximity on its late stability degree. 40 miniscrews were inserted between maxillary second premolars and first molars for anterior retraction. Post-surgical radiographs were used to measure the septum width in the insertion site, insertion height, distal and mesial distance from miniscrew to dental root, and the smallest distance between miniscrew and dental root. The miniscrews were divided in two groups according to septum width: ≤3 mm (20 miniscrews) and >3 mm (20 miniscrews). The soft tissue in the insertion site, sensitivity during load, plaque around the miniscrew, and evaluation period were also considered. The results showed no significant difference in miniscrew mobility degree and success rate between groups. Miniscrew dental root proximity did not influence the stability and success rate when the distance between the miniscrew and dental root indicated no periodontal ligament invasion. The overall success rate was 90% and no variable was associated with miniscrew failure. Nevertheless, patient sensitivity was frequently associated with some degree of mini-implant mobility. The septum width did not influence the stability and success rate of this anchorage system, but the extreme root proximity did.     

An easy way to apply orthodontic extraction for impacted lower third molar compressing to the inferior alveolar nerve

PurposeTo study the results of an easy orthodontic extraction method for impacted lower third molar removal which had roots compressing to the inferior alveolar nerve (IAN).Patients and methodsForty patients were divided into two groups according to their desire. Orthodontic traction group (n = 20) had brackets or mini bone screws on the antagonist maxillary molars as anchorage for orthodontic traction from 3 to 10 weeks until the roots’ tip was away from the IAN, the tooth was then removed. Traditional extraction group (n = 20) had the tooth removed immediately by the same surgeon. Post-operative results were compared between the two groups.ResultsAll 20 patients in the orthodontic extraction group had their lower impacted third molar removed easily without lower lip numbness after surgery, while 5 patients in the traditional extraction group had transient IAN injury and went away 1 week later. There were no anchorage teeth and adjacent mandibular second molar loose or displacement.ConclusionApplication of orthodontic brackets or mini bone screws on the antagonist maxillary molars is an easy way for orthodontic extraction of impacted lower third molar with roots’ tip compressed to the IAN. It is an effective way to avoid IAN injury during tooth extraction.     

Nickel and chromium levels in the saliva of a Saudi sample treated with fixed orthodontic appliances

AimThe aim of this study was to measure the amount of nickel (Ni) and chromium (Cr) released into the saliva of Saudi patients treated with fixed orthodontic appliances.Materials and methodsNinety salivary samples were collected in a cross-sectional manner. Forty samples were collected from patients (17 males, 23 females) with fixed orthodontic appliances after different periods of orthodontic treatment ranging from the first month and up to 32 months into treatment. The fixed orthodontic appliance consisted of 4 bands, 20 stainless steel brackets, and upper and lower nickel titanium or stainless-steel arch wires. The other 50 samples were collected from people without appliances (24 males, 26 females). Samples were analyzed using Inductive Coupled Plasma/Mass Spectrometry and Inductively Coupled Plasma Optical Emission Spectroscopy to measure Ni and Cr levels, respectively. Student’s t-test was used to compare Ni and Cr levels in the treated and untreated control groups.ResultsThe mean Ni level was 4.197 μg/L in the experimental group and 2.3 μg/L in the control group (p < 0.05). The mean Cr level was 2.9 μg/L in the experimental group and 3.3 μg/L in the control group (p < 0.05).ConclusionFixed orthodontic appliances resulted in a non-toxic increase in salivary levels of Ni, but no change in Cr levels. Duration of orthodontic treatment did not affect Ni and Cr levels in the saliva.     

微型种植支抗钉增强后牙支抗的临床观察

目的探讨影响微型种植支抗成功的主要因素。方法对18例须加强支抗的正畸治疗患者,植入微型支抗钉共60枚,术后1周使用弹力橡皮圈牵引加载150-200 g力,远中牵引尖牙及两步法关闭间隙,观察种植钉产生的牵引效果和临床的不适症状。结果60枚种植钉中,1枚术中折断,取出重新种植后获得成功;3枚龈黏膜轻度肿胀,2枚颊黏膜溃疡,对症处理后均自愈;2枚支抗轻度松动,旋紧后继续使用;1枚植入后局部疼痛,2枚加力末期松动明显,都给予拔除;1枚后期支抗钉头移位后去除重新植入。3-6个月内双尖牙间隙关闭速度为每月0.8-1.8 mm。结论种植支抗钉的临床不良反应主要是初期稳定性不足,以及局部软组织反应;稳定的种植支抗可以有效地快速关闭拔牙间隙,增强后牙支抗。     

自攻型微螺钉种植体支抗稳定性的临床研究

目的:研究自攻型微螺钉种植体加载正畸负荷后的稳定性。方法:本研究包括了15例成年患者,以植入上颌颧突的自攻型微螺钉作为前牙内收的颌内支抗。微螺钉植入2周后施力。加力前及加力后9个月分别拍摄X线头颅定位片,将头影测量片进行重叠,测量微螺钉的移位变化。结果:15例中6例患者的微螺钉伸出并向前移位(-0.5～1.5mm)。微螺钉头部平均向前移位0.4mm,有统计学意义(P<0.05)。结论:自攻型微螺钉种植体是一种稳定的支抗装置,但是在承载正畸负荷的过程中,并不保持绝对的稳定,部分微螺钉在正畸力作用下有移位。为了防止因种植体移位伤及临近的重要组织结构,建议自攻型微螺钉应植入在没有主要神经、血管通过的非齿槽骨区,或植入在齿槽间隔区,但种植体与牙根之间应留出2mm的安全距离。     

Low dose propranolol decreases orthodontic movement

ObjectiveLow dose propranolol has previously been demonstrated to suppress bone remodelling. Therefore, its effect on orthodontic movement was tested.DesignRats were assigned as follows (n = 5): animals with no orthodontic appliance (G1); the remaining groups were fitted with a Ni-Ti closed-coil spring ligated to the upper left first molar and connected to the incisors using metal and resin and received vehicle only (G2), 0.1 mg/kg (G3) or 20 mg/kg (G4) of propranolol orally. Cone Beam Computed Tomography was performed using high resolution for image capture. The distance between the first and second upper molars, both with and without the orthodontic appliance, was measured in millimetres. Gingival tissue was harvested and assessed for IL-1β and IL-6 using ELISA and for ICAM-1 and RANKL by Western blotting.ResultsThe orthodontic appliance induced a significant tooth movement in G2 when compared to the animals without an orthodontic appliance (G1) (p < 0.05). The animals from G3 showed a significantly reduction in tooth movement (p < 0.05) when compared with rats from G2. Animals treated with 20 mg/kg of propranolol (G4) showed tooth movement similar to that of G2. The reduced tooth movement observed in the animals treated with 0.1 mg/kg of propranolol (G3) occurred due to decreased amounts of IL-1β and IL-6, in addition to lower ICAM-1 and RANKL expression.ConclusionsLow dose propranolol inhibits bone remodelling and orthodontic movement.     

TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment

The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P = .035) and arthralgia (P = .040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P = .050, P = .004, P = .041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain.     

Effect of honey in preventing gingivitis and dental caries in patients undergoing orthodontic treatment

ObjectivesThis study was conducted to investigate the following: (1) the effects of chewing honey on plaque formation in orthodontic patients, (2) the effect of chewing honey on dental plaque bacterial counts, (3) determine if honey possesses antibacterial effects on bacteria recovered from plaques.MethodsFemale orthodontic patients (n = 20, 12–18 years of age) participated in this randomized controlled study. The effects of honey were compared to treatment with either 10% sucrose or 10% sorbitol that served as positive and negative controls, respectively. The pH of plaque was measured using a digital pH meter prior to baseline and at 2, 5, 10, 20, and 30 min after chewing honey or rinsing with control solutions and the numbers of Streptococcus mutans, Lactobacilli, and Prophymonas gingivalis in respective plaques were determined. The antibacterial activity of honey was tested against commonly used antibiotics using the disk diffusion method.ResultsSignificant differences in pH were observed in the honey and sucrose groups compared to the pH observed in the sorbitol group (p ? 0.001). The maximum pH drop occurred at 5 min in both the honey and sucrose groups; however the pH in the honey group rapidly recovered 10–20 min after exposure and did not drop below the critical decalcification pH of 5.5. On the other hand, the pH following sucrose exposure fell <5.5 and was associated with a 30 min recovery time. The pH observed for the sorbitol group did not change over time. Bacterial counts were significantly reduced in the honey group compared to the other treatment groups (p ? 0.001) and honey significantly inhibited the growth of all studied strains compared to inhibition observed with antibiotics (p ? 0.001).ConclusionsHoney can be used as an alternative to traditional remedies for the prevention of dental caries and gingivitis following orthodontic treatment.     

Nanoindentation of orthodontic archwires: The effect of decontamination and clinical use on hardness,elastic modulus and surface roughness

ObjectivesThe purpose of this research was to investigate the effects of decontamination and clinical exposure on the elastic moduli, hardness and surface roughness of two frequently used orthodontic archwires, namely 0.020 in. × 0.020 in. heat activated (martensitic active) nickel titanium archwires and 0.019 in. × 0.025 in. austenitic stainless steel archwires.MethodThis study was a prospective clinical trial in which 20 consecutive patients requiring an archwire change as part of their course of orthodontic fixed appliance therapy, had either a nickel titanium or stainless steel archwire fitted as deemed clinically necessary. The effect of clinical use was determined by comparing distal end cuts of the “as received” archwires before and after decontamination, with the same retrieved archwires following clinical use and decontamination. Hardness, elastic modulus and surface roughness were determined using an atomic force microscope (AFM) coupled with a nanoindenter.ResultsThe results showed that the decontamination regimen and clinical use had no statistically significant effect on the nickel titanium archwires, but did have a statistically significant effect on the steel archwires. Decontamination of the steel wires significantly increased the observed surface hardness (p = 0.01) and reduced the surface roughness (p = 0.02). Clinical use demonstrated a statistically significant increase in the observed elastic modulus (p < 0.001) and a decrease in surface roughness (p = 0.001).SignificanceAt present it is difficult to predict the clinical significance of these statistically significant changes in archwire properties on orthodontic tooth movement.     

Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3 ± 9.47 years) and 14 patients with skeletal class III (mean age 25.6 ± 6.27 years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann–Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P = 0.002) and inferior (P = 0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P = 0.024) and superior (P = 0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P = 0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.     

Evaluation of effects of activator treatment on mandibular growth by analyzing components of condylar growth and mandibular rotation

PurposeThe objective of this study is to clarify the effects of activator treatment on mandibular growth in relation to condylar growth and total rotation of the mandible, and to investigate the relationships between the treatment responses and pretreatment facial morphology.Materials and methodsThirty Japanese girls with Class II division 1 malocclusion treated with activator were examined. Mean age at the start of treatment was 9.6 ± 1.6 years. Mean treatment duration was 19 ± 4 months. Lateral cephalograms obtained before and after treatment were used to analyze skeletal changes during treatment. Regional superimposition analysis was performed to evaluate activator effects by decomposing the mandibular growth into condylar growth and mandibular total rotation.ResultsThe changes in intermaxillary relationships were significantly correlated with vertical condylar growth and mandibular total rotation (P < 0.05 and P < 0.01). The changes in the forward displacement of the mandible were significantly correlated with sagittal condylar growth and mandibular total rotation (P < 0.05 and P < 0.01). Vertical condylar growth and mandibular total rotation were significantly correlated with pretreatment mandibular morphology (P < 0.05 and P < 0.01).ConclusionBoth the sagittal condylar growth and counterclockwise mandibular total rotation attributed to activator treatment contribute to forward displacement of the mandible. The activator effects are expected greater in patients with flat mandibular plane, small gonial angle, backwardly inclined mandibular ramus and long posterior facial height.     

Do miniscrews remain stationary under orthodontic forces?

Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. Sixteen adult patients with miniscrews (diameter = 2 mm, length = 17 mm) as the maxillary anchorage were included in this study. Miniscrews were inserted on the maxillary zygomatic buttress as a direct anchorage for en masse anterior retraction. Nickel-titanium closed-coil springs were placed for the retraction 2 weeks after insertion of the miniscrews. Cephalometric radiographs were taken immediately before force application (T1) and 9 months later (T2). The cephalometric tracings at T1 and T2 were superimposed for the overall best fit on the structures of the maxilla, cranial base, and cranial vault to determine any movement of the miniscrews. The miniscrews were also evaluated clinically for their mobility (0: no movement, 1: < or =0.5 mm, 2: 0.5-1.0 mm, 3: >1.0 mm). The mobility of all miniscrews was 0 at T1 and T2. On average, the miniscrews tipped forward significantly, by 0.4 mm at the screw head. The miniscrews were extruded and tipped forward (-1.0 to 1.5 mm) in 7 of the 16 patients. Miniscrews are a stable anchorage but do not remain absolutely stationary throughout orthodontic loading. They might move according to the orthodontic loading in some patients. To prevent miniscrews hitting any vital organs because of displacement, it is recommended that they be placed in a non-tooth-bearing area that has no foramen, major nerves, or blood vessel pathways, or in a tooth-bearing area allowing 2 mm of safety clearance between the miniscrew and dental root.     

Fracture strength and fatigue resistance of dental resin-based composites

ObjectivesThe aim of this study was to evaluate in vitro the influence of fiber-reinforcement on the fracture strength and fatigue resistance of resin-based composites.MethodsOne hundred rectangular bar-shaped specimens (2 mm × 2 mm × 25 mm) made of resin-based composite were prepared in a stainless steel split-mould: (i) thirty specimens of particulate filler composite (PFC) (Filtek Z100, 3 M ESPE, St Paul, MN, USA), (ii) thirty specimens of fiber-reinforced composite (FRC) (Everstick C&B, Sticktech Ltd., Turku, Finland) and (iii) forty specimens of PFC and FRC combined in two longitudinal layers of equal thickness. Each specimen was trimmed into a cylindrical hourglass shape. The fracture strength (cantilever beam test, n = 10) and the fatigue resistance (rotating cantilever beam test; staircase method: 10⁴ cycles, 1.2 Hz, n = 20) were determined. Fracture strength, fatigue resistance and work-of-fracture were calculated. The fracture surfaces of failed specimens were analyzed with SEM. Data was analyzed by logistic regression, one-way ANOVA followed by Tukey's post hoc test and, a Student's t-test.ResultsANOVA revealed that fiber-reinforcement had significant effect (P < 0.001) on fracture strength, fatigue resistance, and work-of-fracture. Student's t-test showed significant differences (P < 0.001) in fatigue resistance compared to fracture strength.ConclusionsWithin the limitations of this study, the following conclusions can be drawn (i) the fatigue resistance of resin-based composites is lower than their fracture strength and (ii) FRC are more fatigue resistant than PFC or combinations of FRC and PFC.     

Microbial profile of dental plaque associated to white spot lesions in orthodontic patients immediately after the bracket removal

ObjectiveDenaturing Gradient Gel Electrophoresis (DGGE) is suggested to predict caries risk in young children. Such a tool would be valuable in orthodontic patients undergoing treatment with fixed appliances. In this cross-sectional study the applicability of DGGE and conventional microbiology for caries risk assessment in orthodontic patients were assessed.DesignDental plaque was obtained from orthodontic patients immediately prior to bracket removal. Presence of white spot lesions (WSL) was assessed immediately post debracketing. DGGE-patterns and band counts were assessed using varying automated band detection settings and compared to visually detected bands to determine optimum settings. Optimum settings were used to compare band patterns in subjects with or without WSL. Microbiological samples were assessed for total colony forming units (CFU’s) and percentages of aciduric flora, Streptococcus mutans, Lactobacillus spp. and Candida albicans.ResultsThirty-seven subjects were included with a mean age of 15.4 yr (SD 1.6 yr; 28 with WSL; 9 without WSL). Depending on settings, DGGE outcomes were different. Optimum minimum profiling absolute to the most intense band of 4% showed no significant difference in band numbers for subjects with or without WSL (p = 0.845). Optimum settings for minimum profiling relative to the most intense band of 15% showed significant lower band numbers for subjects with WSL than those without (p = 0.007). No differences between groups were observed for microbiological parameters.ConclusionThe analysis of DGGE-patterns is ambiguous. Software settings significantly affected outcomes. DGGE-patterns and band numbers like CFU counts were not predictive with respect to WSL formation in these orthodontic patients.     

Only severe malocclusion correlates with mastication deficiency

ObjectivesThe relation between level of dentofacial deformity and extent of masticatory deficiency was studied.DesignThree groups of human young adults were formed: (i) subjects needing orthodontics plus orthognathic surgery (SevDFD, n = 18), (ii) subjects needing orthodontic treatment only (ModDFD, n = 12), and (iii) subjects needing no treatment (NoDFD, n = 12). For mastication tests, carrot boluses were collected at the deglutition time. Bolus particle size range was expressed as d50 value, which was compared with the Masticatory Normative Indicator (MNI). Index of treatment need (IOTN), global oral health assessment index (GOHAI) and chewing kinematic characteristics were also recorded. We used a general linear model univariate procedure followed by a Student-Newman-Keuls test.ResultsAll the SevDFD subjects showed impaired mastication with MNI above the normal limit (d50 mean = 7.23 mm). All the ModDFD subjects but one were below this limit (d50 mean = 2.54 mm), and so could adapt to a low level of masticatory impairment as also indicated by kinematics. IOTN indicated a treatment need for ModDFD (3.7 ± 0.5) and SevDFD (4.3 ± 0.6) groups, while GOHAI values were unsatisfactory only for SevDFD (42.6 ± 9.2 vs. 55.3 ± 1.9).ConclusionsOur findings emphasize the need for an objective evaluation of masticatory function to discern truly deficient mastication from mild impairment allowing satisfactory adaptation of the function. However, malocclusions are known to worsen with time justifying thus their corrections as early as possible.     

Biomechanical investigation into the role of the periodontal ligament in optimising orthodontic force: a finite element case study

ObjectivesThis paper aimed to precisely locate centres of resistance (CRe) of maxillary teeth and investigate optimal orthodontic force by identifying the effective zones of orthodontic tooth movement (OTM) from hydrostatic stress thresholds in the periodontal ligament (PDL).MethodsWe applied distally-directed tipping and bodily forces ranging from 0.075 N to 3 N (7.5 g to 300 g) onto human maxillary teeth. The hydrostatic stress was quantified from nonlinear finite element analysis (FEA) and compared with normal capillary and systolic blood pressure for driving the tissue remodelling. Two biomechanical stimuli featuring localised and volume-averaged hydrostatic stresses were introduced to describe OTM. Locations of CRe were determined through iterative FEA simulation.ResultsAccurate locations of CRes of teeth and ranges of optimal orthodontic forces were obtained. By comparing with clinical results in literature, the volume average of hydrostatic stress in PDL was proved to describe the process of OTM more indicatively. The optimal orthodontic forces obtained from the in-silico modelling study echoed with the clinical results in vivo.ConclusionsA universal moment to force (M/F) ratio is not recommended due to the variation in patients and loading points. Accurate computational determination of CRe location can be applied in practice to facilitate orthodontic treatment. Global measurement of hydrostatic pressure in the PDL better characterised OTM, implying that OTM occurs only when the majority of PDL volume is critically stressed. The FEA results provide new insights into relevant orthodontic biomechanics and help establish optimal orthodontic force for a specific patient.     

Changes in condylar and joint disc positions after bilateral sagittal split ramus osteotomy for correction of mandibular prognathism

The effect of combined orthodontic and orthognathic treatment was studied retrospectively in 24 patients with skeletal class III malocclusions with mandibular hyperplasia, particularly the effect on temporomandibular joint (TMJ) disc position. The patients underwent preoperative orthodontic treatment, orthognathic surgery, and postoperative orthodontic treatment. The patients were studied clinically, radiographically with lateral cephalometric radiograph and MRI to locate the position of the TMJ disc in relation to the glenoid fossa. One patient had less pain after treatment, one lost abnormal joint clicking sounds after treatment. There were no TMJ symptoms in 20 of the 24 preoperatively and postoperatively. 48 sagittal MRI images showed that the disc length before treatment was 3.040–12.928 (mean 8.289 ± 2.028) and after treatment was 3.699–11.589 (mean 8.097 ± 1.966); results were not significant (p > 0.05). Maximum disc displacement before treatment was 6.090 (mean 1.383), after treatment it was 11.931 (mean 2.193); results were not significant (p > 0.05). The results suggest that combined orthodontic and orthognathic treatment (including bilateral SSRO and rigid internal fixation) can be used safely to correct skeletal class III malocclusion with mandibular hyperplasia without causing additional TMJ symptoms.     

Bimaxillary protrusion trait in the Indian population: A cephalometric study of the morphological features and treatment considerations

PurposeThe orthodontic literature is discordant with the diagnosis of bimaxillary protrusion with no single anatomic answer and the anomaly has been referred in the literature with protean characteristics. The trait denotes a particular facial configuration and its cephalometric representation in certain ethnic and racial groups revealed a mixed pattern with individual variations. The present study was aimed at analyzing the dento-skeletal characteristics of bimaxillary protrusion in a sample of Indian men and women.Materials and methodsForty-six Indian subjects (28 women and 18 men; 19 ± 3.6 years of age) with Class I malocclusion and interincisal angle ≤110°, who attended orthodontic clinics for a comprehensive fixed orthodontic treatment were included for the study. The lateral films were hand traced and 27 parameters were measured. The data were imported to SPSS version 13 US package and statistical manipulation included means, standard deviation, and coefficient of variation (%). Male and female data were compared by Student's t-test (unpaired). Correlation and regression analysis were performed to assess any relationship between different parameters.ResultsThere was a marked increase in proclination of the maxillary incisors both to the maxillary plane (125.3 ± 5.7°), the NA line (35.1 ± 5.0°) and to sella–nasion (117.7 ± 5.5°). The positional relationship of the mandible to the maxilla with reference to the cranial base was within the normal limits (ANB = 3.1 ± 1.3°) and the skeletal pattern was Class I. The effective lengths of maxilla and mandible did not correlate significantly with sagittal skeletal discrepancy.ConclusionUnlike in other ethnic and racial groups, bimaxillary protrusion in Indian subjects is likely a bidental protrusion over normal dento-alveolar bases. The skeletal characteristics suggested a normal relationship of the functional components of the face. The condition could be treated successfully with orthodontic mechanotherapy alone.