Pakistan Orthodontic Journal

Editor’s Message

Saad Asad — Mon, 30 Jun 2025 00:00:00 +0500

We are pleased to present the latest issue of our journal, continuing our commitment to advancing orthodontic research and clinical practice. Original articles remain the cornerstone of scientific progress, and we deeply value the contributions of our authors whose research adds meaningful knowledge to the field.

This time, we are delighted to share that an original article from the field of Medical Education has been entertained for the first time—marking a step forward in diversifying the academic scope of our publication.

Our sincere appreciation goes to our dedicated peer reviewers and esteemed editorial board, whose efforts ensure the quality and integrity of each publication.

Transforming Regeneration and Disease Management in Oral Biology through Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and Gene Editing

Wajiha Qamar — Mon, 30 Jun 2025 00:00:00 +0500

Biomedical research has been dramatically transformed with the creation of gene editing technologies such as Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR). Their application spans across multiple systemic diseases as they allow for precise, cost-effective, and reliable genome modifications. But their potential in the field of oral biology remains underexplored. This editorial discusses the emerging role CRISPR is having in oral biology, especially its uses in regeneration and oral related diseases treatment. Modifications of oral defective cleft lip or amelogenesis imperfecta or dentinogenesis imperfecta can be treated with mutation targeting techniques that CRISPR offer us. Not only this, but new oral microbiome modulation approaches can be employed to target and prevent dental caries and periodontitis. The broader adoption of emerging technologies, including in vivo delivery systems and CRISPR diagnostics, pose additional opportunities, but issues such as effective delivery to oral tissues, off-target mutations, and ethical implications persist. Multidisciplinary CRISPR implementation will help advance medicine and quite literally change the game for oral health and patient care across the globe.

Open Reduction and Internal Fixation versus Closed Reduction for managing Zygomatic Complex Fractures: Comparison of Surgical Interventions on Orthodontic Occlusion

Mon, 30 Jun 2025 00:00:00 +0500

Objective: The aim of this study is to evaluate and compare the occlusal outcome following closed reduction (CR) and open reduction with internal fixation (ORIF) for managing zygomatic complex fractures.

Methodology: A cross-sectional comparative study design was employed. Sixty patients with zygomatic complex fractures were treated; thirty were managed through open reduction while remaining thirty were managed through closed reduction technique. Experienced orthodontists used standardized occlusal images to perform the follow-up evaluation of the occlusion at 6 months and 1 year interval and rated the occlusion as optimal (normal) or poor (malocclusion). The data was collected and analyzed using SPSS 23.0

Results: There was statistically insignificant difference in the occlusal outcome as assessed by the experienced orthodontists between the two assessed groups at 6 months and 1 year follow-up. The Chi-square frequency table showed no difference between the closed versus open reduction group for gender (p=.341).

Conclusions: This study found that managing zygomatic fractures with either closed reduction or open reduction and internal fixation produced similar occlusal outcomes. This suggests that oral and maxillo-facial surgeons can use both techniques to manage zygomatic complex fractures while taking other factors into consideration.

Analysis of the Skeletal Pattern and Mandibular Symphyseal Architecture in Pakistani Adults

Mon, 30 Jun 2025 00:00:00 +0500

Introduction: The aim of this study is to ascertain the height, thickness, and height-to-thickness ratios of the mandibular symphysis with different sagittal and vertical patterns.

Methodology: This cross-sectional study examined 101 lateral cephalograms of untreated orthodontic patients. Adults (18 to 45 years) of either gender who had lateral cephalograms were included. All cephalograms were traced and examined by a single researcher. Anteroposterior (AP) & vertical skeletal measurements were taken in all participants in relation to symphyseal height, thickness, & ratio between height & thickness. SPSS-26 was used for data analysis.

Results: A non-significant difference was found in anteroposterior and vertical skeletal measurements among males and females. There were no major variations in symphyseal dimensions when analyzed with respect to the anteroposterior skeletal classification (ANB°). Significant associations between the three symphyseal measures and Gonial angle were found in males.

Conclusions: Males had higher mean symphyseal vertex, thickness, & height-thickness ratio than females. AP skeletal categorization was not substantially correlated with symphyseal height, thickness, or ratio (ANBo).Significant relationships existed between Gonial angle & symphyseal height, thickness, & ratio.

Radiographic Analysis of the Location and Bilateral Symmetry of the Mental Foramen on Digital Panorax

Iqra Sana, Numrah Shakeel Malik, Muhammad Umair , Iqraa Shakeel Malik — Mon, 30 Jun 2025 00:00:00 +0500

Introduction: The mental foramen (MF) is situated at the end of the inferior alveolar canal on the mandible's lateral surface and plays a crucial role in all dental procedures, including orthodontics. This research evaluate the digital panoramic based assessment of the locale and bilateral symmetry of mental foramina.

Methodology: The study is a cross-sectional descriptive analysis utilizing hospital records from March 1, 2022, to January 29, 2024, at a Dental Hospital in Rawalpindi, Pakistan. Panoramic radiographs were collected from patients aged 18 to 60 who visited the Dental OPD for their dental concerns. The mental foramen was examined bilaterally, noting its location and symmetry in relation to the patient’s age and gender. The locale was assessed by aligning horizontal planes with the long axes of the bicuspids and a vertical plane extending from the apex of the 1st to the 2nd bicuspid. To locate the precise position of the foramen two horizontal reference planes were drawn along the axis between the 2nd premolar and the mesial root of the 1st molar. In cases where the mental foramen was notably large or situated within the region spanning both premolars and molars, the side demonstrating greater radiolucency was systematically evaluated for further analysis.

Results: This study's results show that on the right side, the most common horizontal position is between bicuspids (43.5%) and below the second premolar on the left side (37.1%) in both males and females, respectively. The vertical position is primarily inferior to the a premolar`s apical area, with 62.5% possessing a bilateral symmetrical vertical position.

Conclusion: In both males and females, the mental foramen is most commonly located between the apices of the first and second premolars on the right side, and inferior to the second premolar on the left side

Analysis of the Correlation between Yen and W Angles and Conventional Sagittal Discrepancy Indicators (ANB and Wits)

Aamir Waheed, Zubair Ahmed, Madeh ul Rehman, Alina Nadeem — Mon, 30 Jun 2025 00:00:00 +0500

Introduction: ANB angle has been used widely for the assessment of skeletal sagittal dysplasia. However several limitations have been associated with ANB angle. The aim of this research is thus to correlate YEN and W angles with conventional sagittal discrepancy indicators (ANB and Wits)

Methodology: Based on ANB angle, a sample of 165 participants were split up into three groups: Group 1 = Skeletal Class I, Group 2 = Skeletal class II, and Group 3 = Skeletal Class III. YEN angle and W angle was analyzed on lateral cephalogram and compared with ANB angle and Wits appraisal.

Results: Mean value of YEN angle for Class I was 123.15° ± 7.6°. Mean value of W angle for Class was 56.61°± 5.5°. Negative correlation of ANB with Yen angle, YEN (r = -0.640, p< .001), and W angle, W (r = -0.798, p < .001) and positive relationship between YEN and W angle (r = 0.675, p < .001) was found.

Conclusion: W and Yen angles can be used in patients as an alternative to ANB angle if reliability of ANB angle is questionable.

Comparison of Patient Satisfaction regarding Dental Care Services provided at Public and Private Teaching Hospitals of Islamabad

Khaliq Aman, Sadaf Hamayoun, Ayesha Yasir — Mon, 30 Jun 2025 00:00:00 +0500

Introduction: Patient satisfaction is measured how well a need was satisfied in relation to the standard of medical care they received. Patients valued assessments and subsequent responses to what they observed in the healthcare environment during the course of their visit were referred to as their level of satisfaction. This study aimed to compare the satisfaction of patients regarding healthcare services provided at public and private Dental Teaching Hospitals of Islamabad.

Methodology: A comparative analytical study was conducted at two teaching hospitals (one private and one public) in Islamabad. This study was approved by ethical review board and written informed consent was taken. A structured survey questionnaire was used to collect data from 250 patients divided equally between two settings. The data collected were analyzed using SPSS 24 for categorical variables (highly satisfied, satisfied, neutral, dissatisfied, and strongly dissatisfied). Overall patient satisfaction (PSQ-18) and its sub-components were assessed. The frequency and percentage were measured for PSQ scale. Average PSQ-18 parameters were compared between public and private hospitals using t-test and ANOVA at significance level of 0.05.

Results: Overall, the mean age was 32.5 ± 12.4 years and females were dominant with 141 (56.4%) cases. The patients from the private facility (65.3 ± 11.4 vs 59.0 ± 8.8) were more satisfied with the healthcare services than the public facility in this study. The general satisfaction and technical aspects were slightly greater in private setting compared to public (7.2 ± 1.5 vs 6.5 ± 1.3) and (14.6 ± 3.1 vs 13.7 ± 2.3) respectively. The sub-components of interpersonal aspects, communication and financial, were found comparable between the two settings.

Conclusion: This study concluded that three-fourths of patients were satisfied or highly satisfied with the dental care. Patient satisfaction was better in the private setting compared to public dental facility. The results have huge implications for undergraduate medical and dental education and practices in terms of need of improved communication skills, time management and technical aspects.

Digital Dilemmas: Unraveling the Challenges of E-Learning

Mon, 30 Jun 2025 00:00:00 +0500

Introduction: The COVID-19 caused universities to switch from conventional face-to-face learning to the technically advanced online learning method. We must identify practical alternatives to equip our graduates with the required skills to overcome the challenges it has brought forth. The aim of the study was to investigate the challenges dental students and faculty members encounter during e-learning.

Methodology: Qualitative methodological framework was used. The setting was Rawal Institute of Health Sciences, a private medical and dental college in Islamabad, Pakistan. Semi-structured interviews were conducted with the dental students and faculty until the point of saturation was achieved. The data were recorded, manually transcribed and thematic analysis was done to derive the results.

Results: There were a total of 29 interviews conducted, out of which 15 were of students and 14 were faculty members of Rawal Institute of Health Sciences. 3 themes and 11 sub themes were generated regarding the challenges faced during e-learning.

Conclusion: The key finding was that, despite the fact that both students and faculty desired to continue e-learning and take the initiative, they preferred to avoid it due to the lack of resources and inadequate training that made it difficult for them to move outside of their comfort zones. Yet, if the right tools are made available, e-learning in dental schools has a bright future.