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A borderline case presents with mild skeletal disharmony or orthodontic problems due to arch length discrepancy and migration of teeth or a combination of these but is masked by a balanced soft tissue relationship. This case report describes one such borderline case of a 13-year-old girl who complained of irregularly placed upper and lower front teeth. Extraoral examination revealed balanced soft tissue with a mild convex profile, competent lips, and an average nasolabial angle. Intraorally, she had mixed dentition with flush terminal in primary molars and a class I relation in the permanent molars, severe crowding in the lower anterior, and congenitally missing permanent right laterals. A nonextraction protocol was followed, harnessing the pubertal growth spurt to alleviate the crowding and thereby preserving the soft tissue harmony. How to cite this article: Rajan AS, Parameswaran R, Rajkumar B, et al. Nonextraction Management of Severe Crowding in a Growing Patient with Borderline Malocclusion: Case Report. Int J Clin Pediatr Dent 2024;17(4):472-478.

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OBJECTIVES: To evaluate Intraoral volume changes in relation to the hard tissue shape changes in asymmetric patients before and after orthognathic surgery and establish a correlation between them. MATERIALS AND METHODS: A retrospective study which evaluated 12 asymmetric patients' pre and post-surgical CT records satisfying the inclusion criteria. Borders were defined for the measurement of extraoral, intraoral and tongue volume. The volume assessment was carried out using software from 3D SYSTEMS, Colorado, US, Version 1.0.2.2055. RESULTS: Predicting changes in volume between extra-oral, intra-oral spaces and tongue, Linear regression modeling of the data revealed that for every mm3 change in post-surgical extra-oral volume the post-surgical intra-oral volume decreased by 0.684 mm3 and for every mm3 change in post-surgical intra-oral volume, the post-surgical tongue volume increased by 0.728 mm3. CONCLUSIONS: Significant decrease in the extra-oral volume, Intra-oral volume and tongue volume was evident after orthognathic surgery in patients with facial asymmetry. This volumetric approach sheds insight into achieving a muscular equilibrium between intraoral and extraoral structures, which would improve orofacial function and enhance facial aesthetics.

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To investigate the pharyngeal airway volume in different anteroposterior skeletal malocclusions. This study was prepared according to the Cochrane criteria for creating a systematic review and meta-analysis and confirms the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. This search was conducted to answer the patient/population, intervention, comparison and outcomes (PICO) question: To evaluate (outcome) and compare (comparison) whether there is a difference in airway volume in patients (participants) with different skeletal malocclusions diagnosed using 3D data (intervention).The first two authors extracted the data from the included studies and assessed the risk of bias in the individual studies using the Newcastle-Ottawa scale. Meta-analysis was done using STATA version 16, which compared various three-dimensional pharyngeal airway parameters in skeletal Class II and skeletal Class III malocclusions with that of skeletal class I malocclusion. Out of 370 articles from the initial search, 17 articles were included in the systematic review. Out of 17 studies, 12 eligible studies were included in the quantitative synthesis. The nasopharynx, oropharynx, hypopharynx, and total airway volume were increased in skeletal Class I malocclusion compared to that of skeletal Class II malocclusion and decreased in comparison to skeletal Class III malocclusion. The moderate quality of evidence indicates the total airway volume, oropharynx, and hypopharynx are largest in skeletal Class III compared to Class I and Class II skeletal malocclusion.

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Dental compensations are an integral part of skeletal malocclusions. Failure to achieve optimal decompensation may lead to compromised surgical movements, thereby resulting in sub-optimal occlusion and soft tissue profile. Hence the mandibular subapical osteotomy was chosen as a minimalistic surgical alternative to the traditional combination of Le Fort 1 and bilateral sagittal split osteotomy. The choice was made by prioritizing soft tissue considerations, which offered the probability of a better post-treatment outcome. This paper highlights two such challenging case scenarios where the surgical plan was modified in accordance with the soft tissue as the primary objective.

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OBJECTIVES: To evaluate the tongue and oral cavity proper volume in pre- and post-bilateral sagittal split osteotomy (BSSO) patients, and to establish whether there was a correlation between them. MATERIALS AND METHODS: A retrospective study that evaluated 12 patients' pre- and post-surgical computed tomography records satisfying the inclusion criteria. Borders were defined for measurement of tongue and oral cavity proper volume. The volume assessment was carried out using 3D slice software. RESULTS: The mean difference of tongue volume was 5.7 ± 1.7 cm3, which showed high statistical significance. The mean difference of oral cavity proper volume (OCVP) was 6.9 ± 3.4 cm3 and indicated high statistical significance. A very strong positive correlation existed between pre- and post-surgical tongue volume. Positive correlation was also evident between pre and post - surgical OCVP. Medium positive correlation was noted when the difference between pre- and post-surgical tongue and OCVP were assessed. CONCLUSIONS: There was a significant change in volume of tongue and oral cavity proper after BSSO advancement surgery. The space around the tongue, position of tongue, and maxillary and mandibular relationship influence the volume of tongue and oral cavity proper.

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