Effect of Probiotic Toothpaste on Enamel Mineralization and Streptococcus mutans Levels in Cleft Orthodontic Patients—A Randomized Clinical Trial Dinesh Murugesan, C. Siva Subramanian, Vignesh Kailasam Cleft Palate Craniofacial Journal, 2026 Objective To assess the effectiveness of probiotic and fluoride toothpaste on enamel mineralization and Streptococcus mutans levels in cleft lip and/or palate patients undergoing fixed orthodontic appliance therapy. Design A randomized comparative trial with a 1:1 allocation ratio. Participants Thirty-two patients with cleft lip and/or palate undergoing fixed orthodontic appliances were recruited. Interventions Cleft lip and/or palate patients undergoing fixed orthodontic appliances were randomized into Group 1 (probiotic toothpaste) or Group 2 (fluoride toothpaste). The toothpaste was given to the patient after oral prophylaxis. The patients were advised to use the toothpaste two times a day (morning and night) for a period of 4 weeks. Main outcomes Enamel mineral content was assessed before intervention (T0) and after 4 weeks of intervention (T1) using DIAGNOdent. Streptococcus mutans levels were assessed after 4 weeks of intervention (T1) for both the groups using real time-polymerization chain reaction (RT-PCR). Paired t-tests and t-tests were used for intragroup and intergroup comparisons, respectively. A P-value < .05 was considered statistically significant. Results Both the groups showed improvement in enamel mineral content after 4 weeks of intervention. Streptococcus mutans levels in the probiotic-containing toothpaste were lesser when compared to the fluoridated toothpaste group. No statistically significant difference was found between probiotic toothpaste and fluoridated toothpaste in both the assessed parameters. Conclusions Probiotic toothpaste is as effective as fluoride toothpaste in enamel remineralization. Probiotic toothpaste showed greater inhibitory effect on Streptococcus mutans than the fluoridated toothpaste.
A Novel Method to Determine Cephalometric Measures Best at Assessing a Class II Skeletal Discrepancy Annapurna Kannan, Vignesh Kailasam International Journal of Clinical Pediatric Dentistry, 2026 Aim and background: To determine the ranking of 21 anteroposterior cephalometric parameters in assessing patients with a class II skeletal discrepancy.Materials and methods: Mixed methodology study-software development and retrospective analysis of archived radiographic records.Setting: Sri Ramachandra Institute of Higher Education and Research (Deemed to be University).Methods: 356 patients, with clinically verified skeletal class II discrepancy, were selected.Software was developed to evaluate 21 anteroposterior cephalometric parameters.The percent difference between the mean value for class II skeletal discrepancy and the patient value was obtained.The patient values were correlated with lateral cephalograms, which were ranked based on the clinical severity of class II skeletal discrepancy.The scatter plots of the rank vs the patient values of the 21 parameters were obtained.Results: Within angular parameters, FABA angle (0.209%), W angle (1.509%), and Yen angle (1.962%) had the least percent difference, and Pi angle (48.638%),APDI angle (33.066%),ANB angle (15.862%), and Down's AB plane angle (15.796%) had the highest percent difference.Within linear parameters, McNamara differential (0.444%), AF-BF distance (0.801%), and Wits appraisal (3.579%) had the least percent difference, and Pi linear (30.913%),Jenkins "a" plane (29.367%), and APP-BPP distance (27.431%) had the highest percent difference.The scatter plots closely followed the percent differences obtained.Conclusion: Overall, FABA angle, Wits appraisal, and the McNamara differential were most accurate in determining a class II skeletal discrepancy.Clinical significance: This would be of immense value, as clinicians will know, among the 21 parameters, which are the ones to be given priority during the treatment planning phase.
A Comparative Study on Vertical and Transverse Orthodontic Relapse in Patients with and Without Cleft Lip and Palate Navia Jose Paul, Annapurna Kannan, Vignesh Kailasam Cleft Palate Craniofacial Journal, 2026 Objective To compare the 2-year post-treatment stability of vertical and transverse dimensions in orthodontic patients with non-syndromic cleft lip and palate (CLP) versus non-cleft controls (NC). Design Retrospective comparative study. Patients/Participants Twenty-eight patients divided into CLP ( n = 14) and NC ( n = 14) groups matched for age and sex. Interventions Orthodontic fixed appliance therapy followed by removable vacuum-formed retainers. Main Outcome Measures Vertical changes were assessed with lateral cephalograms, and transverse relationships were analyzed using the Modified Huddart-Bodenham (MHB) Index. Intragroup changes (T0-T1) were analyzed with paired t -tests and intergroup differences with unpaired t -tests ( P < .05). Results At 2-year post-treatment, the cleft group showed significant reductions in anterior facial height (−1.06 ± 0.59 mm, P < .001), U1-NF (−0.31 ± 0.48 mm, P = .01), L1-MP (−0.54 ± 0.63 mm, P = .004), and U6-NF (−0.66 ± 0.70 mm, P < .001). Transverse relapse was evident at the incisors (−0.36 ± 0.50, P = .006), molars (−0.43 ± 0.51, P = .002), and in total scores (−0.29 ± 0.47, P = .007). The NC group showed minimal changes ( P > .05). Conclusions Patients with CLP demonstrate greater vertical and transverse orthodontic relapse 2-year post-treatment compared to non-cleft patients. These findings underscore the necessity for potential permanent retention protocols tailored to the unique anatomical and physiological challenges of the cleft population.
Genetic factors associated with Class II division 2 malocclusion – A systematic review Shweta Ranjith, Nandita Krishnaswamy, Vignesh Kailasam Journal of Contemporary Orthodontics, 2026 Objective: To systematically review the genes that code for Class II division 2 malocclusion.Materials and Methods: A systematic search using appropriate keywords was performed in PubMed, Scopus, Web of Science, LILACS and OVID database upto 5 August 2025.Inclusion and exclusion criteria were framed to include studies that identified the genes coding for Class II division 2 malocclusion.Down and Black quality checklist was used to assess the risk of bias.Results: A total of 7120 studies were obtained after which 4 articles met the inclusion and exclusion criteria.PAX9, MSX1, FGF8, FOXL2 and ISL1 genes were associated with Class II division 2 malocclusion.In the PAX9 (rs8004560) gene, the AG genotype is more susceptible for the development of Class II division 2 malocclusion by 4 times (OR: 4.38).In the MSX1 (rs3821949) gene, the GG genotype is more susceptible for the development of Class II division 2 malocclusion.FGF8 (rs10786648, rs4919593) and FOXL2 (rs9809852) were associated with Class II division 2 features.The CC genotype in the variant of MSX1 (g.4861745), (g.4861974), (g.4861721), (g.4864876), AA genotype in (g.4861753), GG genotype in (g.4861609) were observed in Class II division 2 malocclusion.Conclusions: This systematic review showed there is conclusive evidence that PAX9, MSX1, FGF8, FOXL2 and ISL1 were associated with Class II division 2 malocclusion.Understanding the underlying mechanisms of this pathology is essential for a deeper insight into its aetiology, enabling the development of preventive measures, personalized therapeutic approaches, and more precise treatment planning strategies.Clinical Relevance: Literature evidences suggests that Class II division 2 malocclusion has a strong genetic influence in its establishment.The treatment of Class II division 2 malocclusion requires intervention at the appropriate timing thereby diagnosis plays a crucial role in the same.
Prostaglandin-E2 Mediated Inflammatory Response and Vas-Reported Pain During Rapid Maxillary Expansion in Patients with and Without Cleft: Prospective Cohort Study Nivedha Ramachandran, C. Siva Subramanian, Vignesh Kailasam, Prasad Nalabothu Cleft Palate Craniofacial Journal, 2026 Objective To compare subjective pain perception and local inflammatory response during rapid maxillary expansion (RME) in patients with and without cleft defects. Design Prospective cohort study. Setting Institutional clinical setting. Participants Sixteen patients were equally allocated to cleft and non-cleft groups (mean age: 9.5 ± 1.9 and 10.5 ± 1.2 years, respectively). Interventions All patients underwent tooth-borne rapid maxillary expansion using a standardised activation protocol of two turns per day (0.5 mm/day). Main Outcomes Measures Local inflammatory response was assessed by measuring prostaglandin E2 (PGE2) levels, while subjective pain was evaluated using a visual analogue scale (VAS). Measurements were recorded at baseline (T0), 1 day after the first activation (T1), at 7 days (T2), 14 days (T3), and 5 days after the final activation (T4). Results PGE2 peaked at T1 in both groups (cleft = 91.91 ± 48.52 pg/ml, non-cleft = 95.20 ± 53.98 pg/ml), then declined through T4. The values were higher in the non-cleft group, but not significant. VAS scores were significantly higher in the non-cleft group compared to the cleft group at T1 (4.50 ± 0.76 and 3.25 ± 1.67, respectively; p = 0.021), with no significant differences at T2 and T3. By T4, pain levels were minimal in both groups. Pearson correlation demonstrated a weak association between PGE2 levels and VAS scores. Conclusions Patients without cleft experienced higher subjective pain only after initial RME activation, while local inflammatory responses were comparable between groups throughout treatment. Clinical Trial Registration The Clinical Trials Registry- India (CTRI/2024/06/068906).
Morphological dimension of the permanent dentition in various malocclusion: a systematic review and meta-analysis Jerome Thomas, Annapurna Kannan, Vignesh Kailasam BMC Oral Health, 2025 BACKGROUND: Achieving optimal dentofacial aesthetics requires an understanding of tooth morphology and its impact on dental harmony. Variations in tooth size can significantly influence the occurrence of different malocclusions, affecting aesthetics and functional occlusion. This systematic review aims to analyse and summarise the existing literature on tooth size variations in different malocclusion categories, focusing on the morphological dimensions of permanent dentition. METHODS: Systematic literature search was conducted in six electronic databases (PubMed/Medline, Cochrane, Web of science, Scopus, LILAC, OVID) until February 2025 for original articles assessing the morphological dimension of the permanent dentition in various malocclusions. The risk of bias and quality assessment was done using the modified Downs and Black quality index for retrospective and cross sectional study. The review was registered on Prospero (CRD42024526671). RESULTS: Nine studies (4 retrospective, 5 cross sectional) met the eligibility criteria. A total of 2044 pre-treatment dental casts of patients with various malocclusions were included. In mandibular first molars, the mean difference (MD) of the mesiodistal width was higher in Class III malocclusion than Class II div 1 malocclusion (3 studies; MD [95%CI]: 0.45[, -0.66, -0.24]), Class II division 2 malocclusion (3 studies; MD [95%CI]: 0.29[, -0.55, -0.24]) and Class I malocclusion (7 studies; MD [95%CI]: 0.20[ -0.35 to -0.05]). These findings were statistically significant. For mandibular canines, MD of the mesiodistal width was higher in Class III malocclusion than in Class II division 1 malocclusion (3 studies; MD [95%CI]:0.28 [ -0.45 to -0.10]), which was statistically significant. With the maxillary canines, the MD of the mesiodistal width was higher in Class II division 1 malocclusion (3 studies; MD [95%CI]: 0.30[0.12, 0.47]), which was statistically significant. CONCLUSION: In Class III malocclusion, the mandibular dentition was found to be significantly larger compared to other malocclusions. The Maxillary dentition was significantly larger in Class II malocclusion compared to other malocclusions. Within the limitations of the study, Class III and Class II malocclusions were found to have larger mesio-distal width as compared to Class I malocclusion. These findings may aid clinicians in treatment planning, particularly in space analysis, arch coordination, and appliance selection during orthodontic interventions.
Association between Maxillary and Mandibular Length and Crowding in Classes 1, 2, and 3 Skeletal Malocclusion: A Systematic Review and Meta-analysis Marshal Lucas, Annapurna Kannan, Vignesh Kailasam International Journal of Clinical Pediatric Dentistry, 2025 arch, 12 while others have suggested that there was no association between the maxillary and mandibular base lengths and severity of dental crowding. 13 With more literature regarding the etiology behind crowding emerging, understanding these factors will aid in better treatment planning.As the available literature exhibited diverse outcomes across the spectrum, this necessitated a thorough review to IntroductIonDental crowding is defined as the discrepancy that arises between tooth size and the space available for proper alignment. 1Factors such as tooth morphology, arch dimensions, teeth size, premature loss of deciduous teeth, incisor and molar inclination, direction of mandibular growth, and increased perioral musculature are contributory factors toward dental crowding. [2][3]][4][5][6][7] Crowded teeth irritate the gingiva, accentuating the difficulty of brushing and flossing effectively, resulting in dental caries. 8t can also cause excessive pressure on the occlusion, leading to temporomandibular disorders. 9Crowded teeth are more likely to chip or crack, which could result in bruxism and radiating pain. 9However, in patients with no history of previous anomalies, there seems to exist an intricate relationship between the length of the maxilla and mandible and crowding. [10][11]1][12] Few articles have suggested that the quantum of dental crowding was inversely associated with the length of the maxilla and mandible. 11,12 Individuals having smaller maxillary and mandibular base lengths experienced greater crowding. 12 The quantum of crowding in class 2 skeletal malocclusion was high, while it was low in class 3 skeletal malocclusion.Further, it has been suggested that no sexual dimorphism was present in the degree of crowding observed. 13 While in class 1 malocclusion, some authors have reported that a positive correlation existed between maxillary base length and crowding of the maxillary and mandibular 1-
Authors’ response Vignesh Kailasam, Hita Rangarajan, Harshini Nivetha Easwaran, M.S. Muthu American Journal of Orthodontics and Dentofacial Orthopedics, 2022
Authors’ response Vignesh Kailasam, Hita Rangarajan, Harshini Nivetha Easwaran, Muthu MS American Journal of Orthodontics and Dentofacial Orthopedics, 2022
Authors' response Keerthi Venkatesan, Vignesh Kailasam, Sridevi Padmanabhan American Journal of Orthodontics and Dentofacial Orthopedics Official Publication of the American Association of Orthodontists Its Constituent Societies and the American Board of Orthodontics, 2021
Corticotomy and piezocision in rapid canine retraction Haritha Pottipalli Sathyanarayana, Bhadrinath Srinivasan, Vignesh Kailasam, Sridevi Padmanabhan American Journal of Orthodontics and Dentofacial Orthopedics, 2016
Rare Complications in Orthodontics--A Case Report and a review International Journal of Orthodontics Milwaukee Wis, 2015
Cleidocranial dysplasia: A family report HThamizh Chelvan, N Malathi, Vignesh Kailasam, A Ponnudurai Journal of Indian Society of Pedodontics and Preventive Dentistry, 2009
A comparison of the effects of argon laser and conventional light cure on demineralization resistance of human enamel Biomedicine India, 2009
The effect of topical fluoride agents on the physical and mechanical properties of NiTi and copper NiTi archwires. An in vivo study. Australian Orthodontic Journal, 2008
