Impact of various finishing and polishing techniques and composite materials on Candida albicans biofilm formation.

Candida albicans biofilms are commonly associated with severe oral infections. In dentistry, prosthetic and restorative materials are potential structures for the adhesion of C. albicans facilitating the formation of Candida biofilm and infection. Three composite resins (Charisma Classic, Sonic Fill, Estelite ∑ Quick) and two finishing-polishing systems (Biscover LV, Dental Finishing Disc) were evaluated for Candida biofilm formation. A Candida biofilm assay showed that both the resin and the finishing/polishing procedures affect Candida biofilm formation. Specifically, Candida biofilm formation was significantly lower in Sonic Fill resin than both Charisma Classic and Estelite ∑ Quick (P = .021). The type of finishing and polishing procedure also significantly affected the Candida biofilm formation to composite material (P < .001). Candida biofilm formation was more advanced after Biscover LV procedure than Dental Finishing Disc procedure.

Comparison of the Effects of Various Methods Used to Remove Adhesive from Tooth Surfaces on Surface Roughness and Temperature Changes in the Pulp Chamber.

OBJECTIVE: The purpose of the present study was to compare the effects of three methods of removing adhesive on enamel surface roughness and dental pulp temperature. METHODS: Ninety human maxillary premolars were randomly divided into three groups (n=30) according to the type of adhesive clean-up procedure: aluminum oxide-based burs, erbium-doped yttrium aluminum garnet (Er:YAG) laser, and tungsten carbide bur. The surface roughness of enamel was measured using a non-contact optical profilometer. After the first readings of surface roughness were measured (T1), orthodontic brackets were attached to the enamel surface with composite. The brackets on the teeth were debonded using bracket removal pliers. The residue of adhesive was eliminated from the enamel surface of the teeth by different procedures in each group. While removing adhesive from the tooth surface, the intrapulpal temperature rise was simultaneously measured using a thermocouple. One-way ANOVA and post-hoc Tukey HSD tests were used to analyze data with a significance level set at 0.05. RESULTS: The highest roughness average (Ra) values were observed for the Er:YAG laser group, with a significant difference with the aluminum oxide bur group and tungsten carbide bur group (p<0.001). Ra values for the aluminum oxide bur group were significantly lower than those for the other groups (p<0.001). Comparing the thermal changes in each group showed a significant decrease in the Er:YAG laser group, but a significant increase in two other groups. CONCLUSION: Within the limitations of the present study, one-step finisher and polisher bur created the smoothest enamel surface, whereas Er:YAG laser the roughest. Tungsten carbide and aluminum oxide-based burs generated more heat than Er:YAG laser.

Comparison of the Effects of Two Different Analgesics on Bone Regeneration During Mandibular Distraction Osteogenesis.

INTRODUCTION: Mandibular distraction osteogenesis (DO) is frequently used in the management of bone defects and craniofacial deformities, with analgesics commonly administered to relieve acute postoperative pain. This experimental animal study investigated the effects of 2 analgesics, acetaminophen and acemetacin, on bone regeneration after DO. MATERIALS AND METHODS: This study was conducted with 14 mature male New Zealand rabbits (2.8-3.2 kg) randomized into 2 groups of 7. Mandibular osteotomies were performed under optimal operating conditions, and a custom-made distractor was applied to the mandible of each subject, with distraction initiated after a 5-day latency period at a rate of 1.0 mm/d (2 × 0.5 mm/d) for 10 days. Analgesics were administered via oral gavage during the latency period and for the first 5 days of the distraction period for 10 days in total, with group I receiving acetaminophen (200 mg/kg/d) and group II receiving acemetacin (5 mg/kg/d). Subjects were sacrificed and their mandibles dissected at the end of 4 weeks postoperatively. Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DEXA), and histomorphometric analysis was performed to evaluate the quality of newly formed bone. Paired group comparisons of non-normally distributed numerical variables were made using the Mann-Whitney U test, with a P value of <0.05 considered statistically significant. RESULTS: No significant differences in BMC and BMD values of intact bone, newly formed bone, or bone around the pin site were observed between the 2 groups. Histometric analysis also indicated acetaminophen and acemetacin to have similar effects on bone regeneration during distraction. CONCLUSION: Acemetacin may be an alternative to acetaminophen for treating pain associated with DO, given the similarities in the effects of the 2 analgesics on bone regeneration. However, this finding should be supported by further experimental and human studies.

The Efficacy of Laser Doppler Flowmetry, Electric Pulp Test and Cold Test in Diagnosing Revascularization of Extrusively Luxated Immature Maxillary Incisors.

OBJECTIVE: To evaluate the effect of extrusion on immature permanent tooth PBF values during a 6-month post-trauma period and to compare the accuracy of cold tests on pulp sensibility of traumatized teeth with that of electric pulp tests (EPT). METHODS: The study group comprised of 26 extruded immature maxillary incisors in 25 trauma patients. The respective contralateral homologous teeth (n=25) were included as a positive control group. Teeth in the study group were treated by repositioning and splinting. Pulp vitality readings for traumatized and control teeth were taken with LDF, EPT and cold test on the day of splint-removal (2-3 weeks after trauma-T1) as well as 6 weeks (T2), 3 months (T3) and 6 months (T4) post-trauma. Student t and Mann-Whitney U-tests were used to compare data among groups. Statistical significance was set at P< 0.05. RESULTS: LDF gave positive vitality readings (>4.5 PU) in all patients from T1 to T4 (with the exception of 1 patient at T1). CONCLUSIONS: LDF was able to accurately identify vitality in traumatized immature teeth even during the first few weeks following trauma, whereas conventional sensibility tests were unable to accurately recognize vitality shortly after trauma.

Combined Use of Retraction and Torque Arch with Mini-Screws: A Cephalometric Study.

OBJECTIVE: Our objective was to investigate and quantify the treatment of micro-implant-aided retraction and torque (R&T) arch on dentofacial structures. METHODS: Twelve patients (mean age 21.2 years) who required orthodontic camouflage treatment were included in the study. Following the canine distalization, mini-screws were placed between maxillary first molars and second premolars, and R&T arch was applied for the retraction of incisors. The vertical retraction arms of the arch were adjusted between the apex of the lateral incisor and the alveolar bone so that the retraction force passed through the center of resistance of four incisors and forced the incisors to bodily retraction. Closed coil-springs applying 150 gr of force were used to retract the incisors. The retraction period lasted for 217±34 days. RESULTS: SNA and NV-A decreased (p<0.05), indicating alveolar bone remodeling around Point A. The reduction in the SNA caused a statistically significant decrease in the ANB (p<0.01). SN/1, NA/1, NA-1, and overjet decreased significantly (p<0.01), depending on the retrusion of the incisors. The distances from the apex and incisal point of the central incisor to the SV reference plane also decreased significantly (p<0.01), revealing a nearly parallel movement of the incisors. Anchorage loss of the molars and decrease in nasolabial angle were not significant (p>0.05). CONCLUSION: A combined use of R&T arch with mini-screws is an effective method to retract the incisors without anchorage loss. The type of movement is nearly parallel.

Intraoral Molar Distalization with Intraosseous Mini Screw.

The aim of the present study was to evaluate the effects of the miniscrew-supported, modified Hyrax appliance on bilateral distalization of posterior teeth. A 15-year-old girl with Class II malocclusion (end-to-end molar relationships, space deficiency for maxillary canine) underwent orthodontic treatment. The patient rejected tooth extraction. Then, she was treated with the miniscrew-supported, modified Hyrax appliance. An activation of 1 mm per month was planned. Lateral cephalometric views were used to evaluate distal movement. Distalization was successfully achieved at 4 months. No anchorage loss and incisor protrusion were noted. It would be beneficial to choose this appliance for the distalization of maxillary molars in patients with maxillary incisor protrusion, as this appliance does not cause anchorage loss in the upper jaw.

Level of Social Appearance Anxiety in Individuals with and without Alignment of Teeth.

OBJECTIVE: The aim of this study is to determine the level of social appearance anxiety in individuals with and without alignment of teeth and to demonstrate that orthodontic treatment is effective in reintegrating the individual into society, as well as in improving self-confidence communication skills, and self-esteem. METHODS: The present study included 50 patients (24 males and 26 females) with dental alignment and 50 patients (28 males and 22 females) without dental alignment. The study was performed as an interview study using the Social Appearance Anxiety Scale, which measures emotional, cognitive, and behavioral anxiety felt by the individual due to his/her appearance. Hypotheses were proven by t-test and one-way analysis of variance using the Statistical Package for the Social Sciences program. RESULTS: The mean level of social appearance anxiety was higher in patients with dental misalignment (p<0.05). The result of t-test analysis revealed no significant difference between the scores of male and female participants (p>0.05). CONCLUSION: The level of social appearance anxiety increases in individuals with dental misalignment. However, it is independent from gender.

Changes in Maxillary Canine Pulpal Blood Flow During Dentoalveolar Distraction Osteogenesis.

OBJECTIVE: The aim of this study was to assess the effects of dentoalveolar distraction osteogenesis (DD) on the pulpal blood flow (PBF) of maxillary canines. MATERIALS AND METHODS: A laser Doppler flowmeter (LDF) was used to measure PBF in maxillary canines of 10 patients undergoing DD (study group) and 10 nonsurgical subjects who received no orthodontic treatment (control group). PBF was measured at baseline, at 4 and 7 days postoperatively, at the end of distraction and at the end of consolidation in the study group and at similar time-points in nonsurgical control subjects. Data were analyzed using paired and Student t tests, with the significance level set at 0.05. RESULTS: Study findings showed that baseline PBF values did not differ significantly between groups. PBF in the control group did not vary over time; however, in the study group, an initial decrease in PBF was observed at 4 days postoperatively and was followed by a gradual increase to preoperative levels at the end of distraction. CONCLUSIONS: During the DD latency period, there appears to be a short-lived ischemic phase when perfusion of pulp tissue declines; however, blood-flow returns to normal by the end of distraction.

Changes in human pulp blood flow during canine retraction.

AIM: To evaluate the effects of maxillary canine retraction on pulpal blood flow (PBF) in humans as recorded by laser Doppler flowmetry (LDF). METHODS: Maxillary canines of 24 participants were divided into two groups (n = 12 each). Teeth in the study group underwent maxillary canine retraction using mini-implants as anchorage for approximately 4 months, with 100 g of force applied via coil springs. Subjects in the control group received no orthodontic treatment. LDF measurements were recorded at baseline (T0); during retraction, at 24 hours (T1), 3 days (T2), 7 days (T3) and 1 month (T4); and at the end of retraction (T5) in the study group and at similar time-points in control subjects. Data were analyzed using the Friedman, Wilcoxon signed rank and Mann-Whitney U tests, with the significance level set at 0.05. RESULTS: No significant changes in PBF perfusion units (PU) were observed in the control group over the course of the study. However, PBF in the study group increased significantly from T0 (3.6 ± 0.2 PU) to T1 (3.7 ± 0.2 PU, p < 0.001) and decreased severely from T1 to T2 (3.3 ± 0.1, p < 0.001). PBF in the study group was still significantly lower at T3 (3.4 ± 0.1 PU, p < 0.001) in comparison to T0; however, at T4 and T5, PBF was found to have returned to pre-retraction levels. CONCLUSION: The fact that PBF values returned to initial levels within one month of the initiation of retraction despite short-term, hyperaemic, regressive changes demonstrates that the changes observed in PBF during canine retraction are reversible.

Comparative evaluation of pulpal blood flow during incisor intrusion.

AIM: The aim of the present study was to evaluate and compare changes in pulpal blood flow (PBF) as a result of maxillary incisor intrusion achieved by one of two methods (utility arches or mini-implants). MATERIALS AND METHODS: Thirty subjects were divided into three groups, the first of which underwent maxillary incisor intrusion using utility arches (UA) and a second group, intrusion via mini-implants (MI). The third group acted as a control. An intrusive force of 100 g was applied to the upper incisors in the treatment groups, whereas no force was applied to the anterior teeth in the control group. A laser Doppler flowmeter (LDF) was used to measure PBF at baseline (T0) and during incisor intrusion at 24 hours (T1), three days (T2), seven days (T3) and three weeks (T4). Statistical changes in PBF were assessed by the Wilcoxon Signed Rank and Mann-Whitney U tests, with significance set at p < 0.05. RESULTS: The mean PBF in the UA and MI groups decreased significantly from T0 to T1 (p < 0.001), slightly increased at T2 and continued to increase gradually at T3. PBF attained levels similar to those measured prior to intrusion at T4. No significant changes in PBF were observed in the control group over the course of the study. The only statistically significant difference between the UA and MI groups were at T1 and T2, at which time the MI group had lower PBF values (p < 0.001). CONCLUSIONS: Despite slight regressive changes in pulpal tissue observed over the short-term, PBF values tended to return to initial levels within three weeks, indicating that changes observed in PBF with the UA and MI intrusion methods are reversible. Although the changes in PBF could not be directly related to the method of intrusion employed, in general, a more severe drop in PBF was observed in the MI group during the first three days of intrusion.

Changes in dental pulp blood flow of different maxillary tooth types after Le Fort I osteotomy.

This study examined the effects of Le Fort I (LF-I) osteotomy on pulpal blood flow (PBF) in maxillary teeth during a 12-month postsurgical period. A laser Doppler flowmeter was used to measure PBF in maxillary incisors, canines, and first premolars of 14 patients undergoing LF-I osteotomy (study group), 7 patients undergoing mandibular osteotomy (surgical control group), and 7 nonsurgical controls. The PBF was measured at baseline (preoperatively) and at 1 week and 1, 3, 6, and 12 months postoperatively and at similar intervals in nonsurgical control subjects. Data were evaluated using Kruskal-Wallis and post hoc Mann-Whitney tests. Changes in PBF over time for each tooth type were evaluated using the Wilcoxon signed-rank test. The level of significance was set at P < 0.05. Study findings showed that baseline PBF values did not differ significantly between groups. Maxillary PBF in the control group did not vary over time; however, an initial decrease in PBF was observed in all tooth types immediately after surgery in the study group. A gradual increase to near-preoperative levels was then observed during a 12-month healing period. Although dramatic reductions in maxillary perfusion of the first premolar and canine pulps were observed at 1 week and 1 month after LF-I osteotomy when compared with baseline (P < 0.001), PBF significantly recovered over time. Moreover, hyperemia was observed in lateral incisors 3 months postoperatively, demonstrating a tooth type-specific effect of LF-I osteotomy on PBF.

Changes in maxillary incisor dental pulp blood flow during intrusion by mini-implants.

AIM: The aim of this clinical study was to identify changes in pulpal blood flow (PBF) in human central incisors resulting from short- and long-term intrusive orthodontic forces from mini-implants. MATERIALS AND METHODS: A total of 40 sound upper central and lateral incisors in 20 patients scheduled for intrusion for orthodontic reasons were divided into two groups. From each group, 20 teeth were subjected to intrusive force from mini-implants (Group 1 = Light Force: 40 g; Group 2 = Heavy Force: 120 g), whereas the remaining 20 contralateral teeth were not subjected to forces from mini-implants and served as controls. Laser-Doppler flowmetry (LDF) measurements were recorded at baseline and at 3 days and 3 weeks following intrusion. RESULTS: PBF decreased significantly at 3 days (Light Force Group: 7.72 ± 0.50; Heavy Force Group: 7.72 ± 0.52) and then increased towards baseline at 3 weeks (Light Force Group: 10.37 ± 0.58; Heavy Force Group: 10.31 ± 0.45) following intrusion. CONCLUSIONS: In other words, despite slight regressive changes in pulpal tissue in the short-term, PBF improved after 3 weeks following intrusion by mini-implants, indicating that the changes observed in PBF is reversible, even following radical incisor intrusion.

Orthodontic management of a patient with cerebral palsy: six years follow-up.

AIM: Cerebral palsy (CP) is a disorder that affects muscle tone, movement and motor skills. CP can also lead to other health issues, including vision, hearing and speech problems, as well as learning disabilities and dental problems. A case report describing the successful orthodontic treatment of a 10-year-old boy with the dyskinesia type of CP and severe malocclusion is presented. MATERIALS AND METHODS: A 10-year and 2-month old boy was presented by his parents for orthodontic treatment, complaining of his unsatisfactory occlusion and poor chewing efficacy. An extraoral examination showed a convex profle. An intraoral examination showed the patient to be in mixed dentition with a class II molar relationship, 10 mm overjet and 4 mm overbite. In addition, his maxillary and mandibular arches were severely crowded. Cephalometric analysis indicated a severe skeletal class II discrepancy, which was confrmed by an ANB of 12°. The frst phase of treatment involved the use of twin blocks with a headgear tube to attempt some growth modification and reduce the overjet. Once it was clear that the appliance was being well tolerated and the oral hygiene was satisfactory, the fxed appliance was used. RESULTS: Because of the good participation of the patient and his parents, orthodontic treatment was successful in the patient, achieving a normal overjet in combination with successful orofacial therapy. CONCLUSION: As demonstrated in our case report, the success of the treatment was dependent on the cooperation of the patient and his parents. Furthermore, this case illustrates the importance of the treatment by a dental team in patients with CP.

Changes in maxillary molar pulp blood flow during orthodontic intrusion.

INTRODUCTION/OBJECTIVE: The aim of this prospective study was to evaluate the effects of maxillary first molar intrusion on pulpal blood flow (PBF) in humans as recorded by laser Doppler flowmetry (LDF). MATERIALS AND METHODS: Maxillary first molars of 16 participants were divided into two groups. In the study group, 20 teeth in 10 participants were subjected to an intrusive force of 100 g delivered from mini-implants for 6 months. A control group of 6 subjects (12 teeth) received no orthodontic treatment. LDF measurements were recorded at baseline and at 3 days, 3 weeks, 3 months and 6 months during intrusion. Data was analysed using the Wilcoxon Signed Rank and Mann-Whitney U tests, with a level of p < 0.05 considered statistically significant. RESULTS: No significant changes in PBF perfusion units (PU) were observed in the control group over the course of the study. However, PBF in the study group was significantly higher at TO (8.7 ± 0.9 PU) when compared with T1 (6.1 ± 0.6 PU, p < 0.001) and T2 (6.0 ± 0.6 PU, p < 0.001). PBF did not vary significantly between T1 and T2 (p = 0.073) or between T3 and T4 (p = 0.262). Moreover, PBF at the end of the study (T4) was similar to baseline PBF values for both groups (study group: p = 0.687; control group: p = 0.525). CONCLUSIONS: Despite significant short-term regressive changes in pulpal tissue during continuous molar intrusion with mini-implants and an applied force of 100 g, blood vessel function was maintained throughout intrusion, as indicated by LDF measurements of PBF, which tended to return to baseline values by the end of the observation period. These results highlight the changes that can occur in molar vascularity, especially during six months of intrusion.

Radiological analysis of the relationship between occlusal tooth wear and mandibular alveolar bone density and height.

AIM: The aim of this study was to examine the relationship between occlusal tooth wear and mandibular alveolar bone density (ABD) and alveolar bone height (ABH) using computer-assisted densitometric image analysis (CADIA) program. MATERIALS AND METHODS: The study was comprised of 134 mandibular first molar teeth in 90 patients with various degrees of occlusal tooth wear. The degree of tooth wear was classified according to the tooth wear index (TWI). Periodontal examinations were performed on all patients and included plaque index, gingival index, probing depth, and clinical attachment loss measurements. ABD and ABH were measured from intraoral digital periapical radiographs and analyzed using CADIA. RESULTS: No increases in ABD were observed between TWI 0 and TWI 1 or between TWI 0 and TWI 2 (P > 0.05). However, increases in ABD were observed between TWI 0 and TWI 3 (P < 0.01), TWI 1 and TWI 3 (P < 0.01), TWI 1 and TWI 2 (P < 0.05) and TWI 2 and TWI 3 (P < 0.05). In addition, ABH was found to increase with increase in wear, with the exception of the interval between TWI 0 and TWI 1. CONCLUSIONS: Occlusal tooth wear does not result in any radiologically identifiable changes in the alveolar bone during the initial stages of wear; however, significant increases in both ABD and ABH may be observed as tooth wear progresses.

Orthodontic treatment of a patient with unerupted maxillary central and lateral incisors and canine: a case report.

AIM: The aim of this case report was to describe the orthodontic and periodontal management of a patient with three impacted anterior teeth. METHODS: An 18-year-old female with Class I crowding on a Class I skeletal base presented with the chief complaint of an unaesthetic smile. Clinical examination revealed an impacted upper right permanent canine (13), lateral (12) and central incisor (11), a retained deciduous incisor and moderate crowding in the lower arch. The impacted teeth were surgically exposed (closed exposure) and aligned with fixed appliances. The 12 was extracted due to root resorption and 44 extracted to resolve the lower arch crowding. A fraenectomy and gingival recontouring were required. RESULTS: Orthodontic treatment resulted in improved overjet, overbite and an acceptable facial profile. The patient reported improved self esteem. CONCLUSIONS: While impacted anterior teeth are a clinical challenge, their surgical exposure, in combination with fixed appliances, is a conservative treatment plan which is not without complications.

Rectangular body ostectomy for the treatment of severe mandibular prognathism.

OBJECTIVE: The aim of this article was to present the surgical technique and the outcomes of rectangular body ostectomy in the treatment of severe mandibular prognathism. METHODS: Mandibular setback by bilateral rectangular body ostectomies combined with Le Fort I level maxillary advancement was performed. The deep bony concavity of paranasal area was grafted with bone blocks harvested from the ostectomized segments of the mandible. RESULTS: Satisfactory functional and aesthetic outcomes were obtained by rectangular body ostectomy combined with Le Fort I level maxillary advancement and an acceptable profile was provided for the patient. CONCLUSIONS: The mandibular rectangular ostectomy remains a safe and versatile procedure with predictable results in well-selected cases.

Orthodontic treatment of transposition of permanent mandibular lateral incisor and left canine in mixed dentition: a case report.

The purpose of this study was to present the orthodontic treatment of a unilateral transposition of a permanent mandibular left canine and permanent mandibular lateral incisor during middle transitional dentition in a 10-year-old female. A panoramic radiograph showed the apex of the permanent mandibular left lateral incisor to be resting on the mesial corner of the permanent mandibular left canine crown, which was ectopically erupted in the proximity of the primary mandibular left second molar. A removable appliance was used to upright the permanent mandibular left lateral incisor, after which a utility arch was used until full eruption of the permanent dentition. Treatment continued with a fixed appliance system that included all teeth until the transposition of the canine and lateral incisor was corrected and a class I occlusion with a favorable smile was obtained (at 36 months).

Alveolar and symphysis regions of patients with skeletal class II division 1 anomalies with different vertical growth patterns.

OBJECTIVES: The aim of this study was to investigate the alveolar and symphysis region properties in hyper-, hypo-, and normodivergent Class II division 1 anomalies. METHODS: Pretreatment lateral cephalograms of 111 young adult female patients with skeletal Class II division 1 anomalies were compared to those of 54 Class I normal subjects (control group). Class II cases were divided into hyperdivergent (n = 58), hypodivergent (n = 19), and normodivergent groups (n = 34). The heights and widths of the symphysis and alveolus and the depth of maxillary palate were measured on the lateral cephalograms. RESULTS: Mean symphysis width was wider in the hypodivergent Class II group than in the other groups, while mean symphysis height was similar among all groups. Maxillary palatal depth, upper incisor angle, upper and lower molar alveolar heights, and Id-Id' width were also similar among groups. CONCLUSION: Symphysis width is the main factor in the differential diagnosis of Class II division 1 anomaly rather than symphysis height and hypodivergent Class II Division 1 anomaly is more suitable for mandibular incisors movements.

Orthodontic approach to dilacerated central incisor localized horizontally on the anterior nasal spine: a case report.

The purpose of this paper was to present a case of surgical exposure of a horizontally impacted permanent maxillary left central incisor followed by fixed orthodontic treatment to eruption in a 9-year-old boy with a 2-mm overjet and 2-mm overbite who had sustained a traumatic injury to his primary maxillary central incisors when he was 6-years-old. Panoramic, occlusal, and cepholometric radiographs showed the affected tooth's crown to be positioned horizontally, and a CT scan showed the impacted central incisor's crown to be located below the anterior nasal spine and its apex to be located parallel to the palatal plane. A treatment plan was devised that included surgically exposing the impacted teeth and applying extrusive forces in the direction of the occlusal plane to bring about eruption. After 22 months of treatment, the central incisor erupted into the oral cavity. The patient now possesses the confidence to smile and enhanced self-esteem.