Diagnostic Accuracy of a Combination of Preoperative 68-Ga Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography and Multiparametric Magnetic Resonance Imaging in Localized Prostate Cancer.

INTRODUCTION: Prostate cancer (PCa) is a common and leading course of cancer-related death in men. Although there are studies on multiparametric magnetic resonance imaging (MpMRI) with good diagnostic results in detecting clinically significant PCa, new methods have been investigated due to the low positive predictive values. In this context, prostate-specific membrane antigen positron emission tomography (PSMA PET) emerges as an alternative imaging method to MpMRI. This study aimed to compare 68Ga PSMA I&T-PET/CT and MpMRI in determining tumor location. METHODS: Preoperative MpMRI and 68Ga PSMA I&T-PET/CT scans and pathology specimens of patients who underwent radical prostatectomy for PCa at our clinic between 2018 and 2021 were retrospectively evaluated. PSMA I&T-PET/CT, MpMRI, combined imaging were compared for tumor localization according to histopathological data. RESULTS: In terms of tumor localization, MpMRI demonstrated overall accuracy rates of 75.9% (p kappa [κ] 0.0001* [0.525]). 68Ga PSMA I&T-PET/CT showed 71.5% (p κ 0.0001* [0.438]). For the combined imaging approach, the overall accuracy rate was calculated as 79.2% (p κ 0.0001* [0.576]). Additionally, high diagnostic accuracy was achieved for the combined imaging approach, particularly in the intermediate ISUP group. Moreover, SUVmax was calculated as 6.37. CONCLUSION: The combined use of 68Ga PSMA I&T-PET/CT and MpMRI has high diagnostic rates. However, the high cost is a significant disadvantage that limits their routine combined use.

IGG4-related giant lymphoproliferative-inflammatory left atrial mass.

Cardiac masses are rare entities that can be challenging in clinical diagnosis and management. Cardiac masses can be detected incidentally in patients with an asymptomatic course or may cause systemic inflammation findings due to inflammatory cytokine release or symptoms such as shortness of breath, chest pain, syncope, sudden cardiac death, and mortality due to the location of the mass. Cardiac masses associated with systemic inflammatory disorders are uncommon in this disease group. This case report will present a case with an asymptomatic IgG4-related left atrial mass detected in routine echocardiographic control imaging due to rheumatic valve disease.

Comparison of Multiparametric and Fast MRI Protocols in Detecting Clinically Significant Prostate Cancer and a Detailed Cost Analysis.

BACKGROUND: Due to the long acquisition time and high cost of multiparametric magnetic resonance imaging (mpMRI), biparametric and, more recently, fast prostate magnetic resonance imaging (fpMRI) protocols have been described. However, there is insufficient data about the diagnostic performance and cost of fpMRI. PURPOSE: To compare the diagnostic performances and cost analysis of fpMRI and mpMRI in clinically significant prostate cancer (csPCA). STUDY TYPE: Retrospective. POPULATION: A total of 103 patients (63 had csPCA) with a mean age of 66.83 (± 7.22) years were included. FIELD STRENGTH/SEQUENCE: A 1.5-T; T1- and T2-weighted turbo spin-echo imaging (T1WI and T2WI), echo-planar diffusion-weighted images, and dynamic contrast-enhanced T1W imaging. ASSESSMENT: Three readers independently evaluated the fpMRI and mpMRI images in different sessions blinded to all patient information. Diagnostic performances of fpMRI and mpMRI were evaluated. Kappa coefficient (κ) was used to determine the interreader and intrareader agreement. A detailed cost analysis was performed for each protocol. STATISTICAL TESTS: Receiver operating characteristics analysis, area under the curve (AUC), and κ test were used. Diagnostic performance parameters were also calculated. RESULTS: Of the 63 malignant index lesions (csPCA), 53/63 of those (84.1%) originated from the peripheral zone and 10/63 lesions (15.9%) originated from the transition zone. The AUC values for fpMRI were 0.878 for reader 1, 0.937 for reader 2, and 0.855 for reader 3. For mpMRI, the AUC values were 0.893 for reader 1, 0.94 for reader 2, and 0.862 for reader 3. Inter and intrareader agreements were moderate to substantial (κ range, 0.5-0.79). The total cost per examination was calculated as €12.39 and €30.10 for fpMRI and mpMRI, respectively. DATA CONCLUSIONS: Fast MRI protocol has similar diagnostic performance with mpMRI in detecting csPCA, and fpMRI can be considered an alternative protocol that could create a lower financial burden on health-care systems. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 6.

Association between incisor positions and amount of interdental stripping in patients undergoing orthodontic treatment.

INTRODUCTION: The study aimed to investigate the effect of a nonextraction treatment approach with interdental stripping (IDS) on the dentofacial structures in patients with dental and skeletal Class I, II, and III malocclusions. METHODS: A total of 60 patients with mild-to-moderate crowding of the teeth and nonsevere skeletal malocclusion were included and divided into 3 groups: Class I, Class II, and Class III groups (n = 20 per group). In all patients, nonextraction orthodontic treatment was administered, and those who underwent IDS at the jaw quadrants as needed were evaluated. For pretreatment and posttreatment evaluation, lateral cephalometric radiography and 3-dimensional dental model scans were acquired for each patient. For statistical analysis, paired-samples t test and 1-way analysis of variance with Tukey post-hoc test were used for parametric variables, whereas the Wilcoxon paired signed rank test and Kruskal-Wallis test with Dunn post-hoc test were used for nonparametric variables. RESULTS: An increase in the maxillary incisor angle was observed in patients with Class I and Class III malocclusions, whereas a decrease was observed in patients with a Class II malocclusion (P < 0.05). Mandibular incisor angles were significantly increased in the Class II malocclusion group (P < 0.05) but unchanged in the other groups. IDS was more frequently applied to the posterior aspect of the maxilla and mandible in patients with a Class II malocclusion than in patients with other malocclusion types, and the amount of IDS at the anterior aspect of the mandible was significantly higher in the Class III group. CONCLUSIONS: Combined nonextraction orthodontic treatment and IDS yielded successful treatment outcomes. IDS application was localized to different jaw regions according to the different malocclusion types.

Effects of different wavelengths of low-level laser therapy on orthodontically induced inflammatory root resorption in rats investigated with micro-computerized tomography.

INTRODUCTION: The objective of this research was to investigate the effects of different wavelengths low-level laser therapies on orthodontically induced inflammatory root resorption (OIIRR) during orthodontic tooth movement in rats by micro-computerized tomography. METHODS: Forty Wistar albino rats were divided into 5 groups: control group (A), 405-nm laser group (B), 532-nm laser group (C), 650-nm laser group (D), and 940-nm laser group (E). The left side of group A was used as a positive control (A-PC), and the right side of group A was used as a negative control (A-NC) group. In all groups, the maxillary left first molars were moved mesially by 50 g of force for 14 days. The lasers were performed for 9 minutes on the maxillary left first molar tooth. At the end of the experimental period, OIIRR measurements were performed at the mesial and the distal sides along the mesial root of the maxillary first molars. RESULTS: The root resorption volume was significantly lower in group A-NC than in groups A-PC, B, and D. The percentage of root resorption was significantly lower in group A-NC than in all other groups. The root resorption volume and the percentage of root resorption in groups C, D, and E were significantly lower than group A-PC. The depth and the width of the lacuna and even the number of mesial lacunae were similar between groups. The distal and the total lacunae were significantly lower in group A-NC than in all other groups except group C. CONCLUSIONS: The 532-nm, 650-nm, and 940-nm lasers significantly reduced the volume of OIIRR. In addition, the 532-nm laser reduced the number of lacunae both distally and totally than all the other groups.

Comparison of cervical vertebral anomalies and sella turcica bridging in different growth stages with various vertical skeletal growth patterns.

PURPOSE: To compare cervical vertebral anomalies and sella turcica bridging (STB) in different growth stages in orthodontic patients with different vertical skeletal growth patterns. METHODS: Lateral cephalometric radiographs (LCR) of 270 patients in the preadolescent, adolescent, or postadolescent periods and having low angle [LA], normal angle [NA], or high-angle [HA] vertical skeletal growth patterns were evaluated retrospectively. STB was visualized using LCRs while evaluating the deficiency of ponticulus posticus (PP) and atlas posterior arch (PAA) associated with the atlas bone. The Pearson chi-square and Fisher's exact tests were used for categorical data and one-way ANOVA for numerical data. RESULTS: The prevalence of fully calcified PP and STB increased from the preadolescent (PP, 10.0%; STB, 11.1%) to the postadolescent period (PP, 24.4; STB, 21.1%); they did not differ from vertical skeletal growth patterns (p > 0.05). The prevalence of PAA deficiency is significantly higher in individuals with LA (46.7%) than with other angles (NA, 27.8%; HA, 26.7%). The vertical skeletal growth pattern was significantly related to STB in the preadolescent period and PAA in the postadolescent period. CONCLUSIONS: Different anomalies during different growth periods correlate with the vertical skeletal growth pattern. It will be useful to evaluate a different anomaly according to the relevant growth period.

A comparative assessment of orthodontic treatment outcomes using the quantitative light-induced fluorescence (QLF) method between direct bonding and indirect bonding techniques in adolescents: a single-centre, single-blind randomized controlled trial.

INTRODUCTION: The aim of this two-arm parallel trial was to evaluate enamel demineralization in fixed orthodontic treatment using an indirect bonding technique in comparison to a direct bonding technique by the quantitative light-induced fluorescence (QLF) method. DESIGN, SETTINGS AND PARTICIPANTS: Fifty-six patients who needed fixed orthodontic treatment were randomly separated into either the direct bonding group or the indirect bonding group. The presence and extent of lesions on the buccal surfaces of all teeth, except the molar teeth, were assessed. The percentage of fluorescence loss (ΔF and ΔFmax), the degree of demineralization (ΔQ) and lesion area (WS area) were determined using the system's software. The data were analysed with the Wilcoxon signed-rank and Mann-Whitney U-tests (P < 0.05). INTERVENTIONS: Treatment with a direct bonding or an indirect bonding technique. RESULTS: This study was completed with 25 patients in the indirect bonding group (12 females, 13 males; mean age: 15.42 ± 1.71 years) and 26 patients in the direct bonding group (12 females, 14 males; mean age: 14.73 ± 1.65 years). In the indirect bonding technique, a few teeth (especially mandibular left canine: 50.45 ± 93.48; 95% confidence interval: -12.35 and 113.26) were found to develop significant white spot lesion (WSL) formation (P < 0.05). However, the number of teeth with demineralization was higher in the direct bonding group (P < 0.05). CONCLUSION: The bonding procedures used in the indirect bonding technique contribute to reducing the degree of WSL formation. Further, the use of flowable composite adhesives in this bonding process is more effective at reducing the appearance of WSLs than in cases where conventional composite adhesives are used. LIMITATIONS: The limitation of our trial may be the small sample size and the short follow-up time for the patients. HARMS: No harms were detected during the study. PROTOCOL: The protocol was not published before trial commencement. REGISTRATION: This trial was registered post hoc at 'Clinical Trials' (http://www.clinicaltrials.gov), registration number (ID): NCT03738839.

Comparing the effects of three different fluoride-releasing agents on white spot lesion prevention in patients treated with full coverage rapid maxillary expanders.

OBJECTIVE: The aim of this study was to assess the effects of three different fluoride-releasing agents on preventing white spot lesions that occur during treatment with full coverage rapid maxillary expanders. MATERIALS AND METHODS: A total of 48 patients with transverse maxillary deficiency were randomly assigned to four equal groups. A fluoride-containing agent was applied to teeth before cementation of the full coverage acrylic-bonded rapid maxillary expanders in the three experimental groups (gel, varnish, and sealent in groups 1, 2, and 3, respectively), while the control group received no agent application. Quantitative light-induced fluorescence (QLF) images of the patients were obtained before cementation and after decementation of the appliances. Four parameters (ΔF, ΔFmax, A, and ΔR) were evaluated on maxillary ten anterior teeth. RESULTS: In the fluoride gel group, upper central and lateral incisors, right first and left second premolars showed significant decreases in fluorescence levels indicating demineralization. Right central and left lateral incisors showed significant white spot lesion formation in the fluoride varnish group. Right and left central incisors and left first premolar were the teeth that mineral loss was observed in the sealent group, while all of the teeth except canines and first premolars showed significant demineralization in the control group. CONCLUSIONS: Multifluorid varnish and Proseal sealant were effective on preventing demineralization and should be applied to teeth clinically before appliance cementation. CLINICAL RELEVANCE: Demineralization is a major problem during orthodontic treatment. The application of effective fluoride-releasing agents could prevent this major iatrogenic complication.

Emissary veins prevalence and evaluation of the relationship between dural venous sinus anatomic variations with posterior fossa emissary veins: MR study.

PURPOSE: The aim of this study was to find the prevalence of emissary veins and to compare the visibility of these emissary veins with the anatomic variations of the dural venous sinuses detected in magnetic resonance venography (MRV). MATERIALS AND METHODS: All MR images of two hundred twenty patients were evaluated retrospectively. Posterior cranial fossa emissary veins diameter measurements were performed in the axial plane. The anatomic variations of the venous sinuses in MRVs of all patients were recorded. Accordingly, the presence of the emissary veins was compared with the dural venous sinus anatomic variations. p < 0.05 was considered statistically significant. An inter-observer reliability analysis was performed. RESULTS: The prevalence of emissary veins in MRI was found in the right mastoid emissary vein (MEV) 82.7% and left MEV 81.4%. Occipital emissary vein (OEV) was present in 63 patients (28.6%) for the first radiologist (R1), and it was present in 61 patients (27.7%) for the second radiologist (R2) (K = 0.978). A statistically significant correlation was detected between the diameter of the left MEV and gender (p < 0.05) for both radiologists. There was a statistically significant difference between the left MEV and OEV and transverse sinus anatomic variations. CONCLUSION: MR imaging is a noninvasive and irradiating imaging method for detecting posterior fossa major emissary veins, and we recommend using MR imaging for preoperative evaluation of posterior fossa major emissary veins and related dural venous sinuses.

A New Technique for Retracting the Protrusive Premaxilla With Fewer Patient Visits.

Bilateral cleft lip and palate with premaxillary protrusion is a great challenge due to a large defect area. Retraction of the premaxilla before surgery can be done with numerous orthopedic treatment options. In patients who have cleft lip and alveolus, but not cleft palate, it is quite difficult to get to the place where the premaxilla should be. To effectively reach the location where the premaxilla should be, new appliances with expansion and retraction screws were designed. This new design aims to treat the patient with fewer visits. Our study presents the treatment of a case with excessive premaxillary growth and no palatal defect treated with our new design.

Experimental investigation of effects of platelet-rich plasma on early phases of orthodontic tooth movement.

INTRODUCTION: The aim of this study was to evaluate the effects of platelet-rich plasma on orthodontic tooth movement in rats. METHODS: We divided 48 Wistar male albino rats into 3 groups: control group, platelet-rich plasma group, and platelet-poor plasma group. The rats in all study groups had orthodontic tooth movement of their maxillary right first molars. Either platelet-rich plasma or platelet-poor plasma was injected into the animals in the platelet-rich plasma and platelet-poor plasma groups, respectively; the rats in the control group had no injection. Distances between the maxillary molar and incisor were measured on days 0, 1, 3, 7, and 14. Active osteoblast numbers in tension sites and osteoclast numbers in compression sites were examined histologically. Immunohistochemical evaluations of tartrate-resistant acid phosphatase (TRAP), transforming growth factor-ß (TGF-ß), and alkaline phosphatase (ALP) expressions were also performed. RESULTS: The rats in the platelet-rich plasma group showed less tooth movement than those in the control group at day 3. At day 14, maximum tooth movement was observed in all groups. However, there was no statistical significance among the groups at day 14. In terms of osteoclast and osteoblast cells, no significant differences were observed in any group or at any time. Also, there were no significant differences in TRAP, ALP, and TGF-ß expressions in the groups. CONCLUSIONS: The application of platelet-rich plasma was not beneficial as an adjunct to orthodontic treatment.

Dental root development associated with treatments by rapid maxillary expansion/reverse headgear and slow maxillary expansion.

OBJECTIVES: To assess dental root development in two groups of paediatric patients who received treatments with reverse headgear and rapid maxillary expansion and slow maxillary dental arch expansion. MATERIALS AND METHODS: The 20 subjects (13 girls, 7 boys; mean age: 8.9 ± 1.3 years) in the first group were treated with a Petit-type reverse headgear attached to a full-coverage bonded rapid maxillary expander via elastics (RME&RHg group). The 20 subjects included in the second group (9 girls, 11 boys; mean age: 9.1 ± 2.2 years) were selected among patients who were treated with Hawley appliances for slow maxillary expansion (SME group). Digitized panoramic radiographs were used. A total of 960 permanent teeth (maxillary-mandibular incisors, canines, premolars, and first molars) were measured quantitatively for pre-treatment and post-treatment. RESULTS: No significant increase was found except for the right and left maxillary and mandibular second premolars and left mandibular and first premolar in the RME&RHg group (P < 0.05). Teeth length values increased significantly in all maxillary and mandibular teeth except maxillary first molars and mandibular incisors in the SME group (P < 0.05). Inter-group comparisons showed that statistically significant differences were observed in maxillary and mandibular incisors, left maxillary first premolar, and molar teeth (P > 0.05). LIMITATION: A limitation of this study is the use of two-dimensional radiographic images for root length measurement. However, ethical obligations limit the dental cone beam computed tomography imaging application for protection of paediatric patients from harm. CONCLUSIONS: RME&RHg therapy inhibits root development of maxillary and mandibular teeth in the early period. However, further studies should be performed to determine whether this effect on root development is reversible or irreversible.

Effect of 3 cements on white spot lesion formation after full-coverage rapid maxillary expander: A comparative in-vivo study.

INTRODUCTION: The aim of this study was to assess the effects of 3 luting agents (glass ionomer cement, compomer, and polycarboxylate cement) on white spot lesion formation in patients with full-coverage bonded acrylic splint expanders. White spot lesion formation was assessed with quantitative light-induced fluorescence. METHODS: Full-coverage rapid maxillary expanders were cemented with glass ionomer cement, compomer, and polycarboxylate cement in groups 1, 2, and 3, respectively. A control group comprised patients who never had orthodontic treatment. Quantitative light-induced fluorescence images taken before and after rapid maxillary expansion treatment were analyzed for these parameters: the percentages of fluorescence loss with respect to the fluorescence of sound tooth tissue (ΔF) and maximum loss of fluorescence intensity in the whole lesion; lesion area with ΔF equal to less than a -5% threshold; and the percentage of fluorescence loss with respect to the fluorescence of sound tissue times the area that indicated lesion volume. RESULTS: All 3 groups showed statistically significantly greater demineralization than the control group. The 3 experimental groups differed from each other in half of the parameters calculated. Teeth in the polycarboxylate group developed the most white spot lesions. CONCLUSIONS: With the highest rate of white spot lesion formation, polycarboxylate cements should not be used for full-coverage bonded acrylic splint expanders. Compomers may be preferred over glass ionomer cements, based on the findings of this study.

White spot lesion formation after treatment with full-coverage rapid maxillary expanders.

INTRODUCTION: The aim of this study was to evaluate whether treatment with full-coverage bonded acrylic splint expanders causes formation of white spot lesions using quantitative light-induced fluorescence. METHODS: The experimental group underwent rapid maxillary expansion (RME) (n = 16; 6 boys, 10 girls; mean age, 14.1 ± 2.2 years), and the control group received no orthodontic treatment (n = 17; 9 men, 8 women; mean age, 20.7 ± 1.1 years). Quantitative light-induced fluorescence images of the RME patients were taken before cementation and after decementation of the appliances. The images of the control group comprised quantitative light-induced fluorescence images taken 3 months apart. Four parameters were calculated for 10 anterior teeth. RESULTS: Between cementation and decementation, statistically significant differences were found in all 4 parameters in the RME group, whereas no significant changes were found in any parameters in the control group. A comparison of the measured parameters between the RME and control groups showed statistically significant differences. CONCLUSIONS: Patients treated with a full-coverage bonded appliance tended to develop more white spot lesions than did the control subjects.

Evaluation of Free Breathing Versus Breath Hold Diffusion Weighted Imaging in Terms Apparent Diffusion Coefficient (ADC) and Signal-to-Noise Ratio (SNR) Values for Solid Abdominal Organs.

BACKGROUND: Our aim was to compare the apparent diffusion coefficient (ADC) values of normal abdominal parenchymal organs and signal-to-noise ratio (SNR) measurements in the same patients with breath hold (BH) and free breathing (FB) diffusion weighted imaging (DWI). MATERIAL/METHODS: Forty-eight patients underwent both BH and FB DWI. Spherical region of interest (ROI) was placed on the right hepatic lobe, spleen, pancreas, and renal cortices. ADC values were calculated for each organ on each sequence using an automated software. Image noise, defined as the standard deviation (SD) of the signal intensities in the most artifact-free area of the image background was measured by placing the largest possible ROI on either the left or the right side of the body outside the object in the recorded field of view. SNR was calculated using the formula: SNR=signal intensity (SI)(organ)/standard deviation (SD)(noise). RESULTS: There were no statistically significant differences in ADC values of the abdominal organs between BH and FB DWI sequences (p>0.05). There were statistically significant differences between SNR values of organs on BH and FB DWIs. SNRs were found to be better on FB DWI than BH DWI (p<0.001). CONCLUSIONS: Free breathing DWI technique reduces image noise and increases SNR for abdominal examinations. Free breathing technique is therefore preferable to BH DWI in the evaluation of abdominal organs by DWI.

Assessment of the positional and morphological differences of unilaterally impacted canines: A cross-sectional study.

INTRODUCTION: This study aimed to use cone beam computed tomography (CBCT) to evaluate the dimensional and morphological characteristics of unilaterally impacted canines, their effects on adjacent teeth, and differences with contralaterally erupted canines. MATERIALS AND METHODS: A sample of 31 patients (22 males, mean age 22.22 ± 4.82 years; 9 females, mean age 23.91 ± 5.16 years) with unilaterally impacted maxillary palatal teeth were included in the study. CBCT images were obtained using a NewTom 5 G unit in standard mode. Three-dimensional multiplanar reconstructions emulating a panoramic view and curved planar reconstructions were evaluated. Individuals were divided into two groups (low- and high-complexity) according to Ericson and Kurol's impaction complexity classification. RESULTS: The crown lengths and mesiodistal crown widths of the impacted canines were similar to the symmetric canine on the opposite arch and significantly larger than adjacent lateral and premolar teeth (p<0.05). The alpha (31.33 ± 8.32) and beta angles (39.53 ± 10.31) and the 'h' height (10.11 ± 2.02) values in the low-complexity group were significantly lower than the high-complexity group (alpha angle=57.40 ± 12.15; beta angle=71.31 ± 13.94; 'h' height=14.35 ± 3.71, and alpha angle: p<0.001; beta angle: p<0.001; 'h' height: p=0.002) CONCLUSION: The root lengths of impacted maxillary canine teeth are significantly shorter than symmetrically erupted canine teeth regarding labiolingual crown width. As the alpha and beta angles and 'h' height increase, the complexity level of the impacted canine also increases.

Relationship between odontogenic bacteremia and orthodontic stripping.

INTRODUCTION: The aim of this study was to evaluate the prevalence of bacteremia associated with an orthodontic stripping procedure. METHODS: The study included 29 orthodontic patients (mean age, 18.2 ± 3.4 years). We used a standardized stripping procedure: a perforated stripping disk with a contra-angle hand piece was used at a low speed (<15,000 rpm; 10 seconds) on the mandibular anterior teeth. Blood samples were collected by inserting a cannula into the left antecubital fossa. A baseline sample was taken before treatment, and a second sample was taken after the stripping procedure. These samples were inoculated into aerobic and anaerobic blood culture bottles and incubated, and the bacterial cultures were identified; the samples collected before and after the stripping procedure were statistically analyzed. RESULTS: Transient bacteremia was not detected in any pretreatment blood sample, but it was found in 1 postoperative blood sample; this sample tested positive for Streptococcussanguis. CONCLUSIONS: The bacterial species in the positive postoperative blood sample was S sanguis, which might be associated with infective endocarditis. Clinicians should explain the level of risk to the patient and consult a concerned medical specialist.

Cone-beam computed tomography evaluation of relationship between tongue volume and lower incisor irregularity.

The aim of this study was to evaluate the relationship between the tongue volume and lower incisor irregularity, using cone-beam computed tomography (CBCT), and to identify the possible gender differences. CBCT images of 60 patients between 16 and 36 years of age were selected from 1400 sets of images in the database. Tomography was carried out using iCAT® (Imaging Sciences International, Hatfield, Pennsylvania, USA) and segmentation was carried out by using Mimics 10.1 software (Materialise NV, Leuven, Belgium). The tongue volume was calculated by using the volume of the voxels from the scan and the number of voxels selected for a given mask. Lower incisor crowding was measured with the Little's irregularity index and divided into three groups: mild, moderate, and severe. Independent samples t-test, analysis of variance (ANOVA), and Tukey test were used at P < 0.05 level. Pearson correlation coefficients and linear regression model were calculated to determine the correlation between tongue volume and incisor irregularity. No significant gender dimorphism was found for the tongue volume (females: 28.13 ± 8.54 cm(3) and males: 31.02 ± 9.75 cm(3)). According to ANOVA, there was statistically significant difference in the tongue volume measurements among subjects with different levels of irregularity. Tukey analysis indicated that mild irregularity group (33.97 cm(3)) showed higher values for tongue volume than severe irregularity group (26.60 cm(3); P = 0.025). The relationship between incisor irregularity and tongue volume was evaluated for both genders and significant inverse correlation (r = -0.429; P = 0.029) was determined between lower incisor irregularity and tongue volume in males. In female group, no significant correlation was determined between tongue volume and incisor irregularity.

Effect of applying intermittent force with and without vibration on orthodontic tooth movement.

PURPOSE: This study aimed to determine whether orthodontic tooth movement could be accelerated by applying an intermittent force protocol. It also examined the effect of applying additional vibrational forces on orthodontic tooth movement and root resorption rates. METHODS: This study included 24 patients (16 males and 8 females) who underwent orthodontic treatment involving first premolar extraction and distal movement of the canines in the maxilla. A Hycon device (Adenta GmbH, Gilching, Germany) was used for canine distalization in all patients. The patients were randomly divided into two groups: one group received 20 min of vibration per day using the AcceleDent device (OrthoAccel Technologies, Inc., Bellaire, TX, USA), while the other group received no vibration. In addition, a split-mouth design was used: an activation-only force protocol was applied on one side, and an intermittent activation-deactivation-activation (ADA) protocol was applied on the other. The duration required for complete canine tooth distalization on each side was calculated. In addition, the effect of vibration on the orthodontically induced root resorption was examined. RESULTS: The intermittent ADA protocol significantly accelerated orthodontic tooth movement compared to the activation-only protocol (p < 0.05). The application of additional vibration did not affect the orthodontic tooth movement rate (p > 0.05). CONCLUSIONS: Using a Hycon device and following an ADA protocol provided significantly faster canine distalization than the activation-only protocol (p < 0.05). This intermittent force method proved very effective in closing the spaces. However, vibration did not significantly affect the orthodontic tooth movement rate (p > 0.05).