Sella turcica bridging and ponticulus posticus calcification in subjects with different dental anomalies.

INTRODUCTION: This study aimed to evaluate and compare the bridging and dimensions of the sella turcica and calcification of the ponticulus posticus in subjects with different dental anomalies. METHODS: Pretreatment records of orthodontic patients with palatally impacted canines (n = 95), mandibular second premolar agenesis (n = 45), maxillary lateral incisor agenesis (n = 75), tooth transpositions (TT, n = 25), peg-shaped maxillary lateral incisors (n = 30), and third molar agenesis (TMA, n = 145) were analyzed and compared with the control group (CG) consisting of 145 subjects with skeletal Class I malocclusion and no dental anomalies. The length, diameter, and depth of the sella turcica were calculated for each patient. The degree of sella turcica bridging was scored as type I, II, and III, whereas the extent of ponticulus posticus was classified as Class I, II, and III. RESULTS: Only decreases in the length and diameter of the sella turcica in subjects with TT were found to be statistically significant. Although type II bridging frequency was found to be significantly lower in subjects with mandibular second premolar agenesis, maxillary lateral incisor agenesis, TT, and TMA, type III bridging frequency was found to be significantly higher only in subjects with TMA. The decrease in Class I calcification frequencies and the increase in Class II calcification frequencies were found to be significant in subjects with palatally impacted canines, TT, and TMA compared with the CG. In addition, the presence of Class III calcification was found to be significantly more frequent in subjects with TMA than in the CG. CONCLUSIONS: Although type II and type III bridging frequencies were found to be higher than in previous studies because of the higher type II bridging frequency in the CG, type II bridging frequency was found to be insignificant. Furthermore, an increased frequency of ponticulus posticus calcification was observed in subjects with palatally impacted canines, TT, and TMA.

A 4-year clinical evaluation of direct composite build-ups for space closure after orthodontic treatment.

OBJECTIVES: To evaluate the medium-term clinical performance of direct composite build-ups for diastema closures and teeth recontouring using a nano and a nanohybrid composite in combination with three- or two-step etch-and-rinse adhesives following treatment with fixed orthodontic appliances. MATERIALS AND METHODS: A total of 30 patients (mean age, 19.5 years) received 147 direct composite additions for teeth recontouring and diastema closures. A nano and a nanohybrid composite (Filtek Supreme XT and CeramX Duo) were bonded to tooth structure by using a three-step (Scotchbond Multipurpose) or a two-step (XP Bond) etch and rinse adhesive. Ten out of 147 composite build-ups (composite addition) constituted tooth recontouring cases, and the remaining 137 constituted diastema closure cases. The restorations were evaluated by two experienced, calibrated examiners according to modified Ryge criteria at the following time intervals: baseline, 1, 2, 3, and 4 years. RESULTS: The 4-year survival rates were 92.8 % for Filtek Supreme XT/Scotchbond Multi-Purpose Plus and 93 % for CeramX Duo/XP Bond. Only ten restorations failed (5 Filtek Supreme XT and 5 CeramX Duo). Statistical analysis revealed no significant differences between the two composite-adhesive combinations with respect to color match, marginal discoloration, wear/loss of anatomical form, caries formation, marginal adaptation, and surface texture on comparing the five time periods (baseline, 1, 2, 3, and 4 years) CONCLUSIONS: The 4-year survival rates in the present study were favorable. The restorations exhibited excellent scores with regard to color match, marginal adaptation, surface texture, marginal discoloration, wear/loss of anatomical form, and caries formation, after 4 years of clinical evaluation. Clinical relevance An alternative clinical approach for correcting discrepancies in tooth size and form, such as performing direct composite restorations following fixed orthodontic treatment, may be an excellent and minimally invasive treatment.

Evaluation of the closest speaking space in different dental and skeletal occlusions.

STATEMENT OF PROBLEM: The closest speaking space (CSS) together with the vertical overlap of anterior teeth during the production of the /s/ sound have not been previously investigated with respect to differences in dental and skeletal orthodontic classifications. PURPOSE: The purpose of this study was to investigate the CSS in dental and skeletal occlusions and to analyze the cause and effect relationship of the CSS and the amount of the vertical overlap of anterior teeth. MATERIAL AND METHODS: Poly vinylsiloxane interocclusal registration material was placed bilaterally onto the occlusal surfaces of premolar and molar teeth of 155 native Turkish speaking adolescent and young adult dentate participants, who were then asked to pronounce the word seyis. The thinnest point between the maxillary and mandibular teeth was recorded in millimeters as the CSS. The occlusion of each participant was classified according to the Angle dental and Steiner skeletal classifications. The differences in CSS values within each classification were statistically analyzed with the Kruskal-Wallis test, and the correlation between the CSS and the vertical overlap was statistically analyzed with the Spearman Rho Correlation tests (P<.05). RESULTS: The differences in the CSS were only significant between Angle Class II division 2 and Class III groups (P=.034), while the differences in the CSS between skeletal classes were not significant. The correlation between the amount of CSS and the amount of vertical overlap was not significant. CONCLUSIONS: The results showed that regardless of dental and skeletal occlusions, average CSS values could be used to determine the occlusal vertical dimension of prosthetic restorations.

Evaluation of the effects of temporomandibular joint disc displacement and its progression on dentocraniofacial morphology in symptomatic patients using posteroanterior cephalometric analysis.

The aim of this study was to evaluate the effects of disc displacement (DD) and its progression on dentocraniofacial morphology in symptomatic patients, and to compare the results with asymptomatic volunteers. Female patients with DD, diagnosed with magnetic resonance imaging (MRI) and posteroanterior cephalometric analysis, were included in this study. Subjects were grouped as follows: control group with bilateral normal disc position (group 1, n=20), unilateral DD with reduction (group 2, n=17), bilateral DD with reduction (group 3, n=32), unilateral DD without reduction (group 4, n=16), and bilateral DD without reduction (group 5, n=19). Thirteen cephalometric variables were measured. A significant increase in the ANS (Anterior nasal spine)-Me (Menton)-MSP (Midsagittal plane) angle in unilateral DD groups and decreases in the Ag (Antegonial notch)-Me dimension on the affected side in all DD groups were observed. Also, the maximum values of the Me-MSP dimension and ANS-Me-MSP angle were observed in group 4. The results of this study showed that the deviation of the menton point toward the disc displacement side causes a mandibular asymmetry. It can be concluded from these results that the presence of DD in female patients affects facial morphology, and its progression makes the differences more significant and remarkable. These results emphasize the importance of early diagnosis and treatment in the management of DD.

Evaluation of the effects of temporomandibular joint disk displacement and its progression on dentocraniofacial morphology in symptomatic patients using lateral cephalometric analysis.

The aim of this study was to evaluate the effects of disk displacement (DD) and its progression on dentocraniofacial morphology in symptomatic patients and compare the results with asymptomatic volunteers. Skeletal and dental Class I female patients with DD, diagnosed using magnetic resonance imaging (MRI) and lateral cephalometric analysis were included in the study. Subjects were grouped as follows: control group with bilateral normal disk position (group 1, n=12), unilateral DD with reduction (group 2, n=16), bilateral DD with reduction (group 3, n=26), unilateral DD without reduction (group 4, n=12), and bilateral DD without reduction (group 5, n=8). Thirty-two (32) cephalometric variables were measured, and statistically significant differences were found in 11. Dental and soft tissue measurements did not reveal any differences, but variables related to the mandible showed statistically significant differences. Progression of DD was associated with an increase in all angular measurements related to vertical skeletal relationships and articular angle and a decrease in the ratio of posterior face height to anterior face height indicating clockwise rotation of the mandible. Similarly, the height of ramus was decreased with the progression of DD. The results of this study demonstrated that the presence of DD in skeletal Class I female patients effects facial morphology, and its progression makes the differences more significant and remarkable. These results emphasize the importance of early diagnosis and treatment in the management of DD.

Up-to-Date Approach in the Treatment of Impacted Mandibular Molars: A Literature Review.

Eruption problems in the mandibular molars are rare, but they have to be diagnosed and treated early. Treatment of impacted molars is challenging due to a limited access and complexity of the mechanics that needs to be applied. Methods for managing impacted or tilted mandibular molars include orthodontic repositioning, surgical uprighting, and extraction with or without transplantation of the third molar into the extraction site. This review highlights the methods and clinical procedures of surgical and orthodontic uprighting procedures of mandibular molars with different degrees and levels of impaction. It further discusses the use of the ramus screw as a temporary anchorage device in the uprighting of horizontally impacted mandibular molars.

Oropharyngeal airway changes following bimaxillary surgery in Class III female adults.

AIM: The aim of this study was to evaluate oropharyngeal airway changes following Le Fort I maxillary advancement and impaction with mandibular setback in Class III deformity. SUBJECTS AND METHODS: 53 female Class III patients (mean age: 24.9+/-0.8 years) had Le Fort I maxillary advancement with impaction, and mandibular setback osteotomies. Lateral cephalograms were taken before (T0), one week postoperatively (T1) and 1.3+/-0.2 years after (T2) bimaxillary surgery. Paired t and Pearson tests were used to evaluate the changes. RESULTS: The mandibular plane-hyoid, upper retropalatal airway space (URP) and hyoid to horizontal reference plane (HY-HOR) distances significantly increased and the third vertebra to menton, hyoid to vertical reference plane (HY-VER) distances decreased in the T0-T1 period. Relapses were found in mandibular plane to hyoid (MP-HY), URP, HY-HOR, third cervical vertebra to menton (C3-Me) and HY-VER distances in T1-T2 period. Correlations were found between the mandibular retraction and increases of the narrowest retropalatal (r: 0.29, p<0.05) and lowest retropalatal airway spaces (r: -0.30, p<0.05) and posterior movement of hyoid (r: 0.60, p<0.001). CONCLUSIONS: Bimaxillary surgery caused an increase in the URP, together with posterior and inferior movement of hyoid bone one week postoperatively. Some relapse was found in these changes over one year later.

Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review.

As the demand for esthetic treatments is increasing, more people are seeking alternatives to fixed orthodontic appliances. Clear aligners are an esthetic and comfortable option for orthodontic treatment and have gained immense popularity over the last decade. This review will highlight the increasing popularity of clear aligners by describing some aligner systems frequently used today. The scope, limitations, effectiveness, efficacy, and stability of treatment results achieved with this method will be discussed. Further, this paper will assess the possible side effects caused by clear aligner treatment.

Evaluation of Crossbites in Relation with Dental Arch Widths, Occlusion Type, Nutritive and Non-nutritive Sucking Habits and Respiratory Factors in the Early Mixed Dentition.

PURPOSE: The purpose of this study was to analyse the connection between dental arch widths, malocclusion type, nutritive sucking habits and non-nutritive sucking habits, and respiratory factors with the presence of crossbites (CB) in the early mixed dentition. MATERIALS AND METHODS: Data were collected from 72 children with and without CB. A questionnaire was applied to parents/carers to obtain information about nutritive and non-nutritive sucking habits. The posterior and anterior crossbites were diagnosed in a centric relationship. Dental arch widths were measured directly from the models by two calibrated examiners. The data were analysed statistically using chi-square and Fisher's exact tests. RESULTS: The incidence of Class III malocclusion and the presence of ear, nose and throat problems in the study group were significantly higher than in the control subjects (p = 0.01, p = 0.047). The mean breastfeeding duration for children in the CB group was found significantly shorter than in the control subjects (p = 0.043). The number of children with mouth breathing in sleep was significantly higher in the CB group than the control subjects (p = 0.046). The children with CB demonstrated a statistically significant increase in mandibular intercanine width (ICW) than the control group (p = 0.044). CONCLUSION: The results demonstrated that an insufficient duration of breastfeeding, mouth breathing, ear-nose-throat problems and Class III malocclusion were associated with the presence of CB in the early mixed dentition.

Microhybrid versus nanofill composite in combination with a three step etch and rinse adhesive in occlusal cavities: five year results.

OBJECTIVES: The aim of the study was to evaluate the 5-year clinical performance of occlusal carious restorations using nanofill and microhybrid composites, in combination with 3-step etch-and-rinse adhesives, in patients who were going to commence orthodontic treatment. MATERIALS AND METHODS: A total of 118 restorations for occlusal caries were conducted prior to orthodontic treatment. Occlusal restorations were performed both with Filtek Supreme XT (3M ESPE) and Filtek Z250 (3M ESPE) before beginning orthodontic treatment with fixed orthodontic bands. Restorations were clinically evaluated at baseline and at 1, 2, 3, 4, and 5-year recalls. RESULTS: None of the microhybrid (Filtek Z250) and nanofill (Filtek Supreme XT) composite restorations was clinically unacceptable with respect to color match, marginal discoloration, wear or loss of anatomical form, recurrent caries, marginal adaptation, or surface texture. A 100% success rate was recorded for both composite materials. There were no statistically significant differences in any of the clinical evaluation criteria between Filtek Z250 and Filtek Supreme XT restorations for each evaluation period. CONCLUSIONS: The composite restorations showed promising clinical results relating to color matching, marginal discoloration, wear or loss of anatomical form, recurrent caries, marginal adaptation, and surface texture at the end of the 5-year evaluation period.

Maxillary incisor trauma in patients with class II division 1 dental malocclusion: associated factors.

PURPOSE: The aim of this study was to assess the association between the presence of maxillary incisor trauma (MIT) with age, gender, dentition type, the degree of overjet (OJ), lip form, respiratory type and dental arch form in patients with Class II division 1 dental malocclusion. SUBJECTS AND METHODS: 256 patients (mean age: 15.80 ± 2.2) were included in this study. The patients' gender, dentition type, superior lip form, dental arch form and respiratory type were recorded. Participants were divided into four groups according to the severity of OJ: 3.5 mm

Multidisciplinary treatment of non-syndromic oligodontia.

Oligodontia is the agenesis of 6 or more teeth, excluding third molars. The etiology of congenital absence of teeth is believed to be rooted in heredity or developmental anomalies. The absence of teeth in patients can cause aesthetic, functional, and psychological problems, particularly if the anterior region is involved. This case report describes the multidisciplinary treatment approach toward a patient 17 years of age with non-syndromic oligodontia, with absence of 11 permanent teeth. Genetic counseling revealed non-syndromic, autosomal-recessive-linked oligodontia. The objectives of the first phase of therapy were pre-prosthetic orthodontic space opening for proper positioning of the missing teeth and correction of inter-maxillary relations, as a prerequisite for proper prosthetic restoration. The second phase of therapy was prosthetic restoration of the missing teeth and provision of occlusion with full-mouth porcelain fused to metal crowns and bridges after increasing occlusal vertical dimension by 2 mm.

An adult case of temporomandibular joint osteoarthritis treated with splint therapy and the subsequent orthodontic occlusal reconstruction.

Herein we report treatment for a 19-year-old female patient with severe osteoarthritis of the temporomandibular joint. The patient had severe open bite with a Class II molar relationship. She had limited mouth opening and pain. Clinical examination and magnetic resonance imaging revealed that she had anterior disc displacement without reduction. By splint therapy, limited mouth opening and pain was eliminated, but an anterior open bite developed after the treatment. By orthodontic treatment, an acceptable occlusion was achieved with a Class I molar relationship.

Changes in head posture and hyoid bone position in Turkish Class III patients after mandibular setback surgery.

The aim of this study was to determine the changes in head posture and hyoid bone position after mandibular setback osteotomy in Turkish adult Class III patients. Serial lateral cephalograms of 42 Turkish Class III patients (24 female, 18 male patients, mean age: 25.4+/-1.2 years) who underwent mandibular setback surgery were evaluated preoperatively, 1.2+/-0.6 years, 2.3+/-0.8 and 4.2+/-0.9 years postoperatively. A mean mandibular setback of 5.6+/-0.8mm was associated with a posterior and inferior movement of the hyoid bone and a significant flexion in the neck posture. Surgical correction of mandibular prognathism altered the position of the hyoid bone by downward repositioning carrying the root of the tongue downwards immediately postoperatively, but followed with a tendency to return to its original position.

Incidence of bridging and dimensions of sella turcica in Class I and III Turkish adult female patients.

Mineralization of the interclinoid ligament of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. The aim of this study was to evaluate the incidence of sella turcica bridging, sella turcica dimensions, and skeletal variables in 57 Class I (mean age, 27.2 ± 5.3 years) and 61 Class III (mean age, 25.8 ± 4.6 years) Turkish adult females. Sella bridging was found in three (5%) of the Class I and 11 (18%) of the Class III individuals (P<.010). The association between sella turcica bridging and manifest skeletal Class III malocclusions was statistically significant according to the chi-square test (P<.050). No significant differences in sella turcica dimensions were found between the Class I and Class III patients. Skeletal variables that differed significantly were SNB (P=.004), ANB (P=.002), and NAPg (P=.000) angles and N-B (P=.030), N-Pg (P=.003), Go-Pg (P=.007), and TM-Pg (P=.002) dimensions.