Early treatment of unilateral temporomandibular joint ankylosis: a multidisciplinary approach.

Ankylosis of temporomandibular joint is a condition in which partial or complete immobilization of mandible occurs because of fusion between mandibular condyle and skull base. This condition can be treated orthodontically, surgically, or therapeutically or by prosthodontic rehabilitation. A 10-year-old female patient presented to the Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, with limited mouth opening. She got injury in the face when she was 5 years old. Extraoral and intraoral examination findings were facial asymmetry on the left side, micrognathic mandible, and 19-mm mouth opening. After radiographic examination, ankylosis (Shawney type I) on the left side was revealed, and the patient was referred to Department of Orthodontics. After orthodontic clinical examination, we create following multidisciplinary treatment approach: (1) acrylic posterior bite block with spring application, (2) interpositional arthroplasty operation, and (3) physiotherapy (passive mouth-opening exercises). After the follow-up of 9 months, significant improvement (5 mm) was noticed in the opening of the mouth, and we decided to remove appliance and operate on the patient. Surgical procedure was performed under general anesthesia via blinded nasotracheal intubation. To prevent postoperative relapse, temporal fascia was interpositioned and sutured. Passive mouth-opening exercises were started 10 days after the surgery. Thirty-one-millimeter mouth opening was reached after the surgery and passive mouth-opening exercises. Patient's routine controls have been continued for 2 years.

Endodontic and orthodontic treatment of fused maxillary central incisors: a case report.

The purpose of this case report was to describe combined endodontic and orthodontic treatment of a patient who had permanent maxillary central incisors fused with supernumerary teeth. A severe esthetic problem and crowding in the maxillary arch were present clinically. Radiographic examination demonstrated two separate crowns, roots and pulpal canals on each side. The therapy was initiated with endodontic treatment. Six months after the completion of endodontic therapy, mesio-distal trimming was performed and the defects were restored with anterior resin composites in order to re-establish the esthetics. Orthodontic treatment was performed for the alignment of the upper arch. Follow-up at 4 years demonstrated that the teeth were asymptomatic and neither root nor alveolar bone resorption was found. In conclusion, instead of extracting the supernumerary teeth, the anomaly was treated successfully in a conservative way.

Morphological comparison of cervical vertebrae in adult females with different sagittal craniofacial patterns: A cross-sectional study.

INTRODUCTION: Cervical vertebral maturation (CVM) methods have gained popularity to assess growth and development status for orthodontic patients. Although craniofacial and craniocervical structures are known to be associated, there is no evidence in the literature if this relation might negatively affect the accuracy of CVM assessments. Therefore, this study aimed to comparatively investigate the sizes of the 2(nd), 3(rd), and 4(th) cervical vertebrae in adult females (radius union stage of skeletal maturity) who have different sagittal skeletal patterns. MATERIALS AND METHODS: A cross-sectional study was conducted, and 151 lateral cephalometric radiographs of adult female patients were assessed in the study. Patients were assigned to three groups according to ANB angle. Parameters including concavity depth at the lower border of the 2(nd), 3(rd), and 4(th) cervical vertebrae and base length, upper border length, body length, posterior height, anterior height, and body height of the 3(rd) and 4(th) cervical vertebrae bodies were measured. One-way analysis of variance was used for between-group comparisons. RESULTS: No statistically significant differences were found between groups in terms of concavity depth at the lower borders of the 2(nd), 3(rd), and 4(th) cervical vertebrae (P > 0.05). Base length, upper border length, body length, posterior height, anterior height, and body height of the 3(rd) and 4(th) cervical vertebrae were also similar between groups (P > 0.05). CONCLUSIONS: The results of this study supports that sagittal craniofacial pattern has no effect on the accuracy of using the methods assessing CVM and calculating cervical vertebral age.

Relationship between orthodontic treatment and gingival health: A retrospective study.

OBJECTIVE: The aim of this retrospective study was to evaluate the relationship between orthodontic treatment and gingival health. MATERIALS AND METHODS: A total of 251 patients among whom 177 were girls and 74 were boys, recruited from the records pool of the Department of Orthodontics, Faculty of Dentistry, University of Gazi, were included in the study. Patients' treatments have been completed by postgraduate students during the period between 2006 and 2012. Patients' folders were analyzed according to their age, treatment time, and the type of orthodontic treatment. Intra-oral photographs were analyzed, and the presence or absence of visible plaque, visible inflammation, and gingival recession were recorded, and incisor inclinations analyzed on lateral cephalometric films, before and after orthodontic treatment. RESULTS: No statistically significant difference was found in patients treated with functional appliances before and after treatment. In patients treated with fixed orthodontic appliances, visible plaque, visible inflammation, and gingival recession showed significant increases after treatment, gingival biotype did not show any significant difference. Positive correlation was found between lower incisor position and gingival recession in patients treated with fixed appliance and extraction. And also cuspids were the teeth with the highest prevalence of gingival recession. CONCLUSION: Considering the relationship between orthodontic treatment and gingival health, cooperation among patients, orthodontists, and periodontists is important.