Geometric morphometric analysis of the pharyngeal airway during treatment of Class III malocclusion.

INTRODUCTION: The pharyngeal airway is important during diagnosis and treatment planning in orthodontics. This study aimed to compare the changes in the shape of the pharyngeal airway in patients with Class III malocclusion treated with a facemask (FM) with a removable maxillary appliance and modified tandem traction bow appliance (MTTBA). METHODS: This study consisted of pretreatment and posttreatment lateral cephalograms of 35 subjects with skeletal and dental Class III malocclusion. In the first group, 20 patients (12 males, 8 females; mean age, 10.2 years) were treated with MTTBA. The mean treatment time was 12 months. In the second group, 15 patients (10 males, 5 females; mean age, 10.3 years) were treated with FM. The mean treatment time was 11.7 months. Nineteen pharyngeal landmarks were considered from the image corresponding to the midsagittal plane and marked using tpsDig software (version 2.04; Stony Brook, NY). Pharyngeal airway shape difference between the groups was assessed by performing a Generalized Procrustes analysis. The shape deformation of the pharyngeal airway from the pre- to posttreatment periods was evaluated using the thin-plate spline method. RESULTS: There were no differences between MTTBA and FM groups according to airway shape for pretreatment and posttreatment periods. However, there were some deformities using the enlargement of the nasopharyngeal area in the FM group and oropharyngeal area in the MTTBA group according to pretreatment periods. CONCLUSIONS: There were no differences between the groups according to the mean pharyngeal airway shapes when the posttreatment periods of the FM and MTTBA groups were examined.

NAM Therapy-Evidence-Based Results.

Many orthodontists working on patients with cleft lip and palate (CLP) have shown great enthusiasm for presurgical infant orthopedics (PSIO) to improve surgical outcomes with minimal intervention. Even though every clinician aims to use the best treatment modality for their patients, PSIO effects can be confounded by surgical type and timing of the primary repair, as is discussed in many studies. In such cases, one should be cautious when evaluating the particular outcomes for patients with CLP since it is difficult to differentiate the sole effect of an individual surgical or orthodontic intervention. As with any treatment methodology, nasoalveolar molding (NAM) has both benefits and limitations. Commonly cited concerns with NAM, and PSIO in general, include increased cost, increased burden of care, and a negative impact on maxillary growth. However, NAM cannot be deemed as having apparent long-term negative or positive effects on skeletal or soft tissue facial growth, based on previous studies. A review of the literature suggests that NAM does not alter skeletal facial growth when compared with the samples that did not receive PSIO. Nevertheless, the published studies on NAM show evidence of benefits to the patient, caregivers, the surgeon, and society. These benefits include documented reduction in severity of the cleft deformity prior to surgery and as a consequence improved surgical outcomes, reduced burden of care on the care givers, reduction in the need for revision surgery, and consequent reduced overall cost of care to the patient and society.

Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space.

Objective: The aim of this study was to evaluate and compare the mandibular arch posterior space changes in Class III patients treated with facemask (FM) with removable upper appliance or modified tandem traction bow appliance (MTTBA). Methods: Pre- and post-treatment and pre- and post-observation lateral cephalograms of 76 subjects with skeletal and dental Class III malocclusion from the period 2000-10 years formed the materials of this study. In the first group, 25 patients (10 girls, 15 boys; mean age: 10 years, 1 month) were treated with MTTBA. The average treatment time was 12 months. In the second group, 26 patients were treated (13 girls, 13 boys; mean age: 10 years, 4 months) with a Delaire-type FM. The average treatment time was 13 months. The remaining 25 children (9 girls, 16 boys; mean age: 9 years, 8 months) were observed without treatment for 10 months. ANOVA, Duncan, and paired t-tests were used for statistical evaluation. Results: Although ramus width and mandibular posterior space increased significantly in all groups, no significant differences were found among the groups. Significant increase in tipping of lower molar (L6/GoMe) in the MTTBA group showed a significant difference compared with the FM and control groups. Significant retroclination of the lower incisors (L1/NB) in the MTTBA and FM treatment groups was significantly different compared with the control group. Retroclination of lower incisors in the MTTBA group was significantly greater than that in the FM group. Conclusions: FM and MTTBA treatment approaches did not affect the dimensions of posterior space. Limitations: To generalize the results of this study, long term evaluation by considering the third molar position should be done.

Prevalence of Posterior Crossbite for Orthodontic Treatment Timing.

OBJECTIVE: To evaluate the prevalence and distribution of posterior crossbite in different dentition stages in a Turkish sample. STUDY DESIGN: 1554 subjects (843 girls, 711 boys) aged 4-25 years were evaluated to determine the prevalence of posterior crossbite in a Turkish sample. The subjects were classified according to four dentition stages (primary, early mixed, late mixed and permanent) and transversal occlusal status. The statistical evaluation was done by Chi-square, Fischer exact tests. RESULTS: Bilateral and unilateral crossbite on the right and left sides had the highest frequency in the permanent dentition (51.0%, 47.3%, and 53.6%; respectively). No significant differences were found between unilateral (right and left) and bilateral crossbite with regard to dentition stages. No significant differences were found between unilateral right or left side posterior crossbite with regard to dentition stages. CONCLUSION: An increasing trend in the prevalence of posterior crossbite was observed from the primary dentition towards permanent dentition in this study.

A Comparison of Three Orthodontic Treatment Indices with Regard to Angle Classification.

OBJECTIVES: To calculate the agreement between the Dental Aesthetic Index (DAI) and the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need and to determine correlations between the Peer Assessment Rating (PAR) and DAI and ICON scores according to Angle classification among patients referred for orthodontic evaluation. STUDY DESIGN: This study included 457 randomly selected patients between 9 to 17 years of age. Patients were divided into four groups according to Angle classification [Class I (n=154), Class II division 1(Class II/1) (n=155), Class II division 2(Class II/2) (n=52) and Class III (n=96)]. Relationships between PAR scores and ICON and DAI scores were evaluated with the Spearman correlation test. Unweighted kappa statistics were used to analyse agreement between the ICON and DAI on the need for treatment, according to Angle classification. RESULTS: Class I malocclusions scored significantly lower than other Angle classifications in all indices. Both the ICON and DAI showed significant positive correlations with the PAR in the general study population. For Class II/2 patients, no correlation was found between PAR and DAI scores. There was significant agreement between the ICON and DAI on treatment need among Class I, Class II/1 and Class II/2 patients however, no agreement was found for Class III malocclusions. CONCLUSIONS: The ICON, DAI and PAR produce similar results and can be used interchangeably for the general orthodontic patient population. However, based on Angle classification, prominent differences exist in scoring certain occlusal features.

The Effects of Er,Cr:YSGG laser on shear bond strength of orthodontic lingual brackets to CAD/CAM ceramic systems.

Purpose: The aim of this study is to compare the bond strength of lingual brackets bonded to resin-matrix and lithium disilicate based-ceramic crowns following various surface treatments. Materials and methods: Sixty ceramic crowns (IPS Emax and Cerasmart) were fabricated by CAD/CAM. Er,Cr:YSGG laser, sandblasting with aluminium oxide and hydrofluoric acid treatment effects on ceramics was tested (n=10/group). A light-cure orthodontic adhesive was used to bond lingual brackets to the ceramic surfaces. Bond strengths of the brackets to ceramics were assessed by shear bond test. The remnant adhesive on bracket and ceramic surfaces was inspected with a light microscope and adhesive remnant index scores were recorded. The data were analyzed statistically using the Kruskal-Wallis test followed by the Mann-Whitney U-test. Results: Cerasmart ceramic specimens showed lower shear bond strength values than IPS Emax ceramic specimens (p<0.05). The statistical analysis of the surface treatment groups regarding bond strength were ranked as follows: Laser ≤ Hydrofluoric acid ≤ Sandblasting (p=0.058). While laser-treated Cerasmart ceramic group displayed the lowest SBS (9.39 MPa), hydrofluoric acid-treated IPS Emax group had the highest (16.8 MPa) bond strength value. Conclusion: The use of Er,Cr:YSGG lasers for etching of CAD-CAM ceramics could be a promising alternative to "conventional techniques", to improve bond strength of lingual brackets to IPS Emax and Cerasmart ceramics.

The Influence of Abnormalities in the Profile and Overjet on Psychological Well-Being.

OBJECTIVE: This study aimed to comparatively evaluate the psychological well-being and health-related quality of life of subjects having either a convex or concave profile and abnormal overjet, with subjects having a straight profile and normal overjet. METHODS: In this study, 163 children and their parents who applied to the Faculty of Dentistry were classified into 3 groups: Group 1: convex profile, Class II molar relationship, and increased overjet (n=62; 28 boys and 34 girls; mean age: 11.6 years); Group 2: concave profile, Class III molar relationship, and negative overjet (n=55; 32 boys and 23 girls; mean age: 11.2 years); and Group 3: straight profile, Class I molar relationship without crowding, and normal overjet (n=46; 24 boys and 22 girls; mean age: 11.0 years). The severity of malocclusion was evaluated using the Index of Orthodontic Treatment Need (IOTN). Self-concept, depression, and state-trait anxiety were evaluated to determine the psychological well-being of the children. RESULTS: No differences were found among the groups with respect to self-concept, depression levels, state-trait anxiety levels, and quality of life scores. No correlation was found between the IOTN scores and psychological well-being. CONCLUSION: Abnormalities in the facial profile and negative or increased overjet have no influence on children's psychological well-being.

Post-treatment evaluation of a magnetic activator device in Class II high-angle malocclusions.

SUMMARY: The purpose of this study was to evaluate changes in dentofacial growth before, during, and after use of a magnetic activator device (MAD) II in high-angle Class II division 1 patients. Lateral cephalometric and hand-wrist radiographs of 10 patients (six girls and four boys) with an average chronological age of 10 years 5 months were obtained at the beginning of the observation period (T1, 9.5 months), beginning of MAD II application (T2), at the end of the treatment (T3), and approximately 4 years after the end of treatment (T4). Thirteen linear, 1 ratio, and 10 angular measurements were evaluated. Paired t-tests were used for statistical evaluation of differences that occurred between the time points. The increase in gonial angle, GnGoAr angle, S-N, Co-Gn, Go-Ar, ANS-Me, S-Go, and N-Me distances and the decrease of overjet, U1-NA distance, and ANB angle were statistically significant during the treatment. At T4, there was a decrease in gonial angle and U1-NA distance, which was significant. The changes as a result of treatment were stable at T4.

Evaluation of the effects of the hybrid Pendulum in comparison with the conventional Pendulum appliance.

OBJECTIVE: To evaluate the anchorage control and distalization of maxillary molars with the hybrid Pendulum appliance and to compare the results with a conventional Pendulum appliance. MATERIALS AND METHODS: This study was carried out on the pre-(T0) and post-(T1) treatment lateral cephalograms and dental casts of 43 patients with Angle Class II molar relationships who were treated with conventional or hybrid Pendulum appliances. The hybrid Pendulum (HP) group consisted of 22 patients (14 females; eight males; mean age 14.3 ± 2.43 years) and treatment results were compared with a conventional Pendulum appliance (CP) group, which consisted of 21 patients (15 females; six males; mean age 14.6 ± 3.39 years). Intragroup comparisons were made with Wilcoxon test and intergroup comparisons were made with Mann-Whitney U-test (P < .05). RESULTS: The mean distalization duration was 0.70 ± 0.25 years in the HP group and 0.83 ± 0.4 years in the CP group. Maxillary first molars showed significant distal movement and tipping of 4.25 mm and 9.09° in the HP group, and 3.21 mm and 9.86° in the CP group. Loss of anchorage at the first premolars was significantly smaller in the HP appliance group compared to CP group. The second premolars distalized spontaneously in the HP group while they mesialized significantly in the CP group. Proclination and protrusion of maxillary incisors were greater with the CP appliance compared to the HP appliance. CONCLUSIONS: Maxillary molar distalization was achieved with both appliances. Mesialization of the anchorage unit was controlled successfully with the hybrid Pendulum; however, the conventional Pendulum appliance caused anchorage loss.

Mandibular posterior space in class II division 1 and 2 malocclusion in various age groups.

PURPOSE: The aim of this study was to compare the mandibular posterior space in subjects with skeletal class II division 1 and division 2 malocclusions in two different age groups. METHODS: Pretreatment cephalometric radiographs of 160 patients from 9 to 13 years of age (n = 80) and 15 to 18 years of age (n = 80) with class II division 1 or division 2 malocclusion were used for the study. Equal numbers of male and female patients (n = 20) were included in the two age groups in each of the malocclusion groups. Eight linear and six angular measurements were taken for mandibular posterior space evaluation. The data obtained from the study were compared using the independent t-test. RESULTS: In the present study, the mandibular posterior space was greater in both malocclusion groups in subjects aged 15-18 years than in those aged 9-13 years (p < 0.05). The available posterior spaces behind the mandibular first molars were 4.4 mm and 6.3 mm in females (class II divisions 1 and 2, respectively) and 5.3 mm and 7 mm in males (class II divisions 1 and 2, respectively) in the 9­ to 13-year-old age group. This space increased significantly by 6.9 mm (p < 0.001) and 3.2 mm (p < 0.01) in females (class II division 1 and 2, respectively) and 3.8 mm (p < 0.01) and 3 mm (p < 0.01) in males (class II division 1 and 2, respectively) in the 15- to 18-year-old age group. CONCLUSION: Class II division 1 and division 2 malocclusions had similar and inadequate posterior space dimensions for the eruption of the third and an unknown portion of the second molars.

Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway.

OBJECTIVE: To evaluate the long-term outcome of treatment with reverse headgear in patients with skeletal Class III malocclusion diagnosed as maxillary deficient. MATERIALS AND METHODS: Twenty-five patients (11 girls, 14 boys; mean age, 11.32 years) treated with a reverse headgear appliance were included in this study. Pretreatment, posttreatment, and 4-year follow-up cephalometric radiographs were obtained; linear, angular, and area measurements were performed. Comparison of treatment and observation changes was performed using a paired t-test. RESULTS: A significant increase was found in the forward movement of the maxilla, which was maintained 4 years after reverse headgear treatment. Treatment changes revealed significant increases in the sagittal dimensions and area of nasopharyngeal airway and remained significant at the end of the 4-year follow-up period. The oropharyngeal airway area increased nonsignificantly after the treatment, but significant increases occurred during the follow-up period. CONCLUSIONS: In young individuals diagnosed with maxillary deficiency treated with reverse headgear, the nasopharyngeal airway dimensions were improved after the treatment, and favorable effects of the treatment remained over the posttreatment period of 4 years.

Peer Assessment Rating (PAR) Index as an Alternative for Orthodontic Treatment Need Decision in Relation to Angle Classification.

OBJECTIVE: This study aimed to determine cut-off points for the Peer Assessment Rating (PAR) index in relation with Angle classification to use as an alternative index for the treatment need assessment. METHODS: This study included 607 orthodontic patients aged between 9 and 18 years. Angle classification, PAR, and dental aesthetic index (DAI) scores were determined. The DAI was used as the gold standard to evaluate the subjects for treatment need. The receiver operating characteristics (ROC) analysis was used to evaluate the PAR index in relation to treatment need assessed by DAI. RESULTS: The mean PAR scores for Class I, II, and III malocclusions and total sample were 17.54, 14.27, 18.7, and 20.04, respectively. The areas under the ROC of PAR scores in relation to the DAI assessment were found as 68.3% for the total sample, 66.6% Class I, 59.2% Class II, and 71.3% Class III malocclusions. For the total sample, the optimum cut-off PAR score was 14 in relation to DAI assessment. The cut-off scores for Class I, II, and III malocclusions were 13, 11, and 16, respectively, but considering psychosocial aspects, the recommended score is 14 for Class III. CONCLUSION: The PAR index can be considered to have an acceptable level of validity for the assessment of orthodontic treatment need regarding Angle classification.

Effects of facemask therapy on the mandibular retromolar space. A follow-up study.

OBJECTIVES: To evaluate the mandibular retromolar space after facemask therapy and a follow-up period.  Methods: This retrospective study was conducted between May and September in 2014. The sample consisted of pre-treatment (T1), post-treatment (T2), and follow-up(T3) panoramic radiographs of 19 skeletal and dental Class III patients (7 female, 12 male; mean age: 10.5 years) treated with facemask and a removable intraoral upper appliance in the Faculty of Dentistry Gazi University, Ankara, Turkey. Each patient's lower arches were evaluated as right and left segments. As third molars were congenitally absent in 3 segments, a total of 35 segments were evaluated. The average treatment time was one year. The average follow-up period was 2.4 years. The positions, angulations, dental maturations of lower third molars, and mandibular retromolar spaces (DJ) were assessed. Friedman's 2-way Analysis of Variance, multiple-comparison, Pearson's correlation, and Chi-square tests were used for statistical evaluation. A p less than 0.05 was considered as significant. RESULTS: The angulation of the first molar (ϒ) increased significantly only in the follow-up period (T3). Mandibular retromolar spaces were increased significantly during all periods. The most commonly determined position of the third molar, by Winter's classification, was vertical angulation in all periods. Moderate and significant correlations were found between third molar angulation(ß) and DJ at T2 and T3. Significant correlations were also found between DJ and Demirjian classification stages during all periods. CONCLUSION: Facemask therapy did not have an adverse effect on the mandibular retromolar space during treatment and follow up periods.

A practical formula for determining growth.

PURPOSE: We aimed to establish a practical method to evaluate skeletal age using cervical vertebrae. METHODS: The study consisted of hand-wrist and cephalometric radiographs of 324 subjects (167 girls, 157 boys; age range, 7.3-17.2 years). Skeletal ages of the subjects were calculated from hand-wrist radiographs, and cervical vertebral bodies were measured using cephalometric radiographs. A single formula based on C3 and C4 vertebral body heights with different coefficients for each gender was derived using ridge regression analysis. RESULTS: The correlation coefficients for vertebral and hand-wrist bone age were 0.825 and 0.856 for girls and boys, respectively. The correlations among vertebral bone age and C3 and C4 vertebral body heights were also found to be significant. The intraclass correlation (ICC) score was found to be 0.914, which shows high consistency between the two measurements of the same investigator for each C3 and C4 vertebral body height result. CONCLUSION: The formula derived for evaluating skeletal age in cephalometric radiographs is reliable and can be applied to both girl and boy subjects for legal requirements or therapeutic needs of age estimation.

Secular trend in the maturation of permanent teeth in a sample of Turkish children over the past 30 years.

This study was performed to evaluate the influence of secular trends on dental maturation among Turkish children over the past 30 years. Orthopantomograms of 757 (385 boys, 372 girls) Turkish children born in the 1980s, 1990s, and 2000s were evaluated. Three groups were formed based on decade with five subgroups by age from 9 to 13 years old for each gender. The number of samples in each age group and gender were matched. The mandibular left seven permanent teeth were evaluated based on formation stage to determine the overall dental maturity score. The groups were compared based on decade and gender. The Bonferroni-corrected Mann-Whitney U test and Kruskal-Wallis tests were used for statistical evaluation. Among 11-, 12-, and 13-year-olds born in the 2000s, girls exhibited significantly more mature dentition than did boys (p<0.01, p<0.05, and p<0.05, respectively). Twelve-year-old girls born in the 1990s and 2000s exhibited significantly more mature dentition than did girls born in the 1980s (p<0.01). Girls generally exhibited more mature dentition than boys. No significant positive secular trends in dental maturity were observed from the 1980s through the 2000s. Dental maturation among Turkish children was not affected by a secular trend.

Comparison of transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system.

OBJECTIVE: To compare the transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system (KIDS). METHODS: We evaluated the pre- and post distalization orthodontic models of 39 patients, including 19 treated using the Frog appliance, which is palatally positioned (Frog group), and 20 treated using KIDS, which is buccally positioned (KIDS group). Changes in intermolar and interpremolar distances and the amount of maxillary premolar and molar rotation were evaluated on model photocopies. Wilcoxon and Mann-Whitney U tests were used for statistical evaluations. A p-value of < 0.05 was considered statistically significant. RESULTS: Significant distopalatal rotation of premolars and distobuccal rotation of molars were observed in Frog group (p < 0.05), while significant distopalatal rotation of molars (p < 0.05), with no significant changes in premolars, was observed in KIDS group. The amount of second premolar and first molar rotation was significantly different between the two groups (p < 0.05 and p < 0.001, respectively). Furthermore, expansion in the region of the first molars and second premolars was significantly greater in KIDS group than in Frog group (p < 0.001 for both). CONCLUSIONS: Our results suggest that the type and amount of first molar rotation and expansion vary with the design of the distalization appliance used.

Comparison of double-plate appliance/facemask combination and facemask therapy in treating class III malocclusions.

OBJECTIVE: To compare the treatment effects of double-plate appliance/facemask (DPA-FM) combined therapy and facemask (FM) therapy in treating Class III malocclusions. MATERIALS AND METHODS: The material consisted of lateral cephalometric radiographs of 45 children with skeletal and dental Class III malocclusion. The first treatment group comprised 15 patients (mean age  =  11 years) treated with FM. The second treatment group comprised 15 patients (mean age  = 10 years 9 months) treated with DPA-FM. The third group comprised 15 patients (mean age  =  10 years 5 months) used as controls. The paired t-test was used to evaluate the treatment effects and changes during the treatment and observation period in each group. Differences between the groups were determined by variance analysis and the Duncan test. RESULTS: With the DPA-FM and FM appliances, the SNA and ANB angles increased significantly. These changes were statistically different compared with the control group. Lower facial height showed a greater increase in both treatment groups than in the control group. Molar relation showed a greater increase in the DPA-FM group than in the FM group. The increase in U6/ANS-PNS angle in the FM group was significantly different from the DPA-FM and control groups. The L1/NB angle and Pg-T increased significantly only in the FM group, but no significant difference was found between the treatment groups. CONCLUSIONS: In the treatment of Class III malocclusion, both appliances were effective. The significant sagittal changes in the lower incisors and pogonion in the FM group compared with the nonsignificant changes in the DPA-FM group might be due to the restriction effect of acrylic blocks in the DPA-FM group.

Effects of self-ligating and conventional brackets on halitosis and periodontal conditions.

OBJECTIVE: To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health. MATERIALS AND METHODS: Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n  =  20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n  =  20), and the control group (group 3, n  =  20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically. RESULTS: No statistically significant group × time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups. CONCLUSIONS: The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.

Effect of the bracket types on microbial colonization and periodontal status.

OBJECTIVE: To evaluate the effect of different bracket types on the levels of Streptococcus mutans (SM) and Lactobacillus (LB) in saliva, in plaque, and on the periodontal condition. MATERIALS AND METHODS: Forty patients aged 14 to 16 years, who had Angle Class I malocclusion with minimal crowding, were nonsmokers, were without systematic disease, and did not use antibiotics or oral mouth rinses during the 3-month period before the study were randomly selected. The patients were subdivided into two groups with random allocation of bracket type: conventional brackets (CB; Avex Mx, OPAL orth.) with steel wire ligature or self-ligating brackets (SLB; F1000, Leone S.p.A.). Microbial and periodontal records were obtained before bonding (T1) and 1 month after bonding (T2). Microbial samples were collected from the stimulated saliva and the plaque from the labial surfaces of the upper and lower lateral incisors. To estimate the number of colony-forming units of SM and LB, Dentocult SM and LB kits were used. The plaque index (PI), gingival index (GI), and pocket depth (PD) values were recorded to evaluate the periodontal condition. Paired t-test and Mann-Whitney U-test were used to compare the groups statistically. RESULTS: No significant differences occurred in SM or LB colonization between the groups. In the SLB group, PI, GI, and PD values increased significantly (P < .05). A greater increase was found in PD value in the SLB group (0.98 mm) compared with the CB group (0.04 mm; P < .05). CONCLUSIONS: The F1000 SLB do not have an advantage over Avex Mx CB with respect to periodontal status and colonization of SM and LB.

Modified tandem traction bow appliance compared with facemask therapy in treating Class III malocclusions.

OBJECTIVE: To compare the effects of the modified tandem traction bow appliance (MTTBA) and the facemask in treating patients with Class III malocclusion. MATERIALS AND METHODS: The material consisted of the pre-post treatment\pre-post observation lateral cephalograms of 65 subjects with skeletal and dental Class III malocclusion. In the first group 21 patients (mean age: 10 years, 6 months) were treated with a Delaire-type facemask (FM). In the second group 22 patients treated (mean age: 10 years) with MTTBA. The remaining 22 children (mean age: 9 years, 7 months) were observed without treatment for 11 months. RESULTS: Increase in SNA, N-FH ⊥ A, and ANB angles were significantly greater in the treatment groups compared to the control group. However, ANB angle showed a significantly greater increase in the FM group (2.8 ± 0.30°) than in the MTTBA group (2.0 ± 0.18°). The overjet and molar relation increased significantly in both treatment groups, but in the FM group (5.2 ± 0.40 mm) increase in overjet was significantly greater than in the MTTBA group (4.0 ± 0.27 mm). Mesial movement of upper molar and incisor were found to be greater in the FM group compared to the modified TTBA group. CONCLUSIONS: Both appliances were found to be effective in the treatment of Class III malocclusion. Their skeletal and dental effects showed differences due to their design.