Cephalometric evaluation of intrusion of maxillary posterior teeth by miniscrews in the treatment of open bite.

INTRODUCTION: The objective of this research was to investigate the effectiveness of orthodontic miniscrews for skeletal anchorage during anterior open bite treatment using cephalometric radiographs. METHODS: This study sample included 20 patients (mean age, 14.71; standard deviation, 1.77) with an anterior open bite. A total of 250 g of force was applied using elastic chains with anchorage from palatal miniscrew to an occlusal splint covering the posterior maxillary teeth. Cephalograms were obtained at the beginning of the treatment when the appliance was first applied and at the 8-month visit when treatment was completed. Paired t tests were used to identify statistically significant differences between initial and final measurements of skeletal and dental parameters. RESULTS: A decrease of 2.72 ± 1.90° in the SN-GoGn angle and 3.63 ± 1.87 mm in the anterior height (N-Me) parameter in the cephalometric evaluations indicated a significant improvement of vertically increased facial dimensions, with the intrusion of the maxillary posterior teeth (P <0.05). Anterior rotation of the mandible was determined by a 1.76 ± 1.09° increase in the SNB angle and a 1.86 ± 0.90° decrease in the ANB angle (P <0.05). Reductions in the open bite amount by 5.8 ± 0.90 mm, Mx6-SN by 4.00 ± 1.01 mm, and Mx6-PP by 4.01 ± 1.00 mm were indicative of significant intrusion in the maxillary posterior teeth (P <0.05). CONCLUSIONS: The present study confirmed that palatal miniscrew and maxillary occlusal splint caused intrusion of the maxillary posterior teeth, a decrease in the anterior open bite, and mandibular advancement, with anterior rotation after the maxillary posterior intrusion. We concluded that the treatment method in our study was appropriate for patients with Class I and mild Class II malocclusions and open bite anomalies.

Deferasirox in children with transfusion-dependent thalassemia or sickle cell anemia: A large cohort real-life experience from Turkey (REACH-THEM).

OBJECTIVES: To evaluate the long-term efficacy and safety of deferasirox therapy in a large observational cohort of children with transfusion-dependent thalassemia (TDT) and sickle cell anemia (SCA) in Turkey. METHODS: This was a multicenter, prospective cohort study including TDT and SCA patients aged 2-18 years with iron overload (≥100 mL/kg of pRBC or a serum ferritin [SF] level >1000 µg/L) receiving deferasirox. Patients were followed for up to 3 years according to standard practice. RESULTS: A total of 439 patients were evaluated (415 [94.5%] TDT, 143 [32.6%] between 2 and 6 years). Serum ferritin levels consistently and significantly decreased across 3 years of deferasirox therapy from a median of 1775.5 to 1250.5 µg/L (P < 0.001). Serum ferritin decreases were noted in TDT (1804.9 to 1241 µg/L), SCA (1655.5 to 1260 µg/L), and across age groups of 2-6 years (1971.5 to 1499 µg/L), 7-12 years (1688.5 to 1159.8 µg/L), and 13-18 years (1496.5 to 1107 µg/L). Serum ferritin decreases were also noted for all deferasirox dose groups but only significant in patients with doses ≥30 mg/kg/d (n = 120, -579.6 median reduction, P < 0.001). Only 9 (2%) patients had adverse events suspected to be related to deferasirox. Serum creatinine slightly increased but remained within the normal range. CONCLUSIONS: Deferasirox has long-term efficacy and safety in children with TDT and SCA, although higher doses (≥30 mg/kg/d) may be required to achieve iron balance.

Comparison of root resorption after bone-borne and tooth-borne rapid maxillary expansion evaluated with the use of microtomography.

INTRODUCTION: Root resorption was compared between bone-borne and tooth tissue-borne rapid maxillary expansion patients with the use of microtomography. METHODS: The study included 20 patients (ages 11-16 years) requiring fixed orthodontic treatment who underwent extraction of their first premolars after rapid maxillary expansion with the use of modified appliances. One side of the appliance covered the teeth with acrylic, while the other side was fixed to the palatal bone by means of a miniscrew. After 3 months' retention, the appliance was removed and teeth were extracted and examined with the use of microtomography. RESULTS: When the apical, middle, and cervical thirds, as well as the buccal and lingual sides, were compared, the volume loss was significantly higher in the tooth tissue-borne group than in the bone-borne group (P <0.01). The least volume loss occurred on the cervical third lingual surface in the tooth tissue-borne group and on the middle third buccal surface in the bone-borne group. In the former group, least resorption occurred on the cervical third and highest resorption on the buccal side. In the latter group, surfaces showed no significant changes. CONCLUSIONS: More root resorption occurred in the tooth tissue-borne group, mostly in the apical and middle thirds. The amount of resorption on the buccal surface was higher than that on the lingual surface.

Paricalcitol inhibits the Wnt/beta-catenin signaling pathway and ameliorates experimentally induced arthritis

Background/aim: The Wnt/ß-catenin pathway has important biological activities, including the differentiation of cells and joint formations. The aim of our study was to determine the effect of paricalcitol on experimentally induced arthritis. Materials and methods: Type II collagen combined with Freund's adjuvant was applied to induce arthritis in Wistar albino female rats. Paricalcitol (0.3 µg/kg daily) was subcutaneously injected starting 1 day after collagen applications (prophylactic group) or 1 day after the onset of arthritis (therapeutic group), until day 29. Results: The 29th day arthritis scores were lower compared to the 13th day scores in the paricalcitol groups (P < 0.05), while they were higher in the arthritis group (P < 0.05). Marked cartilage-bone destruction and extensive perisynovial inflammation were detected in the arthritis group. Decreased cartilage-bone destruction and perisynovial inflammation in the paws were observed in the paricalcitol groups. The tissue mRNA levels of DKK1, Wnt5a, and axin-2 were higher in the arthritis group than in the control group. In the paricalcitol groups, mRNA expressions were lower than in the arthritis group. Conclusion: The present study shows that the Wnt/ß-catenin signaling pathway is active in arthritis. Moreover, paricalcitol ameliorates arthritis via inhibiting the Wnt/ß-catenin pathway. Paricalcitol and the Wnt/ß-catenin pathway are candidates for research in human rheumatoid arthritis.

Prevalence of Endocrinopathies in Turkish Children With ß-Thalassemia Major: A Single-Center Study.

Present chelation protocols have increased the life quality and survival of the patients with ß-thalassemia major (BTM). However, endocrine complications are still mostly experienced. The aim of this study was to determine the prevalence of endocrine complications in children with BTM, and to study the relationship between serum ferritin levels and complications. Forty-five children (female: 23/male: 22, mean age: 12.39±3.72 y) with BTM were enrolled into the study. Blood samples were taken after an overnight fasting, early in the morning from entire study group. Median (range) serum ferritin of the patients was 1365 ng/mL (362 to 5996 ng/mL). The most prevalent endocrine complications were vitamin D insufficiency (54.5%), short stature (42%), pubertal impairment (25% for each sex), and osteopenia (13%), respectively. Ferritin levels were not correlated with anthropometric or laboratory data. Monitoring of growth, vitamin D status, and endocrine functions are essential to achieve a good quality of life in BTM patients.

Pentraxin-3 Levels in Beta Thalassemia Major and Minor Patients and Its Relationship With Antioxidant Capacity and Total Oxidant Stress.

Thalassemia major (TM) results in hemolytic anemia, an increase in intestinal iron absorption, and occurrence of iron loading due to erythrocyte transfusion; the disease is characterized by oxidative damage in major organs. Oxidative stress leads to vascular endothelial damage and forms the basis for serious cardiovascular diseases. Pentraxin-3 (PTX-3) is one of the markers of vascular endothelial damage that increases in response to the oxidative stress, which can be used as an early diagnostic marker for inflammation. This study's purpose is to define the relation between PTX-3 and the vascular endothelial damage that increases with oxidative stress in thalassemia patients. Our study included 35 TM patients, 30 ß-thalassemia minor patients, and 30 healthy children. As a result of our study, in TM patients, a positive relation was detected between the PTX-3 levels and the total oxidative stress, triglyceride, and very low-density lipoprotein values, whereas a negative relation was detected with the total antioxidant capacity and high-density lipoprotein values. This result shows that as oxidant stress increases, PTX-3 levels also increase; very low-density lipoprotein and triglyceride contribute to the endothelial damage occurring with oxidative stress. As a result, it was concluded that vascular endothelial damage in thalassemia patients can be evaluated through the serum PTX-3 level.

Evaluation of the mandibular volume and correlating variables in patients affected by unilateral and bilateral cleft lip and palate: a cone-beam computed tomography study.

OBJECTIVES: The aims of the present study were to evaluate the mandibular volume in patients affected by unilateral (UCLP) and bilateral cleft lip and palate (BCLP) and to compare the findings with a well-matched normal occlusion sample without cleft. MATERIALS AND METHODS: The study sample consisted of 66 patients divided into UCLP (24 patients; mean age, 14.46 ± 3.24 years), BCLP (17 patients; mean age, 14.28 ± 2.85 years), and control (25 patients; mean age, 14.40 ± 2.81 years) groups. The volume of the mandible including the condyle and the roots of the teeth and craniofacial measurements were performed using cone-beam computed tomography and analyzed using the one-way variance analysis and post hoc Tukey's tests. Regression analyses were used to evaluate the relationships of the measurements and the mandibular volume. RESULTS: Patients affected by UCLP and BCLP had similar craniofacial features (p > 0.05), including decreased SNB, Co-A, Co-Gn, Co-Go, and Go-Gn and increased ANB and SN-MP measurements compared to the control group. Both UCLP and BCLP groups had decreased values of mandibular volume compared to the normal occlusion group, while these differences were found to be statistically insignificant (p > 0.05). Co-Go (Beta = 0.420; p = 0.014) and Co-Gn variables (Beta = 0.708; p = 0.045) were positively correlated with mandibular volume, while SNB (Beta = -0.669; p = 0.044) and SN-MP (Beta = -0.358; p = 0.049) variables were negatively correlated (R (2) = 60.3 and p = 0.000). CONCLUSION: Mandibular volume insignificantly differs in cleft patients (p > 0.05), and the variables of Co-Go, Co-Gn, SNB, and SN-MP significantly correlate with the volume. CLINICAL RELEVANCE: This article investigates mandibular volume in patients affected by UCLP and BCLP that has never been investigated in the literature. The present study showed that both UCLP and BCLP groups had insignificantly decreased values of mandibular volume compared to the normal occlusion group.

Effects of different pre-treatment methods on the shear bond strength of orthodontic brackets to demineralized enamel.

OBJECTIVE: To compare the effects of different treatment methods used for the enamel damage, on the shear bond strength (SBS) and fracture mode of orthodontic brackets. MATERIALS AND METHODS: Freshly-extracted 140 premolars were randomly allocated to seven groups: Group I was considered as the control of other groups. The remaining groups were exposed to demineralization. In group II, brackets were directly bonded to the demineralized enamel surface. CPP-ACP paste (GC Tooth Mousse), fluoride varnish (Bifluorid 12), microabrasion with a mixture prepared with 18% hydrochloric acid and fine pumice powder, microabrasion with an agent (Opalustre) and resin infiltrant (Icon®) were applied in Groups III, IV, V, VI and VII, respectively. The specimens were tested for SBS and bond failures were scored according to the Adhesive Remnant Index (ARI). Analysis of variance and Tukey tests were used to compare the SBS of the groups. ARI scores were compared with G-test. The statistical significance was set at p < 0.05 level. RESULTS: Statistically significant differences were found among seven groups (F = 191.697; p < 0.001). The SBSs of groups I (mean = 18.8 ± 2.0 MPa) and VII (mean = 19.1 ± 1.4 MPa) were significantly higher than the other groups. No statistically significant difference was found between groups IV (mean = 11.5 ± 1.2 MPa) and V (mean = 12.6 ± 1.5 MPa). The differences in ARI scores of the groups were statistically significant (p < 0.01). CONCLUSIONS: All demineralization treatment methods improve bonding to demineralized enamel. Resin infiltrant application after demineralization showed similar bond strength values as intact enamel.

Selenium, copper, zinc, iron levels and mortality in patients with sepsis and systemic inflammatory response syndrome in Western Black Sea Region, Turkey.

OBJECTIVE: To evaluate the changing levels of selenium, copper, zinc and iron in patients with sepsis and systemic inflammatory response syndrome and their influence on mortality. METHODS: The prospective study was conducted at a tertiary care university hospital in Zonguldak city in the western Black Sea region of Turkey from January 2012 to December 2013, and comprised patients with sepsis and systemic inflammatory response syndrome. Blood samples were taken on 1st, 3rd, 5th and 7th days to measure serum selenium, copper, zinc and iron levels. Patients' demographic data, presence of additional diseases and mortality were recorded. RESULTS: Of the 57 patients, 28(49.1%) were female and 29(50.9%) were male, with an overall mean age of 60.3±19.4 years, mean height of 166.1±11.4cm, mean weight of 76.5±17.5kg. Copper and zinc levels were in the normal range, while selenium and iron levels were lower than the limit values at all measuring periods. There was no significant difference between first and other days in accordance with element levels (p>0.05). Baseline copper levels in patients with malignancy were lower than patients without malignancy (p< 0.05). In hypertensive patients, baseline copper levels were higher and 7th day levels were lower than non-hypertensive (p< 0.05). Baseline selenium levels of those who died were lower than the other patients (p< 0.05). Selenium and iron levels were decreased in patients with sepsis-systemic inflammatory response syndrome and copper levels were lower in patients with malignancy, hypertension and chronic obstructive pulmonary disease (p< 0.05). There was no change in zinc levels of the patients. CONCLUSIONS: Reduced basal selenium levels of patients with sepsis and systemic inflammatory response syndrome were associated with mortality.

Impact of trastuzumab on wound healing in experimental glaucoma surgery.

BACKGROUND: To investigate the effects of subconjunctivally administered trastuzumab on wound healing in experimental glaucoma filtration surgery. DESIGN: Comparative, experimental study. SAMPLES: Twenty eight eyes. METHODS: Twenty-eight male New Zealand white rabbits were randomly assigned to four groups, each including seven rabbits: The rabbits in the control group were not operated on and did not receive any treatment. The rabbits in the sham group underwent trabeculectomy and had one drop of saline instilled four times a day for 14 days. The rabbits in the mitomycin-C group underwent trabeculectomy, and a sponge soaked in 0.4 mg/mL mitomycin-C was applied intraoperatively to the scleral surgical site for 3 min. The rabbits in the trastuzumab group underwent trabeculectomy and were injected subconjunctivally once with 1.2 mg/0.1 mL of the drug. On day 14 of the experiment, the operated and control eyes were enucleated and immunohistochemically analyzed. MAIN OUTCOME MEASURES: Mean values of fibroblast, mononuclear cell and immunostaining intensities of the transforming growth factor-ß, fibroblast growth factor-ß, and platelet derived growth factor. RESULTS: The mean cell numbers and immunostaining intensities in the sham group were higher than those of the control group (P < 0.01). The mean cell numbers and immunostaining intensities in the mitomycin-C group and trastuzumab group were statistically significantly lower than those of the sham group (P < 0.01) while mean cell numbers and immunostaining intensities in the mitomycin-C group and trastuzumab group were similar (P > 0.05). CONCLUSION: Subconjunctival trastuzumab injection effectively suppressed subconjunctival scarring after experimental glaucoma filtration surgery.

Incidence of white spot lesions among patients treated with self- and conventional ligation systems.

OBJECTIVES: The aim of this study was to investigate the incidence of white spot lesions (WSLs) and its relationship with various patient and treatment variables, in patients treated with self-ligation and conventional ligation orthodontic bracket systems. METHODS: Two-hundred randomly selected patient records (136 female, 64 male) for self-ligation and (108 female, 92 male) for conventional ligation groups were examined to determine WSL development. In the self-ligation group, Damon 3MX (Ormco, Glendora, Calif) brackets had been used, and in the conventional ligation group, Equilibrium 2 (Dentaurum, Phorzeim, Germany) had been used. Labial surfaces of 24 teeth in the pre- and post-treatment photographic records were scored using the WSL index. RESULTS: The prevalence of patients who developed at least 1 WSL before treatment was 19%, whereas after treatment, it was 49% in the self-ligation and 54% in the conventional ligation groups. Before treatment, the patients had only mild WSL, but after treatment, severe WSL and cavitation were observed in both groups. Bracket type, age, and hygiene care were significantly associated with new WSL development (P = 0.008, P = 0.004, P = 0.013, respectively). CONCLUSION: Bracket type and more importantly, the hygiene care therapy provided appeared to influence the development of new WSLs. Ligation can promote plaque accumulation and thereby new WSL development in conventional bracket systems. CLINICAL RELEVANCE: This article investigates the incidence of WSLs in patients treated with self-ligation and conventional ligation. The present study showed that incidence of WSL less in the self-ligation than in the conventional ligation but hygiene care was mostly important factor in developed WSL.

Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion.

INTRODUCTION: The aims of this study were to quantitatively evaluate the changes in arch widths and buccolingual inclinations of the posterior teeth after asymmetric rapid maxillary expansion (ARME) and to compare the measurements between the crossbite and the noncrossbite sides with cone-beam computed tomography (CBCT). METHODS: From our clinic archives, we selected the CBCT records of 30 patients with unilateral skeletal crossbite (13 boys, 14.2 ± 1.3 years old; 17 girls, 13.8 ± 1.3 years old) who underwent ARME treatment. A modified acrylic bonded rapid maxillary expansion appliance including an occlusal locking mechanism was used in all patients. CBCT records had been taken before ARME treatment and after a 3-month retention period. Fourteen angular and 80 linear measurements were taken for the maxilla and the mandible. Frontally clipped CBCT images were used for the evaluation. Paired sample and independent sample t tests were used for statistical comparisons. RESULTS: Comparisons of the before-treatment and after-retention measurements showed that the arch widths and buccolingual inclinations of the posterior teeth increased significantly on the crossbite side of the maxilla and on the noncrossbite side of the mandible (P <0.05). Comparison of the 2 sides showed statistically significant differences in both the maxilla and the mandible (P <0.05). CONCLUSIONS: After ARME treatment, the crossbite side of the maxilla and the noncrossbite side of the mandible were more affected than were the opposite sides.

Effects of Different Demineralization-Inhibiting Methods on the Shear Bond Strength of Glass-Ceramics.

PURPOSE: This in vitro study was undertaken to evaluate the effects of different demineralization-inhibiting methods on the shear bond strength (SBS) of glass-ceramics. MATERIALS AND METHODS: Ninety extracted intact human mandibular lateral insicors were randomly divided into six equal groups. Group C was left untreated, while enamel subsurface demineralization was induced in the other groups. In group D, porcelain discs (3 mm in diameter) were cemented to demineralized enamel by using total-etch photopolymerizing luting composite resin without pretreatment. Demineralized specimens in groups F, CA, M, and I were pretreated with fluoride gel, CPP-ACP paste, microabrasion, and resin infiltration, respectively, and then porcelain discs were cemented. SBS (MPa) was calculated from the failure load (N) per bonded area (mm(2)). Fracture types were examined by optical microscopy (40× magnification). Data were analyzed with ANOVA, Tukey's test, and G-test. RESULTS: ANOVA revealed significant intergroup differences (p < 0.01). No significant differences in SBS (MPa) were found between groups C (19.48 ± 2.0) and I (20.02 ± 1.6). Lower SBS values were recorded in groups D (7.93 ± 0.8), F (12.51 ± 1.5), CA (17.08 ± 1.3), and M (14.84 ± 1.4). Mixed and cohesive failures were the most prevalent in groups M and I, respectively. CONCLUSION: Resin infiltration enhanced the SBS of porcelain discs bonded to demineralized enamel when compared with the other demineralization-inhibiting methods. CLINICAL RELEVANCE: Resin infiltration could be useful to enhance adhesion of glass-ceramics to teeth with white spot lesions.

Frequency of hematological findings associated with severe plasma vitamin B12 deficiency in infants and adolescents.

BACKGROUND: The aim of this study was to determine the hematological status of severe vitamin B12 deficiency in infants and adolescents. METHODS: This study involved 95 infants and 117 adolescents with severe plasma vitamin B12 deficiency (< 120 pg/ mL) and normal plasma folate and ferritin. Infants were aged between one and 24 months. Adolescents were aged between 11 and 17 years. RESULTS: Macrocytic anemia was associated with nine (9.5%) out of 95 infants with severe vitamin B12 deficiency. Neutropenia was found in 16 (16.8%) out of 95 infants with severe vitamin B12 deficiency. Thrombocytopenia was not found in 95 infants with severe vitamin B12 deficiency. Macrocytic anemia was found in two (1.7%) out of 117 adolescents with a severe vitamin B12 deficiency. Neutropenia was associated in one (0.8%) out of 117 adolescents with severe vitamin B12 deficiency. Thrombocytopenia was not found in 117 adolescents with severe vitamin B12 deficiency. CONCLUSIONS: Low clinical or hematological findings for B12 deficiency in infants and adolescents living in regions at risk, such as those with low consumption of meat and other animal products warrant the measurement of vitamin B12 level.

Rabbit antithymocyte globulin treatment in childhood acquired severe aplastic anemia.

Acquired severe aplastic anemia (SAA) is a life threatening bone marrow failure characterized by pancytopenia and hypocellular bone marrow. Matched sibling donor is not available for majority of the patients and many children receive immunosuppressive therapy (IST). Although horse antithymocyte globuline (ATG) is the preferred option, our patients received rabbit ATG; since horse ATG is not available in Turkey. We reviewed the medical records of children with SAA who were treated with rabbit ATG, cyclosporine, and granulocyte colony stimulating factor (GCSF) between 2006 and 2012. Fifteen children with SAA aged between 1.5 and 17 years received rabbit ATG as first line treatment. Only two of them showed partial response and the others did not give any response at 3rd, 6th, and 12th months after the first course of IST. The second course of ATG was given to 8 of the patients; Rabbit ATG at the same dosage was used for 3 of them, and others were given horse ATG. None of the patients responded to the second course of ATG. Invasive fungal infection (IFI) which was seen in 80% of the patients was the most significant problem. Overall survival rate was 60%. The median time between the diagnosis and initiation of IST was 57 (range; 29-144) days. This delay might be significantly contributed to unresponsiveness. In our series, the use of rabbit ATG was not effective for these patients as first line treatment modality. Response rate was very low and the incidence of fungal infections was very high in the SAA patients who received rabbit ATG.

Responsiveness to parenteral iron therapy in children with oral iron-refractory iron-deficiency anemia.

UNLABELLED: Intravenous (IV) ferric iron (Fe)-carbohydrate complexes are used for treating Fe deficiency in children with iron-refractory iron-deficiency anemia (IRIDA). An optimal treatment has yet to be determined. There are relatively little publications on the responsiveness to IV iron therapy in children with IRIDA. PATIENTS AND METHOD: This study analyzed responses to IV iron sucrose therapy given to 11 children, ranging in age from 2 to 13 years (mean 4.8 years), with iron-deficiency anemia who were unresponsive to oral iron therapy. RESULTS: The hemoglobin and ferritin values (mean) of the 11 children with IRIDA were 7.7 g/dL and 4.8 ng/mL at diagnosis. Both hemoglobin and ferritin levels increased to 9.5 g/dL, and 24 ng/mL, respectively, at 6 weeks after the first therapy. Although the level of hemoglobin was steady at 6 months after the first, and 6 weeks after the second therapy, the ferritin levels continued to increase up to 30 ng/mL and 47 ng/mL at 6 months after the first and 6 weeks after the second therapy, respectively. CONCLUSION: We recommend that IRIDA should be considered in patients presenting with iron-deficiency anemia of unknown cause that is unresponsive to oral iron therapy. Our results suggest that IV iron therapy should be administered only once in cases of IRIDA. Continued administration of IV iron would be of no benefit to increase hemoglobin levels. On the contrary, ferritin levels may continue to increase resulting in untoward effects of hyperferritinemia.

Can demineralized enamel surfaces be bonded safely?

OBJECTIVE: To evaluate and compare the effects of enamel demineralization, microabrasion therapy and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on the shear bond strength (SBS) of orthodontic brackets bonded to enamel surfaces and enamel color. MATERIALS AND METHODS: Eighty freshly extracted human maxillary premolar teeth were allocated to one of the four groups. Brackets were bonded directly to non-demineralized enamel surfaces in Group I (control group), directly to the demineralized enamel surfaces in Group II, to demineralized enamel surfaces after CPP-ACP application in Group III and to demineralized enamel surfaces after microabrasion therapy in Group IV. The samples were stored in water for 24 h at 37°C and then underwent thermocycling. The SBS in megapascals (MPa) was determined by a shear test with 0.5 mm/min crosshead speed and failure types were classified with modified adhesive remnant index scores. The data were analyzed with one-way analyses of variance (ANOVA), Tukey and chi-square tests at the α = 0.05 level. RESULTS: Significant differences were found among the four groups (F = 21.57, p < 0.01). No significant difference was found between Group I and III (17.12 ± 2.84 and 15.08 ± 3.42 MPa, respectively) or between Group III and IV (12.82 ± 2.64 MPa). The lowest SBS value was determined in Group II (5.88 ± 2.12 MPa). Enamel demineralization, microabrasion therapy and CPP-ACP application affected enamel color significantly. CONCLUSION: CPP-ACP application and microabrasion therapy are able to increase the decreased SBS of orthodontic brackets because of enamel demineralization.