Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria.

Previous studies have suggested that probiotic supplements in dairy products may affect the oral microbial ecology, but the effect in orthodontic patients has not previously been reported. The aim of the present study was to examine whether short-term consumption of fruit yogurt containing probiotic bifidobacteria would affect the levels of salivary mutans streptococci and lactobacilli in patients with fixed orthodontic appliances. A double-blind, randomized crossover study was performed and 24 healthy adolescents (12-16 years) undergoing orthodontic treatment were followed over four periods. During periods 2 and 4 (2 weeks each), the subjects ingested 200 g fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 (2 x 10(8) colony forming units/g) once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and wash-out periods of 1 and 6 weeks, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits before and after the yogurt consumption periods. Pre- and post-treatment values within each regimen were compared with a two-tailed marginal homogeneity test for categorical data. A statistically significant reduction of salivary mutans streptococci was recorded after probiotic yogurt consumption (P < 0.05), which was in contrast to the control yogurt. No significant alterations of the salivary lactobacilli counts were observed. Short-term daily consumption of fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 may reduce the levels of mutans streptococci in saliva during orthodontic treatment with fixed appliances.

Shear bond strength of brackets bonded to amalgam with different intermediate resins and adhesives.

The aims of this study were to compare, in vitro, the shear bond strength (SBS) of stainless steel orthodontic brackets bonded to silver amalgam with the use of three different intermediate resins and two different adhesives, and to evaluate bond failure mode. Forty-five amalgam specimens were divided into three equal groups. In groups 1 and 2, the brackets were bonded with Unite (3M Unitek) using Reliance Metal Primer (RMP; Reliance Orthodontic Products) and Power Bond OLC (PB OLC; Ortho Organizers Inc.) as intermediate resins, respectively. In group 3, Resinomer and One-Step Plus (OS+; Bisco Inc.) were used. Thirty bovine teeth served as the controls to test bracket bonding to acid-etched enamel with Unite and Resinomer-OS+. After thermocycling from 10 to 50 degrees C 1000 times, all samples were tested for SBS. Bond failure sites were classified using a modified adhesive remnant index (ARI) system. Data were analyzed with one-way analysis of variance, post hoc Tukey multiple comparison and chi-square tests. The results showed that the mean SBS to amalgam surfaces were significantly lower than those to etched bovine enamel (P<0.001). There were no statistically significant differences in mean SBS between the amalgam bonding groups (P>0.05). For the ARI, significant differences were found between the amalgam- and enamel-bonding groups (P<0.001). The mean SBS of stainless steel orthodontic brackets bonded to amalgam surfaces with RMP, PB OLC, OS+ intermediate resins and Unite and Resinomer adhesives was significantly lower than to etched bovine enamel. Bond failure occurred at the amalgam-adhesive interface regardless of the adhesive system and without damage to the amalgam restoration.

Effects of extraction and nonextraction therapy with air-rotor stripping on facial esthetics in postadolescent borderline patients.

INTRODUCTION: A prospective randomized study was designed to compare the skeletal, dental, and soft-tissue profile changes in Class I borderline patients treated with extraction and nonextraction by means of the air-rotor stripping (ARS) technique and to compare the treatment times. METHODS: Twenty-six borderline patients with balanced and orthognathic facial profiles were randomly divided into 2 groups. In the first group, 13 subjects with a mean age of 18.1 +/- 3.7 years and mean maxillary and mandibular crowding of 5.7 +/- 1.5 and 5.9 +/- 1.4 mm, respectively, were treated by removal of 4 premolars with minimum anchorage. In the second group, 13 subjects with a mean age of 17.8 +/- 2.4 years and mean maxillary and mandibular crowding of 5.0 +/- 1.3 and 5.9 +/- 1.3 mm, respectively, were treated with ARS. Lateral cephalometric radiographs and dental models taken before and after treatment were evaluated. RESULTS: The initial skeletal, dental, and profile characteristics of both groups were similar. In the first group, the maxillary and mandibular incisors were slightly retracted, whereas lip positions did not change. In the nonextraction group, maintenance of maxillary incisor position, slight protrusion of the mandibular incisors and the upper and lower lips were observed at the end of treatment. The nasolabial angle decreased significantly. Because of postpubertal growth of the nose and the chin, the lips appeared slightly retrusive after extraction therapy, whereas lip protrusion was compensated in the nonextraction group. The main soft-tissue profile differences between the 2 groups were 1 to 1.5 mm more retruded upper and lower lip positions in the extraction patients, but both groups had well-balanced and desirable facial esthetics with all profile measurements within normal limits. Nonextraction therapy with ARS reduced treatment time by 8 months. CONCLUSIONS: Both extraction and ARS combined with nonextraction therapies are effective treatment alternatives for Class I borderline patients with good facial profile and moderate dental crowding.

Interdisciplinary treatment of an adult patient with old extraction sites.

This case report describes the interdisciplinary treatment of a 31-year-old female patient showing a protrusive profile, maxillary constriction, mandibular crowding, a Class III canine relationship complicated with multiple missing teeth, old atrophic extraction sites, and periodontal defects. The lower dental arch irregularity was eliminated by air-rotor stripping (ARS). The upper extraction site was opened for prosthetic rehabilitation, whereas closure of the lower extraction space was preferred. The narrow alveolar crest of the atrophic bone was augmented with the use of autogenous bone, beta-tricalcium phosphate (Cerasorb), and autogenous platelet-rich plasma. A functional and esthetic occlusion in an improved facial profile was established at the end of orthodontic treatment combined with ARS technique, surgery, and prosthodontics.

Lower incisor retraction with a modified corticotomy.

This case report demonstrates the orthodontic treatment facilitated with a new conservative corticotomy technique to shorten the treatment time during lower incisor retraction. The patient was a 22-year-old woman with protrusive profile, severe anterior crowding, an anterior crossbite, and Class III dental relationship. Orthodontic treatment consisted of the extraction of four first premolars with maximum anchorage. A modified corticotomy technique, in which the lingual vertical and subapical horizontal cuts were eliminated, was combined with orthodontic therapy for the retraction of the lower anterior teeth. Corticotomy-facilitated orthodontics dramatically reduced the treatment time without any adverse effects on the periodontium and the vitality of the teeth. The main advantages of this modified corticotomy technique were the elimination of the lingual cuts and flap, the reduction of surgery time, and minimum discomfort to the patient. At the end of active orthodontic therapy, balanced occlusion and facial esthetics were achieved.

Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis.

BACKGROUND: The aim of this retrospective study was to evaluate changes in patients with Class II Division 1 malocclusions treated with cervical headgear and full fixed orthodontic appliances and without extractions. METHODS: Lateral cephalograms and dental casts of 18 patients were obtained at the beginning and the end of treatment and at the postretention period. Pretreatment records were taken at 11.9 +/- 2.6 years, and the mean treatment time was 2.8 +/- 1.2 years. All patients were asked to use maxillary and mandibular Hawley retainers for 1 year. The average postretention interval was 5.3 years. RESULTS: The assessment of cephalometric findings showed that maxillary growth was restricted; maxillary incisor inclination, overjet, and overbite were decreased; the mandibular incisors were proclined; and a slight mandibular posterior rotation occurred at the end of treatment. At the postretention period, the maxilla remained stable, the mandible moved anteriorly, and the overjet increased slightly (1.25 mm, P < .01). The dental cast changes indicated that both maxillary and mandibular irregularity index values decreased significantly during treatment but increased after 5 years. Mandibular intercanine width decreased 0.47 mm ( P < .01) during the postretention period. CONCLUSIONS: The redirection of maxillary growth remained stable in patients with Class II malocclusions treated with cervical headgear and fixed orthodontic appliances and without extractions, but treatment-induced mandibular rotations tended to return to their original patterns. Various dental changes occurred during the postretention period.

Lower lip sucking habit treated with a lip bumper appliance.

The patient was an 11-year-old girl with a lower lip sucking habit with increased overjet, maxillary generalized spacing, and mandibular incisor irregularity. Hyperactivity of the mentalis muscle and deepening of the labiomental sulcus because of the abnormal sucking habit was observed. Orthodontic treatment was started with a lip bumper appliance to break the lower lip sucking habit and continued with fixed orthodontic mechanotherapy. The lip bumper appliance therapy resulted in the elimination of the lower lip sucking habit, musculus mentalis hyperactivity, and labiomental strain in addition to a gain in arch length, improvement of the lower incisor inclinations, and overjet reduction.

Evaluation of dental arch width and form changes after orthodontic treatment and retention with a new computerized method.

The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained.