Delayed multidisciplinary management of an extrusively luxated maxillary central incisor.

This paper reports a case of delayed (1 month after the injury) multidisciplinary management of an extrusively luxated permanent central incisor. The extruded tooth was diagnosed as necrotic without coronal discoloration. Upon completion of root canal treatment, the tooth was repositioned orthodontically and finally restored for esthetic purposes with a composite resin. The tooth was diagnosed as normal in the 1 year check-up.

Alveolar distraction osteogenesis before placement of dental implants.

Distraction osteogenesis of the edentulous alveolar ridges may be considered an alternative to many other augmentation oriented surgical techniques. It is now being widely used for treating severe forms of alveolar ridge atrophy, especially before the placement of dental implants. Leibinger Endosseous Alveolar Distraction System (LEAD; Stryker Leibinger, Kalamazoo, MI) is an intraosseous distraction device used for edentulous ridges. In this study, the healing was uneventful in all 5 cases that were treated except 1, in which the vitality of the distraction segment could not be maintained. No complications related to the prosthodontic restoration were observed.

Adhesive thickness effects on the bond strength of a light-cured resin-modified glass ionomer cement.

These in vitro studies investigated the effect of adhesive thickness on the tensile and shear bond strength of a light-cured, resin-modified glass-ionomer cement (FO). A light-cured conventional composite resin (CO) was used as the control material. Mesh-based metal brackets were bonded to extracted human premolars using FO and CO. The adhesive thickness was controlled by a special device and 0, 0.25, and 0.5 mm thicknesses were tested for both bonding agents. All bonded specimens were stored in distilled water at 37 degrees C for 48 hours and thermocycled between 5 degrees C and 55 degrees C for 200 cycles before testing. Analysis of variance showed that bond strength was significantly affected by the adhesive thickness (P < .001) and type of adhesive (P = .001). There were statistically significant differences between the mean bond strengths of the groups at the P < .05 level of significance. For all adhesive thicknesses, CO had higher bond strength values than those of FO in both test modes. The bond strength values were also analyzed using a Weibull analysis, which showed the most favorable adhesive thickness, and the 5% and 90% probabilities of failures was 0.25 mm in the FO groups. Bracket-adhesive interface failure was predominant for all groups in tensile testing, but enamel-adhesive interface failures increased with increased adhesive thickness in shear testing for the FO. This study suggests that adhesive thickness under a bracket could be particularly important when using a FO in direct bonding.

Patient discomfort: a comparison between lingual and labial fixed appliances.

This study was undertaken to determine the discomfort differences between patients treated with lingual and labial orthodontic brackets. The study sample consisted of two groups of 30 adolescent patients. Group LI was treated with lingual appliances, and group LA was treated with labial appliances. After three months of treatment, each patient completed a seven-part survey with 12 questions, evaluating intraoral discomfort; tongue-lip-cheek soreness; eating, speech, and oral care difficulties; adaptation period; and general problems. In the LI group, tongue soreness and speech difficulties were significantly greater (P < .001) than in the LA group, whereas cheek (P < .001) and lip (P < .05) soreness were greater in group LA than in group LI. No statistically significant differences were found between the groups in reported intraoral discomfort and eating and oral care difficulties, but adhering of food particles was greater (P < .05) in the LI group. In this study, speech difficulty was the most severe problem for the lingual group. All patients in the LA group and 76.7% of the patients in the LI group reported that the problem was solved at the end of 30 days. However, 23.3% of the LI group claimed that at the end of three months they were still having a problem while speaking. Even the maximum adaptation period was longer in the LI group (90 days) than in the LA group (30 days). General evaluation of this study suggested that after the initial discomfort period, only a small percentage (10%) of lingual orthodontic patients reported some hindrance because of their treatment.

Soft tissue profile in Anatolian Turkish adults: Part I. Evaluation of horizontal lip position using different soft tissue analyses.

This study investigated cephalometrically the horizontal lip position of Anatolian Turkish adults using the soft tissue analyses of Steiner, Ricketts, Burstone, Sushner, Holdaway, and Merrifield. Ninety-six adults (55 females, mean age, 21.63 years; 41 males, mean age, 22.45 years) with Angle Class I occlusal relationships were selected from the dentistry students at the University of Istanbul and called the dentally normal group. Their lateral cephalometric radiographs were analyzed, and 44 subjects (21 females, mean age, 21.35 years; 23 males, mean age, 21.41 years) with normal anteroposterior (ANB angle, 2 degrees +/- 2 degrees ) and vertical (SN-MP angle, 32 degrees +/- 5 degrees ) skeletal relationships were selected from the dentally normal group and called the dentally and skeletally normal group. Ten linear and 6 angular measurements were analyzed on each radiograph, and the significance of the differences between the groups was studied by means of the Mann-Whitney U test. The results of this study indicate that in Anatolian Turkish adults (1) the upper and lower lips were retrusive according to the norms of Steiner and Ricketts; (2) both the upper and lower lip values were within the normal range according to Burstone's B line; (3) the upper lip was protrusive and the lower lip was retrusive compared with the norms developed by Sushner for a black population; (4) the value for the lower lip was similar to the standard proposed by Holdaway, while the values for the nasal prominence and the H angle were greater than Holdaway's norms; and (5) the Z angle was smaller than the norm established by Merrifield.

Soft tissue profile in Anatolian Turkish adults: Part II. Comparison of different soft tissue analyses in the evaluation of beauty.

This study examined the soft tissue analyses of Steiner, Ricketts, Burstone, Sushner, Holdaway, and Merrifield to evaluate orthodontists' perceptions of Anatolian Turkish adults' beauty. Forty-four subjects (21 females, mean age, 21.35 years; 23 males, mean age, 21.41 years) with Angle Class I occlusal relationship, and normal anteroposterior (ANB angle, 2 degrees +/- 2 degrees ) and vertical (SN-MP angle, 32 degrees +/- 5 degrees ) skeletal relationships were selected from the dental students at the University of Istanbul. The material consisted of lateral cephalometric radiographs and facial-profile slides of these subjects. Ten linear and 6 angular measurements were analyzed on each radiograph, and the facial profiles were judged as poor, fair, good, or excellent by 6 raters. After the scoring, 34 subjects (16 females and 18 males) were placed in the unattractive group, and 10 subjects (5 females and 5 males) were placed in the attractive group. The significance of the differences between the groups was studied by means of the Mann-Whitney U test. The results demonstrated that persons having a high mandibular plane angle, a small nose, protrusive lips, and a retrusive profile were selected as attractive. Among the 7 esthetic lines used to evaluate the soft tissue profile, only Ricketts' norms for upper and lower lips corresponded to the values we found for attractive profiles.