Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions.

OBJECTIVES: Purpose of this study is to evaluate the effects of Forsus Fatigue-Resistant Device (FRD) EZ and Andresen activator in terms of skeletal, dental, and soft tissue changes in actively growing patients presenting with class II, division 1 malocclusion. MATERIALS AND METHODS: Study sample included 60 subjects. Inclusion criteria were as follows: class II division 1 malocclusion, retrognathic mandible, normal or low-angle growth pattern, and peak growth period. The first study group consisted of 20 patients who were treated with Forsus appliance, and the second group of 20 patients received treatment with Andresen activator. Control group received no treatment. RESULTS: Our results revealed that both appliances enhanced mandibular growth, helped increase the length of the mandible, and had a restraining growth effect on the maxilla. Anterior face height increased in both of treatment groups, whereas posterior face height had a significant increase in the activator group only. More mandibular incisors protrusion and intrusion were seen with the Forsus appliance. Moreover, occlusal plane and palatal plane rotated significantly in clockwise direction as a result of dentoalveolar changes only in the Forsus group. CONCLUSIONS: As well as the Forsus appliances corrected class II discrepancies mostly through dentoalveolar changes as compared to the activator group, both appliances proved effective in the treatment of growing individuals having class II malocclusions with mandibular retrognathia. CLINICAL RELEVANCE: By this investigation, two treatment methods, which are currently used in clinical practice, will be evaluated, and the results will be useful for clinicians.

Comparison of the effects of fixed and removable functional appliances on the skeletal and dentoalveolar structures.

OBJECTIVE: To compare and analyse the effects of activator and Forsus FRD EZ appliances in the treatment of skeletal Class II division I malocclusion. METHODS: Lateral cephalograms and hand-wrist radiographs were collected from 24 Class II division I growing patients (14 females, 10 males). The patients were randomly divided into two equal groups and either treated with an activator appliance (Mean age 12.67 +/- 1.24 years) or with a Forsus FRD EZ appliance (Mean age 12.31 +/- 1.09 years). Pretreatment and posttreatment cephalometric radiographs were obtained, traced, superimposed and data analysed using paired t-tests and the Wilcoxon signed rank test. RESULTS: The results demonstrated that the Forsus FRD EZ effectively corrected the Class II malocclusion, but the changes were mainly dentoalveolar. The Forsus FRD EZ appliance induced a clockwise rotation of the occlusal plane without significant alteration in the vertical facial dimension. Skeletally, maxillary growth was restricted and pogonion moved forward which improved the profile. CONCLUSION: The Forsus FRD EZ appliance may be an effective dentoalveolar treatment method to manage a skeletal imbalance and improve the profile in growing patients.

Treatment of an adolescent with total ankyloglossia.

This is a report about the orthodontic treatment of a 13-year, 10-month-old boy with total ankyloglossia combined with a Class III occlusion. The patient's tongue was fixed to the floor of his mouth and could not be elevated at all. He had a maxillary deficiency and a mandibular protrusion with a negative overjet. However, he was able to retrude his mandible to an edge-to-edge position. Before orthodontic treatment, the ankyloglossia was surgically rectified. Orthodontic treatment was initiated to improve the patient's occlusion and facial appearance by correcting his retruded maxilla by means of a face mask, fixed appliances, and Class III elastics. This led to a functional occlusion and an acceptable facial appearance.

Noncompliance therapy: Veltri appliance.

AIM: To achieve intraoral molar distalization without any extraoral appliance or patient cooperation. METHODS: The intraoral distalization technique was performed on a female 12 years 8 months of age with cooperation deficiency, and the positive results are presented. The patient initially accepted the headgear planned at the beginning of treatment, but she did not wear it long enough. We therefore abandoned the use of extraoral appliances and employed intraoral distalization instead. We preferred to use a Nance button Veltri appliance we could create in our clinic. Once the patient had accepted our new treatment plan, we completed the distalization process in about 2 months. After a 2-month retention period, we completed treatment with a fixed Roth edgewise appliance and maximum anchorage in the maxilla for approximately 18 months. RESULTS: Following treatment, a Class II Division I dental relationship became a Class I relationship in both the canine and molar regions, and a functional occlusal relationship and esthetic facial appearance were obtained. CONCLUSION: This appliance can be used when patient cooperation is compromised.

One-year follow-up of the effect of fixed orthodontic treatment on colonization by oral Candida.

The aim of this study was to assess quantitative and qualitative alterations in the carrier rate of Candida spp. in south-eastern Turkey among adolescents, and to investigate the effect of fixed orthodontic appliances on the Candida count in a 1-year follow-up study. In the first phase of the study, the oral Candida carriage rate of 72 patients was evaluated. Samples were collected from the dorsal surface of the tongue, the mid-palate and saliva. In the second phase of the study, 42 patients who were determined to be carriers of oral Candida were treated with fixed orthodontic appliances, and from these patients a second set of samples were collected from the saliva and the orthodontic brace surfaces of eight teeth adjacent to the enamel surfaces. The saliva samples were collected before and during orthodontic treatment at 1st, 6th and 12th month, and samples from the braces were collected during the 1st, 6th and 12th month of treatment. Forty-two of the 72 patients (58.5%) were oral Candida carriers. The distribution of Candida spp. in these patients was as follows: (i) Candida albicans was identified in 31 patients (73.8%), (ii) C. tropicalis, C. krusei and C. kefyr were found in three patients each (7.14%) and (iii) C. parapsilosis occurred in two patients (4.76%). During orthodontic treatment, the micro-organism count increased both in the saliva and on tooth surfaces. The results indicate that the prevalence of oral Candida spp. is high in young adults in south-eastern Turkey and that the Candida counts increase when braces are involved.

Comparision of dental arch widths in different types of malocclusions.

AIMS: To compare dental arch and alveolar widths of patients with Class III and Class II division 1 malocclusions and those with Class I ideal occlusion. METHODS: Ninety patients were classified in 3 groups of 30 (15 male and 15 female) according to molar relationship. No subjects had received orthodontic treatment, and in all patients, the primary teeth had completely exfoliated. Dental casts of the 90 subjects were made and photographed with a digital camera on a tripod. Dental cast measurements were taken with a dial caliper to the nearest 0.01 mm. All measurements of all subjects were carried out again 2 weeks later to evaluate the measurement error. RESULTS: Analyses of 1-way analysis of variance demonstrated that (1) there were statistical differences in most of the measurements between the Class I and Class III groups (P>.05) and (2) the Class II division 1 group had differences from other groups (P<.05). This result suggests that transverse discrepancy in Class II division 1 and Class III patients may originate from the maxillary posterior teeth. CONCLUSION: Maxillary intermolar widths are significantly greatest in Class III, Class I, and Class II division 1 groups, respectively.

Longitudinal changes in dental arches from mixed to permanent dentition in a Turkish population.

INTRODUCTION: Orthodontists can benefit from understanding occlusal changes during every stage of human development. The growth and development period is influenced by environmental factors, nutrition, and ethnic variations; systemic health and individual variations can also occur. Our aim in this study was to investigate the longitudinal changes in dental arch dimensions during the transition from mixed dentition (T1) to permanent dentition (T2) in children living in Turkey. METHODS: Sixty-five patients (36 girls, 29 boys) with complete records from the mixed dentition to the early permanent dentition stages were included in this study (total, 130 dental casts). All casts (T1 and T2) had been prepared in centric relation by wax bites, and 14 parameters were measured on these casts. RESULTS: The initial parameters in this Turkish population showed sexual dimorphism; however, during the observation period (T2-T1), there was no sexual dimorphism in arch dimension changes. There were significant changes in arch width parameters (especially in girls), overjet, and overbite in Turkish children between the midmixed and the permanent dentitions. CONCLUSIONS: These results should be useful in planning orthodontic treatment for patients in the mixed and early permanent dentition.

Effects of estrogen deficiency on tooth movement after force application: an experimental study in ovariectomized rats.

OBJECTIVE: The aim of this study was to investigate the effects of estrogen deficiency on tooth movement in ovariectomized rats. MATERIAL AND METHODS: Forty-two adult female Sprague-Dawley rats were assigned at random to one of the following groups: test group (n=20), ovariectomized rats (or estrogen-deficient rats); control group (n=22), non-ovariectomized rats. Two months after ovariectomy, expansion springs exerting 10 g of force were inserted between the upper central incisors in both groups. The amount of movement was measured daily until tooth movement began and then at intervals of 3 days. The rats were sacrificed 18 days after applying the expansion spring and histomorphometric analysis was performed along the left upper central incisor root towards the apex of the alveolar bone. RESULTS: The amount and speed of movement was observed to be greater in ovariectomized rats. On histomorphometric analysis, osteoblast and osteocyte counts on the pressure side were higher in the non-ovariectomized group than in the ovariectomized group (p<0.001). In contrast, the osteoclast count was significantly higher (p<0.01) in the ovariectomized group than in the non-ovariectomized group. The osteoblast and osteocyte counts were significantly higher (p<0.001) on tension side in the non-ovariectomized group than in the ovariectomized group. CONCLUSION: Estrogen deficiency increased orthodontic tooth movements but counts of osteoblasts, which are responsible for new bone formation, were lower in regions of tension and of pressure.

Etching enamel for orthodontics with an erbium, chromium:yttrium-scandium-gallium-garnet laser system.

OBJECTIVE: To test the shear bond strength, surface characteristics, and fracture mode of brackets that are bonded to enamel etched with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser operated at different power outputs: 0.5 W, 1 W, and 2 W. MATERIALS AND METHODS: Human premolars that had been extracted for orthodontic purposes were used. Enamel was etched with an Er,Cr:YSGG laser system operated at one of three power outputs or with orthophosphoric acid. RESULTS: The shear bond strength associated with the 0.5-W laser irradiation was significantly less than the strengths obtained with the other irradiations. Both the 1-W and 2-W laser irradiations were capable of etching enamel in the same manner. This finding was confirmed by scanning electron microscopy examination. The evaluation of adhesive-remnant-index scores demonstrated no statistically significant difference in bond failure site among the groups, except for the 0.5-W laser-etched group. Generally, more adhesive was left on the enamel surface with laser irradiation than with acid etching. CONCLUSION: The mean shear bond strength and enamel surface etching obtained with an Er,Cr: YSGG laser (operated at 1 W or 2 W for 15 seconds) is comparable to that obtained with acid etching.

Interleukine-1beta and tumor necrosis factor-alpha levels in the human gingival sulcus during orthodontic treatment.

OBJECTIVE: To test whether interleukine 1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) levels differ from each other in different treatment levels. MATERIALS AND METHODS: Eighteen patients, nine female and nine male (aged 16-19 years; mean 17.4 +/- 1.8 years), participated in this study. Each subject underwent a session on professional oral hygiene and received oral hygiene instructions. Two months later, a fixed orthodontic appliance was placed. The patients were seen at baseline, at days 7 and 21 and at the 3rd and 6th month as the leveling of the teeth occurred. Records of the baseline scores for the distalization forces were taken at the 6th month. Days 7 and 21 after 6 months of treatment were also recorded. RESULTS: There were increases in the volume of gingival crevicular fluid (GCF) and in the concentrations of IL-1beta and TNF-alpha. CONCLUSIONS: Leveling and distalization of the teeth evoke increases in both the IL-1 and TNF-alpha levels that can be detected in GCF.

Interleukins 2, 6, and 8 levels in human gingival sulcus during orthodontic treatment.

INTRODUCTION: The aims of this study were to determine levels of interleukins 2, 6, and 8 during tooth movement, and test whether they differ from each other with leveling and distalization forces used in various treatment stages of standard orthodontic therapy. METHODS: Fifteen patients (9 female, 6 male; ages, 15-19 years; mean age, 16.7 +/- 2.3 years) participated in this study. Each underwent a session of professional oral hygiene and received oral hygiene instructions. Two months later, a fixed orthodontic appliance was placed. The patients were seen at baseline, at days 7 and 21, and as the teeth were leveled. Records of the baseline scores for the distalization forces were taken at the sixth month. Scores of days 7 and 21 after 6 months of the distalization treatment were also recorded. RESULTS: Increases were seen in the volume of gingival crevicular fluid and the concentrations of interleukins 2, 6, and 8. CONCLUSIONS: Leveling and distalization of the teeth evoke increases in interleukins 2, 6, and 8 levels in the periodontal tissues that can be detected in gingival crevicular fluid.

Intermaxillary Bolton tooth size discrepancies among different malocclusion groups.

The orthodontic "finishing" phase is recognized for the many details necessary to accomplish an excellent result. A high percentage of finishing-phase difficulties arise because of tooth size imbalances that could have been discovered and considered during the initial diagnosis and treatment planning. The aim of our study was to determine whether there is a prevalent tendency for intermaxillary tooth size discrepancies among different malocclusion groups. This study involved 60 subjects who served as the normal occlusion group and 300 patients divided into five malocclusion groups (ie, Class I, Class II, Class II division 1, Class II division 2, and Class III). Tooth size measurements were performed on the models of the normal occlusion group and the pretreatment models of the patients. The tooth size ratios and the one-way analysis of variance test showed no sexual dimorphism for these ratios in each of five groups, so the sexes were combined for each group. Then, these ratios were compared among different malocclusion groups. The results showed no significant difference between subcategories of malocclusion, so these groups were combined as Class I, Class II, and Class III. No significant difference was found for all the ratios between the groups.