Comparison of the change in inferior sclera exposure after maxillary protraction with or without skeletal anchorage.

AIM: The aim of this retrospective study was to evaluate the change in inferior sclera exposition after maxillary protraction with or without skeletal anchorage in patients with maxillary retrognathia. MATERIALS AND METHODS: Fifteen patients (Group 1) who applied maxillary protraction with teeth-supported appliance and fifteen patients who applied maxillary protraction with skeletal anchorage (Group 2) were compared in order to investigate the effect of different maxillary protraction methods on the visibility of sclera. The patients in both groups had dental and skeletal Class III malocclusion with maxillary retrusion (ANB <0; SNA <80), increased vertical growth pattern (SnGoGn> 32) (long face), increased sclera exposure, and no congenital anomalies and dentofacial deformities. Pre- and posttreatment records were used to assess the amount of visible sclera on facial photographs using Adobe Photoshop CS6 program and the change in the movement of maxilla on cephalometric film. The pretreatment and after maxillary protraction values were compared statistically by the Wilcoxon signed-rank test (level of significance, P < 0.05). RESULTS: The amount of inferior sclera exposure to eye height decreased in the right and left eyes of the 30 patients with maxillary protraction. The amount of inferior sclera exposure to eye height of the right and left eyes decreased from 3.59 to 3.5 and from 3.44 to 3.39, respectively, in Group I (P = 0.001 and P < 0.001, respectively). The amount of inferior sclera exposure to eye height of the right and left eyes decreased from 4.17 to 3.93 and from 3.86 to 3.68, respectively, in Group II (P = 0.001 and P < 0.001, respectively). CONCLUSION: There were important results in both of the two methods. Although more improvement was obtained in the skeletal anchorage group, statistically no significant differences were found between the groups.

Surgical difficulties, success, and complication rates of orthodontic miniplate anchorage systems: Experience with 382 miniplates.

PURPOSE: The aim of this study was to evaluate the complications and success rates of the miniplates using both maxilla and mandible for orthodontic anchorage in growing patients. MATERIALS AND METHODS: One hundred and fifty-five consecutive patients (range 8.7-13.8 years) with Class II and III malocclusion without congenital or acquired deformities were included in this study. A total of 382 titanium miniplates were placed by the same surgeon. All miniplates were inserted under local anesthesia. Loading of the miniplates with a force of 200 g with the help of elastics or functional devices were initiated 3 weeks after surgery. RESULTS: The overall success rate of miniplate anchorage in terms of stability was 96.8%. Twenty-one patients reported irritation of the mucosa of the cheeks or lower lip after the surgery in the mandible group. Twelve miniplates needed to be removed and were successfully replaced. CONCLUSION: Skeletal anchorage miniplates is effective for correcting malocclusions. Success depends on proper presurgical patient counseling, minimally invasive surgery, good postsurgical instructions, and orthodontic follow-up.

Evaluation of lip force in patients with unilateral and bilateral cleft lip.

Our aim was to investigate the differences in the dynamics of lip force between a group of participants with repaired cleft lips and a group of patients the same age but without clefts. We evaluated 101 children between the ages of 10 to 15 years (unilateral clefts n=35, bilateral clefts n=15, class I malocclusion n=25, and class III malocclusion n=26). Maximum and minimum forces required to close the lips were evaluated with the Lip De Cum® device (Cosmos Instruments Co Ltd, Tokyo, Japan) for the all groups. We found no significant differences between the maximum and minimum values between boys and girls within the groups, whereas the mean maximum and minimum lip force of the boys was higher than those of the girls in all the groups. This study showed that maximum and minimum lip closing force values were statistically similar in all groups. We conclude, therefore, that patients with bilateral cleft lip have reduced maximum and minimum lip force.

Efficacy of a casein phosphopeptide amorphous calcium phosphate (CPP-ACP) paste in preventing white spot lesions in patients with fixed orthodontic appliances: A prospective clinical trial.

AIM: The aim of this prospective study was to test the efficacy of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) paste applied in-office to prevent white spot lesions (WSL) in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: Study design: this study was designed as a randomised controlled clinical trial. Fifty-seven patients undergoing nonextraction fixed orthodontic treatment were enrolled and divided randomly into two groups (control n = 28, experimental n = 29). The pretreatment plaque, gingival and bleeding indices, and oral hygiene habits were recorded. One group received CPP-ACP paste (GC Tooth Mousse) at each monthly orthodontic follow-up examination; the control group received routine orthodontic treatment. The mean patient age was 16.9 years in the experimental group and 17.1 years in the control group. The periodontal indices, decayed, missing, and filled teeth (DMFT), decayed, missing, and filled surfaces (DMFS), and the WSL prevalence pre- and post-treatment were measured and compared between the groups. STATISTICS: differences between groups in normally distributed data between groups were assessed by the paired-t test, and the Wilcoxon Signed Rank test was used to compare variables that were not normally distributed. RESULTS: There was a lower incidence of WSL in the experimental group compared to the control group. Most of the WSL occurred at the maxillary incisors, mandibular canines and premolars. CONCLUSION: The in-office application of CPP-ACP paste did not prevent WSL development completely; however, it did significantly decrease the number of WSL compared to the control patients.