Retrospective comparison of two different miniscrew-supported molar distalization methods applied in the buccal and palatal regions.

BACKGROUND: To compare dentofacial effects of distalization with miniscrew-supported pendulum and infrazygomatic crest miniscrews. METHODS: The study included 36 patients whose lateral cephalometric radiographs were obtained before (T0) and after (T1) distalization. Patients were divided into two groups according to the treatment methods: 1) distalization with miniscrew-supported pendulum (MSP) (n = 19; 14 girls and 5 boys; mean age 16.9 ± 1.46 years) and 2) distalization with infrazygomatic crest (IZC) miniscrews (n = 17; 8 girls and 9 boys; mean age 17.0 ± 1.68 years). Dental, skeletal and soft tissue measurements were performed on lateral cephalograms taken from individuals. RESULTS: A significant molar distalization was achieved both in the MSP group (3.52 ± 0.76 mm at 8.71 ± 2.02 months) and the IZC group (3.5 ± 0.74 mm at 9.7 ± 2.5 months) (P < 0.001 for both). Premolar distalization was significantly lower in the MSP group (1.73 ± 1.09 mm) than in the IZC group (2.81 ± 0.79 mm) (P < 0.01). Significant molar tipping was observed in both groups (P < 0.001), while no significant difference was found between the groups (P > 0.05). Retrusion of maxillary incisors were significantly higher in the IZC group (2.75 mm) than in the MSP group (0.98 mm) (P < 0.01). A significant difference was found between the two groups with regard to the changes in overjet and overbite (P < 0.05). CONCLUSIONS: Both distalization methods were found to be effective in achieving a Class I molar relationship in patients with Class II malocclusion.

Identification of interleukin 2, 6, and 8 levels around miniscrews during orthodontic tooth movement.

The aim of this study was to identify the levels of interleukin (IL)-2, IL-6, and IL-8 around miniscrews used for anchorage during canine distalization. Sixteen patients (eight males and eight females; mean age, 16.6 ± 2.4 years) who were treated with bilateral upper first premolar extractions were included in the study. Thirty-two maxillary miniscrew implants were placed bilaterally in the alveolar bone between the maxillary second premolars and first molars as anchorage units for maxillary canine distalization. Three groups were constructed. The treatment, miniscrew, and control groups consisted of upper canines, miniscrew implants, and upper second premolars, respectively. Peri-miniscrew implant crevicular fluid and gingival crevicular fluid (GCF) were obtained at baseline (T1) and at 1 (T2), 24 (T3), and 48 (T4) hours, 7 (T5) and 21 (T6) days, and 3 months (T7) after force application. Paired sample t-tests were used to determine within-group changes and Dunnett's t and Tukey's honestly significant difference tests for between-group multiple comparisons. During the 3 month period, IL-2 levels significantly increased (P < 0.01) but only in the treatment group after 24 hours. IL-6 levels were unchanged at all times points in the three groups. IL-8 levels increased significantly at 1 (P < 0.05), 24 (P < 0.01), and 48 (P < 0.01) hours in the treatment group and at 24 (P < 0.05) and 48 (P < 0.01) hours in the miniscrew group. It appears that miniscrews can be used for anchorage in orthodontics when correct physiological forces are applied.

Shear bond strength of bonding to enamel with different laser irradiation distances.

The aim of this study was to investigate the shear bond strength of bonding to enamel following laser etching with the Er:YAG or Er,Cr:YSGG laser using different irradiation distances. Of 99 extracted human premolar teeth, 90 were divided equally into nine groups. In the control group (group A) the teeth were etched with 38% phosphoric acid. In the laser groups (groups B-I) the enamel surface of the teeth was laser-irradiated, groups B-E with the Er:YAG laser and groups F-I with the Er,Cr:YSGG laser at distances of 1, 2, 4 and 6 mm, respectively. The shear bond strengths were tested using a universal testing machine. The shear bond strengths associated with the Er:YAG laser at 4 and 6 mm and the Er,Cr:YSGG laser at 2, 4 and 6 mm were significantly less than the strengths obtained with the other irradiation distances (p<0.001). The Er:YAG laser at 1 mm and the Er,Cr:YSGG laser at 1 mm etched enamel in the same manner (p>0.05). This finding was confirmed by scanning electron microscopy examination. Irradiation distance did influence the strength of adhesion to enamel. The mean shear bond strengths and enamel surface etching obtained with the Er:YAG laser at 1 and 2 mm and the Er,Cr:YSGG laser at 1 mm were comparable to that obtained with acid etching.

In vitro evaluation of microleakage under orthodontic brackets using two different laser etching, self etching and acid etching methods.

This study evaluated the microleakage of brackets bonded by four different enamel etching techniques. Forty freshly extracted human premolars were divided randomly into four equal groups and received the following treatment: group 1, acid etching; group 2, self-etching primer (SEP); group 3, erbium:yttrium-aluminum-garnet (Er:YAG) laser etching; and group 4, erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching. After photopolymerization, the teeth were kept in distilled water for 1 month and then subjected to 500 thermal cycles. Then, the specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned, and examined under a stereomicroscope. In addition, they were scored for marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces from the incisal and gingival margins. Statistical analyses consisted of the Kruskal-Wallis test and the Mann-Whitney U test with Bonferroni correction. Microleakage occurred between the adhesive-enamel and bracket-adhesive interfaces in all groups. For the adhesive-enamel surface, a significant difference was observed between group 1 and groups 2 (P = 0.011), 3 (P = 0.002), and 4 (P = 0.000) on the gingival side. Overall, significant differences were observed between group 1 and groups 3 (P = 0.003) and 4 (P = 0.000). In dental bonding procedures, acid etching was found to result in the least microleakage. Since etching with a laser decreases the risk of caries and is time-saving, it may serve as an alternative to acid etching.

Longitudinal profile changes in an Anatolian Turkish population.

The goal of this study was to assess longitudinal changes in the facial soft tissue profile in relation to age and gender in young Anatolian Turkish subjects. A total of 30 subjects (15 females and 15 males) with an Angle Class I occlusal relationship and normal antero-posterior (ANB, 2-4 degrees) skeletal relationships were selected from the archive of Dicle University. All subjects were of Anatolian Turkish heritage, and none had any apparent facial disharmony or had undergone orthodontic therapy. Lateral cephalometric radiographs taken at T1 (mean age 8.8 years), T2 (mean age 13.8 years), and T3 (mean age 17.8 years) were separately investigated. Non-gender-specific research was also carried out at the same time periods. In total, 24 measurements were analysed longitudinally. Differences between the genders were determined using independent t-tests. Repeated measures analysis of variance tests were used to evaluate repeated measurements, and paired sample t-tests to compare inside effects between the genders. Significant increases (P < 0.05) were found with age for both females and males. Generally, the increases were greater in males than in females. Nasal prominence increased more than chin prominence, resulting in a tendency to have convex profiles.

Dental Aesthetic Index scores and perception of personal dental appearance among Turkish university students.

The aim of this study was to investigate the relationship between Turkish university students' awareness of malocclusion, their satisfaction with their personal dental appearance, and the severity of their occlusal irregularities. The sample consisted of 841 randomly selected university students, 522 (62.1 per cent) males and 319 (37.9 per cent) females, aged 17-26 years (mean age, 21.91+/-1.92 years). A pre-tested questionnaire was used to assess the subjects' awareness of malocclusion and satisfaction with their personal dental appearance; the actual severity of malocclusion was determined using the Dental Aesthetic Index (DAI). Statistical analysis was carried out using chi-square for gender differences and Spearman rank-order correlation coefficients for awareness of malocclusion, satisfaction with personal dental appearance, and DAI scores. Analysis of variance and univariate analysis, with age and gender as the independent variables, were further used to analyse the data. Weak but statistically significant, negative, correlations were found between awareness of malocclusion and satisfaction at the following DAI scores: or= 36 (r= -0.477, P<0.001), and a statistically insignificant, negative correlation at a score of 31-35 (r= -0.102, P>0.05). A statistically significant association was found between DAI and awareness of malocclusion (r= -0.305) and satisfaction with dental appearance (r=0.234). There were no significant associations between the department in which the individuals studied and the investigated variables (P>0.05). DAI scores were significantly higher for females. Generally, no statistically significant gender differences were found in relation to DAI scores, awareness, or satisfaction (P>0.05). The findings of this study showed that age had a significant effect on satisfaction and gender on DAI score variation. Females had a greater need for normative treatment except in the 20- to 22-year-olds, and satisfaction decreased with age.

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.

Nonsurgical orthodontic treatment of an adolescent girl with Class III malocclusion and asymmetric maxillary narrowing.

Class III malocclusion is a difficult anomaly to understand. Because not all Class III patients are candidates for surgical correction, patient assessment and selection are especially important in diagnosis and treatment planning. In this article, we report the orthopedic treatment of a teenage girl with a severe skeletal Class III malocclusion. Her ANB angle was -4.5 degrees, and she had a 2-mm anterior crossbite, a 1-mm overbite, and a posterior asymmetric crossbite (greater on the left side). The patient refused surgery. We used a rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, and reverse headgear to bring the maxilla forward. We performed symmetric expansion, but, because of the asymmetric crossbite in the maxilla, we designed a modified apparatus that permitted greater relapse on 1 side. In this way, the posterior crossbite was ideally corrected by the end of treatment, and ideal overjet and overbite relationships, functional occlusion, and an esthetic facial appearance were all achieved.

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.

Cervical vertebral and dental maturity in Turkish subjects.

INTRODUCTION: The aim of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects. METHODS: A retrospective cross-sectional study was designed. The final study population consisted of 590 Turkish subjects. Statistical analysis of the data was performed with computer software. Spearman rank order correlation coefficients were used to assess the relationship between cervical vertebral and dental maturation. For a better understanding of the relationship between cervical vertebral maturation indexes and dental age, percentage distributions of the studied teeth were also calculated. RESULTS: Strict correlations were found between dental and cervical vertebral maturation of Turkish subjects. For males, the sequence from lowest to the highest was third molar, central incisor, canine, first premolar, second premolar, first molar, and second molar. For females, the sequence from lowest to the highest was third molar, canine, second premolar, first premolar, central incisor, first molar, and second molar. CONCLUSIONS: Dental maturation stages can be used as a reliable indicator of facial growth.

Nonsurgical correction of an adult skeletal class III and open-bite malocclusion.

This case report presents an adult skeletal Class III and open-bite malocclusion case treated without surgical intervention using fixed edgewise technique, reverse headgear, and Class III and anterior box elastics. The patient was a 16-year-old Turkish female who had completed her growth and development. She had a four mm open bite, maxillary retrognathia, a crossbite in the anterior and left posterior, and hypoplasia of the maxillary laterals. In addition, the patient's first molars had previously been extracted because of caries, and extraction spaces were present. We applied a Roth edgewise appliance and a reverse headgear to be used at night only for the first six months. The objective in using a reverse headgear was to displace the maxillary teeth toward the mesial and to rotate the maxilla in a clockwise direction. In the mandible, we retracted the mandibular incisors and canine teeth and moved the second molars mesially toward the first molar extraction space. There would thus be no need for any prosthetic restoration in the mandible. At the end of treatment, we obtained a Class I dental relationship, an ideal occlusion relationship, and an esthetic dental and facial relationship. Treatment of the patient was completed in 20 months.

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.

Bilateral twinned teeth and multiple supernumerary teeth: a case report.

Dental twinning can result from the fusion of the developing dental germinal elements or the gemination of a single germ. In bilateral anterior and posterior dental twinning, problems such as poor esthetics, dental caries, arch-length problems, and periodontal disease often occur as a result of the irregular morphology. Several treatment methods have been described in the literature with respect to the different types and morphologic variations of twinned teeth, including endodontic, restorative, surgical, periodontal, and orthodontic treatment. This report documents the case of a young patient with an exceedingly rare phenomenon of permanent twinned teeth and multiple supernumerary teeth in both sides of the mandibular and maxillary arches, as a result of combined fusion and gemination.