Evaluation of 5 Years Profile of an Infant Cleft Lip and Palate Clinic

The aim of this report was to present the distribution of patients and treatment modalities of all cleft lip and palate (CLP) patients accepted for treatment in the newborn cleft clinic at the Marmara University, Faculty of Dentistry, Department of Orthodontics, during the 5 years from October 2001 to October 2006, and to summarize the structure and organization of the clinic. The goal was to initiate a nationwide exchange of opinions among orthodontic clinics that deal with the treatment of newborn CLP patients, to communicate clinical experience and information, and to make a step forward in standardizing records as a basis for future multicentered research. Even though preoperative orthopedics for newborn cleft lip and palate patients is still a matter of controversy, it has been adopted in our clinic, and the use of feeding plates and nasoalveolar molding is chosen according to the cleft type. Along with the medical history, digital pictures, maxillary and nasal impressions, and written treatment documentation are the basic records. Of the 263 newborn patients who have been accepted for treatment within the last 5 years, only one had a median cleft, 23.2 % were bilateral, 41.8 % were unilateral, 34.6 % were isolated cleft palate patients; while 95 % of the unilateral cases and 85 % of the bilateral cases have been treated via nasoalveolar molding. Patients are being followed up in 6 month intervals after the primary repair, with consultation of a pediatric dentist, a speech therapist, and the surgeon, where necessary. It is obvious that comprehensive cleft care can only be provided by specialists, who dedicate the majority of their time to cleft care in a common separate location and in an interdisciplinary fashion. In order to establish a national health policy that provides optimum conditions and sufficient financial contribution, it is necessary to join specialists all over Turkey in a cleft network and to establish a national data pool as soon as possible

Evaluation of Internet Information about Lingual Orthodontics Using DISCERN and JAMA Tools

Objective:To investigate the quality and reliability of websites providing information about lingual orthodontics in Turkish.Methods:An internet search was conducted on March 6th, 2017, using popular search engines in Turkey: GoogleTM, bingTM, YAHOO!®, and Yandex® for the keywords “lingual ortodonti, görünmeyen braketler, and görünmeyen teller”. The top 10 websites for each keyword and search engine were examined, and duplicates, irrelevant websites, websites showing scientific articles, and orthodontic supplies market sites were excluded. The remaining 58 sites were assessed using the DISCERN instrument and JAMA benchmarksResults:The authors of the remaining sites were orthodontists (48%) and dentists (5%), while 46% of the websites did not state author names. Ninety-one percent lacked references, and 87% lacked a date. Only 30% were balanced and unbiased. The mean overall DISCERN score was very poor (43%) or poor (40%). Of the 58 websites, 48% (28 sites) met authorship, 7% (4 sites) attribution, 71% (41 sites) disclosed website ownership, and 3% (2) currency benchmarks of JAMA.Conclusion:Information on the internet related to lingual orthodontics is poor. Clinicians should warn patients that information on the internet about lingual orthodontics might be inadequate, and they should direct patients to higher-quality websites

Derin kapanış ve ön açık kapanış olgularında kondil konumu ve hareketlerinin sam artikülatörü ile incelenmesi

Altçene eklemi bozukluğunun etyolojisinde dişsel kapanışın da rol oynadığı düşünülmektedir. Konuyla ilgili yayınlarda, geleneksel olarak en sık bahsedilen kapanış özelliklerinden birisi derin kapanış, son yıllarda önem verilmeye başlanan kapanış özelliği ise ön açık kapanıştır. Eklem bozukluğu için risk oluşturduğu düşünülen bir başka özellik de sentrik ilişki-alışılmış kapanış konumlarının uyumsuzluğudur. Bu çalışmanın amacı normal kapanış, derin kapanış ve ön açık kapanış gösteren, eklem hastalığı olmayan bireylerde, sentrik ilişki-alışılmış kapanış uyumsuzluğunu, kondil hareketlerini, maksimum açma yeteneğini ve kondillerin radyografik görüntülerini saptamak ve grupları bu değişkenler açısından birbiriyle karşılaştırmak, bu alanda normatif veriler sağlamaktır. Denekler altçene eklemi bozukluğu riski taşımayan dişsel kapanış özelliklerine sahip, 18-32 yaşlarında, sağlıklı bireyler arasından seçilmiştir. Normal kapanış, derin kapanış ve ön açık kapanışı olan 30'ar kişilik üç grup oluşturulmuştur. Bütün deneklerin keserler arası maksimum açma aralığı kaydedilmiş, Altçene Konum Belirleyicisi (AKB) aygıtı kullanılarak sentrik ilişki-alışılmış kapanış uyumsuzlukları ölçülmüş, aksiyografik kayıtları alınmış ve panoramik radyografileri üzerinde kondil morfolojileri değerlendirilmiştir. Bulgularımız ön açık kapanış olgularında dik yöndeki sentrik ilişki-alışılmış kapanış uyumsuzluğunun daha fazla olduğunu, derin kapanış grubunda yatay yönde klinik önem gösterebilecek miktarlardaki uyumsuzluğun daha fazla olduğunu, sadece normal kapanış grubunda, uyumsuzluk göstermeyen birey bulunduğunu ve bunun da tek bir kişiyle (% 3) sınırlı olduğunu, sentrik ilişkiden alışılmış kapanış konumuna geçerken kondillerin genel olarak aşağı ve öne doğru hareket ettiğini göstermiştir. Maksimum açma aralığı derin kapanış olgularında ve erkeklerde daha fazladır. Çene hareketleri sırasında kaydedilen kondil yolları ön açık kapanış grubunda daha kısa, kondil yolu eğimleri daha diktir. Bütün deneklerin % 23'ünün kondillerinde radyografik olarak erozyon bulgusuna, % 83'ünde ise düzleşme bulgusuna rastlanmıştır. En yüksek erozyon oranı ön açık kapanış grubunda, en yüksek düzleşme oranı derin kapanış grubunda bulunmuştur. Ön açık kapanışı olan bireylerde ve kadınlarda ince kondillere daha sık rastlanmakta, ince kondillerde ise erozyona daha sık rastlanmaktadır. Sonuç olarak, sağlıklı eklemlere sahip bireyler için ön açık kapanış olgularının yukarıda sayılan özellikler bakımından normal kapanış gösteren olgulardan farklı olduğu gösterilmiştir. Bu farklar kısmen ve daha az oranlarda, derin kapanış olguları için de geçerlidir. Ancak bulgularımızın altçene eklemi bozukluğu etyolojisi açısından önemini saptamak için sağlıklı bireyler yerine altçene eklemi bozukluğuna sahip daga fazla sayıda birey üzerinde benzer yöntemlerin kullanılacağı araştırmalara gerek duyulmaktadır. EVALUATION OF CONDYLAR POSITIONS AND MOVEMENTS IN DEEP BITE AND OPEN BITE CASES USING THE SAM ARTICULATOR SUMMARY Etiology of temporomandibular disorders (TMD) is known to be multifactorial. Factors such as deep bite maintained their importance in the dispute about the role of occlusal factors in TMD over years. Anterior open bite is another occlusal feature believed to interfere with normal joint function. Both, deep bite and open bite, are two extremes of vertical incisal guidance, which in turn is suspected to effect condylar positions and movement patterns. The aim of this study is to compare normal overbite, deep bite and open bite cases with clinically healthy temporomandibular joints. Our goal was to establish normative data concerning the difference of condylar positions in centric relation (CR) and habitual or centric occlusion (CO) ; condylar pathways; maximum interincisal distance; and radiographic findings of condylar appearance. Study groups consisted each of 30 non-TMD subjects with healthy, intact dentitions, aged between 18-32 years. The SAM 3 articulator, SAM-Mandibular Position Indicator (MPI) and SAM-Axiograph were used to collect data. Condylar shape, flattening and erosions were evaluated on panoramic radiographs. Our findings revealed greater CR-CO differences in the vertical plane in open bite cases; increased number of big transverse discrepancies in deep bite cases; and great variability in the direction of movements from CR to CO. CR-CO coincided in only one subject (3 %) in the normal overbite group for all three planes and both sides, and also almost only in normal overbite cases for one or two planes on both sides. Maximum opening distances were greater in the deep bite group and also in men for the total sample. Open bite cases had steeper, but significantly shorter pathways recorded during excursive jaw movements. Of the total sample, 23 % showed evidence of erosion and 83 % evidence of flattening of condyles on radiographic images. Erosion rates were higher in the open bite group, but flattening was seen much more often in the deep bite group. On radiographs of women and in open bite cases we observed rather thin condyles, while erosion seemed to occur more on thin condyles. Conclusively it can be said that open bite cases show some significant differences from normal overbite cases for the above mentioned features in nonpatients. Differences exist to a lesser degree for deep bite cases as well. Further research is needed to find out about the role these features play in the etiology of TMD

Effects of Relapse Forces on Periodontal Status of Mandibular Incisors Following Orthognathic Surgery

The aim of this case-control study was to investigate the relationship between the relapse forces and periodontal changes in the mandibular incisor region, following orthognathic surgery. Ten subjects with mandibular prognathism were evaluated twice for mucogingival and alveolar changes, just before mandibular setback surgery, and 6.9 months postoperatively. The results were compared to two control groups, the first consisting of 10 subjects with no orthodontic history, and the second one consisting of 10 cases, undergoing fixed orthodontic treatment with completed leveling of lower incisors. The mean age of the study group was 20.52 years, while both control groups had a mean age of 19 years. Intra-group measurements within the surgery group revealed no significant changes postoperatively, but inter- group results showed a significant increase in the gingival index among control groups, and an increase of the Ramfjord index in the study group. In general, it can be concluded that Class III surgery patients are prone to develop a periodontal disease in the long term; however, our results did not show any specific effects of the early postoperative relapse forces on the mandibular incisor area

Relationship of Maxillary First Molar Rotations with Malocclusions and Other Occlusal Variables

The aim of our study was to determine the relationship between the rotation of maxillary first molars and various features of malocclusions. Initial models of 1237 patients were used for this study. Models were evaluated according to dental malocclusion, cross bite, crowding, rotation of upper incisors, canines and premolars, diastemas, and rotation of mandibular molars. 21.7 % of the models had a Class I, 64.8 % Class II, and 13.4 % Class III dental relationship. In Class III cases a significant increase in maxillary molar rotation was observed, followed by Class II and Class I maloclusions. There were increased second maxillary molar rotation values in Class III maloclusions, but no difference between Class II and Class I. Cases with cross bite, only upper crowding, both upper and lower crowding and rotated upper premolars had a significant increase in maxilary molar rotations. On the contrary, cases with canine and incisor rotations and diastemas had significantly less maxillary molar rotations. No relationship was found between mandibular molar rotations and maxillary molar rotations. Although higher rotational values could be expected in Class II malocclusions due to early migration of maxillary molars, the results of the present study support a stronger association with Class III malocclusions. As a result, during treatment planning, especially in Class III malocclusions, correction of molar rotations routinely should be listed as a treatment objective

Measurement of The Centric Relation-Maximum Intercuspation Difference: MRI Versus The SAM® Mandibular Position Indicator

The aim of this study was to generate normative data about condylar positions and condyle-disc relationship in healthy individuals, and to compare condylar po -sitions on Magnetic Resonance Images (MRI) to articulator generated condylar positions measured with the SAM® Mandibular Position Indicator (MP!) regarding the difference between condylar positions in centric relation (CR) and maximum intercuspation (MI). The study group consisted of 30 subjects with normal occlusion and clinically healthy temporomandibular joints. Centric occlusion-maximum intercuspation differences were recorded using the SAM® MPI. Subsequent MR images were taken with the mandible in CR and MI, and the difference in condylar position compared to the MPI findings of the same subjects. MRI and MPI data of the same individuals did not coincide (antero-posterior: p=0.000; vertical: p=0.007), and condyles were concentric in 73% and 87% for right and left sides respectively

Nasoalveolar Molding In Unilateral Cleft Lip and Palate: Two Case Reports

Nasoalveolar molding is a method which aims to decrease the severity of the deformity of infants with cleft lip and palate before primary repair. Using this method, alveolar segments adjacent to the cleft can be approximated, while a symmetrical archform can be achieved by using tissue expansion principles. Also, alar dome cartilages and columella can be lifted by taking advantage of the malleability of the immature cartilage. In this report, treatment details of two infants with different types of unilateral cleft and the results after primary lip repair will be presented