Modified Haas Expander for the Treatment of Anterior Openbite and Posterior Crossbite Associated with Thumb Sucking-A Case Report: 3-Years Follow-Up

Thumb sucking is an abnormal habit that occurs in childhood and can cause several malocclusions if it persists for a long time. Malocclusions caused by oral habits require proper treatment timing to maintain a normal growth and should be treated at an early age. This case report shows the management of thumb sucking and early correction of anterior open bite and posterior crossbite by a modified Haas expander. Three-year follow-up results showed the effectiveness of this special designed appliance

Adult Orthodontics

Orthodontic treatment demand of adult patients has been increasing for the last 20 years. The aim of this paper is to give information about the comprehensive and adjunctive multidisciplinary treatment alternatives in adult orthodontics and to point out the differences distingueishing the adults from children and adolescants

Early Maxillary Expansion with the Ni-Ti Memory Leaf Expander-A Compliance-Free Fixed Slow Maxillary Expansion Screw: A Report of 2 Cases

Transversal problems such as crowding and crossbite are one of the most common problems dealt with in early orthodontic treatments. Early correction of these problems may ease or even eliminate the future need for treatment. This paper presents the management of 2 cases with transverse discrepancy using the Ni-Ti Memory Leaf Expander––a new compliance-free slow maxillary expansion appliance. The total treatment time for both cases was 9 months. In both cases, the inter-canine, inter-premolar, and inter-molar distances, as well as the arch length, have all increased

Transfer Accuracy of Three Indirect Bonding Trays: An In Vitro Study with 3D Scanned Models

Objective:The goal of the current study is to compare the transfer accuracy of two different conventional indirect bonding trays with 3D-printed trays.Methods:Twenty-two patients’ upper dental models were duplicated, scanned and brackets were bonded digitally. Different indirect bonding trays (double vacuum formed, transparent silicone and 3D-printed) were prepared according to three groups. These trays were used for the transfer of the brackets to the patients’ models, then models with brackets were scanned. GOM Inspect software was used for the superimposition of virtual bracket setups and models with brackets. A total of 788 brackets and tubes were analyzed. Transfer accuracies were determined according to the clinical limit of 0.5 mm for linear and 2° for angular measurements.Results:3D-printed trays had significantly lower linear deviation values than other trays for all planes (p<0.05). 3D-printed trays have significantly lower torque and tip deviation values than other groups (p<0.05). Transfer deviations were within the clinically acceptable limit for all transfer trays in horizontal, vertical and transverse planes. Deviation values of the molars were higher than those of the other tooth groups for all trays in the horizontal and vertical planes (p<0.05). Brackets were generally deviated toward the buccal direction in all tray groups.Conclusion:The transfer accuracy of 3D-printed transfer trays was more successful than the double vacuum formed and transparent silicone trays in the indirect bonding technique procedure. Deviations in the molar group were greater than those in the other tooth groups for all transfer trays

Maxillary Expansion Via Palatal Mini-Implants: A Preliminary Study

Objective:This study evaluates the skeletal and dental effects of a mini-implant supported maxillary expansion (MISME) appliance that applied forces directly to the maxilla.Materials and Method:Records of 9 patients (5 female and 4 male patients; mean age = 12 years 8 months) with indications of maxillary expansion were included in this study. After insertion of four miniscrews (1.6 mm in diameter, 7 mm in length), an acrylic expansion device was bonded on the screws. Two miniscrews were placed in the anterior palate bilaterally, 3–4 mm lateral to the suture and 3–4 mm posterior to the incisive foramen. Two miniscrews were placed bilaterally between the second premolar and first molar roots in the palatal alveolus. The MISME appliance was activated with a semi-rapid protocol until the desired expansion was achieved. The average treatment duration was 97.1 ± 62.2 days. Measurements from cephalometric, posteroanterior radiographs and dental casts taken before and after expansion were evaluated statistically. The nonparametric Wilcoxon test was used for not normally distributed parameters (i.e., Nperp-A), and the parametric paired t test was performed for normally distributed parameters. A finding of p < 0.05 was considered to be statistically significant.Results:Forward movement of the maxilla (p<0.05) as well as an increase in nasal and maxillary skeletal and dental widths (p<0.001) were observed in the sample group. Maxillary intermolar, intercanine, and palatal widths also increased (p<0.001) without buccal tipping of molars. A slight posterior rotation of the mandible was seen. Dentoalveolar measurements did not show any significant changes.Conclusion:The MISME appliance showed successful expansion of the maxilla without such side effects as buccal tipping of molars and bite opening. This appliance, which provides parallel expansion, can be a simple and economic alternative to transpalatal distraction

Association Between Impacted Maxillary Canines and Adjacent Lateral Incisors: A Retrospective Study With Cone Beam Computed Tomography

Objective:The goal of this study was to evaluate the association between the morphologic characteristics of maxillary lateral incisors and maxillary canine impaction by using cone beam computed tomography (CBCT) images.Methods: CBCT images of 52 patients (19 male and 33 female) with unilateral impacted maxillary canines were selected. The volume, root, and total lengths of the lateral incisor, mesiodistal and buccolingual widths of the lateral incisor crowns, angles between the central axis of the lateral incisor and the midline, occlusal plane, and the central axis of canines in both the impacted and non-impacted side were measured and compared.Results:Statistically significant differences were obtained when comparing the volume of the lateral incisor, the mesiodistal and buccolingual widths of the lateral incisor crown, the root and total lengths of the lateral incisors, and angles between the central axis of the lateral incisor and the midline and the central axis of the adjacent canine (P < .05). There were no significant differences in lateral incisor axis and the maxillary occlusal plane angulation.Conclusion:The association between the morphologic and angular features of the maxillary lateral incisors and maxillary canine impaction was confirmed. The volume of the lateral incisor, mesiodistal and buccolingual width of the lateral incisor crown, root and the total length of the lateral incisor, and the lateral incisor angulation to the midline and the axis of adjacent canine were found to be strong predictors of maxillary canine impaction

Dentoalveolar Effects of Miniscrew Implant Supported Distalization System

Aim:The aim of this prospective clinical study is to evaluate the treatment effects of the miniscrew implant supported distalization system in patients with Class II malocclusion.Subjects and Methods:The study sample consisted of 10 patients (5 girls and 5 boys) with a mean age of 14,9 years. Two titanium intermaxillary fixation screws were placed lateral to the foramen incisivum in the anterior paramedian region of the palate. Alginate impressions were taken and appliances were constructed on the model casts. The MISDS was cemented on the upper first molars, then connected to the miniscrews by means of metallic ligatures. The appliance was activated by squeezing the open coil springs. 200 g of distalization force was applied on each side. Lateral cephalometric radiographs were obtained before (T0) and after (T1) the distalization were measured. Data was analysed by SPSS.Results:The mean maxillary first molar distalization was 2,45 mm (p<0.05) and 1° (p<0.05) slight distal tipping accompanied distalization. Maxillary second molars distalized 4.35 mm (p<0.05) and tipped 2°(p<0.05) distally. The upper second premolars showed 3 mm distal drift following the upper first molars and tipped 2.3° distally, while 2.35 mm spontaneous distalization and 1.6° distal tipping were seen on the upper first premolars. Upper incisors were retroclined 1.45° (p<0.05), which decreased the overjet 0.8 mm.Conclusion:MISDS is an efficient way of noncompliance maxillary molar distalization which results with almost translatory distal upper molar movement

Comparison of the initial levelling efficiency of two different self-ligating brackets

Aim: The objective of this study, to evaluate the initial alignment effectiveness of two different passive self-ligating brackets (SLBs) and to compare the differences in arch widths. Materials and Methods: The patients with no skeletal discrepancy, Little’s irregularity index (LII) greater than 3 mm on both arches, who were treated with SLBs and whom had undamaged plaster models at the beginning (T0), 10th week (T1), and 20th week (T2) of their treatment period were enrolled to the study group. Group 1 (Damon) was consisted of 17 patients (mean age=14.5 years) and Group 2 (SmartClip) was consisted of 18 patients (mean age=13.6 years). The analogue dental casts were transferred to a digital model by scanning. Maxillary and mandibular intercanine, intermolar widths and LII were measured by MeshLab software. Wilcoxon signed-rank and Mann Whitney U tests was used for statistical evaluation. Results: There were no significant differences between the groups for the mean LII in T0 (maxillary LII, Group 1= 6.59 mm; Group 2= 6.32 mm; mandibular LII, Group 1= 5.95 mm, Group 2= 5.73mm). The rate of decrease in the LII between T0-T2 and between T1-T2 were found to be significantly higher for Group 1 in the mandible but there was no significant difference between T0-T1 (P= 0.031, P= 0.042, P= 0.113). There was no significant difference for the rate of decrease in the LIIs between the groups in the maxilla. When changes of intermolar and intercanine widths were compared according to the follow-up times, no significant differences were found for the treatment groups. Conclusion: Both SLBs groups were effective for reducing the crowding in maxillary arch. The increases in intercanine and intermolar widths were found to be similar for both groups. Group 1 was found to be better in the speed of the resolution of the crowding only in the lower incisor region

The Surgical Predictability of Maxillary Advancement and Impaction in Le Fort I Osteotomy

Objective:The aim of this study was to evaluate and compare the amount of preoperatively planned surgical movement of the maxilla and postoperatively obtained maxillary repositioning.Materials and Method:Thirty-one patients (16 female and 15 male) were included in this study. Fifteen combined maxillary advancement and impaction, 5 isolated maxillary impaction, and 11 isolated maxillary advancement surgeries were performed by the same surgical team. The 31 patients were divided into 2 groups: group 1 (GoGnSN≤38°) and group 2 (GoGnSN>38°). Various measurements from the horizontal and vertical reference lines were used to compare the predicted maxillary movement and the postoperatively obtained maxillary position. All variables were evaluated by Student's 2-tailed paired t tests.Results:There were statistically significant differences between the preoperatively planned and surgically obtained impaction movements of all evaluated landmarks, but no significant difference was seen between the planned and obtained advancement movement. For the differences between the planned and acquired maxillary advancement movements, 51% were within 2 mm of prediction. For the differences between the planned and the acquired maxillary anterior impaction movements, 51% were within 1 mm of the prediction. The difference was 35% for the impaction of posterior maxilla.Conclusion:The predictability of vertical movement of the maxilla via Le Fort I osteotomy was lower than that for sagittal movement. The difference between planned surgical movement and actual surgical outcome should be taken into consideration during treatment planning

Short-term evaluation of nasal changes after maxillary surgery

Objective: To determine the nasal soft-tissue profile changes in skeletal Class III patients who underwent maxillary or bimaxillary orthognathic surgery. Materials and Method: This clinical retrospective study consists of 40 patients (19 male and 21 female) who had undergone orthognathic surgery. All patients received single jaw maxillary (9 patients) or bimaxillary surgery (31 patients). Standardized lateral cephalograms obtained before operation and at least 6 months after the operation were used. Twelve measurements (4 skeletal and 8 soft-tissue measurements) were made. The distributions of the variables were checked by Shapiro-Wilk test. Paired-samples t test was used for parametric data and Wilcoxon sign rank test for nonparametric data, to analyze the differences between pre- and postoperative measurements. Results: After orthognathic surgery, SNA and ANB increased; SNB decreased significantly. A significant reduction in nasofrontal angle, TH-Prn, and nasal tip projection and a significant increase in nasofacial angle were found. In addition, superior movement of the nasal tip was found, and as a result, the nasal hump decreased. The N-Sn/Pr ratio, nasal tip angle, and nasolabial angle did not show any significant changes. Conclusion: It can be concluded that more vertical nasal changes rather than sagittal nasal changes are observed after maxillary surgery