The Relationship between Orthodontic Treatment and Dental Caries

Orthodontic treatment is the main treatment procedure to achieve a well-aligned dental arch and an esthetic smile. For this purpose, various types of removable or fixed orthodontic appliances are designed. However, each has their specific disadvantages. The most important one is that orthodontic appliances especially the brackets and the ligation mode create new retention areas in addition to blocking plaque-removing shear forces arising from fluid flow and masticatory loads with a resultant undesired effect of accumulation of dental plaque. Increased amount of dental plaque containing cariogenic bacteria is the main etiologic factor in decalcification of enamel during orthodontic treatment. This demineralization of the tooth surfaces results in appearance of white spots or even caries. However, in the literature, there are conflicting results in the relationship between orthodontic treatment and development of dental caries. Many preventive methods such as topical fluoride application, using bonding materials releasing fluoride, using mouth rinse with sodium fluoride, applying chlorhexidine, and so on were defined. The general comment of the authors is that supplying an adequate oral hygiene has the main role in prevention of demineralization-caries during orthodontic treatment. In the light of the previous studies’ results, it can be concluded that professional application like a varnish can be provided for patients who have high caries incidence

Automatic ventilator (surevent™) use for the transport of the patients who had undergone open heart surgery

Bu çalısmanın amacı açık kalp cerrahisi uygulanan hastaların yogun bakıma transportu sırasında balonvalv cihazıyla (Ambu® resüsitatör Mark III) yapılan manuel ventilasyon ile Surevent™ otomatik ventilatörle yapılan mekanik ventilasyona baglı hemodinamik ve kan gazı degisiklikleri karsılastırmaktır.Açık kalp cerrahisinden sonra entübe olarak yogun bakıma transfer edilecek 50 hasta çalısmaya alındı. Hastalar randomize edilerek transportta kullanılacak ventilasyon yöntemine göre manuel ventilasyon (Ambu® resüsitatör Mark III; Grup BV, n= 25) veya mekanik ventilasyon (Surevent™ otomatik ventilatör; Grup SV, n= 25) gruplarından birine dahil edildi. Hastalardan, yogun bakıma transporttan önce (T0), yogun bakıma transporttan hemen sonra (T1) ve yogun bakıma transporttan 20 dakikada sonra (T2) olmak üzere üç kez kan gazı ve hemodinamik verileri kaydedildi.Iki grubun da transport süresinin medyan degeri 5 dakikaydı. Gruplar arasında PaO2' de, transporttan önce fark saptanmazken, yogun bakıma transporttan sonra Grup SV'de Grup BV' den belirgin olarak yüksek bulundu (p= 0,002). Yogun bakıma transporttan sonra 20. dakikada bakılan PaO2 degerlerinde fark saptanmadı. Diger kan gazı verilerinde ve hemodinamik parametrelerde gruplar arasında önemli fark saptanmadı.Surevent™ otomatik ventilatör, açık kalp cerrahisi uygulanan hastaların transportunda kısa süreli olarak kullanılabilecegi ve manuel ventilasyonla karsılastırıldıgında aralarında anlamlı bir fark olmadıgı görüldü.To investigate whether Surevent™automatic ventilator could be safely used or not for the transport of the patients who had undergone open heart surgery to intensive care unit (ICU) and to compare this equipment with manual ventilator(Ambu® Resusitator Mark III). The study included 50 patients greater than 18 years old, that would be transported intubated to ICU after open heart surgery. The patients were randomized to two groups according to the ventilation method that would be used during the transport as, the patients that would be transported with manuel ventilation (Group BV, n= 25) or Surevent™automatic ventilator (Group SV, n= 25). Arterial blood gas testing was performed three times for each patient before the transport to the ICU (T0), after the transport to the ICU (T1), at 20 minutes after the transport to the ICU (T2). Hemodynamic variables were recorded at the same time periods. While there were no significant differences between the two groups according to PaO2 values measured during the preoperative and before the transport, the PaO2 values of group SVwas significantly greater than group BV postoperatively after the transport to the ICU (p= 0.002). PaO2 values at 20 minutes after the transport to the ICU were not different between the two groups. There were no significant differences between the two groups in the hemodynamics variables. Surevent™automatic ventilator can be used for a short period for the transport of the patients after open heart surgery and we observed no significant difference when compared with manual ventilatio

The effects of microlaryngeal tube on respiratory mechanics and ventilation parameters in laryngoscopic surgery

Amaç: Çalışma laringoskopik cerrahi için mikrolaringeal tüp ile entübe edilerek düşük tidal volüm, yüksek frekanslı ventilasyon ile genel anestezi uygulanan hastalarda tüp çapının solunum mekaniklerine olan etkilerini, arteriyel ve end tidal karbondioksit basıncı değişikliklerini incelemek amacıyla yapıldı. Gereç ve yöntem: Çalışmaya laringoskopik cerrahi için mikrolaringeal tüp ile entübe edilerek genel anestezi uygulanan 27 hasta, kontrol grubuna ise uygun çaplı endotrakeal tüp ile entübe edilen 26 hasta alındı. Tüm hastalar, midazolam premedikasyonu ve intravenöz 1g kg fentanil, 1mg kg lidokain, 3mg kg propofol, 0.1 mg kg vekuronyum ile anestezi indüksiyonu yapılarak entübe edildi. Laringoskopi grubunda solunum sayısı: 20 dk , tidal volüm: 5ml kg ; kontrol grubunda ise solunum sayısı: 12 dk , tidal volüm: 8ml kg olarak ayarlandı. Beş dakika ara ile kalp hızı, sistolik ve diyastolik arter basıncı, periferik oksijen satürasyonu, end tidal karbondioksit basıncı, hava yolu direnci, kompliyans, tepe hava yolu basıncı, ortalama hava yolu basıncı, arteriyel parsiyel karbondioksit basıncı değerleri izlendi ve kaydedildi. Bulgular: Laringoskopi grubunda, kontrol grubuna göre kompliyans düşük; tepe hava yolu basıncı, hava yolu direnci yüksek bulundu (p<0.05). Laringoskopi grubunda end tidal karbondioksit basıncında önemli değişiklik olmamakla birlikte arteriyel parsiyel karbondioksit basıncının operasyon süresince yükseldiği (p<0.05) ve end tidal karbondioksit basıncı ile arteriyel parsiyel karbondioksit basıncı arasındaki farkın giderek arttığı gözlemlendi. Sonuç: Sonuç olarak mikrolaringeal tüplerle yapılan düşük tidal volüm, yüksek solunum sayılı ventilasyonda end tidal karbondioksit basınç monitorizasyonunun arteriyel parsiyel karbondioksit basıncını yansıtmadığı saptandı.Purpose: This study was plannedto evaluatethe effects of low tidal volume and high-frequency ventilation with microlaryngeal endotracheal tubes on respiratory mechanics under general anesthesia, to investigate the variations of partial arterial and end-tidal carbon dioxide pressures and to compare these changes in patients with normal tidal volume and frequency ventilation intubated with conventional endotracheal tubes. Materials and methods: Fifty-three patients were enrolled in the study. Twenty-seven patients who underwent laryngoscopic surgery were intubated with microlaryngeal endotracheal tubes in the study group. Twenty-six patients were intubated with conventional endotracheal tubes in the control group. Anesthesia was induced with 1 g kg-1 fentanyl, 1 mg kg-1 lidocaine and 3 mg kg-1 propofol. Intubation was achieved with 0.1mg kg-1 vecuronium. Tidal volume and respiratory rate were set at 5 ml kg-1 and 20 min-1 in laryngoscopy group, and 8 ml kg-1 and 12 min-1 in control group respectively. Heart rate, systolic and diastolic arterial pressures, arterial oxygen saturation, end-tidal carbon dioxide pressures, airway resistance, compliance, peak airway pressure, mean airway pressure andpartial arterial carbon dioxide pressures were monitored and recorded at 5 minute-intervals. Results: Compliance was lower (p<0.05), and peak airway pressure and airway resistance were higher in laryngoscopy group than control group (p<0.05). Although, end-tidal carbon dioxide pressures did not vary during the operation, partial arterial carbon dioxide pressure was continuously elevated in laryngoscopy group. Conclusion: As a conclusion, low tidal volume and high-frequency ventilation with microlaryngeal endotracheal tubes causes elevation of partial arterial carbondioxide pressures

In Vıvo And In Vıtro Assessment Of The Antıbacterıal Effects, Ion Release And Bıocompatıbılıty Of Nano Sılver Coated Orthodontıc Brackets

Bu çalışmanın amacı sabit ortodontik tedavilerin sık görülen yan etkisi olan beyaz nokta lezyonlarının (BNL), gümüşün antibakteriyel özelliğinden yararlanılarak önlenmesi amacıyla, nano gümüş partikülleri ile kaplanan ortodontik braketlerin antibakteriyel özelliklerinin, iyon salınımlarının ve biyouyumluluklarının in vivo ve in vitro olarak değerlendirilmesidir. Mandibular kesici dişlerine nano gümüş partikülleri ile kaplanan ortodontik braket ve konvansiyonel ortodontik braket yapıştırdığımız 12 adet Wistar Albino rat çalışma (6) ve kontrol grubu (6) olarak ayrılmıştır. 0,1, 3, 7, 14, 30, 45 ve 75. günlerde molar ve kesici dişler üzerinden dental plak, alt dudak vestibül mukoza smeari, tükürük ve kan örnekleri alınmıştır. Çürük değerlendirilmesi, 75. günün sonunda anestezi altında sakrifiye edilen ratların alt ve üst çene dişlerinin çürük boyayıcı solüsyonlar ile boyanıp, çürük alanı oranlarının hesaplanması ile yapılmıştır. Biyouyumluluk deneyi için 12 adet rat randomize olarak 2 gruba ayrılmıştır. Ratların sırt bölgelerine çalışma grubunda nano gümüş partikülleri ile kaplanan ortodontik braketler, kontrol grubunda ise konvansiyonel ortodontik braketler yerleştirilmiş ve 7, 14, 30 ve 60. günlerde çevre yumuşak dokuları ile beraber çıkarılıp histopatolojik olarak değerlendirilmiştir. Sonuçlarımıza göre çalışma grubunda özellikle 1 ay sonunda braket etrafında S. mutans sayılarının anlamlı derecede azaldığı, molar diş parlak yüzeylerinde çürük oluşumunun önemli düzeyde önlendiği saptanmıştır. Tükürük ve kan örneklerinde 7. günde gümüş konsantrasyonlarının arttığı sonraki günlerde azaldığı izlenmiştir. Biyouyumlulukları histopatolojik olarak gösterilen nano gümüş kaplanan ortodontik braketlerin klinik uygulamalarda BNL'lerin önlenmesinde olumlu sonuçlar verebileceği düşünülmektedir.The aims of this study were to evaluate the antibacterial properties, ion release, and the biocompatibility of nano silver coated orthodontic brackets, to assess the possible reduction of the areas of tooth decay and demineralization during fixed orthodontic treatment compared to conventional brackets. Nano silver coating process was applied to the standard orthodontic brackets and were placed on the mandibular incisors of Wistar Albino rats in the study group (6) and the conventional brackets in the control group (6). Dental plaque, mucosal vestibular smears, saliva and blood samples were collected from rats at 0, 1, 3, 7, 14, 30, 45, and 75th days of the study. The amount of silver ions in blood and saliva was measured and microbiological evaluation was made in the samples of smear and dental plaque for S. mutans. For testing cariogenicity, all rats were sacrified under anesthesia at the end of 75 days. First of all, the soft tissues of both jaws were removed and cleaned and all teeth were stained using a caries indicator, then the caries ratio was assessed. In the biocompatibility study, nano silver coated and standard brackets were aseptically implanted subcutaneously in the dorsal region of rats. Brackets were removed with the surrounding tissues at 7, 14, 30, and 60 days. The specimens were evaluated for inflammatory response. Results showed that nano coated orthodontic bracket favored the inhibition of S. mutans on day 30 and reduction of caries on the smooth surfaces. Silver counts of saliva and serum samples were significantly higher in study group on day 7 and reduced on following days. The biocompatibility results indicated similarities in terms of tissue reaction between the study and control groups. So we suggest that nano coated orthodontic bracket may be helpful for prevention of WSL during fixed orthodontic treatment

Biocompatibility of nanosilver-coated orthodontic brackets: an in vivo study

Abstract Background Nanosilver particles of which antibacterial and antifungal properties have been shown in various in vitro and in vivo studies are used in many medical and dental fields for the prevention of infection. In this study, it is intended to evaluate the biocompatibility of nanosilver-coated brackets. Methods Nanosilver coating process was applied to the standard orthodontic brackets by a physical vapor deposition system. Brackets were coated with nanosilver particles of 1 μ thickness. A total of 12 Wistar Albino rats were included in the study (six) and control (six) groups. For the study and control groups, four nanosilver-coated and four standard brackets were aseptically implanted subcutaneously in the dorsal region of each rat. The brackets were removed with the surrounding tissues on days 7, 14, 30, and 60. The specimens were evaluated for inflammatory response. Results No significant difference was found in terms of tissue reaction between the study and control groups. On day 7, randomly distributed brown-black granules were seen in the granulation tissue adjacent to the bracket in the study group. These foreign particles continued along the bracket cavity in a few samples, but the inflammatory response was insignificant between the groups. Mast cell count was found to be significantly smaller only on day 7 in the study group than in the control group. Conclusions Nanosilver-coated orthodontic brackets were found to be similar with the standard type concerning inflammation. Further researches are needed with regard to the assessment of the brown-black granules, especially on the deposition of the vessel walls

Does Gender Have an Effect on Craniofacial Measurements?

The aim of this cross-sectional study was to evaluate craniofacial structures in terms of different sagittal relations and gender in adolescent individuals