Surgically Assisted Rapid Maxillary Expansion (SARME) Treatment in a Severe Maxillary Constriction Patient: Case Report

The purpose of this article was to apply surgically assisted rapid maxillary expansion in an adult patient who had severe maxillary constriction followed by two maxillary canine impactions for gaining Class I canine-molar relationship and determine the changes before and after treatment. 18,5 years of age Caucasian female was referred to our clinic with the primary complaint of unaesthetic smile and anterior crowding. In model cast analysis, it has been determined that there was 5.1 mm space requirement in mandible and 12.3 mm in maxilla. Overjet was 6.8 mm, overbite was 2.2 mm. The treatment plan consisted of leveling and alignment of maxillary and mandibular teeth after the SARME. An acrylic cap expansion appliance was preferred. Class I canine-molar relationship at the end of the treatment was aimed. After the treatment the maxillary constriction has been eliminated and class I molar relationship was established on both sides. The radiographic evaluation revealed 3.9 mm nasal and 5.2 mm maxillary width widening. The smile esthetic was improved and the malpositions of the teeth were relieved. As a conclusion; SARME is a successful treatment modality for adult patients requiring palatal expansion

Physical Properties of Different Orthodontic Composites

Objective:The aim of this study was to compare the water sorption, solubility, and compressive strength of 3 traditional orthodontic composites and 1 flowable composite after 1, 7, and 30 days of immersion in water.Materials and Method:The traditional orthodontic composites used in this study were ORTHO Bracket Paste (Bisco, Schaumburg, IL, USA), Transbond XT (3M, Monrovia, CA, USA), and Light Bond (Reliance, Itasca, IL, USA). The flowable composite used was Tetric EvoFlow (Ivoclar Vivadent, Schaan, Liechtenstein). The specimens were subjected to water sorption and solubility tests based on the ISO 4049 and ADA No. 8 requirements. Mechanical tests were performed with an Instron Universal Test Machine.Results:There were no significant differences in solubility among the 4 materials after 1 and 7 days (p > 0.05). Tetric EvoFlow had a lower compressive strength than the traditional orthodontic composites (p > 0.05) and exhibited significantly higher water sorption than the traditional orthodontic composites after immersing them in water for 1, 7, and 30 days (p < 0.001).Conclusion:The results revealed that the flowable composite had higher solubility and water absorption but less compressive strength than the traditional orthodontic composite resins used in this study

Görsel analog skala kullanılarak dişeti estetiğinin değerlendirilmesi

Amaç: Fonksiyonel okluzyona eşlik eden çekici, hoş bir gülümseme başlıca ortodontik tedavi amacıdır. Bu çalışmanın amacı halktan insanlar (hasta velileri) tarafından gülümseme estetiğinde dişeti görünüm miktarının etkisini araştırmaktır.Gereç ve Yöntemler: Çalışmaya İnönü Üniversitesi Diş Hekimliği Fakültesi Ortodonti Anabilim Dalı’na başvuran 50 birey (25 erkek, 25 kadın; ortalama yaş 39) katılmıştır. 11 görüntü sırayla en azdan en çoğa doğru dişeti görünümünün miktarına göre ayarlandı. Görsel Analog Skala (VAS) kullanılarak her gülüşün subjektif estetik değeri belirlendi. Estetik skor minimum 0 ve maksimum 100 olacak şekilde, 0 ve 100 arasında ayarlandı. Yapılan Kolmogorov-Smirnov testinde fotograflardan alınan puanların normal dağılıma uymadığı görüldü (P &lt; 0,05). İstatistiksel analizlerde VAS skorları arasındaki farkı belirlemek için Kruskal-Wallis testi yapıldı. Fark yaratan grubu belirlemek için post hoc test olarak Bonferroni düzeltmeli Mann Whitney U testi yapıldı. Kadınlar ve erkekler arasındaki farkı belirlemede Mann Whitney U testi kullanıldı.Bulgular: İstatiksel analiz, görsel analog skala skorlarının dişeti görünüm miktarından önemli şekilde etkilendiğini göstermektedir (P &lt; 0,001). Ancak skorlamayı yapan kadınlar ve erkekler arasında estetik skorları arasında fark yoktur (P &gt; 0,05). En çok beğenilen görüntü 0 mm’lik dişeti görünümü olan resimdir (P &lt; 0,001).Sonuç: Estetik skorlamada görsel analog skala kullanılmak ile basit, hızlı ve tekrarlanabilir sonuç elde edilebildiğinden tavsiye edilmektedir. Halktan bireyler 0 mm’lik dişeti görünümünü en çekici olarak nitelendirmektedirler

A Patient- and Family-Centered Care Approach to Orthodontics: Assessment of Feedbacks from Orthodontic Patients and Their Families

Objective:This study aimed to evaluate orthodontic patients and their families’ clinical satisfaction and their perception of dentists in the framework of the Patient and Family Centered Care (PFCC) concept.Methods:The study population comprised patients treated at the Orthodontics clinic and their families. A mixed method research with quantitative and qualitative components was employed by conducting questionnaires with 62 patients and 65 parents. Collected data were recorded on the computer, and analyses were performed.Results:A majority of the patients who received treatment at our clinic were high school graduates, while their parents were university graduates. The patient’s and their parents’ overall satisfaction were similar. We also found that the patients and their parents expected doctors to have ethical perception and professional behavior in the treatment process.Conclusion:According to the results obtained from the survey questionnaires, the patients and their parents expect a dentist to have the following qualities: courtesy, friendliness, respect, punctuality, communication skills, and knowledgeableness. Dentists can optimize clinical and patient satisfaction by providing care and attention based on the principles of patient centered care (PCC) and PFCC and shaped in accordance with the expectations of the patients and their parents

Assessment of Reliability of Three Different Computer-Assisted Analysis Programs

Objective:The aim of this study was to assess the reliability of cephalometric analysis using 3 different digital analysis programs.Methods:For this study, a dry human skull with the entire mandible, maxilla, and teeth was used. Fifteen lateral and 15 posteroanterior cephalometric digital images were taken by rotating the skull from 0° to ±14° at 2° intervals to obtain different images. Two researchers located the landmarks on the digital images independently using 3 computer-assisted analysis programs, Dolphin Image Software (Dolphin Imaging and Management Solutions), Quick Ceph Image (Quick Ceph Systems Inc), and Vistadent OC (GAC Int Inc). Following the first measurements (T1), all landmarks were relocated within a 2-week interval (T2) by each examiner. A paired and the independent Student t tests were used for intraexaminer and interexaminer measurements, and Pearson correlations were obtained. Intraclass correlation coefficients (ICC) were calculated to determine intraexaminer repeatability.Results:For the repeated measurements, mean differences were statistically insignificant, and high correlations for the repeated measurements were found, and the intraexaminer correlations were significant for each examiner (p<.001). When the interexaminer correlations of 3 analyses were compared, interexaminer correlations showed high consistency and the lowest Pearson r value was the same angular measurement (S ant-n-ss) (p<.001). ICC values demonstrated high intraexaminer repeatability. The highest value of ICC was the mandibular body length (go-me) for both examiners (p<.001).Conclusion:The 3 tested analysis programs may be accepted as reliable for clinical use

Effect of Xylitol Lozenge on Remineralization of Artificial Carious Lesions - In Situ

The purpose of this study was to evaluate the effect of lozenges containing xylitol on in situ remineralization of artificial carious lesions. Eleven patients (aged between 12 and 15 years old) treated by fixed orthodontic therapy with bilateral maxillary first premolar extractions were included into this study. Each subject wore a modified transpalatal arch that was prepared by adding an acrylic resin to the U region for positioning of the enamel blocks (4X4X3 mm) on it. Three enamel blocks were prepared from the extracted tooth of each patient for both control and experimental groups. Artificial caries lesions were prepared by a low pH solution. This was a two stages study of 14 day periods: no-lozenge and xylitol lozenge (5 times/day, after meals). After each stage, the surface enamel microhardness testing was performed using a Vickers Hardness Tester. Three penetrations were made with a load of 300 g for 15 seconds into the enamel. Friedman's test was used for statistical analyses. The microhardness values were 197.5±127.3, 185.2±106.7, 193.2± 103.4 kgf/mm2 for control, no-lozenge and xylitol groups, respectively. Microhardness results demonstrated that there were no statistically significant differences between amount of remineralization in the control and experimental groups. The results showed that xylitol lozenge was not effective on in situ remineralization of artificial carious lesions but at least non-cariogenic

İNSAN MANDİBULASINDA SONLU ELEMANLAR METODU KULLANILARAK GERİLME ANALİZİ YAPILMASI

In this study use of the finite element method in biomechanics, and an explanation of basicsteps of preparing a FEM model of a mandible, a discussion of the validity of results is the objective. Acomputer FEM model of a mandible is prepared from a real human mandible and stress analysis wasconducted. For this purpose CT sections of the mandible of a 22 year old male was obtained and theimages were scanned and transferred to the computer. In the study the steps of preparing a FEM modelof a human skeleton is explained in detail. By using them a 3 D model of the mandible prepared. One ofthe models is prepared with solid elements; the other is prepared with shell elements. The same loadingswere applied to both of them. The results are compared and it is concluded that there is no importantdifferences between them.Bu çalışmada, sonlu elemanlar metodunun biyomekanikte kullanıldığı bir durum için, modelinhazırlanmasının temel aşamaları ve elde edilen sonuçların geçerliliğinin tartışılması amaçlanmıştır. Birinsan mandibulasının sonlu elemanlar programında gerilme analizini yapmak için bilgisayar modelihazırlanmıştır. Bu amaçla 22 yaşındaki bir erkek mandibulasının bilgisayarlı tomografisi (CT) alınmış,elde edilen görüntüler bilgisayar ortamına aktarılmış ve mandibulanın 3 boyutlu sonlu elemanlarmodeli hazırlanmıştır. Çalışmada modelin hazırlanmasında izlenen adımlar detaylı olarak verilmiştir.Sonlu elemanlar metodu (FEM) ile analizde, mandibulanın kabuk ve tuğla-solid elemanlar kullanılarakelde edilen modelleri ile yapılan gerilme karşılaştırması da verilmiştir. Bu modeller değerlendirildiğindesolid ve kabuk elemanlarla yapılan modellerin yaklaşık aynı mekanik davranışı yansıttığı belirlenmiştir.Kabuk elemanlarla hazırlanan modelin kolay elde ediliyor olması nedeniyle daha kullanışlı olduğugörülmüştür

Effect of Orthodontic Bracket Base Structure on Shear Bond Strength

Direct bonding is the method of choice for attaching fixed orthodontic appliances. These fixed appliances are produced with various bonding bases. The present study aims to compare shear bond strengths (SBS) and fracture characteristics of the bracket adhesive interface of six different bracket base types. Standard mesh base (Ultraminitrim-Dentaurum, Germany), Supermesh base (Microarch- GAC, USA ), Integral base (Dyna-Lock, 3M Unitek, USA and Micro -loc GAC, USA), Micro-etched base (Mi -niature Twin, 3M-Unitek), and laser structured base (Discovery-Dentaurum, Germany) brackets were used. Twenty brackets of each type were bonded to specially constructed 120 bonding bases with Transbond XT (3M Unitek, USA). A testing machine (Model 500, Testometric, Lancashire, England) was used to evaluate shear bond strengths for all groups. After debonding, the amount of residual adhesive on the bracket was assessed according to the adhesive remnant index (ARI). ANOVA revealed statistically significant differences among the 6 groups tested (P<0.05). According to the results of Duncan's test highest SBS was achieved by laser treated Discovery brackets. This was followed by Micro-loc and Miniature Twin brackets. The SBS achieved by the latter two were lower but the difference with laser structured Discovery was statistically insignificant. The lowest SBS was achieved by Microarch bracket. From the results obtained in our study, we suggest that differences in bracket base design may lead to significant differences in shear bond strengths. Micro-loc, Miniature Twin or Discovery bases may be preferred to achieve higher shear bond strengths values and to reveal more accurate resin-enamel bond strength values in bond strength studies

Comparison of Intermaxillary Tooth Size Discrepancies Among Different Malocclusion Groups

The aim of this study was to investigate the Bolton ratio differences between normal occlusion cases and Class I, Class II division 1, Class II division 2 and Class III malocclusion cases and to determine the role of sex differences. The patients were divided into 5 different groups. Class I, Class II division 1, Class II division 2, Class III malocclusions and normal occlusion. Each group had 60 boys and 60 girls. Mesiodistal tooth size measurements of upper and lower teeth were performed on 600 dental casts using a digital caliper. To determine the discrepancy, anterior ratios and total ratios mentioned in Bolton Analysis were calculated. These ratios were compared between different malocclusion and gender groups. The statistical analyses were performed using SPSS for Windows (version 10.0) statistics software. The intergroup comparisons were made using unidirectional variance analysis (ANOVA) and Tukey HSD tests. Lettering method was used in the one by one comparison between different groups. In this study, it was found that there were no differences in tooth dimension ratios between different sex groups in malocclusion cases (Class I, Class II division 1, Class II division 2, Class III malocclusion), but in normal occlusion group, anterior ratio was found to be higher in girls than males. It was observed that there was a significant difference in anterior ratios between Class III and Class II division 1 malocclusions in girls. Statistically significant differences were also observed in total ratios between normal occlusion and Class II division 1 and 2 malocclusion. Since it was a fact that the total and anterior ratio values determined for Turkish population were higher than Bolton's values, it would be better to take these specific values for Turkish people into consideration for treatment planning