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

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

Reliability Assessment of Orthodontic Apps for Cephalometrics

Objective:The aim of this study was to evaluate the accuracy and reliability of cephalometric measurements using iPad apps called CephNinja and SmartCeph Pro. The measurements were compared with the measurements obtained using Dolphin Imaging computer software.Methods:Twenty digital cephalometric radiographs were randomly selected from the archives and traced using the CephNinja app, SmartCeph Pro app, and Dolphin Imaging software. Twenty-one landmarks and 16 measurements were performed in each program. The statistical analysis was conducted using the Bland-Altman analysis at a significance level of 0.05.Results:For the CephNinja app, there were seven measurements that were in accordance with Dolphin Imaging software. For the SmartCeph Pro app, six measurements were in accordance with Dolphin software. Both apps gave better results for angular measurements than linear ones.Conclusion:These findings indicate that, although they are user-friendly, orthodontic apps for cephalometrics are not equal with Dolphin software now and need to be developed to be more reliable for most of the measurements

Mechanical Properties of Different Aesthetic Archwires

Objectives:In response to patient demands for better aesthetics in orthodontics, manufacturers have developed different aesthetic wires and brackets. The aim of this study were to evaluate the mechanical properties of archwires. Thus, color properties and surface roughness of the different aesthetic archwires were analyzed.Materials and Method:Seven brands of aesthetic archwires were evaluated for color and roughness measurements. The color measurement of each sample was performed using a spectrophotometer. A profilometer was used to measure surface roughness. For roughness, Ra (average roughness), Rq (root mean square roughness), and Rz (maximum peak to valley height) parameters were used. A Kruskal-Wallis test was used to compare intergroup differences. For pairwise comparisons, a Mann- Whitney U test was used.Results:Intergroup comparisons revealed remarkable differences between groups for all parameters. The surface roughness and Commission Internationale de l’Eclairage L*a*b* color values were statistically different from each other for all intergroup comparisons (p , .001).Conclusion:Having different color options for aesthetic wires gives clinicians an advantage in terms of the ability to choose archwires that are more harmonious with individual teeth in terms of bracket color and thus provide a more aesthetic appearance

Is There a Relationship between Maxillary Sinus Findings and Skeletal Malocclusion?

Objective:No study has investigated the relationship between maxillary sinus findings and skeletal malocclusion based on conebeam computed tomography (CBCT). The aim of the present study was to determine the relationship between the frequency of sinus findings and patients’ skeletal malocclusion classification.Objective: No study has investigated the relationship between maxillary sinus findings and skeletal malocclusion based on conebeam computed tomography (CBCT). The aim of the present study was to determine the relationship between the frequency of sinus findings and patients’ skeletal malocclusion classification.Methods:A total of 105 CBCT scans were examined and divided into three groups according to skeletal classification. Two experienced observers reviewed the CBCT images and recorded all the maxillary sinus findings. The patients’ skeletal malocclusion, thickness of the Schneiderian membrane, and pathological sinus findings were evaluated.Results:The sinus findings were classified into four groups: 0=no finding, 1=mucosal thickening, 2=partial opacification with liquid accumulation, and 3=total opacification. Statistical analysis showed that there was no correlation between the skeletal malocclusion and pathological sinus findings. However, there were significant differences in the Schneiderian membrane thickness between the groups.Conclusion:The Schneiderian membrane thickness was significantly different in Class II and Class III patients. There was no relationship between pathological sinus findings and skeletal malocclusions

Effect of grape seed extract on bone formation in the expanded inter-premaxillary suture

Objective: Widening the inter-maxillary suture is a preferred procedure in orthodontics. However, relapse can occur in some patients after maxillary expansion therapy. This study aimed to increase bone formation in the inter-maxillary suture and decrease retention time with the help of grape seed extract (GS), which can stimulate bone tissue formation.Materials and Methods: A total of twenty rats were separated into the following two groups (n=20): the control group (group C) comprised rats that received only maxillary expansion therapy, and the other group (group GS) comprised rats that received maxillary expansion therapy along with GS. The grape seeds were systemically administered using an orogastric tube after maxillary expansion in group GS. Expansion springs were placed and activated to produce force. The springs were taken from the mouth 5 days later and exchanged with short rectangular wires for retention. This retention wire was placed for 12 days.Results: Significant differences were found in the percentage of newly formed bone (p<0.05) and bone area (p<0.05) between the two groups. Moreover, group GS had better bone formation than group C.Conclusion: Systemic use of GS during the stages of the orthopaedic expansion of the inter-premaxillary suture area increases newly formed bone and decreases the retention time