Cone Beam Computed Tomography in Orthodontics

Cone beam computed tomography (CBCT) is an important source of three‐dimensional volumetric data in clinical orthodontics. Due to the progress in the technology of CBCT, for orthodontic clinical diagnosis, treatment and follow‐up, CBCT supply much more reliable information compared to conventional radiography. The most justified indications for the use of CBCT in orthodontics are the existence of impacted and transposed teeth. For the management of the impacted teeth, CBCT enhances the ability to localize these teeth accurately and to assess root resorption of adjacent teeth. Patients with craniofacial anomalies like cleft palate cases, the abnormalities of the temporomandibular joint contributing malocclusion, evaluation of airway morphology in obstructive sleep apnea cases, patients needing maxillary expansion or planning orthognathic surgery in severe skeletal discrepancies are also listed among the indications of using CBCT in orthodontics. CBCT is useful in identifying optimal site location for temporary skeletal anchorage device. The use of CBCT for the assessment of treatment outcomes and evaluation of cervical vertebral maturation are still controversial issues. It should be kept in mind that before using CBCT, justification and evaluation of risks and benefits are needed. In order to minimize the radiation dose, the exam should include only the areas of interest

The Influence of Abnormalities in the Profile and Overjet on Psychological Well-Being

Objective:This study aimed to comparatively evaluate the psychological well-being and health-related quality of life of subjects having either a convex or concave profile and abnormal overjet, with subjects having a straight profile and normal overjet.Methods: In this study, 163 children and their parents who applied to the Faculty of Dentistry were classified into 3 groups: Group 1: convex profile, Class II molar relationship, and increased overjet (n=62; 28 boys and 34 girls; mean age: 11.6 years); Group 2: concave profile, Class III molar relationship, and negative overjet (n=55; 32 boys and 23 girls; mean age: 11.2 years); and Group 3: straight profile, Class I molar relationship without crowding, and normal overjet (n=46; 24 boys and 22 girls; mean age: 11.0 years). The severity of malocclusion was evaluated using the Index of Orthodontic Treatment Need (IOTN). Self-concept, depression, and state–trait anxiety were evaluated to determine the psychological well-being of the children.Results: No differences were found among the groups with respect to self-concept, depression levels, state–trait anxiety levels, and quality of life scores. No correlation was found between the IOTN scores and psychological well-being.Conclusion: Abnormalities in the facial profile and negative or increased overjet have no influence on children’s psychological well-being

Orthopedic Treatment of Skeletal Class III Malocclusions With Maxillary Deficiency

Objective:The purpose of this study was to compare the treatment effects of a double-plate appliance (DPA) and a double-plate appliance and facemask combination (DPA-FM) in correcting Class III malocclusions.Materials and Methods:The material consisted of lateral cephalometric radiographs of 40 children with skeletal and dental Class III malocclusion. In the first treatment group, 13 patients (mean age: 10 years 3 months) were treated with DPA. In the second treatment group, 15 patients (mean age: 10 years 9 months) were treated with DPA-FM. In the third group, 12 patients (mean age: 10 years 6 months) were observed without treatment for 9 months. Statistical evaluation was made by ANOVA, Duncan, and paired t tests.Results:The increases in SNA and ANB angles were significantly greater in the DPA-FM group than in the DPA group. The proclination of upper incisors (U1/NA) and retroclination of lower incisors (L1/NB) were significantly greater in the DPA group than in the DPA-FM group. The retroclination of lower incisors (L1/NB) in the DPA group showed a significant difference compared with the control group. The increase in ANS-Me length was significantly greater in the DPA-FM group than in the control group.Conclusion:The DPA-FM treatment was more effective in sagittal correction of the maxilla than the DPA treatment. The dental contribution to Class III treatment seemed to be greater in the DPA group, but in this group vertical skeletal changes were more satisfying

Üst birinci premolar çekiminin maksiller ve mandibular posterior boşluğa etkisinin değerlendirilmesi

Amaç: Üst birinci premolar çekiminin maksiller ve mandibular posterior boşluğa olan etkisinin değerlendirilmesidir. Gereç ve Yöntem: Çalışmanın materyalini, dişsel Sınıf II maloklüzyona sahip, üst iki birinci premolar çekimi ile sabit apareylerle tedavi edilmiş 20 bireyin tedavi öncesi (T1), sonrası (T2) ve pekiştirme sonrası (T3) lateral sefalometrik radyografileri oluşturdu. Lateral sefalometrik radyografiler üzerinde, yedi boyutsal ve dört açısal ölçüm aynı yazar tarafından yapıldı. İstatistiksel analizde, sürekli sayısal değişkenlerin dağılımının normale yakın dağılıp dağılmadığı Shapiro-Wilk testiyle incelendi. Ölçüm ortalamalarında istatistiksel olarak anlamlı değişim olup olmadığı parametrik verilerde Wilks’in Lambda testi, nonparametrik verilerde ise Friedman testiyle incelenerek; Bonferroni düzeltmeli çoklu karşılaştırma ya da Dunn-Bonferroni post-hoc testler uygulandı. p<0.05 değeri anlamlı olarak kabul edildi. Bulgular: SNB açısı T3’te T1’e göre anlamlı düzeyde arttığı bulundu (p<0.05). ANB açısı T3’te T1’e göre anlamlı düzeyde azaldığı bulundu (p<0.05). T1’e göre hem T2 hem de T3’te U1-NA mesafesinin anlamlı düzeyde azaldığı bulundu (p<0.001). T1’e göre hem T2 hem de T3’te ve T2’ye göre T3’te U6-PTV mesafesinin anlamlı düzeyde arttığı bulundu (p<0.001). T1’e göre hem T2 (p<0.01) hem de T3’te (p<0.001) ve T2’ye göre T3’te CLMD (p<0.05) mesafesinin anlamlı düzeyde arttığı bulundu. T1’e göre hem T2 hem de T3’te ve T2’ye göre T3’te DC mesafesinin anlamlı düzeyde arttığı bulundu (p<0.001). CL1 mesafesi T3’te T1’e göre anlamlı düzeyde artmış bulundu (p<0.05). Sonuç: Maksiller posterior boşlukta premolar çekimine bağlı olarak artış izlenmiştir. Mandibular posterior boşlukta izlenen artışın maksiller posterior boşluktan daha az olduğu görülmüştür. Maksiller kesici dişlerde retraksiyon ve maksiller molarlarda meziyalizasyon hareketi izlenmiştir

Modifiye tandem traksiyon yüz arkı apareyinin hava yolu boyutuna etkisi

Amaç: Sınıf III maloklüzyon tedavisinde kullanılan modifiye tandem traksiyon yüz arkı (MTTYA) apareyinin faringeal hava yolu boyutları üzerine olan etkisini incelemekti. Gereç ve Yöntem: Çalışmanın materyalini, iskeletsel ve dişsel Sınıf III maloklüzyona sahip, MTTYA apareyi ile tedavi edilmiş olan 20 bireyin (8 kadın ve 12 erkek; yaş ortalaması 10 yıl 1 ay) tedavi öncesi (T1) ve sonrası (T2) lateral sefalometrik radyografileri oluşturdu. MTTYA apareyinin üst plağından yüz arkına oklüzal düzlemle 35-40° açı yapacak şekilde 400-500 g. kuvvet uygulayan elastikler asıldı. Ortalama 12 aylık tedavi uygulandı. Faringeal havayolu boyut ve alan ölçümleri yapıldı. İstatistiksel analizde, Kolmogorov-Smirnov ve eşleştirilmiş t testleri kullanıldı ve p<0.05 değeri anlamlı olarak kabul edildi. Bulgular: Tedavi ile maksillada ileri yönde harekette (p<0.001) ve efektif maksilla ve mandibula boyutlarında anlamlı artışlar ortaya çıktı (p<0.001). Mandibular düzlem eğiminin artışı (p<0.001) ile mandibulada posterior rotasyon saptandı. Orofaringeal alanda (OA) anlamlı düzeyde (p<0.05) ve nazofaringeal alanda (NA) anlamlı olmayan düzeyde artışlar gözlendi. Hyoid kemik, anlamlı olmayan düzeyde öne ve aşağıya yer değiştirdi. Sonuç: Sınıf III malokluzyon tedavisinde kullanılan MTTYA apareyi uygulaması ile orofaringeal havayolu alanında olumlu yönde değişiklik gözlendi

Comparison of transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system.

To compare the transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system (KIDS)

Comparison of double-plate appliance/facemask combination and facemask therapy in treating Class III malocclusions

Objective: To compare the treatment effects of double-plate appliance/facemask (DPA-FM) combined therapy and facemask (FM) therapy in treating Class III malocclusions. Materials and Methods: The material consisted of lateral cephalometric radiographs of 45 children with skeletal and dental Class III malocclusion. The first treatment group comprised 15 patients (mean age = 11 years) treated with FM. The second treatment group comprised 15 patients (mean age = 10 years 9 months) treated with DPA-FM. The third group comprised 15 patients (mean age = 10 years 5 months) used as controls. The paired t-test was used to evaluate the treatment effects and changes during the treatment and observation period in each group. Differences between the groups were determined by variance analysis and the Duncan test. Results: With the DPA-FM and FM appliances, the SNA and ANB angles increased significantly. These changes were statistically different compared with the control group. Lower facial height showed a greater increase in both treatment groups than in the control group. Molar relation showed a greater increase in the DPA-FM group than in the FM group. The increase in U6/ANS-PNS angle in the FM group was significantly different from the DPA-FM and control groups. The L1/NB angle and Pg-T increased significantly only in the FM group, but no significant difference was found between the treatment groups. Conclusions: In the treatment of Class III malocclusion, both appliances were effective. The significant sagittal changes in the lower incisors and pogonion in the FM group compared with the nonsignificant changes in the DPA-FM group might be due to the restriction effect of acrylic blocks in the DPA-FM group

Effects of combined rapid palatal expansion and face mask therapy on mandibular dentition

Objective: The study aimed to evaluate the effects of combined rapid maxillary expansion (RPE) and face mask (FM) application on the mandibular dentition. Materials and Method: In this retrospective study pre- and post-treatment cephalometric radiographs and orthodontic models of 25 patients (10 female, 15 male) with a mean skeletal age of 12 years and 1 month, being in permanent dentition, having skeletal Class 3 anomaly (ANB<0) accompanying with maxillary retrognathism and posterior crossbite who had been treated with a combined application of bonded Hyrax RPE and FM were evaluated. The mean duration for the RPE-FM application was 8.7 months. The lower arch intermolar and intercanine widths, arch depth and the amount of crowding between canines were evaluated using Littles’ Irregularity Index (LII) on the 3D images of the models utilizing the 3Shape OrthoAnalyzer 2013-1 program. Mandibular incisors’ inclination (IMPA degree) were determined on cephalometric radiographs. The statistical evaluation was done with paired t-test, and the statistical significance was set at p<0.01. Results: In the lower dental arch, a significant increase of 1.38 mm was found in the intermolar width (p<0.001). While no significant difference was observed in the intercanine width, there was a significant decrease in the arch depth (1.45 mm; p<0.001) and a significant increase in the LII value (1.46 mm; p<0.01). Besides, there was no significant difference in the IMPA degree. Conclusion: Combined RPE-FM application in the treatment of skeletal Class 3 malocclusion provides an increase in mandibular intermolar width that may increase the arch length. On the contrary, a decrease in the arch depth results in shortening of the arch length. Clinicians should be conscious of a mandibular anterior crowding during this type of combined therapy

Repeatıbılıty Of Lateral Cephalometrıc Measurements And Dıgıtatıons

The purpose of this study was determine the interexaminer tracing and digitizing repeatibility for computer aided lateral cephalometric measurements. The material used in this study comprised 60 lateral cephalometric radiograps (20 Class 1, 20 Class 2, 20 Class 3). Four examiners traced all radiograps and digitized 134 landmarks by using RMO joe version 5 Package program. In this program 51 measurements were selected. To evaluate statistically the differences between the examiners repeatability degrees were calculated in a PC program made in BASIC for all parameters. SN, SNB, SND, ANB, Ramus height, GnGoAr, MGoS, GoM, SL, Palatal/Mandibuler plane angle, SN/GoGn, Anterior and posterior face heights, MeANS, Lower facial height, Total facial height, SNPg, Y axis, L1NB degree, L1/Mandibular plane, Overjet, Lower lip/esthetic plane and H angle demonstrated high repeatability (r>0.900). Ramus Xi position had very low repeatability degree (r=0.329). Repeatability degrees for maxillary height, Occlusal plane/SN, L1 extrusion and nasolabial angle changed among 0.600-0.700

Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space

Objective: The aim of this study was to evaluate and compare the mandibular arch posterior space changes in Class III patients treated with facemask (FM) with removable upper appliance or modified tandem traction bow appliance (MTTBA). Methods: Pre- and post-treatment and pre- and post-observation lateral cephalograms of 76 subjects with skeletal and dental Class Ill malocclusion from the period 2000-10 years formed the materials of this study. In the first group, 25 patients (10 girls, 15 boys; mean age: 10 years, 1 month) were treated with MTTBA. The average treatment time was 12 months. In the second group, 26 patients were treated (13 girls, 13 boys; mean age: 10 years, 4 months) with a Delairetype FM. The average treatment time was 13 months. The remaining 25 children (9 girls, 16 boys; mean age: 9 years, 8 months) were observed without treatment for 10 months. ANOVA, Duncan, and paired t-tests were used for statistical evaluation. Results: Although ramus width and mandibular posterior space increased significantly in all groups, no significant differences were found among the groups. Significant increase in tipping of lower molar (L6/GoMe) in the MTTBA group showed a significant difference compared with the FM and control groups. Significant retroclination of the lower incisors (L1/NB) in the MTTBA and FM treatment groups was significantly different compared with the control group. Retroclination of lower incisors in the MTTBA group was significantly greater than that in the FM group. Conclusions: FM and MTTBA treatment approaches did not affect the dimensions of posterior space. Limitations: To generalize the results of this study, long term evaluation by considering the third molar position should be done