Assessment of the Relationship between Skeletal Maturity and the Calcifications Stages of Permanent Canines and Second Premolars.

OBJECTIVE: This study aimed to evaluate the relationship between the calcification stages of permanent maxillary and mandibular canines and second premolars and skeletal maturity in both sexes. METHODS: This study included 138 patients (82 females, 56 males) who were treated in the Department of Orthodontics, Altinbas University. The mean age of the patients was 12.31±1.76 years, ranging from 7.8 years to 15.8 years. Dental maturity stages of canines and second premolars were evaluated according to the Demirjian index on digital panoramic radiograph. The skeletal maturation stage was determined using the cervical vertebral maturation (CVM) index. The Pearson correlation analysis was performed to assess the association among CVM stages and calcification stages of canines, second premolars, sex, and chronological ages. RESULTS: A statistically significant correlation was found between CVM and the calcification stages of the canines and second premolars (p<0.05). The calcification stages of the canines and second premolars had the highest distribution of Stage F and Stage G at CVM2 (p<0.01). For the canines and second premolars, Stage H corresponded to CVM3 in female patients and a high percentage of Stage G corresponded to CVM3 in the male group. CONCLUSION: A significant correlation was found between the calcification stages of maxillary and mandibular canines, second premolars, and skeletal maturity in both sexes. It was observed that calcification stages and cervical maturations were advanced in female subjects compared with male subjects.

Mandibular symphysis morphology in different skeletal malocclusions and its correlation with uvulo-glossopharyngeal structures.

Objective: The aim of the present study was to evaluate mandibular symphyseal morphology and its relationship with uvulo-glossopharyngeal structures in patients who had a range of sagittal malocclusions.Methods: The study sample consisted of 100 patients who presented with Class I, Class II div. 1, Class II div. 2, or Class III malocclusions. Skeletal, dental, symphyseal, and uvulo-glossopharyngeal measurements were evaluated on cephalograms.Results: As the vertical growth of the mandibular symphysis increased, the ANB angle and the IMPA and soft palate length and thickness decreased, whereas, the SNB angle and RgnH increased significantly. In addition, as the symphysis inclination in relation to the mandibular plane increased, the IMPA and ANB angles increased, while tongue height decreased.Conclusion: Based on the findings of the present study, it can be concluded that there are relationships between mandibular symphysis morphology and the uvulo-glossopharyngeal structures and differences between sagittal skeletal malocclusions.

Long-term stability of surgical-orthodontic treatment for skeletal Class III malocclusion with mild asymmetry.

Skeletal Class III malocclusion with mandibular prognathism is often associated with mandibular asymmetry, and patients with Cl III deformity and asymmetry may undergo orthognathic surgery to improve facial function and esthetics. However, the long-term stability of mandibular setback surgery has been considered "problematic". We report a 25-year-old female patient who was diagnosed as having a skeletal Class III relationship, mandibular asymmetry and unilateral crossbite. She underwent bilateral sagittal split-ramus osteotomy and orthodontic therapy, and this led to improvement of her dentofacial relationship, esthetics and occlusion. The outcome was stable after 8 years of retention. This case shows that asymmetry correction using mandibular setback surgery for skeletal Class III deformity can yield long-term stability.

Effects of malocclusions on facial attractiveness and their correlations with the divine proportion.

PURPOSE: The aim of this study was to evaluate the effects of malocclusions on facial attractiveness and to determine if it was correlated with the divine proportion. METHODS: Standard frontal facial photos were taken from 335 subjects in natural head position. Facial attractiveness of the subjects was evaluated by 10 dental students using a 10-point visual analog scale (VAS). All of the evaluations were arranged in order, and 30 attractive subjects with the highest score and 30 nonattractive subjects having the lowest score were chosen. On the frontal photos of these subjects, 13 landmarks were determined and 12 ratios were measured. Two way ANOVA was used to determine the effects of malocclusions on facial attractiveness, Student's t test was used to compare the facial proportions of the attractive and nonattractive subjects, and one sample t test was used to define the relationships between the divine proportion and facial ratios. RESULTS: No statistically significant difference was found between malocclusion groups in terms of facial attractiveness. Of the 12 facial ratios, significant differences were found between attractive and nonattractive subjects regarding trichion-menton/nasion-menton, subnasale-menton/stomion-menton, nasion-subnasale/stomion-menton, nasion-subnasale/nasal width, and trichion-menton/right-left frontotemporale ratios. All of the ratios except nasion-subnasale/stomion-menton in the attractive group and subnasale-menton/stomion-menton and nasion-menton/nasion-trichion in the nonattractive group were found to be different from the divine proportion. CONCLUSIONS: Sagittal skeletal malocclusions evaluated by ANB angle are not effective on facial attractiveness. Facial ratios used in this study have little effect on attractiveness, and are different from the divine proportion.

Effects of maxillary molar intrusion with zygomatic anchorage on the stomatognathic system in anterior open bite patients.

The aim of this study was to evaluate the effects of intrusion of the maxillary posterior teeth with zygomatic anchorage on the dentofacial system, on electromyographic (EMG) activity of the masticatory muscles, and on vibration of the temporomandibular joint. The study sample consisted of 19 subjects (13 females, 6 males) with a mean age of 17.7 years. Lateral cephalometric and posteroanterior (PA) radiographs, EMG, and electrovibratographic (EVG) records were obtained before (T0) and after (T1) intrusion. Paired t- and Wilcoxon signed ranks tests were used for statistical evaluation. Maxillary molar intrusion of 3.37 ± 1.21 mm was obtained with a force of 400 g in an average period of 6.84 ± 1.64 months. At T1, all measurements showed that facial growth direction, ANB angle, convexity, and overjet were decreased (P < 0.05). SNB angle, facial depth, and overbite were significantly increased (P < 0.05). Upper lip-E plane distance was increased (P < 0.05). Evaluation of the PA radiographs showed that the right and left molar reference angles were unchanged. EMG and EVG analysis showed that the stomatognathic system at T0 was maintained at T1. Intrusion of the maxillary posterior teeth with zygomatic anchorage is an effective treatment alternative for anterior open bite correction.

Effects of Hawley retainers on consonants and formant frequencies of vowels.

OBJECTIVE: To assess (1) whether Hawley retainers cause speech disturbance and (2) the duration of speech adaptation to Hawley retainers with objective and subjective tests. MATERIALS AND METHODS: Twelve adolescents, aged 11.11 to 18.03 years, were included in this study. The assessment of speech sounds were done subjectively using an articulation test and objectively using acoustic analysis before and after Hawley retainer application. RESULTS: After wearing Hawley retainers, patients showed statistically significant speech disturbances on consonants [s] and [z]. Regarding the vowels, statistically significant changes were recorded with [i], while F1 increased and F2 and F3 decreased. CONCLUSIONS: The tongue changes its target position with the application of a foreign body within the mouth; however, in time it adapts to that new situation.

Uvulo-glossopharyngeal dimensions in non-extraction, extraction with minimum anchorage, and extraction with maximum anchorage.

The aim of this study was to investigate upper respiratory airway dimensions in non-extraction and extraction subjects treated with minimum or maximum anchorage. Lateral cephalograms of 39 Class I subjects were divided into three groups (each containing 11 females and 2 males) according to treatment procedure: group 1, 13 patients treated with extraction of four premolars and minimum anchorage; group 2, 13 cases treated non-extraction with air-rotor stripping (ARS); and group 3, 13 bimaxillary protrusion subjects treated with extraction of four premolars and maximum anchorage. The mean ages of the patients were 18.1 ± 3.7, 17.8 ± 2.4, and 15.5 ± 0.88 years, respectively. Tongue, soft palate, hyoid position, and upper airway measurements were made on pre- and post-treatment lateral cephalograms and the differences between the mean measurements were tested using Wilcoxon signed-ranks test. Superior and middle airway space increased significantly (P < 0.05) in group 1. In group 2, none of the parameters showed a significant change, while in group 3, middle and inferior airway space decreased (P < 0.01). The findings show that extraction treatment using maximum anchorage has a reducing effect on the middle and inferior airway dimensions.

Arch-width and perimeter changes in patients with borderline Class I malocclusion treated with extractions or without extractions with air-rotor stripping.

INTRODUCTION: The aim of this study was to compare dental arch-width and perimeter changes in patients with borderline Class I occlusion, treated with extractions or without extractions with air-rotor stripping (ARS). METHODS: The study was conducted with 26 sets of pretreatment and posttreatment dental models of patients with borderline Class I occlusion. Thirteen patients (mean age, 18.1 +/- 3.7 years) were treated with 4 premolar extractions, and 13 (mean age, 17.8 +/- 2.4 years) were treated without extractions but with the ARS technique. Mean maxillary and mandibular crowding values were 5.7 +/- 1.5 and 5.9 +/- 1.4 mm in the extraction group, and 5.0 +/- 1.3 and 5.9 +/- 1.3 mm in the nonextraction group, respectively. A digital caliper was used to measure maxillary and mandibular intercanine and intermolar arch widths and arch perimeters. The Wilcoxon test was used to evaluate treatment changes in each group. The Mann-Whitney U test was used to compare the pretreatment and posttreatment values and the treatment changes between the 2 groups. RESULTS: At the start of treatment, the maxillary and mandibular intercanine and intermolar widths and the arch perimeters of both groups did not differ statistically. The maxillary intercanine widths were maintained in both groups. The maxillary and mandibular intermolar widths and arch perimeters decreased in the extraction group. In the nonextraction group, intermolar widths decreased, but arch perimeters did not change significantly. After treatment, the maxillary and mandibular intercanine widths were not different between the groups. CONCLUSIONS: In Class I borderline patients with moderate crowding, extraction therapy with minimum anchorage did not result in narrower dental arches, and nonextraction treatment with ARS preserved the intercanine arch widths and arch perimeters.

Occlusal characteristics of deaf-mute individuals in the Turkish population.

OBJECTIVES: To classify and determine the occlusal characteristics of deaf-mute individuals and its gender distribution in the Turkish population. METHODS: For this study, 213 deaf-mute individuals (155 boys and 58 girls) were evaluated. The age range was between 10-24 years, and the mean age was 16.37+/-2.53 years. Measurements were divided into four groups: dental, intraarch, interarch, and, extra data. RESULTS: Of the participants, 75.0% had a Class I molar relationship, whereas 13.0% and 8.0% had Class II and Class III malocclusions, respectively. 23.9% of individuals had a normal overbite, 38.4% had a deepbite, and 23.4% had an openbite. One or more congenitally missing teeth were found in 6.0% of individuals; 81.0% expressed satisfaction with their esthetics, and 19.0% expressed the contrary. CONCLUSIONS: Different characteristics and malocclusions are present in deaf-mute individuals.

Reimplantation of an inverted maxillary premolar: case report of a multidisciplinary treatment approach.

Inversion of premolars is an extremely rare condition, which usually requires extraction. This case report describes the inversion of an impacted maxillary second premolar in an 11-year-old male, and the multidisciplinary treatment approach for bringing the tooth into a normal position within the arch. In order to provide sufficient space for surgical reimplantation of the tooth, the mesially-drifted neighbouring maxillary first molar was first endodontically treated, followed by orthodontic distalization of the tooth. The inverted tooth was removed surgically and reimplanted without the use of splints for stabilization. After a 12-month follow-up period, the tooth maintained its vitality without any root resorption. Reimplantation of impacted inverted premolars can be a viable treatment alternative to extraction.