Nasal soft- and hard-tissue changes following tooth-borne and hybrid surgically assisted rapid maxillary expansion: A randomized clinical cone-beam computed tomography study.

PURPOSE: The aim of this study was to assess the effects of tooth/bone-borne (hybrid) and tooth-borne (TB) surgically assisted rapid maxillary expansion (SARME) on the width of the nasal soft and hard tissue. PATIENTS AND METHODS: Twenty skeletally mature patients (nine males and 11 females; mean age 19.4 years) with transverse maxillary hypoplasia were randomly assigned to hybrid or TB devices. The patients had undergone SARME operations, performed by the same surgical team using the same procedure (Le Fort I osteotomy with pterygomaxillary dysjunction, midline osteotomy, and no down-fracture). Nasal soft- and hard-tissue changes were analyzed using CBCT preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). The study was approved by the relevant ethics committee. RESULTS: The skeletal and soft-tissue nasal parameters increased significantly in the T0-T1 and T0-T2 periods in both groups (P < 0.05). No statistically significant differences between the groups were observed. The mean piriform aperture width increased from 1.26 mm in T0-T1 to 0.97 mm in T1-T2 and 2.17 mm in T0-T2 (P < 0.008). In the soft tissue, the alar base width increased to 2.78 mm and the alar width to 2.95 mm in T0-T2 (P = 0.001). There was a positive correlation (63.6%) between the changes in skeletal and soft-tissue values. CONCLUSION: The hybrid and TB devices led to similarly significant widening effects in nasal soft and hard tissues in both the short term and 6 months after SARME.

Evaluation of the Compliance of Orthodontists to Infection Control Procedures in Turkey.

OBJECTIVE: Orthodontists do not perform surgical procedures, nevertheless they are obliged to practice appropriate sterilization techniques to prevent cross-infection. This is also important from an ethical and legal point of view. The aim of the present study is to evaluate the compliance of orthodontists to infection control procedures in Turkey. METHODS: A questionnaire with 36 items was delivered by e-mail to a total of 1152 orthodontists/residents between October 2014 and March 2015 by the Turkish Orthodontic Society. Various data from surveys were analyzed using the IBM SPSS statistics 22 software. RESULTS: The questionnaire was completed by 130 (11.28%) respondents. 95.4% of the orthodontists were immunized against hepatitis B. The usage rates of type B autoclave, non-type B autoclave, and dry-heat sterilizer were 40%, 17.7%, and 16.9%, respectively. A total of 24.6% of the orthodontists used disinfectant solutions for the sterilization of hand instruments and pliers; the rate of using disinfectants for the sterilization of dental handpieces was found to be higher (56.9%). CONCLUSION: The infection control procedures in the field of orthodontics must be improved in Turkey. Training on compliance with the infection control principles should be included in education programs, and these programs should be repeated on a regular basis.

The effect of low-level laser therapy on tooth movement during canine distalization.

The aim of the study is to determine the effects of low level laser therapy on tooth movement during canine distalization by evaluating IL-1ß, TGF-ß1 levels in gingival crevicular fluid. Maxillary first premolars of the 15 Angle Class II division I patients (12-19 years old) were extracted. Right maxillary canines were distalized by standard protocol as control group whereas the left maxillary canines distalized by laser application. A gallium-aluminum-arsenide diode laser with an output power of 20 mW was applied as five doses from the buccal and the palatal side on the day 0, and the 3rd, 7th, 14th, 21th 30th, 33st, 37th, 60th, 63th, and 67th days. Gingival crevicular fluid samples were obtained with filtration paper at the initial, 7th, 14th, and 21th days, and the IL-1ß and TGF-ß1 cytokine levels were analyzed. Orthodontic models and periodontal indices were taken initially and on the days 30th, 60th, and 90th of canine distalization period. Tooth movement was assessed by scanning models (3Shape). The amount of tooth movement in the laser group was 40% more than the control group. First day IL-1ß levels were statistically higher than initial and 21st day levels (P= 0.003, P = 0.012). The rise in IL-1ß levels caused the negative correlations between 7th day IL-1ß and 21st day TGF-ß1 levels describes the tissue effects of laser application. Periodontal indices showed no sign of gingival inflammation during canine distalization period. As conclusion, laser does accelerate tooth movement and could shorten the whole treatment duration.

Comparison of total-etch, self-etch, and selective etching techniques on class V composite restorations prepared by Er:YAG laser and bur: a scanning electron microscopy study.

The purpose of this study was to compare total-etch, self-etch, and selective etching techniques on the marginal microleakage of Class V composite restorations prepared by Er:YAG laser and bur. Class V cavities prepared on both buccal and lingual surfaces of 30 premolars by Er:YAG laser or bur and divided into six groups. The occlusal margins were in enamel, and the cervical margins were in cementum. Group-1: bur preparation(bp)+Adper Single Bond 2 (ASB)+Filtek Z550 (FZ); Group-2: laser preparation(lp)+(ASB)+(FZ); Group-3: bp + Clearfil S3 Bond Plus (CSBP)+(FZ); Group-4: lp+(CSBP) (FZ); Group-5: bp + acid etching+(CSBP)+(FZ); Group-6: lp + acid etching+(CSBP)+(FZ). All teeth were stored in distilled water at 37°C for 24 hr, and then thermocycled 1000 times (5-55°C). Five teeth from each group were chosen for the microleakage investigation, and two teeth for the scanning electron microscope evaluation. Teeth which were prepared for the microleakage test were immersed in .5% methylene blue dye for 24 hr. After immersion, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p < .05). More microleakage was observed in the cervical regions compared to the occlusal regions in Groups 3, 5, and 6, respectively (p < .05). There is no statistically significant difference in Groups 1, 2, and 4, in terms of cervical regions versus occlusal regions (p > .05). No significant differences were observed among any groups in terms of occlusal and cervical surfaces, separately (p > .05). Different etching techniques did not influence microleakage of Class V restorations prepared by Er:YAG laser and bur.

Comparison of tooth-borne and hybrid devices in surgically assisted rapid maxillary expansion: A randomized clinical cone-beam computed tomography study.

PURPOSE: The objective of this 2-arm, parallel, single-center trial was to compare the skeletal, dental, and periodontal effects of tooth-borne (TB) and hybrid devices in surgically assisted rapid maxillary expansion (SARME). MATERIALS AND METHODS: Twenty consecutive patients (9 male and 11 female) with skeletal transverse maxillary deficiency seeking treatment at the Department of Orthodontics at Istanbul University in Istanbul, Turkey, were randomly assigned to 2 groups (10 patients each). Hybrid devices were inserted in the first group and TB (Hyrax) devices in the second. All of the patients had undergone SARME operations, which were carried out by the same surgeons using the same procedure (a Le Fort I osteotomy with pterygomaxillary dysjunction). All of the patients had similar transverse deficits, and 7 mm of expansion was achieved in all of them over 14 days. CBCT was carried out preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). Measurements were made using Mimics 16.0. RESULTS: Anterior skeletal maxillary widening parameters increased significantly in the T0-T1 and T0-T2 periods in the 2 groups (P = 0.001). There was significantly less dental expansion anteriorly with the hybrid devices (T0-T2: 4.03 mm vs. 6.29 mm). The first molars tipped buccally more in the group with TB devices during the T0-T1 phase (P = 0.029) and moved upright more than those in the group with hybrid devices during the retention phase (P = 0.035). Dental tipping, buccal alveolar bone resorption, and root resorption were observed significantly more often with the TB devices. CONCLUSION: Hybrid RME devices, with similar skeletal effects, different dental movement patterns, and fewer dental and periodontal side effects, thus appear to be a beneficial alternative to TB devices for SARME procedures.

Effect of different parameters of Er:YAG laser irradiations on class V composite restorations: A scanning electron microscopy study.

The purpose of this study was to compare different parameters of Er:YAG laser irradiations on the marginal microleakage of Class V resin composite restorations. A total of 45 extracted premolars were selected for the study. Class V cavities prepared on both buccal and lingual surfaces of teeth by Er:YAG laser or bur and divided into nine groups. The occlusal margins were in enamel and the cervical margins were in cementum. Group-1: bur preparation; Group-2: laser preparation (lp) (600 mJ/5 Hz); Group-3: lp (300 mJ/10 Hz); Group-4: lp (200 mJ/15 Hz); Group-5: lp (150 mJ/20 Hz); Group-6: lp (200 mJ/20 Hz); Group-7: lp (300 mJ/14 Hz); Group-8: lp (400 mJ/10 Hz); Group-9: lp (700 mJ/5 Hz). All teeth were stored in distilled water at 37°C for 24 h, then thermocycled 1,000 times (5-55°C). Five teeth from each group were chosen for the microleakage investigation and two teeth for the scanning electron microscope (SEM) evaluation. Teeth, which were prepared for the microleakage test were immersed in 0.5% methylene blue dye for 24 h. After immersing, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). More microleakage was observed in cervical regions compared to occlusal regions in all groups (p < 0.05) except for Group 6 (p > 0.05). No significant difference was observed among groups in terms of occlusal and cervical surfaces, separately (p > 0.05). It may be concluded that the cavities prepared by Er:YAG laser showed higher degree of microleakage than bur prepared at cervical regions. Different parameters of Er:YAG laser irradiations affected microleakage. SCANNING 38:434-441, 2016. © 2016 Wiley Periodicals, Inc.

Multidisciplinary management of limited interocclusal space: a clinical report.

Prosthetic management of partial edentulism can be challenging with the presence of limited interocclusal space. The extrusion of opposing teeth combined with the alveolar extrusion of the edentulous areas reduces the space needed for fabricating a removable or fixed prosthesis when edentulous areas are present in the maxilla. This clinical report describes the treatment provided to a patient who presented with a limited interocclusal space on the posterior right quadrant. Before prosthetic rehabilitation, mandibular right posterior teeth were intruded, and the maxillary right posterior alveolar crest was reduced by alveoloplasty. After gaining adequate space, prosthetic rehabilitation was completed with a maxillary removable partial denture. During the 2-year follow-up period, the patient's chewing functions and physical appearance improved, and no complications occurred.

The influence of Er:YAG laser conditioning versus self-etching adhesives with acid etching on the shear bond strength of orthodontic brackets.

OBJECTIVE: The aim of this study was to compare the shear bond strength (SBS) of orthodontic brackets after acid etching, laser ablation, self-etching primer application, and combined treatments. METHODS: One hundred defect-free premolars were randomly assigned to five groups. The teeth received the following treatments: group 1: phosphoric acid + Transbond XT primer; group 2: Transbond Plus Self-Etching Primer (TPSEP); group 3: Er:YAG laser ablation + Transbond XT primer; group 4: Er:YAG laser ablation + phosphoric acid + Transbond XT primer; and group 5: Er:YAG laser ablation + TPSEP. Transbond XT Adhesive Paste was used in all groups for bracket bonding. Samples were stored in deionized water at 37 degrees C for 24 h. The shear debonding test was performed at a crosshead speed of 5 mm/min. Failed brackets were examined by a stereomicroscope at 16 x magnification to determine the bond failure interface using a modified adhesive remnant index (ARI). SBS values were compared using one-way analysis of variance (ANOVA). The Kruskal-Wallis test was used for ARI scores and pairwise comparisons were done using the Mann-Whitney U test with Bonferroni correction. RESULTS: Mean SBS values (MPa) and standard deviations for the groups were: group 1, 13.18 +/- 3.45; group 2, 13.52 +/- 4.38; group 3, 10.33 +/- 4.74; group 4, 13.00 +/- 3.47; and group 5, 12.46 +/- 6.31. No significant differences were observed in the SBS of all the groups evaluated, but there was a significant difference in ARI scores, with group 3 showing higher ARI scores than groups 1 and 4. CONCLUSIONS: Er:YAG laser ablation and self-etching primer application showed similar SBS values as conventional acidetching for bonding brackets.

An evaluation of intraoral molar distalization with nickel-titanium coil springs.

The purpose of this study was to determine dental and skeletal effects of compressed nickel-titanium coil springs used for distal movement of the maxillary molars. Initial and follow-up cephalometric radiographs were taken of 8 patients (2 males and 6 females) in the late mixed or permanent dentition stage with Class II malocclusion. Nickel-titanium coil springs exerting a near constant force of approximately 250 g were compressed against the maxillary molar tubes by Gurin locks. The mean treatment time was 6.95 +/- 0.2 months. Dental and skeletal changes were determined as follows: The mean maxillary first molar distalization was 5.44 mm (right) and 3.75 mm (left), with a mesial tipping of 11.56 degrees (right) and 11.34 degrees (left). Anchorage loss occurred as defined by mesial movement of the first premolars and proclination of the central incisors. Vertical dental and skeletal dimensions were not affected.

Evaluation of oral and systemic manifestations in an amelogenesis imperfecta population.

OBJECTIVES: The aim of this investigation was to describe the dental and craniofacial characteristics of patients with amelogenesis imperfecta (AI). METHODS: The study group included 43 patients(33 female and 10 male) with a mean age of 11.4+/-2.6 years. A panoramic and a cephalometric radiograph were obtained from each of these patients. Clinically AI cases were divided into four main groups according to Witkop. All patients were evaluated for chronological, bone and dental age. The patients who had severe retarded bone age were evaluated for plasma growth hormone(GH) concentrations. RESULTS: Dental and bone ages were retarded with respect to chronological age in five patients. Dental maturity and tooth eruption were not age- appropriate in some of our patients. In type III AI patients a delay in skeletal age was observed. Severe late eruption was seen in 3 patients, severe delay in dental maturity was noted in patients with type IV AI. Dental age was clinically lower in GH-deficient subjects, and skeletal age was consistently more retarded than dental age when compared to chronological age. Anterior open bite was present in both primary and permanent dentitions of 50% of the patients with type I AI, 30.8% of the patients with type II AI, and 60% of type III AI. CONCLUSION: It is concluded that the primary structure for the classification of AI be based on the mode of inheritance, with the clinical and radiographic appearances (and any other features such as systemic findings) being the secondary discriminators.