Information on the Internet Regarding Orthognathic Surgery in Turkey: Is It an Adequate Guide for Potential Patients?

OBJECTIVE: To evaluate the quality of information on websites regarding orthognathic surgery in Turkey using the DISCERN toolkit. METHODS: An Internet search was performed using the Google search engine with the terms "orthognathic surgery", "jaw surgery", "jaw operation", "correcting jaw surgery", and "surgery orthodontics." The first 25 websites obtained after searching for each term were evaluated. Duplicate websites, advertisements, discussion groups, links to research articles, videos, and images were not considered. The remaining websites were analyzed using the DISCERN toolkit. This toolkit is composed of 15 questions that were scored from 1 to 5. Results were calculated as mean scores, percentages, and ranges. RESULTS: Among the 36 evaluated websites, 12 (33.3%) belonged to plastic surgeons, 11 (30.6%) belonged to orthodontists, 8 (22.2%) belonged to private dental clinics, 3 (8.3%) belonged to maxillofacial surgeons, 1 (2.8%) was a professional organization website, and 1 (2.8%) belonged to a private hospital. The Turkish Orthodontic Society had the only listed professional organization website. The mean total DISCERN score was 28/75 (range: 15-48). The overall quality of information in 44.4% of the websites was low. The main problems of websites were as follows: no mention of the aims, sources, and production time of information; no links for additional sources of information; and no information for patient carers. CONCLUSION: The quality of web-based information on orthognathic surgery was generally low. Higher quality information provided by public organizations that do not have profit concerns is required.

Cephalometric assessment of soft tissue morphology of patients with acromegaly.

AIM: To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. METHODS: Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test. RESULTS: Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). CONCLUSION: Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

Efficacy of different methods to reduce pain during debonding of orthodontic brackets.

OBJECTIVE: To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience. MATERIALS AND METHODS: Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearman's rank correlation coefficient analysis were used to analyze the data. RESULTS: When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores. CONCLUSIONS: The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.

Changes in airway dimensions and hyoid bone position following class II correction with forsus fatigue resistant device.

OBJECTIVE: The objective of this study was to investigate the effects of fixed functional therapy on oropharyngeal airway dimensions and hyoid bone positions in Class II patients and make comparison with an untreated Class II group. MATERIALS AND METHODS: Eighteen patients (8 girls, 10 boys; mean age 13.62 ± 1.92 years) who were treated with Forsus Fatique Resistant Device (FFRD) and 19 patients (11 girls, 8 boys; mean age 12.74 ± 0.91 years) who served as control were enrolled. Cephalograms were used to assess linear, angular, and area measurements. Intragroup comparisons were made by paired t and Wilcoxon tests and intergroup comparisons were performed by independent t test. RESULTS: With respect to controls, FFRD group showed increased airway dimensions at soft palate (P < 0.05) and more forward positioning of the hyoid bone (P < 0.05). Dentoalveolar changes exhibited mesial movement of lower incisors and molars and reduction in overjet (P < 0.001) in FFRD group. CONCLUSIONS: Positive effects in oropharyngeal airway dimensions and increased values of hyoid bone displacement to a more forward position were found after fixed functional therapy. CLINICAL RELEVANCE: Treatment with fixed functional appliances is mostly based on mesial movement of mandibular dentition, which might influence changes in tongue posture. The present results might indicate that oropharyngeal airway dimensions may be affected by postural changes of the hyoid bone in consequence of dentoalveolar changes. Clinically, these may be considered especially in Class II cases with reduced airway dimensions.

Evaluation of microshear bond strength of orthodontic resin cement to monolithic zirconium oxide as a function of surface conditioning method.

PURPOSE: To evaluate the microshear bond strength (µSBS) of orthodontic resin cement to monolithic zirconium oxide ceramic (MZ) after different surface conditioning methods. MATERIALS AND METHODS: Two types of MZ (BruxZir Solid Zirconia, n = 60; Prettau-Zirkon, n = 60) with two types of surface finish (glazed, n = 30 per group; polished, n = 30 per group) were tested after two surface conditioning methods: 1. air abrasion with 30-µm silica coated aluminum oxide (Al2O3) particles (CoJet), or 2. air abrasion with 50-µm Al2O3particles. The non-conditioned group acted as the control. A universal primer (Monobond-Plus) and an orthodontic primer (Transbond-XT Primer) were applied to all specimen surfaces. Orthodontic resin composite (Transbond-XT) was bonded using a mold and photopolymerized. The bonded specimens were subjected to µSBS testing (0.5 mm/min). Data were analyzed statistically using three-way ANOVA and the Sidac adjustment post-hoc test (α = 0.05). Failure modes were analyzed using a stereomicroscope (30X). RESULTS: Mean µSBS values (MPa) did not show a significant difference between the two brands of MZ (p > 0.05). In both glazed (44 ± 6.4) and polished (45.9 ± 4.8) groups, CoJet application showed the highest µSBS values (p < 0.001). The control group (34.4 ± 6) presented significantly better results compared to that of Al2O3(30 ± 3.8) (p < 0.05) on glazed surfaces, but it was the opposite in the polished groups (control: 20.3 ± 4.7; Al2O3: 33.8 ± 4.7; p < 0.001). Adhesive failure was the dominant type in all groups. Conditioning MZs with Al2O3and CoJet increased the percentage of mixed failure type. CONCLUSION: Air abrasion with CoJet followed by the application of universal primer improved the µSBS of orthodontic resin to both the polished and glazed monolithic zirconium oxide materials tested.