Evaluation of the relationship between anxiety levels and dental appearance.

OBJECTIVE: The aim of this study was to evaluate the relationship between personal traits, dental anxiety level and dental appearance of the individuals. STUDY DESIGN: The study included 431 individuals who completed State Trait Anxiety Inventory-Trait Form (STAI-T) and Corah's Dental Anxiety Scale (CDAS) questionnaires during their first appointment at the orthodontic clinic. The Index of Complexity, Outcome and Need (ICON) index scoring was performed using intraoral frontal photographs by an orthodontist. According to the STAI-T scores, three anxiety groups were formed: mild, moderate, and severe. The Kruskal-Wallis H test was used for intergroup comparisons. Spearman's correlation analysis was performed to evaluate the relationship between STAI-T, CDAS, and ICON scores. RESULTS: It was found that 38.28% of the participants had mild, 34.1% had severe, and 27.62% had moderate anxiety levels. CDAS score was significantly lower in the mild anxiety group (p ≤ 0.0001) compared to the groups showing moderate and severe anxiety. There was no significant difference between the moderate and severe anxiety groups. ICON score was significantly higher in the severe anxiety group (p ≤ 0.0001) than the other groups. It was also significantly higher in the moderate anxiety group (p ≤ 0.0001) than in the mild anxiety group. There was a significant positive correlation between STAI-T and both CDAS and ICON scores. There was no significant correlation between CDAS and ICON scores. CONCLUSION: Dental appearance had a significant effect on the general anxiety of individuals. Improving the dental appearance with orthodontic treatments can have positive effects on reducing anxiety. The low level of dental anxiety in individuals with a high need for treatment will facilitate the work of the orthodontist in the procedures to be applied.

Assessment of agreement between molar landmarks: Repeatability, reproducibility, and comparability.

INTRODUCTION: The aims of this research were to test the repeatability and reproducibility of measurements obtained by different molar landmarks and to determine whether the treatment changes measured by them are comparable. MATERIALS: Pretreatment (T0) and postdistalization (T1) lateral cephalograms of 40 patients with a Class II molar relationship were used. Using the mesial cusp tip, distal crown contour, and centroid, 6 linear and 3 angular measurements were evaluated. The intraexaminer and interexaminer reliabilities were assessed with the Bland-Altman method. The T0 to T1 differences were compared by analysis of variance, followed by multiple comparisons with the Bonferroni adjustment. RESULTS: The greatest intraexaminer agreement intervals were correlated with centroid for tipping and vertical movement, and with distal crown contour for anteroposterior movement at T0 and T1. The narrowest interexaminer agreement intervals were observed with mesial cusp tip for all measurements and comparisons at both time points, except for the anteroposterior measurements at T1. Statistical significance was observed between the measurements made with mesial cusp tip and distal crown contour for tipping and with mesial cusp tip and centroid for distalization. For vertical movement, the treatment changes were statistically significantly greater with distal crown contour. CONCLUSIONS: Mesial cusp tip was the most repeatable and reproducible landmark. Clinically unimportant differences were found in some comparisons of treatment changes obtained by different landmarks.

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features.

The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features

The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

Functional and fixed orthodontic treatment in a child with cerebral palsy.

Cerebral palsy is a permanent neuromuscular motor disorder that results from injury in the developing brain during the prenatal or postnatal period. Common functional and craniofacial problems related to cerebral palsy include impaired swallowing, chewing, and speech; maxillary transverse deficiency; excessive anterior facial height; and Class II malocclusion. This article reports the treatment of a 12-year-old girl with ataxic cerebral palsy; she had a dental and skeletal Class II malocclusion, maxillary transverse deficiency, and severe crowding in both arches. Treatment included rapid maxillary expansion with simultaneous functional therapy and fixed orthodontic extraction therapy in a period of 2 years 3 months. Vertical control was maintained by a vertical chincap. An acceptable occlusion and improvements in facial esthetics, speech, and oral function were achieved.

Deepbite correction with incisor intrusion in adults: a long-term cephalometric study.

INTRODUCTION: The purpose of this study was to investigate the long-term stability of deep overbite correction with mandibular incisor intrusion with utility arches in adult patients. METHODS: Pretreatment, posttreatment, and 5-years postretention lateral cephalograms of 31 patients (mean age, 26.8 years; range, 24.1-30.9 years) with Class II Division 1 malocclusion and deepbite, treated by maxillary first premolar extraction and mandibular incisor intrusion, were traced and measured. RESULTS: Significant decreases in overjet and overbite (6.4 ± 1.2 and 3.9 ± 0.7 mm, respectively), significant retroclination (17° ± 1.9°) and retraction (3.8 ± 1.1 mm) of the maxillary incisors, and significant increases in protrusion (0.8 ± 1.5 mm), proclination (0.6° ± 0.9°), and intrusion (2.6 ± 1.4 mm) of the mandibular incisors were observed at posttreatment. At postretention, there were statistically significant but clinically unimportant increases in overjet and overbite (0.4 ± 0.2 and 0.8 ± 0.4 mm, respectively) and extrusion of the mandibular incisors (0.8 ± 1.1 mm). CONCLUSIONS: Correction of deepbite in nongrowing patients by mandibular incisor intrusion with a utility arch can be considered effective and stable.

Influence of thermoplastic retainers on Streptococcus mutans and Lactobacillus adhesion.

INTRODUCTION: This study was designed to test the hypothesis that thermoplastic retainers influence oral microbial flora during the retention period because they prevent the flushing effect of saliva on dental and mucous tissues. METHODS: Twenty-four orthodontic patients finished the study. After debonding, the patients were given thermoplastic retainers (Essix ACE 0.040-in plastic, Dentsply International, York, Pa) for both jaws and instructed to wear them all day. Plaque samples from tooth surfaces and saliva samples were collected from each patient just after debonding (T0), and on day 15 (T1), day 30 (T2), and day 60 (T3) of retention. The jaws were divided into 6 regions, and the data for each region were evaluated separately. Total viable Lactobacillus and Streptococcus mutans colonies were counted, and the numbers of the viable microorganisms were calculated. RESULTS: The numbers of Lactobacillus colonies at T3 were higher than at T0, T1, and T2, and the difference between T0 and T3 was statistically significant (P <0.05). The numbers of S mutans colonies at T3 were higher than at T0, T1, and T2, and the differences between T0 and T1, and T1 and T2 were statistically significant (P <0.05). CONCLUSIONS: Retention with thermoplastic retainers might create oral conditions conducive to S mutans and Lactobacillus colonization on dental surfaces.