Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects.

OBJECTIVE: The purpose of this work was to evaluate orofacial airway dimensions and the position of the hyoid bone related to changes induced by facemask therapy (combined with rapid palatal expansion) or by chincup therapy as compared to an untreated Class III control group. METHODS: In all, 67 patients with skeletal Class III malocclusion were divided into a facemask group (n = 25; 15 girls and 10 boys), a chincup group (n = 15; 16 girls and 9 boys), and a control group (n=17; 9 girls and 8 boys). Hard- and soft-tissue parameters were analyzed on lateral cephalograms, which were available for all patients and included a baseline radiograph (T1) obtained before treatment and a follow-up radiograph (T2) taken upon completion of active treatment or, in the control group, after a 6-month interval. Statistical analysis was performed at the p ≤ 0.05 level and included a paired-sample t-test, a generalized linear mixed model (GLMM), and a post hoc Tukey test. RESULTS: In the chincup group, significant changes in the perpendicular distance from the hyoid (H) to the C3-Me line were found compared to the control group (p < 0.05). The facemask group, by contrast, showed significant anteroposterior width increases of the pharynx--as measured at the level of the soft palate (p < 0.001)--as well as significant area increases of the nasopharynx based on its anterior portion (p < 0.001) and on its total area (p < 0.001). Both the chincup and the facemask (combined with rapid palatal expansion) therapies were found to induce clockwise rotational effects on the mandible. CONCLUSION: Orofacial airway dimensions were enlarged significantly by facemask treatment in comparison with both chincup treatment and with the control group.

The reliability of the Greulich and Pyle atlas when applied to a Southern Turkish population.

OBJECTIVE: The aim of this study was to evaluate the applicability of Greulich and Pyle (GP) method for Southern Turkish population. MATERIALS AND METHODS: Hand and wrist radiographs of 535 patients (276 females, 259 males aged from 10 to 18 years) selected retrospectively from the archive. Skeletal age (SA) estimation was performed according to GP atlas. The chronological age (CA) and SA were compared using the Paired t-test. RESULTS: The mean difference between the CA and SA ranged from 0.07 to 1.11 years. These differences between the CA and estimated SA were statistically significant in group I (10-10.90 years) (P < 0.001), group II (11-11.90 years) (P < 0.050), group III (12-12.90 years) (P < 0.001), group IV (13-13.90 years) (P < 0.010), and group V (14-14.90 years) (P < 0.001) for females. The mean difference between the CA and SA ranged from -0.41 to -1.79 years for females. These differences between the CA and estimated SA were statistically significant in all age groups. CONCLUSIONS: Statistically significant differences were found in the CA and SA assessed by GP method for the Southern Turkish sample. SA was significantly over-predicted in the 10-15 year ages in males and for 10-18 year ages for females. It is appropriate to use GP method in Southern Turkish children; however, a revision is needed for better results and to minimize the mistakes.

PAX9 polymorphisms and susceptibility with sporadic tooth agenesis in Turkish populations: a case-control study.

BACKGROUND: Hypodontia, the congenital absence of one or a few teeth is one of the most common alterations of the human dentition. Familial hypodontia is caused by mutations in PAX9, Msx1 and Axin2 genes. Limited numbers of studies are present to show etiological factors beyond this anomaly in Turkish community belonging to Caucasian racial family. The purpose of this study is to investigate the relationships between the two different single nucleotide polymorphisms that are G-1031A and T-912C with hypodontia in Caucasians. 200 individuals having hypodontia and 114 normal individuals having all 32 teeth present were selected for the study. Blood samples were collected from each individual and DNA was extracted. To determine the polymorphisms, PCR-RFLP method was used. RESULTS: The outcomes suggest that the individuals having AC haplotype carry less risk in having hypodontia compared with the rest of the haplotype groups (OR = 3.88; CI = 95%; p = 0.001). The ratio of GT haplotype is less in the hypodontia group meaning that the GT carriers are in risk group in terms of hypodontia risk. CONCLUSION: These results indicate that polymorphisms in the promoter region of PAX9 gene may have an influence on the transcriptional factors and activity of this gene and are associated with hypodontia in Caucasian individuals.

Investigation of third molar impaction in Turkish orthodontic patients: Prevalence, depth and angular positions.

OBJECTIVE: We aimed to investigate the prevalence, distribution, angular position, and depth of third molar impaction in a Turkish orthodontic patient population. MATERIALS AND METHODS: We retrospectively reviewed the panoramic radiographs, intraoral photographs, and dental casts of 207 patients (62 men and 145 women; age 20-39 years) who had undergone orthodontic treatment at a university department of orthodontics for impacted third molars (ITMs). A comprehensive chart review of all subjects was conducted. Patient and treatment-related data were recorded in a digital database for comparative analysis. RESULTS: The prevalence of ITMs was 54.1%, and no statistically significant gender differences were evident (61.3% in men and 51.0% in women; P = 0.23). The frequency of maxillary ITMs was 49.3% (148 of 300 teeth) while that of mandibular ITMs was 50.7% (152 of 300 teeth). The most frequently observed angulations of impaction were mesioangular for the mandible (65.1%), and distoangular for the maxilla (64.2%). Of all the ITMs analysed, 61% were partially buried in bone and 39% were completely buried. CONCLUSIONS: Third molar impaction was evident in 54.1% of a group of Turkish orthodontic patients aged 20-39 years, and there was no statistically significant gender bias. Mesioangular and distoangular inclinations were the most common in the mandible and the maxilla, respectively.

Interdisciplinary treatment of a fused lower premolar with supernumerary tooth.

The objective of this report is to describe combined orthodontic and endodontic treatment of a fused mandibular premolar with supernumerary tooth. The patient was a 15 year old girl seeking orthodontic treatment for the correction of maxillary and mandibular crowding. Cephalometric examination revealed skeletally Class I relationship. The panoramic radiograph showed a fused tooth with two separate pulp chambers and two separate root canals connecting in apical third. After the endodontic treatment of the fused teeth, the stripping of the supernumerary tooth was performed to establish a Class I canine relationship and to correct midline deviation. At the end of the treatment, the crowding was resolved and positive overjet and overbite was achieved.

Maxillary expansion in the mixed dentition: rapid or semi-rapid?

The purpose of this study was to investigate the effects of rapid maxillary expansion (RME) and semi-rapid maxillary expansion (SRME) in the mixed dentition period. The SRME group consisted of 18 patients (11 girls and 7 boys) with a mean age of 8.63 +/- 1.09 years and the RME group 17 patients (11 girls and 6 boys) with a mean age of 8.78 +/- 1.21 years. A splint type tooth- and tissue-borne modified bonded RME appliance was used, with the patients activating the screw two-quarter turns per day for the first week, followed by one-quarter turn every other day in the SRME group and two-quarter turns per day throughout treatment in the RME group. The average treatment time was 57.16 +/- 21.52 and 21.23 +/- 8.36 days for the SRME and RME groups, respectively. A Wilcoxon signed rank test was used to evaluate the treatment effects [pre-(T(0)) - post-(T(1)) treatment changes] for both the SRME and RME groups and a Mann-Whitney U-test to determine the differences between the two groups (T(0)-T(1) changes SRME versus T(0)-T(1) changes RME). For both groups, the maxillary base, nasal cavity width and upper intercanine and intermolar distances were increased, and the upper molars tipped buccally. The only statistically significant (P < 0.05) difference between two groups was in inferior movement of posterior nasal spine (PNS) relative to the SN plane (SN upper left and right quadrantsPNS). This measurement increased in both groups yet significantly more in the RME group. The results suggest that RME and SRME have similar effects on dentofacial structures both in the transverse, vertical, and sagittal planes.

Occlusal contact changes with removable and bonded retainers in a 1-year retention period.

OBJECTIVE: To test the hypothesis that there is no difference in the number of occlusal contacts in centric occlusion in patients treated with bonded and removable retention procedures and a control group during a 1-year retention period. MATERIALS AND METHODS: Twenty-five patients received a removable Hawley retainer, and 25 patients received maxillary and mandibular bonded retainers. The retainer patients were compared with 20 control subjects with normal occlusions. Silicone-based impression bites were used to record occlusal contacts. Paired-sample t-test, analysis of variance (ANOVA), and Tukey tests were used to evaluate intragroup and intergroup differences. RESULTS: An increased number of occlusal contacts were recorded in total-arch and posterior combined (actual/near) teeth during the retention period as compared with the control group. In the Hawley group, actual and total contacts on the first and second molar and actual contacts on the premolar and canine showed statistically significant increases. In the bonded retainer group, near and total contacts on the first and second molars and premolars showed statistically significant increases. Slight occlusal changes were seen in the control sample during the observation period, presumably from growth and development. ANOVA comparisons of total contacts of anterior and posterior teeth indicated statistically significant differences in the three groups on posterior segments. CONCLUSIONS: The hypothesis is rejected. Both retention procedures allowed relative vertical movement of the posterior teeth, but the number of contacts on the posterior segment was increased more in the bonded retainer group than in the Hawley and control groups at the end of retention.

Severe gingival recession caused by traumatic occlusion and mucogingival stress: a case report.

Gingival recession is displacement of the soft tissue margin apically leading to root surface exposure. Tooth malpositions, high muscle attachment, frenal pull have been associated with gingival tissue recession. Occlusal trauma is defined as injury resulting in tissue changes within the attachment apparatus as a result of occlusal forces. Trauma from occlusion may cause a shift in tooth position and the direction of the movement depends on the occlusal force. We present the clinical and radiological findings and the limitation of periodontal treatment of a severe gingival recession in a case with traumatic occlusion. A 16 years old male, systemically healthy and non-smoking patient presented to our clinic with severe gingival recession of mandibular canines and incisors. Clinical evaluation revealed extensive gingival recession on the vestibules of mandibular anterior segment. Patient has an Angle class III malocclusion and deep bite. To maintain the teeth until orthodontic therapy and maxillofacial surgery, mucogingival surgeries were performed to obtain attached gingiva to provide oral hygiene and reduce inflammation. After mucogingival surgeries, limited attached gingiva was gained in this case. Regular periodontal maintenance therapy was performed at 2 month intervals to preserve mandibular anterior teeth. Multidisciplinary approach should be performed in this kind of case for satisfactory results. Unless occlusal relationship was corrected, treatment of severe gingival recession will be problematic. For satisfactory periodontal treatment, early diagnosis of trauma from occlusion and its treatment is very important.

Occlusal contacts with different retention procedures in 1-year follow-up period.

INTRODUCTION: The aim of this follow-up study was to evaluate the number of contacts in centric occlusion during a 1-year retention period in patients treated with 2 retention procedures and in a control sample. METHODS: Twenty patients received modified wraparound Hawley retainers, and 20 received maxillary Jensen plates with mandibular fixed retainers. These retention patients were compared with a control group of 20 subjects with normal occlusions. Silicone-based impression bites were used to record occlusal contacts. Paired and independent-sample t tests were used to evaluate intragroup and intergroup differences. RESULTS: Contacts increased in the total arch and the posterior combined (actual/near) during the retention period compared with the control group. In the Hawley retainer group, actual contacts on the second molars (P <.05), near contacts on the premolars (P <.05), and total contacts on the first molars (P <.05) and premolars (P <.01) had statistically significant increases. In the maxillary Jensen plate and mandibular fixed lingual retainer group, the number of actual contacts on the posterior segment increased. Actual contacts on the first molars (P <.01), second molars (P <.01), premolars (P <.05), and canines (P <.05), and total contacts on the first (P <.05) and second (P <.05) molars had statistically significant increases. During the observation period, some slight occlusal changes were seen in the control sample, presumably from growth and development. At the end of the study, during the 1-year follow-up period, no statistically significant occlusal contact differences were observed in the 3 groups. CONCLUSIONS: Retention procedures carried out in this study allowed relative vertical movement of the posterior teeth.

Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship?

INTRODUCTION: The aims of this study were (1) to investigate the relationship between chronologic age and maturation of cervical vertebrae, (2) to identify the relationship between chronologic age and maturation stage evaluated by hand-wrist radiographs, and (3) to determine whether the maturation of cervical vertebrae correlates with maturation indicated by hand-wrist radiographs in a Turkish population. METHODS: The samples were derived from lateral cephalometric and hand-wrist radiographs of 503 subjects (213 male, 290 female; ages, 5.3-24.1 years). Cervical vertebral development was evaluated by the method of Hassel and Farman. Skeletal maturation of each hand-wrist radiograph was determined according to the method described by Björk and Grave, and Brown's system. The Spearman rank-order correlation coefficients were estimated separately for males and females to measure the relationships among chronologic age, cervical vertebral maturation, and the skeletal maturation measured at the hand-wrist. RESULTS: The Spearman correlation coefficients were 0.72 (P <.001) between chronologic age and cervical vertebrae skeletal maturation, and 0.79 (P < .001) between chronologic age and maturation via hand-wrist radiographs. The correlation coefficient between hand-wrist and cervical-vertebrae maturation was 0.86 (P <.001). CONCLUSIONS: The cervical-vertebrae maturation stages are clinically useful maturity indicators of the pubertal growth period Turkish subjects.

Dental and alveolar arch widths in normal occlusion and Class III malocclusion.

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar widths of Class III malocclusion group with a group of untreated normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age, 21.6 +/- 2.6 years) and 100 Class III malocclusion (mean age, 15.4 +/- 2.2 years) subjects. Independent samples t-test was applied for comparing the groups. The findings of this study indicated that the mandibular intercanine and intermolar alveolar widths were significantly larger in the Class Ill group when compared with the normal occlusion sample (P < .001). Maxillary interpremolar, intermolar widths and all maxillary alveolar width measurements were significantly narrower in the Class III group (P < .001). In addition, the lower canine and premolar alveolar width measurements were also statistically significantly larger in the normal occlusion group when compared with the Class III malocclusion group (P < .001). Subjects with Class III malocclusion tend to have the maxillary teeth inclined to the lingual and mandibular teeth inclined to the buccal direction because of the restriction of maxillary growth and development according to dental arch width measurements. Therefore, rapid maxillary expansion should be considered before or during the treatment of a Class III patient with or without face-mask therapy.

Intermaxillary tooth size discrepancy and mesiodistal crown dimensions for a Turkish population.

INTRODUCTION: The aims of this study were to determine the size of individual permanent teeth, tooth-size ratios for the maxillary and mandibular dentitions, and sex differences for those variables in a Turkish population, and to compare the figures obtained with those of the Bolton analysis. METHODS: The data were derived from dental casts of 150 Turkish subjects (72 men, mean age 22.09 +/- 3.11 years; 78 women, mean age, 21.11 +/- 2.08 years) with normal occlusions. The mean, standard deviation, and minimum and maximum values were calculated for individual tooth size, and overall and anterior ratios, separately for men and women. To determine whether there are sex differences in intermaxillary tooth size discrepancies, an independent samples t test was performed. RESULTS: The mesiodistal dimensions of the maxillary teeth showed greater variability than the mandibular teeth, with the first molar dimensions having the greatest variability. The overall and anterior ratios were found to be 89.88 +/- 2.29 and 78.26 +/- 2.61, respectively. A statistically significant sex difference was found only in overall ratio (P < .001). According to Bolton's mean values, a discrepancy in the overall ratio was found in 18% of Turkish normal occlusion subjects, and anterior ratios outside 2 standard deviations from the Bolton mean were found in 21.3% of our sample. CONCLUSIONS: These findings indicate that population-specific standards are necessary for clinical assessments. Bolton's original data do not represent Turkish people, and therefore it is appropriate to use Turkish norms in daily orthodontic practice for Turkish patients.

Effects of camouflage treatment on dentofacial structures in Class II division 1 mandibular retrognathic patients.

The aims of this study were to determine the changes in the dentofacial structures of Class II division 1 mandibular retrognathic patients treated with bilateral extraction of the upper first premolars, and to compare pre- and post-treatment values with the cephalometric norms of Anatolian Turkish adults. The Class II division 1 subjects included 20 males and 33 females (mean age: 17.08 +/- 1.03 years). All received comprehensive orthodontic treatment using an edgewise appliance and appropriate headgear. Lateral cephalograms were taken at the beginning and end of treatment. Twenty-five (14 linear and 11 angular) measurements were analysed on each radiograph. Each cephalogram was traced and digitized. For statistical evaluation, paired and independent-samples t-tests were performed. When the pre- and post-treatment measurements were compared, statistically significant differences were found for nine of 25 measurements. During treatment the facial axis, U1-SN ( degrees ), U1-NA (mm), U1-NA ( degrees ), H angle and upper lip to E plane measurements decreased, while N-ANS, interincisal angle and upper lip to Steiner S line increased. No statistically significant gender differences were found. Significant improvements were determined in ANS-Me and L1-APo measurements compared with Turkish norms. However, statistically significant deterioration was found in values related to point A, upper incisor and lower lip measurements. The findings demonstrates that camouflage treatment in Class II, mandibular retrognathic subjects has characteristic skeletal, dental and soft tissue effects on the dentofacial complex.

The effect of head rotation on cephalometric radiographs.

The aim of this study was to identify the potential projection errors of lateral, postero-anterior (PA) and submentovertex (SMV) cephalometric radiographs due to head rotation in the vertical z-axis. For this investigation, a complete human dry skull of an adult was used. The skull was rotated from 0 to +/-14 degrees at 2 degree intervals. A vertical axis, the z-axis, was used as the rotational axis to expose 15 lateral and 15 PA cephalometric radiographs. The skull was tilted on each side, again at 2 degree intervals, to expose the 15 SMV films. A series of linear and angular measurements was carried out on all cephalograms. The results revealed that horizontal linear and angular measurements between the horizontal planes on lateral cephalograms were subject to changes from 16.1 to 44.7 per cent with a 14 degree rotation of the head position. For PA cephalograms, again horizontal linear measurements, particularly mandibular length, were subject to a projection error of up to 34.9 per cent with head rotation. On the other hand, projection errors were within the 3-4 per cent limit for SMV radiography. The findings indicate that: (1) linear measurements and the measurement of angles between the horizontal planes are likely to be affected by head rotation in lateral cephalograms, (2) angular measurements demonstrate smaller variations with changing rotation of the head in PA cephalograms, (3) SMV radiographs are less vulnerable to head rotation. Vertical linear measurements of lateral cephalograms and angular measurements of PA radiographs are more reliable in minimizing the projection errors associated with head rotation.

Does orthodontic treatment affect patients' and parents' anxiety levels?

The aims of this study were (1) to determine and compare the anxiety levels of two groups of patient and parents, (2) to identify possible gender differences between male and female subjects and (3) to evaluate any changes in anxiety levels after 1 year of treatment. The first group consisted of 40 subjects with a mean age of 15.6 +/- 1.2 years awaiting orthodontic treatment, plus one parent of each subject (mean age 43.4 +/- 2.3 years). The second group comprised 43 patients with a mean age of 16.0 +/- 1.1 years who had been undergoing treatment for a period of 1 year, plus one parent of each patient (mean age 41.0 +/- 1.9 years).Personal information forms and Spielberger's 'State and Trait Anxiety Inventory' (STAI) were applied to both groups. To compare the two groups and to determine the differences between males and females, independent-sample t-tests were used. Internal consistencies for the two scales of the STAI were evaluated with Cronbach's alpha coefficient. Trait anxiety levels of parents (51.05 +/- 5.1) and state anxiety levels of subjects (58.57 +/- 6.73) who were about to start orthodontic treatment were both high. The difference between the groups was statistically significant (P < 0.05). In patients who had undergone treatment for 1 year, the scores were found to be normal (43.28 +/- 5.91). However, their parents' high levels of trait anxiety remained unchanged (50.41 +/- 4.2).

Intermaxillary tooth size discrepancy and malocclusion: is there a relation?

The aims of this study were to identify the possible sex differences in tooth size ratios between males and females, to determine whether there is a difference in the incidence of tooth size discrepancies for both the anterior and overall ratios when comparing with Angle Class I; Class II, division 1; Class II, division 2; and Class III malocclusion groups, to compare the tooth size ratios of different malocclusion groups with the anterior and overall tooth size ratios of 150 untreated normal occlusion subjects. In addition, the aim was to determine the percentage of tooth size discrepancies outside 2 SD from Bolton means for tooth ratios present in each malocclusion group and in the overall sample of this study. This study consisted of 150 subjects who served as the normal occlusion group and 560 patients who showed four different malocclusion characteristics (Angle Class I; Class II, division 1; Class II, division 2; and Class III). Tooth size measurements were performed on the models of normal occlusion and pretreatment models. For statistical evaluation, Student's t-test, analysis of variance and Tukey Honestly Significant Difference tests were performed. A significant sex difference was found only in the overall ratio for normal occlusion subjects (P < .001). All malocclusion groups showed statistically significant higher overall ratios than the normal occlusion group (P < .001). There were no statistically significant differences among malocclusion groups; however, there were a large number of patients within each group who had discrepancies greater than 2 SD from the mean. Further investigations are needed to explain the probable racial differences and relationships between malocclusion and tooth size measurements.

Posteroanterior cephalometric norms in Turkish adults.

PURPOSE: The aims of this study were to establish cephalometric norms from posteroanterior cephalograms for Turkish adults, identify possible gender differences in these norms, compare Turkish norms with the norms of other groups, and identify possible correlations between all investigated transverse linear measurements. MATERIAL: The subjects included 46 Turkish men (mean age, 26.06 +/- 2.10 years) and 54 Turkish women (mean age, 24.10 +/- 3.04 years). Each subject had ideal occlusion and a well-balanced face. Nineteen linear measurements were determined on each radiograph. For each variable, the arithmetic mean, the standard deviation, and the minimum and maximum values were calculated. For statistical evaluation, an independent-samples t test was performed. The Pearson product-moment correlation coefficient was calculated to indicate the relationship between all investigated linear dimensions. RESULTS: Posteroanterior transverse linear norms for Turkish adults were generally similar to Ricketts' clinical norms. Of the 19 craniofacial transverse measurements, 15 showed significant sexual dimorphism. All investigated measures were higher in Turkish men than in women, with the exception of the distance from the intersection of the processus zygomaticus and the processus alveolaris maxillae on the right side and the frontal facial plane. Statistically significant correlations were determined in most measurements. CONCLUSIONS: These Turkish posteroanterior cephalometric norms can be used in the treatment of Turkish patients.

Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2.

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar arches in the canine, premolar, and molar regions of Class II division 1 and Class II division 2 malocclusion groups with normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age: 21.6 +/- 2.6 years), 106 Class II division 1 (mean age: 17.2 +/- 2.4 years), and 108 Class II division 2 (mean age: 18.5 +/- 2.9 years) malocclusion subjects. Independent-samples t-test was applied for comparisons of the groups. These findings indicate that the maxillary interpremolar width, maxillary canine, premolar and molar alveolar widths, and mandibular premolar and molar alveolar widths were significantly narrower in subjects with Class II division 1 malocclusion than in the normal occlusion sample. The maxillary interpremolar width, canine and premolar alveolar widths, and all mandibular alveolar widths were significantly narrower in the Class II division 2 group than in the normal occlusion sample. The mandibular intercanine and interpremolar widths were narrower and the maxillary intermolar width measurement was larger in the Class II division 2 subjects when compared with the Class II division 1 subjects. Maxillary molar teeth in subjects with Class II division 1 malocclusions tend to incline to the buccal to compensate the insufficient alveolar base. For that reason, rapid maxillary expansion rather than slow expansion may be considered before or during the treatment of Class II division 1 patients.

The effects of early preorthodontic trainer treatment on Class II, division 1 patients.

The aim of this study was to clarify the dentoskeletal treatment effects induced by a preorthodontic trainer appliance treatment on Class II, division 1 cases. Twenty patients (10 girls and 10 boys, mean age 9.6 +/- 1.3 years) with a Class II, division 1 malocclusion were treated with preorthodontic trainer appliances (Myofunctional Research Co., Queensland, Australia). The patients were instructed to use the trainer every day for one hour and overnight while they slept. A control group of 20 patients (mean age 10.2 +/- 0.8 years) with untreated Class II, division 1 malocclusions was used to eliminate possible growth effects. Lateral cephalograms were taken at the start and end of treatment. Final cephalograms were taken 13.1 +/- 1.8 months after trainer application, compared with a mean of 11.2 +/- 2.4 months later for the control group. The mean and standard deviations for cephalometric measurements were analyzed by paired-samples t-test and independent-samples t-tests. At the end of the study period, the trainer group subjects showed significant changes including anterior rotation and sagittal growth of the mandible, increased SNB and facial height, reduced ANB, increased lower incisor proclination, retroclination of upper incisors, and overjet reduction. However, only total facial height increase, lower incisor proclination, and overjet reduction were significantly higher when compared with the changes observed in the control group. This study demonstrates that the preorthodontic trainer application induces basically dentoalveolar changes that result in significant reduction of overjet and can be used with appropriate patient selection.

Relationships between dental and skeletal maturity in Turkish subjects.

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Turkish subjects. The samples were derived from dental panoramic and hand-wrist radiographs of 500 subjects (215 males and 285 females). Calcification of the mandibular canines, first and second premolars, and second and third molars was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation of each hand-wrist radiograph, nine ossification events were determined according to the systems of Björk, and Grave and Brown. Statistically significant relationships were determined between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients. Correlations between dental development and skeletal maturity ranged from .490 to 0.826 for females and .414 to .706 for males (P < .01). The second molar showed the highest correlation and the third molar showed the lowest correlation for female and male subjects. For both sexes, root formation of the canine as well as the first premolar was completed in the majority of the subjects at the MP3cap, PP1cap, Rcap stages. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice, when treating a Turkish patient.