Nickel Release and the Viability of Streptococcus mutans Corresponding to Low Risk of Dental Caries in Artificial Saliva Containing Orthodontic Appliances: In Vitro Study.

OBJECTIVE: The aims of this study were to determine the effect of different levels of Streptococcus mutans that correspond to a low risk of dental caries on nickel release and to determine the viability of S. mutans. METHODS: Simulated fixed orthodontic appliances composed of copper nickel titanium, nickel titanium, or stainless steel were immersed in Klimek artificial saliva for 10 days with or without S. mutans inoculation on day 7. Same levels of S. mutans cultures (4 × 104 cfu/mL) were inoculated into the artificial saliva without orthodontic appliances. Nickel release was detected by inductively coupled plasma mass spectrometry. The archwire surface was analyzed by atomic force microscopy and scanning electron microscopy. RESULTS: The density of S. mutans significantly increased in the artificial saliva without orthodontic appliances (P < .05). Appliances with nickel titanium alloys showed higher nickel release in the artificial saliva with or without S. mutans than those with copper nickel titanium or stainless steel archwires (P < .05). However, S. mutans increased nickel release only in orthodontic appliances with stainless steel archwires (P < .05). Although atomic force microscopy showed that the surface of as-received stainless steel archwires was smoother than that of nickel titanium or nickel titanium archwires, S. mutans increased the surface roughness of only the SS archwires. S. mutans adhered to all archwire types. CONCLUSION: While corrosion or corrosion-related processes may have decreased the growth capacity of S. mutans, reciprocally, S. mutans influenced corrosion. Rough surfaces can also promote corrosion; therefore, the surface roughness of metal alloy orthodontic appliances should be evaluated to determine their corrosion behavior.

Effect of Cleft Width on the Outcome of Presurgical Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate.

ABSTRACT: The purpose of this study was to investigate the short-term effects of presurgical nasoalveolar molding (PNAM) according to cleft width (CW) in patients with unilateral cleft lip and palate (UCLP). In this retrospective study, 32 newborns with nonsyndromic UCLP treated with PNAM were allocated to 2 groups based on CW (group A, CW ≤5 mm; and group B, CW >5 mm). The following measurements were carried out using standardized photographs taken before and after PNAM therapy (before primary lip surgery): nostril axis inclination of healthy (NAI-NC) and cleft sides (NAI-C), columellar angle (CA), nasal base inclination (NBI), nasal floor width ratio (NFWR), alar base height ratio (ABHR), and columellar length ratio. Before PNAM therapy, there were significant differences between the 2 groups with respect to NAI-C, NBI, NFWR, and ABHR, indicating greater deformation of the nose in group B. After PNAM therapy, CA, NAI-C, NAI-NC, NFWR, and columellar length ratio were significantly improved in both the groups, whereas NBI and ABHR significantly worsened in group B. The improvement in CA, NAI-C, and NFWR was significantly greater in group B. Although a larger CW had some negative effects on the outcome of PNAM, it was found to be advantageous for nasal symmetry, if initiated as early as possible. Nevertheless, it is important to consider those aspects of the nasolabial area that are involved in the perception of symmetry when evaluating the effect of CW on PNAM outcomes in UCLP.

Effects of Positioning Errors Onto the Ratio and Angle Measurements in Photographs of Patients With Unilateral Cleft Lip and Palate.

BACKGROUND: Nasolabial esthetics is 1 of the most important issues in the evaluation of treatment outcomes in patients with unilateral cleft lip and palate (CLP). Frontal and basal view photographs are commonly used to evaluate nasolabial esthetics in patients with unilateral CLP. High-quality photography plays an important role in evaluating the treatment outcomes and poor quality photographs can result in errors, whereas evaluating the treatment results. Facial proportions and angles are important in the esthetic perception of the face. Hence, this study aimed to determine the effects of positioning errors on the ratio and angle measurements in photographs of patients with unilateral CLP. METHODS: In the clinical and computer environment, a mechanism was set up to take photos at standard and at different angles. A real-size unilateral CLP silicone doll was constructed for the photographs to be taken in the clinical setting. A test-retest was performed to determine the reliability of the measured values. RESULTS: The correlation coefficients for the first measurement and remeasurement values were statistically significant; positive and strong correlations were obtained. CONCLUSIONS: Based on the data obtained from our study, the angle and ratio measurements obtained from the two-dimensional photographs provided reliable results.

A New Approach to Presurgical Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate and Severe Cleft Width.

The aim of this study was to describe a new approach to the presurgical orthopedic treatment of unilateral cleft lip and palate patients with severe cleft width. Modified nostril retainers manufactured from soft acrylic were used for the nasal molding. This technique enables the separation of the nasal molding without having to reduce the cleft width to 5 mm. Nasal molding with the modified nostril retainer resulted in the patient and the physician experiencing a more comfortable treatment period.

Modifications in Presurgical Nasoalveolar Molding Treatment of Bilateral Cleft Lip and Palate Patients With Severely Malpositioned Premaxillae.

OBJECTIVE: The aim of this study was to evaluate a modified presurgical nasoalveolar molding (PNAM) treatment for patients with bilateral cleft lip and palate (BCLP) with severely malpositioned premaxillae. SETTING: This study was conducted at the Faculty of Dentistry, Department of Orthodontics, Ege University, Bornova, Izmir, Turkey. METHOD: Retention arms were manufactured using a mold that we developed, and prefabricated retraction apparatuses were applied to the plaster model obtained from the patient. During the acrylic curing process, the flanges of the appliances were elongated into the sulcus without including the premaxilla. The premaxilla was aligned with the midline with an elastic band system, and the lip hanger was constructed with 0.023-in stainless steel wire. Elastic bands were stretched between the retraction apparatuses and the lip hanger based on the desired force. Nasal stents were added to the retention arms when the cleft width was reduced to less than 6 mm. CONCLUSION: The modified PNAM treatment enabled faster derotation of the premaxilla and earlier initiation of retraction. The prefabricated retraction apparatus and retention arm provided efficient PNAM for patients with BCLP.

Presurgical Orthopedic Treatment Using Modified Nostril Retainers in Patients With Unilateral Cleft Lip With or Without Cleft Palate.

This study aimed to present a new technique for presurgical orthopedic treatment of patients with unilateral cleft lip with or without cleft palate (UCL±P) by means of modified nostril retainers manufactured using a special mold with soft acrylic or orthodontic acrylics material. Nasal molding with the modified nostril retainer is considerably effective and comfortable for the patient.