Mandibular Radiomorphometric Characteristics of Individuals with Bilateral or Unilateral Cleft Lip and Palate.

OBJECTIVE: This study aimed to investigate and compare the mandibular radiomorphometric characteristics of patients with unilateral or bilateral cleft lip and palate (CLP) with those of individuals without CLP and to determine whether there was a difference. DESIGN: Retrospective cohort study. SETTING: Orthodontic Department in Faculty of Dentistry. PATIENTS AND INTERVENTIONS: Mandibular cortical bone thickness was measured on high-quality panoramic radiographs taken from 46 patients with unilateral or bilateral CLP aged 13-15 years and 21 control patients. MAIN OUTCOME MEASURES: Three radiomorphometric indices [antegonial index (AI), mental index (MI), and panoramic mandibular index (PMI)] were measured bilaterally. AutoCAD software was used for MI, PMI, and AI measurements. RESULTS: Left MI values were significantly lower in individuals with unilateral cleft lip and palate (UCLP; 0.029 ± 0.04) than in individuals with bilateral cleft lip and palate (BCLP; 0.033 ± 0.07). In addition, right MI values of individuals with right UCLP (0.26 ± 0.06) were significantly lower than those of individuals with left UCLP (0.34 ± 0.06) or BCLP (0.32 ± 0.08). No difference was observed between individuals with BCLP and left UCLP. These values did not differ between groups. CONCLUSIONS: Antegonial index and PMI values did not differ between individuals with different types of CLP or when compared with control patients. In patients with UCLP, cortical bone thickness was found to be reduced on the cleft side compared to the intact side. Patients with UCLP with a right-sided cleft had a more substantial decrease in cortical bone thickness.

Evaluation of associations between condylar morphology, ramus height, and mandibular plane angle in various vertical skeletal patterns: a digital radiographic study.

BACKGROUND: To evaluate condylar morphology, ramus height, and asymmetry indexes in patients with different vertical skeletal patterns and to determine the association between condylar and ramal measurements with the mandibular plane angle. METHODS: Dental panoramic radiographs of 60 patients with different skeletal patterns were evaluated. According to the cranial base (Sella-Nasion)-mandibular plane (SN-MP) angle, the patients were divided into three groups: normal angle (NA), low angle (LA), and high angle (HA). The condylar area, condylar perimeter, condylar heights, and ramus height were measured, and the asymmetry index value of each measurement was calculated. A one-way analysis of variance as well as a post hoc Tukey and Kruskall-Wallis tests were used to determine intergroup differences. Pearson's correlation coefficient was used to determine the relationship between all measurements and SN-MP. RESULTS: The intergroup comparison of condylar area, condylar perimeter, condylar heights, and ramus height measurements showed that the patients in the LA group have statistically significantly greater values compared to those in the HA group. A statistically significant difference was detected between the NA and LA groups only in the condylar area measurements. There was no statistical difference only in the ramus height measurements between the NA and HA groups. Asymmetry index values of the groups were similar. The negative correlations were found between all measurements and the SN-MP angle. CONCLUSION: HA individuals have lower ramus heights and smaller condylar morphologies than NA and LA individuals. In addition, as the SN-MP angle increases, the condyle dimensions and ramus height decrease, and this is a clinically important finding.

Three-dimensional palatal morphology and upper arch changes following nonsurgical and surgical maxillary expansion in adults.

OBJECTIVE: The objective of this study was to evaluate the effects of nonsurgical rapid maxillary expansion (RME) and surgically assisted RME (SARME) on palatal morphology and upper arch dimensions using three-dimensional (3D) models in skeletally mature patients. STUDY DESIGN: Thirty-eight skeletally mature patients with a maxillary transverse deficiency were divided into RME and SARME groups. Nineteen patients in the RME group (mean age, 19.16 ± 2.25 years) were treated using a full-coverage bonded acrylic splint expander; 19 patients in the SARME group (mean age, 20.38 ± 3.36) were treated using the banded palatal expansion appliance with hyrax screws. The 3D models were obtained before and after expansion. The maxillary dental arch widths, maxillary first molar angulation, palatal area, and palatal volume were calculated on the 3D models. RESULTS: All variables showed statistically significant changes after the retention period (P < .001). The maxillary arch width between first premolars (P < .05), the palatal area (P < .01), and the palatal volume (P < .05) significantly increased in the SARME group compared to the RME group. The maxillary first molar tipping in the RME group was significantly higher than that in the SARME group (P < .01). CONCLUSIONS: Although SARME has more positive effects in skeletally mature patients, nonsurgical RME can be considered as an alternative by evaluating surgical risks, periodontal status, and the need for skeletal expansion.

How much should incisors be decompensated? periodontal bone defects during presurgical orthodontic treatment in class III double-jaw orthognathic surgery patients.

INTRODUCTION: The aims of this study were to evaluate periodontal bone defects around the lower and upper incisors and to identify changes in the buccolingual inclination of the incisors during orthodontic decompensation in skeletal Class III orthognathic surgery patients. MATERIALS AND METHODS: The sample consisted of 26 adults with skeletal Class III deformity who had undergone presurgical orthodontic treatment and orthognathic surgery. Lateral cephalograms obtained before orthodontic treatment and before surgery were used to determine the inclination and position changes of the incisors. Cephalometric measurements were taken using Dolphin Imaging 11.95. Three-dimensional images were generated from cone-beam computed tomography (CBCT) scans prior to surgery and used to detect periodontal bone defects, including fenestration (F) and dehiscence (D). RESULTS: Intraclass correlation coefficients (ICC) were determined and the measurements showed high reproducibility. The cephalometric data showed normal distribution and there were no differences between genders in terms of cephalometric changes, dehiscence, fenestration, or coexistent (D-F/DF) formation. The patients presented maxillary incisor retroclination and mandibular incisor proclination, which was consistent with the tooth decompensation. CBCT assessment was performed for a total of 208 teeth; while 81 upper and 94 lower incisors had D-F/DF formation, 23 upper and 10 lower incisors were healthy. Statistically significant correlations were not found between the inclination degree of the incisors and D-F/DF formation. CONCLUSIONS: Decompensation of incisors during presurgical orthodontic treatment increases the risk of periodontal defects. There is no linear relationship between the increase in the inclination degrees of incisors and D-F/DF formation.

Which method is more effective for accelerating canine distalization short term, low-level laser therapy or piezocision? A split-mouth study.

OBJECTIVES: This study evaluated and compared the effects of low-level laser therapy (LLLT) and piezocision on the amount of orthodontic tooth movement. MATERIALS AND METHODS: Forty maxillary canines from 20 patients (mean age, 16.35 ± 1.14 years) were evaluated in a split-mouth design study. Miniscrew-supported canine distalization was performed. Piezocision was applied in the right maxillary canine region, and the left maxillary canines were irradiated with a diode laser (940 nm, 5 J/cm2). LLLT was performed on day 0 and days 3, 7, 14, 21, and 28 after the start of canine distalization in the first 4­week period. Data were evaluated at baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. The amount of canine movement was determined from three-dimensional models, and the angulation of canines and first molars was analyzed based on lateral cephalograms. RESULTS: Intragroup and intergroup comparisons of canine distalization were performed for four different time intervals (T0-T1, T1-T2, T2-T3, T0-T3). The canine tooth movement in the T0-T1 period was significantly greater in the LLLT group compared to the piezocision group. No statistically significant differences were observed between the groups for the T1-T2, T2-T3, and T0-T3 periods. The amount of canine distalization in the T0-T1 period was significantly greater than that in the T1-T2 and T2-T3 periods in both groups. Tooth movement during the T1-T2 period was higher than that in the T2-T3 period in the LLLT group. Cephalometric evaluation revealed no statistically significant difference between the groups with respect to canine and first molar angulation. CONCLUSION: Although laser application seems more effective during the first 4­week period, considering the 12-week period, the effects of LLLT and piezocision on orthodontic tooth movement during canine distalization were similar.

Changes in pharyngeal airway dimensions following incremental and maximum bite advancement during Herbst-rapid palatal expander appliance therapy in late adolescent and young adult patients: a randomized non-controlled prospective clinical study.

OBJECTIVES: This was a parallel, assessor-blinded, randomized, non-controlled prospective trial with the objective to evaluate and compare the effects of maximum advancement (MA) and incremental advancement (IA) of mandible with cast-splint-type Herbst-rapid palatal expander (RPE) appliance on pharyngeal airway dimensions and hyoid bone position in skeletal Class II late adolescents and young adults. MATERIALS AND METHODS: A total of 48 patients (19 male and 29 female, mean age: 15.45 ± 1.42 years) with skeletal Class II malocclusion were treated with cast-splint Herbst-RPE appliance. Inclusion criteria were skeletal Class II malocclusion, mandibular retrognathia, bilateral Class II molar and canine relationship, increased overjet, normal or decreased vertical dimensions, minimal crowding, and no missing teeth. Enrolled subjects were randomly allocated into two groups according to mandibular advancement type: IA and MA Herbst-RPE therapy. The outcome assessor was blinded. Advancement in MA group was adjusted until tête-à-tête incisor relationship or super Class I molar relationship was obtained. Initial forward movement in IA group was 4-5 mm and followed by bimonthly 2 mm of subsequent advancements. Skeletal, pharyngeal airway, and hyoid measurements were performed using lateral cephalometric films. Statistical significance was set at P value of less than 0.05. RESULTS: Hypopharyngeal airway dimensions (P < 0.000), oropharyngeal airway dimensions (P < 0.001, P < 0.007), and PASmin values (P < 0.010, P < 0.009) were increased and soft palate angle (P < 0.018, P < 0.007) was decreased in MA and IA groups significantly. Hyoid bone measurements revealed a significant difference in H-Cv2 distance (MA: P < 0.002-P < 0.002; IA: P < 0.001-P < 0.043) and H-Cv3 distance (P < 0.005, P < 0.001) for both groups. However, all these changes did not differ among the MA and IA activation groups. ANB°, Wits, overjet, and overbite measurements decreased and SNB°, Co-Gn, Na-Me, ANS-Me, and S-Go increased with the treatment significantly in both mandibular advancement groups (P < 0.000-P < 0.040). CONCLUSIONS: Herbst-RPE appliance provided a similar improvement in the oropharyngeal and hypopharyngeal airway dimensions and similar changes in sagittal and vertical hyoid position for both maximum and IA protocols in patients with skeletal Class II malocclusion. TRIAL REGISTRATION: ISRCTN69743543.

Operating conditions influence microbial community structures, elimination of the antibiotic resistance genes and metabolites during anaerobic digestion of cow manure in the presence of oxytetracycline.

The way that antibiotic residues in manure follow is one of the greatest concerns due to its potential negative impacts on microbial communities, the release of metabolites and antibiotic resistant genes (ARGs) into the nature and the loss of energy recovery in anaerobic digestion (AD) systems. This study evaluated the link between different operating conditions, the biodegradation of oxytetracycline (OTC) and the formation of its metabolites and ARGs in anaerobic digesters treating cow manure. Microbial communities and ARGs were determined through the use of quantitative real-time PCR. The biodegradation of OTC and occurrence of metabolites were determined using UV-HPLC and LC/MS/MS respectively. The maximum quantity of resistance genes was also examined at the beginning of AD tests and concentration was in the order of: tetM >tetO. The numbers of ARGs were always higher at high volatile solids (VS) content and high mixing rate. The results of the investigation revealed that relationship between mixing rate and VS content plays a crucial role for elimination of ARGs, OTC and metabolites. This can be attributed to high abundance of microorganisms due to high VS content and their increased contact with elevated mixing rate. An increased interaction between microorganisms triggers the promotion of ARGs.

Effects of Surgical and Nonsurgical Rapid Maxillary Expansion on Palatal Structures.

AIM: The aim of the present study was to compare the effects of surgical and nonsurgical rapid maxillary expansion (RME) in skeletally mature patients. MATERIALS AND METHODS: Surgically assisted rapid maxillary expansion (SARME) was used in 18 patients (2 males, 16 females) with a mean age of 19.90 years. Two nonsurgical RME groups were constructed to compare the expansion changes of SARME. Eighteen patients in maximum pubertal peak (12 males, 6 females) with a mean age of 13.04 years comprised the growing RME group, while the nongrowing RME (NG-RME) group consisted of 18 skeletally mature patients (1 male, 17 females) with a mean age of 16.41 years. Thirteen linear and 2 angular measurements were made on the study models taken before expansion (T0) and after 3 months of retention period (T1). Intragroup differences were evaluated with paired t test and the intergroup differences were analyzed with 1-way analysis of variance. RESULTS: All groups showed significant transversal skeletal and dental expansion. The palatal width changes at gingival and midpalate levels were the highest in the NG-RME group (6.85 and 5.84 mm, respectively). The most molar tipping was in the NG-RME group (15.00°) and the palatal vault angle showed the most increase in the SARME group (9.77°). The greatest expansion at the base of palatal vault was in the SARME group (4.42 mm). CONCLUSIONS: The pattern of expansion was rotation of the maxillary halves for SARME and lateral displacement of the dentoalveolar structures for NG-RME. Patients with severe skeletal discrepancy or increased age are good candidates for SARME.

Light emitting diode mediated photobiomodulation therapy improves orthodontic tooth movement and miniscrew stability: A randomized controlled clinical trial.

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the effects of light-emitting diode-mediated-photobiomodulation therapy (LPT) on the stability of miniscrews, rate of orthodontic tooth movement, and interleukin-1ß levels in gingival and peri-implant crevicular fluid. MATERIALS AND METHODS: This study was a double blind, randomized placebo/control matched pairs clinical trial to test the efficacy of LPT. This split-mouth design study consisted of 20 patients (13 girls, 7 boys). The eligibility criteria included patients who had extraction of maxillary first premolars. Mini-screws were placed between maxillary first molars and second premolars on both sides as anchorage units. LPT was applied with an energy density of 20 mW/cm2 over a period of 21 successive days (20 minutes per day) over the movement of canine teeth on the test side and using a pseudo application on the placebo side. The main outcome of this study was to assess effect of LPT on the rate of orthodontic tooth movement. The secondary outcomes were measuring stability of miniscrews and interleukin-1ß levels in gingival and peri-implant crevicular fluid after LPT. Randomization was accomplished with random LPT application side selection by coin toss. Measurements were made by blinding clinicians. Blinding of the patients was achieved using the same LPT device on both sides but irradiating only one side. For statistical comparison, paired samples t-test and one-way analysis of variance (ANOVA) were used at P < 0.05 level. RESULTS: Miniscrew stability was similar between control and LPT groups at baseline (T0) and the 1st month (T1). However, miniscrew stability was significantly increased in the LPT group in 2nd (T2) and 3rd (T3) months. Comparison of tooth movement during three different time intervals (T1-T0, T2-T1, and T3-T2) revealed that statistically significantly increased in every time intervals after LPT. No statistically significant change was detected in the IL-1ß levels between groups. CONCLUSION: LPT had the potential of accelerating orthodontic tooth movement and had a positive effect on miniscrew stability. Lasers Surg. Med. 48:936-943, 2016. © 2016 Wiley Periodicals, Inc.

Degradation of oxytetracycline and its impacts on biogas-producing microbial community structure.

The effect of veterinary antibiotics in anaerobic digesters is a concern where methane production efficiency is highly dependent on microbial community structure. In this study, both anaerobic degradation of a common veterinary antibiotic, oxytetracycline (OTC), and its effects on an anaerobic digester microbial community were investigated. Qualitative and quantitative molecular tools were used to monitor changes in microbial community structure during a 60-day batch incubation period of cow manure with the addition of different concentrations of the antibiotic. Molecular data were interpreted by a further redundancy analysis as a multivariate statistics approach. At the end of the experiment, approximately 48, 33, and 17 % of the initially added 50, 100, and 200 mg l(-1) of OTC was still present in the serum bottles which reduced the biogas production via accumulation of some of the volatile fatty acids (VFAs). Biogas production was highly correlated with Methanobacteriales and Methanosarcinales gene copy numbers, and those parameters were negatively affected with oxytetracycline and VFA concentrations.

Changes in microbial community structures due to varying operational conditions in the anaerobic digestion of oxytetracycline-medicated cow manure.

Management of manure containing veterinary antibiotics is a major concern in anaerobic treatment systems because of their possible adverse effects on microbial communities. Therefore, the aim of study was to investigate how oxytetracycline (OTC) influences bacteria and acetoclastic and hydrogenotrophic methanogens under varying operational conditions in OTC-medicated and non-medicated anaerobic cow manure digesters. Concentrations of OTC and its metabolites throughout the anaerobic digestion were determined using ultraviolet-high-performance liquid chromatography (UV-HPLC) and tandem liquid chromatography-mass spectrometry (LC/MS/MS), respectively. Fluorescent in situ hybridization, denaturing gradient gel electrophoresis, cloning, and sequencing analyses were used to monitor changes in microbial community structures. According to the results of analytical and molecular approaches, operating conditions highly influence active microbial community dynamics and associate with biogas production and elimination of OTC and its metabolites during anaerobic digestion of cow manure in the presence of an average initial concentration of 2.2 mg OTC/L. The impact of operating conditions has a drastic effect on acetoclastic methanogens than hydrogenotrophic methanogens and bacteria.

Performance and microbial community variations in thermophilic anaerobic digesters treating OTC medicated cow manure under different operational conditions.

This study aimed to determine the fate and effect of oxytetracycline (OTC) and its metabolites during thermophilic anaerobic digestion of cow manure. OTC-medicated and non-medicated digesters were operated at 55°C with different volatile solids (VS) concentrations (4% and 6%) and mixing rates (90 and 120rpm). OTC and its metabolites were measured by HPLC and LC/MS/MS, respectively. Microbial community dynamics were monitored by denaturing gradient gel electrophoresis (DGGE) and real-time PCR (qPCR). Approximately 2mg/L initial OTC concentration caused 10-30% inhibition on biogas production and higher inhibition was observed as mixing rate increased. DGGE results indicated that OTC caused a shift in bacterial community structure and several species became dominant with time. Archaeal community decreased throughout the digestion period. RNA based qPCR analyses showed that gene copy numbers of bacteria and Methanomicrobiales declined in all digesters whereas gene copy numbers of Methanobacteriales and Methanosarcinales increased in high mixing rate digesters.

Acidification of non-medicated and oxytetracycline-medicated cattle manures during anaerobic digestion.

Possible adverse effects of a commonly used veterinary antibiotic, oxytetracycline (OTC), on acidogenic phase of anaerobic digestion of cattle manure along with optimum operating conditions were investigated. A standard veterinary practice of 50 ml OTC solution (20 mg/kg cattle weight) was injected into the muscles of cattle and then manure samples were collected for 5 days following the injection. The 5-day samples were equally mixed and used throughout digestion experiments. Preliminary batch tests were conducted to obtain the optimum pH range and observe volatile fatty acids (VFAs) production. In this regard, different sets of batch digesters were operated at pH ranging from 5.2 +/- 0.1 to 5.8 +/- 0.1 at mesophilic conditions with total solids content of 6.0 +/- 0.2%. The pH of 5.5 +/- 0.1 was found to be the optimum value for acidification for both non-medicated and OTC-medicated conditions. Under predetermined conditions, maximum total VFA (VFAtot) of 830 +/- 3 mg (as acetic acid)/L was produced and maximum acidification rate was evaluated as 11% for OTC-medicated cattle manure, whereas they were 900 +/- 6 mg (as acetic acid)/L and 12% for non-medicated manure. Digestion studies were further continued in a semi-continuous mode at pH 5.5 +/- 0.1 and SRT/HRT of 5 days. VFAtot concentrations and maximum acidification rate increased up to 2181 +/- 19 mg (as acetic acid)/L and 29% for non-medicated cattle manure. For OTC-medicated cattle manure, lower acidification rate of 18% was observed.

Effect of oxytetracycline on biogas production and active microbial populations during batch anaerobic digestion of cow manure.

The aim of this study was to investigate the effect of a common veterinary antibiotic in biogas plants. 20 mg/kg of oxytetracycline was intramuscularly injected into a cow and its concentration in manure, which was sampled daily during the following 20 days, was measured. A total of 20 % of the injected oxytetracycline was detected in manure. Collected manure samples on days 1, 2, 3, 5, 10, 15, and 20 were digested in triplicate serum bottles at 37 °C for 30 days. Control serum bottles produced 255 ± 13 mL biogas, whereas 50-60 % inhibitions were obtained for the serum bottles operated with samples collected for the 5 days after medication. Multivariate statistics used for the evaluation of FISH results showed that Methanomicrobiales were the main methanogenic group responsible for most of the biogas production. Numbers of active Bacteria and Methanomicrobiales were negatively correlated with the presence of oxytetracycline, whereas Methanosarcinales and Methanobacteriales were less affected.