Do we pay for maxillary protraction? Evaluation of the effects of Alt-RAMEC protocol and face mask treatment on root development.

OBJECTIVES: To evaluate root development of pediatric patients treated with Alt-RAMEC + Face mask therapy. MATERIAL AND METHODS: The 19 subjects (9 girls, 10 boys; mean age: 8.6 ± 1.1 years) treated with Alt-RAMEC and a Petit-type face mask were included to the study. The cone-beam tomography (CBCT) records of these patients were used to quantify the root length. The root length measurements of 456 permanent teeth (maxillary-mandibular incisors, canines, premolars, and first molars) were performed at the beginning of the treatment (T0), after the Alt-RAMEC protocol (T1), and at the end of the face mask treatment (T2) using Planmeca Romexis software. RESULTS: Tooth length values increased significantly in the maxillary teeth except the central incisors, left lateral incisor, the palatal root of the right first molar, and distal and palatinal roots of the left first molar (p < 0.05). Mandibular teeth also showed significant increase in the root length except mandibular central incisors and the distal root of left first molar (p < 0.05). The change in tooth lengths from T0 to T1 showed positive delta values. The comparison of the change in tooth lengths after the Alt-RAMEC protocol and after the face mask therapy showed that ∆T2-T1 was statistically significantly higher compared with ∆T1-T0 (p < 0.05). CONCLUSIONS: Alt-RAMEC + Face mask therapy seem not to inhibit root development of maxillary and mandibular teeth in the mixed dentition. CLINICAL RELEVANCE: These findings suggest that early Alt-RAMEC + Face mask interventions have not played a negative role in root development. However, further studies involving a control group need to be performed.

Voice changes after surgically assisted rapid maxillary expansion.

INTRODUCTION: This study aimed to investigate voice changes in patients who had surgically assisted rapid maxillary expansion (SARME). METHODS: Nineteen adult patients with maxillary transverse deficiency were asked to pronounce the sounds "[a], [ϵ], [ɯ], [i], [ɔ], [œ] [u], [y]" for 3 seconds. Voice records were taken before the expansion appliance was placed (T0) and 5.8 weeks after removal (T1, after 5.2 months of retention). The same records were taken for the control group (n = 19). The formant frequencies (F0, F1, F2, and F3), shimmer, jitter, and noise-to-harmonics ratio (NHR) parameters were considered with Praat (version 6.0.43). RESULTS: In the SARME group, significant differences were observed in the F1 of [a] (P = 0.005), F2 of [ϵ] (P = 0.008), and [œ] sounds (P = 0.004). The postexpansion values were lower than those recorded before. In contrast, the F1 of [y] sound (P = 0.02), F2 of [u] sound (P = 0.01), the jitter parameter of [ɯ] and [i] sounds (P = 0.04; P = 0.002), and the NHR value of [ϵ] sound (P = 0.04) were significantly than the baseline values. In the comparison with the control group, significant differences were found in the F0 (P = 0.025) and F1 (P = 0.046) of the [u] sound, the F1 of the [a] sound (P = 0.03), and the F2 of the [ϵ] sound (P = 0.037). Significant differences were also found in the shimmer of [i] (P = 0.017) and [ɔ] (P = 0.002), the jitter of [ϵ] (P = 0.046) and [i] (P = 0.017), and the NHR of [i] (P = 0.012) and [ɔ] (P = 0.009). CONCLUSION: SARME led to significant differences in some of the acoustics parameters.

Alternative treatment plan for congenitally missing teeth in an adolescent patient: A case report.

BACKGROUND AND OVERVIEW: Mandibular second premolars are the second most commonly missing teeth, and there are various treatment alternatives to restore the space of the missing teeth. However, in growing patients, implants are contraindicated because they prevent growth of bone. CASE DESCRIPTION: In this case report, the authors describe a 13-year-old girl with Class II malocclusion with congenitally missing mandibular second premolars. Autotransplantation of 2 maxillary premolars to the missing teeth site was performed considering the presence of crowding in the maxillary anterior segment. The teeth were fixed with a semirigid splint for 3 months. The patient had an acceptable occlusion at the end of the orthodontic treatment, which lasted 20 months. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The autotransplanted right premolar showed normal physiological adaptation, whereas the tooth on the left side was ankylosed. The short-term results show that autotransplantation, which requires high technical sensitivity, may provide a biological and economical alternative to tooth replacement.

The Accuracy of Information about Orthodontics Available on the Internet.

OBJECTIVE: The aim of the present study was to evaluate the content of the informative websites related to orthodontic terms in Turkish and in English. METHODS: Five different orthodontic terms ("orthodontic appliances (ortodontik aygitlar)," "orthodontic braces (ortodontik braketler)," "orthodontic elastics (ortodontik elastikler)," "orthognathic surgery (ortognatik cerrahi)," and "orthodontic treatment (ortodontik tedavi)") both in Turkish and in English were searched using Google. There were 25 websites evaluated for each term. A total of 137 different websites were evaluated with three measurement tools: DISCERN (questionnaire, University of Oxford, 1999) (quality of information), LIDA (v1.2 Minervation, 2007) (accessibility, usability, and reliability), and AChecker (v0.1 ATutor, 2011) (accessibility). RESULTS: The mean overall score of the quality of information was "good" for terms in Turkish and in English. The LIDA score was classified as "moderate" for terms in Turkish and in English. More accessibility errors were found on the Turkish websites than on the English counterparts. Most of the statistical evaluations between Turkish and English terms were insignificant. However, intragroup evaluation of the terms mostly showed significant differences. CONCLUSION: Accessibility, usability, and reliability; quality of information; and scores of access errors showed variations among Turkish and English sites. The collaboration of website designers and clinicians to increase the quality level of the websites is recommended.

Skeletal, soft tissue, and airway changes following the alternate maxillary expansions and constrictions protocol.

OBJECTIVE: To evaluate the skeletal, soft tissue, and airway effects of the alternate maxillary expansions and constrictions (Alt-RAMEC) protocol in prepubertal patients. MATERIALS AND METHODS: The appliance containing a double-hinged expansion screw was applied to 20 patients with Class III skeletal malocclusion characterized by maxillary retrognathia. The mean age of the study group was 9 years and 8 months. The patients' parents were instructed to open the screw by 1 mm per day during the first week and to close it by 1 mm per day the week after. This alternate opening and closing was repeated for 9 consecutive weeks. Cone beam computed tomography records and three-dimensional photographs were taken before treatment and after 9 week of the Alt-RAMEC protocol. RESULTS: Point A moved slightly forward (0.89 mm) and downward (0.92 mm) (P < .05). The average amount of expansion achieved at the level of point A was 5.54 mm (P < .05). Besides the maxilla, the expansive forces also affected the nasal bone, the zygomaticomaxillary and zygomaticotemporal sutures (P < .05). The soft tissue nasal width increased significantly. The airway volume of the anterior nasal compartment and the nasal cavity also increased (P < .05). CONCLUSIONS: Slight forward movement of point A occurred with the Alt-RAMEC protocol. The expansion affected not only the maxilla but also other structures of the face. Significant cutaneous changes occurred in the paranasal area. Some significant increase in the upper airway volume was obtained.