Ali Altug Bicakci

A Comparison of the Effects of Rapid Maxillary Expansion and Fan-Type Rapid Maxillary Expansion on Dentofacial Structures

The aim of this study was to evaluate and compare the sagittal, transverse, and vertical effects of rapid maxillary expansion (RME) and fan-type RME on dentofacial structures. The study group consisted of 34 patients, 14 boys and 20 girls (average age 12.5 years), selected without considering their skeletal class and sex. The fan-type RME group comprised 17 subjects, who had an anterior constricted maxilla with a normal intermolar width. The RME group comprised 17 other subjects, who had a maxillary transverse discrepancy with a posterior crossbite. The records obtained for each patient included a lateral and a frontal cephalometric film, upper plaster models, and occlusal radiograph obtained before treatment (T1), after expansion (T2), and immediately after a three-month retention period (T3). The data obtained from the evaluation of the records before and after treatment, after treatment and after retention, and before treatment and after retention were compared using paired t-test. Further comparisons between the groups were made using Students t-test. There was significantly greater expansion in the intercanine than in the intermolar width in the fan-type RME group as compared with the RME group. Downward and forward movement of the maxilla was observed in both groups. The upper incisors were tipped palatally in the RME group, but they were tipped labially in the fan-type RME group. There was significantly greater expansion in the nasal cavity and maxillary width in the RME group as opposed to the fan-type RME group.

Efficiency of low-level laser therapy in reducing pain induced by orthodontic forces.

OBJECTIVE The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on reducing post-adjustment orthodontic pain via evaluation of gingival crevicular fluid (GCF) composition changes at the level of prostaglandin-E(2) (PGE(2)) and visual analogue scale (VAS). BACKGROUND DATA LLLT has been found to be effective in pain relief. PGE(2) has the greatest impact on the process of pain signals and can be detected in GCF in order to investigate the response of dental and periodontal tissues in a biochemical manner. MATERIALS AND METHODS Nineteen patients (11 females and 8 males; mean age 13.9 years) were included in this study. Maxillary first molars were banded and then a randomly selected first molar at one side was irradiated (λ820 nm; continuous wave; output power: 50 mW; focal spot: 0.0314 cm(2); exposure duration: 5 sec; power density: 1.59 W/cm(2); energy dose: 0.25 J; energy density: 7.96 J/cm(2) for each shot), while the molar at the other side was served as placebo control. The GCF was collected from the gingival crevice of each molar to evaluate PGE(2) levels, before band placement, 1 and 24 h after laser irradiation. Pain intensity was analyzed at 5 min, 1 h, and 24 h after band placement by using VAS. RESULTS Although no difference was found in pain perception at 5 min and 1 h, significant reduction was observed with laser treatment 24 h after application (p<0.05). The mean PGE(2) levels were significantly elevated in control group, whereas a gradual decrease occurred in laser group. The difference in PGE(2) levels at both 1 and 24 h were statistically significant between two groups (p<0.05). CONCLUSIONS The significant reductions in both pain intensity and PGE(2) levels revealed that LLLT was efficient in reducing orthodontic post-adjustment pain.

Histopathologic evaluation of pulpal tissue response to various adhesive cleanup techniques.

INTRODUCTION The aim of this prospective in-vivo study was to investigate the possible effects of temperature changes from various adhesive cleanup procedures on pulpal tissue. METHODS The materials, consisting of 40 sound maxillary and mandibular premolars to be extracted during orthodontic treatment, were randomly assigned to 4 groups, with 1 group as the control. The teeth in the 3 study groups were etched; brackets were bonded and then debonded. The remaining adhesive was removed with a tungsten carbide bur by using a high-speed hand piece. The teeth in the control group were not etched and bonded. In group 1, the residual adhesive was removed with water cooling, and the teeth were extracted 24 hours later. In group 2, the residual adhesive was removed without water cooling, and the teeth were extracted 24 hours later. In group 3, the residual adhesive was removed without water cooling, and the teeth were extracted 20 days later. The teeth were prepared for histologic examination, and the number of vessels, vessel areas and perimeters, extravasation of red blood cells, vascular congestion, and inflammatory cell infiltration were evaluated to determine pulpal tissue changes. RESULTS According to the findings from histologic and immunohistochemical evaluations, the coronal pulps of the teeth in groups 1 and 3 were almost similar to the control teeth, but some distinct pathologic changes were observed in group 2. CONCLUSIONS Adhesive removal without water cooling caused some vascular and pulpal tissue alterations, but these were tolerated by the pulpal tissues, so the changes were reversible.

Orthodontic and orthopedic treatment of a patient with incontinentia pigmenti.

Incontinentia pigmenti is an uncommon, inherited disorder with predominantly ectodermal manifestations that is associated with skin (100%)), dental (90%), skeletal (40%), central nervous (40%), and ocular (35%) deformities. It is an X-linked dominant disease, usually lethal in males and occurring in female infants. The dental effects include delayed eruption, partial anodontia, microdontia, and cone or peg-shaped teeth. The dental, clinical, and radiological findings in a 16-year-old female are presented here. The patient had peg-shaped teeth and a unilateral maxillary transverse discrepancy associated with oligodontia in the maxillary and mandibular arches. Orthodontic treatment included rapid maxillary expansion and fixed orthodontic therapy for prosthetic purposes and elimination of the functional midline shift.

Late development of a mandibular second premolar.

In this report, we present the case of a girl with delayed odontogenesis of a lower second premolar for which she was followed up for 8.5 years. Congenital absence of permanent mandibular second premolars was observed at the initial radiographic examination at 8 years and 1 month. One year later, during the treatment period, an unexpected odontogenesis of a right second premolar was diagnosed on follow-up radiography. The original treatment plan was revised and a new plan was successfully implemented. Th is unusual case showed that the orthodontists clinical philosophy must be flexible because unexpected situations can arise, especially when treating growing patients.

Does proclination of maxillary incisors really affect the sagittal position of point A

OBJECTIVE To examine the effect of maxillary incisor proclination due to orthodontic treatment upon the sagittal position of point A and evaluate the effect of this possible movement of point A on sella-nasion-point A (SNA) angle. MATERIALS AND METHODS A study group was formed from 25 subjects (12 male and 13 female) who had Class II division 2 malocclusion with retroclined upper incisors, and a control group was formed from 25 subjects (12 male and 13 female) who had minor crowding in the beginning of the treatment and required no or minimal maxillary anterior tooth movement. Treatment changes in maxillary incisor inclination, sagittal position of point A, SNA angle, and movement of incisor root apex and incisal edge were calculated on pretreatment and posttreatment lateral cephalographs. RESULTS Maxillary incisors were significantly proclined (17.33°) in the study group and not significantly proclined (1.81°) in the control group. This proclination resulted in 2.12-mm backward movement of the root apex and 5.76-mm forward movement of the incisal edge of maxillary incisors. Point A moved 1.04 mm backward (P  =  .582) and 0.48 mm (P  =  .811) forward in the study and control groups, respectively. Incisor root apex and incisal edge almost remained stable in the control group. No significant change was observed in the value of the SNA angle in both the study and control groups. CONCLUSIONS Proclination of maxillary incisors accompanied by backward movement of incisor root apex caused posterior movement of point A. However, this posterior movement does not significantly affect the SNA angle.

Does Rapid Maxillary Expansion Affect the Eruption of Upper Third Molars

OBJECTIVE To test the hypothesis that there is no difference in the movement of the upper third molars between rapid maxillary expansion (RME) and non-RME patients. MATERIALS AND METHODS This study was performed on 30 patients divided into two groups. The study group included 20 patients who had maxillary narrowness and bilateral maxillary third molars and who had undergone RME application. The control group of 10 patients had a bilateral crossbite, had bilateral maxillary third molars, and did not receive orthodontic treatment. The records included lateral and frontal cephalometric films and maxillary plaster models. In the study group, records were taken before expansion (T1), after expansion (T2), and at the retention period (T3). T2 records were not taken in the control group because this period was too short to observe any changes. Friedman tests were used to observe within groups, and the Mann-Whitney U-test was used to see the differences between groups on films and casts. RESULTS Frontal films showed that vertical eruption occurred after the retention period in the RME cases. Cephalometric films revealed that the angular eruption occurred immediately after expansion. However, the results were not significant with respect to the control group. CONCLUSION The hypothesis was rejected. Rapid maxillary expansion affects maxillary third molar movement during and after the RME procedure. RME may indicate upper third molar eruption, but the final position of third molar was not different compared to the normal growth pattern.

Is Third-Molar Agenesis Related to the Incidence of Other Missing Teeth?

ABSTRACT Objective: The aim of this study was to investigate whether third-molar agenesis is related to agenesis of other missing teeth (incisor-premolar hypodontia [IPH]). Materials and Method: A sample of 94 Turkish patients with agenesis of upper lateral incisors and/or second premolars was selected from 2357 records. Another sample of 94 patients without agenesis (excluding third molars) was drawn from the same set of records and used as a control group. An orthopantomograph of each patient was used to determine the presence or absence of teeth. Differences in the frequency of third-molar agenesis between sexes and between the groups were assessed by chi-square test. Results: No difference in the prevalence of third-molar agenesis between the groups was shown (p=0.30). The incidence of IPH was found to be significantly different between genders (p=0.00), whereas no significant difference in the incidence of third-molar agenesis was found between sexes (p=0.07). Conclusion: The subjects with IPH were n...

Can Initial Torque Value Predict the Success of Orthodontic Mini-Screws?

ABSTRACT Objective: To investigate the correlation between initial torque and removal torque of orthodontic mini-screws. Materials and Method: Sixty-four orthodontic mini-screws (measuring 1.5 × 4.4 mm, 1.6 × 4.7 mm, 1.7 × 5.5 mm, and 1.8 × 5.6 mm) were used. All mini-screws were inserted into the fibulas of 8 male rabbits. The initial torque values were immediately recorded using a digital torque gauge. For 2 months, 115 g force was applied to mini-screws inserted into the right fibula of the rabbits. The same procedure was followed for inserting the mini-screws into the left fibula of the rabbits but without applying any force. After 2 months, the removal torque values were recorded for all mini-screws. All statistical analyses were performed using SPSS version 14.0 for Windows. Spearmans correlation coefficient was used to analyze the relationships between initial and removal torque values. Results: Intragroup comparison of all brands of mini-screws showed similar features. There were no statistically...