Ali Ihya Karaman

Pain Control During Fixed Orthodontic Appliance Therapy

The control of pain during orthodontic treatment is of great interest to both clinicians and patients. However, there has been limited research into the control of this pain, and there is no standard of care for controlling this discomfort. This prospective study determines the pain sequelae in fixed orthodontic treatment and evaluates comparatively the analgesic effects of nonsteroidal anti-inflammatory drugs for the control of this pain. One hundred and fifty orthodontic patients who were to have teeth bonded in at least one arch were randomly assigned to one of six groups: (1) placebo/placebo, (2) ibuprofen/ibuprofen, (3) flurbiprofen/flurbiprofen, (4) acetaminophen/acetaminophen, (5) naproxen sodium/naproxen sodium, and (6) aspirin/aspirin. The pain evaluations were made during chewing, biting, fitting the front teeth, and fitting the back teeth using a 100-mm visual analogue scale (VAS) for seven days. All the analgesics succeeded in decreasing the pain levels compared with the placebo group. However, naproxen sodium and aspirin groups showed the lowest pain values, and the acetaminophen group showed VAS results similar to those of the two analgesics.

Effect of Self-Etching Primers on Bond Strength—Are They Reliable?

Currently introduced self-etching primers combine conditioning and priming agents into a single product. The purpose of this study was to determine the effects of using three self-etching primers on the shear bond strength (SBS) of orthodontic brackets and on the bracket/adhesive failure mode. Brackets were bonded to extracted human teeth according to one of four protocols. In the control group, teeth were etched with 37% phosphoric acid. In the experimental groups, the enamel was conditioned with three different self-etching primers, Clearfil SE Bond (CSE), Etch & Prime 3.0 (EP3), or Transbond Plus (TBP), as suggested by the manufacturer. The brackets were then bonded with Transbond XT in all groups. The present in vitro findings indicate that conditioning with TBP before bonding orthodontic brackets to the enamel surface resulted in a significantly (P < or = .001) higher SBS (mean, 16.0 +/- 4.5 MPa) than that found in CSE, EP3, and the control (acid-etched [AE]) groups. CSE produced bond strength values (mean 11.5 +/- 3.3 MPa) that are statistically comparable to those produced by acid etching (mean 13.1 +/- 3.1 MPa). The use of EP3 for enamel conditioning resulted in the lowest mean SBS value (mean 9.9 +/- 4.0 MPa). A comparison of the adhesive remnant index scores indicated that there was more residual adhesive remaining on the teeth that were treated with conventional acid etching than in the CSE and EP3 groups. In the TBP group, the failure sites were similar to those of the AE group but different from those of the CSE group.

Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain.

Three experimental groups of 20 patients each, all of whom were to undergo fixed orthodontic treatment, were enrolled in this prospective study. Group 1 was given a placebo, group 2 was given 400 mg ibuprofen, and group 3 was given 550 mg naproxen sodium. All the patients received only one dose that was given one hour before archwire placement. All patients were asked to complete a questionnaire concerning the pain perceived after archwire placement. The questionnaire was in the form of a seven-page booklet that contained 100-mm horizontal Visual Analogue Scale on which the patient marked the degree of discomfort at the indicated time periods. The patients were instructed to make a check on the scale at each time interval to represent the perceived severity of pain during each of four activities, ie, chewing, biting, fitting back teeth together, and fitting front teeth together. Incidence and severity of pain were recorded by the patient at two hours, six hours, nighttime on the day of appointment, 24 hours after the appointment, and two days, three days, and seven days after bonding. The results revealed that patients taking 550 mg naproxen sodium one hour before archwire placement had significantly lower levels of pain at two hours, six hours, and nighttime after adjustment than patients taking placebo or ibuprofen. However, the use of additional postoperative doses was recommended to control orthodontic pain completely.

Unilateral distal molar movement with an implant-supported distal jet appliance.

With the guidance of the basis of the distal jet appliance, we present a new implant-supported distal jet appliance. In this case, we used a modified distal jet appliance that was supported by a palatal implant placed at the anterior edge of the rugae region of the palate for molar distalization. The treatment results were evaluated from lateral cephalometric and panoramic radiographs and dental casts. We conclude that an implant-supported modified distal jet appliance is effective in the correction of a Class II molar relationship.

Maxillary anterior segmental advancement by using distraction osteogenesis: a case report.

After the first clinical application of distraction osteogenesis (DO) to correct mandibular deformity was reported in 1992, various applications such as maxillary or midface advancement, temporomandibular joint reconstruction, alveolar augmentation, and mandibular widening have been described in the oral and maxillofacial region. Block et al and Altuna et al first examined anterior segmental DO experimentally in the maxilla and reported successful results. After these studies, DO has been used clinically for the total advancement of the maxilla or midface. But no clinical application of DO for maxillary anterior segmental advancement was found by a review of the literature in English. In this article, we present a case with a skeletal Class III abnormality resulting from a maxillary deficiency, which was treated by using anterior segmental DO.

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.

Rapid Canine Distalization through Segmental Alveolar Distraction Osteogenesis

OBJECTIVE The objectives of this study were to achieve rapid canine distalization by segmental alveolar distraction method in first premolar extraction cases, to examine the changes in the periodontal tissues surrounding canines, to evaluate the displacement of the canine and first molar teeth, to assess the effects of the procedure on the pulpal vitality of the canines, and to determine the amount of root resorption in retracted canines. MATERIALS AND METHODS The sample of the study consisted of 20 teeth in eight patients (four females and four males, mean age 18.5 years). Pre- and posttreatment dental casts, panoramic radiographs, and standard periapical radiographs were taken from all patients. An electrical vitality test was applied before and after the distraction procedure and during the follow-up period (6 months after the completion of the procedure). In addition, six periodontal indices were used to examine the health of the periodontal tissues. RESULTS The distraction procedure was completed in 12 to 28 days (mean 14.65 +/- 3.49). The anchorage loss ranged from 0 to 3 mm (mean 1.2 +/- 0.83). The distal displacement of the canines ranged from 3 to 8 mm (mean 5.35 +/- 1.22). The canines showed a mean of 9.1 degrees distal tipping, whereas there was no statistically significant change in the axial inclinations of first molars after distraction. CONCLUSION We believe that rapid canine distalization by segmental distraction osteogenesis will become a routine protocol and a popular method among orthodontic applications.

In Vitro Evaluation of Shear Bond Strengths and In Vivo Analysis of Bond Survival of Indirect-Bonding Resins

In this study we evaluate the shear bond strengths (SBS) of indirect-bonding systems available on the market. For the in vitro study, 60 extracted premolars were divided into three groups. In indirect group I, the brackets were bonded to models using Therma Cure laboratory resin and transferred to the teeth using Custom IQ resin for indirect bonding. For indirect group II, the teeth were attached to models using Transbond XT and transferred using Sondhi Rapid Set. In the direct-bonding group, the brackets were bonded to teeth directly using Transbond XT The SBS were evaluated, and the comparisons were made. In the in vivo study, left half of the upper arch and right half of the lower arch were bonded using Sondhis indirect-bonding resin and right half of the upper arch and left half of the lower arch were bonded using Therma Cure as a laboratory resin and Custom IQ as a clinical bonding resin. The failure rates of the brackets were followed for nine months. Analysis of variance and Tukey tests were performed. Mean SBS values (MPa) were 10.3 +/- 4.2, 6.1 +/- 1.6, and 12.8 +/- 5.4 for the indirect groups I and II and for the direct-bonding group, respectively. There were no significant differences between indirect group I and direct group (P > .05), whereas both yielded significantly higher SBS values compared with indirect group II. In vivo bond survival evaluation showed no differences between the two indirect-bonding systems available.

Effects of fast halogen and plasma arc curing lights on the surface hardness of orthodontic adhesives for lingual retainers

The aims of this study were to (1) identify the optimum cure times of 2 different lingual retainer adhesives with a conventional halogen, a fast halogen, and a plasma arc light by measuring Vickers surface hardness, and (2) determine whether different lights produce similar surface hardness values for the same adhesive resin material. The investigated plasma arc curing unit was the PowerPac (American Dental Technologies, Corpus Christi, Tex), and the fast halogen unit was the Optilux 501 (Kerr, Orange, Calif). A conventional curing unit, the Ortholux XT (3M Dental Products, St. Paul, Minn) was used as the control. Two orthodontic lingual retainer adhesives were used: Transbond Lingual Retainer (3M Unitek, Monrovia, Calif) and Light Cure Retainer (Reliance Orthodontic Products, Itasca, Ill). Concise (3M Dental Products) and diluted Concise were used as controls. Transbond Lingual Retainer was polymerized by the PowerPac light in 6 seconds, by the Optilux in 10 seconds, and by the conventional halogen light in 20 seconds. The minimum curing times for Light Cure Retainer adhesive were 15 seconds for PowerPac, 10 seconds for Optilux, and 40 seconds for conventional halogen. Surface hardness values for each resin did not differ significantly with different curing units. However, different adhesives demonstrated significantly different surface hardness values. Final Vickers surface hardness values (averaged across curing units) of Transbond Lingual Retainer, Concise, diluted Concise, and Light Cure Retainer were 62.8, 52.4, 46.0, and 40.4, respectively. Plasma arc or fast halogen units polymerize resin composite adhesive in much shorter times than do conventional curing units, without a significant loss in surface hardness. Therefore, these units are suggested for clinical use to save chairside time.

Effects of a Chlorhexidine Varnish on Shear Bond Strength in Indirect Bonding

The purpose of this study was to evaluate the effects of an antimicrobial varnish on the shear bond strength (SBS) of metallic orthodontic brackets bonded with an indirect bonding resin. For this purpose, 60 noncarious human premolars were divided into three equal groups. Group 1 was an indirect bonding control group and, after acid etching of the enamel, the brackets were indirectly bonded to the teeth with an indirect bonding resin. In group 2, before bonding, an antimicrobial varnish was painted on the etched enamel and indirect bonding was carried out as in group 1. In group 3, Transbond MIP primer and the antimicrobial varnish were thoroughly mixed in a 1:2 proportion, applied to the enamel surface, light cured for 20 seconds, and the brackets were direct bonded. A universal testing machine was used to determine the maximum load necessary to debond the brackets, the SBS values recorded, and the adhesive remnant index scores determined. Data were analyzed using analysis of variance (ANOVA), Tukey HSD, and chi-square tests. Results of ANOVA revealed statistically significant differences in the SBS among the various groups tested (P < .05). Indirect bonding of brackets with Sondhi Rapid Set after the application of the antimicrobial varnish showed significantly lower SBS when compared with both the group 2, indirect bonding control group, and the group 3, direct bonded-antimicrobial varnish group.