Burcu Baloş Tuncer

Levels of Interleukin-8 During Tooth Movement

A host-derived neutrophil-activating cytokine interleukin-8 (IL-8) is secreted mainly by monocytes and is considered to be important in regulating alveolar bone resorption during tooth movement. The aim of this study was to evaluate the levels of IL-8 during mechanical forces on periodontal tissues at different stages of orthodontic therapy. Ten canine teeth of patients having different Angle classifications were selected for the study. After the premolars were extracted, the maxillary/mandibular canines were tipped distally. Gingival crevicular fluid was sampled from mesial and distal gingival crevices of each canine separately at baseline and one hour, 24 hours, six days, 10 days, and 30 days after the application of the force. An enzyme-linked immunosorbent assay for quantitative detection of IL-8 was used. Although there was an increase in the concentration of IL-8 at tension (mesial) sites after one hour, 24 hours, six days, and 10 days, a decrease was observed at 30 days. Pressure (distal) sites did not demonstrate such an increase at any period except at 10 days. However, the concentration of IL-8 at both sites showed a similar decrease and approached each other at day 30. We concluded that local host response toward the orthodontic forces might lead an increase in IL-8 and neutrophil accumulation, and this may be one of the triggers for bone remodeling processes.

A case report comparing 3-D evaluation in the diagnosis and treatment planning of hemimandibular hyperplasia with conventional radiography.

INTRODUCTION Cephalometric radiography is the main investigation used in the diagnosis of maxillofacial deformities. Three-dimensional (3-D) computed tomography (3-D CT) imaging has recently been used in the diagnosis and treatment planning of craniofacial morphology. The purpose of this report was to present the diagnosis and treatment planning of a hemimandibular hyperplasia case by using conventional radiographs and 3-D cephalometric analysis. METHODS A 24-year-old girl presented with hemimandibular hyperplasia and the main complaint was her facial appearance. Conventional cephalometric analysis including lateral and frontal cephalograms were traced by hand and evaluated by the same clinician. Twenty-one measurements on the lateral cephalograms and 13 measurements on the frontal cephalograms were performed. In addition, axial images were reconstructed into a 3-D model by using medical image processing software. Linear and angular measurements were presented in coronal and sagittal planes. RESULTS The 3-D CT analysis has a superior image quality when compared with conventional cephalograms. CONCLUSIONS The 3-D CT analysis provides more advanced diagnostic image information in evaluating craniofacial morphology. We conclude that 3-D CT images can facilitate the diagnosis, treatment planning, and outcome evaluation of severe asymmetry cases.

Effects of Maxillary Protraction and Fixed Appliance Therapy on the Pharyngeal Airway

OBJECTIVE To evaluate the long-term outcome of treatment with reverse headgear in patients with skeletal Class III malocclusion diagnosed as maxillary deficient. MATERIALS AND METHODS Twenty-five patients (11 girls, 14 boys; mean age, 11.32 years) treated with a reverse headgear appliance were included in this study. Pretreatment, posttreatment, and 4-year follow-up cephalometric radiographs were obtained; linear, angular, and area measurements were performed. Comparison of treatment and observation changes was performed using a paired t-test. RESULTS A significant increase was found in the forward movement of the maxilla, which was maintained 4 years after reverse headgear treatment. Treatment changes revealed significant increases in the sagittal dimensions and area of nasopharyngeal airway and remained significant at the end of the 4-year follow-up period. The oropharyngeal airway area increased nonsignificantly after the treatment, but significant increases occurred during the follow-up period. CONCLUSIONS In young individuals diagnosed with maxillary deficiency treated with reverse headgear, the nasopharyngeal airway dimensions were improved after the treatment, and favorable effects of the treatment remained over the posttreatment period of 4 years.

Effect of fluoride-releasing light-cured resin on shear bond strength of orthodontic brackets.

INTRODUCTION The aim of this study was to analyze the effect of an enamel-protective resin on the shear bond strength (SBS) of orthodontic brackets bonded with self-etching primer. METHODS Eighty extracted premolars were randomly divided into 4 groups of 20, and metal brackets were bonded. Group 1 specimens were bonded with Transbond Plus self-etching primer (3M Unitek, Monrovia, Calif) and no fluoride resin; in group 2, a fluoride-releasing resin (Ortho-Coat, Pulpdent, Watertown, Mass) was used with the Transbond Plus self-etching primer; group 3 teeth were bonded with a new antimicrobial self-etching primer (Clearfil Protect Bond, Kuraray Medical, Osaka, Japan) with no fluoride resin; and the same protocol was used in group 4 with an application of Ortho-Coat. A universal testing machine was used to determine the SBS, and the adhesive remaining after debonding was assessed. RESULTS There was no difference in SBS whether fluoride-releasing resin was used. Groups 3 and 4 had higher SBS values than the other groups (P <0.001). The Kruskal-Wallis test showed no significant differences in the adhesive remnant index (chi-square = 0.019, P = 0.990). CONCLUSIONS The application of enamel-protective resin did not affect the bond strength of orthodontic brackets to enamel with self-etching primer systems.

The effect of drill-free and drilling methods on the stability of mini-implants under early orthodontic loading in adolescent patients

The aim of this study was to compare the stability of mini-implants using drill-free and drilling methods, both before and after early force loading. Sixty-two adolescent patients (24 males and 38 females, mean age 15.7 ± 4.2 years) were randomly assigned to three groups and 112 titanium mini-implants were placed between the upper first molars and second premolars to achieve molar distalization. Groups I (n = 22) and II (n = 20) received pilot drilling with diameters of 1.1 and 0.9 mm, respectively, while the drill-free method was used in group III (n = 20). Distalization forces of up to 200 g were applied with nickel-titanium (NiTi) open coil springs. The Z-test was used for statistical analyses to compare the success rates of the groups with each other. The overall success rate was 77.7 per cent. There was no significant difference between groups I and II either before or after loading. Significant differences were found between groups I and III (P = 0.0002) and between groups II and III (P = 0.045) both before and after loading. Mini-implants using the drill-free method provided the highest success rate before orthodontic force application and also maintained their stability after early loading for 1 month during orthodontic treatment. Smaller drill diameters can contribute to clinical stability of mini-implants in the short-term, however long-term evaluations are needed to clarify the stability of temporary skeletal anchorage devices throughout orthodontic loading.

Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator

Abstract Aim. The aim of this study was to evaluate the long-term effects of Class 2 functional treatment on airway dimensions and positional changes in hyoid bone and compare it with that of an untreated Class 2 control group. Methods. Lateral cephalograms of 16 patients (eight girls, eight boys, mean chronological age = 11.36 ± 0.77 years) who were treated with activator and 19 patients (11 girls, eight boys, mean chronological age = 12.14 ± 0.65 years) who served as control were used for linear, angular and area measurements regarding airway track and hyoid bone. Statistics. Intra-group comparisons were performed by paired t-test and Wilcoxon test, whereas independent t-test and Mann Whitney-U were used for inter-group comparisons. Results. During treatment (T2–T1), nasopharyngeal height and nasopharyngeal area increased (p < 0.05) and hyoid bone moved downward (H-SN; p < 0.001) and forward (H-C3; p < 0.01). During retention period (T3–T2); nasopharyngeal (p < 0.01) and oropharyngeal area increased (p < 0.05). H-SN (p < 0.01) and C3-H distances (p < 0.05) increased. Hyoid bone position exhibited significant changes (H-SN, p < 0.001; C3-H, p < 0.01). The increases in C3-H in long-term was more in the activator group than control (p < 0.05). Conclusions. In growing Class 2 patients with mandibular deficiency and airway track without obstructions, functional appliance treatment provided favorable effects on nasopharyngeal and oropharyngeal area throughout the retention period.

Osteotomy assisted maxillary posterior impaction with miniplate anchorage.

This case report presents orthodontic treatment with miniplate anchorage accelerated by osteotomy-assisted maxillary posterior impaction in a severe open bite case. A 14-year-old girl with a severe anterior open bite was treated by intrusion of the maxillary posterior teeth. A segmental osteotomy was applied, and the miniplates were fixed to the zygomatic buttress area. The intrusive force was applied with nickel-titanium closed coil springs using a force of 250 g between the miniplates and the upper first and second molar buccal tubes. The intrusion was completed 2.5 months after osteotomy. The treatment was continued with the fixed orthodontic appliances and completed after 12 months. At the end of treatment, optimal occlusion and the correction of the anterior open bite were achieved. The maxillary molars were impacted 4.0 mm, and the mandibular plane showed a counterclockwise autorotation of 3.0 degrees . The results showed that osteotomy-facilitated orthodontic treatment clearly reduced the treatment time and had no adverse effects. In conclusion, this one-stage osteotomy technique can be an effective option to help molar intrusion in severe open bite cases.

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

Abstract Objective. The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Materials and methods. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. Results. With respect to controls, anterior (p < 0.05), middle (p < 0.01) and posterior (p < 0.05) cranial base lengths were increased, sella turcica was enlarged (p < 0.001) and upper spine morphology demonstrated differences in the height of atlas (p < 0.01) and axis (p < 0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p < 0.01) and the mandible (p < 0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p < 0.001), uvular (p < 0.01), mandibular (p < 0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p < 0.001) compared to healthy controls. Soft palate width was significantly higher (p < 0.001) and the hyoid bone was more vertically positioned (p < 0.01) in patients with acromegaly. Conclusions. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

Endodontic and orthodontic treatment of fused maxillary central incisors: a case report

The purpose of this case report was to describe combined endodontic and orthodontic treatment of a patient who had permanent maxillary central incisors fused with supernumerary teeth. A severe esthetic problem and crowding in the maxillary arch were present clinically. Radiographic examination demonstrated two separate crowns, roots and pulpal canals on each side. The therapy was initiated with endodontic treatment. Six months after the completion of endodontic therapy, mesio-distal trimming was performed and the defects were restored with anterior resin composites in order to re-establish the esthetics. Orthodontic treatment was performed for the alignment of the upper arch. Follow-up at 4 years demonstrated that the teeth were asymptomatic and neither root nor alveolar bone resorption was found. In conclusion, instead of extracting the supernumerary teeth, the anomaly was treated successfully in a conservative way.

Efficacy of different methods to reduce pain during debonding of orthodontic brackets.

OBJECTIVE To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience. MATERIALS AND METHODS Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearmans rank correlation coefficient analysis were used to analyze the data. RESULTS When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores. CONCLUSIONS The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.