Cenk Doruk

Rapid Maxillary Expansion and Surgically Assisted Rapid Maxillary Expansion Effects on Nasal Volume

The purpose of this study was to compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on nasal volume using acoustic rhinometric methods. Two groups of subjects were used in the study. Group 1 consisted of 10 subjects (mean age 12.30 +/- 0.82 years) who were treated with RME, and group 2 consisted of 10 subjects (mean age 18.70 +/- 2.54 years) who were treated by SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Nasal volume records were taken by the same otorhinolaryngologist with an AR device. AR recordings were performed for each patient with and without the use of a decongestant. The first record was taken before expansion, and the second record was taken at the end of retention. The data for both groups were evaluated using Wilcoxon signed rank test and Mann-Whitney U-test. The nasal volume showed a significant increase in both the RME and the SARME groups (P < .05). The measurement with the use of decongestant was similar to that without use of decongestant on the both groups (P < .05), but the different increments in nasal volume between the RME and the SARME groups were not statistically significant. Although the mean ages between the RME and the SARME groups were different, the increase in nasal volume was similar in both groups.

Nasal airway changes due to rapid maxillary expansion timing.

The purpose of this study was to evaluate the effect of rapid maxillary expansion (RME) on nasal minimum cross-sectional area (MCA) using acoustic rhinometry (AR) in two groups of subjects who were treated before and after the pubertal growth spurt. The sample consisted of 29 patients with maxillary constriction and a control sample of 15 subjects. Both samples were divided into two groups according to individual skeletal maturation as assessed by the cervical vertebral maturation (CVM) method. Group I T (early-treated) consisted of 16 patients (eight girls and eight boys). Group I C (early-control) consisted of eight patients, and both groups had not reached the pubertal peak (CVM Stage 1-3). Group II T (late-treated) consisted of 13 patients (eight girls and five boys). Group II C (late-control) consisted of seven patients, and both groups were at a stage during or after the pubertal peak (CVM Stage 4-6). AR records were obtained for each treated subject before treatment (T1), after expansion (T2), and immediately after a three-month retention period (T3); only T1 and T3 records were obtained for controls. The overall increase in MCA was significantly greater in the early- and late-treated groups (group I T, group II T) as compared with the early and late controls. (group I C, group II C) (P < .05). The results of the present study suggest that even the overall (T1-T3) increase for MCA in group I T is greater (0.34 mm) than the increase for MCA in group II T (0.19 mm), but the difference was not significant (P > .05).

Pulpal blood flow: effects of corticotomy and midline osteotomy in surgically assisted rapid palatal expansion

INTRODUCTION/PURPOSE Surgically assisted rapid palatal expansion is used for the management of transverse maxillary deficiency in the early permanent dentition. The success depends on the maintenance of an adequate blood supply to the mobilized segments. The aim of this study was to assess the effects of corticotomy and midline osteotomy on the tooth pulpal blood flow. MATERIAL Laser Doppler flowmetry was applied as a non-invasive and reliable technique for the assessment of pulpal blood flow in the maxillary centrals, canines and first molars. The blood flow was investigated pre- and postoperatively, on the first, third, and seventh postoperative days bilaterally in 13 cases. RESULTS The results of this study indicate that ischaemia of the pulp can occur following osteotomy at the Le Fort I level. CONCLUSION Corticotomy 5mm above the dental apices and separating the midpalatal suture did not have any serious effect on pulpal blood flow in this study.

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.

Pulpal blood flow changes due to rapid maxillary expansion.

OBJECTIVE To determine the pulpal blood flow (PBF) changes in anchorage teeth associated with the high forces of a rapid maxillary expansion (RME) appliance. MATERIALS AND METHODS The study was performed with 14 girls and 7 boys for a total of 21 patients between 10 and 15 years of age (mean, 13.1 +/- 1.39 years). A modified acrylic bonded RME appliance was used as an expansion appliance. Laser Doppler flowmetry was used for the pulpal perfusion measurements. Records were taken from 42 upper central incisors, 28 canines, and 42 first molars at the following time intervals: just before expansion (T1); at the first week of expansion (T2); at the end of the expansion process (T3); and at the third (T4), seventh (T5), and 12th weeks of retention (T6). The data gained were statistically evaluated by parametric tests. RESULTS PBF values of the anchorage teeth were doubled at the first week of expansion; however, these values began to decrease because of separation of the median palatal suture. PBF values tended to reach their initial values during the retention period. Pulpal perfusion changes of all examined anchorage teeth were similar to each other from the beginning to the end of the evaluation. CONCLUSION PBF changes that occur with RME are reversible.

Comparison of the effects of RME and fan-type RME on nasal airway by using acoustic rhinometry

OBJECTIVE To evaluate and compare the nasal airway changes following rapid maxillary expansion (RME) and fan-type RME using acoustic rhinometry (AR). MATERIALS AND METHODS The study sample consisted of three groups. The RME group comprised 15 subjects with maxillary transverse discrepancies and posterior crossbites. The fan-type RME group comprised 15 subjects, who had an anteriorly constricted maxilla with a normal intermolar width. The third group included 15 patients who had an ideal occlusion and received no orthodontic treatment and served as the control group. AR was used to measure nasal volume and the minimal cross-sectional area (MCA) before expansion (T1), after expansion (T2), and 6 months after expansion (T3). Each AR recording was performed with and without the use of a decongestant. Two-way analysis of variance was used to determine differences among the groups and three-way analysis of variance was used for the differences between groups. If evidence of statistically significant differences was found, a Bonferroni test was used. RESULTS The results showed that nasal volume and MCA were significantly increased with RME and fan-type RME immediately after expansion (P < .05). At the end of retention, nasal volume and MCA values of RME showed significant differences with both expansion fan-type RME and control groups (P < .05). CONCLUSIONS RME and fan-type RME had similar effects on the nasal airway immediately after expansion. The increase in nasal volume and MCA was more stable in the RME group than in the fan-type RME group at the end of the retention period.

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.

Oral and Nasal Malodor In Patients With and Without Cleft Lip and Palate Who Had Undergone Orthodontic Therapy

Objective: To compare oral and nasal malodor in patients with and without cleft lip and palate (CLP) who had undergone orthodontic therapy. Setting: University of Cumhuriyet, Sivas, Turkey. Patients: The study included 33 patients. Group 1 was composed of 11 patients with CLP. Measurements were taken while they were undergoing treatment with orthodontic fixed appliances. Group 2 included 11 individuals without CLP; measurements were taken during fixed orthodontic therapy. Group 3 consisted of 11 individuals without CLP who did not receive orthodontic therapy. Intervention: Oral malodor, nasal malodor, Gingival Index, Plaque Index, and probing depths were evaluated in each group. Results: Plaque Index, Gingival Index, and probing depths showed no significant differences between groups 1 and 2. In contrast, oral malodor was significantly different between the two groups (p < .05). Groups 2 and 3 showed differences in gingival and plaque indices but not in probing depths and oral malodor. All healthy nostrils in Group 1, Group 2, and Group 3 were significantly different from affected nostrils in the CLP patients. There was significant malodor in affected nostrils when compared with nonaffected nostrils in group 1 (p < .05). Conclusion: Oral malodor was increased in patients with CLP. Nasal malodor level was also higher in affected nostrils of the CLP patients compared to nostrils of healthy subjects.

Orthodontic treatment of a patient with oral-facial-digital syndrome.

Oral-facial-digital syndrome is characterized by heterogeneous clinical features involving malformations of the face, oral cavity, and digits. The syndrome has been reported only in women, suggesting that it is lethal in males. Affected females have malformations of the oral cavity (cleft palate, lip and tongue, abnormal dentition, and hamartomas), face (hypertelorism and milia), and digits (syndactyly, brachydactyly, and polydactyly). In this article, we report the orthodontic treatment of a 21-year-old woman with oral-facial-digital syndrome.