Elçin Esenlik

Traumatic injuries to permanent teeth in Turkish children, Ankara

The aim of this study was to identify the types and etiologies of dento-alveolar injuries among patients who were treated for injuries to maxillary and/or mandibular permanent teeth at the Gulhane Medical Academy, Department of Pediatric Dentistry, Center of Dental Sciences in Ankara, Turkey to provide a basis for determining optimal treatment approaches and educational needs. From a total of 4956 children aged 6-12 years (mean age: 8.91 +/- 1.95) applying to the Center, 472 children (9.5%) were found to have suffered dental injuries during a period of 2 years. Injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Injury rates were highest among children age 6 and ages 8-10. The most frequently injured permanent teeth were the maxillary central incisors (88.2%), and the maxillary right central permanent incisor made up 47.2% of all injured teeth. The most common cause of dental trauma was falling while walking or running (40.3%). Most injuries involved a single tooth (64.8%). The most common type of injury was enamel fracture (44.6%). There was a significant difference in gender, where boys more often suffered from a dental hard tissue and pulp injury than girls (P = 0.019), whereas there was no difference in gender (P = 0.248) in the distribution of periodontal injuries. Injuries were found to occur more frequently during the summer (P < 0.001). Children with increased overjet were 2.19 times more likely to have dental injuries than other children. Considering that the incidence of traumatic dental injury is highest among children ages 6 and ages 8-10 as well as the fact that patients with increased overjet are more prone to dental trauma, preventive orthodontic treatment in early mixed dentition may play an important role in reducing traumatic dental injuries.

Evaluation of dental maturation in children according to sagittal jaw relationship

Objective: The aims of this retrospective study were to determine compliance with dental and chronological ages and to analyze the relationships between dental age and orthodontic sagittal anomalies. Materials and Methods: A total of 221 subjects between the ages of 7 and 15.9 years (165 girls and 156 boys) were included in the study. The dental age of seven left mandibular teeth was assessed according to the Demirjian method. The maxillary protrusion, mandibular protrusion, maxillo-mandibular and vertical plane angles were measured from cephalometric films. Results: The mean difference between the chronological age and dental age in female patients was 0.94 years and 0.33 years in male patients (P < 0.01). No differences between the sagittal classification groups were found. There was no relationship between dental age and the SNA° or the GoGn-SN°. A statistically significant negative relationship was found between dental age and the SNB° and there was a significant linear relationship between dental age and the ANB°. Conclusion: Dental age in girls and boys has been estimated to be more advanced than chronological age in all classes and dental maturation advanced in cases with a tendency to develop Class II malocclusions.

Evaluation of the nose profile after maxillary advancement with impaction surgeries.

ObjectiveThe aim of this study was to identify and quantify nasal profile changes following maxillary advancement (MA) and maxillary advancement with impaction (MAI) with Le Fort I osteotomies. MethodsThe study consisted of preoperative and postoperative lateral cephalograms of 42 class III adult patients. The study sample was divided into 2 groups, with the first group composed of 22 patients who underwent MA surgery and the second group composed of 20 patients who underwent MAI surgery. In total, 7 skeletal parameters and 17 soft-tissue parameters related to nasal projection, hump, dorsal convexity, and the nasolabial region were evaluated on the cephalograms, and hard- and soft-tissue relationships were assessed. ResultsNasal length, hump, nasal depths, distance from the most convex point of the Alar curvature to the most inferior point of the nostril, alar curvature-subnasale, and subnasale-pronasale measurements decreased postoperatively. In the MAI group, MA correlated with significant decreases in nasal length and hump. In the MA group, MA correlated with pronasale position (P < 0.05); significant decreases in nasal depth, columella convexity, and subnasale-pronasale length; and significant changes in subnasale position. ConclusionsThere is little difference in the effects of the 2 different maxillary surgeries on the postoperative nasal profile.

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia

INTRODUCTION The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. METHODS Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. RESULTS Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P < 0.05). CONCLUSIONS The undesired dentoalveolar effects of the FM treatment were eliminated with SA treatment, except with regard to lower incisor inclination. Favourable skeletal outcomes can be achieved by SA therapies, which could be an alternative to the extraoral appliances frequently applied to treat skeletal Class III patients with maxillary deficiency.

Surgical difficulties, success, and complication rates of orthodontic miniplate anchorage systems: Experience with 382 miniplates

Purpose: The aim of this study was to evaluate the complications and success rates of the miniplates using both maxilla and mandible for orthodontic anchorage in growing patients. Materials and Methods: One hundred and fifty-five consecutive patients (range 8.7–13.8 years) with Class II and III malocclusion without congenital or acquired deformities were included in this study. A total of 382 titanium miniplates were placed by the same surgeon. All miniplates were inserted under local anesthesia. Loading of the miniplates with a force of 200 g with the help of elastics or functional devices were initiated 3 weeks after surgery. Results: The overall success rate of miniplate anchorage in terms of stability was 96.8%. Twenty-one patients reported irritation of the mucosa of the cheeks or lower lip after the surgery in the mandible group. Twelve miniplates needed to be removed and were successfully replaced. Conclusion: Skeletal anchorage miniplates is effective for correcting malocclusions. Success depends on proper presurgical patient counseling, minimally invasive surgery, good postsurgical instructions, and orthodontic follow-up.

Morphometric Evaluation of Craniofacial and Alveolar Arch Structures in Anencephalic Human Fetuses: A Cadaveric Study

Objective The aim of the present study was to compare the morphometrics of the craniofacial and alveolar arch structures of anencephalic fetuses with those of normal human fetuses without anencephaly or any other anomaly. Design Original article. Methods Standard lateral and posteroanterior cephalometric radiographs of 23 anencephalic and 33 normal human fetuses aged between 21 and 40 weeks of gestation were compared. These fetuses were divided into three periods based on gestational age, and vertical, sagittal, transverse, and angular measurements were taken in the cranial base and facial regions. Moreover, intraoral measurements from the maxillary and mandibular arches were also made to determine the width and depth. Results N-S and S-Ba lengths and the N-S-Ba angle, measured on lateral cephalometric radiographs, were statistically smaller in anencephalic fetuses (p < .05). The S-N-ANS, S-N-Pg, and ANS-N-Pg angles and the Go-Me length were significantly greater in anencephalic fetuses (p < .05). Maxillary length, ramus length, and anterior facial heights were similar in both groups. On posteroanterior radiographs, all parameters except bigonial distance were found to be smaller in the anencephalic fetuses (p < .05). Maxillary alveolar width was small among anencephalic fetuses in all three periods; whereas, the mandibular alveolar width was narrow only in the third period. Conclusion Cranial and facial structures were affected morphometrically to various degrees in anencephalic cases. The most significant alterations in anencephalic cases were related to measurements in the transverse direction. This indicated that cephalic tissue influenced not only the cranial base but also all facial structures.

Vitamin E supplementation modulates gingival crevicular fluid lipid peroxidation and antioxidant levels in patients with orthodontic tooth movement

The aim of this study was to investigate the levels of the oxidant and antioxidant changes in orthodontic tooth movement and the effects of vitamin E on these parameters. For this purpose, 50 orthodontic patients (aged 13–18 years) required non‐extracted treatment were divided randomly into the following groups: Control and Vitamin E. Same pre‐adjusted appliances were applied to all patients, and vitamin E (300 mg day−1) was given during 1 month in vitamin E group. Gingival crevicular fluid was collected and periodontal indexes were recorded at the baseline and after 1 month. Lipid peroxidation (LP) levels as malonyldialdehyde, reduced glutathione (GSH) and glutathione peroxidase (GSH‐Px), vitamin C and E levels were measured in the anterior and posterior regions of the dentition. After 1 month, orthodontic treatment LP levels increased in control group in both anterior and posterior regions in vitamin E group. LP levels also increased in vitamin E group in only posterior region. The level of GSH and vitamin C did not change statistically in control and vitamin E groups. Periodontal indexes did not show any differences in comparison with the groups.

Nasoalveolar molding in a case of incomplete cleft lip: Is it worth doing?

The purpose of this study was to evaluate the effects of presurgical nasoalveolar molding in an infant with incomplete cleft lip and alveolar notch. The patient was a 15-day-old female infant with a two-thirds vertical separation of the left side of the upper lip, with an intact nasal sill. A modified molding appliance was made to improve nasal esthetics and correct the alveolar notch. Although the nasal and alveolar region abnormalities were not serious, the molding appliance improved the nasal and lip esthetics and was stable during the 4-year follow-up.

Cephalometric investigation of craniomaxillofacial structures during the prenatal period: A cadaver study

INTRODUCTION We aimed to investigate the morphometric development of the cranial base and its related structures, and their growth rate changes from the ninth gestational week to full term in a large group of human fetuses. METHODS We selected 203 (109 male, 94 female) fetuses between 9 and 40 weeks of gestation and without any external anomalies. From each fetus, standard lateral and posteroanterior cephalometric images were taken using a dental digital panoramic and cephalometric x-ray machine. Fourteen linear and 9 angular parameters were measured. RESULTS The cranial base angle showed a statistically significant increase between the groups from only the second to the third trimester periods. The sagittal translation of the maxilla increased during the prenatal period, whereas the mandibular sagittal relation grew at a steady rate. The vertical plane angles of the maxilla and the mandible did not show any significant changes. The maxillary length to mandibular length ratio remained stable. CONCLUSIONS The cranial base angle increased, especially in the second through the third trimesters. The maxilla and the mandible demonstrated different growth patterns in the sagittal direction. The findings of this study could be a guide for interpreting the relationships among the craniofacial structures.

An Investigation Into the Morphometric Developments of the Maxillary and Mandibular Arches During the Fetal Period

Objective The objective of this study was to determine the developments, morphometric features, and shapes of the maxillary and mandibular arches during the prenatal period in a large series of fetal material. Methods The study was carried out on 225 human fetuses aged between 8 and 40 weeks of gestation. General, extraoral, and intraoral parameters were taken from each fetus. The width and depth measurements and the shapes of the maxillary and mandibular arches were achieved using the casts obtained. The arches were categorized according to the shapes of the anterior and posterior regions of the arches. Results Palatal and mandibular indices did not change during the prenatal period. Maxillary arch measurements were greater than the mandibular measurements. Moreover, width measurements of both arches were greater than the depth measurements during fetal life. We found that the frequencies of triangular maxillary and mandibular arches were highest in the first and second trimesters; whereas, the square model became more frequent in the third trimester and at full term. Classification of the arches according to their posterior regions showed that the tips of the arches shifted medially toward the term. There were significant correlations between width and depth parameters of the arches and extraoral parameters. Conclusion Data obtained in the study would be useful for clinicians by presenting an objective scale related to the prenatal period as well as being helpful in assessing the development of this region, identifying the anomalies and pathologies, and assisting treatment.