Erol Akin

Forsus Nitinol Flat Spring and Jasper Jumper Corrections of Class II division 1 Malocclusions

OBJECTIVE To compare the effects of Forsus Nitinol Flat Spring (FNFS) and Jasper Jumper (JJ) in the correction of Class II division I malocclusions. MATERIALS AND METHODS Our research was conducted on 48 adolescents, who had a normal or horizontal growth pattern and retrognathic mandible. The patients were divided into three equal groups randomly. First group was treated with FNFS, and the second group was treated with JJ appliances, whereas the third group was the control group. Lateral cephalograms and study models were obtained after the leveling phase and at time of the removal of the appliances. RESULTS Cephalometric analysis revealed that both the appliances stimulated mandibular growth, increased the anterior face height because of the lower face, and elongated the posterior face height because of the growth of temporomandibular joint. Maxillary central incisors were extruded, retruded, and distally tipped. Contrarily, intrusion, protrusion, and labial tipping were observed in the mandibular central incisors. Distal movement and intrusion of the maxillary first molars and mesial movement and extrusion of the mandibular first molars were the other dental alterations. Overjet and overbite were decreased, and a Class I molar relationship and improvement in the profile were attained in both treatment groups. Cast model analysis showed expansion in the maxillary and mandibular dental arches. CONCLUSIONS Both the appliances were effective in the treatment of Class II malocclusion and revealed nearly same alterations in the skeletal, dental, and soft tissue parameters.

Effects of PGI2and TxA2Analogs and Inhibitors in Orthodontic Tooth Movement

Abstract This study evaluates the effects of prostacyclin (PGI2) and thromboxane A2 (TxA2) in orthodontic tooth movement and osteoclastic activity in rats. The study sample consisted of 150 male Sprague- Dawley rats. The rats were randomly divided into five equal groups, and each group was again equally divided into three subgroups (SGs). Twenty grams of reciprocal force was applied to maxillary incisors of the rats with a spring bent from 0.35 mm stainless steel wire, except for the rats in the last SG. Iloprost (PGI2analog), indomethacin (PGI2inhibitor), U 46619 (TxA2analog), and imidazole (TxA2inhibitor) were dissolved in 0.9% NaCl (saline solution), and each material was prepared in three different concentrations (10−4, 10−5, and 10−6M/L). Iloprost was administered (20 μL/12 hours) in the first three SGs with the sequence of 10−4, 10−5, and 10−6M/L. Indomethacin, U 46619, and imidazole were administered in the next nine SGs with the same sequence and dose. In SG 13, 0.9% NaCl solution was administered...

Dynamic MRI evaluation of tongue posture and deglutitive movements in a surgically corrected open bite.

Tongue thrust usually develops in the presence of anterior open bite in order to achieve anterior valve function. In the literature, tongue thrust is described both as the result and the cause of open bite. If it is an adaptation to malocclusion, then tongue posture and deglutitive tongue movements should change after treatment. In this case report, an adult who had skeletal open bite and Class II malocclusion caused by mandibular retrusion was treated surgically. The mandible was advanced in a forward and upward direction with a sagittal split osteotomy. The open bite and Class II malocclusion were corrected and an increase in the posterior airway space (PAS) was observed. Pretreatment and posttreatment dynamic magnetic resonance imaging (MRI) revealed that tongue tip was retruded behind the incisors and contact of the tongue with the palate increased. It was also determined that the anterior and middle portions descended, whereas the posterior portion was elevated at all stages. Advancement of the mandible, correction of open bite, and an increase in PAS affected not only the tongue posture and deglutitive movements, but also the breathing pattern of the patient.

Measurement accuracy of a computer-assisted three-dimensional analysis and a conventional two-dimensional method

OBJECTIVE To determine the differences between manual and cephalometric measurements on different sections of the human skull, which were obtained using computer-assisted three-dimensional (3D) analysis and conventional two-dimensional (2D) techniques. MATERIALS AND METHODS Measurements were carried out on 13 dry human skulls, then 2D cephalograms and 3D computed tomographic (CT) images were obtained. Anatomic landmarks were determined and marked with clay before CT images were taken, and the same landmarks were marked with the help of metallic balls and pins for lateral and frontal cephalograms. Manual, lateral/frontal cephalometric, and computer-assisted 3D cephalometric measurements were compared statistically. One-way analysis of variance and Tukey Honestly Significant Difference tests were used to compare the results among the groups. RESULTS All measurements were statistically insignificant between the computer-assisted 3D and manual measurements. On the other hand, the differences between the conventional 2D and the manual measurements were statistically significant. The greatest amount of magnification was found at the Nasion-Menton distance (14.6%), which was located at the farthest distance from the central x-ray beam in the lateral cephalogram (P < .01). For the same reason, the greatest enlargement (16.2%) was observed in the distance between the zygomaticomaxillary sutures on the conventional frontal cephalogram (P < .01). CONCLUSIONS The computer-aided 3D cephalometric measurements were found to be more accurate than the conventional cephalometric measurements. The results revealed that 3D cephalometric measurements were consistent with the manual measurements. In addition, the magnification and distortion might limit the results of conventional cephalometric measurements.

Effects of interferon-gamma on bone remodeling during experimental tooth movement.

OBJECTIVE To determine the effects of interferon-gamma (IFN-gamma) on bone remodeling during orthodontic tooth movement. MATERIALS AND METHODS Thirty adult male Sprague Dawley rats were randomly categorized into five groups. IFN-gamma was administered in three different doses (0.01, 0.02, and 0.05 microg/20 microL) and the remaining two groups served as control. Mandibular first molars were moved mesially by means of Ni-Ti closed coil springs in all groups. The results were evaluated histomorphometrically, and parameters of trabecular bone volume (BV/TV), trabecular bone number (Tr.N), and trabecular separation (Tr.Sep) were observed at the interradicular bone area of the mandibular first molars. RESULTS Increases in BV/TV and Tr.N and decreases in Tr.Sep revealed the antiosteoclastic activity of IFN-gamma. CONCLUSION IFN-gamma administration may be useful clinically for anchorage control.

Initial Intrusion of the Molars in the Treatment of Anterior Open Bite Malocclusions in Growing Patients

The treatment of the hyperdivergent phenotype and/or anterior openbite is one of the common problems facing orthodontists. The purpose of this study is to present a new appliance (Molar Intruder) for molar intrusion and to determine its effects in the treatment of anterior openbite. The study group comprised 14 patients (eight girls and six boys), with a mean age of 10 years and 7 months. All presented anterior open bite malocclusions between the second premolars. The study was carried out on lateral head films taken before (T1) and after (T2) molar intrusion. Periapical radiographs, study models, and standard photographs of all the patients were also obtained before and after molar intrusion. The paired sample t-test was used to determine the differences between the parameters. The average treatment time with the Molar Intruder was five months. The mean intrusion of maxillary and mandibular molars was 1.86 mm and 1.04 mm, respectively. Maxillary incisors extruded 0.54 mm with a labial tipping of 1.46 degrees and overbite increased by 4.00 mm. The mandibular plane angle was decreased by 1.57 degrees, and the anterior face height was decreased by 1.86 mm on average. The mandible showed a counterclockwise rotation, the chin moved forward, and the posterior facial height/anterior facial height ratio was increased. Anterior openbites of the patients were significantly rehabilitated at the end of the intrusion period, simplifying further orthodontic treatment.

Use of zygomatic anchors during rapid canine distalization: a preliminary case report.

Rapid canine distalization is a technique involving periodontal ligament distraction. The primary aim of this technique is to distalize the canines without anchorage loss and to shorten the duration of orthodontic treatment. After the rapid canine distalization, the healing process of the periodontal ligament is similar to rapid palatal expansion and requires a consolidation period. The long consolidation period of the technique conflicts with the second aim. Skeletal anchorage systems seem to compensate for this conflict because they can be also used for retraction of incisors during consolidation period. This case report presents the orthodontic treatment of a 16-year-old female, who had a bimaxillary retrusion and a dental Class II division I malocclusion. Upper first premolars were extracted and, while the canines were being distalized rapidly by periodontal ligament distraction, the incisors were retracted using a zygomatic anchorage system. The treatment of the patient was completed in five months without any anchorage loss.

Initial effects of the tongue crib on tongue movements during deglutition: a Cine-Magnetic resonance imaging study.

The objective of this study was to investigate the initial effects of a tongue crib on tongue movements during deglutition by using real time balanced turbo field echo (B-TFE) Cine-MR imaging. A total of 21 patients were evaluated in this study. The open-bite group (OBG) consisted of 11 patients (seven girls, four boys) who had a mean age of 11.09 +/- 2.02 years and a mean overbite of -5.14 +/- 1.83 mm. These patients were evaluated initially (T1) and while wearing a tongue crib (T2). A total of 10 patients (five girls, five boys) with a mean age of 14.5 +/- 2.6 years and with a mean overbite of 1.6 +/- 0.5 mm served as controls (CG), and only initial records were obtained from these patients. T2 was compared with T1 and CG. T1 was also compared with CG. We evaluated deglutition during three stages matching oral (1), pharyngeal (2), and esophageal (3) stages. Our results indicated that the tongues tip positioned more posteriorly when the crib was in place (T2) compared with both T1 and CG; the anterior portion of the tongues dorsum was at a lower position in T2 compared with both T1 and CG at stage 3; the midportion of the tongues dorsum was at a lower position in T2 than in T1 and CG at stages 1 and 2. To compensate for the posterior position of the tongues tip (caused by the tongue crib), adaptive changes occurred in the anterior and midportions of the dorsum of the tongue.

Tongue movements in patients with skeletal Class III malocclusions evaluated with real-time balanced turbo field echo cine magnetic resonance imaging

INTRODUCTION The aim of this study was to evaluate the position and movements of the tongue in patients with skeletal Class III malocclusion. METHODS Sixty-six patients (31 male, 35 female) with Class III malocclusion were divided into 3 groups according to cephalometric analysis. The first group comprised 23 patients (13 male, 10 female) with mandibular prognathism, the second group comprised 21 patients (9 male, 12 female) with maxillary retrognathism, and the third group comprised 22 patients (9 male, 13 female) with both maxillary retrognathism and mandibular prognathism. Twenty-two skeletal Class I patients (10 male, 12 female) were also included as the control group. RESULTS Dentofacial morphology affects the position and the movements of the tongue during deglutition. Contact of the anterior portion of the tongue with the rugae area of the hard palate decreased in the Class III malocclusion groups. The posterior portion of the dorsal tongue was positioned more inferiorly, and the root of the tongue was positioned more inferiorly and anteriorly in patients with Class III malocclusion than in the control group. The tip of the tongue was also in a more anterior position in the Class III groups. When the deglutition stages were evaluated, we observed that the manner of bolus transfer was different in patients with skeletal Class III malocclusion than in those with skeletal Class I malocclusion. CONCLUSIONS Tongue posture is affected by dentofacial structures, and adaptive changes occur in the tip, dorsum, and root of the tongue. Deglutitive tongue movements in patients with skeletal Class III malocclusion are also different from those with skeletal Class I malocclusion.

Distraction osteogenesis in a severe mandibular deficiency

ObjectiveDistraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible.Materials and methodsThe patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After seven days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 12 weeks.ResultsThe patients mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13° to 6°, overjet of 15 mm decreased to 4 mm, corpus length increased from 49 mm to 67 mm, and ramus length increased from 41 mm to 43 mm. Posterior airway space (PAS) also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased.ConclusionSatisfactory results from both aesthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus.