Faruk Ayhan Basciftci

Does the Timing and Method of Rapid Maxillary Expansion Have an Effect on the Changes in Nasal Dimensions

The aim of this study was to assess the effects of rapid maxillary expansion (RME) and surgical assisted rapid maxillary expansion (SARME) on nasopharyngeal area. The study group consisted of 30 subjects in the permanent dentition who had both maxillary constriction and a posterior cross-bite. The patients were divided into two groups, RME and SARME. The subjects in the RME group consisted of 15 patients (eight girls, seven boys) whose average age was 12.1 +/- 1.1 years. The SARME group also consisted of 15 patients (eight boys, seven girls) whose mean age was 18.4 +/- 1.4 years. An acrylic bonded RME appliance was used in both groups. Surgery was performed using lateral cortical osteotomies in the SARME group. The nasopharyngeal and respiratory area was determined using a digital planimeter on lateral cephalometric radiographs taken before and after RME. Nasal cavity width was evaluated on postero-anterior radiographs. Nasal dimension was measured using planimeter measurements of the respiratory and nasopharyngeal areas before and after treatment. The data obtained were analyzed using SPSS. Comparisons within the groups were carried out with paired t-tests and comparisons between the groups were with a Students t-test. In both groups, the respiratory area and the ratio of the respiratory area to nasopharyngeal (RA/NA) area increased following RME. There were no statistically significant differences between the groups. Nasal cavity width and maxillary width also increased, but the difference between the groups was not significant. Following RME, various differences in both the maxilla and surrounding bones occurred and nasal width increased with a decrease in nasal airway resistance. At the end of treatment there were increases in the width of the nasal floor near the midpalatal suture and nasal cavity. As the maxillary structures separated, the outer walls of the nasal cavity moved laterally resulting in an increase in internasal volume. Nasal resistance decreased and respiratory area increased in patients treated with RME.

Relationships Between Dental and Skeletal Maturity in Turkish Subjects

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Turkish subjects. The samples were derived from dental panoramic and hand-wrist radiographs of 500 subjects (215 males and 285 females). Calcification of the mandibular canines, first and second premolars, and second and third molars was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation of each hand-wrist radiograph, nine ossification events were determined according to the systems of Björk, and Grave and Brown. Statistically significant relationships were determined between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients. Correlations between dental development and skeletal maturity ranged from .490 to 0.826 for females and .414 to .706 for males (P < .01). The second molar showed the highest correlation and the third molar showed the lowest correlation for female and male subjects. For both sexes, root formation of the canine as well as the first premolar was completed in the majority of the subjects at the MP3cap, PP1cap, Rcap stages. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice, when treating a Turkish patient.

Can previously bleached teeth be bonded safely

The purpose of our study was to determine the effect of a 35% hydrogen peroxide bleaching agent on the shear bond strength of metallic orthodontic brackets. Sixty premolars were randomly divided into 3 groups of 20 each. Teeth in group A were etched with 37% phosphoric acid before bonding metallic premolar brackets. Teeth in the other 2 groups were bleached with a 35% hydrogen peroxide in-office bleaching agent according to the manufacturers recommendations. Twenty bleached teeth (group B) were bonded immediately, and the other 20 (group C) were stored in artificial saliva for 30 days before bonding. Shear bond strength of these brackets was measured on a universal testing machine and recorded in MPa. Adhesive remnant index (ARI) scores were determined after the brackets failed. Data were analyzed with analysis of variance (ANOVA) and chi-square tests. The shear bond strength values of groups A, B, and C were 12.9 +/- 3.4, 12.0 +/- 4.6, and 14.8 +/- 4.0 MPa, respectively. Results of ANOVA showed no statistically significant differences in shear bond strengths between groups (P >.05). ARI scores were significantly different in all groups. The unbleached groups failures were primarily at the bracket/adhesive interface, whereas the bleached groups either showed cohesive failures within the adhesive or failed at the adhesive/enamel interface. The results of this study suggest that office bleaching with hydrogen peroxide does not adversely affect the bond strengths of brackets bonded immediately after bleaching or 30 days after bleaching, even though bleaching can result in differences in the failure site.

Intermaxillary Tooth Size Discrepancy and Malocclusion: Is There a Relation?

The aims of this study were to identify the possible sex differences in tooth size ratios between males and females, to determine whether there is a difference in the incidence of tooth size discrepancies for both the anterior and overall ratios when comparing with Angle Class I; Class II, division 1; Class II, division 2; and Class III malocclusion groups, to compare the tooth size ratios of different malocclusion groups with the anterior and overall tooth size ratios of 150 untreated normal occlusion subjects. In addition, the aim was to determine the percentage of tooth size discrepancies outside 2 SD from Bolton means for tooth ratios present in each malocclusion group and in the overall sample of this study. This study consisted of 150 subjects who served as the normal occlusion group and 560 patients who showed four different malocclusion characteristics (Angle Class I; Class II, division 1; Class II, division 2; and Class III). Tooth size measurements were performed on the models of normal occlusion and pretreatment models. For statistical evaluation, Students t-test, analysis of variance and Tukey Honestly Significant Difference tests were performed. A significant sex difference was found only in the overall ratio for normal occlusion subjects (P < .001). All malocclusion groups showed statistically significant higher overall ratios than the normal occlusion group (P < .001). There were no statistically significant differences among malocclusion groups; however, there were a large number of patients within each group who had discrepancies greater than 2 SD from the mean. Further investigations are needed to explain the probable racial differences and relationships between malocclusion and tooth size measurements.

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.

Rapid maxillary expansion. Is it better in the mixed or in the permanent dentition

The aim of this study was to compare the dentoskeletal effects of a modified acrylic-bonded rapid maxillary expansion (RME) device when it is used in the mixed and permanent dentitions. The study group consisted of 51 patients in the mixed and permanent dentition (26 girls and 25 boys) who underwent RME treatment. Group 1 was composed of 34 subjects in the mixed dentition (19 girls and 15 boys; mean age, 9.2 +/- 1.3 years). Group 2 consisted of 17 subjects in the permanent dentition (seven girls and 10 boys; mean age 12.7 +/- 1.2 years). Lateral and frontal cephalograms and upper dental casts were collected before treatment (T1), after treatment (T2), and after retention (T3). Intragroup and intergroup changes were evaluated by paired t-test and Students t-test, respectively. In both groups after RME, the maxilla moved forward; mandible rotated posteriorly; facial height increased; nasal, maxillary, and maxillary intercanine and first molar widths increased; and the upper molars tipped buccally. Almost all these significant changes were stable at follow-up (T3). When overall (T1 - T3) differences were considered, upper molars tipped more, and the ANB angle increased less in the mixed dentition group compared with the permanent dentition group (P < .01). Within the limits of this study, the results suggest that the orthopedic effects of RME are not as great as expected at early ages, and it might be a better alternative to delay RME to early permanent dentition.

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.

Effects of Extraction and Nonextraction Treatment on Class I and Class II Subjects

This study aims to examine the profile as well as the dentoalveolar and skeletal effects of extraction or nonextraction treatment in a wide range of patients including Class I and Class II, division 1 cases. Results achieved with extraction and nonextraction modalities have also been compared. The study was performed on pretreatment and posttreatment lateral cephalograms of 87 orthodontic patients. There were no significant differences between the pretreatment values of extraction and nonextraction Class I groups, whereas SN-GoGn (degrees), maxillary incisor to A-Po (degrees), mandibular incisor to A-Po (mm), Co-Gn (mm), overjet (mm), and overbite (mm) measurements of extraction Class II group were significantly higher before the treatment. After treatment, these differences were eliminated in the Class II group; however, incisors were significantly protruded in both nonextraction groups. No other differences in profile or lip position were found between the extraction and nonextraction groups. The results of this study indicate that in successfully treated cases, whether by extraction or nonextraction, the same soft and hard tissue profile posttreatment end points were reached except for the incisor positioning, which is rather easier to anticipate than profile and soft tissue changes. The simple statement that extraction means a more retrusive or dished-in profile seems to be unacceptable. It seems that a more thorough assessment and investigation including pretreatment extent of crowding and factors related to anchorage, soft tissue thickness, and strain should be carried out.

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.

Can white spot lesions be treated effectively

OBJECTIVE To compare the effects of sodium fluoride mouth rinse, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and the microabrasion technique in treating white spot lesions. MATERIALS AND METHODS The study population consisted of 80 patients (46 females, 34 males; 966 affected teeth) who had developed multiple decalcified enamel lesions after fixed orthodontic therapy. The study population was divided into four groups of 20 patients each. The control group (group I) participants were to just brush their teeth, the fluoride group (group II) participants were instructed to use 20 ml of neutral 0.025% sodium fluoride rinse, the participants in the CPP-ACP group (group III) were instructed to use tooth mousse twice a day in addition to fluoride toothpaste for 6 months, and the participants in the microabrasion group (group IV) were to undergo treatment by the microabrasion technique, which is a commonly used mixture of 18% hydrochloric acid. Data were analyzed with the generalized linear mixed model and Tukey HSD at the P < .05 level. RESULTS The area of the white spot lesions decreased significantly in all groups. Inter group differences in the treatment success rates were significant. The highest success rate was observed for group IV (97%). The success rate of group III (58%) was significantly higher than that of groups II (48%) and I (45%). CONCLUSIONS The use of CPP-ACP can be more beneficial than fluoride rinse for postorthodontic remineralization. Microabrasion is an effective treatment for cosmetic improvement of long-standing white spot lesions.