Gökmen Kurt

Mandibular Asymmetry in Class II Subdivision Malocclusion

OBJECTIVE To evaluate the condylar and ramal mandibular asymmetry in a group of patients with Class II subdivision malocclusion to identify possible gender differences between male and female subjects. MATERIALS AND METHODS Mandibular asymmetry measurements (condylar, ramal, and condylar-plus-ramal asymmetry values) were performed on the panoramic radiographs of 80 subjects (34 male and 46 female). The study group consisted of 40 Class II subdivision patients (18 male and 22 female; mean age 14.53 +/- 3.14 years). The control group consisted of 40 subjects with normal occlusion (16 male and 24 female; mean age 14.43 +/- 3.05 years). The Kruskal-Wallis test was used to determine the possible statistically significant differences between the groups for condylar, ramal, and condylar-plus-ramal asymmetry index measurements. Identified differences between groups were further analyzed using the Mann-Whitney U-test at the 95% confidence interval (P < .05). RESULTS No gender-related difference was found for any of the asymmetry indices. Comparison of condylar, ramal, and condylar-plus-ramal asymmetry index values and gonial angle measurements for Class I and Class II sides in the Class II subdivision group and for right and left sides in the Class I group showed no statistically significant differences. However, the Class II subdivision group has longer values for condylar, ramal, and condylar-plus-ramal height measurements and only these differences were statistically significant (P < .001). CONCLUSIONS Except for condylar ramal and condylar-plus-ramal height measurements, Class II subdivision patients have symmetrical condyles when compared to normal occlusion samples according to Habbets mandibular asymmetry indices.

Condylar and ramal vertical asymmetry in unilateral and bilateral posterior crossbite patients and a normal occlusion sample

INTRODUCTION Our objective was to evaluate the condylar, ramal, and condylar-plus-ramal mandibular vertical asymmetry in a group of adolescent subjects with normal occlusion and unilateral and bilateral posterior crossbite malocclusions. METHODS Mandibular asymmetry index measurements (condylar, ramal, and condylar-plus-ramal) were made on the panoramic radiographs of 126 subjects (51 boys, 75 girls). The study groups consisted of 46 unilateral (19 boys, 27 girls; mean age, 13.06 +/- 3.52 years) and 40 bilateral (16 boys, 24 girls; mean age, 12.72 +/- 3.22 years) posterior crossbite patients and a group of 40 subjects (16 boys, 24 girls; mean age, 14.43 +/- 3.05 years) with normal occlusion. One-way analysis of variance (ANOVA) was used to determine possible statistically significant differences between the groups for condylar, ramal, and condylar-plus-ramal asymmetry index measurements at the 95% confidence interval. RESULTS No group showed statistically significant sex- or side-specific differences for posterior vertical height measurements (P > 0.05). Asymmetry indexes (condylar, ramal, and condylar-plus-ramal) were similar, and no statistically significant differences were found among the unilateral and bilateral posterior crossbite groups and the normal occlusion sample. CONCLUSIONS No statistically significant sex- or side-specific mandibular asymmetry was found among the 3 groups. Condylar asymmetry index values were significantly high compared with the 3% threshold value in each of the 3 groups, but comparisons between groups were not statistically significant.

Effects of surgically assisted rapid palatal expansion with and without pterygomaxillary disjunction on dental and skeletal structures: a retrospective review.

OBJECTIVE The aim of this study was to evaluate and compare dental and skeletal changes in surgically assisted rapid palatal expansion (SARPE) patients with (+PP) and without (-PP) pterygomaxillary disjunction. STUDY DESIGN The study casts of 18 maxillary constriction patients indicated for SARPE formed the sample of this retrospective review. The sample was divided into 2 groups. Twenty linear and 2 angular measurements were performed on the study models. RESULTS All transversal measurements increased after expansion in both the +PP and -PP groups. The -PP group showed greater expansion at the midpalatal and gingival levels, while the +PP group exhibited a greater increase of 0.78 mm at the apical base level and 11.25° less tipping in the molar teeth. A greater expansion of nearly 0.7 mm was measured in the premolar region of the +PP group. CONCLUSIONS Both SARPE techniques resulted in significant maxillary expansion.

Stability of surgically assisted rapid maxillary expansion and orthopedic maxillary expansion after 3 years' follow-up

OBJECTIVE To evaluate the stability of surgically assisted rapid palatal expansion (SARME) and orthopedic maxillary expansion (OME) after 3 years of follow-up, and compare these changes with a control group. MATERIALS AND METHODS The subjects of the study were divided into three groups. Group 1 was composed of 10 patients (6 males, 4 females) with a mean age of 15.51 years (range: 13.33-17.58 years) and treated with OME, Group 2 comprised 10 patients (7 males, 3 females) with a mean age of 19.01 years (range: 16.25-25.58 years) and treated with SARME. Group 3 was the control group, consisting of 10 untreated, skeletal Class 1 subjects (6 males, 4 females) with a mean age of 15.27 years (range: 13.42-17.00 years) and matched to the OME group for sex and age. Lateral cephalometric and posteroantererior films were taken before expansion (T1), postexpansion (T2), and 3 years after the retention period (T3). RESULTS After OME and SARME, significant increases were observed for both dental and skeletal transverse widths (P < .01). After 3 years of follow-up, maxillary basal width decreased 1.35 +/- 0.44 mm in the SARME group and 1.19 +/- 0.41 mm in the OME group, while upper molar width decreased 2.23 +/- 1.24 mm in the SARME group and 2.79 +/- 1.01 mm in the OME group. CONCLUSIONS Both the OME and SARME procedures remained stable after 3 years of follow-up with some amount of postretention relapse, compared with the control group.

Changes in nasal structures following orthopaedic and surgically assisted rapid maxillary expansion

The aim of this study was to investigate and compare changes in the nasomaxillary complex substructures following orthopaedic rapid maxillary expansion (RME) and surgically assisted RME (SARME). 10 patients received RME, 10 patients received SARME, and 10 patients served as an untreated control group. Lateral and posteroanterior cephalograms were obtained for each individual at pre-expansion/pre-control (T1) and post-expansion/post-control (T2). Descriptive parameters and transversal measurements on maxillo-mandibular dentoalveolar structures and skeletal bases, right and left nasal cavity angles (NC/Lom/VL and CN/Lom/VL, respectively), total nasal cavity angle (NC/Lom/CN), nasal cavity width (NC-CN) and nasal septum angle (sn/Lom/VL) were also calculated. Paired t-tests were used to evaluate changes within groups following treatment/control. Analysis of variance (ANOVA) and Duncans tests were used to compare changes between groups. With the exception of nasal septum deviation, all nasal parameters significantly increased following RME and SARME. The increases in the SARME group were greater than in the other groups, but no statistically significant differences were recorded between the RME and SARME groups. Neither RME nor SARME created positional changes in the nasal septum.

Evaluation of shear bond strength of metallic and ceramic brackets bonded to enamel prepared with self-etching primer

The aim of this in vitro study was to evaluate the shear bond strength (SBS) of different metallic and ceramic bracket bonding combinations using self-etching primers (SEPs). Eighty freshly extracted human premolar teeth were randomly divided into four equal groups for bonding with ceramic or metallic brackets as follows: group 1, metallic brackets bonded with conventional acid etching; group 2, metallic brackets bonded with Transbond Plus Self-Etching primer (TPSEP); group 3, ceramic brackets bonded as per group 1; group 4, ceramic brackets bonded as per group 2. The SBS of these brackets was measured and recorded in megapascals (MPa). The adhesive remnant index (ARI) scores were determined after bracket failure. Data were analyzed with the analysis of variance, Tukey, and chi-square tests. The bond strength of group 3 (mean: 36.7 +/- 11.8 MPa) was significantly higher than group 4 (mean: 26.6 +/- 8.9 MPa; P < 0.05), group 1 (mean: 25.5 +/- 5.1 MPa; P < 0.01), and group 2 (mean: 22.9 +/- 7.3 MPa; P < 0.001). No significant differences in debond locations were found among the groups (P > 0.05). Compared with conventional acid etching, SEPs significantly decreased the SBS of ceramic orthodontic brackets.

Rapid tooth movement and orthodontic treatment using dentoalveolar distraction (DAD). Long-term (5 years) follow-up of a Class II case.

The purpose of this report is to describe the dentoalveolar distraction (DAD) technique and to present its effects on the surrounding structures by presenting a Class II case. A 15-year-old skeletal and dental Class II female patient with an overjet of 9 mm was treated by DAD osteogenesis. A custom-made, rigid, tooth-borne intraoral distraction device was used for rapid canine retraction. Osteotomies surrounding the canines were made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. The amount of canine retraction was 7.5 mm in 12 days at a rate of 0.625 mm per day, with no posterior anchorage loss. The canine teeth showed 1.6 mm extrusion and 11 degrees inclination change (distal tipping) during the same period. Orthodontic treatment continued for 6 months with no clinical and radiographic evidence of complications such as root fracture, root resorption, ankylosis, and soft tissue dehiscence. The DAD technique is an innovative method, because it reduces overall orthodontic treatment time by about 50%, with no unfavorable effects on periodontal tissues and surrounding structures and with no need to use any intraoral or extraoral anchorage appliances.

Combined Orthodontic and Surgical Therapy for a Deeply Impacted Third Molar Related with a Dentigerous Cyst

The dentigerous cysts are the common cause that inhibits the eruption of the teeth. Large dentigerous cysts can cause pathological fractures in mandible. Temporary or permanent inferior alveolar and lingual nerve damage can occur associated with deeply impacted third molar surgery. We treated the dentigerous cyst arised from deeply impacted mandibular third molar with orthodontic extraction combined with the marsupialization therapy. This orthodontic-surgical procedure reduced the risk of nerve damage and pathological fracture of the mandible.

Effects of Surgical and Nonsurgical Rapid Maxillary Expansion on Palatal Structures

AIM The aim of the present study was to compare the effects of surgical and nonsurgical rapid maxillary expansion (RME) in skeletally mature patients. MATERIALS AND METHODS Surgically assisted rapid maxillary expansion (SARME) was used in 18 patients (2 males, 16 females) with a mean age of 19.90 years. Two nonsurgical RME groups were constructed to compare the expansion changes of SARME. Eighteen patients in maximum pubertal peak (12 males, 6 females) with a mean age of 13.04 years comprised the growing RME group, while the nongrowing RME (NG-RME) group consisted of 18 skeletally mature patients (1 male, 17 females) with a mean age of 16.41 years. Thirteen linear and 2 angular measurements were made on the study models taken before expansion (T0) and after 3 months of retention period (T1). Intragroup differences were evaluated with paired t test and the intergroup differences were analyzed with 1-way analysis of variance. RESULTS All groups showed significant transversal skeletal and dental expansion. The palatal width changes at gingival and midpalate levels were the highest in the NG-RME group (6.85 and 5.84 mm, respectively). The most molar tipping was in the NG-RME group (15.00°) and the palatal vault angle showed the most increase in the SARME group (9.77°). The greatest expansion at the base of palatal vault was in the SARME group (4.42 mm). CONCLUSIONS The pattern of expansion was rotation of the maxillary halves for SARME and lateral displacement of the dentoalveolar structures for NG-RME. Patients with severe skeletal discrepancy or increased age are good candidates for SARME.Aim: The aim of the present study was to compare the effects of surgical and nonsurgical rapid maxillary expansion (RME) in skeletally mature patients. Materials and methods: Surgically assisted rapid maxillary expansion (SARME) was used in 18 patients (2 males, 16 females) with a mean age of 19.90 years. Two nonsurgical RME groups were constructed to compare the expansion changes of SARME. Eighteen patients in maximum pubertal peak (12 males, 6 females) with a mean age of 13.04 years comprised the growing RME group, while the nongrowing RME (NG-RME) group consisted of 18 skeletally mature patients (1 male, 17 females) with a mean age of 16.41 years. Thirteen linear and 2 angular measurements were made on the study models taken before expansion (T0) and after 3 months of retention period (T1). Intragroup differences were evaluated with paired t test and the intergroup differences were analyzed with 1-way analysis of variance. Results: All groups showed significant transversal skeletal and dental expansion. The palatal width changes at gingival and midpalate levels were the highest in the NG-RME group (6.85 and 5.84 mm, respectively). The most molar tipping was in the NG-RME group (15.00°) and the palatal vault angle showed the most increase in the SARME group (9.77°). The greatest expansion at the base of palatal vault was in the SARME group (4.42 mm). Conclusions: The pattern of expansion was rotation of the maxillary halves for SARME and lateral displacement of the dentoalveolar structures for NG-RME. Patients with severe skeletal discrepancy or increased age are good candidates for SARME.