Güvenç Başaran

Etching Enamel for Orthodontics with an Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser System

OBJECTIVE To test the shear bond strength, surface characteristics, and fracture mode of brackets that are bonded to enamel etched with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser operated at different power outputs: 0.5 W, 1 W, and 2 W. MATERIALS AND METHODS Human premolars that had been extracted for orthodontic purposes were used. Enamel was etched with an Er,Cr:YSGG laser system operated at one of three power outputs or with orthophosphoric acid. RESULTS The shear bond strength associated with the 0.5-W laser irradiation was significantly less than the strengths obtained with the other irradiations. Both the 1-W and 2-W laser irradiations were capable of etching enamel in the same manner. This finding was confirmed by scanning electron microscopy examination. The evaluation of adhesive-remnant-index scores demonstrated no statistically significant difference in bond failure site among the groups, except for the 0.5-W laser-etched group. Generally, more adhesive was left on the enamel surface with laser irradiation than with acid etching. CONCLUSION The mean shear bond strength and enamel surface etching obtained with an Er,Cr: YSGG laser (operated at 1 W or 2 W for 15 seconds) is comparable to that obtained with acid etching.

Laser etching of enamel for orthodontic bonding

INTRODUCTION The purposes of this study were to assess the shear bond strength, the surface characteristics, and the adhesive remnant index scores of teeth prepared for bonding with erbium, chromium doped: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching, and to compare laser etching with phosphoric-acid etching and a self-etching primer. METHODS Sixty-four premolars, extracted for orthodontic purposes, were randomly divided into 4 groups, and a different method was used to prepare the tooth enamel in each group for bonding: irradiation for 15 seconds with a 0.75-W Er,Cr:YSGG laser; irradiation for 15 seconds with a 1.5-W Er,Cr:YSGG laser; etching with 37% phosphoric acid; application of a self-etching primer. After surface preparation, standard edgewise stainless steel premolar brackets were bonded; 1 tooth in each group was not bonded and was examined under a scanning electron microscopic. The brackets were debonded 24 hours later; shear bond strengths were measured, and adhesive remnant index scores were recorded. RESULTS Irradiation with the 0.75-W laser produced lower shear bond strengths than the other methods. No statistically significant differences were found between 1.5-W laser irradiation, phosphoric-acid etching, and self-etching primer. Adhesive remnant scores were compared with the chi-square test, and statistically significant differences were found between all groups; when the 0.75-W laser irradiation group was excluded, no statistically significant differences were observed. CONCLUSIONS Irradiation with a 1.50-W laser produced sufficient etching for orthodontic bonding, but irradiation with the 0.75-W laser did not.

Comparison of sandblasting, laser irradiation, and conventional acid etching for orthodontic bonding of molar tubes

The purpose of the study was to determine if sandblasted and laser-irradiated enamel may be viable alternatives to acid etching for molar tube bonding. Seventy-seven molar teeth extracted for periodontal reasons were used. Seventy teeth underwent shear bond strength (SBS) testing and the remaining seven were examined under scanning electron microscopy (SEM). Adhesive remnant index (ARI) scores were also considered. An erbium, chromium-doped:yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser was used for enamel etching. Sandblasted and laser-irradiated enamel surfaces with different power outputs (0.5, 0.75, 1, 1.5, and 2 W) were compared with conventional phosphoric acid etching. Descriptive statistics, including mean, standard deviation, and minimum and maximum values, were calculated for each group. Multiple comparisons of the SBS of different etching types were performed by analysis of variance testing. The chi-square test was used to evaluate differences in ARI scores between groups. Acid-etched, 1-, 1.5-, and 2-W laser irradiation groups demonstrated a clinically acceptable mean SBS (7.65 +/- 1.38, 6.69 +/- 1.27, 7.13 +/- 1.67, 7.17 +/- 1.69 MPa, respectively). Irradiation with an output of 0.5 and 0.75 W and sandblasting of the enamel showed a lower SBS than the other groups (2.94 +/- 1.98, 4.16 +/- 2.87, 2.01 +/- 0.64 MPa, respectively). SEM evaluation of 1, 1.5, and 2 W laser irradiation revealed similar etching patterns to acid etching. Sandblasting and 0.5, and 0.75 W laser etching were not able to etch enamel in preferential patterns. Laser irradiation at 1.5 and 2 W was able to etch enamel. More adhesive was left on the enamel surface with low-power laser irradiation. Sandblasting and low-power laser irradiation (0.5, 0.75, and 1 W) are not capable of etching enamel suitable for orthodontic molar tube bonding, but 1.5- and 2-W laser irradiation may be an alternative to conventional acid etching.

Surface roughness of the restored enamel after orthodontic treatment

INTRODUCTION After fixed appliance treatment, one concern is to restore the enamel surface as closely to its original state as possible. A variety of cleanup processes are available, but all are time-consuming and carry some risk of enamel damage. The purpose of this study was to examine tooth surfaces restored with different cleanup protocols. METHODS Ninety-nine premolars extracted for orthodontic purposes were used. The 2 materials tested were Sof-Lex disks (3 M ESPE AG, Seefeld, Germany) and fiberglass burs (Stain Buster, Carbotech, Ganges, France). These were used alone and in combination with high- and low-speed handpieces, with which they were also compared. Eight groups were ultimately tested. All groups were compared with intact enamel, which served as the control group. From each group, 10 samples were examined with profilometry and 1 with scanning electron microscopy. Adhesive remnant index scores were recorded to ensure equal distributions for the groups. The time required for the cleanup processes and profilometry test results were also recorded. RESULTS The fastest procedure was performed with high-speed handpieces, followed by low-speed handpieces. Sof-Lex disks and fiberglass burs required more time than carbide burs but did not result in significantly longer times for the cleanup procedure when combined with tungsten carbide-driven low- or high-speed handpieces or when used alone with low-speed handpieces. Although Sof-Lex disks were the most successful for restoring the enamel, it was not necessary to restore the enamel to its original surface condition. Generally, all enamel surface-roughness parameters were increased when compared with the values of intact enamel. The average roughness and maximum roughness depth measurements with Sof-Lex disks were statistically similar to measurements of intact enamel. CONCLUSIONS No cleanup procedure used in this study restored the enamel to its original roughness. The most successful was Sof-Lex disks, which restored the enamel closer to its original roughness.

Interleukine-1β and Tumor Necrosis Factor–α Levels in the Human Gingival Sulcus during Orthodontic Treatment

Abstract Objective: To test whether interleukine 1β (IL-1β) and tumor necrosis factor–α (TNF-α) levels differ from each other in different treatment levels. Materials and Methods: Eighteen patients, nine female and nine male (aged 16–19 years; mean 17.4 ± 1.8 years), participated in this study. Each subject underwent a session on professional oral hygiene and received oral hygiene instructions. Two months later, a fixed orthodontic appliance was placed. The patients were seen at baseline, at days 7 and 21 and at the 3rd and 6th month as the leveling of the teeth occurred. Records of the baseline scores for the distalization forces were taken at the 6th month. Days 7 and 21 after 6 months of treatment were also recorded. Results: There were increases in the volume of gingival crevicular fluid (GCF) and in the concentrations of IL-1β and TNF-α. Conclusions: Leveling and distalization of the teeth evoke increases in both the IL-1 and TNF-α levels that can be detected in GCF.

Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions

ObjectivesPurpose of this study is to evaluate the effects of Forsus Fatigue-Resistant Device (FRD) EZ and Andresen activator in terms of skeletal, dental, and soft tissue changes in actively growing patients presenting with class II, division 1 malocclusion.Materials and methodsStudy sample included 60 subjects. Inclusion criteria were as follows: class II division 1 malocclusion, retrognathic mandible, normal or low-angle growth pattern, and peak growth period. The first study group consisted of 20 patients who were treated with Forsus appliance, and the second group of 20 patients received treatment with Andresen activator. Control group received no treatment.ResultsOur results revealed that both appliances enhanced mandibular growth, helped increase the length of the mandible, and had a restraining growth effect on the maxilla. Anterior face height increased in both of treatment groups, whereas posterior face height had a significant increase in the activator group only. More mandibular incisors protrusion and intrusion were seen with the Forsus appliance. Moreover, occlusal plane and palatal plane rotated significantly in clockwise direction as a result of dentoalveolar changes only in the Forsus group.ConclusionsAs well as the Forsus appliances corrected class II discrepancies mostly through dentoalveolar changes as compared to the activator group, both appliances proved effective in the treatment of growing individuals having class II malocclusions with mandibular retrognathia.Clinical relevanceBy this investigation, two treatment methods, which are currently used in clinical practice, will be evaluated, and the results will be useful for clinicians.

Orthognathic surgical planning on three-dimensional stereolithographic biomodel.

The aim of this report was to present the orthognathic surgical planning of a patient with maxillary retrusion, mandibular prognathism, and midline shift on a three-dimensional stereolithographic biomodel.A patient who complained about facial deformity and difficulty in chewing was referred to our department. After a short-term presurgical orthodontic treatment, Le Fort I osteotomy and bilateral sagittal split ramus osteotomy were performed. Triangular axial gaps occurred anteriorly and posteriorly between the proximal and distal segments of the osteotomized mandible. These gaps were filled with bone grafts in accordance with templates that were constructed on a three-dimensional stereolithographic biomodel.Rotational movement of the distal mandibular segment around the y axis caused axial triangular gapping between the proximal and distal mandibular segments. In the presented case, orthognathic surgical planning was performed on the three-dimensional solid models, and templates were reconstructed according to these gaps. These templates were used to determine the size of the bone grafts during the surgical approach. The patient was diagnosed with lateral cephalometric and posteroanterior cephalometric analysis in postretention for 2 years, and it was determined that long-term results were perfect and skeletal relapse did not occur after 2.5 years of surgery.Movement at the site of the osteotomy is usually the main cause of relapse after orthognathic surgery. In the presented case, a three-dimensional stereolithographic biomodel was used to plan the orthognathic surgery and to reconstruct the templates to determine the size and shape of the bone grafts. Using bone grafts established close contact between proximal and distal osteotomized bone segments, enhanced bone healing, and diminished relapse risk.

Evaluation of ectodermal dysplasia.

This case series report outlines possible cranio‐maxillofacial deformation consequences associated with ectodermal dysplasia (ED) and embryonic malformations, including dental agenesis. Also described are the oral aspects and rehabilitation. A total of 14 ED patients (7 males and 7 females, aged 5‐45 years) underwent clinical examination before assessment and treatment. Lateral cephalometric radiography, Steiners analysis, and respiratory capacity tests were performed. Most of the patients had sparse or absent hair, a short face with an unusual facial concavity, a maxillary retrusion, and a relative mandible protrusion. Depending on age and orthopedic abnormalities, patients were treated with prosthodontic and orthodontic approaches or implant treatment. Therapists should take a comprehensive and multidisciplinary approach with these patients to improve their dental, masticatory, growth, and orthognathic conditions, as well as esthetic appearance.

Nonsurgical orthodontic treatment of an adolescent girl with Class III malocclusion and asymmetric maxillary narrowing

Class III malocclusion is a difficult anomaly to understand. Because not all Class III patients are candidates for surgical correction, patient assessment and selection are especially important in diagnosis and treatment planning. In this article, we report the orthopedic treatment of a teenage girl with a severe skeletal Class III malocclusion. Her ANB angle was -4.5 degrees, and she had a 2-mm anterior crossbite, a 1-mm overbite, and a posterior asymmetric crossbite (greater on the left side). The patient refused surgery. We used a rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, and reverse headgear to bring the maxilla forward. We performed symmetric expansion, but, because of the asymmetric crossbite in the maxilla, we designed a modified apparatus that permitted greater relapse on 1 side. In this way, the posterior crossbite was ideally corrected by the end of treatment, and ideal overjet and overbite relationships, functional occlusion, and an esthetic facial appearance were all achieved.

Longitudinal Study of Untreated Skeletal Class I Subject's Growth and Development with Mc Namara Cephalometric Analysis

ABSTRACT This study evaluated longitudinal craniofacial changes in 14 female and 14 male Turkish subjects between 9 and 18 years of age who had not undergone orthodontic or orthopedic treatment. All of the subjects had a skeletal and dental Class I relationship. Serial cephalometric radiographs were taken at ages 9, 14, and 18 years. The effects of age and sex on the sagittal and vertical growth of the craniofacial structures were investigated using analysis of variance (repeated measures ANOVA) and the Tukey HSD test. We observed remarkable mandibular growth augmentation from 9 to 18 years in both sexes, and the effective mandibular length changes were nearly double the maxillary length changes. In both sexes, the mandibular plane angle decreased, while the lower anterior face height increased. Angles SNA and SNB increased remarkably, and angle ANB decreased. Our findings revealed that craniofacial alterations are affected by age, the dimensions Co-A and Co-Gn, angle SNB, and the nasolabial angle, and the differences were statistically significant in both sexes. In conclusion; The growth change between T1 and T2 was greater than that between T2 and T3 and generally, the mean values in males were greater than those in females.