Hakan Türkkahraman

Archwire Ligation Techniques, Microbial Colonization, and Periodontal Status in Orthodontically Treated Patients

Fixed or removable orthodontic appliances impede the maintenance of oral hygiene and result in plaque accumulation. Plaque retention surrounding orthodontic appliances leads to enamel demineralization caused by organic acids produced by bacteria in the dental plaque. Many studies have evaluated the effects of fixed orthodontic appliances on microbial flora and periodontal status, but only a few have evaluated the method of ligation as an additional factor. The aim of this study was to determine the changes in microbial flora and periodontal status after orthodontic bonding and to determine whether two different archwire ligation techniques affect these changes. A total of 21 orthodontic patients scheduled for fixed orthodontic treatment were selected for this split-mouth study. Two commonly used auxiliaries (elastomeric rings and ligature wires) for tying archwires were tested. Microbial and periodontal records were obtained before bonding (T0), one week later (T1), and five weeks after bonding (T2). Paired t-test and Wilcoxon signed rank test were used to compare the groups statistically. Although, teeth ligated with elastomeric rings exhibited slightly greater numbers of microorganisms than teeth ligated with steel ligature wires, the differences were not statistically significant and could be ignored. The two archwire ligation techniques showed no significant differences in the gingival index, bonded bracket plaque index, or pocket depths of the bonded teeth. However, teeth ligated with elastomeric rings were more prone to bleeding. Therefore, elastomeric ring use is not recommended in patients with poor oral hygiene.

Facial Profile Preferences Among Various Layers of Turkish Population

There are many criteria and methods used to constitute and determine a standardized esthetic concept in orthodontics. However, the subjectivity of the esthetic concept is the common opinion of the authors. Ethnic and racial differences play a major role in diversifying esthetic preferences. The aims of this study were to determine the general esthetic preference of a Turkish population and to find out whether this preference was affected by sex, age, education, social status, geographic location, or personal profile. Toward these aims, eight profile estimates for each sex were morphed by a video imaging technique and then scored by 400 participants. Analysis of variance (ANOVA) and independent sample t-tests were used to compare the preferences of the groups. The orthognathic profile in both sexes was selected as the most preferred profile whereas the convex profile with a prognathic maxilla and a retrognathic mandible were the least preferred. The public also admired fuller and protrusive lips in females and retrusive lips with a prominent nose and chin in males. Sex, age, education, social status, geographic location, and personal profile were also shown to affect the publics profile preferences.

Malocclusion and Crowding in an Orthodontically Referred Turkish Population

This study was conducted to evaluate malocclusion and crowding in 1356 patients (793 girls, 563 boys) referred to the Department of Orthodontics, Suleyman Demirel University, Turkey. Class I was the most frequently seen malocclusion in this referred Turkish orthodontic population whereas Class II, division 2 was the least frequently seen. Comparison of mean ages of the malocclusion groups indicated statistically significant difference between Class I and Class II, division 1 groups (P < .05). The lowest mean age was present in the Class II, division 1 group. Mild mandibular crowding was the most common finding whereas severe mandibular crowding was seen least frequently in all malocclusion groups. Cross tabulation of maxillary and mandibular crowding indicated that mild maxillary and severe mandibular crowding in the same patient was rarely seen in all types of malocclusions. Moderate maxillary and severe mandibular crowding in the same patient was another rare finding for all malocclusion groups.

Comparison of Dental Arch and Alveolar Widths of Patients with Class II, Division 1 Malocclusion and Subjects with Class I Ideal Occlusion

This study evaluates dental arch and alveolar widths of patients with Class II, division 1 malocclusion. Thirty female patients with Class II, division 1 malocclusion were compared with 30 female subjects with Class I ideal occlusion. Patients with posterior crossbites even in a single tooth were excluded from the study. According to our results, arch widths measured between maxillary second premolars and maxillary first molars were found narrower in the Class II, division 1 group, and mandibular intercanine widths were narrower in the Class I group. Interalveolar widths showed no difference between the groups. These results suggested that transverse discrepancy in Class II, division 1 patients originated from upper posterior teeth and not from the maxillary alveolar base. Therefore, slow maxillary expansion rather than rapid maxillary expansion may be considered before or during the treatment of Class II, division 1 patients.

Cephalometric Evaluation of Nongrowing Females with Skeletal and Dental Class II, division 1 Malocclusion

Studies evaluating maxillary and mandibular skeletal and dental positions and the vertical components of Class II patients have reported conflicting results. In addition, no common results have been found regarding cranial base configurations. However, few studies have evaluated nongrowing subjects. The aim of this study was to establish whether patients with skeletal and dental Class II division 1 malocclusion have specific craniofacial features. For this, 40 nongrowing females were evaluated cephalometrically. Wide variations were observed for almost all measurements of Class II division 1 patients. However, a posteriorly positioned and rotated mandible, protrusive mandibular incisors, and an increased cranial base angle were all mean characteristics of Class II division 1 patients.

Relationship between mandibular anterior crowding and lateral dentofacial morphology in the early mixed dentition.

Mandibular anterior crowding is identified as the discrepancy between mesiodistal tooth widths of four permanent incisors and available space in the alveolar process. However, incisor crowding is not merely a tooth-arch size discrepancy. Many variables such as direction of mandibular growth, early loss of deciduous molars, the oral and perioral musculature and incisor and molar inclination can be associated with crowding. Only few studies evaluated the relationship between mandibular anterior crowding and cephalometric measurements in the early mixed dentition. It was the aim of this study to search for dentofacial factors that might be associated with mandibular crowding in the early mixed dentition. Lateral cephalograms and dental casts of 60 children (33 girls, 27 boys) were evaluated. It was determined that patients with crowding had smaller lower incisor to NB angles, maxillary skeletal lengths, mandibular skeletal length, and mandibular dental measurements. They also had greater interincisal angles, overjet, overbite, and Wits appraisal measurements. Significant inverse correlations were found between crowding and SNB, lower incisor to NB angle, anterior cranial length, mandibular length, maxillary length, mandibular dental measurement and direct correlations between crowding and interincisal angle, overjet, overbite, and FMIA. According to these results, we conclude that crowding of the mandibular incisors is not only a tooth-arch size discrepancy. Dentofacial characteristics also contribute to this misalignment.

Bleaching and Desensitizer Application Effects on Shear Bond Strengths of Orthodontic Brackets

OBJECTIVE To evaluate the effects of bleaching and desensitizer application on shear bond strengths of orthodontic brackets. MATERIALS AND METHODS Forty-eight extracted human premolar teeth were randomly assigned to 4 groups of 12 each. The first group of teeth was bleached with a 35% hydrogen peroxide office bleaching agent. The second group was bleached the same as the first group and UltraEZ desensitizer was applied. No bleaching procedures were applied on the third and fourth groups. UltraEZ desensitizer alone was applied to teeth in the third group. The fourth group served as control. Orthodontic brackets were bonded with a LC (light cure) composite resin and cured with a halogen light. After bonding, the shear bond strengths of the brackets were tested with a Universal testing machine. RESULTS The results showed that bleaching, bleaching plus desensitizer, and desensitizer procedures significantly reduced the bonding strengths of the orthodontic brackets (P < .05, P < .001, and P < .01, respectively). No statistically significant difference was found between bleaching, bleaching plus desensitizer, and desensitizer groups (P > .05). CONCLUSIONS Because bleaching and desensitizer application significantly affected shear bond strengths of orthodontic brackets on human enamel, they should be delayed until the completion of orthodontic treatment.

Factors Contributing to Mandibular Anterior Crowding in the Early Mixed Dentition

The aim of this study was to uncover the possible factors contributing to mandibular anterior crowding in the early mixed dentition. Mandibular dental casts of 60 children in the early mixed dentition were divided into two groups according to the severity of mandibular anterior crowding. The space available for the mandibular permanent incisors, total incisor width, deciduous intercanine width, deciduous intermolar widths, permanent intermolar width, interalveolar width, and total arch length were compared between the crowded group (CG) and noncrowded group (NCG), and correlations with crowding were investigated. The mandibular deciduous intercanine width, mandibular deciduous intermolar widths, mandibular permanent intermolar width, mandibular interalveolar width, space available for the mandibular permanent incisors, and total arch length were significantly larger in the NCG. The total width of the four mandibular incisors did not differ significantly between CG and NCG. Significant inverse correlations were found between crowding and available space, deciduous intercanine width, deciduous intermolar widths, permanent intermolar width, and interalveolar width. Total incisor width was directly correlated with crowding. No significant correlation was found between crowding and total arch length. The results of this study suggested that individual variations play an important role in treatment planning. However, one must not overlook arch length discrepancies and transverse discrepancies in patients with mandibular anterior crowding.

Effects of adhesion promoters on the shear bond strengths of orthodontic brackets to fluorosed enamel

The aims of this in vitro study were to evaluate the effect of enamel fluorosis on the shear bond strength (SBS) of orthodontic brackets and to determine whether adhesion promoter, Enhance LC, increases the bond strength of brackets to fluorosed enamel. Forty-five (30 fluorosed and 15 non-fluorosed) non-carious fresh human premolar teeth, extracted for orthodontic reasons and without any caries or visible defects, were used in this study. The fluorosed teeth were selected according to the modified Thylstrup and Fejerskov index, which is based on the clinical changes in fluorosed teeth. In groups 1 (fluorosed teeth) and 3 (control), the brackets were bonded with Light Bond composite resin and cured with a halogen light. In group 2, Enhance LC was applied to fluorosed enamel before bonding. After bonding, the SBS of the brackets was tested with a universal testing machine. One-way analysis of variance and Tukey multiple comparison tests were used to compare the SBS of the groups. Any adhesive remaining after debonding was assessed and scored according to the modified adhesive remnant index. The results showed that while fluorosis significantly reduced the bond strengths of the orthodontic brackets (mean 13.94 +/- 3.24 MPa; P < 0.01), Enhance LC significantly increased bond strength on fluorosed enamel (mean 18.22 +/- 5.97 Mpa; P < 0.05). Groups 1 and 3 had greater bond failures at the composite-bracket interface, whereas group 2 showed bond failure primarily at the enamel-composite interface.

Treatment effects of intrusion arches and mini-implant systems in deepbite patients

INTRODUCTION The purpose of this study was to compare the skeletal and dental effects of 2 intrusion systems involving mini-implants and the Connecticut intrusion arch in patients with deepbites. METHODS The study sample consisted of 45 adults (26 women, 19 men) with deepbites. They were divided into 3 groups: 2 treatment groups and 1 untreated control group (15 subjects in each group). The Connecticut intrusion arch and the implant groups underwent maxillary incisor intrusion with Connecticut intrusion arches and a mini-implant system, respectively. During the 7-month study period, no other treatment was performed with the exception of maxillary incisor intrusion. RESULTS The mean amounts of genuine intrusion were 2.20 mm (0.31 mm per month) in the Connecticut intrusion arch group and 2.47 mm (0.34 mm per month) in the implant group. No statistically significant differences were found in the extent of maxillary incisor intrusion between the 2 intrusion systems (P >0.05). Both systems led to protrusion and intrusion of the maxillary incisors (P <0.05), and protrusion and extrusion of the mandibular incisors (P <0.05). In the Connecticut intrusion arch group, the maxillary molars were extruded by moving the crown distally and the root mesially. The 2 intrusion systems were statistically different in the extent of alterations in the axial inclinations of the maxillary molars (P <0.05). CONCLUSIONS Both the Connecticut intrusion arch and the mini-implant intrusion systems successfully intruded the 4 maxillary incisors. Although the movement of the maxillary molars led to the loss of sagittal and vertical anchorages during intrusion of the incisors in the Connecticut intrusion arch group, these anchorages were maintained in the implant and control groups.