Hasan Babacan

Rapid Maxillary Expansion and Surgically Assisted Rapid Maxillary Expansion Effects on Nasal Volume

The purpose of this study was to compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on nasal volume using acoustic rhinometric methods. Two groups of subjects were used in the study. Group 1 consisted of 10 subjects (mean age 12.30 +/- 0.82 years) who were treated with RME, and group 2 consisted of 10 subjects (mean age 18.70 +/- 2.54 years) who were treated by SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Nasal volume records were taken by the same otorhinolaryngologist with an AR device. AR recordings were performed for each patient with and without the use of a decongestant. The first record was taken before expansion, and the second record was taken at the end of retention. The data for both groups were evaluated using Wilcoxon signed rank test and Mann-Whitney U-test. The nasal volume showed a significant increase in both the RME and the SARME groups (P < .05). The measurement with the use of decongestant was similar to that without use of decongestant on the both groups (P < .05), but the different increments in nasal volume between the RME and the SARME groups were not statistically significant. Although the mean ages between the RME and the SARME groups were different, the increase in nasal volume was similar in both groups.

Nasal airway changes due to rapid maxillary expansion timing.

The purpose of this study was to evaluate the effect of rapid maxillary expansion (RME) on nasal minimum cross-sectional area (MCA) using acoustic rhinometry (AR) in two groups of subjects who were treated before and after the pubertal growth spurt. The sample consisted of 29 patients with maxillary constriction and a control sample of 15 subjects. Both samples were divided into two groups according to individual skeletal maturation as assessed by the cervical vertebral maturation (CVM) method. Group I T (early-treated) consisted of 16 patients (eight girls and eight boys). Group I C (early-control) consisted of eight patients, and both groups had not reached the pubertal peak (CVM Stage 1-3). Group II T (late-treated) consisted of 13 patients (eight girls and five boys). Group II C (late-control) consisted of seven patients, and both groups were at a stage during or after the pubertal peak (CVM Stage 4-6). AR records were obtained for each treated subject before treatment (T1), after expansion (T2), and immediately after a three-month retention period (T3); only T1 and T3 records were obtained for controls. The overall increase in MCA was significantly greater in the early- and late-treated groups (group I T, group II T) as compared with the early and late controls. (group I C, group II C) (P < .05). The results of the present study suggest that even the overall (T1-T3) increase for MCA in group I T is greater (0.34 mm) than the increase for MCA in group II T (0.19 mm), but the difference was not significant (P > .05).

Pulpal blood flow: effects of corticotomy and midline osteotomy in surgically assisted rapid palatal expansion

INTRODUCTION/PURPOSE Surgically assisted rapid palatal expansion is used for the management of transverse maxillary deficiency in the early permanent dentition. The success depends on the maintenance of an adequate blood supply to the mobilized segments. The aim of this study was to assess the effects of corticotomy and midline osteotomy on the tooth pulpal blood flow. MATERIAL Laser Doppler flowmetry was applied as a non-invasive and reliable technique for the assessment of pulpal blood flow in the maxillary centrals, canines and first molars. The blood flow was investigated pre- and postoperatively, on the first, third, and seventh postoperative days bilaterally in 13 cases. RESULTS The results of this study indicate that ischaemia of the pulp can occur following osteotomy at the Le Fort I level. CONCLUSION Corticotomy 5mm above the dental apices and separating the midpalatal suture did not have any serious effect on pulpal blood flow in this study.

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.

Stability in dental changes in RME and SARME: a 2-year follow-up.

OBJECTIVE To compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on dentoalveolar structures following orthodontic treatment, as well as stability at 2-year follow-up. MATERIALS AND METHODS Two groups of subjects were used in the study. Group 1 consisted of 14 subjects (mean age, 12.7 +/- 1.4 years) who were treated with RME, and Group 2 consisted of 13 subjects (mean age, 18.5 +/- 2.3 years) who were treated with SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Maxillary dental casts were available at three different intervals: pretreatment (T1), after orthodontic treatment (T2), and at follow-up recall (T3). Intermolar and interpremolar width, palatal height, and maxillary arch depth and length were assessed from maxillary dental casts. RESULTS Treatment by RME and SARME produced significant increases in intermolar and interpremolar width and maxillary arch length after expansion (T2) (P < .05). The amount of relapse was not significantly different 2 years after treatment (P > .05). CONCLUSIONS Although age ranges of the patient groups are different, the dentoalveolar responses of RME and SARME were similar after orthodontic treatment.

Maxillary Canine-First Premolar Transposition in the Permanent Dentition

Maxillary canine premolar transposition is the most frequently reported transposition type, which many orthodontists face. Although correcting the transposed tooth order is not advised after the eruption of the permanent tooth, several articles published in the last decade demonstrated nonextraction treatment of transposition using fixed mechanics. This article describes the nonextraction treatment of a complete transposition between a maxillary left canine and a first premolar, using similar mechanics as suggested earlier. The correct tooth order was established with a functional Class I canine and molar relationship at the end of treatment. Although triangular cortical bone resorption at the vestibule of the canine root was detected on computed tomography at the end of treatment, spontaneous regeneration of bone tissue at the resorption area was present on the postretention computed tomography scan.

Comparison of retention characteristics of Essix and Hawley retainers

Objective We aimed to compare the retention characteristics of Essix and Hawley retainers. Methods Adolescents undergoing fixed appliance treatment at 2 centers were recruited for this study. Twenty-two patients (16 women and 6 men) wore Essix retainers (Essix group) while 20 (14 women and 6 men) wore Hawley retainers (Hawley group). The mean retention time was 1 year, and the mean follow-up recall time for both groups was 2 years. Two qualified dental examiners evaluated the blind patient data. Maxillary and mandibular dental casts and lateral cephalograms were analyzed at 4 stages: pretreatment (T1), post-treatment (T2), post-retention (T3), and follow-up (T4). Results The results revealed that Essix appliances were more efficient in retaining the anterior teeth in the mandible during a 1-year retention period. The irregularity index increased in both arches in both groups after a 2-year post-retention period. The mandibular arch lengths increased during treatment and tended to return to their original value after retention in both groups; however, these changes were statistically significant only in the Hawley group. Cephalometric variables did not show any significant differences. Conclusions The retention characteristics of both Essix and Hawley retainers are similar.

Pulpal blood flow changes due to rapid maxillary expansion.

OBJECTIVE To determine the pulpal blood flow (PBF) changes in anchorage teeth associated with the high forces of a rapid maxillary expansion (RME) appliance. MATERIALS AND METHODS The study was performed with 14 girls and 7 boys for a total of 21 patients between 10 and 15 years of age (mean, 13.1 +/- 1.39 years). A modified acrylic bonded RME appliance was used as an expansion appliance. Laser Doppler flowmetry was used for the pulpal perfusion measurements. Records were taken from 42 upper central incisors, 28 canines, and 42 first molars at the following time intervals: just before expansion (T1); at the first week of expansion (T2); at the end of the expansion process (T3); and at the third (T4), seventh (T5), and 12th weeks of retention (T6). The data gained were statistically evaluated by parametric tests. RESULTS PBF values of the anchorage teeth were doubled at the first week of expansion; however, these values began to decrease because of separation of the median palatal suture. PBF values tended to reach their initial values during the retention period. Pulpal perfusion changes of all examined anchorage teeth were similar to each other from the beginning to the end of the evaluation. CONCLUSION PBF changes that occur with RME are reversible.

Effects of zoledronic acid on sutural bone formation: a computed tomography study

The aim of this study was to investigate the effects of systemically applied zoledronic acid (ZA) on osteoblastic bone formation and relapse in the rat sagittal suture after expansion. Eighteen 12-week-old male Wistar rats were divided into three groups. In groups 1 and 2, a saline solution was given subcutaneously after expansion and the retention period lasted for 14 and 7 days, respectively. In group 3, 0.1 mg of ZA was diluted with saline and given subcutaneously after expansion: the retention period lasted for 7 days. Computed tomography (CT) measurements were obtained at the start of the study (T1), after expansion (T2), after the retention period (T3), and after the follow-up period (T4). The amount of expansion and relapse and the density of the newly formed bone in the expansion area were measured. The mean bone density values in hounsfield unit (HU) of the newly formed bone were recorded using MX View Workstation. Data were analysed using the Kruskal-Wallis, Friedman, Wilcoxon, and Mann-Whitney U-tests. The results showed that there were significant differences between the groups in the density of newly formed bone after the retention period (P < 0.05). Statistically significant differences were observed when the relapse percentages were compared between the groups (P < 0.05). ZA stimulated bone formation and decreased the relapse ratio after expansion in the rat sagittal suture.

Identical unerupted maxillary incisors in monozygotic twins.

Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered by the orthodontist by chance on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. The occurrence of identical unerupted maxillary central incisors and mesiodentes in monozygotic twins suggests that genetic factors might influence the etiology of this problem. In this case report, we discuss the treatment of unerupted maxillary permanent incisors caused by mesiodentes in monozygotic twins.