Hülya Kılıçoğlu

Profile changes in patients with class III malocclusions after delaire mask therapy

The purpose of this study was to make a detailed evaluation of hard and soft tissue changes after Delaire orthopedic mask therapy (France-Orthodontie). The treatment group, which comprised 16 girls (mean age: 8.65 years, SD: 1.4 years) with skeletal Class III relationships caused by maxillary retrognathism, was compared with an untreated control group of 10 girls (mean age: 9.29 years, SD: 1.4 years). The following results were obtained: (1) After maxillary protraction, the maxilla was displaced anteriorly, whereas the mandible rotated posteriorly; (2) the maxillary incisors moved in the anterior direction, whereas the mandibular incisors moved posteriorly; (3) the mandibular plane angle and anterior lower and total face heights increased; (4) these changes were reflected in the profile, whereby the skeletal profile convexity increased and soft tissue facial angle and facial convexity decreased; and (5) the Class III concave profile became more balanced, with the upper lip area becoming more marked.

Comparison of the effectiveness of two types of toothbrushes on the oral hygiene of patients undergoing orthodontic treatment with fixed appliances

The purpose of this study was to investigate whether orthodontic toothbrushes were superior to classical toothbrushes in the elimination of microbial dental plaque on teeth and brackets and in the maintenance of periodontal tissue health in patients, ages 12 to 22 years, with fixed appliances. Twenty patients undergoing orthodontic treatment with fixed appliances and brushing with the Bass technique were included in the study. Ten patients used the Oral B Ortho type toothbrushes (Oral B Laboratories Ltd.), whereas the remaining 10 patients used the Oral B Plus 35 type toothbrushes. Quigley-Hein plaque index, bonded bracket index, sulcus bleeding index, and periodontal pocket depth measurements were made at the beginning of the study and a month later. No statistically significant difference was found for plaque, sulcus bleeding, and periodontal pocket depth between Oral B Ortho and Plus 35 groups when the preinvestigatory and postinvestigatory measurements for the vestibular and proximal surfaces of upper and lower teeth were compared. This short-term study concluded that the Ortho-type toothbrush is not superior to the Plus 35-type toothbrush.

The effect of enamel bleaching on the shear bond strengths of metal and ceramic brackets

The aim of this study was to evaluate the effects of bleaching and delayed bonding on the shear bond strengths of metal and ceramic brackets bonded with light and chemically cure composite resin to human enamel. One hundred and twenty extracted human premolar teeth were randomly divided into three groups of 40 each. The first two groups were bleached with 20 per cent carbamide peroxide (CP) at-home bleaching agent. No bleaching procedures were applied to the third group and served as control. The first two and control groups were divided into equal subgroups according to different adhesive-bracket combinations. Specimens in group 1 (n = 40) were bonded 24 hours after bleaching process was completed while the specimens in group 2 (n = 40) were bonded 14 days after. The specimens in all groups were debonded with a Universal testing machine while the modified adhesive remnant index was used to evaluate fracture properties. No statistically significant differences were found between the shear bond strengths of metal and ceramic brackets bonded to bleached enamel after 24 hours, 14 days, and unbleached enamel with light or chemical cure adhesives (P > 0.05). The mode of failure was mostly at the bracket/adhesive interface and cohesive failures within the resin were also observed. Our findings indicated that at-home bleaching agents that contain 20 per cent CP did not significantly affect the shear bond strength of metal and ceramic orthodontic brackets to enamel when bonding is performed 24 hours or 14 days after bleaching.

The effects of two methods of Class III malocclusion treatment on temporomandibular disorders

The aim of this research was to evaluate, within a controlled clinical study, the effects of a Delaire-type facemask or a modified Jasper Jumper (JJ) used in the treatment of children with Class III malocclusions due to maxillary retrognathia on temporomandibular disorders (TMDs). Forty-six patients with Class III malocclusions referred for orthodontic treatment were divided into two groups, a test and a control. The test group comprised 33 randomly chosen patients (15 females, 18 males) aged 8-11 years. The control group included 13 patients (eight females, five males) with similar features. TMD assessment was performed before and after treatment using a two-axis questionnaire, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs). Qualitative data were evaluated using chi-square and McNemar tests. No statistically significant differences related to the presence of TMD were observed pre- or post-treatment (P > 0.05). The most commonly encountered diagnosis was arthralgia in the JJ group both before and after treatment. Evaluation of joint and muscle regions showed decreased symptoms, apart from the diagnosed discomforts, in the JJ group (P < 0.05). Reduced symptoms were observed in the Delaire group; however, this reduction was not statistically significant. An increase, not considered to be statistically significant, was observed in the control group. The Delaire-type facemask and modified JJ used in the early phase of Class III malocclusion treatment did not result in TMD.

An Atypical Form of Necrotizing Periodontitis

BACKGROUND Necrotizing ulcerative gingivitis/periodontitis are considered necrotizing periodontal diseases. This case report presents an atypical form of necrotizing periodontitis, which does not fit into this classification. METHODS A 12-year-old child was referred to our clinic for gingival inflammation, extensive alveolar bone loss, and tooth mobility. Clinical and microbiologic examinations were carried out, and radiographs were taken. Clinical examination revealed soft and hard tissue destruction up to the mucogingival junction at the right maxillary premolar and mandibular incisors. Unusual infections or abnormalities in systemic functions were not detected through clinical and laboratory evaluations made at the Pediatrics Department, Istanbul University. Although an intensive established treatment protocol for necrotizing periodontitis was completed, management of long-standing health conditions could not be achieved because of recurrence of the disease, which caused us to repeat this treatment protocol at short intervals. RESULTS Investigation led to a diagnosis of an atypical form of necrotizing periodontitis because the disease had a recurrent acute phase even under a standard treatment protocol. CONCLUSIONS Our patient exhibits an unusual, necrotizing form of periodontal disease. The reason for the rapid rate of periodontal disease progression remains unclear.

CLINICAL AND CEPHALOMETRIC ANALYSIS OF THREE CASES WITH PYCNODYSOSTOSIS: CASE REPORTS

The aim of this article is to present intra- and extra-oral and cephalometric findings of three patients with a rare disease: the pycnodysostosis. Two cases had skeletal Class III malocclusion due to maxillary retrognathia and one had bimaxillary retrusion with Class I relationship. Total circular crossbite, increased gonial angle and vertical facial proportions, deep-narrow palates and retruded upper lip were found in all cases. Maxillary expansion, face mask treatment or/and orthognathic surgery are treatment alternatives, considering the growth and development. Bone fragility and the risk of osteomyelitis after extractions should be considered in such cases before orthodontic treatment and orthognatic surgery.

Evaluation of Skeletal and Dental Effects of Modified Jasper Jumper Appliance and Delaire Face Mask with Pancherz Analysis

Objective The aim of this study was to evaluate the skeletal and dental changes in Class III patients treated with Modified Jasper Jumper appliance and Delaire face mask before the growth peak. Methods A study sample comprising 16 patients with functional Class III malocclusion treated with Modified Jasper Jumper appliance and 17 patients treated with Delaire face mask was compared with a control group comprising 13 patients. Pancherz analysis was used as the analysis method. Results In both treatment groups forward movement of maxillary base and incisors and an increase in the overjet while no positional change in the mandibular base was observed. In the Modified Jasper Jumper group, 4.63 mm overjet correction was due to 51.4% skeletal and 48.6% dental changes; 4.77 mm Class III molar correction was due to 49.9% skeletal and 50.1% dental changes. In the Delaire face mask group, 5.17 mm overjet correction was due to 70.6% skeletal and 29.4% dental changes and 4.87 mm Class III molar correction was due to 75% skeletal and 25% dental changes. Conclusion It was shown that both appliances were skeletally and dentally effective. Therefore, Modified Jasper Jumper therapy may be an alternative treatment modality for patients with poor cooperation, who are not ideal recipients for Delaire face mask.

Evaluation of the effects of the chincup appliance on the craniofacial structures by the finite element analysis

Aims: The aim of this study is to evaluate the effects of the chincup appliance used in the treatment of Class III malocclusions, not only on the mandible or temporomandibular joint (TMJ) but also on all the craniofacial structures. Materials and Methods: Chincup simulation was performed on a three-dimensional finite element (FE) model. 1000 g (500 g per side) force was applied in the direction of chin-condyle head. Nonlinear FE analysis was used as the numerical analysis method. Results: By the application of chincup, stresses were distributed not only on TMJ or mandible but also on the circummaxillary sutures and other craniofacial structures. Conclusions: Clinical changes obtained by chincup treatment in Class III malocclusions are not limited by only mandible. It was seen that also further structures were affected.

III. SINIF ÜÇ OLGUNUN TEDAVİSİNDE YÜZ MASKESİ UYGULAMASI (Olgu Bildirimi)-FACE MASK IN THE TREATMENT OF THE THREE CLASS III CASES (A Case Report)

OZET Bu olgu bildirisinde, tedavisinde Delaire yuz maskesi uygulanan, iskele tsel ve dissel III. sinif malokluzyonu olan uc olgunun tedavi sonuclarina iliskin degerlendirmeler yapilmistir. Gelisim doneminde olan iki olguda, yuz maskesinin ortopedik etkisi ile iskeletsel uyumsuzluk duzelmistir. Gelisimini tamamlamis olan ucuncu olguda yuz maskesi, ortognatik cerrahi uygulamasindan sonra postoperatif donemde agiz ici fiksasyon ile beraber, agiz disi fiksasyon amaci Ile kullanilmis ve nuksun onlenmesinde yararli olmustur. Anahtar sozcukler: Yuz maskesi, III. sinif tedavi FACE MASK IN THE TREATMENT OF THE THREE CLASS III CASES (A Case Report) ABSTRACT: In Oils case report, treatment results of the three skeletal and dental class III cases treated with face mask have been investigated. In two cases skeletal improvement has been obtained with orthopedic effect of the face mask during growth period. The third adult case was treated with an orthognatr hie surgical approach. Face mask was used to stabilize the post surgical result in addition to intraoral fixation and the mask was helpful in stabilization of the surgical result. Key Words: Face mask, Class III treatment