M. Okan Akçam

Prevalence of dental anomalies in various malocclusions

INTRODUCTION The purpose of this study was to evaluate the prevalence of dental anomalies in different orthodontic malocclusions. METHODS Based on pretreatment diagnostic records, 900 orthodontic patients were classified as Class I (n = 358), Class II (n = 325), Class II Division 2 (n = 51), or Class III (n = 166). The occurrence rates of each dental anomaly were calculated as percentages of the total sample. Differences in incidence rates of each dental anomaly by sex and malocclusion were analyzed by using chi-square, Fisher exact, and z tests. The Mann-Whitney U test was used to determine whether there were significant differences in the occurrence of dental anomalies by age. RESULTS It was found that 40.3% of patients (n = 363) had at least 1 dental anomaly. Agenesis was the most common (21.6%), followed by dens evaginatus (6.2%), invaginatus (5.0%), pulp stones (4.2%), and impaction (2.9%). No statistically significant correlations were found between dental anomaly and type of malocclusion, with the exception of impaction and short or blunt roots (P <0.01 and P <0.05, respectively). The Mann-Whitney U test indicated no significant difference in dental anomalies by age. CONCLUSIONS A remarkably high rate of dental anomalies was recorded in orthodontic patients; therefore, orthodontists should carefully examine pretreatment records for dental anomalies to include their management in the treatment planning.

Dental anomalies in individuals with cleft lip and/or palate

Significant heterogeneity has previously been reported but with no consensus on the prevalence of dental anomalies in subjects with a cleft lip and palate (CLP), thus, the purpose of this study was to investigate the frequency of various dental anomalies in the upper dental arch in different cleft groups. Diagnostic records, i.e., panoramic, occlusal and periapical films, dental casts, and intra-oral photographs, of 122 subjects (mean age: 14 +/- 5 years; 67 males and 55 females) were grouped as either unilateral left cleft lip and palate (ULCLP), unilateral right cleft lip and palate (URCLP), bilateral cleft lip and palate (BCLP), or cleft palate (CP). Prevalence rates of 15 different dental anomalies were calculated for each group. Wilcoxons test was used to determine if there was a statistically significant difference in the number of missing teeth between the right and left sides, in each cleft group. Overall, 96.7 percent of patients were found to have at least one dental anomaly. The most prevalent was agenesis in the anterior region on the cleft side (70.8-97.1 percent). There was a statistically significant difference in the prevalence of agenesis by cleft and non-cleft sides but only in the ULCLP group (P < 0.001). Significantly higher rates of impaction were observed in the anterior and premolar regions in the CLP groups (2.9-29.2 percent), with the highest rates in the anterior region on the cleft sides. A very high proportion of subjects were found to have at least one dental anomaly. Thus, the management of dental anomalies should be central to the treatment planning process of individuals with a cleft.

Longitudinal Investigation of Soft Palate and Nasopharyngeal Airway Relations in Different Rotation Types

The relationship between the soft palate and the nasopharyngeal airway in different mandibular growth rotation models was investigated. A total of 72 lateral cephalograms were obtained three years longitudinally from 24 individuals. The subjects had a mean age of 10.7 +/- 1.2 years and showed a normal (n = 8), posterior (n = 8), and anterior (n = 8) mandibular rotation pattern. Linear and angular measurements of the soft palate and nasopharyngeal airway were recorded by using PORDIOS computer program and were examined by means of descriptive statistics and paired t-tests. A linear increase in the soft palate length (SPL) was observed in all groups, with the posterior mandibular rotation group showing the largest increase within the observation period (28.56 +/- 4.83 to 34.98 +/- 2.87; P < .01). According to the paired t-test, palatal plane (ANS-PNS)/soft palate tip (SPT) angle showed a statistically significant decrease in the posterior rotation group (P < .01). The ratio between SPL and superior nasopharyngeal space (SPS) did not show a statistically significant difference among the groups. Although various amounts of soft palate and nasopharyngeal airway growth occurred in the different mandibular rotation types, the ratio between SPL and SPS (SPL/SPS), which plays an indispensable role in velopharyngeal functions, did not show a statistically significant difference in the groups. This assured velopharyngeal closure throughout the active growth period.

Evaluation of 3-dimensional tooth crown size in cleft lip and palate patients

INTRODUCTION The aims of this study were to evaluate 3-dimensional (3D) tooth crown sizes in patients with cleft lip and palate (CLP) and to compare them with those of a Class I control group. METHODS Orthodontic dental casts were used of 72 subjects with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], 18 unilateral right [URCLP]) and 53 adolescents in the permanent dentition stage with Class I occlusion. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements were recorded by the same examiner using a digital caliper. Statistical analyses were conducted, including repeatability, analysis of variance (ANOVA), and the Duncan tests. RESULTS Maxillary and mandibular premolar MD dimensions were larger in the CLP groups than in the control group. The smallest MD dimensions were those of the maxillary right lateral incisors in the BCLP group (P <0.05). The maxillary left lateral incisor MD dimensions in the ULCLP group were smaller when compared with other CLP groups (P <0.001). In general, all LL and OG measurements were smaller in the CLP groups than in the Class I group in both dental arches. CONCLUSIONS In general, MD, LL, and OG dimensions of CLP patients were smaller than those of the Class I subjects, not only in the affected maxillary dental arch, but also in the mandibular dental arch. Variations in 3D tooth dimensions were found among all CLP types. The lateral incisor in the cleft region was the smallest. A 3D tooth-size evaluation should be included in the diagnostic records to determine precise treatment planning and final occlusion in CLP patients.

A cephalometric evaluation of lower lip in patients with unilateral cleft lip and palate.

Objective The aim of this study was to evaluate cephalometrically the lower lip position and area of patients with unilateral cleft lip and palate (UCLP) comparatively with Class I skeletodental normal subjects. Patients Lateral cephalometric and hand-wrist radiographs obtained from 24 patients with UCLP (mean age 12.86 years), along with 20 normal individuals (mean age 12.33 years) used as a control group, were examined. Design In addition to standard cephalometric dentofacial variables, lower lip area (superior, middle, inferior) was also measured using a digital planimeter on the lateral cephalograms. Results The superior and middle part of the lower lip areas were significantly smaller (p < .05) in the UCLP group, compared to the control group. The inferior and total lower lip areas of patients with UCLP were found to be significantly smaller than controls. The labiomental angle was also smaller (38.79 degrees). Conclusions The results suggest that the lower lip of patients with UCLP is smaller, retruded, and curved, with a deep labiomental sulcus, compared with normal individuals during puberty. Therefore, practitioners should focus not only on the upper lip of patients with UCLP but also should consider the lower lip as it was found distinct from normal individuals during puberty.

Three-dimensional tooth crown size symmetry in cleft lip and cleft palate

OBJECTIVE To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. MATERIALS AND METHODS Dental casts of 72 individuals with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], and 18 unilateral right [URCLP]) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. RESULTS Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P < .01); LL dimension: mandibular first premolar (URCLP, P < .05); OG dimension: maxillary central incisor and first premolar (ULCLP, P < .05 and P < .01, respectively), central incisor (BLCLP, P < .01), mandibular canine and first premolar (ULCLP, P < .01), and first molar (ULCLP, P < .05). Tooth crown size asymmetries were also recorded in the Class I group. CONCLUSIONS Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group.

ÖN ÇAPRAZ KAPANIŞIN ERKEN TEDAVİSİ: OLGU SUNUMU

OZET: On capraz kapanislar, stomatognatik sistem bunyesindeki dissel, fonksiyonel veya iskeletsel bir uyumsuzluktan kaynaklanabilir. Hareketli ya da sabit aygitlar bunlari duzeltmede kullanilan yaygin yontemlerdir. Bu calismada sinif III aktivatoru, on egik duzlem, cenelik ve 2 by 4 sabit mekanikleri ile tedavi edilmis olan on capraz kapanisa sahip 4 olgu sunulmustur. Bu aygitlar kullanilarak on capraz kapanis basarili olarak duzeltilmis ve elde edilen sonuclar sunulmustur.

DUDAK-DAMAK YARIKLI BİREYLERDE ALT DUDAK PROFİLİNİN İNCELENMESİ

OZET: Bu calismanin amaci, puberte oncesi unilateral dudak-damak yarikli (DDY) bireylerin alt dudak morfoloji ve posturlerinin, skeleto-dental sinif I iliski gosteren normal bireyler ve puberte sonrasi unilateral DDY bireyler ile karsilastirarak degerlendirilmesidir. Arastirma materyalini 24 pre-peak unilateral (Ortalama yas; 12.86±0.85 yil), 14 post-peak unilateral (Ortalama yas; 16.53±0.77 yil) toplam 38 DDY vakadan ve Sinif I notral okluzyona ve dengeli profile sahip 20 kontrol bireyinden (Ortalama yas; 12.3310.85 yil) elde edilen lateral sefalometrik ve el-bilek filmleri olusturmustur. Sefalometrik noktalar iki kez dijitize edilmis ve olcumler bir bilgisayar program! yardimiyla hesaplanmistir. Konvansiyonel dentofasiyal parametrelerin yanisira, alt dudak alani sefalometrik cizimler uzerinde dijital planimetre yardimiyla olculmustur. Pre-peak unilateral DDY ile kontrol grubu arasindaki farkliliklarin incelenmesi icin Bonferroni testi, pre- ve post-peak unilateral DDY gruplar arasindaki farklarin degerl...

Functional analysis of cleft lip and palate patients with modified Rakosi method.

OBJECTIVE The aim of this study was to investigate the mandibular functions of patients with cleft lip and palate (CLP) by means of modified Rakosi Functional Analysis and to test whether there was a risk of tendency to temporomandibular joint disorder when compared with Angle Class I non-CLP patients. DESIGN Fifteen patients with unilateral CLP with a mean age of 12.2 +/- 1.91 years and randomly selected 15 Angle Class I orthodontic patients with a mean age of 10.5 +/- 2.01 years as a control group. None of the subjects had complaint of symptoms of temporomandibular joint disorder in their histories. All subjects were evaluated using modified Rakosi Functional Analysis method in accordance with a scoring system of the findings. MAIN OUTCOME MEASURES Intra- and extracapsular clinical functional surveys were taken. A Mann-Whitney U test was used to evaluate the differences between the CLP and non-CLP groups. RESULTS AND CONCLUSION There was a significant difference (p <.01) between the distributions of the total scores of the two groups. A significant difference (p <.05) in right lateral movement was also observed between the two groups. However, there were no significant but borderline differences in clicking, crepitus, and maximum mouth opening findings between the two groups. Because these results do not explain the reason for the aforementioned differences, further studies seem essential.

GUINEA PİG'LERDE YAPILAN ORTODONTİK ARAŞTIRMALARDA KULLANILMAK ÜZERE GELİŞTİRİLEN DARRELİ MANYETİK ALAN ÜRETECİ*

OZET: Bu calismada, asiri az frekansli darbeli manyetik alanlarin kikirdak dokularin hizli kemiklesmesi uzerine etkilerini inceleme imkani saglayacak bir elektronik sistemin tasarimi ve uygulanmasi tarif edilmektedir. 8 cm aralikla parallel olarak yerlestirilen 16 bobin tarafindan olusturulan silindirik hazne icerisinde 5.3 milli tesla (peak) siddetinde 100 Hz darbeli manyetik alan uretmektedir.