Mete Özer

Effects of first molar extraction on third molar angulation and eruption space

OBJECTIVES The aim was to investigate the effects of orthodontic treatment with 4 first molar extractions on the angulations and eruption spaces of all third molars and to compare these changes with outcomes of nonextraction samples used as a control group. STUDY DESIGN This study was carried out on standardized panoramic radiographs of 41 subjects (8 male, 33 female) with a mean age of 16.6 years (range 13 to 20 years). Twenty-one of the subjects were orthodontically treated with extraction of the 4 first permanent molars, and 20 had nonextraction treatment. The angulational changes and eruption spaces of third molars were evaluated on the panoramic radiographs taken before treatment and at the end of the observation period. RESULTS Analysis of the linear variables demonstrated a statistically significant difference between the 2 groups for all third molar eruption spaces (P < .001). The mean differences in the third molar eruption spaces between the pretreatment and posttreatment values for the first molar extraction group were higher than those of the nonextraction cases. CONCLUSION Orthodontic treatment accomplished with extractions of the permanent first molars increases the eruption spaces of third molars and decreases their impaction. In addition, it has greater favorable effect on the angulation of the upper third molars than of the lower third molars.

Adhesive thickness effects on the bond strength of a light-cured resin-modified glass ionomer cement.

These in vitro studies investigated the effect of adhesive thickness on the tensile and shear bond strength of a light-cured, resin-modified glass-ionomer cement (FO). A light-cured conventional composite resin (CO) was used as the control material. Mesh-based metal brackets were bonded to extracted human premolars using FO and CO. The adhesive thickness was controlled by a special device and 0, 0.25, and 0.5 mm thicknesses were tested for both bonding agents. All bonded specimens were stored in distilled water at 37 degrees C for 48 hours and thermocycled between 5 degrees C and 55 degrees C for 200 cycles before testing. Analysis of variance showed that bond strength was significantly affected by the adhesive thickness (P < .001) and type of adhesive (P = .001). There were statistically significant differences between the mean bond strengths of the groups at the P < .05 level of significance. For all adhesive thicknesses, CO had higher bond strength values than those of FO in both test modes. The bond strength values were also analyzed using a Weibull analysis, which showed the most favorable adhesive thickness, and the 5% and 90% probabilities of failures was 0.25 mm in the FO groups. Bracket-adhesive interface failure was predominant for all groups in tensile testing, but enamel-adhesive interface failures increased with increased adhesive thickness in shear testing for the FO. This study suggests that adhesive thickness under a bracket could be particularly important when using a FO in direct bonding.

Mandibular symphyseal distraction osteogenesis using a bone-supported distractor.

Increases in mandibular width by symphyseal distraction osteogenesis have recently been shown to be an acceptable and stable treatment option for transverse deficiencies. This case report presents the application of symphyseal distraction osteogenesis for increasing mandibular width using a bone-supported distractor as part of the orthodontic treatment of a 14-year-old male with a tapered shaped mandible and severe mandibular anterior crowding.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Sandblasted Metal Brackets Bonded with Resin-modified Glass Ionomer Cement In Vivo

The aim of this in vivo study was to evaluate the effects of sandblasting metal brackets on their clinical performance when resin-modified, chemically cured glass ionomer cement was used for bonding. A total of 60 patients with a range of malocclusions were allocated randomly into two groups. For the first 30 cases, teeth were divided into quadrants so that sandblasted, mesh-based metal brackets (SB) were bonded directly to the upper left and lower right quadrants using the resin-modified glass ionomer cement. The mesh-based (no sandblasting) brackets bonded to the other quadrants with the same adhesive were used as control (CO). A split-mouth design was used, and the allocation of the brackets per quadrant was reversed for the second 30 cases. Sandblasting of the bracket bases was accomplished using 25-microm aluminum oxide particles for three seconds. The manufacturers instructions were followed for bonding. The number, site, and date of first-time bracket failures were monitored throughout active orthodontic treatment, and the observation time was 20 months. The bond failure rates were 4.9% and 4.3% for the SB and CO brackets, respectively. No statistically significant difference was found between the groups for failure rates. The bond failure sites were predominantly at the enamel-adhesive interface in both groups. Sandblasting did not have a positive effect on the clinical performance of the mesh-based metal brackets when bonded with resin-modified glass ionomer cement.

Nonextraction Treatment with Rapid Maxillary Expansion and Mandibular Symphyseal Distraction Osteogenesis and Vertical Skeletal Dimensions

OBJECTIVE To investigate the effects of rapid maxillary expansion (RME) and mandibular symphyseal distraction osteogenesis (MSDO) on vertical dimensions of the face. MATERIALS AND METHODS Fourteen patients, nine girls and five boys, underwent RME and MSDO procedures. Distraction was carried out at a rate of 1 mm per 24 hours with a tooth-borne appliance. The amount of distraction was 7 mm for each patient. Standardized lateral cephalograms were taken at the following time periods: before treatment (T0), after RME (T1), at the completion of MSDO (T2), and at the end of fixed orthodontic treatment (T3). The data were evaluated by using a general linear model of repeated-measures analysis of variance and paired t-tests at the 95% confidence level. RESULTS RME significantly increased the vertical dimensions of the face and decreased the overbite (P < .001). Although the vertical parameters of the face on the lateral cephalogram decreased after MSDO, these decreasing effects were statistically insignificant just for the distances measured from the horizontal reference line to the chin points. In other words, MSDO decreased the vertical skeletal dimensions that were increased by RME, but this neutralizing effect of MSDO was not as much as the increase caused by RME. CONCLUSION Treatment modalities (RME, MSDO, and fixed orthodontic treatment) described in this study, in total, had little effect on the vertical skeletal measurements of the face.

Multidisciplinary approach for the rehabilitation of central giant cell granuloma: A clinical report

The central giant cell granuloma (CGCG) is benign, nonodontogenic, and intraosseous lesion of the jaw. Aggressive subtypes of CGCG have a tendency to recur after excision and require wide resection that leads to major defects in the jaw. In this case report a patient who had severe mandibular bony deficiency as a result of excision of aggressive CGCG, orthodontic, and prosthetic treatment was described. The defect was reconstructed with iliac bone graft. Four years later vertical distraction osteogenesis was performed on the grafted mandible in order to obtain a satisfactory bony height of mandibular ridge. After healing period three endosseous dental implants were placed to grafted region. Because of pubertal growth stage, a hybrid removable denture was constructed. The construction of a hybrid removable denture markedly improved the patients speech, mastication, and appearance. After pubertal growth stage, a fixed partial denture construction was planned and future parts of treatment procedures were described to the patient. Distraction osteogenesis and endosseous dental implants can be a good alternative method for the unsatisfactory reconstructions of mandibular deficiencies.

Closure of a Large Palatal Fistula With Maxillary Segmental Distraction Osteogenesis in a Cleft Palate Patient

Various techniques have been proposed for the repair of palatal clefts. The first surgical closure technique that should be kept in mind is the use of adjacent mucosal flaps. When the palatal cleft is too large to close with adjacent mucosal flaps, distant flaps such as from the tongue or nasolabial region may be considered. This report presents a cleft patient who had previously undergone an unsuccessful palatal cleft repair with a tongue flap. The size of the large palatal fistula was reduced by approximating the segments to each other with maxillary anterior segmental distraction osteogenesis to make it more manageable using conventional mucosal flaps.

Clinical bond failure rates of adhesive precoated self-ligating brackets using a self-etching primer

OBJECTIVE To comparatively assess the failure rate of adhesive precoated (APC) self-ligating metal brackets bonded with two different enamel surface preparation techniques: self-etching primer (SEP) and conventional two-step etch and primer method (CM). MATERIALS AND METHODS Fifty-seven patients with complete permanent dentition were included in this study. A total of 1140 APC self-ligating brackets (3M Unitek, Monrovia, Calif) were bonded using a split-mouth design. For each patient, SEP (Transbond Plus SEP, 3M Unitek) and CM (37% phosphoric acid) were used in alternate quadrants. All brackets were bonded by the same investigator after pumicing and rinsing of all of the teeth. The number, site, and date of first-time bracket failures were monitored throughout orthodontic treatment (mean, 22 months). The survival rates of the brackets were estimated by Kaplan-Meier and log-rank tests (P < .05). The adhesive remnant index was used to determine the bond failure interface. RESULTS The bond failure rates were 2.97% and 2.18% for the CM and SEP, respectively. No statistically significant difference in failure rates was found between the groups. The bond failure sites were predominantly at the enamel-adhesive interface in both groups. CONCLUSION This long-term in vivo study showed that the combined use of SEP and the APC bracket system can be used effectively for bonding brackets after pumicing the enamel surfaces in clinical orthodontics.

Üst Keser Dişlerde Meydana Gelen Travma Sonrası Multidisipliner Tedavi Yaklaşımı: Bir Olgu Sunumu

Amac: Travma sonrasi dislerde hasar meydana gelmesi siklikla karsilasilan problemlerdendir. Daimi dentisyon sirasinda medya gelen travmalarda ise kesici dislerin avulsuyonuna rastlanabilir. Bu durumlarda splintlenme onerilmekte ancak caprasikligi olan olgularda travma yasanabilmektedir. Bu vaka raporunda amac travma sonrasinda fiber ile guclendirilmis lingual retainerin splint olarak etkinligini ve iyilesme sonrasi yapilan ortodontik ve protetik tedavileri gostermektir