Ömür Polat-Özsoy

Comparison of cephalometric measurements with digital versus conventional cephalometric analysis

The aim of this study was to evaluate the accuracy and reliability of angular and linear cephalometric measurements using a computerized method of direct digital radiographs. This was then compared with the measurements obtained with a computerized method that uses a digitizing pad and hand tracing of printout radiographs. Pre-treatment digital cephalometric radiographs of 125 patients were traced using Vistadent 2.1 AT and Jiffy Orthodontic Evaluation (JOE) software programs and by hand tracing of the printouts. Twenty-six anatomical landmarks were defined on each radiograph by a single investigator and 28 variables were calculated. Statistical analysis was undertaken using one-way analysis of variance and multiple group comparisons using Duncans test at a significance level of 0.05. Low correlation coefficients indicated poor reproducibility for nasolabial angle for each of the three methods (P > 0.05). Most of the variables showed consistency between the three methods except for nasolabial angle, ANS-Me, APFH, L1-NB, Nperp-Pg, Go-Me, and U1-NA measurements. The findings indicated that most of the cephalometric measurements were highly reproducible with direct digital radiographs using Vistadent 2.1 AT as well as with printouts using both JOE software and hand tracing. Despite the low correlation for some measurements between the Vistadent 2.1 AT, JOE, and hand-tracing methods, most of the commonly used measurements were accurate. The user-friendly and time-saving nature of the computerized method using digital radiographs makes it the preferred option.

Pendulum appliances with 2 anchorage designs: Conventional anchorage vs bone anchorage

INTRODUCTION The aim of this retrospective study was to compare the dentoalveolar and skeletal effects obtained with 2 types of pendulum appliance with different anchorage designs: bone-anchored pendulum appliance (BAPA) and conventional pendulum appliance (CPA). METHODS The sample consisted of 39 patients (25 girls, 14 boys) with Angle Class II molar relationships. Correction of the molar relationship was achieved with the BAPA with palatal intermaxillary fixation screws for anchorage in the first group (n = 22) and with the CPA in the second group (n = 17). Lateral cephalograms before treatment and at the end of distalization were measured, and changes in the groups and the differences between the groups were analyzed statistically. RESULTS The average distalization times were 6.8 months for the BAPA group and 5.1 months for the CPA group. The maxillary first molars were tipped 9.1 degrees in the BAPA group and 5.3 degrees in the CPA group; the molars moved distally 4.8 mm in the BAPA group and 2.7 mm in the CPA group. Despite mesialization of the premolars and proclination of the incisors with the CPA, both premolars were spontaneously distalized, and the incisors were retruded with the BAPA. CONCLUSIONS The amount of distal molar movement was similar between the BAPA and the CPA. No anchorage loss or spontaneous distal premolar and incisor movement, which might decrease total treatment time, was seen with the BAPA.

Differences in cephalometric measurements: a comparison of digital versus hand-tracing methods

The aim of this study was to evaluate the accuracy of cephalometric measurements using computerized tracing of direct digital radiographs in comparison with hand tracing of digital radiographic printouts. Comparisons were made between methods in terms of accuracy of individual measurements as well as evaluation of treatment outcomes. Pre- (T1) and post- (T2) treatment cephalometric digital radiographs of 30 patients were traced using the Vistadent OC 1.1 computer software program (group 1) and manually (group 2) by the same investigator. A total of 26 anatomical landmarks were located and measured. Measurement reproducibility was evaluated by calculating intraclass correlation coefficients, and paired t-tests were used to compare differences in individual measurements and treatment outcomes between methods. Differences greater than 0.05 were considered to be statistically significant. Significant differences were found between the two methods for SNB, Wits appraisal, Cd-A, Cd-Gn, FMA, SN-PP, U1-NA (mm), U1-FH, L1-NB (mm), and Li-E plane. No significant differences were found between the two methods in the measurement of treatment changes. Cephalometric measurements of most parameters were reproducible for both methods. Despite some discrepancies in measured values between hand-tracing and the computerized method, any differences were minimal and clinically acceptable.

Effects of a fluoride-containing casein phosphopeptide- amorphous calcium phosphate complex on the shear bond strength of orthodontic brackets

The purpose of this study was to investigate the effects of enamel pre-treatment with a new fluoride-containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) complex on the shear bond strength (SBS) of brackets bonded with etch-and-rinse or self-etching adhesive systems. The material comprised 66 extracted human premolars randomly divided into six equal groups with respect to the enamel pre-treatment and adhesive system employed: 1. No pre-treatment and brackets bonded with the etch-and-rinse adhesive system (Transbond XT). 2. Pre-treatment with fluoride-containing CPP-ACP paste (MI Paste Plus) and Transbond XT. 3. Pre-treatment with non-fluoride CPP-ACP paste (MI Paste) and Transbond XT.4. No pre-treatment and brackets bonded with the self-etching adhesive system (Transbond Plus). 5 and 6. Enamel pre-treated as for groups 2 and 3, respectively, and the Transbond Plus. Bonded specimens were subjected to thermal cycling (×1000) before SBS testing. The residual adhesive on the enamel surface was evaluated after debonding with the adhesive remnant index (ARI). Data evaluation was made using one-way analysis of variance and Tukey test for SBS results, and Kruskal-Wallis test for ARI results. The results showed that enamel pre-treatment with either fluoride or non-fluoride CPP-ACP paste had no significant effect on the SBS of the self-etching adhesive system (P > 0.05). Enamel pre-treatment with non-fluoride CPP-ACP in group 3 significantly reduced the SBS of the etch-and-rinse adhesive (P < 0.001), while pre-treatment with fluoride-containing CPP-ACP paste (groups 2 and 5) did not affect debonding values (P > 0.05). The fluoride-containing CPP-ACP did not compromise the SBS of brackets bonded with the tested etch-and-rinse and self-etching systems, but its non-fluoride version significantly decreased the SBS of the etch-and-rinse adhesive system.

Self-reported pain associated with the use of intermaxillary elastics compared to pain experienced after initial archwire placement

OBJECTIVE To evaluate the pain during the use of intermaxillary elastics and to compare it with that of initial archwire placement. MATERIALS AND METHODS Sixteen orthodontic patients who underwent initial bonding (7 girls, 13 boys; mean age 16.75 ± 2.61 years) and 19 patients who would be using intermaxillary elastics for the first time (13 girls, 7 boys; mean age 16.21 ± 3.01 years) were enrolled in this prospective study. A visual analog scale form was given to each patient to measure the pain levels, and these were measured by the same investigator using a digital caliper. Data were evaluated using Mann Whitney U-test. RESULTS The pain started to increase 2 hours after the application of elastics. The highest levels were achieved at the sixth hour and the same night. The pain levels started to decrease at day 2. Although the pain levels of the elastic group started to decrease after the second day, the pain levels of the initial bonding group were still significantly high. CONCLUSIONS Intermaxillary elastics cause similar amounts of pain compared with initial archwire placement, but the pain of the elastics did not last as long as the pain felt after initial bonding.

Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration

OBJECTIVE To investigate the color alterations in enamel following the use of different orthodontic bonding resins and adhesive residue-removal burs. MATERIALS AND METHODS Metal brackets were bonded to extracted human premolars (n  =  175) by using an etch-and-rinse adhesive system, a self-etch adhesive system (SEP), or a resin-modified glass ionomer cement (RMGIC). After 24 hours of photoaging, the brackets were removed and the adhesive residue on the tooth surfaces was cleaned with either a tungsten carbide bur or a Stainbuster bur. Tooth colors were measured with a spectrophotometer at baseline, after adhesive removal, and after additional photoaging. Color evaluation was made, and color differences induced by photoaging were calculated. Statistical evaluation was made using the Kruskal-Wallis test and the Mann-Whitney U-test, with Bonferroni correction. RESULTS All specimens showed discoloration at varying levels. The highest color change was observed in the etch-and-rinse adhesive/tungsten carbide bur group. When the etch-and-rinse and self-etch adhesives were used, adhesive-remnant removal with Stainbuster burs resulted in significantly lower discoloration. The type of bur did not affect the extent of enamel discoloration in the RMGIC group. CONCLUSIONS Orthodontic treatment alters the original color of enamel, and both the adhesive system and the resin-removal methods are responsible for this change. When brackets are bonded with the etch-and-rinse system or the SEP, cleaning the adhesive residuals with Stainbuster burs is recommended for minimal change. RMGIC can be safely cleaned with tungsten carbide burs.

Palatal implant versus zygoma plate anchorage for distalization of maxillary posterior teeth

This study aimed to examine the skeletal, dental, and soft tissue effects of the implant-supported pendulum (ISP) and the zygoma anchorage system (ZAS) used for the distalization of maxillary posterior teeth. Among 30 patients showing Angle class II malocclusion, 15 patients with a mean age of 14.3±1.6 years and treated with ISP were included in the first group; 15 patients with a mean age of 14.7±2.5 years and treated with ZAS were included in the second group. The predistalization and postdistalization lateral cephalograms were analysed. Statistical evaluation was carried out using SPSS. Point A and upper incisors protruded in the ISP group, retruded in the ZAS group. Upper posterior teeth were distalized in both groups, but more in the ZAS group. Significant differences were observed between the groups for the sagittal movements of Point A, incisors, and posterior teeth. Overbite decreased in the ISP group, overjet decreased in the ZAS group, upper and lower lips retruded only in the ZAS group. Both methods provided absolute anchorage for distalization of posterior teeth, but the skeletal and soft tissue outcome and distalization obtained was greater in the ZAS group. Both methods can be used as alternatives to extraoral traction and conventional molar distalization appliances with different patient requirements.

Treatment of horizontal root-fractured maxillary incisors--a case report.

Traumatic dental injuries often occur to the teeth and their supporting tissues and they are the main reasons for emergency visit to a dental clinic. Management of a fracture depends on its position and the extent of root involvement. Horizontal root fractures are not seen frequently and the treatment consists of reduction and long-term rigid fixation of the coronal segment. The present case demonstrates the successful management of two horizontally fractured maxillary central incisors with a follow-up period of 9 months.

Soft tissue profile after distal molar movement with a pendulum K-loop appliance versus cervical headgear.

OBJECTIVE To evaluate the soft tissue changes associated with the pendulum appliance that was supported with a K-loop buccally and to compare these treatment changes with a cervical headgear group. MATERIALS AND METHODS The records of 30 patients having skeletal Class I, dental Class II malocclusions were divided to two groups. Group 1 consisted of 7 girls, 8 boys (mean age, 15.0 +/- 3.4 years), and Group 2 consisted of 10 girls, 5 boys (mean age 14.2 +/- 2.9 years). The first group was treated with a pendulum appliance that was supported with a K-loop buccally, and the second group was treated with cervical headgear. Lateral cephalograms were taken at the beginning of treatment and at the end of distal molar movement. Treatment changes within the groups were analyzed using the paired t-test, and between group changes were analyzed with the independent t-test. RESULTS The results showed that the pendulum/K-loop appliance had no significant effect on skeletal and dental variables and soft tissue A point, upper lip thickness, and sagittal upper lip position relative to the E plane. A significant difference for the change in Vp-Ls distance was found in patients in the pendulum/K-loop group (P < .05). Patients in the cervical headgear group showed significant retrusion in skeletal, dental, and soft tissue measurements (P < .05). CONCLUSIONS The pendulum/K-loop appliance produces distal molar movement without causing any significant changes in the sagittal or vertical positions of either the jaw or the soft tissue profile.

Comparison of short-term effects of mini- implant-supported maxillary expansion appliance with two conventional expansion protocols

OBJECTIVE This study evaluates the dentoskeletal effects of a mini-implant-supported maxillary expansion (MISME) appliance in comparison with two types of conventional expansion methods. METHODS Records of 42 patients with bilateral or unilateral posterior crossbite were included in this study. The patients were divided into three groups. In group 1, four miniscrews were placed to the palatal region and an acrylic expansion device was bonded on these screws. A bonded maxillary expansion appliance was used in group 2, while a banded expansion appliance was used in group 3. Measurements from cephalometric, postero-anterior radiographs, and dental casts taken before and after expansion were evaluated statistically. RESULTS ANB angle increased significantly in group 1 and 3. MISME group also showed an increase of SNA angle. Measurements regarding the vertical dimension did not change with MISME but significant posterior rotation was found in group 2 and 3. Overbite value showed a significant decrease in group 2 and 3, but remained stable in group 1. The nasal, maxillary, maxillary intermolar widths showed significant increases in all groups. The difference between MISME group and other groups in maxillary width was significant indicating more skeletal expansion in MISME group. The maxillary molars showed significant buccal tipping in group 2 and 3, while lingual tipping of molars was found in MISME group. CONCLUSIONS MISME can be a better alternative to bonded expansion particularly in patients with vertical growth patterns and lack of anchorage teeth.