Sabri Ilhan Ramoglu

Relationships Between Dental and Skeletal Maturity in Turkish Subjects

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Turkish subjects. The samples were derived from dental panoramic and hand-wrist radiographs of 500 subjects (215 males and 285 females). Calcification of the mandibular canines, first and second premolars, and second and third molars was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation of each hand-wrist radiograph, nine ossification events were determined according to the systems of Björk, and Grave and Brown. Statistically significant relationships were determined between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients. Correlations between dental development and skeletal maturity ranged from .490 to 0.826 for females and .414 to .706 for males (P < .01). The second molar showed the highest correlation and the third molar showed the lowest correlation for female and male subjects. For both sexes, root formation of the canine as well as the first premolar was completed in the majority of the subjects at the MP3cap, PP1cap, Rcap stages. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice, when treating a Turkish patient.

Third-Molar Development in Relation to Chronologic Age in Turkish Children and Young Adults

OBJECTIVE To assess estimation of chronologic age based on the stages of third-molar development following the eight stages (A-H) method of Demirjian et al and to compare third-molar development by sex and age with results of previous studies. MATERIALS AND METHODS The final sample consisted of 900 orthopantomograms from young Turkish subjects of known chronologic age (range, 8-25 years; mean age, 15.18 +/- 4.81 years) and sex (380 males with a mean age of 14.51 +/- 4.55; 520 females with a mean age of 15.67 +/- 4.94). Statistical analysis was performed using the Mann-Whitney U-test and the Wilcoxon test between sex and age. Regression analysis was performed to obtain regression formulas for dental age calculation with the chronologic age RESULTS Statistically significant differences (P < .05) in third-molar development between males and females were revealed regarding the calcification stages D and G. Third-molar genesis was attained earlier in males than in females. Statistical analysis showed a strong correlation between age and third-molar development for males (r(2) = .65) and for females (r(2) = .61). New equations (Age = 8.92 + 1.50 Development stage) were derived for estimating chronologic age. CONCLUSION The use of third molars as a developmental marker is appropriate, especially when comparing the obtained standard deviation with other skeletal age calculation techniques.

Mandibular Asymmetry in Class II Subdivision Malocclusion

OBJECTIVE To evaluate the condylar and ramal mandibular asymmetry in a group of patients with Class II subdivision malocclusion to identify possible gender differences between male and female subjects. MATERIALS AND METHODS Mandibular asymmetry measurements (condylar, ramal, and condylar-plus-ramal asymmetry values) were performed on the panoramic radiographs of 80 subjects (34 male and 46 female). The study group consisted of 40 Class II subdivision patients (18 male and 22 female; mean age 14.53 +/- 3.14 years). The control group consisted of 40 subjects with normal occlusion (16 male and 24 female; mean age 14.43 +/- 3.05 years). The Kruskal-Wallis test was used to determine the possible statistically significant differences between the groups for condylar, ramal, and condylar-plus-ramal asymmetry index measurements. Identified differences between groups were further analyzed using the Mann-Whitney U-test at the 95% confidence interval (P < .05). RESULTS No gender-related difference was found for any of the asymmetry indices. Comparison of condylar, ramal, and condylar-plus-ramal asymmetry index values and gonial angle measurements for Class I and Class II sides in the Class II subdivision group and for right and left sides in the Class I group showed no statistically significant differences. However, the Class II subdivision group has longer values for condylar, ramal, and condylar-plus-ramal height measurements and only these differences were statistically significant (P < .001). CONCLUSIONS Except for condylar ramal and condylar-plus-ramal height measurements, Class II subdivision patients have symmetrical condyles when compared to normal occlusion samples according to Habbets mandibular asymmetry indices.

Microleakage under metallic and ceramic brackets bonded with orthodontic self-etching primer systems.

OBJECTIVE To compare the in vitro microleakage of orthodontic brackets (metal and ceramic) between enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival sides produced by self-etching primer system with that of conventional acid etching and bonding. MATERIALS AND METHOD Sixty freshly extracted human mandibular premolar teeth were used in this study. The teeth were separated into four groups of 15 teeth each and received the following treatments: Group 1, 37% phosphoric acid gel + Transbond XT liquid primer + stainless steel bracket; Group 2, Transbond Plus Self-Etching Primer (TSEP) + stainless steel bracket; Group 3, 37% phosphoric acid gel + Transbond XT liquid primer + ceramic bracket; Group 4, TSEP + ceramic bracket. After curing, specimens were further sealed with nail varnish, stained with 0.5% basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-adhesive and bracket-adhesive interfaces from both occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U tests. RESULTS The gingival sides in all groups exhibited higher microleakage scores compared with those observed in occlusal sides for both adhesive interfaces. Enamel-adhesive interfaces exhibited more microleakage than did the adhesive-bracket interfaces. Brackets bonded with self-etching primer system showed significantly higher microleakage at the enamel-adhesive interface of the gingival side. CONCLUSIONS TSEP causes more microleakage between enamel-adhesive interfaces, which may lead to lower bond strength and/or white-spot lesions.

Bond Strength of Amorphous Calcium Phosphate–Containing Orthodontic Composite Used as a Lingual Retainer Adhesive

OBJECTIVE To evaluate the shear bond strength and fracture mode difference between amorphous calcium phosphate (ACP)-containing adhesive and conventional resin-based composite material used as an orthodontic lingual retainer adhesive. MATERIALS AND METHODS Forty crowns of extracted lower human incisors were mounted in acrylic resin, leaving the buccal surface of the crowns parallel to the base of the molds. The teeth were randomly divided into two groups: experimental and control, containing 20 teeth each. Conventional lingual retainer composite (Transbond-LR, 3M-Unitek) and ACP-containing orthodontic adhesive (Aegis-Ortho) were applied to the teeth surface by packing the material into the cylindrical plastic matrices with a 2.34-mm internal diameter and a 3-mm height (Ultradent) to simulate the lingual retainer bonding. For shear bond testing, the specimens were mounted in a universal testing machine, and an apparatus (Ultradent) attached to a compression load cell was applied to each specimen until failure occurred. The shear bond data were analyzed using Students t-test. Fracture modes were analyzed by chi(2) test. RESULTS The statistical test showed that the bond strengths of group 1 (control Transbond-LR, mean: 24.77 +/- 9.25 MPa) and group 2 (ACP-containing adhesive, mean: 8.49 +/- 2.53 MPa) were significantly different from each other. In general, a greater percentage of the fractures were adhesive at the tooth-composite interface (60% in group 1 and 55% in group 2), and no statistically significant difference was found between groups. CONCLUSION The ACP-containing Aegis-Ortho adhesive resulted in a significant decrease in bond strength to the etched enamel surface.

Accelerated aging effects on surface hardness and roughness of lingual retainer adhesives.

OBJECTIVE To test the null hypothesis that accelerated aging has no effect on the surface microhardness and roughness of two light-cured lingual retainer adhesives. MATERIALS AND METHODS Ten samples of light-cured materials, Transbond Lingual Retainer (3M Unitek) and Light Cure Retainer (Reliance) were cured with a halogen light for 40 seconds. Vickers hardness and surface roughness were measured before and after accelerated aging of 300 hours in a weathering tester. Differences between mean values were analyzed for statistical significance using a t-test. The level of statistical significance was set at P < .05. RESULTS The mean Vickers hardness of Transbond Lingual Retainer was 62.8 +/- 3.5 and 79.6 +/- 4.9 before and after aging, respectively. The mean Vickers hardness of Light Cure Retainer was 40.3 +/- 2.6 and 58.3 +/- 4.3 before and after aging, respectively. Differences in both groups were statistically significant (P < .001). Following aging, mean surface roughness was changed from 0.039 microm to 0.121 microm and from 0.021 microm to 0.031 microm for Transbond Lingual Retainer and Light Cure Retainer, respectively. The roughening of Transbond Lingual Retainer with aging was statistically significant (P < .05), while the change in the surface roughness of Light Cure Retainer was not (P > .05). CONCLUSIONS Accelerated aging significantly increased the surface microhardness of both light-cured retainer adhesives tested. It also significantly increased the surface roughness of the Transbond Lingual Retainer.

Microleakage under ceramic and metallic brackets bonded with resin-modified glass ionomer

OBJECTIVE To test the null hypothesis that there is no significant difference between the microleakage of adhesive interferences at the occlusal and gingival margins of both ceramic and metallic brackets bonded with light-cured resin-modified glass ionomer and a conventional adhesive. MATERIALS AND METHODS Sixty freshly extracted human maxillary premolar teeth were randomly divided into four groups of 15 teeth each. Metal and ceramic brackets were bonded to groups 1 and 2 with resin-modified glass ionomer adhesive (RMGIA). Metal and ceramic brackets were bonded to group 3 and group 4 with a conventional adhesive (CA) system. A dye-penetration method was used for microleakage evaluation. Microleakage from the occlusal and gingival margins was determined by a stereomicroscope for the enamel-adhesive and bracket-adhesive interfaces. Statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U-test with a Bonferroni correction. RESULTS The gingival side of all groups exhibited higher microleakage scores compared with the occlusal side for both adhesive interfaces. All bracket and adhesive combinations displayed statistically significant differences in microleakage between the enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival sides of the brackets (P < .001). When the adhesive systems were compared, the RMGIA showed more microleakage than the CA between the different interfaces. CONCLUSIONS The hypothesis is rejected. RMGIA results in more microleakage between enamel-adhesive interfaces.

Microleakage under orthodontic brackets using high-intensity curing lights

OBJECTIVE To compare the microleakage of the enamel-adhesive-bracket complex at the occlusal and gingival margins of brackets bonded with high-intensity light curing lights and conventional halogen lights. MATERIALS AND METHODS Forty-five freshly extracted human maxillary premolar teeth were randomly separated into three groups of 15 teeth each. Stainless steel brackets were bonded in all groups according to the manufacturers recommendations. Specimens (15 per group) were cured for 40 seconds with a conventional halogen light, 20 seconds with light-emitting diode (LED), and 6 seconds with plasma arc curing light (PAC). After curing, the specimens were further sealed with nail varnish, stained with 0.5% basic-fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-adhesive and bracket-adhesive interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with a Bonferroni correction. RESULTS The type of light curing unit did not significantly affect the amount of microleakage at the gingival or occlusal margins of investigated interfaces (P >.05). The gingival sides in the LED and PAC groups exhibited higher microleakage scores compared with those observed on occlusal sides for the enamel-adhesive and adhesive-bracket interfaces. The halogen light source showed similar microleakage at the gingival and occlusal sides between both adhesive interfaces. CONCLUSIONS High-intensity curing units did not cause more microleakage than conventional halogen lights. This supports the use of all these curing units in routine orthodontic practice.

Microleakage under orthodontic brackets bonded with the custom base indirect bonding technique

The aim of this in vitro study was to compare microleakage of orthodontic brackets between enamel-composite and composite-bracket interfaces at the occlusal and gingival margins, bonded using indirect bonding systems with that of a conventional direct bonding method. Forty freshly extracted human maxillary premolar teeth were randomly divided into two groups. In group 1, the brackets were bonded to teeth directly according to the manufacturers recommendations. Group 2 consisted of 20 teeth bonded indirectly with Transbond XT (3M-Unitek), as the adhesive, and Sondhi Rapid Set A/B Primer (3M-Unitek), a filled resin primer. After bonding, the specimens were further sealed with nail varnish, stained with 0.5 per cent basic fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage at the enamel-composite and composite-bracket interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction. The gingival sides of group 1 displayed a higher median microleakage score than the occlusal side at the enamel-composite interface but this was not statistically significant (P > 0.05). All occlusal margins in both groups showed no microleakage under orthodontic brackets at the enamel-composite or composite-bracket interfaces. Comparisons of the microleakage scores between the direct and the indirect bonding groups at the enamel-composite and composite-bracket interfaces indicated no statistically significant microleakage differences at the gingival and occlusal margins (P > 0.05). The type of bonding method (direct versus indirect) did not significantly affect the amount of microleakage at the enamel-composite-bracket complex.

The effect of different concentrations of topical ozone administration on bone formation in orthopedically expanded suture in rats.

BACKGROUND/OBJECTIVE The aim of this study was to investigate the effects of different concentrations of ozone (O3) therapy on bone regeneration in response to an expansion of the inter-premaxillary suture in rats. MATERIALS AND METHODS Forty-eight Wistar rats were randomly divided into four groups (n = 12). In groups I, II, and III, 1ml of O3 at 10, 25, and 40 µg/ml was injected at the premaxillary suture, respectively. In group IV (control group), 1ml of saline solution was injected at the same point during the expansion procedure for 5 days. Bone regeneration in the suture was evaluated histomorphometrically. The area of new bone and fibrotic area, the number of osteoblasts and osteoclasts, and the amount of vascularity were measured and compared. The density of the newly formed bone in the expansion area was measured by using cone beam computed tomography. Data were analyzed using the Kruskal-Wallis one-way analysis of variance and post hoc Student-Newman-Keuls tests. RESULTS New bone area, fibrotic area, osteoblast and osteoclast numbers, and the amount of vascularity were significantly higher in experimental groups compared with the control group (P < 0.001). The density of newly formed bone (P < 0.001), new bone formation (P = 0.009), number of capillaries (P < 0.001), number of osteoclasts (P = 0.016), and number of osteoblasts (P < 0.001) in the maxillary sutures were highest in the 25 μg/ml O3 group compared with the other experimental groups and control group. CONCLUSIONS/IMPLICATIONS The application of O3 therapy can stimulate bone regeneration in an orthopedically expanded inter-premaxillary suture during both the expansion and retention periods.