Selin Kale Varlık

Influence of lower facial height changes on frontal facial attractiveness and perception of treatment need by lay people.

OBJECTIVE To test the hypothesis that lower facial height has no influence on frontal facial attractiveness and treatment need perception of lay people. MATERIALS AND METHODS Frontal facial silhouettes of a man and a woman with normal lower facial height values (male: 81.5 mm; female: 70.5 mm) were modified by increasing and decreasing their lower facial heights in steps of 1 mm to obtain frontal images with different lower facial height alterations ranging from +6 mm to -6 mm for each sex. A panel of 100 lay people scored each silhouettes attractiveness on a 100-mm visual analogue scale (VAS) and also indicated whether they would seek treatment if the image represented their own. The Wilcoxon signed rank test was used to compare the VAS scores. RESULTS Unaltered +/-1-mm and +/-2-mm silhouettes got the highest VAS scores. Scores were significantly lower (P < or = .001) as the divergence from the normal value exceeded 2 mm. Beyond +3 mm and -4 mm in females and +4 mm and -3 mm in males the difference between the scores became statistically insignificant. At +/-4 mm, more than 75% of the raters elected to have treatment. CONCLUSION The hypothesis was rejected.

Comparison of the effects of Twin Block and activator treatment on the soft tissue profile.

The aim of this study was to evaluate and compare the effects of activator and Twin Block (TB) appliances on the soft tissue profile. The study included 50 skeletal Class II patients (25 girls and 25 boys, mean age: 11.9 +/- 0.16 years) who were randomly allocated to one of two functional appliance treatment groups. The control group included 25 untreated skeletal Class II patients (13 boys and 12 girls, mean age: 10.11 +/- 0.91 years). Data were obtained from standardized lateral cephalograms taken at the beginning (T0) and end (T1) of appliance wear. The mean treatment time was 9 months for the activator group and 8 months for the TB group. The observation period of the control group was 8 months. Soft tissue profile changes were evaluated by means of 12 linear and five angular measurements. The groups were compared at T0 and T1 using analysis of variance, and treatment/observation differences (T1-T0) were evaluated with the Kruskal-Wallis test. Treatment changes in both appliance groups differed significantly (P < or = 0.001) from those in the control group, except for Ss-y, Ls-y, Li-E, and A-y measurements in the TB group and Ls-y, Li-E, nasolabial angle, and A-y measurements in the activator group. When the effects of the two appliances were compared, significant differences were observed only for SS-y (P < or = 0.05), Ss-E (P < or = 0.05), Si-E (P < or = 0.05), and nasolabial angle (P < or = 0.01). The effects of the activator and TB appliances on the soft tissue profile were similar; both significantly changed the soft tissue profile.

Influence of thermoplastic retainers on Streptococcus mutans and Lactobacillus adhesion

INTRODUCTION This study was designed to test the hypothesis that thermoplastic retainers influence oral microbial flora during the retention period because they prevent the flushing effect of saliva on dental and mucous tissues. METHODS Twenty-four orthodontic patients finished the study. After debonding, the patients were given thermoplastic retainers (Essix ACE 0.040-in plastic, Dentsply International, York, Pa) for both jaws and instructed to wear them all day. Plaque samples from tooth surfaces and saliva samples were collected from each patient just after debonding (T0), and on day 15 (T1), day 30 (T2), and day 60 (T3) of retention. The jaws were divided into 6 regions, and the data for each region were evaluated separately. Total viable Lactobacillus and Streptococcus mutans colonies were counted, and the numbers of the viable microorganisms were calculated. RESULTS The numbers of Lactobacillus colonies at T3 were higher than at T0, T1, and T2, and the difference between T0 and T3 was statistically significant (P <0.05). The numbers of S mutans colonies at T3 were higher than at T0, T1, and T2, and the differences between T0 and T1, and T1 and T2 were statistically significant (P <0.05). CONCLUSIONS Retention with thermoplastic retainers might create oral conditions conducive to S mutans and Lactobacillus colonization on dental surfaces.

Deepbite correction with incisor intrusion in adults: A long-term cephalometric study

INTRODUCTION The purpose of this study was to investigate the long-term stability of deep overbite correction with mandibular incisor intrusion with utility arches in adult patients. METHODS Pretreatment, posttreatment, and 5-years postretention lateral cephalograms of 31 patients (mean age, 26.8 years; range, 24.1-30.9 years) with Class II Division 1 malocclusion and deepbite, treated by maxillary first premolar extraction and mandibular incisor intrusion, were traced and measured. RESULTS Significant decreases in overjet and overbite (6.4 ± 1.2 and 3.9 ± 0.7 mm, respectively), significant retroclination (17° ± 1.9°) and retraction (3.8 ± 1.1 mm) of the maxillary incisors, and significant increases in protrusion (0.8 ± 1.5 mm), proclination (0.6° ± 0.9°), and intrusion (2.6 ± 1.4 mm) of the mandibular incisors were observed at posttreatment. At postretention, there were statistically significant but clinically unimportant increases in overjet and overbite (0.4 ± 0.2 and 0.8 ± 0.4 mm, respectively) and extrusion of the mandibular incisors (0.8 ± 1.1 mm). CONCLUSIONS Correction of deepbite in nongrowing patients by mandibular incisor intrusion with a utility arch can be considered effective and stable.

Effect of light-cured filled sealant on shear bond strength of metal and ceramic brackets bonded with a resin-modified glass ionomer cement

INTRODUCTION Our objective was to evaluate the effects of a highly filled light-cured sealant (HFLCS) on the shear bond strength and bond failure site of metal and ceramic brackets bonded with resin-modified glass ionomer cement (RMGIC). METHODS Eighty freshly extracted maxillary premolars were randomly divided into 4 groups (20 in each group). In all groups, the teeth were etched with 37% phosphoric acid for 20 seconds, and RMGIC (Fuji Ortho LC, GC Europe, Leuven, Belgium) was used for bracket bonding. In groups 1 and 3, the brackets were bonded directly to etched enamel surfaces; in groups 2 and 4, the etched enamel was covered with HFLCS (Pro Seal, Reliance Orthodontic Products, Itasca, Ill). Groups 1 and 2 received metal brackets, and groups 3 and 4 had ceramic brackets. The specimens were stored in distilled water at room temperature for 24 hours and subsequently tested in shear mode with a universal testing machine. After debonding, the teeth and the brackets were examined under a stereomicroscope (model SMZ-1B, Nikon, Osaka, Japan) at 20-times magnification to assess the residual adhesive on the tooth surfaces. RESULTS Interaction between HFLCS and bracket type was not statistically significant (P = 0.15). Pretreatment with HFLCS did not cause a statistically significant change in the shear bond values of either metal or ceramic brackets (P = 0.38). Shear bond values of the ceramic brackets were higher than those of the metal brackets independent of HFLCS application (P <0.001). No significant differences were found in bond failure modes in the 4 groups. CONCLUSIONS HFLCS application on enamel etched with 37% phosphoric acid did not affect the bond strength values and the bond failure modes of metal and ceramic brackets bonded with RMGIC. RESULTS Interaction between HFLCS and bracket type was not statistically significant (P = 0.15). Pretreatment with HFLCS did not cause a statistically significant change in the shear bond values of either metal or ceramic brackets (P = 0.38). Shear bond values of the ceramic brackets were higher than those of the metal brackets independent of HFLCS application (P <0.001). No significant differences were found in bond failure modes in the 4 groups. CONCLUSIONS HFLCS application on enamel etched with 37% phosphoric acid did not affect the bond strength values and the bond failure modes of metal and ceramic brackets bonded with RMGIC.

Effect of light-cured filled sealant on the bond failure rate of orthodontic brackets in vivo

INTRODUCTION The purpose of this study was to evaluate the effect of a highly filled light-cured sealant (HFLCS) on the bond failure rate of metal brackets bonded with a conventional composite adhesive in vivo for 18 months. METHODS In 30 consecutively treated patients, the teeth were divided into 2 groups based on the universal numbering system (1-32). Metal brackets were bonded to all odd-numbered teeth (n = 272) with a conventional composite resin; they served as the controls. Metal brackets were also bonded to all even-numbered teeth with the same composite resin but with a different sealant: HFLCS (Pro Seal, Reliance Orthodontic Products, Itasca, Ill). A total of 544 teeth were bonded and followed for 18 months. The difference between the failure rates (expressed as percentages) was compared with the McNemar test. RESULTS In the control teeth, the bond failure rate was 3.7%, and the mean failure time was 149 days. The teeth pretreated with Pro Seal had a bond failure rate of 2.9% and a mean bracket failure time of 127 days. Comparison of the bond failure rates did not show statistical significance (P = 0.81). CONCLUSIONS HFLCS did not adversely affect the failure rate and time of metal brackets when it was used instead of conventional sealant in a composite resin bonding system.

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features

The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

The effects of cervical headgear with an expanded inner bow in the permanent dentition

In this study, the effects of cervical headgear (CHG) use on the transverse dimension of the maxillary dental arch were evaluated in patients in the permanent dentition. Thirteen girls and 12 boys (mean age: 13.41 +/- 0.52 years) with a bilateral full cusp Class II molar relationship comprised the study group. Fifteen girls and 10 boys with a Class I normal occlusion comprised the controls. In the treatment group, CHG with an expanded inner bow was used for a mean period of 11.2 +/- 5.6 months. The headgear was used for molar distalization and the force magnitude was 196.1 cN. After CHG treatment, the patients underwent non-extraction fixed orthodontic treatment for 14.1 +/- 2.5 months. During this period, the control group received regular dental check-ups. Dental casts obtained at the beginning (T1) and end (T2) of headgear use and at the end of orthodontic treatment (T3) and posteroanterior cephalograms taken at T1 and T2 were evaluated. A Students t-test was used for intergroup comparison at T1, T2, and T3 and a Mann-Whitney U-test with a Bonferroni correction for comparison of treatment/observation changes. At T2, intercanine (0.96 +/- 0.56 mm), interpremolar (1.6 +/- 0.55 mm for the first premolar, 1.74 +/- 0.65 mm for the second premolar), and intermolar (2.31 +/- 0.75 mm) widths increased, while the distance between the intersection of the zygomatic process and the maxillary alveolar process on the right (JR) and left (JL) did not change. Fixed orthodontic treatment did not have any effect on any of the measurements. With the intentional expansion of the inner bow of CHG, the amount of maxillary dental arch expansion achieved in the permanent dentition was statistically significant (P < 0.017).

Assessment of agreement between molar landmarks: Repeatability, reproducibility, and comparability.

INTRODUCTION The aims of this research were to test the repeatability and reproducibility of measurements obtained by different molar landmarks and to determine whether the treatment changes measured by them are comparable. MATERIALS Pretreatment (T0) and postdistalization (T1) lateral cephalograms of 40 patients with a Class II molar relationship were used. Using the mesial cusp tip, distal crown contour, and centroid, 6 linear and 3 angular measurements were evaluated. The intraexaminer and interexaminer reliabilities were assessed with the Bland-Altman method. The T0 to T1 differences were compared by analysis of variance, followed by multiple comparisons with the Bonferroni adjustment. RESULTS The greatest intraexaminer agreement intervals were correlated with centroid for tipping and vertical movement, and with distal crown contour for anteroposterior movement at T0 and T1. The narrowest interexaminer agreement intervals were observed with mesial cusp tip for all measurements and comparisons at both time points, except for the anteroposterior measurements at T1. Statistical significance was observed between the measurements made with mesial cusp tip and distal crown contour for tipping and with mesial cusp tip and centroid for distalization. For vertical movement, the treatment changes were statistically significantly greater with distal crown contour. CONCLUSIONS Mesial cusp tip was the most repeatable and reproducible landmark. Clinically unimportant differences were found in some comparisons of treatment changes obtained by different landmarks.

Jasper Jumper and activator-headgear combination: A comparative cephalometric study

Aim: The aim of this study was to evaluate and compare the skeletal and dentoalveolar effects of Jasper Jumper (JJ) and activator-headgear (AcHg) combinations and an untreated control group. Materials and Methods: The sample comprised 37 Class II high-angle patients. Twenty of them (mean age: 12.4 ± 0.61 years) were treated with JJ and 17 of them (mean age: 10.9 ± 0.74 years) were treated with AcHg. Mean treatment time was 5 months for the JJ group and 11 months for the AcHg group. Control group consisted of 20 Class II high angle patients (mean age: 10.4 ± 0.41 years) and mean observation period was 10 months. Results: Co-A showed significant increase in the JJ and control groups while SNA angle decreased significantly in only JJ group. Increase in SNB angle in AcHg group was significantly greater than in the JJ and control groups. In the JJ group, mandibular incisors protruded significantly. Conclusion: Both the AcHg and JJ treatments had restraining effect on maxillary growth, but stimulated significant mandibular growth. Anteroposterior discrepancy was corrected in the AcHg group mostly by the mandibular growth compared to JJ treatment. Maxillary incisors were retroclined in the AcHg group while mandibular incisors were proclined in the JJ group.