Sema Yüksel

A case report comparing 3-D evaluation in the diagnosis and treatment planning of hemimandibular hyperplasia with conventional radiography.

INTRODUCTION Cephalometric radiography is the main investigation used in the diagnosis of maxillofacial deformities. Three-dimensional (3-D) computed tomography (3-D CT) imaging has recently been used in the diagnosis and treatment planning of craniofacial morphology. The purpose of this report was to present the diagnosis and treatment planning of a hemimandibular hyperplasia case by using conventional radiographs and 3-D cephalometric analysis. METHODS A 24-year-old girl presented with hemimandibular hyperplasia and the main complaint was her facial appearance. Conventional cephalometric analysis including lateral and frontal cephalograms were traced by hand and evaluated by the same clinician. Twenty-one measurements on the lateral cephalograms and 13 measurements on the frontal cephalograms were performed. In addition, axial images were reconstructed into a 3-D model by using medical image processing software. Linear and angular measurements were presented in coronal and sagittal planes. RESULTS The 3-D CT analysis has a superior image quality when compared with conventional cephalograms. CONCLUSIONS The 3-D CT analysis provides more advanced diagnostic image information in evaluating craniofacial morphology. We conclude that 3-D CT images can facilitate the diagnosis, treatment planning, and outcome evaluation of severe asymmetry cases.

Effects of Maxillary Protraction and Fixed Appliance Therapy on the Pharyngeal Airway

OBJECTIVE To evaluate the long-term outcome of treatment with reverse headgear in patients with skeletal Class III malocclusion diagnosed as maxillary deficient. MATERIALS AND METHODS Twenty-five patients (11 girls, 14 boys; mean age, 11.32 years) treated with a reverse headgear appliance were included in this study. Pretreatment, posttreatment, and 4-year follow-up cephalometric radiographs were obtained; linear, angular, and area measurements were performed. Comparison of treatment and observation changes was performed using a paired t-test. RESULTS A significant increase was found in the forward movement of the maxilla, which was maintained 4 years after reverse headgear treatment. Treatment changes revealed significant increases in the sagittal dimensions and area of nasopharyngeal airway and remained significant at the end of the 4-year follow-up period. The oropharyngeal airway area increased nonsignificantly after the treatment, but significant increases occurred during the follow-up period. CONCLUSIONS In young individuals diagnosed with maxillary deficiency treated with reverse headgear, the nasopharyngeal airway dimensions were improved after the treatment, and favorable effects of the treatment remained over the posttreatment period of 4 years.

Skeletal and dental effects during observation and treatment with a magnetic device.

The aim of this study was to evaluate the effects of a magnetic appliance, MAD IV, on the treatment of anterior open bites in growing patients. The study material included the lateral cephalograms and hand-wrist radiographs of 16 patients who had an anterior open bite malocclusion. The radiographs were taken at the beginning (T1) and at the end of observation period (T2) and at the end of MAD IV application (T3). At the beginning of the study, the mean age of the subjects was 11 years two months. To define the direction of facial growth, the patients were first observed for nine months without any orthodontic or orthopedic approach. At the end of the observation period, patients who had shown a vertical growth direction, resulting in an increase in open bite, were given an MAD IV appliance and were instructed to wear the appliance 18 hours a day for 7.5 months. Thirty-two different parameters were evaluated from the lateral cephalograms. Paired t-tests were used for statistical evaluation of differences that occurred during the periods and between the periods. During the observation period, the patients continued their mandibular posterior rotation resulting in an increase in lower facial height (P < .001) and an open bite (P < .01). During the treatment period, the patients showed an anterior mandibular rotation with statistically important decreases in lower facial height and open bite (P < .001). In the treatment of anterior open bite with the MAD IV appliance, skeletal changes played a role along with dental and dentoalveolar effects.

Treatment and Posttreatment Changes with Combined Headgear Therapy

OBJECTIVE To determine the effects of combined headgear treatment in high-angle patients and to evaluate the differences 2 years after treatment. MATERIALS AND METHODS The study material consisted of lateral cephalograms of 21 patients (13 girls and eight boys; mean age 10 years 3 months) with Class II dental relationship. Only extraoral combined traction that was applied to maxillary first molars was used in the treatment of all patients. The patients were instructed to wear the appliance 20 hours per day until the molar relationship was corrected. The treatment time was approximately 5 months. At the beginning (T0), at the end (T1), and approximately 2 years after (T2) combined headgear treatment, lateral cephalometric radiographs were obtained. RESULTS SNA and ANB angles and convexity decreased significantly during treatment (T0-T1; P<.05 and P<.01, respectively), and the net changes (T0-T2) in ANB angle and convexity were also found to be statistically significant (P<.01). During treatment, significant distal movement was found in the upper first molar, and the second premolar and molar were also distalized significantly (P<.001). At the end of 2 years, there was a significant mesial migration of the upper molars and the second premolar during the posttreatment period, but all of them were positioned more distally compared to the beginning of treatment (P<.001). The decrease in molar relation was statistically significant during the T0-T1 and T0-T2 periods (P<.001).

Effects of self-ligating and conventional brackets on halitosis and periodontal conditions

OBJECTIVE To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health. MATERIALS AND METHODS Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n  =  20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n  =  20), and the control group (group 3, n  =  20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically. RESULTS No statistically significant group × time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups. CONCLUSIONS The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.

Modified tandem traction bow appliance compared with facemask therapy in treating Class III malocclusions.

OBJECTIVE To compare the effects of the modified tandem traction bow appliance (MTTBA) and the facemask in treating patients with Class III malocclusion. MATERIALS AND METHODS The material consisted of the pre-post treatment\pre-post observation lateral cephalograms of 65 subjects with skeletal and dental Class III malocclusion. In the first group 21 patients (mean age: 10 years, 6 months) were treated with a Delaire-type facemask (FM). In the second group 22 patients treated (mean age: 10 years) with MTTBA. The remaining 22 children (mean age: 9 years, 7 months) were observed without treatment for 11 months. RESULTS Increase in SNA, N-FH ⊥ A, and ANB angles were significantly greater in the treatment groups compared to the control group. However, ANB angle showed a significantly greater increase in the FM group (2.8 ± 0.30°) than in the MTTBA group (2.0 ± 0.18°). The overjet and molar relation increased significantly in both treatment groups, but in the FM group (5.2 ± 0.40 mm) increase in overjet was significantly greater than in the MTTBA group (4.0 ± 0.27 mm). Mesial movement of upper molar and incisor were found to be greater in the FM group compared to the modified TTBA group. CONCLUSIONS Both appliances were found to be effective in the treatment of Class III malocclusion. Their skeletal and dental effects showed differences due to their design.

Effect of different surface treatments on bond strength of recycled brackets to feldspathic porcelain

Abstract Aim: The aim of the study was to compare the shear bond strength of three different types of recycled brackets on porcelain facets following different surface treatments. Materials and Methods: Eighty-four porcelain facets were produced by duplication of the labial surface of a maxillary right first premolar. Each porcelain facet was individually embedded in autopolymerizing acrylic resin. A thin coat of sealant was also painted on the bracket base and cured for 15 s before applying the paste. The bracket was then positioned on the porcelain facet, pressed lightly and light-cured. Each specimen was loaded into a universal testing machine using Nexjen software for testing, with the long axis of the specimen perpendicular to the direction of the applied force. Then, the brackets were rebonded following different surface treatments (Laser, hydrofluoric acid, sandblasting with Al2O3, and silane treatment). Kruskal–Wallis analysis of variance and post hoc Wilcoxon signed-rank tests were performed to test the differences in shear bond strength values (p < 0.05). The significance of differences in the ARI scores was analyzed with chi-square test (p < 0.05). Results: Statistical analysis indicated significant differences among surface treatment procedures (p < 0.0001). In addition, the effect of the first and second bonding factors on shear bond strength behaviors was shown to be significant for the brackets (p < 0.001). Conclusion: The use of sandblasting, HF treatment and silanization procedure could be used for improving the rebond shear bond strength of zirconia brackets to porcelain surface. However, rebonding the brackets to porcelain surfaces may not be recommended due to the dramatic decrease in bonding values.

MODİFİYE 3D BİMETRİK MAKSİLLAR DİSTALİZASYON ARKI İLE MOLAR DİSTALİZASYONU

OZET: Bu calismada Sinif II malokluzyona sahip kronolojik yaslari 11 ile 12 yil arasinda olan 4 kiz bireyde hizli maksillar molar distalizasyonunun sonuclari degerlendirildi. Klinik ve radyolojik gozlemler sonucunda 4-6 haftada maksillar molarlarin parelel hareketi ile Sinif II iliskinin duzeldigi; maksillar keser ve mandibular molarlarda ankrajin korundugu; mandibular keserlerde hafif protruzyon oldugu gozlenmistir.

JASPER JUMPER-OKSİPİTAL HEADGEAR VE AKTİVATÖR-OKSİPİTAL HEADGEAR UYGULAMALARININ DENTOFASİYAL YAPIYA ETKİLERİ

OZET: Bu arastirmanin amaci jasper jumper-oksipital headgear ve aktivator-oksipital headgear uygulamalarinin dentofasial yapiya etkilerinin incelenmesi ve sonuclarinin karsilastirilmasidir. Iskeletsel Sinif 2 yuksek acili 25 vaka arastirma materyalini olusturmaktadir. Uygulama baslangicinda jasper jumper-oksipital headgear (JJOH) grubundaki 8 bireyin ortalama kemik yaslari 12.37 yil, aktivator-oksipital headgear (AOH) grubundaki 9 bireyin 11.51 yil, kontrol grubundaki 8 bireyin ise 10.98 yil olarak belirlendi. Her iki uygulama grubunda da ANB acisi kontrol grubuna gore onemli duzeyde azalma gosterdi. Ust ve alt keser egimi acilari ve ust ve alt molar dislerin yatay yonde yer degistirmelerine iliskin olcumlerde iki uygulama grubu arasinda onemli duzeyde farklilik bulundu. Uygulama suresi JJOH grubunda AOH grubuna gore onemli duzeyde kisa bulundu.

Aktif Ortodontik Tedavi Sırasında Apeksifikasyon

OZET: Ondort yasinda bir kiz cocugunun kronik apikal periodontitis tanisi konulan so! ust surekli santral disine, aktif ortodontik tedavi sirasinda apeksifikasyon islemi uygulanarak bir yillik klinik ve radyolojik takip sonucu kok ucunun kapandigi gozlendi. Sonuc olarak apeksifikasyon tedavisinin bu cesit vakalarda basariyla uygulanan bir tedavi yontemi olarak onerilebilecegi bildirildi.