Sıddık Malkoç

Management of Alveolar Clefts Using Dento-osseous Transport Distraction Osteogenesis

This article evaluates the usage of distraction osteogenesis (DO) in the treatment of cleft alveoli. The procedure was carried out on eight alveolar clefts of five patients between the ages of 17 and 25 years. Three patients had bilateral alveolar clefts (BAC) and two patients had unilateral alveolar clefts (UAC). DO was carried out bilateral to the palatal segments for the BAC patients and unilateral to the lesser segment for the UAC patients. A custom-made tooth-borne distractor was used. The average amount of distraction was eight mm (range, 5-11.5 mm). The average amount of distal movement of the anchorage teeth was 0.8 mm (range, 0-2 mm). The average amount of inclination changes of the transport segments and anchorage teeth was 7.6 degrees (range, 2-17.5 degrees) and 3.3 degrees (range, 0-9 degrees), respectively. Two important problems were observed attributable to the method. First, the transport segment was docked in a more superior position at the end of distraction process. This undesirable movement also changed the inclination of the teeth in the transport segment and increased tooth tipping. Removing the device in the second week of the consolidation period and retracting the segment to its ideal position orthodontically solved these problems. Second, the bony defect on the nasal side of the alveolar cleft could not be completely closed. This method for repairing small or large alveolar clefts is a simple, cost-effective, and useful treatment option. However, repairing the alveolar cleft without grafts seems to be impossible when using a tooth-borne device.

Angular photogrammetric analysis of the soft tissue facial profile of Turkish adults

One of the most important components of orthodontic diagnosis and treatment planning is the evaluation of the patients soft tissue profile. The aim of this study was to develop angular photogrammetric standards for Class I Anatolian Turkish males and females. A random sample of 100 Turkish individuals (46 males and 54 females; ages 19-25 years) was obtained. The photographic set-up consisted of a tripod that held a 35 mm camera and a primary flash. The camera was used in its manual position and photographic records were taken of the subjects in natural head posture. The photographic records, 35 mm slide format, were digitized and analyzed using the Quick Ceph Image software program for Windows. Twelve measurements were digitally analyzed on each photograph. For statistical evaluation a Students t-test was performed and the reliability of the method was analyzed. The results were compared with reported norms of facial aesthetics. The nasofrontal (G-N-Prn), nasal (Cm-Sn/N-Prn), vertical nasal (N-Prn/TV), and nasal dorsum (N-Mn-Prn) angles showed statistically insignificant gender differences (P>0.05). The nasolabial angle (Cm-Sn-Ls) demonstrated large variability. Gender differences were present in the mentolabial (Li-Sm-Pg) and cervicomental (G-Pg/C-Me) angles. The mentolabial angle showed a high method error and large variability. Facial (G-Sn-Pg) and total facial (G-Prn-Pg) convexity angles were similar, while Cm-Sn-Ls angle range was larger compared with other angles. The mean values obtained from this sample can be used for comparison with records of subjects with the same characteristics and following the same photogrammetric technique. Angular photogrammetric profile analysis can provide the orthodontist with a way of determining problems associated with various soft tissue segments of the face.

Mandibular Symphyseal Distraction and Its Geometrical Evaluation: Report of a Case

In this report, the case of a patient who has been treated with a different use of a tooth-borne custom-made mandibular symphyseal distraction device is presented. The difference in the application is that the distal arm of the device was sectioned during the retention phase to allow the possible relapse of displaced condyles to their original positions while the labial segment expansion is being maintained. The effect of this procedure was also evaluated on a geometrical model using measurements from the patients cast. We conclude that symphyseal distraction is an effective and fast method of correcting orthodontic anomalies. The effect of the procedure on the condyle was only 3 degrees of distolateral rotation as calculated using the geometrical model.

Influence of different tooth types on the bond strength of two orthodontic adhesive systems

The aim of this investigation was to evaluate the effects of different tooth types on the shear bond strength (SBS) of two orthodontic resin adhesive systems in vitro. Two hundred extracted sound human teeth were used in the study. Ten teeth of each tooth type were the mounted in acrylic resin leaving the buccal surface of the crowns parallel to the base of the moulds. In each experimental group, the adhesives (Transbond XT™ and Light Bond™) were applied to the etched enamel surfaces. The orthodontic composite resins were then applied to the surface in cylindrical-shaped plastic matrices. For SBS testing, a force transducer (Ultradent™) was applied at a crosshead speed of 1 mm/minute at the interface between the tooth and composite until failure occurred. Data were analysed using two-way analysis of variance (ANOVA), Kruskal–Wallis one-way ANOVA, a Bonferroni adjusted Mann–Whitney U-test, and an independent t-test. Generally, it was found that tooth type had a significant effect on SBS (P < 0.05) with Light Bond™ showing a higher SBS than Transbond XT™ (P < 0.05). The highest bond strengths were observed for the upper central incisor and lower molars with Light Bond™ (P < 0.05) and the lowest mean bond strengths for the upper molars and lower canine with Transbond XT™ (P <0.05). The results demonstrated that enamel SBS was significantly altered by both tooth type and adhesive system. Thus, the findings of this study confirm that enamel bond strength is not uniform for all teeth. These results may also explain the variability in the enamel-bonding efficacy of adhesives.

Comparison of Two Different Gingivectomy Techniques for Gingival Cleft Treatment

Interdental clefts or invaginations contribute to orthodontic relapse and poor periodontal health in extraction cases. These clefts or invaginations can be removed both by electrosurgical or conventional surgical gingivectomy techniques. This study investigates and compares the efficacy of two different techniques to remove gingival clefts with respect to periodontal health and patient tolerance. Twenty-two patients (mean age, 15.7 years) with bilateral gingival clefts participated in this study. In each patient, the gingival invaginations were removed by gingivectomy using electrosurgery on one side and conventional surgery on the contralateral side. The length and depth of the invaginations, the gingival index of the adjacent teeth, and the changes in visual analogue scale scores were recorded before and after the operation for both groups. Mann-Whitney U-test and Wilcoxon tests were used to analyze the data statistically. The results showed significant improvement in invagination depth and length and gingival index scores for both techniques. There were no statistical differences between the two gingivectomy techniques with respect to gingival health and patient tolerance. Both techniques can be used to remove the gingival invaginations efficiently.