Tuba Tortop

Dentofacial effects of a modified tandem traction bow appliance

The aim of this study was to evaluate the dentofacial effects of a modified tandem traction bow appliance (modified TTBA) in skeletal Class III subjects, and the effect of age on treatment response. The material consisted of the pre-treatment/pre-observation and post-treatment/post-observation lateral cephalograms and hand-wrist films of 45 children with skeletal and dental Class III malocclusions. Thirty patients were treated with a modified TTBA. Two treatment groups of 15 patients each were formed: an early (nine girls, six boys; mean skeletal age: 8.18 ± 0.50 years) and a late treatment (5 girls, 10 boys; mean skeletal age: 11.75 ± 1.00 years) group. The remaining 15 children (5 girls, 10 boys; mean skeletal age: 7.90 ± 0.62 years) were observed without treatment for 8 months and served as a control for the early treatment group. Wilcoxon and Mann-Whitney U-tests were used for statistical analysis. Significant forward maxillary movement was determined in both treatment groups (P < 0.01) while the decrease in SNB was significantly greater in the early treatment group compared with the control (P < 0.01). Upper molar tipping and sagittal displacement of point A (point A-T, N(⊥)FH-A) was found to be significantly greater in the late treatment group compared with the early treatment group (P < 0.05). In both treatment groups, dental and skeletal correction of the Class III malocclusion was achieved.

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).

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.

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.

Effects of facemask therapy on the mandibular retromolar space. A follow-up study

Objectives: To evaluate the mandibular retromolar space after facemask therapy and a follow-up period. Methods: This retrospective study was conducted between May and September in 2014. The sample consisted of pre-treatment (T1), post-treatment (T2), and follow-up(T3) panoramic radiographs of 19 skeletal and dental Class III patients (7 female, 12 male; mean age: 10.5 years) treated with facemask and a removable intraoral upper appliance in the Faculty of Dentistry Gazi University, Ankara, Turkey. Each patient’s lower arches were evaluated as right and left segments. As third molars were congenitally absent in 3 segments, a total of 35 segments were evaluated. The average treatment time was one year. The average follow-up period was 2.4 years. The positions, angulations, dental maturations of lower third molars, and mandibular retromolar spaces (DJ) were assessed. Friedman’s 2-way Analysis of Variance, multiple-comparison, Pearson’s correlation, and Chi-square tests were used for statistical evaluation. A p<0.05 was considered as significant. Results: The angulation of the first molar (¡) increased significantly only in the follow-up period (T3). Mandibular retromolar spaces were increased significantly during all periods. The most commonly determined position of the third molar, by Winter’s classification, was vertical angulation in all periods. Moderate and significant correlations were found between third molar angulation(ß) and DJ at T2 and T3. Significant correlations were also found between DJ and Demirjian classification stages during all periods. Conclusion: Facemask therapy did not have an adverse effect on the mandibular retromolar space during treatment and follow up periods.

Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space

Objective The aim of this study was to evaluate and compare the mandibular arch posterior space changes in Class III patients treated with facemask (FM) with removable upper appliance or modified tandem traction bow appliance (MTTBA). Methods Pre- and post-treatment and pre- and post-observation lateral cephalograms of 76 subjects with skeletal and dental Class III malocclusion from the period 2000-10 years formed the materials of this study. In the first group, 25 patients (10 girls, 15 boys; mean age: 10 years, 1 month) were treated with MTTBA. The average treatment time was 12 months. In the second group, 26 patients were treated (13 girls, 13 boys; mean age: 10 years, 4 months) with a Delaire-type FM. The average treatment time was 13 months. The remaining 25 children (9 girls, 16 boys; mean age: 9 years, 8 months) were observed without treatment for 10 months. ANOVA, Duncan, and paired t-tests were used for statistical evaluation. Results Although ramus width and mandibular posterior space increased significantly in all groups, no significant differences were found among the groups. Significant increase in tipping of lower molar (L6/GoMe) in the MTTBA group showed a significant difference compared with the FM and control groups. Significant retroclination of the lower incisors (L1/NB) in the MTTBA and FM treatment groups was significantly different compared with the control group. Retroclination of lower incisors in the MTTBA group was significantly greater than that in the FM group. Conclusions FM and MTTBA treatment approaches did not affect the dimensions of posterior space. Limitations To generalize the results of this study, long term evaluation by considering the third molar position should be done.

Long term results of double plate appliance and facemask combination in the treatment of Class III malocclusion: cephalometric analysis

Amac: Sinif III malokluzyonun tedavisinde kullanilan agiz-ici cift plak ile yuz maskesi (ACP-YM) kombine tedavisinin uzun donem sonuclarinin buyume potansiyeli bitmis ya da bitmekte olan hastalarda degerlendirilmesidir . Gerec ve Yontem: Calismanin materyali ACP-YM kombine tedavisi uygulanmis olan iskeletsel ve dissel Sinif III malokluzyona sahip 13 hastaya (5 kiz, 8 erkek; ortalama kronolojik yas: 11.1±1.40 yil) ait tedavi oncesi (T1), sonrasi (T2) ve uzun donem takip (T3) lateral sefalometrik ve el bilek radyografilerinden olusturuldu. Ortalama ACP-YM tedavi suresi 10.8±1.88 aydir. T3 doneminde, el bilek buyume ve gelisim safhasi, MP3u veya Ru donemidir. Ortalama takip suresi 5.0±1.98 yildir. Tedavi (T2-T1), takip (T3-T2) ve toplam (T3-T1) degisiklikleri degerlendirmek icin Friedman iki yonlu ANOVA ve Wilcoxon isaretli siralar testleri kullanildi . Bulgular: ACP-YM tedavisi ile SNA ve ANB acilarinda artis bulundu (p<0.001). Ancak bu parametrelerde T3-T2 doneminde onemli duzeyde bir degisiklik meydana gelmedi [p=0.655 (SNA), p=0.805 (ANB)]. N ┴ FH-A mesafesi tedavi (p<0.01) ve takip (p<0.05) donemlerinde onemli duzeyde artti. Molar iliskide, hem ACP-YM tedavisi sirasinda hem de toplam surede onemli duzeyde bir artis meydana geldi (p<0.001). Overjet ise, tedavi (p<0.001), takip (p<0.05) ve toplam surede (p<0.001) onemli duzeyde artti. Tedavi, takip donemlerinde ve toplam surede, ust keserlerde (U1/NA) onemli duzeyde protruzyon gozlendi (p<0.05). U6/PP ve L6/MP acilari ACP-YM tedavisi ile degismezken, takip periyodunda ve toplam surede bu parametrelerde onemli duzeyde azalma meydana geldi (p<0.05). Sonuc: ACP-YM kombine tedavisi, Sinif III malokluzyonun tedavisinde etkili bulundu. Bu ortopedik tedavi ile meydana gelen iskeletsel ve dissel sagital degisikliklerin uzun donem takip periyodunda korundugu gozlendi .

Comparison of transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad’s integrated distalizing system

Objective To compare the transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karads integrated distalizing system (KIDS). Methods We evaluated the pre- and post distalization orthodontic models of 39 patients, including 19 treated using the Frog appliance, which is palatally positioned (Frog group), and 20 treated using KIDS, which is buccally positioned (KIDS group). Changes in intermolar and interpremolar distances and the amount of maxillary premolar and molar rotation were evaluated on model photocopies. Wilcoxon and Mann-Whitney U tests were used for statistical evaluations. A p-value of < 0.05 was considered statistically significant. Results Significant distopalatal rotation of premolars and distobuccal rotation of molars were observed in Frog group (p < 0.05), while significant distopalatal rotation of molars (p < 0.05), with no significant changes in premolars, was observed in KIDS group. The amount of second premolar and first molar rotation was significantly different between the two groups (p < 0.05 and p < 0.001, respectively). Furthermore, expansion in the region of the first molars and second premolars was significantly greater in KIDS group than in Frog group (p < 0.001 for both). Conclusions Our results suggest that the type and amount of first molar rotation and expansion vary with the design of the distalization appliance used.

Evaluation of the effects of modified bonded rapid maxillary expansion on occlusal force distribution: A pilot study.

Objective: To evaluate the effects of modified bonded rapid maxillary expansion (RME) on occlusal force distribution. Materials and Methods: The sample included 12 patients (7 girls and 5 boys; mean age: 13.1 years) at the permanent dentition stage with bilateral posterior cross-bite. The patients were treated with a modified bonded RME appliance, activated twice a day. The study was terminated when the palatal cusps of the maxillary posterior teeth were occluding with the buccal cusps of the mandibular posterior teeth. The postretention period was 3 months. The T-Scan III device was used to analyze the percentages of occlusal force distribution, and records were taken at the pretreatment (T1), the postreatment (T2), and the postretention (T3) periods. Wilcoxon signed rank test was used for statistical analyses. Results: Incisors were most frequently without contact, followed by canines. The highest forces were seen in the second and first molar regions. A significant decrease was seen in total occlusal force during treatment (T1–T2); however, during retention, the force returned to its initial value, and no significant differences were found (T1–T3). No differences were found between right and left sides and in occlusal forces of the teeth in all time periods. Conclusion: The use of modified bonded RME decreases the total occlusal forces during the treatment period, but it does returns to its initial value after the postretention period.

Efficacy of different methods to reduce pain during debonding of orthodontic brackets.

OBJECTIVE To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience. MATERIALS AND METHODS Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearmans rank correlation coefficient analysis were used to analyze the data. RESULTS When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores. CONCLUSIONS The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.