Tülin Arun

Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria

Previous studies have suggested that probiotic supplements in dairy products may affect the oral microbial ecology, but the effect in orthodontic patients has not previously been reported. The aim of the present study was to examine whether short-term consumption of fruit yogurt containing probiotic bifidobacteria would affect the levels of salivary mutans streptococci and lactobacilli in patients with fixed orthodontic appliances. A double-blind, randomized crossover study was performed and 24 healthy adolescents (12-16 years) undergoing orthodontic treatment were followed over four periods. During periods 2 and 4 (2 weeks each), the subjects ingested 200 g fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 (2 x 10(8) colony forming units/g) once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and wash-out periods of 1 and 6 weeks, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits before and after the yogurt consumption periods. Pre- and post-treatment values within each regimen were compared with a two-tailed marginal homogeneity test for categorical data. A statistically significant reduction of salivary mutans streptococci was recorded after probiotic yogurt consumption (P < 0.05), which was in contrast to the control yogurt. No significant alterations of the salivary lactobacilli counts were observed. Short-term daily consumption of fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 may reduce the levels of mutans streptococci in saliva during orthodontic treatment with fixed appliances.

Skeletal, Dental and Soft-Tissue Changes Induced by the Jasper Jumper Appliance in Late Adolescence

The purpose of this study was to evaluate the skeletal, dental, and soft-tissue changes in late-adolescent patients treated with Jasper Jumpers applied with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 75 lateral cephalometric films. Among these radiograms, 15 were taken before the leveling stage in the treatment group. Half of the remaining 60 were taken before placement and after removal of the Jasper Jumper appliance in the treatment group and the other half at the beginning and six months after in the control group. The patient selection criteria were Class II malocclusion caused by retrognathic mandible, normal or low-angle growth pattern, and postpeak growth period. The statistical assessment of the data suggests that the sagittal growth potential of the maxilla was inhibited. There were no significant changes in the vertical skeletal parameters. The mandibular incisors were protruded and intruded, whereas the maxillary incisors were retruded and extruded. The upper molars tipped distally as the lower molars tipped mesially. Because of these changes, the occlusal plane rotated in the clockwise direction. Overbite and overjet were reduced, and the soft-tissue profile improved significantly. The results revealed that, in late-adolescent patients, the Jasper Jumper corrected Class II discrepancies mostly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.

Debonding of ceramic brackets by a new scanning laser method

INTRODUCTION The purpose of this in-vitro study was to develop a new method to debond ceramic brackets by scanning with an Er:YAG laser. METHODS Sixty bovine mandibular incisors were randomly divided into 2 groups of 30. Polycrystalline ceramic brackets were placed on their labial surfaces by using the orthodontic composite adhesive Transbond XT (3M Unitek, Monrovia, Calif) and light cured for a total of 40 seconds. The first group was the control group, with no laser application performed. The Er:YAG laser was used on each bracket in the study group at 4.2 W for 9 seconds with the scanning method. The force required for debonding the brackets was applied 45 seconds after laser exposure. Shear bond strengths were measured in megapascals with a universal testing machine, and adhesive remnant index scores were assigned to each specimen. RESULTS Statistically significant (P <0.001) lower shear bond strengths were found in the laser group (9.52 MPa) compared with the control group (20.75 MPa). Likewise, the adhesive remnant index scores were statistically different (P <0.001); the laser group had twice as many samples with adhesive, with the adhesive remnant index scores of 2 or 3. CONCLUSIONS The application of the Er:YAG laser with the scanning method is effective for debonding ceramic brackets by degrading the adhesive through thermal softening.

Vertical growth changes after adenoidectomy.

The purpose of this retrospective investigation is to compare vertical growth component of craniofacial structure of subjects with early and late adenoidectomy history. The study consisted of 93 lateral cephalometric radiographs of three groups of randomly selected patients. The first group was made up of 12 patients (10 male and two female) with an average age of 11.16 +/- 2.08 years, who had been operated upon between 1.5-4 years of age. The second group was made up of 54 patients (25 maleand 29 female) with an average age of 12.18 +/- 2.6 years, who had been operated upon after four years of age. The third group of 27 patients (7 male and 20 female) with clear airway with an average age of 11.18 +/- 2.35 years was used as the control. The data obtained from two adenoidectomy groups were compared and because no statistically significant difference was found except for ANSMe/NMe, the two groups were pooled and compared with the growth pattern in the control sample. There were statistically significant differences in the following parameters: SNGoMe, PPGoMe angle, Gonial angle, Gonial ratio, sigma of inner angles, ANSMe/NMe ratio, Jarabak ratio, PNS-adl distance, PNS-ad2 distance, OAW1 distance. When compared with the control group, the adenoidectomy group showed a more vertically directed growth pattern, however, there were no vertical growth pattern differences between the two groups of children who had adenoidectomy before and after four years of age.

Comparison of Facial Soft Tissue Measurements on Three-dimensional Images and Models Obtained With Different Methods

Aim:The aim of this study was to compare the clinical facial soft tissue measurements with the measurements of facial plaster cast, three-dimensional scanned facial plaster cast, 3-dimensional digital photogrammetrical images, and three-dimensional laser scanner images. Materials and Methods:Three-dimensional facial images of 15 adults were obtained with stereophotogrammetry and a three-dimensional laser scanner. Facial models of subjects were obtained using silicone impression and were scanned. Landmarks were marked on the subjects and plaster casts, digitized on three-dimensional models, and measured in Mimics 12.0 software (Materialises Interactive Medical Image Control System, Leuven, Belgium). Results:No statistically significant differences were found between all three-dimensional measurement methods in mouth width, philtrum median height, and nasal width. Comparison of clinical measurements with facial plaster cast measurements revealed that philtral width, nasal tip protrusion, and right lip and nostril heights were wider and longer in clinical measurements than in facial plaster cast measurements. Comparison of clinical measurements to the laser scanned and stereophotogrammetric model measurements revealed that philtrum lateral and lip heights and philtral width were significantly different between methods. When laser scanned and stereophotogrammetric measurements were compared, significant differences were observed in lip and nostril heights. Conclusions:Facial impression may be problematic owing to the depression caused by the impression material especially on the tip of the nose. Laser scanning is not sensitive enough to visualize the deeper indentations such as nostrils. Stereophotogrammetry is promising for three-dimensional facial measurements and even will be better when color identification between mucocutaneous junctions of the lip region is achieved.

Effects of different silanes and acid concentrations on bond strength of brackets to porcelain surfaces

The aim of this study was to determine the optimum silane-coupling agent and the optimum concentration of acid agent when bonding to porcelain surfaces. Eighty deglazed feldspathic porcelain discs with a diameter of 10 mm and a thickness of 2 mm mounted in acrylic resin blocks were randomly divided into four groups. In groups 1 and 2, the porcelain surfaces were etched with 9.6 per cent hydrofluoric (HF) acid and in groups 3 and 4 with 5 per cent HF acid. In groups 1 and 3, the Dynalock maxillary central incisor brackets were bonded with Pulpdent silane and Unite bonding adhesive and in groups 2 and 4 with Reliance silane and Unite. Shear forces were applied to the samples using an Instron universal test machine. The non-parametric Kruskal-Wallis test was used to determine significant differences in bond strengths between the four groups and Dunns multiple comparison test to compare subgroups. The mean bond strengths and standard deviations of groups 1 to 4 were 5.51 +/- 1.19, 6.54 +/- 0.002, 4.55 +/- 1.93, and 6.39 +/- 0.45 MPa, respectively. Specimens bonded with Reliance showed a statistically significantly higher in vitro bond strength than those bonded with Pulpdent. The concentration of etching gels did not result in any statistically significant difference on the in vitro bond strength when evaluated separately.

Evaluation of the apical adaptation performance of various root canal instruments.

Objective: The aim of this study was to evaluate the apical root canal adaptation performance of various root canal instruments. Materials and Methods: A total of 40 freshly extracted single-rooted mandibular incisors were used in this study. Coroner parts of all teeth were removed from cemento-enamel junction and root canal of each tooth was explored with a size 8 K-file until the tip of the file was just visible at the apex. Working lengths (WLs) were determined as 1 mm short of these measurements. ProTaper, K-file, profile and hedstroem files were inserted into the root canals of 10 teeth to the WL following the flaring of the coronal and middle thirds. Instruments were fixed in the root canals with acrylic resin. The apical 1 mm of each root tip was ground on wet sandpaper to expose the canal and the instrument at the WL and the apical region of each tooth was examined under stereomicroscope. The stereoscopic images of the teeth were digitized and analyzed with software in order to determine the differences between the areas of root canals and file tips. Result data were analyzed using the one-way analysis of variance test (P = 0.05). Results: There were no significant differences between apical file/root canal areas of the evaluated instruments (P > 0.05). Conclusions: None of the evaluated instruments performed a perfect adaptation with the apical root canal surface at the WL in mandibular incisors. Therefore, total removal of the debris from the apical canal surface may not be achieved when these filing instruments are used.

Conscious hypnosis as a method for patient motivation in cervical headgear wear--a pilot study.

The aim of the present study was to assess the efficiency of conscious hypnosis on patient cooperation. The subjects were 30 patients (14 females and 16 males) with a skeletal Class II division 1 malocclusion, divided into two equal groups, a control and a study group. The mean age was 10.78 +/- 1.06 years for the hypnosis, and 10.07 +/- 1.09 years for the control group. Both groups were treated with cervical headgear containing a timer module. The patients were also asked to record their actual wear time on timetables. The hypnosis group patients were motivated with conscious hypnosis while the control group were given verbal motivation by their orthodontist. The timer modules were read at every visit and compared with the timetables. Analysis of variance was used to determine the differences in measurements at each time point. For comparison of the groups, an independent t-test was used. A statistically significant decrease (P < 0.05) in headgear wear was observed in the control group from the first to the sixth month; however, the difference in the hypnosis group was not significant. This result indicates that conscious hypnosis is an effective method for improving orthodontic patient cooperation. There was a low correlation between actual headgear wear indicated by the patient and that recorded by the timing modules, which showed that, timetables are not consistent tools for measuring patient cooperation.

Evaluation of facial hard and soft tissue asymmetry using cone-beam computed tomography.

INTRODUCTION The purposes of this study were to (1) evaluate facial asymmetry 3 dimensionally using cone-beam computed tomography (CBCT) and (2) compare the right and left facial hard and soft tissues volumetrically and their interferences on each other. METHODS The CBCT data of 49 asymmetric (soft tissue menton deviation, ≥4 mm; distance from the facial midline) (mean age, 19.9 ± 5.6 years) and 39 symmetric patients (soft tissue menton deviation, <4 mm) (mean age, 17.8 ± 5.5 years) were exported to the MIMICS software program (version 13.0; Materialise, Leuven, Belgium). Linear, surface distance, angular, volumetric, and surface area measurements were performed 3 dimensionally to assess and compare intragroup and intergroup differences. RESULTS In the asymmetry group, linear measurements such as ramus height, mandibular effective and corpus length, and absolute mandibular volumetric measurements were significantly decreased (P <0.001), whereas facial mandibular, and soft and hard tissue volumetric measurements made on 3-dimensional images, and linear measurements on 2-dimensional images were increased (P <0.001) on the deviation side. CONCLUSIONS Facial hard and soft tissue asymmetries can be precisely quantified using CBCT. However, especially in the gonial region where the surface topography shows alterations caused by asymmetry, many anatomic landmarks should be chosen for the assessment of asymmetry. At the gonial level, the compensation of the soft tissues for the hard tissues was found on 2-dimensional images; nevertheless, 3-dimensional right and left volumetric soft tissue evaluations provide evidence for asymmetry.

Evaluation of metal concentrations in hair and nail after orthognathic surgery.

Introduction:Titanium miniplates are widely used in orthognathic surgery. Titanium is considered to be a bioinert material, although its long-term accumulation in distant human tissues is unclear. The study was designed to evaluate the concentrations of aluminum (Al), titanium (Ti), and vanadium (V) in the hair and nail of patients who underwent orthognathic surgery. Methods:The study group comprised 20 patients who had had orthognathic surgery minimum 14 and maximum 96 months previously (mean [SD], 54.7 [3.5] mo). Miniplates and miniscrews were made of Ti-6Al-4V alloys (Trimed, Ankara, Turkey). The control group comprised 10 healthy adults not operated on. Metal concentrations in the hair and nail of the subjects were measured by inductively coupled plasma mass spectroscope (Thermo Elemental X7 series; Thermo Electron, London, England). Descriptive statistical methods were used for data analysis, and Mann-Whitney test was used to compare both groups. Results:Concentrations of Al, Ti, and V in the hair of the study group were significantly higher than those in the control group (P < 0.001). Nail Ti and V concentrations of the study group were also significantly higher than those of the control group (P < 0.001 and P < 0.01, respectively). Nail Al concentration was similar in both groups (P > 0.05). Conclusions:Increased corrosive element concentrations may be observed in the hair and nail of patients who underwent orthognathic surgery.