Zehra Ileri

Comparison of the outcomes of the lower incisor extraction, premolar extraction and non-extraction treatments

The aim of this retrospective study was to evaluate the treatment outcome of lower incisor extraction and to compare it with premolar extraction and non-extraction treatment. The sample consisted of 60 subjects with Class I malocclusion and moderate crowding. The sample was separated into three groups: extraction of a lower incisor group, extraction of a four first premolar group and a non-extraction group. All groups involved 13 girls and 7 boys with a total of 20 patients. The Peer assessment rating (PAR) index was applied to a patients pre-treatment (T1) and post-treatment (T2) dental casts. T1 dental casts were also used for determining Bolton discrepancy. One-way analysis of variance and post hoc Tukey HSD tests were used for statistical analysis. For the mean percentage PAR score reduction for each group, there was one significant difference seen between the lower incisor extraction group and the non-extraction group (P = 0.047). For the mean anterior ratios, there were significant differences among premolar extraction group versus non-extraction group (P = 0.042) and non-extraction group versus lower incisor extraction group (P = 0.000). For the mean overall ratios, there were significant differences among the premolar extraction group versus lower incisor extraction group (P = 0.048) and the non-extraction group versus lower incisor extraction group (P = 0.001). Orthodontic treatment without extraction has a better treatment outcome than the four-first premolar extraction and single lower incisor extraction protocols in Class I cases with moderate to severe mandibular anterior crowding.

Effect of pine bark extract on bond strength of brackets bonded to bleached human tooth enamel

Abstract Aim. The purpose was to investigate the effect of pine bark (proanthocyanidin, natural antioxidant) solution on the shear bond strength (SBS) of metal brackets bonded with composite resin to human enamel after bleaching with hydrogen peroxide (HP). Materials and methods. Sixty recently extracted premolars were divided into an experimental group (n = 45), which was bleached with 40% HP, and a control group (n = 15), which was not bleached. The experimental group was further divided into three sub-groups. Specimens in group IB (n = 15) were bonded immediately after bleaching; specimens in group SA (n = 15) were bleached, then treated with 10% sodium ascorbate and then bonded; group PB specimens (n = 15) were bleached, then treated with 5% pine bark solution and bonded. The specimens were debonded with Universal testing machine. The adhesive remnant index was calculated. Results. No significant differences in shear bond strength were noted when the pine bark treated group was compared with the control group and sodium ascorbate group (p > 0.05). Treating the bleached enamel surface with 10% sodium ascorbate or 5% pine bark solution reverses the SBS reduction. Conclusion. So, as a natural antioxidant and less hazardous, clinicians can choose pine bark solution instead of sodium ascorbate.

Long-term stability of dentoalveolar, skeletal, and soft tissue changes after non-extraction treatment with a self-ligating system

Objective To evaluate the long-term effects of self-ligating brackets (SLBs) on transverse dimensions of arches and skeletal and soft tissues and to quantitatively evaluate the treatment outcome after non-extraction treatment with SLBs. Methods The sample consisted of 24 (18 female and six male) subjects, with a mean age of 14.23 ± 2.19 years, who received treatment with the Damon®3 appliances. Complete records including cephalometric radiographs and plaster models were obtained before treatment (T1), immediately after treatment (T2), six months after treatment (T3), and two years (T4) after treatment. Digital study models were generated. Twenty lateral cephalometric, six frontal cephalometric, and eight dental cast measurements were examined. The Peer Assessment Rating index was used to measure the treatment outcome. The Wilcoxon test was applied for statistical analysis of the changes. Results There were significant increases in all transverse dental cast measurements with active treatment. There was some significant relapse in the long term, particularly in maxillary width (p < 0.05). Statistically significant increases were found in nasal (p < 0.001), maxillary base, upper molar, lower intercanine, and antigonial (p < 0.05) widths in T1-T2. Lower incisors were proclined and protruded in T1-T2. Conclusions SLBs correct crowding by mechanisms involving incisor proclination and protrusion and expansion of the dental arches, without induction of clinically significant changes in hard and soft tissues of the face.

Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion

INTRODUCTION The aims of this study were to quantitatively evaluate the changes in arch widths and buccolingual inclinations of the posterior teeth after asymmetric rapid maxillary expansion (ARME) and to compare the measurements between the crossbite and the noncrossbite sides with cone-beam computed tomography (CBCT). METHODS From our clinic archives, we selected the CBCT records of 30 patients with unilateral skeletal crossbite (13 boys, 14.2 ± 1.3 years old; 17 girls, 13.8 ± 1.3 years old) who underwent ARME treatment. A modified acrylic bonded rapid maxillary expansion appliance including an occlusal locking mechanism was used in all patients. CBCT records had been taken before ARME treatment and after a 3-month retention period. Fourteen angular and 80 linear measurements were taken for the maxilla and the mandible. Frontally clipped CBCT images were used for the evaluation. Paired sample and independent sample t tests were used for statistical comparisons. RESULTS Comparisons of the before-treatment and after-retention measurements showed that the arch widths and buccolingual inclinations of the posterior teeth increased significantly on the crossbite side of the maxilla and on the noncrossbite side of the mandible (P <0.05). Comparison of the 2 sides showed statistically significant differences in both the maxilla and the mandible (P <0.05). CONCLUSIONS After ARME treatment, the crossbite side of the maxilla and the noncrossbite side of the mandible were more affected than were the opposite sides.

Three-dimensional evaluation of hybrid expander appliances: A pilot study

OBJECTIVE To evaluate transverse dimensional changes in dentoalveolar and skeletal structures caused by hybrid expander, using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of nine patients (five boys and four girls) (mean age 13.61 ± 0.72 years) treated with hybrid expander were examined. CBCT images were taken at pretreatment and after the expansion. ELSA (point equidistant to both foramina spinosa) was determined as a reference point to compare the distances in all three dimensions. Nineteen transversal dimensions and four angles were measured for both right and left sides. Wilcoxon signed rank test was used for statistical comparison at P < .05 levels. RESULTS A V-shaped expansion of suture was successfully achieved in all patients without teeth support. The amount of opening was greater in anterior than posterior and in inferior than superior. An 8.75-mm screw expansion was achieved for all patients. Expansion effects reverberated to maxillary central incisor, canine, first premolar, and first molar at 70%, 75%, 92%, and 89%, respectively. The molar teeth tipped buccally (right 3.06° and left 3.24°) as did premolars (right 2.88° and left 3.02°). CONCLUSION The hybrid expander, minimally invasive expansion appliance that protects teeth by including bone support, can be used easily for rapid maxillary expansion treatment.

Shear-bond-strength of orthodontic brackets to aged nano-hybrid compositeresin surfaces using different surface preparation

The aim of this study was to evaluate the effects of different surface preparation methods on the shear bond strength (SBS) of orthodontic metal brackets to aged nano-hybrid resin composite surfaces in vitro. A total of 100 restorative composite resin discs, 6 mm in diameter and 3 mm thick, were obtained and treated with an ageing procedure. After ageing, the samples were randomly divided as follows according to surface preparation methods: (1)Control, (2)37% phosphoric acid gel, (3)Sandblasting, (4)Diamond bur, (5)Air-flow and 20 central incisor teeth were used for the control etched group. SBS test were applied on bonded metal brackets to all samples. SBS values and residual adhesives were evaluated. Analysis of variance showed a significant difference (p<0.001) between the groups. Sandblasted group had the highest SBS value (12.85 MPa) in experimental groups. The sandblasting surface treatment is recommended as an effective method of bonding orthodontic metal brackets to nano-hybrid composite resin surfaces.

Can demineralized enamel surfaces be bonded safely

Abstract Objective. To evaluate and compare the effects of enamel demineralization, microabrasion therapy and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on the shear bond strength (SBS) of orthodontic brackets bonded to enamel surfaces and enamel color. Materials and methods. Eighty freshly extracted human maxillary premolar teeth were allocated to one of the four groups. Brackets were bonded directly to non-demineralized enamel surfaces in Group I (control group), directly to the demineralized enamel surfaces in Group II, to demineralized enamel surfaces after CPP-ACP application in Group III and to demineralized enamel surfaces after microabrasion therapy in Group IV. The samples were stored in water for 24 h at 37°C and then underwent thermocycling. The SBS in megapascals (MPa) was determined by a shear test with 0.5 mm/min crosshead speed and failure types were classified with modified adhesive remnant index scores. The data were analyzed with one-way analyses of variance (ANOVA), Tukey and chi-square tests at the α = 0.05 level. Results. Significant differences were found among the four groups (F = 21.57, p < 0.01). No significant difference was found between Group I and III (17.12 ± 2.84 and 15.08 ± 3.42 MPa, respectively) or between Group III and IV (12.82 ± 2.64 MPa). The lowest SBS value was determined in Group II (5.88 ± 2.12 MPa). Enamel demineralization, microabrasion therapy and CPP-ACP application affected enamel color significantly. Conclusion. CPP-ACP application and microabrasion therapy are able to increase the decreased SBS of orthodontic brackets because of enamel demineralization.

Intranasal Midazolam May Prevent Gagging Reflex: a Case Report

ABSTRACT Background Gagging can become a conditioned response that makes dental treatment difficult or impossible for both the individual and the dentist. The aim of this study is to report a 50 year old female and two children (15 and 11 years old) with exaggerated gag reflex referred to Faculty of Dentistry of Selçuk University. Methods During obtaining records, taking impression procedure was elicited the patients’ hypersensitive gagging reflex. Therefore, it was decided to administer intranasal midazolam to facilitate the taking of accurate dental impressions. After given verbal information about the procedure, 2.5 mg intranasal midazolam (Demizolam, Dem Medikal, Istanbul) were applied incrementally in both nostrils. Results Five minutes later; patients had no gagging reflex and allowed the clinician to take satisfying impressions. No serious adverse effects were observed and the patients remained cooperative during the entire procedure which was completed to the full satisfaction of all involved. The short absorption time and the fast relief process of anaesthetics transferred to the systemic circulatory system are important advantages of nasal application. Conclusions Intranasal midazolam may be very useful for the treatment of gag reflex probably effecting on the depression of upper airway reflex sensitivity.

Evaluation of Enamel Surface Roughness after Various Finishing Techniques for Debonding of Orthodontic Brackets

Objective The aim of this study was to evaluate the surface roughness of enamel after debonding with various types of burs. Methods The buccal surfaces of 20 mandibular incisors for each group of bur were subjected to profilometer analysis, and three parameters of surface irregularity were recorded. After bracket debonding, adhesive remnants were removed by tungsten carbide burs in low-speed, high-speed, and stainbuster settings. The samples were evaluated at pre-treatment (on sound enamel) (T1) and post-treatment (T2) by a profilometer. The specimens were measured twice, and the mean values were recorded. Results The results were analyzed in intra-group comparisons with paired t-tests and in inter-group comparisons with one-way ANOVA and Tukeys HSD test. All resin removal techniques significantly increased enamel surface roughness (p<0.05). According to one-way ANOVA, there were significant differences in the effect of enamel surface roughness between all methods (p<0.05). The high-speed bur caused the maximum roughness values and the stainbuster bur caused the minimum roughness values in all the parameters (Ra, Rz, and Rq). Conclusion The three types of burs used for finishing methods revealed significant differences in the enamel surface after debonding. However, the stainbuster bur created smoother surfaces than the other applied methods.

Treatment of periodontal abscess caused by occlusal trauma: A case report

Orthodontic treatment has a big role in prevention and treatment of dental malposition. The signs and symptoms experienced by patients with occlusal trauma are mobility of teeth, pain on mastication, and periodontal disease. In this case report, an 8-year-old girl who was noticed to have intraoral swelling by her parents 2 days ago is reported. It was diagnosed as a periodontal abscess caused by occlusal trauma. As a treatment planning, it was decided that abscess be drained and orthodontic appliances be used to eliminate chronic trauma. Root developing and healthy periodontal status were observed following the treatment as a result of 36 months follow-up.