Turkish Journal of Orthodontics最新文献

Objective: This study aimed to evaluate proximal caries formation and Decay, Missing, Filled Teeth (DMFT) scores during clear aligner (CA) therapy compared with fixed orthodontic treatment.

Methods: A total of 50 patients with a mean age of 19.9 years were divided into two equal groups (n=25) according to treatment method. Both CA and fixed appliance (FA) patients had low-to-medium levels of crowding. Caries formation and DMFT scores were assessed via radiographic and clinical examination before treatment (T0) and at the end of a six-month observation period (T1). The numbers of caries lesions and fillings was analyzed using a Two-Way Analysis of Variance with a significance level of 0.05.

Results: Significant statistical differences were found for both groups (p<0.001). The amount of proximal caries significantly increased in both groups, whereas the increase in non-proximal caries was only statistically significant in the FA group. DMFT scores also increased significantly in both groups, with the FA group showing a higher increase at the end of the observation period.

Conclusion: Although CAs had an advantage in decreasing the overall risk of caries, no distinct advantage was found in reducing the risk of proximal caries lesions. The DMFT index was significantly higher in fixed orthodontic treatment patients than in CA treatment patients.

Tooth eruption is a highly complex mechanism that is controlled by many factors. Various mechanical, systemic, or genetic factors can cause eruption disorders. Primary failure of eruption (PFE) is known as an eruption disorder occurring due to non-syndromic genetic factors. It is frequently seen in the first and second molars and causes posterior open bite. It can be observed unilaterally or bilaterally. Studies show that mutations in many different genes that control the tooth eruption mechanism, mainly the PTH1R and KMT2C genes, constitute the genetic basis of PFE. Primary eruption disorders are very difficult to treat. It is known that the application of active orthodontic forces causes local ankylosis in the tooth and the failure of the tooth to return to its normal position. For this reason, determining the correct diagnosis and treatment method is very important. Although there are different treatment methods, the results of research about the success of these treatment methods are quite limited. This review aims to explain the etiology, diagnosis, and treatment of PFE in light of current genetic studies.

Objective: To assess the effects of rapid maxillary expansion (RME) and orthodontic treatment with fixed appliances on the developing roots of anchor teeth compared with completely formed roots.

Methods: Pre- and post-treatment cone-beam computed tomography (CBCT) scans of 19 patients (mean pre-treatment age 10.9±1.3, mean post-treatment age 13.66±1.29) with incompletely formed roots who had undergone RME and orthodontic treatment with fixed appliances were selected. In addition, 15 CBCT scans of age- and sex-matched untreated controls (mean age 13.69±1.08) with completely formed roots of the same teeth were obtained. Pre- and post-treatment CBCT records of the experimental group were segmented and reconstructed to obtain linear and volumetric measurements of the roots for comparison with the control group. Changes in the root dimensions were analyzed using the paired t-test; Independent Student's t-test was used for comparisons between the groups.

Results: All premolars in the experimental group showed a statistically significant increase in root length and volume post-treatment (p<0.05), with the greatest increase seen in the second premolar. The distobuccal and palatal root lengths of the molars decreased significantly after treatment in the experimental group. The comparison of post-treatment root dimensions between the experimental and untreated control groups showed no significant difference.

Conclusion: The teeth with developing roots attain normal root length after RME and orthodontic treatment with fixed appliances, with no significant differences in root length and volume compared with teeth with completely formed roots.

Several procedures have been proposed as adjuvant treatments in orthodontics to accelerate orthodontic tooth movement (OTM). This review aimed to evaluate and compare the effectiveness of surgical and non-surgical techniques in accelerating tooth movement, ascertain the influence of different orthodontic appliances on the rate of tooth movement and analyze their clinical applicability as supportive approaches in orthodontic treatment. A bibliographic search was carried out in April 2024 across Pubmed, Scopus, Web of Science, and the Cochrane Library using combinations of keywords and Medical Subject Heading terms relevant to the topic. The search had no time restriction and was limited to studies published in English. A total of 76 articles were included in this systematic review. Corticotomy exhibited the highest acceleration potential among surgical techniques but is highly invasive and associated with considerable pain and discomfort. Among non-surgical techniques, vibration and photobiomodulation (PBM) showed the most promising results due to their non-invasiveness and effectiveness in accelerating tooth movement. This review provides a comprehensive overview of techniques for accelerating OTM. The literature remains limited in involving surgical and non-surgical procedures using orthodontic aligners, highlighting the need for further research. Considering all the pros and cons, PBM appears to be the most promising technique; however, its effectiveness is yet suboptimal. Future efforts should be dedicated to optimizing PBM protocols to stimulate specific remodeling phenomena, ensuring its establishment as a safe, effective, painless, and non-invasive acceleration technique.

Objective: To compare the pharyngeal airway size and area between Class III patients exhibiting optimal vertical growth direction and Class I patients at the MP3cap stage, considering gender differences.

Methods: This retrospective study analyzed pre-treatment cephalograms of a total of 180 patients with Class I (45 girls, 45 boys) and Class III (maxilla or maxillo-mandibular origin) (45 girls, 45 boys) malocclusions. Linear and angular measurements were conducted on lateral cephalograms utilizing the GNU Image Manipulation Program (GIMP 2.10.18, NY, USA; https://www.gimp.org/). The pharyngeal airway areas were computed utilizing AUTOCAD (Autodesk 2018, San Rafael, CA, USA). The Independent Samples t-test and Mann-Whitney U test were employed for comparative analysis of variables across groups. The forward selection method was employed in conjunction with regression analysis.

Results: No significant differences were observed in the nasopharyngeal area (NA; mm²) across the malocclusion groups and genders. In Class III girls, the oropharyngeal area (OA; mm²), retroglossal (RG; mm²) area, and superior pharyngeal space (SPS; mm) were significantly larger than those of Class III boys, and Class I girls (p<0.05). The inferior pharyngeal space (IPS; mm) was significantly larger in Class III girls compared to Class III boys (p<0.05). Girls with Class I/III malocclusions demonstrated a more pronounced head posture than boys (p<0.05).

Conclusion: The findings indicate the necessity of accounting for gender-specific variations in Class I and III patients, as well as evaluating pharyngeal airway characteristics in orthodontic diagnosis and treatment planning. In Class III girls, the OA and RG areas, as well as the superior and inferior pharyngeal spaces, were larger compared to Class III boys.

Objective: This study aimed to investigate the positional changes of maxillary first molars in patients treated with the hybrid hyrax-mentoplate and Cl III elastics combination using cone-beam computed tomography (CBCT).

Methods: Ten patients (7 females-3 males, mean age: 11.66±0.83 years) treated with hybrid hyrax-mentoplate at Marmara University Department of Orthodontics were included. Angular and linear measurements were taken from pre-treatment and post-treatment CBCT images, and changes in maxillary first molar teeth were examined using 3D SLICER version 5.0.2 (www.slicer.org). Statistical significance was set at p≤0.05.

Results: Significant increases were observed in all distance measurements except C16p-C26p in the coronal plane, and significant decreases were observed in angular measurements only at 16mb and 26mb (p≤0.05). All measurements in the sagittal plane significantly increased compared to the vertical and horizontal reference lines (p≤0.001). Angular measurements relative to the palatal reference line significantly increased only in P-16p, P-26mb, and P-26p (p≤0.05). In skeletal measurements, significant changes were observed only in V-A, V-ANS, H-PNS, and V-PNS measurements (p≤0.05). The expansion at the apical level was significantly higher than that at the coronal level (p≤0.05). Compared to the V line, more mesial movement was observed at the coronal level than at the apical level (p≤0.001).

Conclusion: The use of Class III elastics causes greater expansion at the apical level than the coronal. Molar teeth exhibit a mesial movement, but there could be multiple contributing factors. In molars connected to Class III elastics, extrusion occurs. When vertical control is important, appropriate safety measures are advised.

Objective: This retrospective study aimed to assess the presence and amount of external apical root resorption (EARR) in endodontically treated teeth (ETT) and contralateral teeth with vital pulp (VPT) following orthodontic treatment.

Methods: The study sample included panoramic radiographs of 503 patients (314 females and 189 males; 16.29 years±3.98) with 620 ETT and 580 VPT. The tooth length was measured on digital panoramic radiographs, which were collected at the beginning and end of the orthodontic therapy for each subject. The pre- and post-orthodontic treatment radiographic evaluation included the percentage of EARR in ETT and contralateral VPT for all tooth types. Any relationship between EARR and orthodontic treatment type (one- and two-phase; extraction and non-extraction), duration, and patients' age and gender were investigated. Mann-Whitney U, Wilcoxon signed rank, Kruskal-Wallis and Spearman correlation tests were applied for comparisons and to test the correlations.

Results: A statistically significant difference was observed in all orthodontic treatment groups when ETT and VPT were compared in terms of EARR (p<0.05). EARR was positively correlated with orthodontic treatment duration and type (p<0.05) but was not influenced by patient age or gender. Statistically significant EARR was observed in the two-phase extraction orthodontic treatment group for both ETT and VPT. In VPT, a statistically significant EARR was found in the one-phase extraction treatment group compared with the non-extraction treatment group, whereas no significant difference was found in ETT.

Conclusion: ETT showed significantly lower EARR than VPT. ETT can therefore be moved safely during orthodontic treatment.

Objective: This study aims to compare the impact of titanium and stainless steel (SS) retainer wires on lower incisor stability and periodontal health.

Methods: Fifty patients between the ages of 14.1 and 29.5 years were recruited for the study. The impact of 0.027x0.011-inch rectangular titanium dead-soft wire retainers was compared with that of 0.0215-inch six-stranded SS wire retainers. The retainers were bonded to the mandibular arch, and 3D models were evaluated after completion of the orthodontic treatment (T1), at the third month (T2), and at the sixth month (T3). Little's irregularity index (LII), the intercanine width, the pocket depth, the plaque index, bleeding on probing, and retainer survival were analyzed. The generalized linear model method was used to compare scores on LII, the intercanine width, the pocket depth, and plaque index values. Cochran's Q test was used to compare intragroup bleeding.

Results: A significant increase was found in the irregularity index parameter according to time (p=0.004) but no statistically significant difference was found between groups in terms of the LII according to material and time (p=0.826). No significant difference was found in intercanine width parameters between the groups according to material and time (p=0.977). No statistically significant difference was found between the groups in terms of pocket depth and plaque index scores, according to material and time. No retainer failure was observed in either group.

Conclusion: Both retainer wires offer successful results in terms of stability parameters and periodontal parameters after six months.

Objective: This study aimed to evaluate the skeletal, dental, and soft tissue effects of the nickel titanium memory Leaf Expander in a growing sample of patients with unilateral posterior crossbite compared with a control group using digital models and lateral cephalometric radiographs.

Methods: The research included a total of 24 patients, 12 of whom were treated and 12 untreated. The Leaf Expander group consisted of 4 males and 8 females (mean age= 8.6±10.7 years), and the control group consisted of 5 males and 7 females (mean age: 9.2±0.8 years). Changes during the observation period in both groups were evaluated using the Wilcoxon signed-rank test. We used the Mann-Whitney U test to compare the data between the groups.

Results: There was a significant increase in the values indicating the vertical position of the maxilla and mandible in the treatment group. The palatal surface area increased significantly in both groups, but the increase was significantly higher in the treatment group than in the control group. In addition, intermolar width and arch perimeter measurements were significantly higher in the treatment group than in the control group.

Conclusion: With the advantage that this device does not require parent compliance, the possibility of incorrect activation was eliminated, and effective expansion using the Leaf Expander was achieved in patients with unilateral crossbite.