Turkish Journal of Orthodontics最新文献

Objective: The aim of this study was to examine the quality of life and behavioral disorders in children with obstructive sleep apnea (OSA) or primary snoring, as well as how these problems changed after monobloc treatment.

Methods: Fourteen children with primary snoring and 16 children with OSA who had skeletal class II malocclusion due to mandibular retrognathia were treated with monobloc appliances. To investigate the relationship between behavioral disorders and quality of life, parents were asked to complete four questionnaires: attention deficit and hyperactivity disorder (ADHD) scale, strength and difficulties questionnaire (SDQ), pediatric sleep questionnaire (PSQ), and Pittsburgh sleep quality scale (PSQS). Mann-Whitney U and Wilcoxon signed-rank tests were used to evaluate the data.

Results: According to the results of the PSQ and PSQS, an increase in sleep quality was observed after monobloc treatment. The decrease in the total ADHD score at the end of the treatment was found to be statistically significant in both the OSA (p<0.01) and snoring (p<0.01) groups. According to the SDQ scores, the increase in the social behavior score and the decrease in the peer bullying score in the snoring group were statistically significant (p<0.05).

Conclusion: The use of a monobloc appliance in pediatric patients exhibiting primary snoring and OSA resulted in a notable reduction in sleep-breathing disorder symptoms and a notable enhancement in their overall quality of life. Based on the analyses of the questionnaires, it was concluded that the increase in sleep quality improved the pediatric patients' quality of life after orthodontic treatment with orthodontic monobloc appliances.

Objective: This retrospective clinical study aimed to evaluate the maturation of intramaxillary and circummaxillary suture systems and cervical vertebral maturation as predictors of the skeletal response achieved by rapid maxillary expansion (RME).

Methods: A Digital Imaging and Communication in Medicine dataset of 20 patients (mean age: 15.55 years) prior (T0) and after (T1: 3.5±0.5 months) to RME were retrieved from the archive and analyzed. Bone density values of midpalatal suture (MPS), zygomaticomaxillary suture (ZMS), zygomaticotemporal suture (ZTS), pterygopalatine suture (PPS), and transverse palatine suture (TPS) were measured. The cervical vertebral maturational stages (CVS) were examined. The linear distances between the most lateral points of the piriform apertures were measured as the anterior reference, and the medial margins of the greater palatine foramina on the axial slice were chosen as the posterior reference. The difference at T1-T0 was calculated as the skeletal response to RME at anterior and posterior skeletal references. Spearman's rho rank and Kruskal-Wallis tests were used.

Results: Mean density values of ZMS, PPS, ZTS, TPS, MPS-Anterior, and MPS-Posterior were 922.81, 807.44, 753.83, 640.77, 661.13, and 604.59 HU, respectively. Mean linear changes in anterior and posterior skeletal expansion were 2.93±1.78 and 1.93±2.52 mm. There was no significant relationship between maturation indicators and skeletal response. Significant relationships were found between CVS and MPS density and CVS and circummaxillary suture average density (p≤0.05).

Conclusion: Sutural density showed significant variations among CVSs. Although there was no correlation between skeletal response and density measurements, sutural density was found to be a promising indicator for future studies.

Objective: To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors.

Methods: An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated.

Results: TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask.

Conclusion: The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.

Expeditious strides in the fields of biomaterials, computer-aided design, and manufacturing have catapulted clear aligner therapy (CAT) to become a comprehensive orthodontic treatment modality. The efficiency of achieving planned tooth movement with clear aligners is a significant consideration while setting up the final treatment goals, as well as calculating treatment times and costs based on the available evidence. Contemporary research outcomes confirm that one of the most commonly reported clinical concerns with CAT is the discrepancy between the prescribed outcome in the digital treatment plan and the clinically achieved outcome from a given series of aligners. Inaccurate prediction of tooth movements may not only lead to a prolonged duration of aligner treatment with an additional need for refinement strategies; but it may also cause other concerns, such as patient burnout and increased potential for relapse. The authors of this paper have elucidated some of the critical elements that may help address this discrepancy between digitally prescribed and clinical outcomes based on an evidence-based approach with regard to the predictability and accuracy of CAT. A strong diagnostic acumen, judicious case selection, solid biomechanical understanding of various types of orthodontic tooth movements, a research framework that keeps pace with technological and material developments and provides evidence-based knowledge of the limitations of CAT; and above all, the ability of the clinician to continually innovate as per different clinical scenarios, all contribute to attaining treatment predictability, efficacy, and efficiency with CAT.

Objective: To compare the reliability of two scoring systems for detecting white spot lesions (WSLs) from clinical photographs captured during debonding of fixed orthodontic appliances.

Methods: Digital images of 58 healthy adolescents (34 females and 24 males) were examined, depicting 384 buccal surfaces of maxillary incisors, canines, and first premolars. Three trained examiners (E1, E2 and E3) independently evaluated the fully anonymized photos in a randomized order using the Gorelick index (GI) and the modified International Caries Detection and Assessment System (ICDAS II). A 1-2-week interval separated the scorings. Spearman's rank correlation coefficient, Fisher's z-test, and the interclass correlation coefficient (ICC) were applied to compare the scoring methods and express examiner agreement.

Results: The two scoring systems showed a moderate to strong positive relationship, but inter-examiner variations were significant (p<0.05). We found moderate to good reliability (ICC 0.60 to 0.84) with the ICDAS II system and good to excellent values with the GI (ICC 0.72 to 0.94), depending on the examiner. The agreement concerning the sound surfaces and the most severe WSLs was perfect, whereas the scoring of the milder lesion stages appeared more uncertain.

Conclusion: A moderate to strong positive relationship was demonstrated between the two methods when scoring the presence and severity of WSLs from digital images. Significant inter-examiner variations affected reliability.

Objective: The quality of orthodontic forces in aligners is mainly influenced by their mechanical properties. At present, there is insufficient information on how environmental factors affect the mechanical function of aligners, and studies have shown that patients do not pay enough attention to removing aligners while eating and drinking. Therefore, in this study, we investigated the effect of different chemicals on the mechanical properties of thermoplastic materials.

Methods: In this study, 175 thermoplastic samples from Easy-Vac gasket (3A Medes, Korea) were prepared, and their chemical composition, tensile strength, and hardness before and after exposure to solutions of orange juice, Cola, chlorhexidine mouthwash, and distilled water were measured. One-Way analysis of variance (ANOVA), Tamhane's test, and Tukey's test were used for statistical analysis.

Results: The tensile strength of the sheets increased with continuous exposure to orange juice and chlorhexidine mouthwash, and their hardness decreased with continuous exposure to carbonated beverages. There was no change in the chemical composition of the samples after exposure to different chemicals.

Conclusion: Although these changes are statistically significant, they do not have a significant effect on the result of aligner performance. Therefore, the only concern is the cariogenicity of orange juice and Cola during treatment with aligners and the administration of chlorhexidine mouthwash.

Objective: To investigate the most common retention practices, factors influencing the retention protocol, and the differences among orthodontists regarding retention practices.

Methods: An online validated questionnaire was anonymously sent to 3,000 orthodontic residents and clinicians. The survey consisted of 19 questions regarding the participants' demographics, prescribed retention appliances, factors affecting retention appliance choices, and adjunctive retention procedures. Descriptive statistics, Chi2 and Kendall's Tau-b tests were applied.

Results: Five hundred fifty-five orthodontic residents and clinicians, 53.3% males and 46.7% females, completed the survey, indicating a response rate of 18.5%. Although participants' demographics, type of treatment and pre-treatment malocclusion influence the choice of retention protocols, thermoplastic retainers (TR) were the most popular retention regime for the maxillary arch for both adults (47.4%) and adolescents (42.3%). Bonded retainers (BR) were the favored option for the mandibular arch (44.9% of adults and 40.7% of adolescents). The degree of arch expansion (64.1%) and the degree of interdigitation (50.1%) after treatment were the most influential factors for the choice of the preferred type of retainers by the respondents. 68.6% of the participants thought professional retention guidelines would be useful.

Conclusion: Thermoplastic retainers were the most common retention appliances for adults and adolescents in the maxilla. At the same time, BR was the most favored retainer in the mandibular arch, with clinical experience, practice setting, and malocclusion- and treatment-related factors influencing the type of the chosen appliance. The demographic differences and the uneven participation in the survey need to be considered while interpreting the findings of this study.

Objective: This study aimed to evaluate the accuracy of dental calcification stages in predicting the peak pubertal stage.

Methods: This retrospective study was conducted on panoramic and lateral cephalometric images of 406 female patients aged 9-14 years. The skeletal maturity and calcification stages of the mandibular canines, first premolars, second premolars, and second molars were determined using the Hassel-Farman and Demirjian (DI) methods, respectively. The prediction accuracy of the peak pubertal stage with the studied teeth was assessed using a receiver operating characteristic curve and the area under the curve (AUC). The DI stage of H was designated as the reference level, and Bayesian logistic regression analysis was used to assess the coinciding chance of each DI stage and peak pubertal stage.

Results: The AUC range of studied teeth was 0.84-0.92 in predicting peak pubertal stage (all p<0.001). In the canines and first premolars, the coinciding chance of peak pubertal stage and stage H was significantly higher than that in other stages [p<0.05, odds ratio (OR) ≤0.14]. In the second premolars and second molars, the chance of peak pubertal stage coinciding with stages H and G did not significantly differ (p>0.05); however, the chance of stage G coinciding with peak pubertal stage in the second molars was higher than in stage H (OR=4.59).

Conclusion: Stage H in all studied teeth and stage G in the second premolars and second molars predict peak pubertal stage with high accuracy. Considering that stage H is the end of tooth calcification stages and the accuracy of predicting stage G of second molar teeth is higher than the above stage, estimating the peak pubertal stage is recommended by the second case.

Objective: To compare the consistency of two interproximal reduction (IPR) methods in terms of the amount of planned and performed IPR during clear aligner therapy (CAT).

Methods: Thirty-four patients who received IPR using hand-operated abrasive strips (Group 1, 20 patients, 162 teeth) and motor-driven 3/4 oscillating segmental disks (Group 2, 14 patients, 134 teeth) during CAT were included in this preliminary study. The consistency between the planned and performed IPR amounts was evaluated within and between groups for teeth and quadrants.

Results: In Group 1, the amount of IPR performed on teeth numbers 22 and 43 and in the upper left quadrant was found to be statistically less than that of planned. On the other hand, the amount of performed IPR was statistically higher on tooth number 44 and in the upper right quadrant, whereas it was statistically less on tooth number 33 when compared with the planned amount in Group 2. The inconsistency between the planned and performed IPR amounts were statistically significant only in Group 1 and for teeth numbers 11, 21, 32, 33, and 43. No significant difference was found when the same parameter was compared between the groups.

Conclusion: The consistency of IPR was found to be better with the motor-driven oscillating disk system than with the hand-operated IPR strip system.

Objective: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners.

Methods: Videos were screened using YouTube^TM by conducting a search for "Invisalign". After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters.

Results: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01).

Conclusion: Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content.