Turkish Journal of Orthodontics最新文献

Objective: Maxillary expansion is a common treatment in clinical orthodontics and can be performed in a wide age range using different methods. This bibliometric analysis aims to provide an overview of research on maxillary expansion.

Methods: A literature search was performed in the Web of Science database, and publications related to maxillary expansion between 1970 and 2023 were included. Data, including titles, abstracts, keywords, countries, regions, and references, were exported and analyzed within the scope of the bibliometric indicators.

Results: The study was conducted on 2633 publications. Between 1970 and 2023, research on maxillary expansion showed a general upward trend in the number of publications. From the analyzed publications, we observed that rapid maxillary expansion (RME) was the most common type of maxillary expansion, accounting for 78% of all publications. Most publications originated from the United States (24.3%), and these articles were also the most cited (17180). Lorenzo Franchi contributed the most publications (85, 3.2%) and was cited 2830 times for maxillary expansion. The highest number of publications was from the University of Sao Paolo (119), and the most cited institution was the University of Florence (3287).

Conclusion: The bibliometric indicators showed a rapid increase in the number of published works on the topic of maxillary expansion, particularly in recent years. Advances in patient evaluation (3D imaging, modeling) and application methods (mini-screws, clear aligners) appear to have helped to maintain the popularity of maxillary expansion. We also observed that maxillary expansion is associated with several other specialties in addition to dentistry.

Objective: This study aimed to determine the correlation between pain perception and knowledge, attitude, and diet diversity in patients undergoing fixed orthodontic treatment.

Methods: A total of 103 patients (15-40 yrs.; 67 females, 36 males) undergoing orthodontic treatment with a 0.022-inch slot (MBT prescription) in both arches were recruited. Information on pain perception, knowledge, attitude, and diet diversity scores was collected through validated questionnaires using visual analogue scale and close-ended questions at one time point. The correlation between variables was analyzed using the Pearson's correlation coefficient.

Results: Of the patients, 48.5% were aged 15 to 19 years old, with 65% females and 73.8% of Chinese ethnicity. Approximately 90% of the orthodontic patients perceived low levels of pain from orthodontic treatment, and 98% had a positive attitude toward orthodontic treatment. The patients had a good level of knowledge (Mean: 6±0.65). Approximately 49.5% of patients reported having moderate diet diversity. No significant correlation was found between pain perception and knowledge, or pain perception and diet diversity (r=0.062, p=0.534). However, a significant weak negative correlation (r=-0.289, p<0.05) between pain perception and attitude was observed.

Conclusion: Patients undergoing fixed orthodontic treatment presented with overall low pain perception, a positive attitude, and good knowledge about their treatment with moderate diet diversity. Informing the patient in advance about different orthodontic procedures encourages a positive attitude and facilitates patient cooperation. An interprofessional approach involving nutritionists can provide a holistic patient approach during orthodontic treatment.

Objective: The aim of this double-blind in vivo study was to compare the extent of corrosion on the surface of nickel-titanium (NiTi) wires in various mouthwashes.

Methods: A total of 80 patients who received orthodontic treatment with as-received 0.016x0.022 inch NiTi wires were included in the study, and they were split into 4 groups. The first group used 0.05% of (225ppm F-) sodium fluoride (NaF) (Colgate Plax^®) containing mouthwash, 21.6% alcohol (Listerine Cool Mint^®) containing mouthwash, and 0.2% clorhexidine (CHX) (Klorhex^®) containing mouthwash and the control group used drinking water with melt menthol as mouthwash. After 30 days of using mouthwash, the surfaces of NiTi wires were examined with atomic force microscopy (AFM), and surface roughness values were calculated.

Results: Mouthwashes containing fluoride, essential oils, and CHX created higher surface roughness on NiTi wires than the control group. The floride-containing mouthwash group showed less corrosion than the CHX group, whereas there was no difference between the essential oil group. AFM images show supportive data with the results of the clinical study. The results were assessed using a 95% confidence interval and a significance level p<0.05.

Conclusion: CHX, essential oil, and floride-containing mouthwashes cause corrosion of NiTi wires. Floride-containing mouthwash can be preferred over CHX mouthwash due to its lesser corrosion effect.

Objective: To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar.

Methods: Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student's t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides.

Results: The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height.

Conclusion: The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.

Objective: To determine the optimum miniscrew head design in orthodontic treatments for primary stability and compare stress distribution on a representative bone structure.

Methods: Miniscrews with cross heads, mushroom-shaped heads, button heads, bracket heads, and through-hole heads were compared using finite element analysis. Miniscrews, whose three-dimensional drawings were completed using the SolidWorks computer-aided software package, were inserted in the bone block. Orthodontic force was applied to the head, and stress distributions, strains, and total deformations were investigated.

Results: The lowest von Mises stress of 5.67 MPa was obtained using the bracket head. On the other hand, the highest von Mises stress of 22.4 MPa was found with the button head. Through mesh convergence analysis, the most appropriate mesh size was determined to be 0.5 mm; approximately 230,000 elements were formed for each model.

Conclusion: Because the need for low stress is substantial for the primary stability of the miniscrew, this study demonstrated that the bracket head miniscrew is the optimal head design. In addition, it is posited that the success rate of orthodontic anchorage treatments will increase when bracket head miniscrews are used.

Objective: To evaluate the effect of continuous arch and piggyback mechanics in a straight wire appliance (SWA) for the alignment of buccal and variably vertically positioned maxillary canines.

Methods: A three-dimensional finite element model with near-normal occlusion and buccal and vertically displaced maxillary canines was used. Two groups were created to simulate two commonly used SWAs techniques, continuous archwire (Group 1) and piggyback models (Group 2). Each group had three subgroups with varying vertical displacement of the canine from 2 to 6 mm from the occlusal plane. The displacement and stress distribution were noted in each group.

Results: As the vertical displacement increased in Group 1, the concentration of von Mises stress increased progressively at the incisal third (0.36, 0.41 and 0.44 MPa) at 2, 4, and 6 mm, respectively, with decreased maximum occlusal movement in the vertical plane with respect to the canine. Group 2 exhibited a similar pattern but greater occlusal movement of the canine compared with Group 1.

Conclusion: A vertical displacement of 4 mm is the optimal level at which continuous arch mechanics should be considered. For displacements beyond 4 mm, the piggyback wire technique is a suitable alternative.

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.

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.