Turkish Journal of Orthodontics最新文献

Objective: This in vitro study aimed to evaluate the effectiveness of pretreatment with a self-etching primer for bonding aligner attachments to lithium disilicate (LD) and monolithic zirconia (MZ) ceramics.

Methods: Forty ceramics, including LD (n=20) and MZ (n=20), were divided into four study groups according to the surface pretreatments: LD specimens pretreated with universal primer (Monobond Plus, MP) after hydrofluoric acid etching (Group 1); MZ ceramics pretreated with MP after sandblasting (Group 2); LD ceramics pretreated with self-etching ceramic primer (Monobond etch & prime, MEP) (Group 3); and MZ ceramics pretreated with MEP after sandblasting (Group 4). The aligner composite (GC Aligner Connect) and universal adhesive (GPremio Bond) were used to prepare the resin attachments. The bond strength was evaluated by micro-shear bond strength (SBS) testing (0.1 mm/min) after thermocycling, and the remnant adhesive was scored according to the resin attachment remnant index (RARI). The SBS data were analyzed using ANOVA and Tukey tests, and the RARI scores were analyzed using the chi-square test.

Results: Group 1 had the lowest SBS, and group 2 had the highest SBS. There were significant differences between the groups in terms of bond strength (p<0.05). The RARI scores showed no significant differences, regardless of the pretreatment and ceramic type.

Conclusion: The use of a self-etching primer increased the bond strength of resin attachments on LD ceramics. For zirconia ceramics, both ceramic primers are recommended for aligner attachment bonding.

Objective: To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile.

Methods: Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software.

Results: Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns.

Conclusion: Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.

Objective: This study compared dentoskeletal and soft tissue changes with face mask (FM) therapy. Rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocols were used with the two different types of expansion appliance, and their effects on the treatment outcome were investigated.

Methods: The study consisted of 79 (37 and 42 patients in the RME and Alt-RAMEC groups with FM, respectively) patients who had received FM treatment. The effects of the RME/FM (20 female, 17 male) and Alt-RAMEC/FM (14 female, 28 male) protocols were evaluated using lateral cephalometric films. The chronological ages of the RME/FM and Alt-RAMEC/FM groups were 11.58 and 11.99 years, respectively. In addition, both groups were divided into two subgroups based on the design of the expansion appliance (Spolyar or full coverage type). Differences in all parameters were analyzed using Student's t-tests.

Results: The maxilla significantly moved forward in both the RME/FM and Alt-RAMEC/FM groups (p<0.001). No significant skeletal differences were observed between the groups. Sagittal movement of the upper incisors significantly increased, and the lower incisors significantly retruded in both groups. While similar skeletal changes were found between the Spolyar and full-coverage appliance groups, the upper incisors protruded significantly more in the full-coverage type.

Conclusion: RME/FM and Alt-RAMEC/FM therapies were found to be efficient for maxillary protraction and resulted in similar skeletal changes. A full-coverage expansion appliance produced a more upper incisor protrusion than a spherical-type appliance.

A thorough clinical and radiographical assessment of an impacted maxillary canine's location forms the basis for proper diagnosis and successful treatment outcomes. Implementing a correct biomechanical approach for directing force application primarily relies on its precise localization. Poor biomechanical planning can resorb the roots of adjacent teeth and result in poor periodontal outcomes of the canine that has been disimpacted. Furthermore, treatment success and time strongly rely on an accurate assessment of the severity of impaction, which depends on its 3D spatial location. The evolution of cone-beam computed tomography (CBCT) radiographs provides more detailed information regarding the location of the impacted canines. In addition, the literature has shown that CBCT imaging has enhanced the quality of diagnosis and treatment planning by obtaining a more precise localization of impacted canines. This review article highlights current evidence regarding comprehensive evaluation of three-dimensional orientations of impacted canines on CBCT images for precise diagnosis and treatment planning.

Objective: To evaluate the effectiveness of a diode laser (810 nm) for circumferential supracrestal fiberotomy compared with conventional surgical circumferential supracrestal fiberotomy in preventing rotational relapse in orthodontically treated cases.

Methods: Seventy-six patients (age range from 18-25 years) with mandibular crowding ranging between 5-8 mm and rotation >10˚ (from the individualized arch form) treated non-extraction with a straight wire appliance (McLaughlin, Bennet, Trevisi; 0.022 inch) prescription were selected for the study. The patients were randomly allocated into 3 groups of 22 patients each: Group 1 (Control group-No circumferential supracrestal fiberotomy), Group 2 (Conventional circumferential supracrestal fiberotomy), and Group 3 (diode laser circumferential supracrestal fiberotomy). After leveling and alignment up to "0.019x0.025" stainless steel wire, the arch wire was removed for a period of 1 month. Impressions were made and the poured casts were scanned. The 3D models (.STL files) were evaluated for changes in the irregularity index and rotational relapse.

Results: One-way ANOVA and post-hoc Tukey's test were used for data analysis. Group 1 (Control group) showed greater relapse in both irregularity index and rotation angulations in comparison with Groups 2 and 3, which was statistically significant (p<0.001). There was no statistically significant difference in irregularity index and rotational relapse between Group 2 and Group 3 (p=0.35 for irregularity index, and p=0.41 for rotational relapse).

Conclusion: The control group showed significantly more relapse than both circumferential supracrestal fiberotomy groups. Both conventional and diode laser circumferential supracrestal fiberotomy decreased the relapse tendency.

Objective: Presurgical nasoalveolar molding (PNAM) using a modified nostril retainer is a new treatment approach. This study aimed to evaluate the outcomes of early nasal molding using this approach with an average follow-up of 2 years in patients with severe unilateral cleft lip and palate.

Methods: This retrospective study included 18 patients with unilateral cleft lip and palate without genetic syndromes who underwent PNAM with modified nostril retainers. The Grayson technique was employed with an intraoral plate to approximate cleft segments. Nasal molding was initiated before reducing the cleft width to 5 mm. Measurements, including alar base height ratio (ABHR), nasal floor width ratio (NFWR), columellar length ratio (CLR), columellar angle (CA), and nostril axis inclination on the cleft and non-cleft sides (NAI-C and NAI-NC, respectively), were calculated from standard photographs taken before PNAM (T1), after PNAM (T2), after an average of 1.81 months post-surgery (T3), and after an average of 2.2 years after T3 (T4). Pairwise comparisons of values at the four time points were conducted.

Results: NFWR, CLR, CA, NAI-C and NAI-NC significantly increased after PNAM (p<0.05). However, no significant change was observed in ABHR (p>0.05) from T1 to T2. These outcomes were maintained at T4, and no patient developed a mega nostril.

Conclusion: The use of a modified nostril retainer for nasal molding appears to provide stability during the high probability of relapse reported in the literature.

Objective: We aimed to evaluate the effectiveness of functional mandibular advancer (FMA) in treating growing patients with Class II malocclusion.

Methods: Electronic searches were conducted in MEDLINE (via PubMed), Cochrane Library, Web of Science, Scopus, Embase, and Lilacs from 1945 to 30^th November 2021. Studies were selected based on the following inclusion criteria: human studies, Class II growing patient treated with FMA, untreated control group or a comparable group treated with another fixed functional appliance, pre- and post-treatment lateral cephalograms/magnetic resonance imaging/cone-beam computed tomography, randomized clinical trials, prospective studies, and retrospective studies. Data extraction of the included articles was independently performed independently by two authors. The risk of bias was assessed using the ROBINS-I tool. Meta-analysis was performed using the inverse generic model.

Results: Seven articles met the criteria and were included in the systematic review and three articles were included in the meta-analysis. Three studies had at low risk of bias and four studies had a moderate risk of bias. All articles reported anterior positioning of the mandible along with an increase in mandibular length. The meta-analysis results indicated a negligible difference between FMA and other functional appliances for the parameters SNA [0.11, 95% confidence interval (CI) of -1.07 and 1.29] and ANB (-1.00, 95% CI of -1.34 and -0.65). The evidence was limited for soft tissue changes.

Conclusion: Class II correction with FMA involved a combination of skeletal and dentoalveolar changes and was similar to other fixed functional appliances.

Objective: To determine the changes in orthodontists' interest in various orthodontic appliances during the coronavirus disease-2019 (COVID-19) pandemic.

Methods: A questionnaire probing respondents' interest in orthodontic appliances and techniques, including standard buccal metal brackets, self-ligating brackets, standard ceramic brackets, lingual brackets, clear aligners, orthodontic facemasks, removable functional appliances, fixed functional appliances, orthognathic surgery, orthodontic miniscrews, and lingual retainers, was prepared using Google Forms and then sent to the Turkish Orthodontic Society to invite all members of the society to participate in the survey. Of the 1903 members invited, 230 (response rate, 12.08%) orthodontists completed the questionnaire.

Results: The respondents' interest in brackets did not change among 70% of the respondents (standard buccal metal bracket 80%, self-ligating bracket 72.2%, standard ceramic bracket 77%, and lingual bracket 76.5%). A significant difference was observed between the genders only about the interest in standard metal brackets and fixed functional appliances (p<0.05 for both). Interest in standard metal brackets decreased as respondents' work experience increased (p<0.05). The interest in self-ligating brackets was higher among respondents with 1-5 years of experience than among other respondents (p<0.05). Interest in self-ligating brackets increased more among lecturers and residents than among clinicians (p<0.05).

Conclusion: The interest of orthodontists in clear aligners showed the highest increase during the COVID-19 pandemic among all orthodontic appliances, whereas their interest in other appliances, particularly standard buccal metal brackets, did not change.

Objective: The aim of this study was to compare the effects of flash-free and conventional adhesive brackets and different finishing techniques on enamel discoloration.

Methods: Forty human premolar teeth were utilized and randomly divided into four groups based on the type of brackets and finishing technique: (1) Gemini^® brackets were used for orthodontic bonding. After debanding, adhesive remnants were cleaned using a 12-blade tungsten carbide bur. (2) Gemini^® suspenders were used for orthodontic bonding. After debanding the brackets, adhesive remnants were cleaned using12-blade APC™ Flash-Free brackets were used for orthodontic bonding. After debanding, adhesive remnants were cleaned a 12-blade tungsten carbide bur and polished with Sof-Lex disks. (4) APC™ Flash-Free brackets were used for orthodontic bonding. After debanding, the adhesive remnants were cleaned using a 12-blade tungsten carbide bur. A Vita Easyshade spectrophotometer was used to measure the color change values of the 40 teeth.

Results: The color change of the enamel surface in the Flash Free bracket group was significantly less than that in the conventional groups (p=0.003 p˂0.05). The mean ΔE values obtained from the Sof-Lex groups were lower than those obtained from the groups without Sof-Lex, but these results were not statistically significant (p=0.280 p>0.05).

Conclusion: It is recommended to use Flash-Free brackets and polish with Sof-Lex disk following the clean-up procedures to minimize the possibility of discoloration of the teeth during orthodontic treatment.

Objective: To compare maxillary sinus volumes and surface areas among individuals with Class III skeletal patterns, with different sagittal positions of maxilla and Class I patients with normal jaw positions using cone-beam computed tomography (CBCT).

Methods: CBCT images of 168 patients were analyzed retrospectively. The calculated surface areas and sinus volumes of 58 patients with Class I, normal mandibular and maxillary position (0SNA>80, 82>SNB>78) were compared with 61 patients with Class III retrognathic maxillary and normal mandibular positions (MRs) (ANB<0, SNA<80, 82>SNB>78) and 49 patients with Class III normal maxillary and prognathic mandibular positions (MP) (ANB<0, 84>SNA>80, SNB>82). Also, volume differences between genders and sides were investigated. One-way ANOVA and t-test were used to compare age, gender, skeletal patterns, and maxillary sinus measurements.

Results: CBCT images of 94 females and 74 males were examined. There was no statistically significant difference in the right and left maxillary sinus volume and surface area measurements among Class I, Class III MR, and Class III MP groups (p>0.05). When the maxillary sinus volume and surface area were evaluated according to gender, the right maxillary sinus surface area and volume of males were found to be statistically significantly higher than those of females (p=0.012 and p=0.024). Similarly, the left maxillary sinus surface areas and volumes of males were also found to be significantly higher than those of females (p=0.000 and p=0.002).

Conclusion: Different sagittal positions of the maxilla do not appear to affect maxillary sinus volume, and males tend to have greater maxillary sinus volume than females. CBCT images can be used to calculate intrabony air spaces.