Effect of ED-71, a New Active Vitamin D Analog, on Bone Formation in an Orthopedically Expanded Suture in Rats. A Histomorphometric Study

Objectives: The aim of this experimental study was to evaluate the effects of ED-71, a new active vitamin D analog, on bone regeneration in response to expansion of the mid-palatal suture, in rats, histomorphometrically.

Methods: Sixteen male 50-60 days old Wistar rats were separated into two equal groups (control and experimental). Both groups were subjected to expansion, and 30 grams of force was applied to the maxillary incisors with a helical-spring. Experimental group was treated with single-dose ED-71 (0.8 μg/kg body weight) in the mid-palatal suture locally and eight control animals received vehicle solution. Bone regeneration in the mid-palatal suture was evaluated by bone histomorphometric method and mineralized area (Md.Ar), fibrosis area (Fb.Ar), mineralized area/fibrosis area (Md.Ar/ Fb.Ar), bone area (B.Ar) and osteoblast number (N.Ob) parameters were evaluated. Mann Whitney-U test was used for statistical evaluation at P<.05 level.

Results: Statistical analysis showed significant differences between groups for all investigated histomorphometric parameters. Md.Ar (P<.001), Md.Ar/Fb.Ar (P<.001), B.Ar (P<.01) and N.Ob (P<.001) parameters were significantly increased and Fb.Ar (P<.001) measurement was significantly decreased in experimental group. ED-71 group with a mean of 24.55±6.47 showed statistically higher N.Ob than the control group (mean N.Ob: 12.82±5.81).

Conclusions: ED-71 has positive effects on early phase of bone regeneration in the mid-palatal suture in response to expansion and may be beneficial in routine maxillary expansion procedures. (Eur J Dent 2009;3:165-172)

Efficiency of Amorphous Calcium Phosphate–Containing Orthodontic Composite and Resin Modified Glass Ionomer on Demineralization Evaluated By a New Laser Fluorescence Device

Objectives: The aim of this in vitro study was to compare the efficacy of Amorphous Calcium Phosphate (ACP)-containing orthodontic composite and resin-modified glass ionomer cement (RMGIC) on enamel demineralization adjacent to orthodontic brackets evaluated by a new laser fluorescence device.

Methods: Sixty extracted maxillary premolars were used in the present study. Twenty orthodontic brackets were bonded with ACP-containing orthodontic adhesive (Aegis-Ortho), 20 were bonded with RMGIC (Fuji Ortho LC) ad20 were bonded with Transbond XT composite as the control. All samples were then cycled for 21 days through a daily procedure of demineralization for 6 hours and remineralization for 17 hours. After this procedure, demineralization evaluations were undertaken by a pen-type laser fluorescence device (DIAGNO-dent Pen). Analysis ofvariance (ANOVA) and Tukey test was used for statistical evaluation, at P<.05 level.

Results: According to ANOVA, significant demineralization variations (ΔD) were determined among groups (F=6.650; P<.01). The ACP-containing composite showed the lowest (mean: 8.98±2.38) and the control composite showed the highest (mean:12.15±3.83) ΔD, during 21 days demineralization process (P<.01). Significant difference was also observed between the ΔD scores of the RMGIC (mean: 9.24±2.73) and control (P<.05).No significant differences was found in preventive effects of ACP-containing composite and RMGIC (P<.05) against demineralization.

Conclusions: The use of both ACP-containing orthodontic composite and RMGIC should be recommended for any at-risk orthodontic patient to provide preventive actions and potentially remineralize subclinical enamel demineralization. (Eur J Dent 2009;3:127-134)

Hypodontia. Does the Prevalence and Distribution Pattern Differ in Orthodontic Patients?

Objective: The aim of this study was to document the prevalence of hypodontia in the permanent dentition among a group of Turkish sample who sought orthodontic treatment and to compare present results with the specific findings of other populations. The occurrence was evaluated in relation to gender, specific missing teeth, the location and pattern of distribution in the maxillary and mandibular arches and right and left sides.

Materials And Methods: Orthodontic files of 2413 patients (1557 females-mean age: 17.78±5.41 years old and 856 males-mean age:17.02±5.47 years old) which included orthopantomograms, study models, and anamnestic data were examined for evidence of hypodontia.

Results: The prevalence of hypodontia was 7.54% (8.09% for female and 6.54% for male). Hypodontia was found considerably more frequently in the maxilla than in the mandible. Similarity in the distribution of missing teeth between the right and left sides was detected. The most frequently missing teeth were the maxillary lateral incisors, followed by the mandibular and maxillary second premolars. The majority of patients had one or two teeth missing, but seldom three or more.

Conclusions: Present data for hypodontia were within the wide range reported in the literature. The findings of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant were an indication of a great need for orthodontic treatment. By early detection of missing teeth, alternative treatment modalities can be planned and performed with a multidisciplinary team approach. (Eur J Dent 2007;1:167-173)

Facial soft-tissue changes after rapid maxillary expansion analyzed with 3-dimensional stereophotogrammetry: A randomized, controlled clinical trial

OBJECTIVE

 To evaluate three-dimensional (3-D) soft tissue facial changes following rapid maxillary expansion (RME) and to compare these changes with an untreated control group.

MATERIALS AND METHODS

 Patients who need RME as a part of their orthodontic treatment were randomly divided into two groups of 17 patients each. Eligibility criteria included having maxillary transverse deficiency with crossbite, and to be in the normal range according to body mass index. In the first group (mean age  =  13.4 ± 1.2 years), expansion was performed. The second group received no treatment initially and served as untreated control (mean age  =  12.8 ± 1.3 years). Skeletal and soft tissue changes were evaluated using posteroanterior cephalograms and 3-D facial images. The primary outcome of this study was to assess the soft tissue changes. The secondary outcomes were evaluation hard tissue and soft tissue relations. Randomization was done with preprepared random number tables. Blinding was applicable for outcome assessment only. MANOVA, t-test, and correlation analyses were used (P  =  .05).

RESULTS

 In both groups, there was a general trend of increase for the transverse skeletal measurements, but these increases were more limited in the control group. Alar base width was greater in the treatment group (P  =  .002). Pogonion soft tissue point (P  =  .022) was located more posteriorly in the expansion group compared with the control group.

CONCLUSIONS

 Soft tissue changes between groups were similar, except for the alar base, which became wider in the treatment group. Weak correlations were found between the skeletal and soft tissue changes.

Outcomes of different Class II treatments : Comparisons using the American Board of Orthodontics Model Grading System

OBJECTIVE

The aim of this study was to evaluate the clinical outcomes of three different Class II treatment modalities followed by fixed orthodontic therapy, using the American Board of Orthodontics Model Grading System (ABO-MGS).

MATERIALS AND METHODS

As a retrospective study, files of patients treated at postgraduate orthodontic  clinics in different cities in Turkey was randomly selected. From 1684 posttreatment records, 669 patients were divided into three groups: 269 patients treated with extraction of two upper premolars, 198 patients treated with cervical headgear, and 202 patients treated with functional appliances. All the cases were evaluated by one researcher using ABO-MGS. The χ (2), Z test, and multivariate analysis of variance were used for statistical evaluation (p < 0.05).

RESULTS

No significant differences were found among the groups in buccolingual inclination, overjet, occlusal relationship, and root angulation. However, there were significant differences in alignment, marginal ridge height, occlusal contact, interproximal contact measurements, and overall MGS average scores. The mean treatment time between the extraction and functional appliance groups was significantly different (p = 0.017).

CONCLUSION

According to total ABO-MGS scores, headgear treatment had better results than functional appliances. The headgear group had better tooth alignment than the extraction group. Headgear treatment resulted in better occlusal contacts than the functional appliances and had lower average scores for interproximal contact measurements. Functional appliances had the worst average scores for marginal ridge height. Finally, the functional appliance group had the longest treatment times.

Different pulse modes of Er:YAG laser irradiation: effects on bond strength achieved with self-etching primers

OBJECTIVE

The aim of this study was to compare the effects of different pulse modes of Er:YAG laser on shear bond strength (SBS) of orthodontic brackets bonded with self-etching primers (SEP) and phosphoric acid etching.

MATERIALS AND METHODS

A total of 120 human mandibular third molars were randomly assigned to 3 groups of 40 specimens depending on the bonding procedure to be used. The groups were divided into two subgroups according to the pulse mode of the erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation as medium-short pulse (MSP) mode and quantum-square pulse (QSP) mode at 120 mJ, 10 Hz, 1.2 W. In each subgroup, the mesio- or distobuccal tooth surfaces were randomly assigned as experimental or control sides. After surface preparation with different modes of Er:YAG laser on experimental side, whole buccal tooth surfaces were treated with phosphoric acid etching or two different SEPs. Then metallic brackets were bonded with Transbond XT (3 M Unitek, Monrovia, CA, USA) or Kurasper F (Kuraray, Okayama, Japan). SBS values and the amount of adhesive remaining on the tooth after debonding were assessed. One-way analysis of variance (ANOVA) was used to evaluate the changes in mean SBS between groups resulting from laser etching, followed by post hoc test of Tukey.

RESULTS

There were statistically significant differences between the experimental and control sides of all groups (p < 0.05).

CONCLUSION

Laser etching with QSP and MSP modes increases the SBS of metallic brackets and Er:YAG laser irradiation with QSP mode increases the SBS of SEPs.

Reproducibility and reliability of three-dimensional soft tissue landmark identification using three-dimensional stereophotogrammetry

OBJECTIVE

To evaluate the intraexaminer repeatability and interexaminer reproducibility of soft tissue landmarks on three-dimensional (3-D) stereophogrammetric images.

MATERIALS AND METHODS

Thirty-four stereophotogrammetric images were taken and 19 soft tissue points were identified. The images were obtained using the 3-DMD Face (3-DMD TM Ltd, Atlanta, Ga) system. Two examiners marked 34 images manually with a mouse-driven cursor 4 weeks apart. Intraexaminer marking differences were calculated and classified as <0.5 mm, 0.5-1 mm, and >1 mm. Intraclass correlation coefficients were calculated for intraexaminer reliability. A paired-samples t-test was used to evaluate the difference between the examiners. Interexaminer reproducibility was evaluated by kappa analysis. Statistical significance was set at P < .05.

RESULTS

Only one landmark (labiale superior) had an intraexaminer marking difference less than 0.5 mm. Existing landmarks had an intraexaminer difference less than 1 mm, but higher than 0.5 mm. The intraclass correlation coefficients (ICCs) indicated good intraexaminer repeatability for both observers. The ICC range for examiners 1 and 2 was 0.986-1.000 and 0.990-1.000, respectively. Kappa scores showed good interexaminer agreement, especially on the z-axis.

CONCLUSIONS

Except labiale superior, the soft tissue landmarks used in this study were shown to have moderate reproducibility, but the difference between the landmarks was less than 1 mm, and they had clinically acceptable reproducibility.

Natural head position and lower incisor irregularity: Is there a relationship?

OBJECTIVE

The aim of this study was to assess the relationship between dynamic measurements of natural head position (NHP) and lower incisor irregularity to identify potential gender differences.

MATERIALS AND METHODS

A total of 103 plaster models and dynamic NHP measurements were taken from 51 male (mean age: 14.20 ± 2.51 years) and 52 female (mean age: 15.02 ± 2.67 years) subjects. The dynamic NHP data were gathered by using an inclinometer device and a portable data logger. Lower incisor irregularity was measured with Little's irregularity index. The Mann-Whitney U and Kruskal-Wallis rank tests were used at a significance level of p < 0.05. To evaluate the correlation between NHP and lower incisor irregularity, Spearman correlation coefficients (r) were calculated.

RESULTS

There were significant gender differences in the sagittal measurements of NHP (p = 0.031) and incisor irregularity (p = 0.023). A Kruskal-Wallis test revealed no significant difference in NHP measurements between subjects presenting different levels of irregularity. Females displayed no significant correlation between incisor irregularity and any NHP measurement. However, in the males high correlation coefficients between incisor irregularity and sagittal NHP measurements (r = 0.369; p = 0.008) were noted.

CONCLUSION

Significant correlations between lower incisor irregularity and sagittal NHP measurements in males were observed. Females had a more forwardly inclined NHP than males. Moreover, male subjects displayed greater incisor irregularity than female subjects.

Effects of different pre-treatment methods on the shear bond strength of orthodontic brackets to demineralized enamel

OBJECTIVE

To compare the effects of different treatment methods used for the enamel damage, on the shear bond strength (SBS) and fracture mode of orthodontic brackets.

MATERIALS AND METHODS

Freshly-extracted 140 premolars were randomly allocated to seven groups: Group I was considered as the control of other groups. The remaining groups were exposed to demineralization. In group II, brackets were directly bonded to the demineralized enamel surface. CPP-ACP paste (GC Tooth Mousse), fluoride varnish (Bifluorid 12), microabrasion with a mixture prepared with 18% hydrochloric acid and fine pumice powder, microabrasion with an agent (Opalustre) and resin infiltrant (Icon®) were applied in Groups III, IV, V, VI and VII, respectively. The specimens were tested for SBS and bond failures were scored according to the Adhesive Remnant Index (ARI). Analysis of variance and Tukey tests were used to compare the SBS of the groups. ARI scores were compared with G-test. The statistical significance was set at p < 0.05 level.

RESULTS

Statistically significant differences were found among seven groups (F = 191.697; p < 0.001). The SBSs of groups I (mean = 18.8 ± 2.0 MPa) and VII (mean = 19.1 ± 1.4 MPa) were significantly higher than the other groups. No statistically significant difference was found between groups IV (mean = 11.5 ± 1.2 MPa) and V (mean = 12.6 ± 1.5 MPa). The differences in ARI scores of the groups were statistically significant (p < 0.01).

CONCLUSIONS

All demineralization treatment methods improve bonding to demineralized enamel. Resin infiltrant application after demineralization showed similar bond strength values as intact enamel.

Development of the curve of Spee in Class II subdivision malocclusion: a longitudinal study

OBJECTIVE

To compare the depth of curve of Spee (COS) in Class I and II sides of Class II subdivision malocclusion longitudinally and to describe the changes in the COS in relation to dental arch over time.

MATERIALS AND METHOD

The study group comprised 17 subjects exhibiting Class II subdivision malocclusion. The depth of COS, intermolar width, distances from mesial anatomic contact points of the first permanent molars to the contact point of the central incisors in Class I and II sides and arch length in mandible were analysed on digital models in three different time points based on cervical vertebral maturation (T1; mean age: 12.4 years, T2; mean age: 15.1 years, and T3: mean age: 19.1 years). Pearson's correlation coefficients were calculated and linear multiple regression analysis with enter method was carried out.

RESULTS

No significant differences were found in the depth of COS between Class I and II sides in all time periods. The mesiobuccal cusp of the first molar was the deepest part of COS in both sides and in all time periods, with a maximum depth of 2.37±0.83mm in T1 and a minimum depth of 1.91±0.66mm in T3. Between baseline and final follow-up; the depth of COS, ach length, and distance in Class I side decreased significantly. Arch length had a significant correlation with the depth of COS (r = 0.471) in T3.

CONCLUSIONS

As the depth of COS did not differ between either the Class II or I sides, the same mechanics can be used to level the COS in either sides of the mandibular arch.

Relationship between pretreatment case complexity and orthodontic clinical outcomes determined by the American Board of Orthodontics criteria

OBJECTIVE

To evaluate the relationship between pretreatment case complexity and orthodontic treatment outcomes.

MATERIALS AND METHODS

The total sample contained 1693 cases (853 females and 840 males, mean age  =  16.3 years) from the archives of postgraduate orthodontic clinics. The complexity of each case was evaluated using the American Board of Orthodontics (ABO) Discrepancy Index (DI), and orthodontic clinical outcomes were evaluated using the ABO Objective Grading System (OGS). Only one investigator evaluated all cases. Multivariate analysis of variance, correlation analysis, and multiple variable regression analysis were used for statistical evaluation (P < .05 as significant).

RESULTS

The mean total DI score was 16.2, and the mean total OGS score was 18. No significant correlation was found between the total DI and the total OGS scores. However, pretreatment overbite, lateral open bite, crowding, buccal posterior crossbite, and other components affected the total OGS score significantly. The highest percentage of passing OGS values was found for cases of medium-level complexity.

CONCLUSION

This retrospective study of university clinical records showed that the posttreatment clinical outcomes were significantly affected from pretreatment case complexity. Posttreatment alignment was affected significantly from pretreatment buccal posterior crossbite and cephalometric values. Similarly, posttreatment buccolingual inclination was affected from pretreatment anterior open bite, occlusion, and other factors. Occlusal contacts were affected significantly from pretreatment lingual posterior crossbite and other factors. In addition, we determined that posttreatment root angulations were affected significantly from pretreatment crowding values.

Buccal cortical bone thickness at miniscrew placement sites in patients with different vertical skeletal patterns

OBJECTIVE

Cortical bone thickness plays an important role in the primary stability of miniscrews. The purpose of this study was to evaluate the buccal cortical bone thickness in adolescent subjects with different vertical skeletal patterns using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

We examined the CBCT images of 75 patients (30 males, 45 females; mean age 16.5 years; range 15.3-17.7 years) in the present study. High-, average- and low-angle subgroups were generated according to SN-GoMe angle. On volumetric images, we measured the buccal cortical bone thickness from canine to the second molar teeth at heights of 5, 7 and 9 mm from cemento-enamel junction (CEJ). For statistical evaluation, the Wilcoxon signed rank, Kruskal-Wallis and Tukey HSD tests were applied at the p < 0.05 level.

RESULTS

Buccal cortical bone was thickest in the low-angle group. We observed statistically significant differences in the maxilla between the high- and low-angle groups at all levels. In the mandible, we noted statistically significant differences between high-angle and low-angle groups in the canine-first premolar regions at heights of 5 and 7 mm, and in the second premolar-first molar region at 7 mm height from CEJ. Significant differences were also present between the first and second premolars at heights of 7 and 9 mm. Average cortical bone thickness ranged from 1.10-1.37 mm in the maxilla and 1.20-3.28 mm in the mandible for all groups.

CONCLUSION

Buccal cortical bone thickness in adolescents varied in different vertical skeletal patterns and was greater in the mandible than in the maxilla, with the distance increasing from the CEJ to the apex. As the buccal cortical bone is thinner in high-angle patients, patient-specific measures should be taken when performing miniscrew treatment.

Shear bond strength of a self-adhering flowable composite when used for lingual retainer bonding

OBJECTIVE

The goal of this work was to assess the shear bond strength (SBS) and fracture mode of a self-adhering flowable composite when used after thermocycling for lingual retainer bonding.

MATERIALS AND METHODS

A total of 80 human mandibular incisor teeth were categorized into four equal groups: group 1: Vertise™ Flow (VF) without acid etching; group 2: VF with acid etching; group 3: VF with a self-etching bonding agent accompanied by an additional acid etching; group 4: Transbond LR control. Either VF or Transbond LR was applied to the lingual surface of the teeth by packing the material into cylindrical plastic matrices to simulate the lingual retainer bonding area. After all teeth were thermocycled (5000 cycles, 5 and 55 °C), fracture modes were examined under × 20 magnification. The SBS data were assessed via analysis of variance (ANOVA) and Tukey's tests. Fracture modes were analyzed by the χ(2) test at a significance level of 0.05.

RESULTS

Statistically significant differences in SBS values between groups (p < 0.001) were observed. Group 4 exhibited the highest (14.63 ± 1.36 MPa) and group 1 the lowest SBS (2.67 ± 1.35 MPa) values. Statistically significant differences were noted in fracture modes between groups 1, 3, and 4 (p < 0.001). In all the self-adhering flowable composite groups, the adhesive type (tooth-composite interface) fracture occurred more frequently than cohesive and mixed-type fractures.

CONCLUSION

When applied to bond lingual retainers to unetched enamel or with self-etching bonding agent accompanied by an additional acid etching, Vertise™ Flow resulted in a significant decrease in bond strength.

Bone marrow mesenchymal stem cells enhance bone formation in orthodontically expanded maxillae in rats

OBJECTIVE

To transplant bone marrow-derived mesenchymal stem cells (MSCs) into the interpremaxillary suture after rapid maxillary expansion with the aim of increasing new bone formation in the suture.

MATERIALS AND METHODS

Nineteen male Wistar rats were divided into two groups (control, n  =  9; experimental, n  =  10). Both groups were subjected to expansion for 5 days, and 50 cN of force was applied to the maxillary incisors with a helical spring. Pkh67(+) (green fluorescent dye)-labeled MSCs were applied to the interpremaxillary suture after force application into the interpremaxillary suture of rats. Bone formation in the sutural area was histomorphometrically evaluated, including the amount of new bone formation (µm(2)), number of osteoblasts, number of osteoclasts, and number of vessels. Mann-Whitney U-test was used for statistical evaluation at the P < .05 level.

RESULTS

After 10 days of retention, Pkh67(+) can be detected in suture mostly in the injection site under fluorescence microscope. Histomorphometric analysis revealed that a single local injection of MSCs into the midpalatal suture increased the new bone formation in the suture by increasing the number of osteoblasts and new vessel formation, compared with controls injected with phosphate-buffered saline.

CONCLUSIONS

This preclinical study might provide foundations for the underlying potential clinical use of MSCs after maxillary expansion. Given the fact that MSCs are currently in use in clinical trials, this approach might be a feasible treatment strategy to accelerate new bone tissue formation in midpalatal suture and to shorten the treatment period for patients undergoing maxillary expansion reinforcement.

Longitudinal evaluation of dental arch asymmetry in Class II subdivision malocclusion with 3-dimensional digital models

INTRODUCTION

Class II subdivision malocclusions with their asymmetric occlusal relationships often pose treatment difficulties. The aim of this study was to evaluate the longitudinal changes of dental arch asymmetry in untreated subjects with Class II subdivision malocclusion.

METHODS

From 706 files from the University of Michigan Growth Study, longitudinal records of 17 untreated subjects with Class II subdivision malocclusion were included this study. Dental arch changes at 3 consecutive longitudinal intervals, defined by the cervical vertebral maturation method, were analyzed on digital dental models. The average ages of the subjects were 12.4, 15.1, and 19.1 years at the 3 time periods, respectively. Maxillary and mandibular reference lines were constructed and used for the intra-arch asymmetry measurements. The Friedman test and analysis of variance with repeated measures were used to determine dental arch asymmetries at the P <0.05 level.

RESULTS

All subjects were found to have a type 1 Class II subdivision malocclusion characterized by distal positioning of the mandibular first molar on the Class II side. No statistically significant intra-arch asymmetry changes were found for the maxillary and mandibular dental arches in any time period. Between the baseline and the final follow-up, the data indicated decreases in maxillary and mandibular intercanine arch widths and arch lengths symmetrically.

CONCLUSIONS

The results of this study indicate that the dental arch asymmetry in patients with Class II subdivision malocclusions did not improve or worsen with growth.

OPG and RANKL levels around miniscrew implants during orthodontic tooth movement

INTRODUCTION

The aim of this study was to determine the peri-miniscrew implant crevicular fluid receptor activator of nuclear factor-кB ligand (RANKL) and osteoprotegerin (OPG) levels around loaded and unloaded miniscrew implants at different time intervals.

METHODS

Twenty loaded and 16 unloaded miniscrew implants were included in this study. All miniscrew implants were placed bilaterally between the maxillary second premolars and first molars as anchorage units for canine distalization. Peri-miniscrew implant crevicular fluid was taken from the mesiobuccal aspects of the loaded and unloaded miniscrew implants before loading; at 24, 48, and 168 hours; and on day 30 after force application. Enzyme-linked immunosorbent assay kits were used to determine RANKL and OPG levels in the peri-miniscrew implant crevicular fluid samples. Wilcoxon, Mann-Whitney U, and Spearman correlation tests were used for statistical evaluations at the P <0.05 level.

RESULTS

Although the total amount of OPG was not different between the groups, the total amount of RANKL was significantly elevated in the loaded miniscrew implant group (P <0.05) at all time periods. Peri-miniscrew implant crevicular fluid volume was the highest at 48 hours in the loaded group. Also, the OPG/RANKL ratio in the peri-miniscrew implant crevicular fluid was significantly decreased in the loaded miniscrew implant group.

CONCLUSIONS

The OPG and RANKL levels vary around loaded and unloaded miniscrew implants as a result of force application.

Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography

Objective

To evaluate lower incisor position and bony support between patients with Class II average- and high-angle malocclusions and compare with the patients presenting Class I malocclusions.

Methods

CBCT records of 79 patients were divided into 2 groups according to sagittal jaw relationships: Class I and II. Each group was further divided into average- and high-angle subgroups. Six angular and 6 linear measurements were performed. Independent samples t-test, Kruskal-Wallis, and Dunn post-hoc tests were performed for statistical comparisons.

Results

Labial alveolar bone thickness was significantly higher in Class I group compared to Class II group (p = 0.003). Lingual alveolar bone angle (p = 0.004), lower incisor protrusion (p = 0.007) and proclination (p = 0.046) were greatest in Class II average-angle patients. Spongious bone was thinner (p = 0.016) and root apex was closer to the labial cortex in high-angle subgroups when compared to the Class II average-angle subgroup (p = 0.004).

Conclusions

Mandibular anterior bony support and lower incisor position were different between average- and high-angle Class II patients. Clinicians should be aware that the range of lower incisor movement in high-angle Class II patients is limited compared to average- angle Class II patients.

Graduate orthodontic education in Turkey: the residents' perspective

The aim of the present study was to explore residents' perceptions of their educational and clinical treatment experiences including the number of clinical cases undertaken, patient completion rates, techniques utilised and the scientific component of Turkish graduate orthodontic programmes. Residents recorded in the list of Turkish Orthodontic Society were sent an e-mail to participate in a survey containing 46 multiple-choice questions and ten one-line answers. An e-mail with a personalised online link was sent to a total of 227 residents throughout the Turkey. Data were categorised, and basic statistics including chi-square comparative analyses were performed. A total of 136 (response rate of 59.91%) residents completed the survey. The majority of residents (58.08%) were either 'very satisfied' or 'satisfied' with their programme. Respondents said they have just the right amount of formal didactic teaching sessions or dedicated and protected academic time. Most residents (69.11%) indicated their programme offers training in numerous philosophies; whilst 97.79% said they have sufficient clinically based training and 42.64% said they have sufficient research-based training. Overall, residents in the Turkey are satisfied with their orthodontic programme. They receive comprehensive training with the opportunity to start and complete a significant number of their patients. The survey findings suggest that orthodontic programmes in Turkey are deficient in providing care to underserviced populations and disabled patients. Programmes could improve the opportunity for residents to treat patients requiring interdisciplinary treatment.

Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography

Objective

To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT).

Methods

The CBCT records of 20 subjects (9 boys, mean age: 13.97 ± 1.17 years; 11 girls, mean age: 13.53 ± 2.12 year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05.

Results

The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively.

Conclusions

RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.

Mandibular anterior bony support and incisor crowding: Is there a relationship?

INTRODUCTION

The aim of this study was to test the null hypothesis that increased irregularity of the mandibular incisors is associated with a reduction in the alveolar support on cone-beam computed tomographic sections.

METHODS

From a sample of 1100 digital volumetric tomographs, 125 tomographs of subjects with Class I malocclusion (mean age, 21.6 ± 4.8 years) were selected for this study. An irregularity index was used to categorize these tomographs as having mild, moderate, or severe crowding. All tomographs were taken by using an iCAT (Imaging Sciences International, Hatfield, Pa) imaging device. The following parameters were measured on the sections corresponding to the 4 mandibular incisors with the iCAT software: height, thickness, and area of the entire symphysis; height, thickness, and area of the cancellous bone of the symphysis; and distance between the vestibular and lingual cortices. For the statistical evaluation, independent samples t test, analysis of variance, and the Tukey HSD test were used at an alpha level 0.05. The Pearson correlation coefficient and a simple linear regression were calculated to determine the relationship between mandibular anterior bony support and incisor crowding.

RESULTS

Almost all mandibular anterior bone measurements were greater in the male subjects than in the female subjects (height of the mandibular symphysis, P <0.001; cancellous bone height, P <0.001). Female subjects with mild crowding had higher values for cancellous bone height (P = 0.025) and vestibular cancellous bone thickness (P = 0.004) than did those with severe crowding. However, no differences were detected in the male subjects. Additionally, significant correlations were determined between incisor crowding and thickness of the mandibular symphysis, cancellous bone thickness, and the vestibular part of cancellous bone thickness in female subjects.

CONCLUSIONS

Significant relationships were found between the measures of mandibular incisor crowding and basal bone dimensions in female subjects. Except for the vestibular part of cancellous bone thickness, all mandibular incisor bone measurements were greater in the male subjects than in the female subjects.

Measurements from conventional, digital and CT-derived cephalograms: a comparative study

OBJECTIVE

The purpose of this retrospective radiographic study was to determine the reliability and reproducibility of skeletal and dental measurements of lateral cephalograms created from a computerised tomography (CT) scan compared with conventional and digital lateral cephalograms.

METHODS

CT and conventional lateral cephalograms of the same patients were obtained from university archives. The lateral cephalometric radiographs of 30 patients were manually traced. The radiographs were subsequently scanned and traced using Dolphin Imaging software version 11 (Dolphin Imaging, Chatsworth, CA, USA). The CT-created lateral cephalograms were also traced using the same software. Sixteen (10 angular and 6 linear) measurements were performed. Cephalometric measurements obtained from conventional, digital and CT-created cephalograms were statistically compared using repeated measures analysis of variance (ANOVA). Statistical significance was set at the p < 0.05 level of confidence.

RESULTS

The intra-rater reliability test for each method showed high values (r > 0.90) except for mandibular length which had a correlation of 0.82 for the CT-created cephalogram. Five measurements (N-A-Pog, N-S, ANS-PNS, Co-ANS and CoGn) were found to be significantly different between the CT-created and conventional cephalograms and three measurements (SNB, ANB, and/1-MP) were found to be significantly different between the CT-created and digital cephalograms.

CONCLUSIONS

There are statistically-significant differences in measurements produced using a traditional manual analysis, a direct digital analysis or a 3D CT-derived cephalometric analysis of orthodontic patients. These differences are, on average, small but because of individual variation, may be of considerable clinical significance in some patients.

Comparison of craniofacial morphology, head posture and hyoid bone position with different breathing patterns

OBJECTIVES

The aim of this study was to evaluate differences in craniofacial morphology, head posture and hyoid bone position between mouth breathing (MB) and nasal breathing (NB) patients.

METHODS

Mouth breathing patients comprised 34 skeletal Class I subjects with a mean age of 12.8 ± 1.5 years (range: 12.0-15.2 years). Thirty-two subjects with skeletal Class I relationship were included in the NB group (mean 13.5 ± 1.3 years; range: 12.2-14.8 years). Twenty-seven measurements (15 angular and 12 linear) were used for the craniofacial analysis. Additionally, 12 measurements were evaluated for head posture (eight measurements) and hyoid bone position (four measurements). Student's t-test was used for the statistical analysis. Probability values <0.05 were accepted as significant.

RESULTS

Statistical comparisons showed that sagittal measurements including SNA (p < 0.01), ANB (p < 0.01), A to N perp (p < 0.05), convexity (p < 0.05), IMPA (p < 0.05) and overbite (p < 0.05) measurements were found to be lower in MB patients compared to NB. Vertical measurements including SN-MP (p < 0.01) and PP-GoGn (p < 0.01), S-N (p <0.05) and anterior facial height (p < 0.05) were significantly higher in MB patients, while the odontoid proses and palatal plane angle (OPT-PP) was greater and true vertical line and palatal plane angle (Vert-PP) was smaller in MB patients compared to NB group (p < 0.05 for both). No statistically significant differences were found regarding the hyoid bone position between both groups.

CONCLUSIONS

The maxilla was more retrognathic in MB patients. Additionally, the palatal plane had a posterior rotation in MB patients. However, no significant differences were found in the hyoid bone position between MB and NB patients.

Comparison of three different orthodontic wires for bonded lingual retainer fabrication

OBJECTIVE

We evaluated the detachment force, amount of deformation, fracture mode, and pull-out force of 3 different wires used for bonded lingual retainer fabrication.

METHODS

We tested 0.0215-inch five-stranded wire (PentaOne, Masel; group I), 0.016 × 0.022-inch dead-soft eight-braided wire (Bond-A-Braid, Reliance; group II), and 0.0195-inch dead-soft coaxial wire (Respond, Ormco; group III). To test detachment force, deformation, and fracture mode, we embedded 94 lower incisor teeth in acrylic blocks in pairs. Retainer wires were bonded to the teeth and vertically directed force was applied to the wire. To test pull-out force, wires were embedded in composite that was placed in a hole at the center of an acrylic block. Tensile force was applied along the long axis of the wire.

RESULTS

Detachment force and mode of fracture were not different between groups. Deformation was significantly higher in groups II and III than in group I (p < 0.001). Mean pull-out force was significantly higher for group I compared to groups II and III (p < 0.001).

CONCLUSIONS

Detachment force and fracture mode were similar for all wires, but greater deformations were seen in dead-soft wires. Wire pull-out force was significantly higher for five-stranded coaxial wire than for the other wires tested. Five-stranded coaxial wires are suggested for use in bonded lingual retainers.

Effects of demineralizaton-inhibition procedures on the bond strength of brackets bonded to demineralized enamel surface

Objective

To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces.

Methods

Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration (ICON®, DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined after the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests.

Results

Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001).

Conclusions

Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.

Dehiscence and fenestration in patients with different vertical growth patterns assessed with cone-beam computed tomography

OBJECTIVE

To test the null hypothesis that the presence of alveolar defects (dehiscence and fenestration) was not different among patients with different vertical growth patterns.

MATERIALS AND METHODS

A total of 1872 teeth in 26 hyper-divergent (mean age: 24.4 ± 4.8 years), 27 hypo-divergent (mean age: 25.1 ± 4.5 years), and 25 normo-divergent (mean age: 23.6 ± 4.1 years) patients with no previous orthodontic treatment were evaluated using cone-beam computed tomography. Axial and cross-sectional views were evaluated with regard to whether dehiscence and/or fenestration on buccal and lingual surfaces existed or not. For statistical analysis, the Pearson chi-square test was used at a P < .05 significance level.

RESULTS

According to the statistical analysis, the hypo-divergent group (6.56%) had lower dehiscence prevalence than the hyper-divergent (8.35%) and normo-divergent (8.18%) groups (P  =  .004). Higher prevalences of dehiscence and fenestration were found on buccal sides in all vertical growth patterns. While fenestration was a common finding for the maxillary alveolar region, dehiscence was a common finding in the mandible in all groups.

CONCLUSION

The null hypothesis was rejected. Although the prevalence of fenestrations was not different, significant differences for dehiscences were found in patients with different vertical growth patterns.

Dehiscence and fenestration in skeletal Class I, II, and III malocclusions assessed with cone-beam computed tomography

OBJECTIVE

To test the null hypothesis that the presence of dehiscence and fenestration was not different among patients with skeletal Class I, II, and III malocclusions.

MATERIALS AND METHODS

In this retrospective study, a total of 123 cone-beam computed tomography (CBCT) images were obtained with an iCAT scanner (Imaging Sciences International, Hatfield, Pa). Patients with normal vertical patterns were classified according to dental malocclusion and ANB angle. Class I comprised 41 patients-21 girls and 20 boys (mean age, 22.4 ± 4.5 years); Class II comprised 42 patients-22 girls and 20 boys (mean age, 21.5 ± 4.2 years); and Class III comprised 40 subjects-22 girls and 18 boys (mean age, 22.1 ± 4.5 years). A total of 3444 teeth were evaluated. Analysis of variance and Tukey's test were used for statistical comparisons at the P < .05 level.

RESULTS

Statistical analysis indicated that the Class II group had a greater prevalence of fenestration than the other groups (P < .001). No difference was found in the prevalence of dehiscence among the three groups. Although fenestration had greater prevalence in the maxilla, more dehiscence was found in the mandible for all groups. In Class I, alveolar defects (dehiscence, fenestration) were matched relatively in both jaws. Furthermore, Class II and Class III subjects had more alveolar defects (41.11% and 45.02%, respectively) in the mandible. Dehiscences were seen with greater frequency in the mandibular incisors of all groups.

CONCLUSION

The null hypothesis was rejected. Significant differences in the presence of fenestration were found among subjects with skeletal Class I, Class II, and Class III malocclusions. Fenestrations had greater prevalence in the maxilla, but more dehiscences were found in the mandible.

Effect of a self-etching adhesive containing an antibacterial monomer on clinical periodontal parameters and subgingival microbiologic composition in orthodontic patients

INTRODUCTION

The aims of this study were to evaluate the effect of a self-etching adhesive system containing an antibacterial monomer on periodontal health and subgingival microbiologic composition in orthodontic patients and to compare it with a conventional adhesive system.

METHODS

A split-mouth design was chosen, and 15 patients were included in the study. Brackets in contralateral quadrants were bonded with either a conventional adhesive system (control) or a self-etching adhesive system that contained an antibacterial monomer. Clinical periodontal parameters including plaque index, gingival index, probing depths, and bleeding on probing were determined. Subgingival plaque samples were collected before bracket placement (T0) and at the 6-month follow-up (T1). The real-time TaqMan polymerase chain reaction assay was used to determine the subgingival counts of Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Campylobacter rectus. For clinical periodontal parameters, analysis of covariance (ANCOVA) and, for bacterial counts, Wilcoxon tests were used for statistical comparisons at the P <0.05 level.

RESULTS

Clinical periodontal parameters were not changed, and they were not different between the groups from T0 to T1. T forsythensis and F nucleatum increased during the treatment period in both groups (P <0.05). The majority of the bacteria were T nucleatum at T0 and T1 in both groups. Changes in bacterial load from T0 to T1 were not different between groups except for T forsythensis and F nucleatum (P <0.05).

CONCLUSIONS

The use of an antibacterial monomer did not have an additional positive effect on clinical periodontal parameters. When used in bonding orthodontic brackets, the antibacterial monomer failed to reduce periodontopathogenic bacteria when compared with the conventional adhesive system during a 6-month treatment period.

Mandibular asymmetry in unilateral and bilateral posterior crossbite patients using cone-beam computed tomography

OBJECTIVE

To test the hypotheses that (1) there is no difference in mandibular asymmetry between the crossbite and normal side in a unilateral crossbite group (UCG) and between the right and left sides in a bilateral crossbite group (BCG) and a control group (CG); and (2) there is no significant difference in mandibular asymmetry among crossbite groups and control group.

MATERIALS AND METHODS

The cone-beam computed tomography scans of three groups were studied: (1) 15 patients (6 male, 9 female; mean age: 13.51 ± 2.03 years) with unilateral posterior crossbite; (2) 15 patients (8 male, 7 female; mean age: 13.36 ± 2.12 years) with bilateral posterior crossbite; and (3) 15 patients (8 male, 7 female; mean age: 13.46 ± 1.53 years) as a control group. Fourteen parameters (eight linear, three surface, and three volumetric) were measured. Side comparisons were analyzed with paired samples t-test, and for the intergroup comparison, analysis of variance (ANOVA) and Tukey tests were used at the P < .05 level.

RESULTS

According to side comparisons, no statistically significant difference was found in the UCG. There were statistically significant differences in hemimandibular (P = .008) and ramal (P = .004) volumes for the BCG and in ramal height (P = .024) and body length (P = .021) for the CG. Intergroup comparisons revealed significant differences in hemimandibular (P = .002) and body volume (P < .001) for the normal side of the UCG and left sides of the other groups, and in angular unit length (P = .025) and condylar width (P = .007) for the crossbite side of the UCG and the right sides of the other groups.

CONCLUSIONS

Contrary to UCG, CG and BCG were found to have side-specific asymmetry. Skeletal components of the mandible have significant asymmetry among the crossbite groups and the CG.

Aripiprazole in children and adolescents with conduct disorder: a single-center, open-label study

OBJECTIVE

The aim of this study was to determine the eff ectiveness and safety of aripiprazole in children and adolescents with both attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD).

METHODS

20 children and adolescents, ranging in age from 6–16 years, participated in a singlecenter, open-label study (19 to completion). We began treating patients with 2.5 mg of aripiprazole in an open-label fashion for 8 weeks. Outcome measures included the Turgay DSM-IVbased child and adolescent behavior disorders screening and rating scale (T-DSM-IV), the clinical global impressions-severity and improvement scales (CGI-S and CGI-I), the child behavior checklist (CBCL), the teachers report form (TRF) and the extrapyramidal symptom rating scale (ESRS), along with laboratory assessments.

RESULTS

The mean daily dosage of aripiprazole at the end of 8 weeks was 8.55 mg (SD = 1.73), with a maximum dosage of 10 mg. Based on the global improvement subscale of the CGI, we classified 12 of 19 patients (63.1 %) as responders (very much or much improved). We observed significant improvements after aripiprazole treatment with regard to inattention, hyperactivity/impulsivity, ODD, and CD subscales of the T-DSMIV (parent, teacher and clinician forms). We also observed significant improvements on many of the CBCL and TRF subscales (e. g., attention problems as well as delinquent and aggressive behavior). The participants tolerated aripiprazole, and no patient was excluded from the study because of adverse drug events.

CONCLUSION

Aripiprazole is an eff ective and well-tolerated treatment for ADHD and CD symptoms; however, additional studies (specifically, placebo-controlled and double-blind studies) are needed to better defi ne the clinical use of aripiprazole in children and adolescents with ADHD-CD.

Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces

OBJECTIVES

The aims of the present study were (1) to determine ethnic differences in craniofacial dimensions between Turkish and Saudi populations and (2) to identify possible gender differences between males and females, based on a sample of untreated young adult subjects with normal occlusions and well-balanced faces.

METHODS

In total, 163 cephalometric radiographs were traced and evaluated to compare untreated adults of Turkish and Saudi ethnicity. The Turkish group comprised 86 subjects; 45 females and 41 males. The Saudi group comprised 77 subjects; 39 females and 38 males. For statistical evaluation, an independent-samples t-test was performed.

RESULTS

The Turkish sample had a more retrognathic maxilla and mandible (p < 0.001 for SNA and SNB) and a more vertical direction of facial development (p < 0.001), with Turkish males having more retrusive lips (p < 0.001). Distinctive ethnic differences were found in craniofacial structures between Turkish and Saudi young adults.

CONCLUSIONS

It is appropriate to consider these aesthetic differences when a Turkish or a Saudi patient is being evaluated during routine diagnosis and treatment planning.

Evaluation of root resorption following rapid maxillary expansion using cone-beam computed tomography

OBJECTIVE

To evaluate the root resorption after rapid maxillary expansion (RME) via cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

Records of 25 patients who had undergone RME with tooth-borne banded expander were obtained from the archive of the orthodontic department. CBCT data were reconstructed with surface and volume rendering, and the volumetric images were manipulated to display the root surfaces from various orientations. On these three-dimensional images, permanent first molars and first and second premolars were segmented, and their roots were isolated. Volumes of roots were calculated. The difference between pre-expansion and postexpansion root volumes was statistically evaluated with a paired-samples t-test. Also, the percentage of root volume loss was calculated for each root and statistically compared with each other with one-way analysis of variance at the P < .05 level.

RESULTS

The difference between the pre-expansion and postexpansion root volumes was statistically significant for all roots investigated. Maximum volume decrease was observed for the mesiobuccal root of first molar teeth (18.60 mm(3)). It was determined that the distobuccal root of first molar teeth was less affected from the expansion procedure (9.47 mm(3)). No statistically significant difference was found for the percentage of root volume loss.

CONCLUSION

Following RME treatment, significant root volume loss was observed for all investigated posterior teeth. However, the percentage of volume loss was not statistically different among roots.

Do enamel microabrasion and casein phosphopeptide-amorphous calcium phosphate affect shear bond strength of orthodontic brackets bonded to a demineralized enamel surface?

Objective:

To evaluate and compare the effects of enamel microabrasion, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and their combination on the shear bond strength (SBS) of orthodontic brackets bonded to demineralized enamel surface.

Materials and Methods:

One hundred human first premolar teeth were randomly allocated to one of five groups. Group I was considered as the control of other groups. For the remaining groups, demineralization was performed via solutions. In group II, brackets were directly bonded to the demineralized enamel surface. CPP-ACP was applied in group III, microabrasion was performed in group IV, and both microabrasion and CPP-ACP application were performed in group V. The specimens were tested for SBS. Bond failures were scored according to the Adhesive Remnant Index (ARI). Analysis of variance and Tukey tests were used to compare the SBS of the groups. ARI scores of the groups were evaluated with a G-test. The statistical significance was set at P &lt;. 05 level.

Results:

Statistically significant difference was found among the five investigated groups (F  =  111.870; P &lt; .001). The SBS of groups II and IV were significantly lower than the other groups. No statistically significant difference was found among groups I (control; mean 24.1 ± 4.1 MPa), III (mean 22.0 ± 3.6 MPa), and V (mean 24.3 ± 1.9 MPa). Microabrasion and combination with CPP-ACP showed higher SBS compared to the control group. The differences between ARI scores of the groups were statistically significant (P &lt; .001).

Conclusion:

CPP-ACP pretreatment, microabrasion of the enamel, and the combination of these two methods improve the bonding to demineralized enamel.

Cone-beam computed tomography evaluation of relationship between tongue volume and lower incisor irregularity

The aim of this study was to evaluate the relationship between the tongue volume and lower incisor irregularity, using cone-beam computed tomography (CBCT), and to identify the possible gender differences. CBCT images of 60 patients between 16 and 36 years of age were selected from 1400 sets of images in the database. Tomography was carried out using iCAT® (Imaging Sciences International, Hatfield, Pennsylvania, USA) and segmentation was carried out by using Mimics 10.1 software (Materialise NV, Leuven, Belgium). The tongue volume was calculated by using the volume of the voxels from the scan and the number of voxels selected for a given mask. Lower incisor crowding was measured with the Little's irregularity index and divided into three groups: mild, moderate, and severe. Independent samples t-test, analysis of variance (ANOVA), and Tukey test were used at P < 0.05 level. Pearson correlation coefficients and linear regression model were calculated to determine the correlation between tongue volume and incisor irregularity. No significant gender dimorphism was found for the tongue volume (females: 28.13 ± 8.54 cm(3) and males: 31.02 ± 9.75 cm(3)). According to ANOVA, there was statistically significant difference in the tongue volume measurements among subjects with different levels of irregularity. Tukey analysis indicated that mild irregularity group (33.97 cm(3)) showed higher values for tongue volume than severe irregularity group (26.60 cm(3); P = 0.025). The relationship between incisor irregularity and tongue volume was evaluated for both genders and significant inverse correlation (r = -0.429; P = 0.029) was determined between lower incisor irregularity and tongue volume in males. In female group, no significant correlation was determined between tongue volume and incisor irregularity.

Effect of antibacterial monomer-containing adhesive on enamel demineralization around orthodontic brackets: an in-vivo study

INTRODUCTION

The aims of this study were to evaluate the effect of an antibacterial monomer-containing self-etching adhesive in reducing enamel demineralization around orthodontic brackets in vivo and to compare it with the conventional adhesive system quantitatively.

METHODS

Fourteen orthodontic patients were randomly divided into 2 equal groups; they received brackets fitted to all their teeth, bonded with either Clearfil Protect Bond (Kuraray Medical, Okayama, Japan) (experimental group) or Transbond XT (3M Unitek, Monrovia, Calif) (control group). Block randomization to obtain equal numbers in each group was used. After 30 days, all first premolars were extracted with orthodontic indications and longitudinally sectioned. Demineralization was assessed by cross-sectional microhardness. Determinations were made at the bracket edge cementing limits and at occlusal and cervical points 100 and 200 μm away from the edge. In all of these positions, 6 indentations were made at depths of 10 to 90 μm from the enamel surface. Analysis of variance (ANOVA) and the Tukey post-hoc test were used. The statistical significance level was set at P <0.05.

RESULTS

ANOVA showed statistically significant differences for adhesive type, position, depth, and their interactions (P <0.05). The multiple comparison test showed that the antibacterial monomer-containing adhesive was significantly more efficient than the conventional adhesive system, reducing enamel demineralization in almost all evaluations (P <0.05).

CONCLUSIONS

The results indicated that using antibacterial monomer-containing adhesive for bonding orthodontic brackets successfully inhibited caries in vivo. This cariostatic effect was localized at the area around the brackets and was significant after 30 days.

Orofacial airway dimensions in subjects with Class I malocclusion and different growth patterns

OBJECTIVE

To test the null hypotheses that there are no significant differences in craniofacial structures and orofacial airway dimensions in subjects with Class I malocclusion and different growth patterns.

MATERIALS AND METHODS

Lateral cephalometric radiographs of 31 low angle (mean age, 14.0 ± 2.0 years; range, 10.3-16.5 years), 40 high angle (mean age, 12.7 ± 1.6 years; range, 10.1-16.2 years), and 33 normal growth (mean age, 13.9 ± 1.3 years; range, 11.2-16.8 years) subjects with Class I malocclusion were examined. In total, 34 measurements (27 craniofacial and 7 orofacial airways) were evaluated. Groups were constituted according to the SN-MP angle. Group differences were analyzed with analysis of variance (ANOVA) and the Tukey test, at the P < .05 level.

RESULTS

According to ANOVA, only 5 of the 27 craniofacial measurements showed no statistically significant differences among different growth patterns. For orofacial airway measurements, statistically significant differences were found in nasopharyngeal airway space (P < .01), palatal tongue space (P < .05), upper posterior airway space (PAS) (P < .05), and tongue gap (P < .001). No statistically significant orofacial airway differences were determined between low angle and normal growth subjects. High angle subjects had a larger tongue gap than those with normal and low angles (P < .01). Additionally, nasopharyngeal airway space (P < .01) and upper PAS (P < .05) measurements were larger and palatal tongue space (P < .05) was narrower in low angle than in high angle subjects.

CONCLUSIONS

The null hypotheses were rejected. Significant differences in craniofacial morphology and orofacial airway dimensions of Class I subjects with different growth patterns were identified.

Do fluoride and casein phosphopeptide-amorphous calcium phosphate affect shear bond strength of orthodontic brackets bonded to a demineralized enamel surface?

OBJECTIVE

To compare the effects of fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing topical agents on shear bond strength (SBS) and fracture mode of orthodontic brackets bonded to demineralized enamel.

MATERIALS AND METHODS

Eighty freshly extracted human premolar teeth were randomly divided into four equal groups. The first group was the control, and no pretreatment was performed on this group. In the remaining three groups, demineralization process was performed and teeth were stored in artificial saliva. In group II, bonding was performed after demineralization. Pretreatment with fluoride and CPP-ACP gels was performed in groups III and IV, respectively. Brackets were bonded using a conventional system. The SBS of these brackets was measured and recorded in MPa. Adhesive remnant index (ARI) scores were determined after the brackets failed. Data were analyzed with analysis of variance (ANOVA), Tukey, and G-tests at the P < .05 level.

RESULTS

ANOVA comparison of four groups revealed statistically significant differences. No significant differences were found between control and CPP-ACP-treated groups. However, lower SBS values were recorded for group II (6.6 ± 3.9 MPa) and group III (17.1 ± 2.9 MPa). ARI scores were significantly different among the four groups (P < .001). No enamel detachment was found in the control group, and enamel detachment measured 75% for group II.

CONCLUSIONS

Fluoride and CPP-ACP gel applications showed higher debonding forces compared to bonding in untreated demineralized samples. CPP-ACP pretreatment resulted in comparable SBS values compared with the control group.

Rapid maxillary expansion effects on dynamic measurement of natural head position

OBJECTIVE

To identify the effect of rapid maxillary expansion (RME) procedure on dynamic measurement of natural head position (NHP).

MATERIALS AND METHODS

The treatment group comprised 23 patients, 12 girls and 11 boys (mean age: 10.1 ± 1.1 years), and the control group comprised 15 subjects, 8 girls and 7 boys (mean age: 9.7 ± 1.4 years). The test subjects underwent RME treatment using full cap acrylic device, and the mean amount of expansion was 5.48 mm. An inclinometer and a portable data logger were used to collect the NHP data. Intragroup changes were evaluated by using nonparametric Wilcoxon test, and intergroup changes were analyzed with Mann-Whitney U-test. P values less than .05 were considered statistically significant.

RESULTS

The mean difference between initial and final NHP was 0.31°, and this difference was not statistically significant. Also, there were no statistically significant differences between the RME and control groups before and after treatment.

CONCLUSION

Treatment with the RME procedure showed no statistically significant effects on dynamic measurement of NHP when compared with initial values or untreated control.