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ABSTRACT: To compare and analyse the effects of activator and Forsus FRD EZ appliances in the treatment of skeletal Class II division I malocclusion.
Lateral cephalograms and hand-wrist radiographs were collected from 24 Class II division I growing patients (14 females, 10 males). The patients were randomly divided into two equal groups and either treated with an activator appliance (Mean age 12.67 +/- 1.24 years) or with a Forsus FRD EZ appliance (Mean age 12.31 +/- 1.09 years). Pretreatment and posttreatment cephalometric radiographs were obtained, traced, superimposed and data analysed using paired t-tests and the Wilcoxon signed rank test.
The results demonstrated that the Forsus FRD EZ effectively corrected the Class II malocclusion, but the changes were mainly dentoalveolar. The Forsus FRD EZ appliance induced a clockwise rotation of the occlusal plane without significant alteration in the vertical facial dimension. Skeletally, maxillary growth was restricted and pogonion moved forward which improved the profile.
The Forsus FRD EZ appliance may be an effective dentoalveolar treatment method to manage a skeletal imbalance and improve the profile in growing patients.
Australian orthodontic journal 11/2011; 27(2):110-6. · 0.25 Impact Factor
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ABSTRACT: After fixed appliance treatment, one concern is to restore the enamel surface as closely to its original state as possible. A variety of cleanup processes are available, but all are time-consuming and carry some risk of enamel damage. The purpose of this study was to examine tooth surfaces restored with different cleanup protocols.
Ninety-nine premolars extracted for orthodontic purposes were used. The 2 materials tested were Sof-Lex disks (3 M ESPE AG, Seefeld, Germany) and fiberglass burs (Stain Buster, Carbotech, Ganges, France). These were used alone and in combination with high- and low-speed handpieces, with which they were also compared. Eight groups were ultimately tested. All groups were compared with intact enamel, which served as the control group. From each group, 10 samples were examined with profilometry and 1 with scanning electron microscopy. Adhesive remnant index scores were recorded to ensure equal distributions for the groups. The time required for the cleanup processes and profilometry test results were also recorded.
The fastest procedure was performed with high-speed handpieces, followed by low-speed handpieces. Sof-Lex disks and fiberglass burs required more time than carbide burs but did not result in significantly longer times for the cleanup procedure when combined with tungsten carbide-driven low- or high-speed handpieces or when used alone with low-speed handpieces. Although Sof-Lex disks were the most successful for restoring the enamel, it was not necessary to restore the enamel to its original surface condition. Generally, all enamel surface-roughness parameters were increased when compared with the values of intact enamel. The average roughness and maximum roughness depth measurements with Sof-Lex disks were statistically similar to measurements of intact enamel.
No cleanup procedure used in this study restored the enamel to its original roughness. The most successful was Sof-Lex disks, which restored the enamel closer to its original roughness.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 03/2010; 137(3):368-74. · 1.33 Impact Factor
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ABSTRACT: The aim of this study was to investigate the shear bond strength of bonding to enamel following laser etching with the Er:YAG or Er,Cr:YSGG laser using different irradiation distances. Of 99 extracted human premolar teeth, 90 were divided equally into nine groups. In the control group (group A) the teeth were etched with 38% phosphoric acid. In the laser groups (groups B-I) the enamel surface of the teeth was laser-irradiated, groups B-E with the Er:YAG laser and groups F-I with the Er,Cr:YSGG laser at distances of 1, 2, 4 and 6 mm, respectively. The shear bond strengths were tested using a universal testing machine. The shear bond strengths associated with the Er:YAG laser at 4 and 6 mm and the Er,Cr:YSGG laser at 2, 4 and 6 mm were significantly less than the strengths obtained with the other irradiation distances (p<0.001). The Er:YAG laser at 1 mm and the Er,Cr:YSGG laser at 1 mm etched enamel in the same manner (p>0.05). This finding was confirmed by scanning electron microscopy examination. Irradiation distance did influence the strength of adhesion to enamel. The mean shear bond strengths and enamel surface etching obtained with the Er:YAG laser at 1 and 2 mm and the Er,Cr:YSGG laser at 1 mm were comparable to that obtained with acid etching.
Lasers in Medical Science 02/2010; 26(2):149-56. · 2.00 Impact Factor
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ABSTRACT: The purpose of the study was to determine if the irradiation of enamel with laser of different output powers might be viable alternatives to acid etching for the bonding of resin luting agents. Seventy-seven maxillary central incisors, extracted for periodontal reasons, were used. The enamel was etched with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser operated at one of six power outputs (0.5 W, 0.75 W, 1 W, 1.5 W, 1.75 W and 2 W) or with 38% phosphoric acid. Seventy teeth were used for the bond strength experiments, and the remaining seven (one specimen for each group) were used for scanning electron microscopy (SEM) to determine the topography and morphology of the treated enamel surface. The acid-etched group yielded the highest mean of shear bond strength (13.5 ± 2.8 MPa). The means of the shear bond strength for the teeth irradiated at 0.5 W, 0.75 W, 1 W, 1.5 W , 1.75 W and 2 W laser were 3.28 ± 2.4 MPa, 5.44 ± 3.4 MPa, 8.8 ± 4.5 MPa, 10.2 ± 4.0 MPa, 11.4 ± 4.8 MPa and 11.9 ± 4.3 MPa, respectively. Laser irradiation at 1.5 W, 1.75 W and 2 W produced a type III acid-etched pattern similar to that produced by acid etching. No significant enamel surface etching was obtained by 0.5 W or 0.75 W laser irradiation. Irradiation at 0.5 W and 0.75 W produced a type V acid-etched pattern. We concluded that the mean shear bond strength and enamel surface etching obtained with Er,Cr:YSGG laser (operated at 1.5 W and 1.75 W for 15 s) is comparable to that obtained with acid etching.
Lasers in Medical Science 12/2009; 26(1):13-9. · 2.00 Impact Factor
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ABSTRACT: This study evaluated the microleakage of brackets bonded by four different enamel etching techniques. Forty freshly extracted human premolars were divided randomly into four equal groups and received the following treatment: group 1, acid etching; group 2, self-etching primer (SEP); group 3, erbium:yttrium-aluminum-garnet (Er:YAG) laser etching; and group 4, erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching. After photopolymerization, the teeth were kept in distilled water for 1 month and then subjected to 500 thermal cycles. Then, the specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned, and examined under a stereomicroscope. In addition, they were scored for marginal microleakage at the adhesive-enamel and bracket-adhesive interfaces from the incisal and gingival margins. Statistical analyses consisted of the Kruskal-Wallis test and the Mann-Whitney U test with Bonferroni correction. Microleakage occurred between the adhesive-enamel and bracket-adhesive interfaces in all groups. For the adhesive-enamel surface, a significant difference was observed between group 1 and groups 2 (P = 0.011), 3 (P = 0.002), and 4 (P = 0.000) on the gingival side. Overall, significant differences were observed between group 1 and groups 3 (P = 0.003) and 4 (P = 0.000). In dental bonding procedures, acid etching was found to result in the least microleakage. Since etching with a laser decreases the risk of caries and is time-saving, it may serve as an alternative to acid etching.
Lasers in Medical Science 07/2009; 25(6):811-6. · 2.00 Impact Factor
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ABSTRACT: Class III malocclusion is a difficult anomaly to understand. Because not all Class III patients are candidates for surgical correction, patient assessment and selection are especially important in diagnosis and treatment planning. In this article, we report the orthopedic treatment of a teenage girl with a severe skeletal Class III malocclusion. Her ANB angle was -4.5 degrees, and she had a 2-mm anterior crossbite, a 1-mm overbite, and a posterior asymmetric crossbite (greater on the left side). The patient refused surgery. We used a rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, and reverse headgear to bring the maxilla forward. We performed symmetric expansion, but, because of the asymmetric crossbite in the maxilla, we designed a modified apparatus that permitted greater relapse on 1 side. In this way, the posterior crossbite was ideally corrected by the end of treatment, and ideal overjet and overbite relationships, functional occlusion, and an esthetic facial appearance were all achieved.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 09/2008; 134(2):309-17. · 1.33 Impact Factor
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ABSTRACT: The purposes of this study were to assess the shear bond strength, the surface characteristics, and the adhesive remnant index scores of teeth prepared for bonding with erbium, chromium doped: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser etching, and to compare laser etching with phosphoric-acid etching and a self-etching primer.
Sixty-four premolars, extracted for orthodontic purposes, were randomly divided into 4 groups, and a different method was used to prepare the tooth enamel in each group for bonding: irradiation for 15 seconds with a 0.75-W Er,Cr:YSGG laser; irradiation for 15 seconds with a 1.5-W Er,Cr:YSGG laser; etching with 37% phosphoric acid; application of a self-etching primer. After surface preparation, standard edgewise stainless steel premolar brackets were bonded; 1 tooth in each group was not bonded and was examined under a scanning electron microscopic. The brackets were debonded 24 hours later; shear bond strengths were measured, and adhesive remnant index scores were recorded.
Irradiation with the 0.75-W laser produced lower shear bond strengths than the other methods. No statistically significant differences were found between 1.5-W laser irradiation, phosphoric-acid etching, and self-etching primer. Adhesive remnant scores were compared with the chi-square test, and statistically significant differences were found between all groups; when the 0.75-W laser irradiation group was excluded, no statistically significant differences were observed.
Irradiation with a 1.50-W laser produced sufficient etching for orthodontic bonding, but irradiation with the 0.75-W laser did not.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 09/2008; 134(2):193-7. · 1.33 Impact Factor
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ABSTRACT: The purpose of the study was to determine if sandblasted and laser-irradiated enamel may be viable alternatives to acid etching for molar tube bonding. Seventy-seven molar teeth extracted for periodontal reasons were used. Seventy teeth underwent shear bond strength (SBS) testing and the remaining seven were examined under scanning electron microscopy (SEM). Adhesive remnant index (ARI) scores were also considered. An erbium, chromium-doped:yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser was used for enamel etching. Sandblasted and laser-irradiated enamel surfaces with different power outputs (0.5, 0.75, 1, 1.5, and 2 W) were compared with conventional phosphoric acid etching. Descriptive statistics, including mean, standard deviation, and minimum and maximum values, were calculated for each group. Multiple comparisons of the SBS of different etching types were performed by analysis of variance testing. The chi-square test was used to evaluate differences in ARI scores between groups. Acid-etched, 1-, 1.5-, and 2-W laser irradiation groups demonstrated a clinically acceptable mean SBS (7.65 +/- 1.38, 6.69 +/- 1.27, 7.13 +/- 1.67, 7.17 +/- 1.69 MPa, respectively). Irradiation with an output of 0.5 and 0.75 W and sandblasting of the enamel showed a lower SBS than the other groups (2.94 +/- 1.98, 4.16 +/- 2.87, 2.01 +/- 0.64 MPa, respectively). SEM evaluation of 1, 1.5, and 2 W laser irradiation revealed similar etching patterns to acid etching. Sandblasting and 0.5, and 0.75 W laser etching were not able to etch enamel in preferential patterns. Laser irradiation at 1.5 and 2 W was able to etch enamel. More adhesive was left on the enamel surface with low-power laser irradiation. Sandblasting and low-power laser irradiation (0.5, 0.75, and 1 W) are not capable of etching enamel suitable for orthodontic molar tube bonding, but 1.5- and 2-W laser irradiation may be an alternative to conventional acid etching.
The European Journal of Orthodontics 05/2008; 30(2):183-9. · 0.89 Impact Factor
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ABSTRACT: The aim of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects.
A retrospective cross-sectional study was designed. The final study population consisted of 590 Turkish subjects. Statistical analysis of the data was performed with computer software. Spearman rank order correlation coefficients were used to assess the relationship between cervical vertebral and dental maturation. For a better understanding of the relationship between cervical vertebral maturation indexes and dental age, percentage distributions of the studied teeth were also calculated.
Strict correlations were found between dental and cervical vertebral maturation of Turkish subjects. For males, the sequence from lowest to the highest was third molar, central incisor, canine, first premolar, second premolar, first molar, and second molar. For females, the sequence from lowest to the highest was third molar, canine, second premolar, first premolar, central incisor, first molar, and second molar.
Dental maturation stages can be used as a reliable indicator of facial growth.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 05/2007; 131(4):447.e13-20. · 1.33 Impact Factor
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ABSTRACT: To test whether interleukine 1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) levels differ from each other in different treatment levels.
Eighteen patients, nine female and nine male (aged 16-19 years; mean 17.4 +/- 1.8 years), participated in this study. Each subject underwent a session on professional oral hygiene and received oral hygiene instructions. Two months later, a fixed orthodontic appliance was placed. The patients were seen at baseline, at days 7 and 21 and at the 3rd and 6th month as the leveling of the teeth occurred. Records of the baseline scores for the distalization forces were taken at the 6th month. Days 7 and 21 after 6 months of treatment were also recorded.
There were increases in the volume of gingival crevicular fluid (GCF) and in the concentrations of IL-1beta and TNF-alpha.
Leveling and distalization of the teeth evoke increases in both the IL-1 and TNF-alpha levels that can be detected in GCF.
The Angle Orthodontist 10/2006; 76(5):830-6. · 1.21 Impact Factor
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ABSTRACT: The aims of this study were to determine levels of interleukins 2, 6, and 8 during tooth movement, and test whether they differ from each other with leveling and distalization forces used in various treatment stages of standard orthodontic therapy.
Fifteen patients (9 female, 6 male; ages, 15-19 years; mean age, 16.7 +/- 2.3 years) participated in this study. Each underwent a session of professional oral hygiene and received oral hygiene instructions. Two months later, a fixed orthodontic appliance was placed. The patients were seen at baseline, at days 7 and 21, and as the teeth were leveled. Records of the baseline scores for the distalization forces were taken at the sixth month. Scores of days 7 and 21 after 6 months of the distalization treatment were also recorded.
Increases were seen in the volume of gingival crevicular fluid and the concentrations of interleukins 2, 6, and 8.
Leveling and distalization of the teeth evoke increases in interleukins 2, 6, and 8 levels in the periodontal tissues that can be detected in gingival crevicular fluid.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 08/2006; 130(1):7.e1-6. · 1.33 Impact Factor
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ABSTRACT: This case report presents an adult skeletal Class III and open-bite malocclusion case treated without surgical intervention using fixed edgewise technique, reverse headgear, and Class III and anterior box elastics. The patient was a 16-year-old Turkish female who had completed her growth and development. She had a four mm open bite, maxillary retrognathia, a crossbite in the anterior and left posterior, and hypoplasia of the maxillary laterals. In addition, the patient's first molars had previously been extracted because of caries, and extraction spaces were present. We applied a Roth edgewise appliance and a reverse headgear to be used at night only for the first six months. The objective in using a reverse headgear was to displace the maxillary teeth toward the mesial and to rotate the maxilla in a clockwise direction. In the mandible, we retracted the mandibular incisors and canine teeth and moved the second molars mesially toward the first molar extraction space. There would thus be no need for any prosthetic restoration in the mandible. At the end of treatment, we obtained a Class I dental relationship, an ideal occlusion relationship, and an esthetic dental and facial relationship. Treatment of the patient was completed in 20 months.
The Angle Orthodontist 06/2006; 76(3):527-32. · 1.21 Impact Factor
