To compare the effects of the face mask and Carrière Motion® III appliance in growing patients with Class III malocclusion associated with maxillary retrognathia. The null hypothesis was that both appliances, applied after rapid maxillary expansion, would have similar effects. Skeletal, dental, and soft tissue changes were evaluated using lateral cephalometric radiographs of 26 patients aged 6-9 years, taken before (T0) and after treatment (T1). Cephalometric analyses were performed using Nemoceph® software (NEMOTEC, Madrid, Spain). Statistical analyses were carried out with MedCalc version 12.7.7 (MedCalc Software bvba, Ostend, Belgium) with significance set at p<0.05. SNA°, A-NasionPerp, and Co-A increased significantly in both groups, with no significant intergroup difference. Co-Gn, Wits, ANB°, S-N, and the articular angle also increased significantly in both groups. SNB° decreased significantly only in the Carrière Motion® III group. Greater anterior maxillary rotation occurred with the face mask, while reduced rotation was observed with the Carrière Motion® III. Lower facial height decreased slightly but significantly in the Carrière Motion® III group, and increased in the face mask group. Overjet and molar relationship improved significantly in both groups. The UL-E line distance decreased in the face mask group, while the Carrière Motion® III showed no significant soft tissue changes. The null hypothesis was rejected. The two appliances had different effects; however, the Carrière Motion® III proved effective for early Class III treatment and may be considered an alternative, particularly for patients with social concerns about extraoral traction.

The present study aimed to investigate changes in cervical lordosis, neck disability, and postural balance through static and dynamic tests in patients with skeletal Class III malocclusion who were treated with bimaxillary orthognathic surgery. In this prospective observational study, 18 patients (mean age 23.3±5.4 years) with maxillary retrusion and mandibular prognathia were treated by bimaxillary orthognathic surgery. Static and dynamic balance tests were recorded with the Kinesthetic Ability Trainer preoperatively (T1) and at least 2 months postoperatively (T2). Cervical lordosis angle (C2-C7) was evaluated with the posterior tangent method on the lateral cephalometric films taken at T1 and T2. Neck disability and pain were assessed through questionnaires at both time points. The median follow-up time was 5.8 months. The mean maxillary advancement was 4.0 mm at point A (p=0.001). The mean mandibular setback was 2.4 mm at point B (p=0.166). An 8.4 mm maxillomandibular correction was observed according to the Wits appraisal (p=0.001). Static and dynamic balance tests, cervical lordosis angle, neck disability, and pain revealed no significant change between T1 and T2. No statistically significant correlation was observed between surgical movements and changes in the cervical lordosis angle. Orthognathic surgical correction of skeletal Class III malocclusion, -primarily through maxillary advancement with less mandibular setback- did not lead to significant changes in cervical lordosis, neck disability, or postural balance as assessed through static and dynamic tests.

This study aimed to investigate the positional changes of maxillary first molars in patients treated with the hybrid hyrax-mentoplate and Cl III elastics combination using cone-beam computed tomography (CBCT). Ten patients (7 females-3 males, mean age: 11.66±0.83 years) treated with hybrid hyrax-mentoplate at Marmara University Department of Orthodontics were included. Angular and linear measurements were taken from pre-treatment and post-treatment CBCT images, and changes in maxillary first molar teeth were examined using 3D SLICER version 5.0.2 (www.slicer.org). Statistical significance was set at p≤0.05. Significant increases were observed in all distance measurements except C16p-C26p in the coronal plane, and significant decreases were observed in angular measurements only at 16mb and 26mb (p≤0.05). All measurements in the sagittal plane significantly increased compared to the vertical and horizontal reference lines (p≤0.001). Angular measurements relative to the palatal reference line significantly increased only in P-16p, P-26mb, and P-26p (p≤0.05). In skeletal measurements, significant changes were observed only in V-A, V-ANS, H-PNS, and V-PNS measurements (p≤0.05). The expansion at the apical level was significantly higher than that at the coronal level (p≤0.05). Compared to the V line, more mesial movement was observed at the coronal level than at the apical level (p≤0.001). The use of Class III elastics causes greater expansion at the apical level than the coronal. Molar teeth exhibit a mesial movement, but there could be multiple contributing factors. In molars connected to Class III elastics, extrusion occurs. When vertical control is important, appropriate safety measures are advised.

The aim of this study was to evaluate and compare microleakage under the conventional and flash-free ceramic brackets bonded with different agents. Forty extracted human maxillary premolar teeth were randomly divided into five groups. According to the groups, adhesive coated and conventional bracket systems were bonded to the tooth surfaces with the specified adhesive agents. To simulate a six-month oral environment, all teeth were subjected to a thermal cycle procedure. Micro-computed tomography (micro-CT) was used to view and measure the microleakage. Kruskal-Wallis test was used to compare the parameters and Mann-Whitney U test was used for the determination of the group that caused the difference. For intragroup comparisons Wilcoxon signed-rank test was used. Microleakage volume (mm3) and microleakage percentage (%) measured in Blugloo™ group was found significantly lower (p<0.05) then other groups. There was no significant difference in microleakage volume (mm3) and percentage (%) in comparison of gingival and occlusal regions (p>0.05). Adhesive precoated flash-free brackets were not shown a significant difference compared to their conventional equivalent for microleakage volume. The brackets bonded with Blugloo™ adhesive were showed significant less microleakage than the other groups.

This study aimed to evaluate the skeletal, dental, and soft tissue effects of the nickel titanium memory Leaf Expander in a growing sample of patients with unilateral posterior crossbite compared with a control group using digital models and lateral cephalometric radiographs. The research included a total of 24 patients, 12 of whom were treated and 12 untreated. The Leaf Expander group consisted of 4 males and 8 females (mean age= 8.6±10.7 years), and the control group consisted of 5 males and 7 females (mean age: 9.2±0.8 years). Changes during the observation period in both groups were evaluated using the Wilcoxon signed-rank test. We used the Mann-Whitney U test to compare the data between the groups. There was a significant increase in the values indicating the vertical position of the maxilla and mandible in the treatment group. The palatal surface area increased significantly in both groups, but the increase was significantly higher in the treatment group than in the control group. In addition, intermolar width and arch perimeter measurements were significantly higher in the treatment group than in the control group. With the advantage that this device does not require parent compliance, the possibility of incorrect activation was eliminated, and effective expansion using the Leaf Expander was achieved in patients with unilateral crossbite.

This study aimed to determine the correlation between pain perception and knowledge, attitude, and diet diversity in patients undergoing fixed orthodontic treatment. A total of 103 patients (15-40 yrs.; 67 females, 36 males) undergoing orthodontic treatment with a 0.022-inch slot (MBT prescription) in both arches were recruited. Information on pain perception, knowledge, attitude, and diet diversity scores was collected through validated questionnaires using visual analogue scale and close-ended questions at one time point. The correlation between variables was analyzed using the Pearson's correlation coefficient. Of the patients, 48.5% were aged 15 to 19 years old, with 65% females and 73.8% of Chinese ethnicity. Approximately 90% of the orthodontic patients perceived low levels of pain from orthodontic treatment, and 98% had a positive attitude toward orthodontic treatment. The patients had a good level of knowledge (Mean: 6±0.65). Approximately 49.5% of patients reported having moderate diet diversity. No significant correlation was found between pain perception and knowledge, or pain perception and diet diversity (r=0.062, p=0.534). However, a significant weak negative correlation (r=-0.289, p<0.05) between pain perception and attitude was observed. Patients undergoing fixed orthodontic treatment presented with overall low pain perception, a positive attitude, and good knowledge about their treatment with moderate diet diversity. Informing the patient in advance about different orthodontic procedures encourages a positive attitude and facilitates patient cooperation. An interprofessional approach involving nutritionists can provide a holistic patient approach during orthodontic treatment.

The purpose of this study was to compare the effects of cherry juice, coffee, coke, gastric acid, and the thermo-aging procedure (TAP) on the shear bond strength (SBS) of APC II, APC flash-free, and conventional ceramic brackets. A total of 180 human premolar teeth were randomly divided into three major groups according to the type of ceramic bracket. Then, six subgroups (n=10) were established from each major group: Group 1: control; Group 2: only TAP; Group 3: 72 hours of cherry juice exposure + TAP; Group 4: 72 hours of coffee exposure + TAP; Group 5: 72 hours of coke exposure + TAP; and Group 6: 24 hours gastric acid exposure + TAP. SBS was assessed for each specimen using a universal test device, and the adhesive remnant index (ARI) was scored under a light microscope. Kruskal-Wallis and post-hoc Tamhane tests were used to analyze the data. Among the control groups, the highest SBS value belonged to conventional ceramic brackets (p<0.01). SBS values for all groups decreased as a result of each liquid and TAP. Gastric acid and coke had the greatest detrimental effects on SBS, while TAP had the least negative effects. The SBS values of APC II, APC flash-free, and conventional brackets were found to be statistically insignificant after different liquid exposures and TAP. TAP and various fluids had a negative impact on the SBS value of ceramic brackets. SBS values, however, were still higher than clinically acceptable (8-9 MPa) values, even after exposure to gastric acid and coke.

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.

The current systematic review appraises the effectiveness of the types of tooth movements performed with Invisalign® clear aligner on the maxillary incisors. An electronic literature search of published trials was performed through PubMed, LILACS, Scopus, Cochrane Library, and Web of Science databases, and selected journals, from 2009 to 2020. Out of 291 references, five relevant publications were identified for analysis: four studies were performed retrospectively and one prospectively, all non-randomized. Despite the limited set of selected articles, the sample size is significant, with 148 subjects included in the reviewed studies involving the orthodontic treatment of upper incisors. We concluded that movements with the Invisalign® clear aligner on the upper incisors present distinct accuracy, possibly related with movement complexity; intrusion of the incisors has low accuracy (in some cases, 0% of accuracy was reported when the tooth extruded), while incisor extrusion exhibit some of the highest accuracy values reported in the included studies (45%-142%, when the achieved movement was greater than the predicted). Besides, axial (i.e., torque and tip) and horizontal (i.e., translation and rotation) movements are usually effective, with accuracy values between 39%-156% and 42%-79%, respectively. Overall, we determined that the efficiency of aligner to reach the desired movements in the upper incisors was low, as often refinements were required in the included studies. The use of aligner features must be more often considered to improve movement accuracy.

Objective:The present study aimed to find a chemical reagent that would reduce the debonding force to enable easier debonding of the ceramic brackets, thus reducing enamel damage as well as chair side time.Methods:The study included 4 groups -control (distilled water), eucalyptus oil, glutathione and lemon essential oil for immersing teeth bonded with ceramic brackets. Samples (25 in each group), extracted first premolars, were mounted and immersed in their respective solution for a duration of 10 minutes following which they were tested to evaluate the debonding force using the INSTRON universal testing machine. The amount of adhesive left behind on the enamel surface was evaluated using adhesive remnant index (ARI) score and surface changes were checked using a scanning electron microscope.Results:Teeth immersed in glutathione showed the greatest amount of reduction in debonding force (p=0.001) compared with other groups. ARI scores were low for specimens immersed in glutathione. SEM images showed that teeth in the glutathione group had a cleaner enamel surface, suggesting less or no adhesive was left behind and no sign of enamel damage after debonding ceramic brackets.Conclusion:Specimens that were immersed in glutathione for a duration of 10 minutes before debonding of ceramic brackets showed the greatest reduction in debonding force compared with control and demonstrated peel off effect with no enamel damage. Glutathione can be used as an effective reagent during the clinical debonding of ceramic brackets.