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Are the flowable composites suitable for orthodontic bracket bonding?
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2004) Uysal, T; Sari, Z; Demir, A
The study aims to determine the shear bond strength (SBS) values of different flowable composites (Pulpdent(R) Flows-Rite, 3M(TM) Filtek Flow, and Heraeus Kulzer(R) Flow Line) in comparison with a conventional orthodontic adhesive and the bond failure sites of these composites. Eighty extracted human premolars were divided into four groups of 20 teeth each. Brackets were bonded to the teeth in each test group with different composites,. according to the manufacturer's instructions. SBS values of these brackets were recorded (in MPa) using a universal testing machine. Adhesive remnant index (ARI) scores were determined after the failure of brackets. Data were analyzed using analysis of variance (ANOVA), Tukey honestly significant difference, and chi-square tests. SBS values of groups 1 (Transbond XT), 2 (Flows-Rite), 3 (Flow), and 4 (Flow Line) were found to be 17.10 +/- 2.48 MPa, 6.60 +/- 3.2 MPa, 7.75 +/- 2.9 MPa, and 8.53 +/- 3.50 MPa, respectively. The results of this study demonstrate that the orthodontic adhesive (Transbond XT) had higher SBS values than the flowable composites. Results of ANOVA revealed statistically significant differences among the groups (P < .05). The SBS values were significantly lower in all flowable composite groups than the orthodontic adhesive. ARI scores were significantly different between the orthodontic adhesive and all the flowable groups investigated. The use of flowable composites is not advocated for orthodontic bracket bonding because of significantly lower SBS values achieved.
Comparative evaluation of a new removable jasper jumper functional appliance vs an activator-headgear combination
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2003) Sari, Z; Goyenc, Y; Doruk, C; Usumez, S
The aim of this study was to comparatively evaluate the effects of an activator-headgear (FIG) combination to a Jasper Jumper (JJ) plus occipital HG, which was incorporated into removable upper and lower plates. The study group consisted of 60 subjects with mandibular deficiency and a vertical growth pattern. Of these, 20 were treated with JJ appliance-HG incorporated to removable upper and lower plates, 20 were treated with an activator-HG combination. Another 20 subjects who refused orthodontic treatment served as controls. Pre- and postreatment lateral cephalograms and hand-wrist films were gathered for all 60 subjects. Lateral cephalograms were manually traced before being transferred to RMO JOE software by a digitizer. Measurements that are not included in the software were measured manually. Thirty-five dental and skeletal parameters were used in the study. The collected data were subjected to statistical analysis using SPSS packet software. Wilcoxon paired t-test was used for intragroup comparisons. Differences between groups were evaluated by analysis of variance and Bonferroni tests. Results suggest that ANB angle was decreased significantly in both treatment groups compared with the controls. Increase in total facial height was greater in the activator group than in the JJ group. Vertical growth inhibition of lower incisors was greater in the JJ group. The activator-HG appliance was more effective on the mandible, whereas the JJ appliance was mainly active on the maxilla. Thus, ideal cases for JJ-splinted appliance should be high-angle cases, particularly with maxillary excess and some mandibular deficiency.
Dental and alveolar arch widths in normal occlusion and class III malocclusion
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2005) Uysal, T; Usumez, S; Memili, B; Sari, Z
The aim of this study was to compare the transverse dimensions of the dental arches and alveolar widths of Class III malocclusion group with a group of untreated normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age, 21.6 +/- 2.6 years) and 100 Class III malocclusion (mean age, 15.4 +/- 2.2 years) subjects. Independent samples Mest was applied for comparing the groups. The findings of this study indicated that the mandibular intercanine and intermolar alveolar widths were significantly larger in the Class III group when compared with the normal occlusion sample (P < .001). Maxillary interpremolar, intermolar widths and all maxillary alveolar width measurements were significantly narrower in the Class III group (P < .001). In addition, the lower canine and premolar alveolar width measurements were also statistically significantly larger in the normal occlusion group when compared with the Class III malocclusion group (P < .001). Subjects with Class III malocclusion tend to have the maxillary teeth inclined to the lingual and mandibular teeth inclined to the buccal direction because of the restriction of maxillary growth and development according to dental arch width measurements. Therefore, rapid maxillary expansion should be considered before or during the treatment of a Class III patient with or without face-mask therapy.
Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2005) Uysal, T; Memili, B; Usumez, S; Sari, Z
The aim of this study was to compare the transverse dimensions of the dental arches and alveolar arches in the canine, premolar, and molar regions of Class II division 1 and Class II division 2 malocclusion groups with normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age: 21.6 +/- 2.6 years), 106 Class II division 1 (mean age: 17.2 +/- 2.4 years), and 108 Class II division 2 (mean age: 18.5 +/- 2.9 years) malocclusion subjects. Independent-samples t-test was applied for comparisons of the groups. These findings indicate that the maxillary interpremolar width, maxillary canine, premolar and molar alveolar widths, and mandibular premolar and molar alveolar widths were significantly narrower in subjects with Class II division 1 malocclusion than in the normal occlusion sample. The maxillary interpremolar width, canine and premolar alveolar widths, and all mandibular alveolar widths were significantly narrower in the Class II division 2 group than in the normal occlusion sample. The mandibular intercanine and interpremolar widths were narrower and the maxillary intermolar width measurement was larger in the Class II division 2 subjects when compared with the Class II division 1 subjects. Maxillary molar teeth in subjects with Class II division 1 maloc-clusions tend to incline to the buccal to compensate the insufficient alveolar base. For that reason, rapid maxillary expansion rather than slow expansion may be considered before or during the treatment of Class II division 1 patients.
Does orthodontic treatment affect patients' and parents' anxiety levels?
(OXFORD UNIV PRESS, 2005) Sari, Z; Uysal, T; Karaman, AI; Sargin, N; Ure, O
The aims of this study were (1) to determine and compare the anxiety levels of two groups of patient and parents, (2) to identify possible gender differences between male and female subjects and (3) to evaluate any changes in anxiety levels after 1 year of treatment. The first group consisted of 40 subjects with a mean age of 15.6 +/- 1.2 years awaiting orthodontic treatment, plus one parent of each subject (mean age 43.4 +/- 2.3 years). The second group comprised 43 patients with a mean age of 16.0 +/- 1.1 years who had been undergoing treatment for a period of 1 year, plus one parent of each patient (mean age 41.0 +/- 1.9 years). Personal information forms and Spielberger's 'State and Trait Anxiety Inventory' (STAI) were applied to both groups. To compare the two groups and to determine the differences between males and females, independent-sample t-tests were used. Internal consistencies for the two scales of the STAI were evaluated with Cronbach's alpha coefficient. Trait anxiety levels of parents (51.05 +/- 5.1) and state anxiety levels of subjects (58.57 +/- 6.73) who were about to start orthodontic treatment were both high. The difference between the groups was statistically significant (P < 0.05). In patients who had undergone treatment for 1 year, the scores were found to be normal (43.28 +/- 5.91). However, their parents' high levels of trait anxiety remained unchanged (50.41 +/- 4.2).
The effect of head rotation on cephalometric radiographs
(OXFORD UNIV PRESS, 2005) Malkoc, S; Sari, Z; Usumez, S; Koyuturk, AE
[Abstract not Available]
The effects of activator treatment on the craniofacial structures of Class II division 1 patients
(OXFORD UNIV PRESS, 2003) Basciftci, FA; Uysal, T; Buyukerkmen, A; Sari, Z
The aim of the present study was to clarify the skeletal treatment effects induced by activator treatment. Fifty actively growing patients with Class II division 1 malocclusions were treated with an activator appliance. A control group consisting of longitudinal growth data from 20 patients (untreated Class II division 1 malocclusions) was used to eliminate possible differences in growth pattern. Lateral cephalograms of each patient were taken at the start and end of treatment. Final cephalograms were taken after a mean of 16.4 (+/-2.0) months activator treatment, compared with a mean of 14.2 (+/-2.4) months for the control group. Each cephalogram was traced and digitized by the same individual. The mean and standard deviations for linear and angular cephalometric measurements were analysed statistically, and intra- and inter-group changes were evaluated by paired- and independent-sample t-tests. At the end of the study period, the overjet was decreased in all patients. Ramus height, corpus length, anterior and posterior face height all increased significantly (P < 0.05). In the treatment group, ANB angle decreased and the bite was opened. The activator appliance caused maxillary incisor lingual tipping and mandibular incisor labial tipping. The overjet was decreased as a result of the increased forward growth of the mandible and dentoalveolar changes. The results demonstrated that the activator appliance has a characteristic skeletal and dental effect on the developing craniofacial complex.
Effects of camouflage treatment on dentofacial structures in Class II division 1 mandibular retrognathic patients
(OXFORD UNIV PRESS, 2005) Demir, A; Uysal, T; Sari, Z; Basciftci, FA
The aims of this study were to determine the changes in the dentofacial structures of Class II division 1 mandibular retrognathic patients treated with bilateral extraction of the upper first premolars, and to compare pre- and post-treatment values with the cephalometric norms of Anatolian Turkish adults. The Class II division 1 subjects included 20 males and 33 females (mean age: 17.08 +/- 1.03 years). All received comprehensive orthodontic treatment using an edgewise appliance and appropriate headgear. Lateral cephalograms were taken at the beginning and end of treatment. Twenty-five (14 linear and 11 angular) measurements were analysed on each radiograph. Each cephalogram was traced and digitized. For statistical evaluation, paired and independent-samples t-tests were performed. When the pre- and post-treatment measurements were compared, statistically significant differences were found for nine of 25 measurements. During treatment the facial axis, U1-SN (degrees), U1-NA (mm), U1-NA (degrees), H angle and upper lip to E plane measurements decreased, while N-ANS, interincisal angle and upper lip to Steiner S line increased. No statistically significant gender differences were found. Significant improvements were determined in ANS-Me and L1-APo measurements compared with Turkish norms. However, statistically significant deterioration was found in values related to point A, upper incisor and lower lip measurements. The findings demonstrates that camouflage treatment in Class II, mandibular retrognathic subjects has characteristic skeletal, dental and soft tissue effects on the dentofacial complex.
The effects of early preorthodontic trainer treatment on class II, division 1 patients
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2004) Usumez, S; Uysal, T; Sari, Z; Basciftci, FA; Karaman, AI; Guray, E
The aim of this study was to clarify the dentoskeletal treatment effects induced by a preorthodontic trainer appliance treatment on Class II, division 1 cases. Twenty patients (10 girls and 10 boys, mean age 9.6 +/- 1.3 years) with a Class II, division 1 malocclusion were treated with preorthodontic trainer appliances (Myofunctional Research Co., Queensland, Australia). The patients were instructed to use the trainer every day for one hour and overnight while they slept. A control group of 20 patients (mean age 10.2 +/- 0.8 years) with untreated Class II, division 1 malocclusions was used to eliminate possible growth effects. Lateral cephalograms were taken at the start and end of treatment. Final cephalograms were taken 13.1 +/- 1.8 months after trainer application, compared with a mean of 11.2 +/- 2.4 months later for the control group. The mean and standard deviations for cephalometric measurements were analyzed by paired-samples t-test and independent-samples t-tests. At the end of the study period, the trainer group subjects showed significant changes including anterior rotation and sagittal growth of the mandible, increased SNB and facial height, reduced ANB, increased lower incisor proclination, retroclination of upper incisors, and overjet reduction. However, only total facial height increase, lower incisor proclination, and overjet reduction were significantly higher when compared with the changes observed in the control group. This study demonstrates that the preorthodontic trainer application induces basically dentoalveolar changes that result in significant reduction of overjet and can be used with appropriate patient selection.
Evaluation of the dental plaque pH recovery effect of a xylitol lozenge on patients with fixed orthodontic appliances
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2004) Sengun, A; Sari, Z; Ramoglu, SI; Malkoc, S; Duran, I
The purpose of this study was to evaluate the influence of a xylitol lozenge on the dental plaque pH profile of fixed orthodontic patients. Twelve volunteers participated in this study. Before the measurement of plaque pH, subjects were asked to refrain from brushing their teeth for 48 hours and from eating and drinking for two hours. The subjects' baseline dental plaque pH was recorded using the touch technique. It was followed by a one-minute rinse with 15 ml of a 10% solution of sucrose, and subsequent plaque pH measurements were carried out during the next one hour. Xylitol lozenges were taken five times a day during a 14-day period. The variables of resting-plaque pH, minimum-plaque pH (MP pH), time required to reach MP pH (TMP), last-plaque (LP) pH at the end of one hour, cH area (CH), and pH at each test time were calculated for each pH test of the subjects. The paired sample t-test was used for statistical comparison. The mean MP pH values increased from 4.81 to 5.09 in the experimental measurement (P < .05). The mean TMP was not affected by the use of xylitol (P > .05). Although the LP pH showed an increase during the experimental period, the difference between control and experimental periods was not statistically significant (P > .05). The CH of the experimental period was significantly less than that of the control period (P < .05). As a result, the use of a xylitol lozenge after a sucrose challenge can be an advisable practice for fixed orthodontic patients to prevent future dental caries.
An interdisciplinary approach for restoring function and esthetics in a patient with amelogenesis imperfecta and malocclusion: A clinical report
(MOSBY-ELSEVIER, 2004) Ozturk, N; Sari, Z; Ozturk, B
This clinical report describes an interdisciplinary approach for the coordinated treatment of a patient diagnosed with amelogenesis imperfecta and malocclusion. The patient's functional and esthetic expectations were successfully met with interdisciplinary treatments, including orthodontics, porcelain laminate veneers, metal-ceramic fixed partial dentures, and direct composite restorations.
Intermaxillary tooth size discrepancy and mesiodistal crown dimensions for a Turkish population
(MOSBY, INC, 2005) Uysal, T; Sari, Z
Introduction: The aims of this study were to determine the size of individual permanent teeth, tooth-size ratios for the maxillary and mandibular dentitions, and sex differences for those variables in a Turkish population, and to compare the figures obtained with those of the Bolton analysis. Methods: The data were derived from dental casts of 150 Turkish subjects (72 men, mean age 22.09 +/- 3.11 years; 78 women, mean age, 21.11 +/- 2.08 years) with normal occlusions. The mean, standard deviation, and minimum and maximum values were calculated for individual tooth size, and overall and anterior ratios, separately for men and women. To determine whether there are sex differences in intermaxillary tooth size discrepancies, an independent samples t test was performed. Results: The mesiodistal dimensions of the maxillary teeth showed greater variability than the mandibular teeth, with the first molar dimensions having the greatest variability. The overall and anterior ratios were found to be 89.88 +/- 2.29 and 78.26 +/- 2.61, respectively. A statistically significant sex difference was found only in overall ratio (P < .001). According to Bolton's mean values, a discrepancy in the overall ratio was found in 18% of Turkish normal occlusion subjects, and anterior ratios outside 2 standard deviations from the Bolton mean were found in 21.3% of our sample. Conclusions: These findings indicate that population-specific standards are necessary for clinical assessments. Bolton's original data do not represent Turkish people, and therefore it is appropriate to use Turkish norms in daily orthodontic practice for Turkish patients.
Rapid maxillary expansion. Is permanent it better in the mixed or in the dentition?
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2003) Sari, Z; Uysal, T; Usumez, S; Basciftci, FA
The aim of this study was to compare the dentoskeletal effects of a modified acrylic-bonded rapid maxillary expansion (RME) device when it is used in the mixed and permanent dentitions. The study group consisted of 51 patients in the mixed and permanent dentition (26 girls and 25 boys) who underwent RME treatment. Group I was composed of 34 subjects in the mixed dentition (19 girls and 15 boys; mean age, 9.2 +/- 1.3 years). Group 2 consisted of 17 subjects in the permanent dentition (seven girls and 10 boys; mean age 12.7 +/- 1.2 years). Lateral and frontal cephalograms and upper dental casts were collected before treatment (T1), after treatment (T2), and after retention (T3). Intragroup and intergroup changes were evaluated by paired t-test and Student's t-test, respectively. In both groups after RME, the maxilla moved forward; mandible rotated posteriorly; facial height increased; nasal, maxillary, and maxillary intercanine and first molar widths increased; and the upper molars tipped buccally. Almost all these significant changes were stable at follow-up (T3). When overall (T1 - T3) differences were considered, upper molars tipped more, and the ANB angle increased less in the mixed dentition group compared with the permanent dentition group (P < .01). Within the limits of this study, the results suggest that the orthopedic effects of RME are not as great as expected at early ages, and it might be a better alternative to delay RME to early permanent dentition.
Relationships between dental and skeletal maturity in Turkish subjects
(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2004) Uysal, T; Sari, Z; Ramoglu, SI; Basciftci, FA
The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Turkish subjects. The samples were derived from dental panoramic and hand-wrist radiographs of 500 subjects (215 males and 285 females). Calcification of the mandibular canines, first and second premolars, and second and third molars was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation of each hand-wrist radiograph, nine ossification events were determined according to the systems of Bjork, and Grave and Brown. Statistically significant relationships were determined between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients. Correlations between dental development and skeletal maturity ranged from .490 to 0.826 for females and .414 to .706 for males (P < .01). The second molar showed the highest correlation and the third molar showed the lowest correlation for female and male subjects. For both sexes, root formation of the canine as well as the first premolar was completed in the majority of the subjects at the MP3(cap), PP1(cap), R-cap stages. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice, when treating a Turkish patient.

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