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Turkish Journal of Orthodontics Jun 2024Expeditious strides in the fields of biomaterials, computer-aided design, and manufacturing have catapulted clear aligner therapy (CAT) to become a comprehensive...
Expeditious strides in the fields of biomaterials, computer-aided design, and manufacturing have catapulted clear aligner therapy (CAT) to become a comprehensive orthodontic treatment modality. The efficiency of achieving planned tooth movement with clear aligners is a significant consideration while setting up the final treatment goals, as well as calculating treatment times and costs based on the available evidence. Contemporary research outcomes confirm that one of the most commonly reported clinical concerns with CAT is the discrepancy between the prescribed outcome in the digital treatment plan and the clinically achieved outcome from a given series of aligners. Inaccurate prediction of tooth movements may not only lead to a prolonged duration of aligner treatment with an additional need for refinement strategies; but it may also cause other concerns, such as patient burnout and increased potential for relapse. The authors of this paper have elucidated some of the critical elements that may help address this discrepancy between digitally prescribed and clinical outcomes based on an evidence-based approach with regard to the predictability and accuracy of CAT. A strong diagnostic acumen, judicious case selection, solid biomechanical understanding of various types of orthodontic tooth movements, a research framework that keeps pace with technological and material developments and provides evidence-based knowledge of the limitations of CAT; and above all, the ability of the clinician to continually innovate as per different clinical scenarios, all contribute to attaining treatment predictability, efficacy, and efficiency with CAT.
PubMed: 38952301
DOI: 10.4274/TurkJOrthod.2024.2024.4 -
Turkish Journal of Orthodontics Jun 2024The aim of this study was to examine the quality of life and behavioral disorders in children with obstructive sleep apnea (OSA) or primary snoring, as well as how these...
OBJECTIVE
The aim of this study was to examine the quality of life and behavioral disorders in children with obstructive sleep apnea (OSA) or primary snoring, as well as how these problems changed after monobloc treatment.
METHODS
Fourteen children with primary snoring and 16 children with OSA who had skeletal class II malocclusion due to mandibular retrognathia were treated with monobloc appliances. To investigate the relationship between behavioral disorders and quality of life, parents were asked to complete four questionnaires: attention deficit and hyperactivity disorder (ADHD) scale, strength and difficulties questionnaire (SDQ), pediatric sleep questionnaire (PSQ), and Pittsburgh sleep quality scale (PSQS). Mann-Whitney U and Wilcoxon signed-rank tests were used to evaluate the data.
RESULTS
According to the results of the PSQ and PSQS, an increase in sleep quality was observed after monobloc treatment. The decrease in the total ADHD score at the end of the treatment was found to be statistically significant in both the OSA (p<0.01) and snoring (p<0.01) groups. According to the SDQ scores, the increase in the social behavior score and the decrease in the peer bullying score in the snoring group were statistically significant (p<0.05).
CONCLUSION
The use of a monobloc appliance in pediatric patients exhibiting primary snoring and OSA resulted in a notable reduction in sleep-breathing disorder symptoms and a notable enhancement in their overall quality of life. Based on the analyses of the questionnaires, it was concluded that the increase in sleep quality improved the pediatric patients' quality of life after orthodontic treatment with orthodontic monobloc appliances.
PubMed: 38952285
DOI: 10.4274/TurkJOrthod.2023.2023.78 -
Turkish Journal of Orthodontics Jun 2024To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of...
Assessment of Bone Thickness at the Infra Zygomatic Crest Region for Various Orthodontic Miniscrew Implant (OMSI) Insertion Angles: A Cone-Beam Computed Tomographic Study.
OBJECTIVE
To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar.
METHODS
Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student's t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides.
RESULTS
The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height.
CONCLUSION
The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.
PubMed: 38952284
DOI: 10.4274/TurkJOrthod.2023.2023.14 -
Turkish Journal of Orthodontics Jun 2024To determine the optimum miniscrew head design in orthodontic treatments for primary stability and compare stress distribution on a representative bone structure.
OBJECTIVE
To determine the optimum miniscrew head design in orthodontic treatments for primary stability and compare stress distribution on a representative bone structure.
METHODS
Miniscrews with cross heads, mushroom-shaped heads, button heads, bracket heads, and through-hole heads were compared using finite element analysis. Miniscrews, whose three-dimensional drawings were completed using the SolidWorks computer-aided software package, were inserted in the bone block. Orthodontic force was applied to the head, and stress distributions, strains, and total deformations were investigated.
RESULTS
The lowest von Mises stress of 5.67 MPa was obtained using the bracket head. On the other hand, the highest von Mises stress of 22.4 MPa was found with the button head. Through mesh convergence analysis, the most appropriate mesh size was determined to be 0.5 mm; approximately 230,000 elements were formed for each model.
CONCLUSION
Because the need for low stress is substantial for the primary stability of the miniscrew, this study demonstrated that the bracket head miniscrew is the optimal head design. In addition, it is posited that the success rate of orthodontic anchorage treatments will increase when bracket head miniscrews are used.
PubMed: 38952257
DOI: 10.4274/TurkJOrthod.2023.2022.189 -
Turkish Journal of Orthodontics Jun 2024The quality of orthodontic forces in aligners is mainly influenced by their mechanical properties. At present, there is insufficient information on how environmental...
OBJECTIVE
The quality of orthodontic forces in aligners is mainly influenced by their mechanical properties. At present, there is insufficient information on how environmental factors affect the mechanical function of aligners, and studies have shown that patients do not pay enough attention to removing aligners while eating and drinking. Therefore, in this study, we investigated the effect of different chemicals on the mechanical properties of thermoplastic materials.
METHODS
In this study, 175 thermoplastic samples from Easy-Vac gasket (3A Medes, Korea) were prepared, and their chemical composition, tensile strength, and hardness before and after exposure to solutions of orange juice, Cola, chlorhexidine mouthwash, and distilled water were measured. One-Way analysis of variance (ANOVA), Tamhane's test, and Tukey's test were used for statistical analysis.
RESULTS
The tensile strength of the sheets increased with continuous exposure to orange juice and chlorhexidine mouthwash, and their hardness decreased with continuous exposure to carbonated beverages. There was no change in the chemical composition of the samples after exposure to different chemicals.
CONCLUSION
Although these changes are statistically significant, they do not have a significant effect on the result of aligner performance. Therefore, the only concern is the cariogenicity of orange juice and Cola during treatment with aligners and the administration of chlorhexidine mouthwash.
PubMed: 38952245
DOI: 10.4274/TurkJOrthod.2023.2022.176 -
Turkish Journal of Orthodontics Jun 2024To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and...
OBJECTIVE
To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors.
METHODS
An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated.
RESULTS
TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask.
CONCLUSION
The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.
PubMed: 38952229
DOI: 10.4274/TurkJOrthod.2023.2023.2 -
Turkish Journal of Orthodontics Jun 2024To compare the reliability of two scoring systems for detecting white spot lesions (WSLs) from clinical photographs captured during debonding of fixed orthodontic...
OBJECTIVE
To compare the reliability of two scoring systems for detecting white spot lesions (WSLs) from clinical photographs captured during debonding of fixed orthodontic appliances.
METHODS
Digital images of 58 healthy adolescents (34 females and 24 males) were examined, depicting 384 buccal surfaces of maxillary incisors, canines, and first premolars. Three trained examiners (E1, E2 and E3) independently evaluated the fully anonymized photos in a randomized order using the Gorelick index (GI) and the modified International Caries Detection and Assessment System (ICDAS II). A 1-2-week interval separated the scorings. Spearman's rank correlation coefficient, Fisher's z-test, and the interclass correlation coefficient (ICC) were applied to compare the scoring methods and express examiner agreement.
RESULTS
The two scoring systems showed a moderate to strong positive relationship, but inter-examiner variations were significant (p<0.05). We found moderate to good reliability (ICC 0.60 to 0.84) with the ICDAS II system and good to excellent values with the GI (ICC 0.72 to 0.94), depending on the examiner. The agreement concerning the sound surfaces and the most severe WSLs was perfect, whereas the scoring of the milder lesion stages appeared more uncertain.
CONCLUSION
A moderate to strong positive relationship was demonstrated between the two methods when scoring the presence and severity of WSLs from digital images. Significant inter-examiner variations affected reliability.
PubMed: 38952228
DOI: 10.4274/TurkJOrthod.2023.2022.58 -
Turkish Journal of Orthodontics Jun 2024This retrospective clinical study aimed to evaluate the maturation of intramaxillary and circummaxillary suture systems and cervical vertebral maturation as predictors...
OBJECTIVE
This retrospective clinical study aimed to evaluate the maturation of intramaxillary and circummaxillary suture systems and cervical vertebral maturation as predictors of the skeletal response achieved by rapid maxillary expansion (RME).
METHODS
A Digital Imaging and Communication in Medicine dataset of 20 patients (mean age: 15.55 years) prior (T0) and after (T1: 3.5±0.5 months) to RME were retrieved from the archive and analyzed. Bone density values of midpalatal suture (MPS), zygomaticomaxillary suture (ZMS), zygomaticotemporal suture (ZTS), pterygopalatine suture (PPS), and transverse palatine suture (TPS) were measured. The cervical vertebral maturational stages (CVS) were examined. The linear distances between the most lateral points of the piriform apertures were measured as the anterior reference, and the medial margins of the greater palatine foramina on the axial slice were chosen as the posterior reference. The difference at T1-T0 was calculated as the skeletal response to RME at anterior and posterior skeletal references. Spearman's rho rank and Kruskal-Wallis tests were used.
RESULTS
Mean density values of ZMS, PPS, ZTS, TPS, MPS-Anterior, and MPS-Posterior were 922.81, 807.44, 753.83, 640.77, 661.13, and 604.59 HU, respectively. Mean linear changes in anterior and posterior skeletal expansion were 2.93±1.78 and 1.93±2.52 mm. There was no significant relationship between maturation indicators and skeletal response. Significant relationships were found between CVS and MPS density and CVS and circummaxillary suture average density (p≤0.05).
CONCLUSION
Sutural density showed significant variations among CVSs. Although there was no correlation between skeletal response and density measurements, sutural density was found to be a promising indicator for future studies.
PubMed: 38952227
DOI: 10.4274/TurkJOrthod.2023.2022.191 -
JMIR Medical Education Jun 2024Multiple-choice examinations are frequently used in German dental schools. However, details regarding the used item types and applied scoring methods are lacking.
BACKGROUND
Multiple-choice examinations are frequently used in German dental schools. However, details regarding the used item types and applied scoring methods are lacking.
OBJECTIVE
This study aims to gain insight into the current use of multiple-choice items (ie, questions) in summative examinations in German undergraduate dental training programs.
METHODS
A paper-based 10-item questionnaire regarding the used assessment methods, multiple-choice item types, and applied scoring methods was designed. The pilot-tested questionnaire was mailed to the deans of studies and to the heads of the Department of Operative/Restorative Dentistry at all 30 dental schools in Germany in February 2023. Statistical analysis was performed using the Fisher exact test (P<.05).
RESULTS
The response rate amounted to 90% (27/30 dental schools). All respondent dental schools used multiple-choice examinations for summative assessments. Examinations were delivered electronically by 70% (19/27) of the dental schools. Almost all dental schools used single-choice Type A items (24/27, 89%), which accounted for the largest number of items in approximately half of the dental schools (13/27, 48%). Further item types (eg, conventional multiple-select items, Multiple-True-False, and Pick-N) were only used by fewer dental schools (≤67%, up to 18 out of 27 dental schools). For the multiple-select item types, the applied scoring methods varied considerably (ie, awarding [intermediate] partial credit and requirements for partial credit). Dental schools with the possibility of electronic examinations used multiple-select items slightly more often (14/19, 74% vs 4/8, 50%). However, this difference was statistically not significant (P=.38). Dental schools used items either individually or as key feature problems consisting of a clinical case scenario followed by a number of items focusing on critical treatment steps (15/27, 56%). Not a single school used alternative testing methods (eg, answer-until-correct). A formal item review process was established at about half of the dental schools (15/27, 56%).
CONCLUSIONS
Summative assessment methods among German dental schools vary widely. Especially, a large variability regarding the use and scoring of multiple-select multiple-choice items was found.
Topics: Germany; Humans; Surveys and Questionnaires; Educational Measurement; Education, Dental; Schools, Dental
PubMed: 38952022
DOI: 10.2196/58126 -
Journal of Yeungnam Medical Science Jul 2024
Correction to "Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study".
PubMed: 38952017
DOI: 10.12701/jyms.2023.00934.e1