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OBJECTIVE: To investigate the effects of fixed anterior biteplane treatment on temporomandibular joint in deep bite patients. METHODS: The sample comprised 17 Class II patients with deep bite and decreased lower anterior facial height. The average patient age was 9.9±0.9 years. Transcranial temporomandibular joint radiographs were obtained from the subjects before (T0) and after fixed anterior biteplane treatment (T1). Anterior joint space, posterior joint space, superior joint space, anteroposterior thickness of the condylar head, vertical height of the articular fossa, and the articular fossa slope were measured on temporomandibular joint radiographs to evaluate the position of the mandibular condyles in the glenoid fossa. RESULTS: The average treatment duration was 8.5±2.1 months. Slope of the articular fossa, vertical height of the articular fossa, anteroposterior thickness of the condyle, posterior joint space, superior joint space, and anterior joint space showed no statistically significant difference between T0 and T1 (p>0.05). CONCLUSION: Fixed anterior biteplane appliance treatment did not change the condyle fossa relationship in Class II deep bite patients at the time of appliance removal.

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BACKGROUND: This study aimed to investigate and compare the positions and dimensions of the temporomandibular joint and its components, respectively, in patients with Class II division 1 and division 2 malocclusions. MATERIAL AND METHODS: Computed tomography images of 14 patients with Class II division 1 and 14 patients with Class II division 2 malocclusion were included with a mean age of 11.4 ± 1.2 years. The following temporomandibular joint measurements were made with OsiriX medical imaging software program. From the sagittal images, the anterior, superior, and posterior joint spaces and the mandibular fossa depths were measured. From the axial images, the greatest anteroposterior and mediolateral diameters of the mandibular condyles, angles between the long axis of the mandibular condyle and midsagittal plane, and vertical distances from the geometric centers of the condyles to midsagittal plane were measured. The independent samples t-test was used for comparing the measurements between the two sides and between the Class II division 1 and 2 groups. RESULTS: No statistically significant differences were observed between the right and left temporomandibular joints; therefore, the data were pooled. There were statistically significant differences between the Class II division 1 and 2 groups with regard to mandibular fossa depth and anterior joint space measurements. CONCLUSIONS: In Class II patients, the right and left temporomandibular joints were symmetrical. In the Class II division 1 group, the anterior joint space was wider than that in Class II division 2 group, and the mandibular fossa was deeper and wider in the Class II division 1 group. Key words:Temporomandibular joint, Class II malocclusion, Cone beam computed tomography.

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OBJECTIVE: The aim of this study was to compare the effects of two retainer types (Essix and Hawley) on speech performance. SUBJECTS AND METHODS: The speech articulation of 30 patients was evaluated prospectively. Five patients did not appear during the follow-up periods. The patients were randomly divided into retention groups by treatment allocation cards as Essix and Hawley. The Essix group included 13 participants with a mean age of 15.3±2.4 years; the Hawley group included 12 participants with a mean age of 16.3±2.56 years. Speech sound assessments were performed on the first day and 1 week, 4 weeks, and 3 months later. On the first day, the assessments were conducted prior to inserting the retainers, immediately after maxillary and mandibular retainer application, individually, and with both retainers applied. The acoustic analyses were obtained using spectral and temporal parameters. RESULTS: Statistical analyses were performed with IBM SPSS for Windows, version 20. A P value less than 0.05 was considered statistically significant. The most apparent changes were found in the [a] vowel in the Hawley group, the [e] vowel in the Essix group, and the [u] vowel in both groups (P < 0.05). While the number of affected consonant-vowel couples in the Essix group was low, alterations were common in the Hawley group. There was a statistically significant difference (P < 0.05) in voice onset time of the [d] sound between the groups. LIMITATIONS: The trial had a small sample size and a short follow-up period. CONCLUSIONS: The Hawley retainer affected articulatory movements in consonant-vowel combinations more prominently than the Essix retainer did. Voice onset time of the consonant [d] in the Hawley group was shorter than normal, indicating rapid articulatory movement in the alveolar region.

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INTRODUCTION: Our objective was to comparatively evaluate different bracket types (conventional, active self-ligating, and passive self-ligating) combined with broad archwires in terms of maxillary dental arch widths and molar inclinations. METHODS: Forty-six patients aged 13 to 17 years with moderate maxillary and mandibular crowding and a Class I malocclusion were included in this prospective clinical trial. The primary outcome measures were changes in maxillary arch width dimensions and molar inclinations. The secondary outcome measures were changes in maxillary and mandibular incisor inclinations. Group I included 15 patients (mean age, 14.4 ± 1.5 years) treated with 0.022-in active self-ligating brackets. Group II included 15 patients (mean age, 14.4 ± 1.6 years) treated with 0.022-in Roth prescription conventional brackets. Group III was a retrospective group of 16 patients (mean age, 14.8 ± 1.0 years) previously treated with 0.022-in passive self-ligating brackets. Each participant underwent alignment with the standard Damon archwire sequence. Whereas the differences among groups were evaluated by 1-way analysis of variance or Kruskal-Wallis tests, the paired-samples t test was applied for intragroup comparisons. For all possible multiple comparisons, the Bonferroni correction was applied to control for type I error. RESULTS: The maxillary intercanine, interpremolar, and intermolar widths were significantly greater after treatment in each bracket group. However, when the levels of expansion achieved among the 3 groups were compared, no significant difference was found. Although all posteroanterior cephalometric variables showed significant changes during treatment in all groups, these changes were not significant among the groups. A statistically significant labial proclination of the teeth was seen in each group. CONCLUSIONS: No differences in maxillary arch dimensional changes or molar and incisor inclination changes were found in conventional and active and passive self-ligating brackets used with broad archwires.

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OBJECTIVE: This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. METHODS: This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. RESULTS: The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. CONCLUSIONS: Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

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OBJECTIVE: The purpose of this study is to compare the accuracy of the treatment simulation module of Quick Ceph Studio (QCS) program to the actual treatment results in Class II Division 1 patients. DESIGN: Retrospective study. MATERIALS AND METHODS: Twenty-six skeletal Class II patients treated with functional appliances were included. T0 and T1 lateral cephalograms were digitized using QCS. Before applying treatment simulation to the digitized cephalograms, the actual T0-T1 difference was calculated for the SNA, SNB, ANB angles, maxillary incisor inclination, and protrusion and mandibular incisor inclination and protrusion values. Next, using the treatment simulation module, the aforementioned values for the T0 cephalograms were manually entered to match the actual T1 values taking into account the T0-T1 differences. Paired sample t-test were applied to determine the difference between actual and treatment simulation measurements. RESULTS: No significant differences were found for the anteroposterior location of the landmarks. Upper lip, soft tissue A point, soft tissue pogonion, and soft tissue B point measurements showed statistically significant difference between actual and treatment simulation in the vertical plane. CONCLUSION: Quick Ceph program was reliable in terms of reflecting the sagittal changes that would probably occur with treatment and growth. However, vertical positions of the upper lip, soft tissue pogonion, soft tissue A point, and soft tissue B point were statistically different from actual results.

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OBJECTIVE: To evaluate two different treatment systems with regard to incisor position, transverse dimension changes in maxillary arch, changes in maxillary molar inclinations, clinical periodontal parameters, and pain intensity in patients with a Class I malocclusion. MATERIALS AND METHODS: Seventeen patients (with a mean age of 14.5 years) underwent orthodontic treatment with the Roth prescribed edgewise bracket systems after expanding the maxillary arch with a quad-helix appliance, and 16 patients (with a mean age of 14.8 years) underwent orthodontic treatment with the Damon 3MX bracket system. Each subject's lateral cephalometric and posteroanterior radiographs and dental casts were obtained at the beginning of the treatment and after debonding. In addition to these, the periodontal index and pain scores were taken. RESULTS: Cephalometric data showed that in both treatment systems, overjet value decreased and maxillary and mandibular incisors proclined. Posteroanterior measurements demonstrated a greater increase in the maxillary molar inclination in the Damon group. Significant increase of maxillary intercanine, interpremolar, and intermolar widths was shown in both systems. Periodontal index and pain score changes between different observation periods were the same. CONCLUSIONS: The conventional and Damon systems were found similar with regard to the incisor position, transverse dimension changes in maxillary arch, clinical periodontal parameters, and pain intensity. The only significant difference was that the Damon system inclined the maxillary molars more buccally than the conventional group.

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OBJECTIVE: To assess (1) whether Hawley retainers cause speech disturbance and (2) the duration of speech adaptation to Hawley retainers with objective and subjective tests. MATERIALS AND METHODS: Twelve adolescents, aged 11.11 to 18.03 years, were included in this study. The assessment of speech sounds were done subjectively using an articulation test and objectively using acoustic analysis before and after Hawley retainer application. RESULTS: After wearing Hawley retainers, patients showed statistically significant speech disturbances on consonants [s] and [z]. Regarding the vowels, statistically significant changes were recorded with [i], while F1 increased and F2 and F3 decreased. CONCLUSIONS: The tongue changes its target position with the application of a foreign body within the mouth; however, in time it adapts to that new situation.

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INTRODUCTION: The aim of this study was to compare Delaire and Grummons protraction facemasks with a new articulator system (Amtech MG1, American Technologies, Brazil) that can record condylar positions. METHODS: Thirty-four patients treated with protraction facemask therapy were divided into 2 groups; 18 were treated with the Delaire facemask (DFM) and 16 with the Grummons facemask (GFM). The observation periods were 8.5 months for the DFM group and 10 months for the GFM group. Mandibular position indicator (MPI) recordings were taken with the new articulator system and evaluated before and after the protraction facemask therapies. RESULTS: MPI recordings in the sagittal plane showed forward and downward movement from centric relation to maximum intercuspal position for both condyles at the beginning of treatment for most patients. After treatment, the discrepancy between centric relation and maximum intercuspation was less in the DFM group than in the GFM group. However, more compressive movement of the condyles through the glenoid fossa was observed in the DFM group. CONCLUSIONS: Although the centric slide amount decreased more with the Delaire facemask compared with the Grummons facemask, patients treated with the Delaire facemask must be monitored for signs and symptoms of temporomandibular joint disorder.

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OBJECTIVES: To classify and determine the occlusal characteristics of deaf-mute individuals and its gender distribution in the Turkish population. METHODS: For this study, 213 deaf-mute individuals (155 boys and 58 girls) were evaluated. The age range was between 10-24 years, and the mean age was 16.37+/-2.53 years. Measurements were divided into four groups: dental, intraarch, interarch, and, extra data. RESULTS: Of the participants, 75.0% had a Class I molar relationship, whereas 13.0% and 8.0% had Class II and Class III malocclusions, respectively. 23.9% of individuals had a normal overbite, 38.4% had a deepbite, and 23.4% had an openbite. One or more congenitally missing teeth were found in 6.0% of individuals; 81.0% expressed satisfaction with their esthetics, and 19.0% expressed the contrary. CONCLUSIONS: Different characteristics and malocclusions are present in deaf-mute individuals.

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BACKGROUND: The aim of this retrospective study was to evaluate changes in patients with Class II Division 1 malocclusions treated with cervical headgear and full fixed orthodontic appliances and without extractions. METHODS: Lateral cephalograms and dental casts of 18 patients were obtained at the beginning and the end of treatment and at the postretention period. Pretreatment records were taken at 11.9 +/- 2.6 years, and the mean treatment time was 2.8 +/- 1.2 years. All patients were asked to use maxillary and mandibular Hawley retainers for 1 year. The average postretention interval was 5.3 years. RESULTS: The assessment of cephalometric findings showed that maxillary growth was restricted; maxillary incisor inclination, overjet, and overbite were decreased; the mandibular incisors were proclined; and a slight mandibular posterior rotation occurred at the end of treatment. At the postretention period, the maxilla remained stable, the mandible moved anteriorly, and the overjet increased slightly (1.25 mm, P < .01). The dental cast changes indicated that both maxillary and mandibular irregularity index values decreased significantly during treatment but increased after 5 years. Mandibular intercanine width decreased 0.47 mm ( P < .01) during the postretention period. CONCLUSIONS: The redirection of maxillary growth remained stable in patients with Class II malocclusions treated with cervical headgear and fixed orthodontic appliances and without extractions, but treatment-induced mandibular rotations tended to return to their original patterns. Various dental changes occurred during the postretention period.

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The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained.

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In cases of bimaxillary protrusion, extraction of 4 premolars and orthodontic treatment with retraction of the anterior teeth is a widely used approach. However, there is controversy over whether the changes that occur in the anterior alveolar bone always follow the direction and quantity of tooth movement. Nineteen patients with dentoalveolar bimaxillary protrusion treated by extracting the 4 first premolars were evaluated with lateral cephalograms and computed tomography (CT). Cephalograms and CT scans were made before treatment and 3 months after retraction of the incisors. The measurements of the cephalograms showed that maxillary and mandibular incisors were retracted primarily by controlled tipping of the teeth. For all maxillary and mandibular incisors, we assessed the labial and the lingual alveolar plates at crest level (S1), midroot level (S2), and apical level (S3) for bone-thickness changes during retraction of the maxillary and mandibular anterior segments. In the mandibular arch, the labial bone maintained its original thickness, except the S1 measurements, which showed a significant decrease in bone thickness (P <.001). In the maxillary arch, the labial bone thickness remained unchanged. There were statistically significant decreases in lingual bone width in both arches after retracting the incisors. Some of the patients demonstrated bone dehiscence that was not visible macroscopically or cephalometrically. When tooth movement is limited, forcing the tooth against the cortical bone may cause adverse sequelae. This type of approach must be carefully monitored to avoid negative iatrogenic effects.

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