Objective: To determine if density measurements of several maxillary regions in Hounsfield Units (HU) and outcomes of rapid maxillary expansion (RME) are correlated. Is correlation powerful enough to give us direct information about maxillary resistance to RME? Materials and Methods: Twenty-two computed tomographic (CT) scans (14 years) are used in this archive study. Two CT records were collected, one before RME (T 1 ) and one after 3 months of retention period (T 2 ). Maxillary measurements were made using dental and skeletal landmarks in first molar and first premolar slides to measure the effects of RME. Density of midpalatal suture (MPSD) and segments of maxillary bone is measured in HU at T 1 . Correlation analysis was conducted between density measurements and maxillary variables. Regression analysis was then performed for variables that showed positive correlation. Results: There was no correlation between density and skeletal measurements. Intermolar angle (ImA) in molar slice showed statistically significant correlation with density measurements. The ImA variable showed the highest correlation with MPSD in frontal section (r 5 0.669, P , .01). Conclusions: There is correlation of 32.1-43.3% between density measurements and ImA increase. Our density measurements explain a certain percentage of ImA increase, but density is not the only and definitive indicator of changes after RME. (Angle Orthod. 2015;85:109-116.)

Purpose: The aim of the present study was to investigate the effects of insertion and sterilization on primary stability and to examine the mechanical and surface characteristics of mini screws. Materials and methods: 140 miniscrews (70 Dual-Top; 70 Ortho-Easy) were divided into 3 groups. Group 1: control group, 10 miniscrews of each brand, evaluated without any primary procedure. Group 2: 30 miniscrews of each brand, each inserted into the sawbone once, then sterilized and tested. Group 3: 30 miniscrews of each brand, each inserted into the sawbone twice, sterilized after each insertion and then tested. The miniscrews were evaluated for changes in primary stability, mechanical and surface characteristics with scanning electron microscopy (SEM) analysis, torsion tests, maximum insertion-removal torques and vertical-horizontal pull out strength tests. Results: The maximum insertion torque values of the unused miniscrews (Group 1) were found to be significantly higher than those of the reused (Groups 2, 3) mini screws (p<0.05). Removal torque, vertical-horizontal pull-out strength and torsional strength value changes were found to be statistically insignificant. In SEM analysis, wear and atrophy were seen on the threads of used miniscrews especially in the apical region and the oxide layer was seen to have disappeared from some regions of the coated miniscrews. Conclusion: Although wear and atrophy were detected in SEM analysis of used miniscrews, the overall primary stability and fracture torque resistance tests did not show any significant changes after the first and second insertion and sterilization procedures.

ObjectivesForsus™ Fatigue Resistant Device (FRD) is one of the commonly used semirigid fixed functional devices. Purpose of the present study was to investigate effects and long‐term stability of Class II correction following use of Forsus FRD in a retrospective clinical study.Setting and Sample PopulationRecords of 20 patients (mean age 18.3 ± 2.5 years) with Class II malocclusion, who had undergone fixed functional treatment protocol with Forsus FRD, were collected from our clinical archive.Materials and MethodsLateral cephalometric radiographs at pre‐treatment (T0), end of comprehensive treatment (T1) and post‐retention period (T2, mean duration: 19 ± 3 months) were analysed and superimposed to assess skeletal and dental changes on the long‐term. Repeated measurement one way ANOVA was used for the study of the significant differences among the mean values of cephalometric parameters at T0, T1, and T2. To analyse the nature of the bilateral significant differences between two different time points, Bonferroni test was used.ResultsSagittal and vertical skeletal changes at T0‐T1 were statistically insignificant while all dentoalveolar parameters exhibited highly significant changes. At T1‐T2, all skeletal and dentoalveolar parameters were stable except the slight relapse in overjet (0.3 ± 0.5 mm; P < .05). At T0‐T2 interval, no significant skeletal changes were recorded while the dentoalveolar changes remained significantly improved.ConclusionCorrection of Class II malocclusion achieved with Forsus FRD was dentoalveolar and treatment effects were stable in the 19 ± 3 months follow‐up period.

The purpose of the present review is to update knowledge of the literature and better understand the efficiency and abilities of clear aligners and to clarify their indications for use. Materials and Method: The study question was defined as ''How efficient is orthodontic treatment with clear aligners in comparison to fixed orthodontic treatment in patients with permanent dentition?'' An Internet-based search was performed with 6 databases: Medline, PubMed, Clinical Key, ProQuest Dissertations and Theses, Dentistry and Oral Sciences Source (EBSCO Host), and the Cochrane Library. The final search was run in January 2014. Key words used were clear aligner, eCligner, Invisalign, and AsoAligner. Results: We retrieved 110 publications from the databases. After reviewing titles and abstracts, case reports and clinical studies reporting treatment outcomes on segmental dental arches (i.e., anterior dentition) were excluded. Finally, 3 studies that addressed the study question were included in the review. Conclusion: Not enough studies were available to arrive at definite conclusions to compare clear aligner and fixed orthodontic treatment. In simpler cases, Invisalign may result in treatment outcomes as good as those of traditional orthodontic treatment. However, controlled clinical studies are necessary to define and support the abilities and limits of clear aligner therapy with evidence.

Ates x; 3 and Nazan Kü çü kkeles x 4 ABSTRACT Objective: The present study was designed to investigate the general anchorage protocols and especially the tendencies during mini-implant usage among Turkish orthodontists. The main aim of the survey is to reveal if mini-implants are being used more than once and in different patients. Materials and Method: This is a cross-sectional study conducted with orthodontists who are members of the Turkish Orthodontic Society. The orthodontists were asked to click on a link to complete an automated questionnaire of 27 multiple-choice questions. Results: It was found that mini-implants are used by a great majority of the participants and in various cases. General tendencies during mini-implant usage show compatibility with the literature. Conclusion: This survey displays the preferences of Turkish orthodontists regarding mini-implant usage in their clinical practice. Moreover, it is especially important for documenting the fact that mini-implants are being used more than once and also in different patients.

Objectives To evaluate the attractiveness of changes in vertical position of maxillary canines in frontal smiles of different facial types, and to evaluate the esthetic perceptions of orthodontists and laypeople, and the influence of facial type on these perceptions. Materials and Methods Three adult female volunteers were selected as individuals with normal, vertical, and horizontal growth patterns. Frontal posed smile photographs were digitally altered by adjusting vertical positions of the maxillary canines above, below, or coincident with the incisal line in increments of 0.5 mm within a range of 1 mm of extrusion and intrusion. For assessment, a web-based survey was formed with 18 images (six images for each model). A scale was present underneath each image, graded from 0 to 10 (0: unattractive; 10: the most attractive). Images were rated by 233 participants (105 orthodontists; 128 laypeople). Results Orthodontists scored 0-mm images significantly as the highest in all groups. Laypeople scored significantly higher for −0.5 mm images regardless of facial type. The lowest scored images were −1 mm (except for horizontal pattern) and +1 mm images. Mean values of scores given by men were higher (P &lt; .05). Conclusions Orthodontists favored ideal dental alignment and preferred the incisal edges of central and canine teeth to be at the same level. Laypeople preferred a smoother smile arc than orthodontists and found harmony with the soft tissue more attractive. Facial type affected perceptions of the vertical changes of maxillary canines.

Overeruption of maxillary molars due loss of opposing teeth creates occlusal and functional interferences. Before reconstruction can be initiated, intrusion of overerupted molars becomes essential. This report illustrates treatment of overerupted maxillary premolar and molar via direct use of miniscrew anchorage. A 24-year old female had lost first and second left mandibular molars due to pulpal necrotizing agents, resulting with a large alveolar bone defect and overerupted maxillary premolar and molar. She had a history of unsuccessful alveolar distraction of mandibular left premolars to increase the alveolar bone height prior to implant placement. Patient was satisfied with her smile and refused comprehensive orthodontic treatment. Maxillary premolar and molar were intruded segmentally for 4mm in 8 months, using a combination of a mini-implant and partialfixed edgewise appliances. Biological responses of teeth and surrounding bony structures to intrusion appeared normal and acceptable in radiographic and clinical examination.

Rapid maxillary expansion (RME) is an effective orthopedic procedure to correct maxillary transversal deficiency in young patients. In cases of sutural closure, surgically assisted RME is used to reduce the resistance to sutural disjunction. Foundation of a diagnostic relationship between maturation indices and the expected skeletal response to expansion can enable clinicians to identify the need for surgically assisted RME prospectively. The primary aim of this study was to assess the correlation between the amount of achieved skeletal expansion with midpalatal suture density on computed tomography images, and the secondary aim was to assess the correlation between the amount of achieved skeletal expansion with the recently suggested midpalatal suture maturation indicators: cervical vertebral maturation (CVS), midpalatal suture maturation stage (MPSM) and midpalatal suture density ratio. Forty Digital Imaging and Communications in Medicine data from the archived computed tomography scans of 20 patients (mean age: 15.55 years) before RME (T1) and after 3-month retention period (T2) were analyzed. The tested maturity indicators did not show statistically significant correlation between the skeletal effect proportions. However, clinically and radiologically effective RME was seen in MPSMs A, B, and C and also cervical vertebra stages CVS5 and CVS6. More research is needed to determine a diagnostic predictor for the skeletal effects of maxillary expansion treatment modalities.