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Mini-screw assisted lower molar distalization was planned for a present mild Class III malocclusion case. Two mini-screws were inserted into the available inter-root area: one on the left, and the other on the right side in the posterior region in the mandible. Distalization of lower molars, premolars and canines were achieved. Orthodontic treatment lasted approximately 2.5 years with 1 year of molar distalization. Minimal relapse was seen in the postretention period. Dentoalveolar changes with mini-screw assisted lower molar distalization are reported in the present case.

Aim: To assess apical root resorption (ARR) after Class II malocclusion treatment with the Forsus FRD and fixed technique and to identify the possible risk factors retrospectively. Material and Methods: Seventy-three Class II patients (52 females, 21 males; mean age 14.26±1.28 years) treated with Forsus FRD and fixed technique in the department of Orthodontics were included in this study. The crown and root lengths of 1368 teeth were measured from the panoramic radiographs taken at the beginning and the end of the treatment from these patients. ARR was calculated as the root-crown ratio (RCR) and relative changes of RCR (rRCR). Apical displacement of the incisors was assessed by the superimposition of the lateral cephalograms taken at the beginning and the end of the treatment. Besides, the effect of age, gender, treatment period, tooth type, and apical displacement on ARR was evaluated. Data were statistically analyzed.Results: ARR was detected in 66 (90.41%) patients and 228 (16.67%) teeth. ARR was mild (90≤rRCR

The goal was to evaluate the effects of Angle class II malocclusion treatment using the Forsus fatigue resistant device (FRD, 3M, St. Paul, MN, USA) on the position and angulation of mandibular third molars and retromolar space.In all, 58 class II patients (mean age 13.6 ± 1.8 years) treated with the FRD (FRD group) were compared with 51 class I patients (mean age 13.5 ± 1.6 years) who underwent orthodontic treatment (control group). A total of 109 mandibular third molars in the FRD group and 91 in the control group were evaluated. Changes in the retromolar space, angulation of the second (ɣ) and third molars (β), and the angle between these teeth (α) were assessed with panoramic radiographs taken at the beginning and the end of the treatment. Data were statistically analyzed.At the end of the treatment, there were significant increases in ɣ and β in the FRD group and ɣ in the control group (p 0.05). The decrease in α in the FRD group and increase in the control group were not significant (p 0.05); however, this change led to a small significant change between the groups (p 0.05). The retromolar space significantly increased in the FRD group compared to the control group (p 0.05). No significant correlation was found between retromolar space and third molar uprighting in any of the groups (p 0.05).Class II correction with FRD led to mesialization of the lower arch which provided an increase in the retromolar space. Little improvement in the uprighting of the third molars occurred.ZIELSETZUNG: Ziel war es, die Auswirkungen der Behandlung einer Angle-Klasse-II-Malokklusion mit der ermüdungsresistenten Forsus-Apparatur („fatigue resistant device“, FRD; 3M, St. Paul/MN, USA) auf Position und Angulation der dritten Unterkiefermolaren, sowie auf den Retromolarraum zu untersuchen.Insgesamt wurden 58 Klasse-II-Patienten (Durchschnittsalter 13,6 ± 1,8 Jahre), die mit der FRD behandelt wurden (FRD-Gruppe), mit 51 Klasse-I-Patienten (Durchschnittsalter 13,5 ± 1,6 Jahre) verglichen, die sich einer kieferorthopädischen Behandlung unterzogen (Kontrollgruppe). Ausgewertet wurden 109 dritte Unterkiefermolaren in der FRD-Gruppe und 91 in der Kontrollgruppe. Veränderungen im Retromolarraum, die Angulation der zweiten (γ) und dritten Molaren (β) sowie der Winkel zwischen diesen Zähnen (α) wurden mit Panoramaröntgenaufnahmen zu Beginn und am Ende der Therapie beurteilt. Die Daten wurden statistisch ausgewertet.Am Ende der Behandlung gab es signifikante Anstiege von γ und β in der FRD-Gruppe und γ in der Kontrollgruppe (p 0,05). Die Abnahme von α in der FRD-Gruppe und die Zunahme in der Kontrollgruppe waren nicht signifikant (p 0,05). Allerdings führte diese Veränderung zu einer kleinen signifikanten Veränderung zwischen den Gruppen (p 0,05). Der Retromolarraum nahm in der FRD-Gruppe im Vergleich zur Kontrollgruppe signifikant zu (p 0,05). Zwischen dem Retromolarraum und der Aufrichtung der dritten Molaren wurde in keiner der Gruppen eine signifikante Korrelation gefunden (p 0,05).Die Klasse-II-Korrektur mit FRD führte zu einer Mesialisierung des unteren Zahnbogens und einer konsekutiven Vergrößerung des Retromolarraums. Die Aufrichtung der dritten Molaren wurde nur wenig verbessert.

Objective: This study aimed to assess the lower arch length discrepancy in a group of patients with unilateral cleft lip and palate (UCLP). Materials and Method: Pretreatment dental casts and panoramic radiographs of 23 patients (aged 9–19 years) with a nonsyndromic complete UCLP, without having large restorations/crowns, tooth agenesis, impacted or supernumerary teeth in the lower arch, and previous orthodontic and/or prosthetic treatment, were evaluated. All patients underwent lip and palate repair. Lower arch discrepancies were determined using the Hayes-Nance analysis. Panoramic radiographs were used to estimate the size of permanent premolars for the patients with late mixed dentition. The positive discrepancy defined diastema, whereas the negative discrepancy defined crowding in the lower arch. Descriptive statistics were presented using frequencies and percentages, and the differences were evaluated using the binomial test. Results: One out of 23 patients had no discrepancy in the lower arch. For the remaining patients (n = 22), the prevalence of diastema was 47.8% (n = 10), with a mean value of 3.6 ± 1.9 mm, and lower arch crowding was observed in 52.2% (n = 12), with a mean value of –2.9 ± 1.4 mm. No significant difference was found between the prevalence of crowding and diastema (p = 0.832). Conclusion: In patients with a UCLP, diastema can be encountered approximately at the same frequency as crowding in the lower arch. Crowding was at a low to mid-level.

Many orthodontists working on patients with cleft lip and palate (CLP) have shown great enthusiasm for presurgical infant orthopedics (PSIO) to improve surgical outcomes with minimal intervention. Even though every clinician aims to use the best treatment modality for their patients, PSIO effects can be confounded by surgical type and timing of the primary repair, as is discussed in many studies. In such cases, one should be cautious when evaluating the particular outcomes for patients with CLP since it is difficult to differentiate the sole effect of an individual surgical or orthodontic intervention. As with any treatment methodology, nasoalveolar molding (NAM) has both benefits and limitations. Commonly cited concerns with NAM, and PSIO in general, include increased cost, increased burden of care, and a negative impact on maxillary growth. However, NAM cannot be deemed as having apparent long-term negative or positive effects on skeletal or soft tissue facial growth, based on previous studies. A review of the literature suggests that NAM does not alter skeletal facial growth when compared with the samples that did not receive PSIO. Nevertheless, the published studies on NAM show evidence of benefits to the patient, caregivers, the surgeon, and society. These benefits include documented reduction in severity of the cleft deformity prior to surgery and as a consequence improved surgical outcomes, reduced burden of care on the care givers, reduction in the need for revision surgery, and consequent reduced overall cost of care to the patient and society.

Introduction: The treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion. Methods: Pretreatment cephalograms of 306 patients (131 men, 175 women; overall ages 18-45 years) were evaluated. Four groups were constructed. Three groups had increased overbite (>4.5 mm): group 1 (n = 96) skeletal Class I (ANB = 0.5 degrees-4 degrees), group 2 (n = 85) skeletal Class II (ANB >4.5 degrees) with Class II/1; and group 3 (n = 79) skeletal Class II with Class II/2 malocclusion. Group 4 as a control (n = 46) skeletal Class I normal overbite. Dental and skeletal characteristics of the groups were compared by sex. For statistical evaluations, analysis of variance followed by Tukey post hoc, Mann-Whitney U, and Kruskall-Wallis tests were used. Additionally correlation coefficients between overbite and skeletal/dental parameters were calculated. Results: Between sexes, with regard to skeletal parameters, the men had greater values in millimetric measurements, and the women had higher SN/GoGn values. Maxillary/ mandibular molar heights and the mandibular incisor heights were higher in men. In group 1, decreased lower anterior facial height (LAFH), retrusive mandibular incisors, and increased interincisal degree were determined. The maxillary molars were intrusive, whereas the vertical position of the mandibular molars and incisors in both jaws were normal. In group 2, retrognathic mandible, increased LAFH and mandibular plane angle, extrusive maxillary/mandibular incisors, protrusive mandibular incisors, and decreased interincisal degree were found. In group 3, decreased LAFH, increased interincisal degree, and retrusive incisors in both jaws were determined. There were significant negative correlations between SN/GoGN, palatal plane, and overbite in group 2 and between ANS-SN and overbite in group 3, and positive correlation between interinsical angle and overbite in all increased overbite groups. Conclusion: Dental morphology seems to be the main factor of increased overbite. Differences between groups were related primarily to inclinations and vertical positions of the incisors, rather than molar positions.

We present the multidisciplinary treatment of a young adult patient with unilateral complete cleft lip and palate (UCLP). The patient with UCLP was 17 years old and had not applied for treatment before. He presented with a concave profile, lateral crossbite and a tete-a-tete overbite. After initial orthodontic treatment the patient's cleft lip and nose and afterwards his palate were operated on. During the orthodontic treatment the patient had a negative overjet of 6 mm, a residuel fistule in soft palate, maxillary and secondary nose base deficiency, also a severe alveolar cleft in the premaxilla. To fix these problems, the patient's maxilla was advanced by applying a Lefort-1 osteotomy, the secondary fistule in the soft palate was operated on and the alveolar defect was grafted with a biocollagen membrane, cansellous block graft and cansellous granular graft. The orthodontic treatment lasted 1 year following the orthognathic surgery. At the end of the orthodontic treatment Class I molar relationship was achieved on the right side and full Class II on the left side and also a 1 mm overjet and overbite. After a period of retention of 1.5 years some relapse occurred and delayed prosthetic treatment was performed by applying an adhesive bridge. Late term multidisciplinary treatment gave the UCLP patient a good appearance as well as psychological and social benefits.

This study was designed to identify variables affecting family functions and life quality of parents with cleft lip and/or palate children.Family Assesment Scale (FAS) and short form of World Health Organization quality of life (WHOQOL-BREF-TR) were used to measure family functions and life quality of parents. Questionnaire Forms were given to 146 parents: 74 having cleft lip and/or palate children (cleft-group), and the other 72 with healthy children (control-group). Parents were divided into 3 subgroups according to children's age as 0 to 6, 7 to 12, and 13 to 18 years. Kruskal-Wallis and Mann-Whitney U tests were used to evaluate differences between the groups.Behavior of cleft patients' parents was found to be problematic in behavioral control, required attention and role areas at 0 to 6 years, required attention area at ages 7 to 12 and 13 to 18 years. When compared to control group, significant differences were detected in required attention at ages 0 to 6 years, problem-solving, and communication areas at 7 to 12 years. Findings of life quality were found to be over medium level in physical, social, psychological and environmental areas in cleft group at all age groups; however, life quality was found better in control group in physical, psychological, and social subtests at age 13 to 18 years.Cleft children influence family functions in behavioral control, required attention and role areas at early childhood, and continue to affect required attention through adolescence. Also social, physical, and psychological fields of life quality were found lower in cleft parents compared to control group at adolescence.

Objective:The purpose of this study was to evaluate and compare the efficacy of nasoalveolar molding (NAM) therapy in the improvement of alveolar and palatal cleft deformity on unilateral (UCLP) versus bilateral (BCLP) cleft lip and palate.Materials and Methods:A total of 19 UCLP (14 boys and 5 girls) and 8 BCLP (7 boys and 1 girl) infants completed NAM therapy were included in this study. Standardized parameters of cleft width of alveol and palate were measured on photocopies taken from the pre- and post-treatment plaster casts. To assess the intragroup differences, paired-samples test in UCLP and Wilcoxon test in BCLP groups were used. Mann-Whitney U test was used to evaluate the differences between the groups.Results:Significant decreases in alveolar and palatal cleft gaps were achieved in an average period of 3.31.9 and 3.7 +/- 1.6 months in UCLP and BCLP patients, respectively. The alveolar cleft decreased 7.85 +/- 4.59 mm in UCLP and 4.25 +/- 3.13 and 3.81 +/- 3.50 mm in right and left alveolar cleft sides in BCLP, respectively. The palatal clefts were decreased 4.63 +/- 2.44 mm in medial and 3.72 +/- 2.62 mm in posterior parts in UCLP. The decrements in BCLP were 3.00 +/- 2.75 mm in medial and 2.88 +/- 2.75 mm in posterior palatal cleft distances. No significant differences were determined in the amount of alveolar or palatal cleft closure between UCLP and BCLP groups. The only decrease in arch width was 1.39 mm in medial part of palate in UCLP.Conclusion:The NAM device provides significant decreases in both alveolar and palatal cleft deformities in UCLP and BCLP infants, as compared with their birth status.

Objective: To evaluate the dentofacial effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage (FRDMS) and compare them with those of conventional FRD and an untreated Class II control group. Materials and Methods: The sample consisted of 48 Class II subjects. Sixteen patients (13.68 ± 1.09 years of age) were treated with FRDMS, whereas 17 subjects (14.64 ± 1.56 years of age) were treated with only FRD. Also, a control sample of 15 untreated Class II subjects (14.13 ± 1.50 years of age) was constructed. Angular and linear measurements were made on 96 lateral cephalograms. Paired t, one-way analysis of variance, and Tukey tests were used for statistical analysis. Results: Class I molar relationship and overjet correction were achieved in an average period of 6.5 ± 1.97 and 5.5 ± 1.80 months in the FRDMS and FRD groups, respectively. No skeletal effect was determined in both treatment groups. Greater overbite correction was found in the FRD group. Retrusion and extrusion of maxillary incisors, distalization of maxillary molars, and extrusion of mandibular molars were significant in both treatment groups. Labial tipping of mandibular incisors was significantly greater in the FRD group than in the FRDMS group. Conclusion: Overjet and molar correction was totally dentoalveolar. Unfavorable labial tipping of mandibular incisors was effectively minimized with the usage of miniscrews.

This study describes the management of a case of multiple missing teeth involving premolar autotransplantation, othodontic treatment, and a 6-year follow-up of autotransplantation. The prognosis of the transplant was good with a satisfactory crown-root ratio. Autotransplantation is a viable treatment option that eliminates the need for prosthetic therapy or implants for children with missing permanent teeth. (Angle Orthod 2010;80:396-404.)

Amac: Iskeletsel Sinif 1 ve 2 anomali ile birlikte artmis overbite’a sahip eriskinlerde kraniyofasiyal morfolojiyi degerlendirmek ve cinsiyet bakimindan karsilastirmaktir.Gerec ve Yontem: Ortodontik tedaviye alinmis, artmis overbite’a (≥4.5 mm) sahip 16-45 yaslari arasindaki 188 (75 erkek, 113 kiz) bireye ait lateral sefalometrik film degerlendirildi. Orneklem 3 gruba ayrildi: Grup 1 (n=87) iskeletsel Sinif 1 (ANB=0-4), Grup 2 (n=64) iskeletsel Sinif 2 (ANB≥4.5), dissel Sinif II/1 ve Grup 3 (n=37) iskeletsel Sinif 2, dissel Sinif II/2 malokuzyona sahip bireyler. Gruplar cinsiyetlere gore karsilastirildi. Bes acisal, sekiz dogrusal olcum yapilarak kraniyofasiyal yapilar sagital ve vertikal yonde degerlendirildi. Elde edilen verilerin istatistiksel degerlendirmesinde Bonferroni duzeltmeli ANOVA testi, Mann-Whitney U testi ve Kruskal-Wallis testi kullanildi. Ayrica, overbite ile GoGnSN degeri arasindaki korelasyon degerlendirildi.Bulgular: Grup 1 ve 2’de milimetrik olcumlerde erkeklerin kizlardan daha buyuk degerlere sahip oldugu belirlendi. Her iki cinsiyette; SNB degerinin Grup 1 ve 2 arasinda anlamli farklilik gosterdigi, SN/GoGn degerinin Grup 2’de anlamli seviyede yuksek oldugu bulundu. Tum gruplarda SN/GoGn ile overbite arasinda negatif korelasyon saptandi. ANS-SN (mm) degeri ve ust yuz yuksekliginin (N-ANS; mm) yalniz erkeklerde Grup 2’de artmis oldugu ve Grup 1 ve Grup 3 ile anlamli farklilik gosterdigi saptandi.Sonuc: Grup 1 ve 3’te kraniyofasiyal yapilarin sagital ve vertikal yonde benzerlik gosterdigi bulunurken; Grup 2’de sagital yonde mandibulanin daha geride konumlandigi, vertikal yon boyutlarinin ise artmis oldugu tespit edildi.

Objective: To evaluate the vertical position and inclinations of the 1. molars and incisors in adults having skeletal Class 1 and 2 anomaly combined with increased overbite.Materials and Method: Pretreatment cephalograms of 185 orthodontic patients (75 men, 113 women) between 16 and 45 years of age with increased overbite (≥ 4.5mm), without great restorations/crown on incisors, 1. molar teeth and tooth agenesis were evaluated. The sample was divided into 3 groups as: Group 1 (n=87) skeletal Class I (ANB=0-4), Group 2 (n=64) skeletal Class 2 (ANB>4.5) with Angle class II/1 and Group 3 (n=37) skeletal Class 2 with Angle Class II/2 malocclusions. Three angular and 8 linear measurements were performed. Groups were compared according to gender. For statistical evaluations Bonferroni-corrected ANOVA test, Mann-Whitney U and Kruskal-Wallis tests were used.Results: In all groups no significant differences were found in incisors’ inclination [1-NA (°), 1-NB (°), interincisal degree (°)] and sagittal position [1-NA (mm), 1-NB (mm)] between the genders. However significant differences were found in 1. molar and incisor vertical positions (1-PP, 6-PP, 1-GoGn, 6-GoGn) between Groups 1 and2. In all genders significant differences were foundd in interincisal degree whereas no differences were observed in maxillary and mandibular 1. molar heights in all groups. In Group 2, more protrusive mandibular incisors, extrusive mandibular and maxillary incisors and lower interincisal degree were found. In Group 3, increased interincisal degree and more retrusive and retroclined incisor positions were found compared to Group 1 and 2.Conclusion: The differences between groups were related to incisors’ vertical position and inclinations rather than first molars’ positions., Amaç: İskeletsel sınıf 1 ve 2 anomali ile birlikte artmış overbite’a sahip erişkinlerde 1. azı ve kesici dişlerin dik yön konumlarını ve eğimlerini karşılaştırmalı olarak değerlendirmektir.Gereç ve Yöntem: Overbite’ı artmış (≥4.5 mm), kesici ve azı dişlerde büyük restorasyon veya kron olmayan ve diş eksikliği bulunmayan, 16-45 yaşları arasındaki 185 (75 erkek, 113 kadın) ortodonti hastasının tedavi başı lateral sefalometrik filmleri değerlendirildi. Örneklem 3 gruba ayrıldı: Grup 1 (n=87) iskeletsel Sınıf 1 (ANB=0-4), Grup 2 (n=64) iskeletsel Sınıf 2 (ANB≥4.5), dişsel Angle Sınıf II/1 ve Grup 3 (n=37) iskeletsel Sınıf 2, dişsel Angle Sınıf II/2 malokuzyona sahip bireyler. Filmler üzerinde 3 açısal ve 11 doğrusal ölçüm yapıldı. Gruplar cinsiyetlere göre karşılaştırıldı. Elde edilen verilerin istatistiksel değerlendirmesinde Bonferroni düzeltmeli ANOVA testi, Mann-Whitney U ve Kruskal-Wallis testi kullanıldı.Bulgular: Tüm gruplarda cinsiyetler arasında kesici dişlerin eğimleri [1-NA (°), 1-NB (°), interinsizal açı (°)] ve sagital yöndeki konumlarında [1-NA (mm), 1-NB (mm)] farklılık bulunmazken; Grup 1 ve 2’de maksiller, mandibular 1.azı ve kesici dişlerin dik yön konumlarının (1-PP, 6-PP, 1-GoGn, 6-GoGn) önemli farklılık gösterdiği belirlendi. Her iki cinsiyette interinsizal açı bakımından tüm gruplar arasında istatistiksel olarak anlamlı farklılıklar bulundu. Maksiller ve mandibular 1. büyükazı dişlerin dik yön konumu bakımından her iki cinsiyette gruplar arasında fark saptanmadı. Grup 2’de interinsizal açı daha düşük, alt kesiciler daha protrüziv, maksiller ve mandibular kesiciler daha ekstrüziv bulundu. Grup 3’te interinsizal açının artmış olduğu, kesici konumlarının Grup 1 ve2’ ye göre daha retrüziv ve dik olduğu saptandı.Sonuç: Gruplar arasında, 1. büyükazı dişlerin konumlarından ziyade, kesici dişlerin dik yön konumları ve eğimlerinde farklılıklar saptandı.

Distraction osteogenesis technique has been successfully applied in the craniofacial area for long time, and it is being applied increasingly more in cleft lip and palate patients also. Especially in large cleft palate cases, bone grafting or surgical procedures such as distraction osteogenesis can be applied in order to ensure a smooth alveolar arc. In this literature review, alveolar (segmental) distraction osteogenesis applications in patients with cleft lip and palate, indications of the technique, advantages and disadvantages, application methods and types of appliances used for this purpose have been evaluated. As conclusion, especially with the application of alveolar (segmental) distraction osteogenesis, successful outcome can be achieved in cleft lip and palate patients with velopharyngeal insufficiency, maxillary hypoplasia and maxillary crowding, and this technique may be an alternative to conventional osteotomies and extraoral distractions., Kraniyofasiyal bölgede başarıyla uygulanmakta olan distraksiyon osteogenezis yönteminin dudak damak yarıklı bireylerde uygulanmasının giderek arttığı görülmektedir. Özellikle geniş damak yarıklı hastalarda düzgün bir alveolar ark sağlanmasına yönelik olarak kemik greftleme veya distraksiyon osteogenezis gibi cerrahi işlemler uygulanabilmektedir. Bu derlemede dudak damak yarığı olan bireylerde alveolar (segmental) distraksiyon osteogenezis uygulayan çalışmaların verileri ışığında, uygulamanın endikasyonları, avantaj ve dezavantajları, uygulama metodları ve bu amaçla kullanılan aparey çeşitleri değerlendirildi. Sonuç olarak, özellikle alveolar distraksiyon osteogenezis uygulaması ile velofaringeal yetmezlik, maksiller hipoplazi ve maksiller çapraşıklığa sahip dudak damak yarığı olan hastalarda başarılı sonuçlar elde edilebildiği ve bu yöntemin konvansiyonel osteotomilere ve ağız dışı distraktörlerle yapılan distraksiyon uygulamalarına alternatif olabileceği belirlendi.

Aim The purpose of this prospective study was to determine the number of contacts in centric occlusion during retention with modified and full-coverage thermoplastic Essix retainers. Methods This research was based on 36 patients who were randomly assigned to wear either modified (18 patients) or full-coverage (18 patients) Essix retainers. Silicone-based bite registrations were used to record occlusal contacts at the beginning (T1), end of full-time (6 months; T2), and end of night-time (3 months; T3) wear of retainers. The occlusal contacts determined in treated patients were compared with the values of 18 untreated "normal" Class I subjects. Bonferroni-adjusted Wilcoxon and Kruskal-Wallis tests were used to evaluate intra- and intergroup differences. Results Total posterior contacts increased significantly at T3 compared to T1 and T2 only in the modified Essix group. Non-ideal and total contacts on premolars, non- ideal and actual contacts on first molars, and actual contacts on second molars increased significantly at T3 in the modified Essix group. No significant increase was determined in the final total posterior contacts in the full-coverage Essix group. Actual contacts on premolars and first molars and total posterior actual contacts were significantly greater at T3 in the modified Essix group compared to the full-coverage Essix Group. Also the number of final posterior ideal contacts in the modified Essix group was greater than in the normal sample. Total anterior contacts decreased significantly in the modified Essix group, whereas they increased significantly in the full-coverage Essix group. Conclusions Increase in posterior contacts was achieved only during night-time wear of modified Essix retainers.

Impacted teeth are those with a delayed eruption time or those which are not expected to erupt completely based on clinical and radiographic assessment (Richardson & Russell, 2000). All teeth can be impacted. However, third molars, maxillary canines, maxillary and mandibular premolars, and maxillary central incisors are the teeth most frequently involved (Rajic et al., 1996). Impactions are twice as common in females (1.17 %) as in males (0.51 %). The prevalence of impacted maxillary canines is 0.9–2.2%, but mandibular canine impaction occurs 20 times less frequently than maxillary canines (Alaejos-Algarra et al., 1998; Aydin et al., 2004; D’Amico et al., 2003). It is an even more rare phenomenon when such an impacted mandibular canine migrates to the other side of the mandible, crossing the mandibular midline (Joshi, 2001). Shah et al. (1978) found 8 unerupted mandibular canines in 7886 individuals. Grover and Lorton (1985) found 11 impacted mandibular canines in 5000 individuals. Ericson and Kural (1986) estimated the incidance of mandibular canine impaction to be 0.35 %. The etiology of impacted teeth is unknown, though several mechanisms have been proposed. Tumors, cysts, and odontomes may cause malposition of teeth if they lie in the path of eruption of teeth. Other possible etiologic factors suggested by some authors are premature loss of deciduous teeth, prolonged retention or early loss of the deciduous canine, crowding, spacing, supernumerary teeth, abnormal position of the tooth bud, excessive length of the crown of the mandibular canines, dilaceration of the root, iatrogenic origin and idiopathic condition with no apparent cause cystic lesions, an abnormally strong eruption force and heredity (Bishara, 1992; Javid, 1985; Joshi & Shetye, 1994). The treatment options for impacted canines are no treatment, surgical intervention, removal, transplantation, prosthetic or restorative treatment or surgical exposure with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and alignment (Blair et al.,1998). Successful treatment of impacted canines is dependent on the position of the tooth in both the sagittal and transversal planes, ankylosis and dilaceration of the tooth. It has generally been accepted that the more a canine is horizontally impacted, the less successfull the tooth will be brought into its correct position (Odegaard, 1997). Since prevention of impacted canines provides the best long-term results, intervention with surgical attachment of an orthodontic button or bracket should be implemented only as a second alternative (Crawford, 2000).

The aim of this prospective study was to evaluate the number of contacts in centric occlusion during retention with thermoplastic retainers (Essix retainers) and in the long term. After four premolar extractions and active orthodontic treatment of 15 Class I (10 females, 5 males; mean age 17.20 +/- 1.7 years), thermoplastic retainers were used. Occlusal contacts were determined from occlusal registrations taken in centric occlusion at the beginning (T0), end (9 months of retention; T1), and after 2.5 years (T2). The occlusal contacts determined in these patients were compared with the values of 15 'normal' Class I subjects (9 females, 6 males; mean age 17.10 +/- 1.60 years) who had not undergone orthodontic treatment. Wilcoxon and a Mann-Whitney U-tests were used to evaluate intra- and intergroup differences. No significant change was observed in the number of posterior contacts during T1, whereas a significant increase was found at T2 (P < 0.01) for the second premolars (P < 0.01) and second molars (P < 0.05). Both 'ideal' and 'non-ideal' contacts increased significantly but only at T2 (P < 0.05). The number of ideally located contacts on the posterior teeth at all three periods were lower than normal values (P < 0.01); while non-ideal contacts at T1 (P < 0.05) and T2 (P < 0.01) were found more often when compared with the values of normal subjects. Only the increased number of premolar contacts at T2 was more than normal values (P < 0.01). There was no expected increase in occlusal contacts at T2; however, posterior occlusal contacts were increased at T3.

The aim of this prospective study was to evaluate the dentofacial effects of the reciprocal mini-chin cup (RMCC) appliance in subjects with pubertal growth and development potential (group 1) and in subjects that had completed this period (group 2). Eighteen patients (13 females, five males) with an Angle Class II division 1 and nine patients (six females, three males) with a Class II division 2 malocclusion, with mandibular dentoalveolar retrusion and optimal vertical facial dimension were included. A control group consisting of 14 subjects (nine females, five males) with pubertal growth and development potential was constructed for comparison with group 1. In both treatment groups a RMCC was used. A Class I molar relationship was achieved in an average period of 5.11 months in group 1 and 10.57 months in group 2. From lateral cephalometric tracings, beside the angular and linear parameters, eight parameters that determined the ratio of the skeletal and dental effects of RMCC were measured and statistically evaluated. A paired comparison t -test was used to assess the differences in each group and a Student's t text to evaluate the differences between the groups. In both groups, no effect of RMCC was found on either the maxilla and/or the sagittal position of the mandible. In group 1, lower anterior face height was increased more compared with group 2; the mandibular plane angle increased and the mandible developed mostly in the vertical dimension. While a Class I molar relationship and correction of the overbite and overjet were achieved in both groups, a greater correction of overjet was found in group 1. Retrusion of the upper incisors without extrusion, protrusion, or proclination of the lower incisors, distalization of the upper molars, mesialization and extrusion of the lower molars and mesialization of the mandibular dentoalveolar structures were observed in both groups. Contributions to the correction of overjet and molar relationship were mostly dentoalveolar in both groups.

Norogelisimsel bozukluk, beyin veya merkezi sinir sistemi hasariyla karakterize, buyumekte olan cocugun duygu durumunu, ogrenme kabiliyetini ve hafizasini etkileyen anormal beyin fonksiyonu durumudur. Bu bozukluklarda, genellikle sosyal gelisimde gecikme, iletisim bozuklugu, tekrarlayici davranis, anormal yeme aliskanligi, uyku bozuklugu, seslere karsi hassasiyet ve kas tonusuyla alakali motor problemler gorulebilmektedir. Serebral palsi, Down sendromu, Turner sendromu, otizm, epilepsi, Fragile X sendromu, dikkat eksikligi ve hiperaktivite bozuklugu, dis hekimligi acisindan onemi olan norogelisimsel bozukluklardir. Ozel ihtiyaclari olan cocuklarda dental ve ortodontik problemler siklikla gorulmesine ragmen, bu konuda yeterli donanima sahip dis hekimi sayisi oldukca azdir. Ortodontik tedavi ile engelli cocuklarda, yutkunma, salya akitma, konusma, cigneme gibi fonksiyonlarda iyi yonde gelisim elde edilerek, bu bireylerin ozguvenlerinin ve yasam kalitelerinin artmasi saglanabilmektedir.

Four miniscrews were placed into the available inter-root area, two in the posterior and the other two in the anterior region in the maxilla as skeletal anchorage for facemask protraction in a girl 11 years and 11 months old with maxillary retrusion. No tooth support was used for the protraction of the maxilla. Applying orthopedic forces directly to the maxilla resulted in a 2 mm maxillary advancement. Undesired skeletal and dental effects of facemask therapy were eliminated with this new technique. Skeletodental changes in response to the miniscrew-anchored facemask treatment are reported in the present case.