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Force provided by elastomers used in orthodontics can be affected by several factors present in the oral cavity. The aim of our study was to investigate the role of mouthwashes, toothbrushing, and smoking in the force decay of such elastomers. Tensile strength, changes in the force continuously exerted, and force decay of elastic chains (Ortho Organizer and Masel Short Power Chain) and elastic ligatures (Dentaurum and Masel) by two separate manufacturers were measured. Measurements were initially made on untreated elastics, followed by exposure to different environmental factors including cigarette smoke, toothbrushing (mechanical plaque control), and two different mouthwashes (chemical plaque control). Changes on the surface of the elastics were studied with scanning electron microscopy (SEM). Untreated Masel elastic ligature showed lower tensile strength than Dentaurum elastic ligature (2339 cN vs. 3660 cN), while significantly higher tensile strength was measured for Ortho Organizer elastic chains than Masel chains (2639 cN vs. 1324 cN). The decrease in the elastic force of Masel ligature was greater in response to all external factors compared to Dentaurum. Although brushing with toothpaste and toothbrush impacted the force of both Masel and Ortho organizer ligatures negatively, force degradation was more apparent in the case of the Ortho organizer. Surface changes were more visible when applying Curasept mouthrinse, however force decay was higher in the Corsodyl group. Mechanical and chemical plaque control can influence the tensile strength and force decay of orthodontic elastomers, which should be considered by selecting the elastomers or determining their changing interval for the practice.

Class II malocclusion is one of the most common dental anomalies and the use of intermaxillary elastomers is the standard method in its treatment. However, orthodontic elastics cannot exert continuous force over a period of time due to force degradation. Our goal was to mechanically characterize the different types of elastomers during static and cyclic loads, based on uniform methodology and examine the morphological changes after loading. Ten types of latex-containing and four latex-free intermaxillary elastics were examined from six different manufacturers. To determine the mechanical characteristics of the elastomers, tensile tests, cyclical tensile fatigue tests and 24 h relaxation tests were performed, and the elastics were also subjected to scanning electron microscopy (SEM) and Raman spectroscopy. Regardless of the manufacturer, the latex-containing elastomers did not show significant differences in the percentage of elongation at break during the tensile test. Only one type of latex-containing elastomer did not tear during the 24 h cyclical fatigue test. Fatigue was confirmed by electron microscopy images, and the pulling force reduced significantly. During the force relaxation test, only one latex-free ligature was torn; the force degradation was between 7.8% and 20.3% for latex ligatures and between 29.6% and 40.1% for latex-free elastomers. The results showed that dynamic loading was more damaging to ligatures than static loading, latex-containing elastomers were more resistant than latex-free elastics, and which observation could have clinical consequences or a potential effect on patient outcome.

Összefoglaló. Az achondroplasia kialakulásáért az FGFR3-gén mutációja tehető felelőssé, mely a porc növekedési lemezében található chondrocyták érésében okoz zavart. Az esetbemutatásban szereplő lánygyermeknél a születést követő első hónapban a klinikai, laboratóriumi és röntgenvizsgálatok alapján achondroplasia igazolódott. A klinikai tünetek közé tartoznak a rövid végtagok – különösen a proximalis szegmensben –, a macrocephalia, a hypotonia és a horkolás. Szembetűnő a középarc hypoplasiája. A középfül diszfunkciója tovább súlyosbítja a kórképet, sok esetben megfigyelhető a hallás nagyfokú csökkenése, illetve kezelés hiányában akár a hallás elvesztése. A közlemény részletesen bemutatja az obstruktív alvási apnoe szindróma diagnózisrendszerét és kezelési alternatíváit, hangsúlyozva az orthodontiai szempontokat. A fül-orr-gégészeti és a fogszabályozó terápiának köszönhetően, a diagnózistól számított harmadik évre, az alvási apnoe szindróma megszüntetésével a folyamatos pozitív nyomású lélegeztetést el lehetett hagyni. A horkolás és az alvási apnoe szindróma kezelése napjainkban egyre nagyobb hangsúlyt kap, melynek komplex kezelésében a fogszabályozás is jelentős lehet. A harmonikus együttműködés és teamkezelés betegünknél jelentős életminőség-javulást eredményezett. Orv Hetil. 2021; 162(17): 683–688. Summary. Development of achondroplasia is due to the mutation of FGFR3 gene, which disrupts the maturation of chondrocytes found in the growth plate. The diagnosis of the girl in the present case study was established based on clinical symptoms, laboratory tests and X-ray imaging in the first month following childbirth. Clinical symptoms include shorter limbs especially in the proximal segments, macrocephaly, hypotonia and snoring. Hypoplasia of the midface is apparent. Dysfunction of the middle ear further worsens the condition, in many cases severe hearing loss and, without treatment, even deafness can be observed. The publication describes the diagnostic criteria and therapeutic options of obstructive sleep apnea syndrome in detail, with an emphasis on the orthodontic aspects. A comprehensive combined three-year oto-laryngological and orthodontic treatment finally succeeded in controlling the sleep apnea syndrome and it was possible to discontinue the continuous positive airway pressure therapy by the end of the orthodontic therapy. Nowadays, even more alternative therapeutic approaches are available to treat snoring and sleep apnea syndromes, in which the role of orthodontics must not be neglected. Harmonic collaboration and team work treatment resulted in a significant improvement in the quality of life of our patient. Orv Hetil. 2021; 162(17): 683–688.

Headache is a common problem with great effect both on the individual and on the society. Recent studies raised the possibility of increasing rate of specialty referrals, inappropiate treatment and advanced imaging for simple headache. The aim of our study was to analyze the characteritics of patients (including duration of symptoms, headache type, brain imaging, treatment) referred to our specialized headache clinic between 01/01/2014 and 01/01/2015 by their general practitioners and primary care neurologists due to chronic/treatment-resistant headache syndromes. 202 patients (mean age 53.6 ± 17.6 years) were evaluated in our clinic (102 females, mean age 50.14 ± 16.11 years and 100 males, mean age 57 ± 18.1 years). Migraine (84/202) and tension-type (76/202) were the most common syndromes. 202 plain brain CT, 60 contrast-enhanced CT and 128 MRI were carried out by their general practitioners or other healthcare professioners including neurologists before referral to our headache centre. Despite of extensive brain imaging appropiate treatment was started less than 1/3 of all patients and significant proportion received benzodiazepines or opioid therapy. Furthermore, more than 10% of referred patients presented with secondary headache including one meningitis. The management of headache is still a challenge for primary care physicians leading to medical overuse. Vast majority of our patients should not be referred to our specialized headache clinic as they had uncomplicated headache or other underlying conditions than pain.

Absztrakt: A Gorlin–Goltz-szindróma autoszomális dominánsan öröklődő kórkép. Vezető tünetei az állcsontok keratocystái, a multiplex basaliomák, csontvázfejlődési rendellenességek, intracranialis calcificatio és tenyéri, talpi dyskeratosis. A szindróma egyik leggyakoribb és sokszor először észrevehető tünete az állcsonti keratocysta. A szerzők munkájukban egy fogszabályozó osztályon diagnosztizált és kezelt gyermek esetét mutatják be. A betegség ritka előfordulása ellenére fontos a korai, fiatalkorban történő felismerés. A betegek rendszeres gondozásával megelőzhetők az akár életet veszélyeztető elváltozások és a radikális műtéttel járó kezelések. Orv Hetil. 2020; 161(2): 67–74.

Abstract: Orofacial pain is the common name of a variety of disorders from inflammatory diseases to neuropathic pain syndromes. This condition is quite common, it may involve 7% of the whole population. Patients (and doctors) are not aware of the origin of their complaints, therefore initial management falls among the variety of healthcare professionals. The aim of our review was to summarize the current evidence of chronic orofacial pain including diagnosis, management and pitfalls. Orv Hetil. 2019; 160(27): 1047–1056.

Összefoglaló. Az achondroplasia kialakulásáért az FGFR3-gén mutációja tehető felelőssé, mely a porc növekedési lemezében található chondrocyták érésében okoz zavart. Az esetbemutatásban szereplő lánygyermeknél a születést követő első hónapban a klinikai, laboratóriumi és röntgenvizsgálatok alapján achondroplasia igazolódott. A klinikai tünetek közé tartoznak a rövid végtagok - különösen a proximalis szegmensben -, a macrocephalia, a hypotonia és a horkolás. Szembetűnő a középarc hypoplasiája. A középfül diszfunkciója tovább súlyosbítja a kórképet, sok esetben megfigyelhető a hallás nagyfokú csökkenése, illetve kezelés hiányában akár a hallás elvesztése. A közlemény részletesen bemutatja az obstruktív alvási apnoe szindróma diagnózisrendszerét és kezelési alternatíváit, hangsúlyozva az orthodontiai szempontokat. A fül-orr-gégészeti és a fogszabályozó terápiának köszönhetően, a diagnózistól számított harmadik évre, az alvási apnoe szindróma megszüntetésével a folyamatos pozitív nyomású lélegeztetést el lehetett hagyni. A horkolás és az alvási apnoe szindróma kezelése napjainkban egyre nagyobb hangsúlyt kap, melynek komplex kezelésében a fogszabályozás is jelentős lehet. A harmonikus együttműködés és teamkezelés betegünknél jelentős életminőség-javulást eredményezett. Orv Hetil. 2021; 162(17): 683-688. Summary. Development of achondroplasia is due to the mutation of FGFR3 gene, which disrupts the maturation of chondrocytes found in the growth plate. The diagnosis of the girl in the present case study was established based on clinical symptoms, laboratory tests and X-ray imaging in the first month following childbirth. Clinical symptoms include shorter limbs especially in the proximal segments, macrocephaly, hypotonia and snoring. Hypoplasia of the midface is apparent. Dysfunction of the middle ear further worsens the condition, in many cases severe hearing loss and, without treatment, even deafness can be observed. The publication describes the diagnostic criteria and therapeutic options of obstructive sleep apnea syndrome in detail, with an emphasis on the orthodontic aspects. A comprehensive combined three-year oto-laryngological and orthodontic treatment finally succeeded in controlling the sleep apnea syndrome and it was possible to discontinue the continuous positive airway pressure therapy by the end of the orthodontic therapy. Nowadays, even more alternative therapeutic approaches are available to treat snoring and sleep apnea syndromes, in which the role of orthodontics must not be neglected. Harmonic collaboration and team work treatment resulted in a significant improvement in the quality of life of our patient. Orv Hetil. 2021; 162(17): 683-688.

Gorlin-Goltz syndrome is an autosomal dominant hereditary disease. Its leading symptoms include keratocysts of the jaws, multiple basal cell carcinomas, skeletal abnormalities, intracranial calcifications and dyskeratosis of the soles and palms. One of the most common and often firstly discovered symptoms is the single or multiplex keratocysts of the jaws. The authors present a case of a child, diagnosed in their orthodontic department. Despite the rare occurrence of the disease, an early detection is important, especially in young patients. Regular follow-up and timely care for patients may avoid life-threatening malformations and radical surgical treatments. Orv Hetil. 2020; 161(2): 67-74.Absztrakt: A Gorlin–Goltz-szindróma autoszomális dominánsan öröklődő kórkép. Vezető tünetei az állcsontok keratocystái, a multiplex basaliomák, csontvázfejlődési rendellenességek, intracranialis calcificatio és tenyéri, talpi dyskeratosis. A szindróma egyik leggyakoribb és sokszor először észrevehető tünete az állcsonti keratocysta. A szerzők munkájukban egy fogszabályozó osztályon diagnosztizált és kezelt gyermek esetét mutatják be. A betegség ritka előfordulása ellenére fontos a korai, fiatalkorban történő felismerés. A betegek rendszeres gondozásával megelőzhetők az akár életet veszélyeztető elváltozások és a radikális műtéttel járó kezelések. Orv Hetil. 2020; 161(2): 67–74.

Orofacial pain is the common name of a variety of disorders from inflammatory diseases to neuropathic pain syndromes. This condition is quite common, it may involve 7% of the whole population. Patients (and doctors) are not aware of the origin of their complaints, therefore initial management falls among the variety of healthcare professionals. The aim of our review was to summarize the current evidence of chronic orofacial pain including diagnosis, management and pitfalls. Orv Hetil. 2019; 160(27): 1047-1056.Absztrakt: Az orofacialis fájdalom egy gyűjtőszó, mely sokféle kórképet takarhat a gyulladásos kórképektől kezdve a neuropathiás fájdalomig. Maga a kórkép nem ritka, akár a populáció 7%-át érintheti. Sokszor maguk a betegek sem tudják, hogy panaszokkal fogászhoz vagy más szakemberhez forduljanak. A régió sok szakma határterületét képezi (fogászat, fülészet, szemészet, neurológia stb.), így nem meglepő, hogy egy-egy beteg akár 6–7 specialistánál megfordul. Összefoglaló közleményünk célja, hogy áttekintést adjunk a krónikus orofacialis fájdalommal járó kórképek diagnózisáról, az esetleges differenciáldiagnosztikai lehetőségekről és kezelési módokról. Orv Hetil. 2019; 160(27): 1047–1056.

Introduction.Stroke is a significant underlying cause of epilepsy. Seizures due to ischemic stroke (IS) are generally categorized into early seizures (ESs) and late seizures (LSs). Seizures in thrombolysis situations may raise the possibility of other etiology than IS.Aim.We overtook a systematic review focusing on the pathogenesis, prevalence, risk factors, detection, management, and clinical outcome of ESs in IS and in stroke/thrombolysis situations. We also collected articles focusing on the association of recombinant tissue-type plasminogen activator (rt-PA) treatment and epileptic seizures.Results.We have identified 37 studies with 36,775 participants. ES rate was 3.8% overall in patients with IS with geographical differences. Cortical involvement, severe stroke, hemorrhagic transformation, age (Conclusion.ESs are rare complications of acute stroke with substantial burden. A significant proportion can be presented at the onset of stroke requiring an extensive diagnostic workup.

The aim of this in vitro study was to examine the effects of surgical drill wear after coronectomy on bone temperature changes and preparation times for bone cavity drilling.Tungsten carbide round drills were used to perform 10 (D_10), 20 (D_20), or 30 (D_30) coronectomies on extracted lower third molars to elicit drill wear, and then 5-mm-deep cavities were drilled in pig ribs with a testing apparatus-controlled surgical unit. Temperature changes and preparation times were measured. Differences in mean values were examined with analyses of variance and the Tukey honest significant difference post hoc test.The unused drills prepared the holes significantly faster (2.52 ± 1.6 seconds) than the D_20 (13.29 ± 5.76 seconds) and D_30 (31.48 ± 12.93 seconds) drills (P = .01 and P.001, respectively). The D_10 (change, 2.33 ± 0.77°C), D_20 (change, 2.57 ± 0.57°C), and D_30 (change, 3.94 ± 0.62°C) drills produced significantly more heat than the D_0 drills (change, 1.18 ± 0.28°C; P.001). At higher axial pressures of 25 N (to provoke ≤ 3-second preparation times in line with new drills), the D_30 drills produced a temperature change of 6.31 ± 1.23°C with 60 mL/minute and significantly more heat (change, 20.48 ± 8.84°C; P.001) with 20 mL/minute of irrigation.Intraosseous heat produced by surgical tungsten carbide round drills remains under the threshold temperature of bone necrosis for up to 30 coronectomies; however, the use of increased axial pressure (∼ 25 N), especially with the combination of decreased irrigation (∼ 33%), can cause unacceptable temperatures during bone removal. Professionals should select drills and drilling parameters that generate an acceptable amount of heat during surgical tooth removal.

Aims: Orthodontic mini‑implants are important devices for successful anchorage management in orthodontics; however, the survival of these devices depends on several clinical factors. The aim of our study was to calculate the success and complication rates of orthodontic mini‑implants. Materials and Methods: In this retrospective study, patients of our orthodontic department were enrolled, getting overall 59 orthodontic mini‑implants during their orthodontic treatment in a 2‑year period. Every patient had one or more of the 1.6 mm × 8 mm in size self‑drilling mini‑implants (Jeil Dual Top Anchor System, Jeil Medical Corp., Seoul, Korea). Screw loading was performed immediately after insertions, keeping tension forces under 150 g. Soft tissue and bone infections, implant mobility and screw loss, implant fracture, and neighboring tooth injury were registered. Relationships between variables were tested using the Chi‑square test for statistical significance. Results: The success rate of the orthodontic mini‑implants was 89.8% in this study while the average loading period was 8.1 months. Soft‑tissue infections varied between 6.3% and 33.3% of the cases while screw mobility varied between 3.1% and 20.8% of the cases regarding the anatomic localization. Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034). Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034) and screw mobility was found more frequently in case of intrusions than by extrusions (P = 0.036). Conclusions: The overall success rate of mini‑implants was found acceptable in this study, however, screw mobility in the buccal fold showed a high incidence, suggesting the thorough consideration of the immediate loading by buccal mini‑implants.Keywords: Implant loosening, implant loss, mini‑screw, orthodontic mini‑implant, success rate

A fogszabályozó kezelés során, szkeletális horgonylat céljából egyre szélesebb indikációs területen alkalmazhatók azortodonciai minicsavarok. Az önfúró minicsavar kézi behajtása során is számolni kell a csontra akár káros hőterheléssel.Szerzők célja volt, hogy szobahőmérsékletű, illetve használat előtt lehűtött minicsavar alkalmazása során is meghatározzáka csontban keletkező hőmérsékleteket. 1,6 × 8 mm minicsavarokat helyeztek be kézi behajtó segítségével 2 mmvastag kortikálissal rendelkező sertésbordacsontba, miközben ellenállás hőmérőszondák segítségével regisztráltáka behajtás során mérhető hőterheléseket. A hűtött csavarok vizsgálatához felhasználás előtt a minicsavart és a behajtóműszert is mélyhűtőbe helyezték. A szobahőmérsékletű és a hűtött eljárások során mérhető hőmérséklet-különbségeketkétmintás t próba segítségével hasonlították össze.Az átlagos hőmérséklet-emelkedés a csontban jelentősen nagyobb értéket (ΔT = 11,3°C) mutatott szobahőmérsékletűminicsavar alkalmazása során, mint a hűtött önfúró csavar használata közben (ΔT = 6,6 °C).A szkeletális horgonylatként felhasznált ortodonciai minicsavarok kézi behajtása során képződő hőterhelések rámutattakarra, hogy a keletkező hőmérsékletek a csavar előzetes hűtésével jelentősen csökkenthetők, feltételezhetően csökkentvea csavarok élettartamát hátrányosan befolyásoló szövődményeket is.

Introduction: In orthodontic diagnosis and treatment planning it is an important goal to reach the best functional and esthetic results. However, during treatment planning the size of the teeth is a frequently ignored factor. The discrepancies of the mesiodistal widths of the teeth can be examined with the Bolton analysis. Our aim is to investigate whether the results described by Bolton are applicable to the population treated by us. Methods: At our clinic we examined the relative tooth size differences of the maxillary and mandibular teeth in 102 clinical patients (64 girls and 38 boys). During the study we formed groups based on gender and dental anomalies. Results: Our resultant measurements diverged from the results published by Bolton to some extent but did not show significant differences. Conclusions: As a conclusion, it can be stated that the diagnostic method developed by Bolton can be applied to the regional dento-alveolar values.

This in vitro study investigated intraos seous heat production during insertion, with and without pre-drilling, of a self-drilling orthodontic mini-implant. To measure temperature changes and drilling times in pig ribs, a special testing apparatus was used to examine new and worn pre-drills at different speeds. Temperatures were measured during mini-implant placement with and without pre-drilling. The average intraosseous temperature increase during manual mini-implant insertion was similar with and without pre-drilling (11.8 ± 2.1°C vs. 11.3 ± 2.4°C, respectively; P = 0.707). During pre-drilling the mean temperature increase for new drills was 2.1°C at 100 rpm, 2.3°C at 200 rpm, and 7.6°C at 1,200 rpm. Temperature increases were significantly higher for worn drills at the same speeds (2.98°C, 3.0°C, and 12.3°C, respectively), while bone temperatures at 100 and 200 rpm were similar for new and worn drills (P = 0.345 and 0.736, respectively). Baseline bone temperature was approximated within 30 s after drilling in most specimens. Drilling time at 100 rpm was 2.1 ± 0.9 s, but was significantly shorter at 200 rpm (1.1 ± 0.2 s) and 1,200 rpm (0.1 ± 0.03 s). Pre-drilling did not decrease intraosseous temperatures. In patients for whom pre-drilling is indicated, speeds of 100 or 200 rpm are recommended, at least 30 s after pilot drilling.

In certain orthodontic treatments therapy includes the removal of permanent tooth or teeth. The number of objective studies on assessing extraction frequency is low and values in the international publications range between wide limits. This shows that often the extraction decision in the treatment planning does is not made upon the criteria of evidence-based dentistry. In our practice, a retrospective analysis of treatment plans prepared between the 1st of January 2004 and the 31st of December 2006 (416 cases) has been performed. The overall prevalence of treatments with extraction was 41.59% for all patients, the rate was 51.63% in patients with permanent dentition at the time of the planning. The highest proportion of extraction (49.71%) was found in Class II subdivision 2 cases, and the lowest percentage (30.17%) in Class I cases. The decision for extraction does not seem to be influenced by cephalometric analysis directly. The higher percentage of extraction found in permanent dentition period shows that when we cannot use interceptive treatment alternatives, we are forced to extract tooth more frequently. On the other hand, the lower value in early mixed dentition period can be explained by the relatively higher number of treatments with the aim to avoid extraction.