Publications by authors named "Metin Orhan"

15 Publications

  • Page 1 of 1

Reverse Forsus vs. facemask/rapid palatal expansion appliances in growing subjects with mild class III malocclusions : A randomized controlled clinical study.

J Orofac Orthop 2021 Jul 16. Epub 2021 Jul 16.

Department of Orthodontics, Faculty of Dentistry, Yıldırım Beyazıt University, Ankara, Turkey.

Purpose: To investigate the skeletal, dental, and soft tissue effects of reverse Forsus (RF; 3M Unitek, Monrovia, CA, USA) and facemask/rapid palatal expansion (FM/RPE) appliances in growing subjects with class III malocclusions.

Methods: The data of this prospective randomized controlled trial (RCT) were derived from pre- and posttreatment/observation lateral cephalograms of 45 subjects with mild class III malocclusions: group 1 (8 girls, 7 boys; mean age 10.54 years) received a FM/RPE appliance; group 2 (6 girls, 9 boys; mean age 10.49 years) received the RF appliance; and an untreated control group (7 girls, 8 boys; mean age 10.66 years) was matched to the treatment groups with regard to sagittal skeletal and dental classifications. Angular and linear measurements were evaluated using lateral cephalograms. Statistical analyses were performed by one-way analysis of variance, Kolmogorov-Smirnov test, Kruskal-Wallis, paired-samples t‑test, and Wilcoxon test, whereby p < 0.05 was accepted to be statistically significant.

Results: The intermaxillary (ANB), interdental (overjet), and sagittal lip relations in the FM/RPE and RF groups showed significant improvements compared to the control group (p < 0.05). Although the anterior and inferior traction of the maxilla was greater in the FM/RPE group compared to the RF group (p < 0.05), both treatment groups showed similar clockwise rotation of the mandible compared to the control group. While significantly more proclination of maxillary incisors occurred in the RF group compared to the FM/RPE and control groups (p < 0.05), both treatments led to significantly retroclined mandibular incisors compared to the control group (p < 0.001).

Conclusion: Both therapies led to intermaxillary and interdental improvements. The RF appliance had a limited effect on the maxilla and it mostly had dentoalveolar effects when compared to FM/RPE therapy.
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http://dx.doi.org/10.1007/s00056-021-00330-1DOI Listing
July 2021

Accelerated Calcium Phosphate Mineralization by Peptides with Adjacent Oppositely Charged Residues.

ACS Biomater Sci Eng 2020 07 29;6(7):3791-3798. Epub 2020 Jun 29.

Department of Clinical Sciences, School of Dentistry, Ankara Yildirim Beyazit University, Ankara 06760, Turkey.

Calcium phosphate mineralizing peptides are of special importance for dental and orthopedic applications, such as caries remineralization and improved osteointegration. Uncovering the mechanism of action for such peptides is an ongoing challenge with the aim of a better fundamental understanding of biomineralization processes and developing optimized peptides for clinical use. It has recently been reported that "adjacent oppositely charged residue" motifs are found abundantly in cation binding, inorganic surface binding, or biomineralization-related proteins and may play a key role in the biomineralization events. Despite their medical importance, the role of these motifs has not yet been investigated on calcium phosphate mineral systems. To investigate this, we have designed peptides with different structural properties and different numbers of adjacent oppositely charged residues. We have evaluated their effects on calcium phosphate mineralization kinetics and mineral properties. The kinetics of the mineralization increased proportionally with an increasing number of adjacent oppositely charged residues. Two peptides with relatively high structural stability and two adjacent oppositely charged residues resulted in faster mineralization and more crystalline mineral compared to a peptide with a higher structural degree of freedom that contained only acidic residues. The fastest mineralization and the highest mineral crystallinity were obtained with a peptide containing the highest number of adjacent oppositely charged residues and highest structural degree of freedom. Our findings and observations from previously identified natural or designed peptides indicate that, in addition to structural instability, adjacent oppositely charged residues play a role in the cation binding, inorganic surface binding, and biomineralization of peptides and require further investigation. Lastly, the peptide identified in this study is an agent with potential medical applications involving the treatment of mineralized tissues.
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http://dx.doi.org/10.1021/acsbiomaterials.0c00194DOI Listing
July 2020

Aetiological Evaluation of Oligodontia in a Three-Generation Family.

Oral Health Prev Dent 2020 Apr 1;18(1):271-275. Epub 2020 Apr 1.

Purpose: The aim of this study was to assess the genetic evaluation of a three-generation consanguineous family with isolated oligodontia.

Materials And Methods: A 16-year-old male patient who had been referred for orthodontic treatment due to the presence of oligodontia, and his family members who presented several missing teeth had been enrolled in the study. Clinical and radiological assessments and genetic analysis including whole-exome sequencing were performed.

Results: Genetic evaluations revealed both homozygous and heterozygous mutations (c.T682A:p.F228I) in the WNT10A gene of six affected members of the family. Higher frequency of agenesis of mandibular second molar was found in homozygous relative to heterozygous WNT10A mutations.

Conclusion: The present findings have provided evidence for a known variant in the WNT10A gene in a three-generation consanguineous family with isolated oligodontia, while the results confirmed that cases with homozygous mutation revealed clinical heterogeneity.
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http://dx.doi.org/10.3290/j.ohpd.a44033DOI Listing
April 2020

Effect of cortical bone thickness and density on pullout strength of mini-implants: An experimental study.

Am J Orthod Dentofacial Orthop 2020 Feb;157(2):178-185

Department of Mechanical Engineering, TOBB University of Economics and Technology, Ankara, Turkey. Electronic address:

Introduction: Anchorage, which is defined as resistance against undesired tooth movements, is one of the most important factors in success of orthodontic treatment. In recent years, mini-implants have been used instead of uncomfortable headgears and Nance appliances. The pullout test is the most common method for measuring the anchorage capacity of mini-implants. The aim of this study was to investigate the effects of cortical bone thickness and cortical layer bone density on pullout strength of mini-implants.

Methods: Mini-implants were placed in polyurethane foam blocks representing 3 different cortical thicknesses (1 mm, 2 mm, and 3 mm) and 3 different cortical bone densities (grade 40, grade 45, and grade 50). Pullout tests were performed with 5 mm/min loading rate. Load vs displacement values were recorded during the tests.

Results: Comparing cortical thicknesses on the same bone densities, statistically significant differences were found between 1 mm, 2 mm, and 3 mm thicknesses. Likewise, comparing bone densities on the same cortical thicknesses, statistically significant differences were found among all groups. Spearman rank tests showed that both cortical thickness and cortical bone density are correlated with pullout strength (rs, 0.548; P <0.001 and rs, 0.691; P <0.001, respectively).

Conclusions: Although both factors are positively correlated with pullout strength, the effect of cortical bone density was the dominant factor affecting primary stability.
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http://dx.doi.org/10.1016/j.ajodo.2019.02.020DOI Listing
February 2020

Salivary opiorphin in dental pain: A potential biomarker for dental disease.

Arch Oral Biol 2019 Mar 15;99:15-21. Epub 2018 Dec 15.

Department of Clinical Sciences, School of Dentistry, Ankara Yildirim Beyazit University, Ankara, Turkey. Electronic address:

Objectives: Opiorphin is a recently discovered peptide shown to inhibit the enkephalin-degrading enzymes and prolong the effects of enkephalins. Although opiorphin is found in high concentrations in saliva, the relationship between salivary opiorphin and orofacial pains is not yet fully understood. We aimed to determine salivary opiorphin concentrations in dental pain related to symptomatic irreversible pulpitis (SIP), and symptomatic apical periodontitis (SAP).

Design: 39 patients participated in this study. The participants were categorized into SIP and SAP based on their diagnosis. All the patients were treated with root canal treatment. Saliva specimens were collected, and pain levels were recorded at pre-treatment, 7 days post-treatment and 30 days post-treatment. Saliva opiorphin levels were measured using a commercially available ELISA kit. Pre-treatment and post-treatment opiorphin levels were evaluated using repeated measures ANOVA. Correlations between VAS scores, opiorphin levels and age were evaluated using Spearman's Rank Correlation.

Results: The average saliva opiorphin level pre-treatment, 7 days post-treatment and 30 days post-treatment were 31.28 ± 7.10 ng/ml, 20.41 ± 2.67 ng/ml and 18.61 ± 2.05 ng/ml respectively. Significantly higher pre-treatment opiorphin levels were observed in the SIP group compared to the SAP group. A strong correlation was observed between the pre-treatment pain levels and the saliva opiorphin concentrations.

Conclusions: Our findings indicate that saliva opiorphin levels increase in inflammation related dental pain. The level of salivary opiorphin is strongly correlated with the reported level of pain. The extent of the inflammation (pulpal vs. periodontal) also affects the opiorphin level.
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http://dx.doi.org/10.1016/j.archoralbio.2018.12.006DOI Listing
March 2019

Effects of modified and conventional facemask therapies with expansion on dynamic measurement of natural head position in Class III patients.

Am J Orthod Dentofacial Orthop 2011 Nov;140(5):e223-31

Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.

Introduction: The aim of this prospective clinical trial was to assess the effects of varying force directions on the dynamic measurement of natural head position and orofacial airway dimensions of Class III patients during maxillary orthopedic protraction compared with an untreated control group.

Methods: The conventional facemask group comprised 15 patients (8 girls, 7 boys; mean age, 9.6 ± 1.3 years), the modified facemask group comprised 15 patients (7 girls, 8 boys; mean age, 9.5 ± 1.5 years), and the control group comprised 15 subjects (7 girls, 8 boys; mean age, 9.8 ± 1.6 years). Natural head position measurements and cephalometric records were obtained from all subjects before and after treatment or the control period (approximately 1 year). An inclinometer and a portable data logger were used to collect the dynamic natural head position data. For statistical comparisons, paired samples t tests, analysis of variance (ANOVA), and post-hoc Tukey tests were used at the P <0.05 level.

Results: Both treatment groups showed statistically significant changes in the sagittal (pitch) measurements of natural head position and upper pharynx, aerial, and total area of airway measurements during the treatment period. In the control group, the only statistically significant change was an increased upper pharynx measurement (P = 0.020). According to the intergroup comparisons, statistically significant natural head position differences were found in the conventional (6.4° flexion) and the modified (5.7° flexion) facemask groups when compared with the controls. The modified facemask group also showed significant changes in aerial (P = 0.003) and total (P <0.001) areas of the airway measurements compared with the control group. No statistically significant differences were observed between the 2 treatment groups.

Conclusions: These findings suggest that modified and conventional facemask therapy with expansion have significant cranial flexion effects on the dynamic measurements of natural head position. Additionally, the modified facemask procedure showed significant effects on the orofacial airway dimensions compared with the initial values and the values of the untreated controls.
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http://dx.doi.org/10.1016/j.ajodo.2011.05.018DOI Listing
November 2011

Rapid maxillary expansion effects on dynamic measurement of natural head position.

Angle Orthod 2011 Sep 14;81(5):850-5. Epub 2011 Mar 14.

Erciyes University, Faculty of Dentistry, Department of Orthodontics, Kayseri, Turkey.

Objective: To identify the effect of rapid maxillary expansion (RME) procedure on dynamic measurement of natural head position (NHP).

Materials And Methods: The treatment group comprised 23 patients, 12 girls and 11 boys (mean age: 10.1 ± 1.1 years), and the control group comprised 15 subjects, 8 girls and 7 boys (mean age: 9.7 ± 1.4 years). The test subjects underwent RME treatment using full cap acrylic device, and the mean amount of expansion was 5.48 mm. An inclinometer and a portable data logger were used to collect the NHP data. Intragroup changes were evaluated by using nonparametric Wilcoxon test, and intergroup changes were analyzed with Mann-Whitney U-test. P values less than .05 were considered statistically significant.

Results: The mean difference between initial and final NHP was 0.31°, and this difference was not statistically significant. Also, there were no statistically significant differences between the RME and control groups before and after treatment.

Conclusion: Treatment with the RME procedure showed no statistically significant effects on dynamic measurement of NHP when compared with initial values or untreated control.
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http://dx.doi.org/10.2319/112410-686.1DOI Listing
September 2011

Influence of lower facial height changes on frontal facial attractiveness and perception of treatment need by lay people.

Angle Orthod 2010 Nov;80(6):1159-64

Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkey.

Objective: To test the hypothesis that lower facial height has no influence on frontal facial attractiveness and treatment need perception of lay people.

Materials And Methods: Frontal facial silhouettes of a man and a woman with normal lower facial height values (male: 81.5 mm; female: 70.5 mm) were modified by increasing and decreasing their lower facial heights in steps of 1 mm to obtain frontal images with different lower facial height alterations ranging from +6 mm to -6 mm for each sex. A panel of 100 lay people scored each silhouette's attractiveness on a 100-mm visual analogue scale (VAS) and also indicated whether they would seek treatment if the image represented their own. The Wilcoxon signed rank test was used to compare the VAS scores.

Results: Unaltered +/-1-mm and +/-2-mm silhouettes got the highest VAS scores. Scores were significantly lower (P < or = .001) as the divergence from the normal value exceeded 2 mm. Beyond +3 mm and -4 mm in females and +4 mm and -3 mm in males the difference between the scores became statistically insignificant. At +/-4 mm, more than 75% of the raters elected to have treatment.

Conclusion: The hypothesis was rejected.
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http://dx.doi.org/10.2319/032509-176.1DOI Listing
November 2010

Relationship between static natural head position and head position measured during walking.

Am J Orthod Dentofacial Orthop 2006 Jan;129(1):42-7

Department of Orthodontics, Marmara University, Istanbul, Turkey.

Introduction: The aim of this project was to determine whether there is a statistically significant difference between the means of static and dynamic (measured during walking) measurements of head posture.

Methods: The sample consisted of 50 subjects, 25 women and 25 men, 20 to 25 years of age. None had a history of orthodontic treatment, head or neck injury, or nasal breathing problems, and none wore eyeglasses to correct vision. Static measurement of head position was recorded by using the self-balance position. Dynamic measurements of head position were made with an inclinometer device with the subject walking in a relaxed manner for 5 minutes. The data, measured in degrees, were stored in a pocket data logger. Recorded static and dynamic head posture data were transferred to a computer for analysis. The means of the measurements were statistically compared with the t test (alpha = .05). The mean walking head position was tipped forward relative to the mean static head position.

Results: The mean value of static position minus walking head position measurements was +4.60 degrees . The differences between the 2 recordings were statistically significant (P < .001).

Conclusions: Static and walking head position measurements are not interchangeable. Therefore, it might be advisable to use the mean dynamic measurement of head position to represent natural head position for positioning when taking case records such as lateral and posteroanterior cephalograms, clinical extraoral photography, or 3-dimensional imaging.
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http://dx.doi.org/10.1016/j.ajodo.2004.09.026DOI Listing
January 2006

Effect of cervical headgear wear on dynamic measurement of head position.

Eur J Orthod 2005 Oct 10;27(5):437-42. Epub 2005 Aug 10.

Department of Orthodontics, Faculty of Dentistry, Marmara Universitesi, Istanbul, Turkey.

The aim of this study was to identify the effect of cervical headgear (CHG) wear on dynamic measurement of head posture during walking. Six male and 10 female patients (mean age, 11.9 +/- 1.9 years) who were receiving CHG therapy for correction of a Class II molar relationship as part of their orthodontic treatment were included in this study. Dynamic head posture measurements were recorded using an inclinometer and data logger apparatus during a walking session of 5 minutes. This procedure was repeated before (T1) and after (T2) insertion of CHG. The T1 and T2 measurements were repeated twice at 30-minute intervals. The mean dynamic head posture was calculated for each subject using the collected data. The means of these measurements were statistically compared using a paired t-test. Of the 16 subjects, 14 showed a cranial flexion with CHG wear in relation to T1 (1.4 to 8.9 degrees). The other two subjects showed a cranial extension of -1.6 and -3.8 degrees. The mean values at T1, T2 and T1-T2 were 1.4, -1.8, and 3.1 degrees, respectively, which indicated a mean cranial flexion at T2 in relation to T1. According to the paired sample t-test, there were statistically significant differences between the two measurements of dynamic head posture recorded before and after CHG insertion (P < 0.001). CHG wear causes a significant cranial flexion which may be responsible for its effects on the mandible.
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http://dx.doi.org/10.1093/ejo/cji058DOI Listing
October 2005

Effect of rapid maxillary expansion on nocturnal enuresis.

Angle Orthod 2003 Oct;73(5):532-8

University of Selçuk, School of Dentistry, Department of Orthodontics, Konya, Turkey.

One of the effects of rapid maxillary expansion (RME) is a reduction in nighttime bed-wetting. The aim of this prospective study was to investigate the effects of RME on nocturnal enuresis (NE) in children who are liable to psychosocial stress conditions. Eight children (six boys and two girls) who had not responded to different conventional medical treatments were included in the study. The subjects were between eight and 11 years of age with a mean age of nine years five months, and were residents of a government orphanage. All the children wet the bed at least one time every night and previously had been subjected to unsuccessful conventional treatment modalities. Maxillary expansion was performed using a rigid acrylic RME device. Lateral and PA cephalometric films and dental casts were used in the assessment of the dentofacial and nasopharyngeal structures. Data were analyzed using a paired t-test. In seven of the eight children, remarkable improvement was observed in NE after three to six mm RME. At the end of eight months observation, the mean rate of improvement in bed-wetting in the seven successful subjects was 74.2% (57.6-87.5%). The findings also indicated significant changes in the nasomaxillary structures and nasopharyngeal airway dimensions with the use of RME. However, none of the subjects became completely dry, and the disorder is probably multicausal including psychological emotions and tensions. This study demonstrated that RME treatment could cause relief for the enuretic children. However, the long-term success rate is still questionable.
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http://dx.doi.org/10.1043/0003-3219(2003)073<0532:EORMEO>2.0.CO;2DOI Listing
October 2003

Effect of complete dentures on dynamic measurement of changing head position: A pilot study.

J Prosthet Dent 2003 Oct;90(4):394-400

Department of Prosthodontics, Selçuk University, Ankara, Turkey.

Statement Of Problem: Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited.

Purpose: The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking.

Materials And Methods: The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05).

Results: Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015).

Conclusion: The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically significant change. The overall effect of wearing dentures was an irregular flexion or extension pattern on dynamic head posture.
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http://dx.doi.org/10.1016/s0022-3913(03)00414-1DOI Listing
October 2003

Mandibular symphyseal distraction and its geometrical evaluation: report of a case.

Angle Orthod 2003 Apr;73(2):194-200

Department of Orthodontics Campus, Faculty of Dentistry, Selcuk University, Konya, Turkey.

In this report, the case of a patient who has been treated with a different use of a tooth-borne custom-made mandibular symphyseal distraction device is presented. The difference in the application is that the distal arm of the device was sectioned during the retention phase to allow the possible relapse of displaced condyles to their original positions while the labial segment expansion is being maintained. The effect of this procedure was also evaluated on a geometrical model using measurements from the patient's cast. We conclude that symphyseal distraction is an effective and fast method of correcting orthodontic anomalies. The effect of the procedure on the condyle was only 3 degrees of distolateral rotation as calculated using the geometrical model.
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http://dx.doi.org/10.1043/0003-3219(2003)73<194:MSDAIG>2.0.CO;2DOI Listing
April 2003

Reproducibility of natural head position measured with an inclinometer.

Am J Orthod Dentofacial Orthop 2003 Apr;123(4):451-4

Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey.

Sagittal (pitch) and transversal (roll) natural head position (NHP) was measured once in 20 subjects, 18 to 24 years of age, with an inclinometer; the measurements were repeated 2 years later. The method error (reproducibility) after 2 years was 1.1 degrees for sagittal and transversal measurements. The mean change in NHP measurement was -0.3 degrees for both measurements, and the variance was 1.21 degrees (= 1.1(2)).
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http://dx.doi.org/10.1067/mod.2003.71DOI Listing
April 2003

Laser etching of enamel for direct bonding with an Er,Cr:YSGG hydrokinetic laser system.

Am J Orthod Dentofacial Orthop 2002 Dec;122(6):649-56

Faculty of Dentistry, Department of Orthodontics, Selçuk University, Konya 42079, Turkey.

Irradiation of enamel with laser energy changes the physical and chemical characteristics of the enamel surface, and these alterations hold promise for the conditioning of enamel for bonding procedures. This laboratory study examined the influence of laser irradiation of enamel at 2 different power settings with an erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) hydrokinetic laser system (Millennium System, Biolase Technology, Inc; San Clemente, Calif) on the shear bond strength of orthodontic appliances and compared these with that of acid-etching. The prepared surfaces of 40 noncarious, intact, extracted premolars were exposed to laser energy: 20 teeth at 2-W setting (5.6 J/cm(2)) and 20 teeth at 1-W setting (2.7 J/cm(2)) of the commercial laser unit. Twenty teeth were etched with 37% orthophosphoric acid. Brackets were bonded with an orthodontic no-mix adhesive, and shear bond strength was determined with a universal testing machine. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Etched and restored surfaces of an acid-etched tooth and a 2-W laser-irradiated tooth were examined with scanning electron microscopy (SEM). Laser treatment under 2 W resulted in bond strengths of 7.11 +/- 4.56 megapascals (MPa), which was not significantly different from that of acid etching (8.23 +/- 2.30 MPa). Laser irradiation at 1 W resulted in bond strengths of 5.64 +/- 3.19 MPa, which was significantly different from that of acid etching (P <.05). However, large SD and coefficient of variation values of both laser groups made reliability of this method as an enamel conditioner questionable. Scanning electron microscopy studies of the restored irradiated surfaces showed good surface characteristics, whereas the lased surface was still more irregular than the restored acid-etched sample. Although laser devices are effectively used in some other areas of dentistry, enamel conditioning with an Er,Cr:YSGG laser cannot be considered a successful alternative to the conventional methods of increasing bond strengths to enamel.
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http://dx.doi.org/10.1067/mod.2002.127294DOI Listing
December 2002
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