Person: YILMAZ, HANİFE NURAY
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YILMAZ
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HANİFE NURAY
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Publication Open Access Comparison of the effects of rapid maxillary expansion and alternate rapid maxillary expansion and constriction protocols followed by facemask therapy(KOREAN ASSOC ORTHODONTISTS, 2019) ÖNEM ÖZBİLEN, ELVAN; Ozbilen, Elvan Onem; Yilmaz, Hanife Nuray; Kucukkeles, NazanObjective: The aim of this retrospective study was to evaluate and compare the changes in the pharyngeal airway (PA), maxillary sinus volume, and skeletal parameters after rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) followed by facemask (FM) therapy. Methods: The records of 40 patients with skeletal Class lll malocclusion due to maxillary retrognathism were collected, and the patients were assigned into two groups. The first group comprised 8 male and 12 female patients (mean age, 10.0 +/- 1.1 years) treated using RME/FM for an average of 10 months. The second group comprised 10 male and 10 female patients (mean age, 9.64 +/- 1.3 years) treated using Alt-RAMEC/FM for an average of 12 months. Cone-beam computed tomography images acquired before (TO) and after treatment (T1) were evaluated. Results: Regarding the skeletal effects, significant differences between the groups were the increase in ANS-HRP (perpendicular distance of ANS to the horizontal reference plane, 0.99 mm, p <0.05) in the Alt-RAMEC/FM group and the decrease in PP-SN (palatal plane to Sella-Nasion plane, 0.93 degrees, p < 0.05) in the RME/FM group. Maxillary sinus volumes increased significantly in both the groups, and the increase was statistically significantly higher in the AltRAMEC/FM group. Although no significant intergroup differences were observed in PA volumes, both lower (1,011.19 mm(3)) and total (1,601.21 mm(3)), PA volume increased significantly in the Alt-RAMEC/FM group. Conclusions: The different expansion devices and protocols used with FM therapy do not seem to affect the forward movement of the maxilla and PA volumes. In contrast, the increase in maxillary sinus volume was greater in the Alt-RAMEC/FM protocol.Publication Open Access Does maxillary protraction with Alt-RAMEC protocol affect inferior sclera exposure? A controlled 3dMD study(2022-03-01) ÖNEM ÖZBİLEN, ELVAN; ACAR, YASEMİN BAHAR; YILMAZ, HANİFE NURAY; ACAR Y. B., YILMAZ H. N., ÖNEM ÖZBİLEN E.Objective: The purpose of this controlled retrospective study was to measure and evaluate the inferior sclera exposure changes using 3dMD stereophotogrammetric images in a prepubertal Class III patient sample that underwent maxillary protraction with alternate rapid maxillary expansions and constrictions protocol followed by facemask. Methods: The study group included 15 prepubertal patients (mean age: 9.85 ± 1.44 years) with Class III malocclusion due to maxillary retrognathism. Nine weeks of alternate rapid maxillary expansions and constrictions protocol was followed prior to 7 months of face mask treatment and 3 months of retention with Bionator. Pretreatment (T0) and post-retention (T1) lateral cephalometric radiographs and 3dMD images were retrieved from clinical archive. The same records were used for a control group of 15 well-matched, untreated patients (mean age: 9.4 ± 0.79 years). The distance between the upper eyelid margin and the lower eyelid margin was recorded as the overall eye height (E), and the distance between inferior limbus and the lower eyelid margin was recorded as inferior sclera exposure (S). The S : E ratio in percentage was calculated. Sella-nasion-A point angle (SNA) was used as the skeletal variable. Results: SNA angle, right S : E, and left S : E changed significantly in both groups at T1-T0. The intergroup comparison was highly significant for SNA angle but was not significant for right and left S : E variables. Conclusion: The S : E ratio decreased significantly in both alternate rapid maxillary expansions and constrictions/facemask and the control groups. However, the change in S : E ratio between groups was not significant.Publication Open Access Does Alt-RAMEC protocol and facemask treatment affect dentoalveolar structures? A 3-dimensional study(E H ANGLE EDUCATION RESEARCH FOUNDATION, INC, 2021-09-01) ÖNEM ÖZBİLEN, ELVAN; Ozbilen, Elvan Onem; Yilmaz, Hanife Nuray; Acar, Yasemin BaharObjectives: To evaluate dentoalveolar changes immediately after the alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol and facemask (FM) treatment using cone-beam computed tomography images. Materials and Methods: Cone-beam computed tomography images of 20 patients (mean age = 9.64 +/- 1.3 years) who received the Alt-RAMEC protocol before FM treatment were retrieved in this retrospective study. Dental and alveolar inclinations, buccal and palatal alveolar bone thickness, and buccal and palatal alveolar bone height changes were measured before treatment (T0), after the Alt-RAMEC protocol (T1), and after FM treatment (T2). Measurements for right and left molars were performed separately. The Shapiro-Wilks test was used to assess the conformity of the parameters to the normal distribution. The paired t-test and repeated measures analysis of variance were used for normally distributed data. The Wilcoxon signed-rank test and Friedman test were used for non-normally distributed data. The Bonferroni correction was used to reduce the chances of obtaining false-positive results. Statistical significance was set at P < .05. Results: Buccal alveolar bone thickness and alveolar bone inclinations decreased significantly from T1 to T0 and showed no significant change from T2 to T1. The total reduction T2-T0 was statistically significant. The change in palatal alveolar bone thickness was not significant T1-T0 but increased significantly for T2-T1 and T2-T0. Buccal alveolar bone height, palatal alveolar bone height, and molar inclinations increased significantly T1-T0, but there was no significant change T2-T1. The total reduction at T2-T0 was statistically significant. Conclusions: The results of this study revealed that the effects of the Alt-RAMEC protocol on dentoalveolar tissues were similar to the changes reported in the literature after rapid palatal expansion.Publication Open Access Soft tissue evaluation after maxillary protraction with RPE or with the ALT-RAMEC protocol A controlled 3D study(2022-09-01) ÖNEM ÖZBİLEN, ELVAN; YILMAZ, HANİFE NURAY; ÖNEM ÖZBİLEN E., Ari M. O. , YILMAZ H. N. , Biren S.Purpose To evaluate soft tissue changes following maxillary protraction with different expansion protocols using three-dimensional (3D) stereophotogrammetry. Methods Pretreatment (T0) and postprotraction (T1) stereophotogrammetry and lateral cephalometric images of skeletal class III patients were included in this retrospective study. In all, 32 patients were treated either with a combination of rapid palatal expansion and facemask (RPE/FM; n = 16; mean age: 9.94 +/- 0.68 years) or with alternate rapid maxillary expansion and constriction together with a facemask (Alt-RAMEC/FM; n = 16; mean age: 9.74 +/- 1.35 years). As a control group 16 untreated patients were recruited (mean age: 9.46 +/- 0.8 years). For superimpositioning of the 3D images taken at T0 and T1, the face was divided into defined regions and 3D and differences between the groups were evaluated using 3-matic software (Materialise Europe, Leuven, Belgium). Cephalometric analyses were also performed. Results While the increases in the cephalometric parameters SNA and ANB were significantly greater in the treatment groups, the value for SNB also increased in the control group (p < 0.05). The results of the stereophotogrammetry analyses demonstrated that the mean changes in the RPE/FM and in the Alt-RAMEC/FM groups were significantly different for the midface compared to the control group (0.33 +/- 0.26 mm, 0.3 +/- 0.31 mm, 0.1 +/- 0.18 mm). The maximum positive, negative, and mean changes were also significantly different between the treatment and control groups for the upper lip (p < 0.05). For the lower lip and the chin significant backward movements in the RPE/FM as well as in the Alt-RAMEC/FM group (-1.06 +/- 1.26 mm, -0.68 +/- 0.45 mm) were observed, while the control group (0.09 +/- 0.53 mm) presented changes in the opposite direction. Regarding soft tissue changes, no significant differences were found between the RPE/FM and Alt-RAMEC/FM groups. Conclusion Both treatment protocols improved the soft tissue profile due to a forward movement of the midface and the upper lip, and a backward movement of the lower lip and chin, compared to the control group.