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YILMAZ, HANİFE NURAY

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YILMAZ

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HANİFE NURAY

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  • PublicationOpen Access
    Does surgically assisted maxillary protraction with skeletal anchorage and Class III elastics affect the pharyngeal airway? A retrospective, long-term study
    (2023-01-01) YILMAZ, HANİFE NURAY; Ozbilen E. O., Papaefthymiou P., YILMAZ H. N., Küçükkeleş N.
    © 2023 The Korean Association of Orthodontists.Objective: Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics. Methods: The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period. Conclusions: No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.
  • PublicationOpen Access
    Occlusal plane rotation and orthodontic decompensation: influence on the outcome of surgical correction of class III malocclusion
    (2022-03-01) YILMAZ, HANİFE NURAY; ŞEKER E. D., SUNAL AKTÜRK E., YILMAZ H. N., Kucukkeles N.
    Purpose The aim of this retrospective multicenter study is to evaluate the influence of surgical manipulation of the upper occlusal plane (UOP) and orthodontic decompensation on the outcome of class III orthognathic surgery. Methods Incisor inclinations, occlusal plane inclination as well as skeletal and soft tissue changes were assessed in lateral cephalograms of 85 class III patients who had previously undergone orthognathic surgery. Fourteen linear and eight angular measurements were performed on each radiograph at the beginning of treatment (T0), before surgery (T1) and at the end of treatment (T2) using imaging software. After measurement of variables, Mann-Whitney U-test, repeated-measures analysis of variance (ANOVA) with Bonferroni multiple comparison test, and Spearman\"s correlation analysis were performed. Results A statistically significant improvement was observed in both sagittal skeletal and soft tissue measurements (p < 0.05). Surgical change in UOP was significantly correlated with changes in overbite, upper lip strain and soft tissue B-point change in the sagittal direction (p < 0.05). Overjet change was significantly correlated with changes in the soft tissue and all sagittal skeletal parameters except for SNA. Changes in the incisor inclinations was significantly correlated with changes in the sagittal skeletal parameters and lower facial height. Significant differences were also observed between the groups with induced clockwise or counterclockwise rotation of the mandible in terms of IMPA (long axis of LI to mandibular plane), overbite, upper lip strain and position of soft tissue B-point (p < 0.05). Conclusion Sufficient dental decompensation is crucial for controlling the sagittal as well as the vertical relationship during surgery. Counterclockwise rotation provides an increase in sagittal projection of the mandibular body at the soft tissue B-point.
  • Publication
    Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third-molar extractions
    (CHURCHILL LIVINGSTONE, 2021) YILMAZ, HANİFE NURAY; Civak, Tayfun; Ustun, Tugba; Yilmaz, Hanife Nuray; Gursoy, Bahar
    Objective: This study compared patient postoperative pain, swelling, and trismus after usage of rotary instruments, piezosurgery, and Er:YAG lasers in mandibular third-molar extraction. Materials and methods: This prospective study was executed with class II and position B vertically impacted mandibular third molars. Patients were divided into three groups according to the osteotomy system used to remove retentive bone: rotary instruments, piezosurgery, and Er:YAG laser. Postoperative painwas evaluated using VAS questionnaires at 12 h, 24 h, 48 h, and 7 days after procedures. Trismus was evaluated by measuring the distance between the maxillary and mandibular incisors at maximum mouth opening, and comparing preoperative measurements with those for postoperative days 2 and 7. Analyses of swelling were carried out via a stereophotogrammetry system. Operation times were measured using a digital stopwatch from the initial incision to the final suture. Results: There were no statistically significant differences between the groups in terms of pain, trismus, or swelling (p > 0.05). Pain persisted more in the rotary instrument group 24 h later (0 +/- 1.3; p = 0.001). The pain scores obtained after 48 h for the piezosurgery (1.81 +/- 2.29) and rotary (2.2 +/- 2.12) groups were observed at 24 h in the laser group (2.19 +/- 1.52). The mean operation time was highest using the laser (19.1 +/- 3.85 min; p = 0.001) and lowest using rotary instruments (9.88 +/- 2.97 min; p = 0.001). Conclusion: Piezosurgery and Er:YAG laser are good alternatives to rotary instrument systems in third-molar extraction, but both systems are slower than traditional rotary instruments. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
  • Publication
    Maternal and paternal anxiety levels through primary lip surgery
    (ELSEVIER, 2020) ABUHAN, ECE; Yilmaz, Hanife Nuray; Abuhan, Ece
    Aim: The aim of this study was to evaluate the anxiety levels of the parents of infants with cleft lip and palate (CLP) before and after primary lip surgery. Materials and method: Forty mothers (mean ages: 31.9 +/- 6.16 years) and 40 fathers (mean ages: 34.6 +/- 5.91 years) of infants with CLP were included in this study. They were asked to answer the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Spielberger's State-Trait Anxiety Inventory (STAI) just 1 h before the primary lip surgery (T0) and 1 month after (T1) surgery. Student t-test and Mann-Whitney U test were used for inter-group comparison, the paired-sample t was used for the intragroup comparisons (p < 0.05). Results: There were no statistically significant differences for the comparisons of state (STAI-S) and trait (STAI-T) anxiety or APAIS scores between the parents. While state anxiety scores of the mothers increased significantly post-surgically, APAIS scores showed significant decreases in both parents (p < 0.05). APAIS scores of the fathers with bilateral CLP infants were significantly higher (p < 0.05) than the fathers of unilateral ones. The parents with local anesthesia experience showed significantly lower APAIS scores (p < 0.05). A negative correlation was present between maternal age and STAI-T, whereas a positive correlation was present between paternal age and the anxiety. Conclusions: The anxiety levels of the parents were similar. Parents asked for more information about the anesthesia than the surgery, therefore communication with the anesthesiologist in the preoperative period is important. Routine assessment of parents' stress and psychosocial support should be provided by the cleft team. (C) 2020 Elsevier Masson SAS. All rights reserved.
  • Publication
    Correlation of Dental Anomalies with Cleft Type and Gender in Non-Syndromic Oral Cleft Patients: A Cross-Sectional Study
    (2022-09-01) YILMAZ, HANİFE NURAY; Papaefthymiou P., Agrafioti M., YILMAZ H. N.
    Objective To investigate the distribution of dental anomalies between non-syndromic orofacial cleft patients and their association with the cleft type and gender. Design Retrospective cross-sectional study involving examination of intraoral dental records and radiographs. Patients 300 non-syndromic orofacial cleft patients included (161 males and 139 females, mean age: 10.23 +/- 2.3 years). Main Outcome Measures: Variables analyzed: tooth agenesis, microdontia, and supernumerary teeth. Data analysis: Chi-square and Fisher\"s exact tests to investigate the correlation between dental anomalies, cleft type, and gender. Results Agenesis occurred in 66% of the subjects, supernumerary teeth in 19.6%, and microdontia in 18.3%. In females with unilateral left cleft lip and palate (CLP), agenesis was significantly higher compared to males. Both genders presented significant agenesis of maxillary lateral incisors and right central incisor. Significant agenesis of central incisor, canine and second premolar on the upper left side and lower second premolars were observed only in males, with significant microdontia for maxillary lateral incisors and left central incisor. Significant agenesis of maxillary first premolars was seen only in females. Agenesis in maxillary quadrants was significant for patients with unilateral right and left CLP, and bilateral CLP. In mandibular quadrants, agenesis was substantially higher for patients with isolated CP. Conclusions Results suggest that tooth agenesis and microdontia might not be directly associated with the cleft area\"s anatomical irregularity but are affected by gender and other genetic factors that regulate the development of the anomaly and the orofacial clefting mutually.
  • Publication
    Effect of piezocision on molar intrusion in open-bite treatment using a modified MEAW technique
    (URBAN & VOGEL, 2021) YILMAZ, HANİFE NURAY; Yilmaz, Hanife Nuray; Alakus, Evin; Erdem, Buket; Kucukkeles, Nazan
    Purpose The aim of this retrospective study was to investigate whether a piezocision technique influences molar intrusion in open-bite cases. Methods In all, 30 patients with open-bite malocclusion were assigned to one of two groups: the piezocision group comprised 15 patients who were treated using curved arches and anterior elastics with the simultaneous combination of piezocision which was performed interdentally in the upper posterior region, while the control group comprised 15 patients who were treated with the same treatment mechanics without piezocision. In both groups, after leveling and aligning, upper 0.017 x 0.025 accentuated curve and lower 0.017 x 0.025 reversed curve of Spee NiTi archwires were placed. Anterior vertical elastics were applied between laterals and the canines on both sides. The effects of treatments were investigated on cone-beam computed tomography images acquired before use of elastics and after correction of open-bite. Results Open-bite closure was achieved in 2.85 +/- 0.85 and 4.1 +/- 1.58 months in the piezocision and control groups, respectively, while total treatment lasted 1.4 +/- 0.42 and 1.7 +/- 0.43 years, respectively. Extrusion of lower posterior teeth (p < 0.05) was observed together with extrusion of incisors and canines (p < 0.001) in the piezocision group, while only incisors and canines were extruded in the control group (p < 0.001). There were no significant differences between the groups (p > 0.05) except significant lower incisor extrusion (p < 0.05) and counter-clockwise rotation of the lower occlusal plane in the piezocision group (p < 0.001). Conclusion The duration of open-bite correction was significantly shorter in the piezocision group. No molar intrusion was observed in either group. Open bite correction was achieved mainly by extrusion and retrusion of the incisors while maintaining upper molar positions.
  • PublicationOpen 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.
  • PublicationOpen Access
    Three-dimensional evaluation of the temporomandibular joints after unilateral surgically assisted rapid maxillary expansion in adults: A preliminary retrospective study
    (2023-01-01) KARABİBER, GÜLDEN; YILMAZ, HANİFE NURAY; KARABİBER G., YILMAZ H. N.
    Background: Unilateral surgically assisted rapid maxillary expansion (U-SARME) is a successful method for correction of true unilateral posterior crossbite (TUPC). Objectives: This retrospective preliminary study aimed to evaluate the position and morphology of condyles in TUPC cases and the effects of U-SARME on condyle with the help of cone beam computed tomography (CBCT). Methods: Fifteen patients (mean age: 18.69 ± 1.59 years) who were diagnosed as TUPC and undergone U-SARME were selected. Preoperative (T0) and after 6-month retention (T1) DICOM data of CBCT images were evaluated with MIMICs version 19.0 software. Condylar morphology (medio-lateral and antero-posterior dimensions) and position (anterior, posterior, medial and lateral joint spaces, frontal/axial axis angles, the ratio of posterior to anterior joint space and the percentage of posterior to anterior joint space) were evaluated. Student\"s t-test was used for intergroup (crossbite, normal) comparisons. Paired-samples t-test was used for intra-group comparisons (p =.05). Results: There were no positional or dimensional asymmetry of the condyles between crossbite and normal sides initially and after expansion. Regarding T0-T1 changes, while significant increase was determined in medial (0.3 ± 0.29 mm; p =.001) and superior (0.39 ± 0.7 mm; p =.045) joint spaces on crossbite side, posterior (0.79 ± 0.99 mm; p =.008), superior (0.5 ± 0.79 mm; p =.029) and lateral joint spaces (0.31 ± 0.54 mm; p =.042) presented significant increases on normal side. However, no significant changes were found between crossbite and normal sides at T0 and T1. Conclusions: Condyles were symmetrical in true unilateral posterior crossbite cases and the symmetry were not disrupted following U-SARME.
  • Publication
    Three-dimensional evaluation of treatment results of the Alt-RAMEC and facemask protocol in growing patients
    (URBAN & VOGEL, 2020) YILMAZ, HANİFE NURAY; Sitaropoulou, V; Yilmaz, H. N.; Yilmaz, B.; Kucukkeles, N.
    Purpose The aim of this retrospective study was to evaluate the skeletal, dental, and soft tissue effects of the alternating rapid maxillary expansions and constrictions (Alt-RAMEC) protocol combined with a facemask in prepubertal patients. Methods The study group (mean age 9.74 +/- 1.46 years) consisted of 20 patients with class III malocclusion characterized by maxillary retrognathism. They were treated with a facemask for 7 months following a 9-week Alt-RAMEC protocol. Cone-beam computed tomography (CBCT) records and three-dimensional (3D) photographs taken before (T0) and after the protraction and retention period (T1) were evaluated. The study group was compared with a well-matched control group of 16 untreated patients (mean age 9.44 +/- 0.79 years) with the same malocclusion. The records for the control group included cephalometric radiographs and 3D photographs. Results In the study group, significant forward movements of A point (3.49 mm), nasal (2.91 mm) and zygomatic bones were achieved. Intermolar, internasal, and interzygomatic widths increased. Soft tissue points followed the hard tissue movements, apart from b and pog. In the control group, A (0.97 mm), B (1.69 mm), Pog, and b points presented forward movement. Significant differences were found regarding the forward movement of the maxilla between the groups. Conclusion The Alt-RAMEC/facemask protocol was effective not only in the maxillary region but also in the midface.
  • PublicationOpen 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 Bahar
    Objectives: 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.