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YILMAZ, HANİFE NURAY

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Diş Hekimliği Fakültesi

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YILMAZ

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HANİFE NURAY

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Open 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.
Open 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.
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.
Open 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.
Open Access
The impact of dental midline angulation towards the facial flow curve on the esthetics of an asymmetric face: Perspective of laypeople and orthodontists
(2023-01-01) YILMAZ, HANİFE NURAY; Ntovas P., Karkazi F., Ozbilen E., Lysy J., Gogolas N., YILMAZ H. N., Papazoglou E., Coachman C.
Purpose: The objective of the present article was to evaluate the ımpact of dental midline angulation in asymmetrical faces. Materials and Methods: A full-portrait image was used to create a set of digitally modified images with a different degree of facial asymmetry, towards the right and the left side of the face respectively. Half of the images were designed with an equivalent angulation of the dental midline in respect to the curve of the lower third of the face and half of them without. Through a web survey, 250 laypeople and 250 orthodontists were asked to assess the attractiveness of each image separately. Results: As the asymmetry of the face was increased, facial attractiveness was further decreased both for laypersons and orthodontists. For each one of the modified images, when the dental midline was following the curve that was formed from the inclination of the simulated asymmetry of the face, the smile attractiveness scores were significantly higher compared to a straight dental midline. Conclusion: Facial asymmetries derived from the inclination of the nose, the chin and the commissural line of the lips can significantly affect the smile attractiveness. An orientation of the dental midline towards the facial asymmetry in order to follow the facial curve, can be beneficial for the smile attractiveness compared to a perpendicular to the face dental midline. During the design of a smile, clinicians have to take into consideration deviations in facial midline, in order their restorations to be in harmony with the rest of the face. Clinical Significance: During the design of a smile, clinicians have to take into consideration deviations in the facial midline, in order their restorations to be in harmony with the rest of the face.
Open Access
Perception of smile attractiveness among laypeople and orthodontists regarding the buccal corridor space, as it is defined by the eyes. An innovated technique
(2023-01-01) YILMAZ, HANİFE NURAY; Ntovas P., Karkazi F., Özbilen E. Ö., Flavio A., Ladia O., Papazoglou E., YILMAZ H. N., Coachman C.
© 2023 Wiley Periodicals LLC.Objective: To investigate whether there is a relationship between the distance between the iris and pupil with the ideal size of buccal corridors. Materials and Methods: A full-portrait image of a male Caucasian was used to create a set of 11 digitally modified images with different buccal corridor space. A web-based cross-sectional study was designed and distributed via an online survey to 200 laypeople and 200 orthodontists to assess image attractiveness, using a Visual analogue scale. For the statistical analysis, Wilcoxon signed-rank and Mann–Whitney U tests were used. The significance level was set at p < 0.05. Results: The response rate for laypeople was 70% (n = 139), while the rate for orthodontists was 73% (n = 146). For the layperson group, the maximum smile attractiveness score was 10% of buccal width reduction, compared to the iris-pupillary distance, while for the orthodontists, it was 20%. The attractiveness of the smile was significantly reduced in both groups when the buccal corridor width was increased in comparison to the iris-pupillary distance. Conclusion: The length between the mesial part of the iris and the distal of the pupil, may constitutes a landmark for the estimation of the desired width of the buccal corridor. Clinical Relevance: Inter iris-pupillary distance can be the starting point in the smile designing process, in order to perform a facial driven selection of buccal corridor size.
Open Access
Assessment of Relationship between Intelligence Quotient and Orthodontic Treatment Need Procjena odnosa između kvocijenta inteligencije i potrebe za ortodontskom terapijom
(2023-09-01) YILMAZ, MÜESSER AHU; YILMAZ, HANİFE NURAY; AĞRALI, ÖMER BİRKAN; KARGÜL, BETÜL; Yavuz B. S., YILMAZ M. A., YILMAZ H. N., AĞRALI Ö. B., Bilsel S. O., KARGÜL B.
Objective: Low cognitive ability may reduce the ability to understand the importance of oral health and to perform the necessary practices to maintain proper oral hygiene. Early loss of primary teeth following high caries risk may lead to malocclusion of permanent dentition. This study aimed to eval-uate the relationship between the cognitive levels of adolescents and their orthodontic treatment needs. Material and Methods: Between January 2018 and May 2018, 200 adolescents aged 10 – 15 who applied to the Pediatric Dentistry Clinic of Marmara University and sought orthodontic treatment were invited to participate in the study. The orthodontic treatment needs of 150 adolescents who agreed to participate were evaluated with the Index of Orthodontic Treatment Need-Aesthetic Component and their cognitive levels were evaluated with the Raven Standard Progressive Matrices (SPM) Test. P-value < 0.05 was considered statistically significant. Results: The mean age (± standard deviation) of 126 adolescents (77 females and 49 males) who completed the SPM test was 11.8 (± 1.3). There was no consistency between the intellectual level and the need for orthodontic treatment (Kappa value = 0.071, p-value = 0.081). There was no correlation between malocclusion sever-ity and intelligence quotient scores of adolescents (ρ [rho] =-0.089, p = 0.322). According to Mul-tiple logistic regression results, there was no difference between ‘borderline need’ (p = 0.059) and ‘great need’ (p = 0.881) from ‘no need’ for orthodontic treatment in adolescents with different intelligence quotients. Conclusions: The results showed no evidence for an association between maloc-clusion and intelligence quotient.
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.