Publication: Sınıf II mandibular retrognati vakalarının mandibula anterior bölgenin alveolar distraksiyonu ile tedavisinin değerlendirilmesi
Abstract
1. Özet Çalışmamızın amacı son yıllarda popülerlik kazanan Distraksiyon Osteogenizi yönteminin lokal olarak alt çene ön bölgede uygulanması ile Sınıf II dişsel ilişkilerin düzeltimini ve bu tedavinin etki ve etkinliğini araştırmaktır. Çalışmamız yaşları 16 ile 20 arasında değişen 10 kız 5 erkekten oluşmaktadır. Vaka seçimimiz Sınıf II dişsel kapanışı olan Sınıf I iskeletel özelliklere sahip bireylerden yapılmıştır. Cerrahi işlemler sedasyon altında Piezon cerrahi cihazı ile yapılmış ve distraksiyon işlemi için ark teline geçebilen Archwise distraktörler özel olarak ürettirilmiştir. Ark teline oturan distraktörler sayesinde distraksiyon işlemi sonrasında distraktörlerin çıkarılması için cerrahi işlem ihtiyacı ortadan kaldırılmıştır. Hastalar ortalama 2 haftalık bir sürede distraksiyon işlemini tamamlamışlar ve Sınıf I kanin kapanış ilişkisine ulaşmışlardır. Distraksiyonun iskeletsel ve dişsel etkilerinin en detaylı şekilde görüntülenmesi için distraksiyon öncesinde (T0) ve sonrasında (T1) Konik ışınlı bilgisayarlı tomografi (CBCT) görüntüleri elde edilmiştir. Görüntüler Simplant Standalone 13.0 programına aktarılmış ve program yardımı ile sefalometrik noktalar belirlenmiş ve ölçümler yapılmıştır. Yapılan ölçümler istatistiksel olarak paired sample t test uygulanarak analiz edilmiştir. Tüm bireylerde cerrahi işlemler sorunsuz olarak gerçekleştirilmiştir. 1 vaka dışında distraksiyon işlemi sonrasında uygun kemik oluşumu gözlenmiştir. Tüm vakalarda Sınıf I kanin ilişki elde edilmiştir. İstatistiksel sonuçlara bakıldığında distraksiyon yapılan parçanın ileriye gittiği ancak bu hareket sırasında rotasyona uğradığı gösterilmiştir. Sonuç olarak mandibula anterior bölgenin distraksiyonu ile Sınıf II düzeltimi özellikle cerrahi düzeltimlere iyi bir alternatif oluşturmaktadır. Daha basit, genel anestezi gerektirmeyen ve daha az komplikasyon riski olan etkin bir yöntemdir. straksiyon osteogenezi, alveolar distraksiyon, Sınıf II maloklüzyon 2.
The evaluation of outcomes of Class II mandibular retrognatia treatment by distraction of mandibular alveolar region using alveolar distraction technique The aim of this study is to evaluate the efficiency and effectiveness of correcting Class II relationship by local advancement of mandibular anterior region using distraction osteogenesis technique. Our study group consist 10 girls 5 boys, age range between 16 to 20. Cases having Class II dental relationship and Class I skelatel relationship were included to the study group. Our surgical precedures were done under sedation with Piezon surgery device and unique Archwise distractors that can be attached to the arcwire were custumly manufactured. Since the distractors were attached to the arcwire with ease, there were no need for a surgery to remove them. Total distraction period was appraximately 2 weeks and in all cases Class I canine relationship was achieved. For our investigation, one of the most detailed scanning method, cone beam computed tomography were taken before (T0) and after (T1) the distraction. Data were uploaded to Simplant Standalone 13.0 software. The software was used for cephalometric digitations and all measurements. Paired sample t test was used for statistical analysis. Surgical procedures were accomplished without any complication. Natural bone formation after distraction were seen in all cases except 1 case. Class I canine relation was achieved an all cases. After analysising the statistical results, it has beeen seen that mandibular anterior segments moved forward with some rotation. As a result correction of Class II dental relationship by distraction of mandibular anterior region is a unique and good alternative for bisagital split osteotomy. This method has advantages of being simplier, of no need to general anesthesia and of less risk of complications over bisagital split osteotomy. Key Words: Distraction osteogenesis, Alveolar distraction, Class II malocclusion
The evaluation of outcomes of Class II mandibular retrognatia treatment by distraction of mandibular alveolar region using alveolar distraction technique The aim of this study is to evaluate the efficiency and effectiveness of correcting Class II relationship by local advancement of mandibular anterior region using distraction osteogenesis technique. Our study group consist 10 girls 5 boys, age range between 16 to 20. Cases having Class II dental relationship and Class I skelatel relationship were included to the study group. Our surgical precedures were done under sedation with Piezon surgery device and unique Archwise distractors that can be attached to the arcwire were custumly manufactured. Since the distractors were attached to the arcwire with ease, there were no need for a surgery to remove them. Total distraction period was appraximately 2 weeks and in all cases Class I canine relationship was achieved. For our investigation, one of the most detailed scanning method, cone beam computed tomography were taken before (T0) and after (T1) the distraction. Data were uploaded to Simplant Standalone 13.0 software. The software was used for cephalometric digitations and all measurements. Paired sample t test was used for statistical analysis. Surgical procedures were accomplished without any complication. Natural bone formation after distraction were seen in all cases except 1 case. Class I canine relation was achieved an all cases. After analysising the statistical results, it has beeen seen that mandibular anterior segments moved forward with some rotation. As a result correction of Class II dental relationship by distraction of mandibular anterior region is a unique and good alternative for bisagital split osteotomy. This method has advantages of being simplier, of no need to general anesthesia and of less risk of complications over bisagital split osteotomy. Key Words: Distraction osteogenesis, Alveolar distraction, Class II malocclusion