Publication: Maksiller retrognati olgularında iskeletsel ankraj ve sınıf III lastik uygulamasının sefalometrik değerlendirmesi
Abstract
1. ÖZET Bu çalışmada ağız içi Sınıf III lastikler kullanılarak iskeletsel ankraj ve kortikotomi desteği ile üst çenenin hızlı ilerletilmesi yönteminin etkinliğinin sınanması amaçlanmıştır. Araştırmada çalışma grubu, Marmara Üniversitesi Diş Hekimliği Fakültesi Ortodonti tedavi olmak için başvuran maksiller retrognati ile karakterize Sınıf III maloklüzyona sahip 19 (9 kız, 10 erkek) hastadan oluşturulmuştur. Bu bireylerin kronolojik yaş ortalaması 13.12±1.28 yıl olarak belirlenmiştir. Hastaların 5 aylık takibi sefalometrik radyografi ile yapılmış ve bu kayıtlar kontrol grubu olarak kullanılmıştır. Operasyon öncesi kayıtlar tekrarlandıktan sonra üst çeneye birinci molarlar seviyesinde tel uzantıları olan akrilik aygıt simante edilmiş, üst çeneye incomplete Le Fort I osteotomi uygulanmış, alt çeneye ise simfiz bölgesine iki adet miniplak yerleştirilmiştir. Operasyonu takiben Sınıf III lastikler kullanılmıştır. Tedavi sonucu dentofasiyal yapıda ortaya çıkan değişiklikler tedavi öncesi ve sonrası sefalometrik röntgen ve konik ışınlı bilgisayarlı tomografi görüntüleri kullanılarak değerlendirilmiştir. Sonuç olarak, hızlı maksiller ilerletme elde edilmiş, okluzal düzlem saatin tersi yönünde rotasyon yapmış, mandibula bir miktar saat yönünde rotasyon yapmış ve Sınıf I profil elde edilmiştir. Bu tedavi protokolünün uygulanmadığı dönemde, büyüme gelişimin etkisi ile üst çenedeki öne büyümenin Sınıf III ilişkiyi düzeltebilecek nitelikte olmadığı, dolayısıyla Sınıf III maloklüzyonun daha da şiddetlendiği görülmektedir. Yöntemin maksiller ilerletmede hızlı ve etkili bir yöntem olduğu ve özellikle derin kapanışlı low angle büyüme modeli olan hastalarda iyi sonuç verdiği görülmüştür. Anahtar Sözcükler: Ağız içi Lastikler, İskeletsel Ankraj, Maksiller Retrognati, Maksiller İlerletme, Sınıf III 2.
Cephalometric Evaluation of Maxillary Retrognathism Treated with Skeletal Anchorage and Class III Elastics In this study, our aim was to investigate the effectiveness of corticotomy assisted maxillary protraction with skeletal anchorage and Class III elastics. Research was performed using 19 (9 girls, 10 boys) patients who were referred to Marmara University, Dentistry Faculty, Department of Orthodontics for the treatment of Class III malocclusion characterized with maxillary retrognatism. Their mean age was 13.12±1.28 years. Five month follow-up of the patients were made by cephalometric radiographs and these records were used as a control group. After the repetition of records preoperatively, acrylic cap splints with hooks on the level of molars were bonded to upper dental arch, Le Fort I osteotomy was performed and miniplates were placed on anterior wall of symphysis. Following the operation, Class III elastics were used. Changes in the dentofacial structures were measured on pretreatment and postreatment cephalometric radiographs and cone beam computed tomography images. In conclusion, maxilla moved anteriorly in a short time, occlusal plane was rotated in counterclockwise direction; whereas, mandible showed limited clockwise rotation and Class I profile was achieved. When the cases were not treated, forward growth of the maxilla which occured by the normal growth and development was not enough to correct the Class III malocclusion, resulting in a more severe Class III relationship. This protocol is found fast and effective in maxillary protraction especially in cases which have deep overbite and low angle growth pattern. Key Words: Class III, Intraoral Elastics, Maxillary Retrognatism, Maxillary Protraction, Skeletal Anchorage
Cephalometric Evaluation of Maxillary Retrognathism Treated with Skeletal Anchorage and Class III Elastics In this study, our aim was to investigate the effectiveness of corticotomy assisted maxillary protraction with skeletal anchorage and Class III elastics. Research was performed using 19 (9 girls, 10 boys) patients who were referred to Marmara University, Dentistry Faculty, Department of Orthodontics for the treatment of Class III malocclusion characterized with maxillary retrognatism. Their mean age was 13.12±1.28 years. Five month follow-up of the patients were made by cephalometric radiographs and these records were used as a control group. After the repetition of records preoperatively, acrylic cap splints with hooks on the level of molars were bonded to upper dental arch, Le Fort I osteotomy was performed and miniplates were placed on anterior wall of symphysis. Following the operation, Class III elastics were used. Changes in the dentofacial structures were measured on pretreatment and postreatment cephalometric radiographs and cone beam computed tomography images. In conclusion, maxilla moved anteriorly in a short time, occlusal plane was rotated in counterclockwise direction; whereas, mandible showed limited clockwise rotation and Class I profile was achieved. When the cases were not treated, forward growth of the maxilla which occured by the normal growth and development was not enough to correct the Class III malocclusion, resulting in a more severe Class III relationship. This protocol is found fast and effective in maxillary protraction especially in cases which have deep overbite and low angle growth pattern. Key Words: Class III, Intraoral Elastics, Maxillary Retrognatism, Maxillary Protraction, Skeletal Anchorage