Publication: Tek taraflı dudak-damak yarıklı hastada ideal gülüş estetiği kazandırılmasında ortodontik-protetik işbirliği - olgu sunumu
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2021-03-12
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AMAÇ:Bu olgu sunumunun amacı burun, dudak ve alveol kretini etkileyen sol tek taraflı dudak-damak yarıklı hastanın, sabit ortodontik apareyler ve protetik restorasyon ile multidisipliner olarak tedavisinin anlatılmasıdır.OLGU:Takvim yaşı 12 yıl 4 ay olan pubertal atılım dönemindeki erkek hastada intraoral olarak açık kapanış, Sınıf II molar ve kanin ilişkisi, yarık hattına komşu bölgede lateral diş eksikliği, sürme bozukluğu ve üst ön dişlerde mine deformasyonları ve şiddetli çapraşıklık ile birlikte maksiller darlık tespit edilmiştir. Panoramik radyografide sol tarafta alveol kreti ve sert damağı içine alan yarık hattı izlenmiştir. Lateral sefolametrik incelemede ise iskeletsel Sınıf I ilişki ile birlikte keser eğimlerinde azalma gözlemlenmiştir. Geç karma dişlenme döneminde olan hastada alt çenede lingual ark; üst çenede ise transvers yönde yetersizlik sebebiyleQuad-heliks aygıtları ile tedaviye başlanmıştır. Üst ve alt çenede sabit ortodontik apareyler ile hizalanma sonrası, eksik olan 22 numaralı dişin protetik rehabilitasyonu için yer açılması planlanmıştır. Tedavi sonrasında intermaksiller elastiklerin kullanımı ile Sınıf I molar ve kanin ilişkisi sağlanmıştır. Üst ve alt kesici dişlerin açılanmaları ideal değerlerine getirilerek 22 numaralı diş, 13-24 numaralı dişler arasında metal destekli seramik köprü uygulaması ile rehabilite edilmiş olup; vaka ideal overjet ve overbite ilişkisinde sonlandırılmıştır.SONUÇ:Dudak-damak yarıklı hastalarda; yarık bölgesindeki dişlerde sürme problemleri, şekil bozuklukları, dişlerin kuronlarında mine deformasyonları veya diş eksiklikleri görülebilir. Ayrıca yarık bölgesine komşu dişlerde destek kemik kaybında azalma ve dişeti çekilmeleri de gözlenebilir. Bu vakada mine deformasyonları ile 11ve 21 numaralı dişlerin alveol kretinde yer alan defekt oluşumu metal destekli seramik veneer yardımıyla giderilmiştir. Ayrıca keser açılanmaları ideal değerlerine getirilerek istenilen düzeyde dudak projeksiyonu sağlanmıştır. Tedavi sonunda Hawley plak ve sabit retainerlar ile pekiştirme yapılmaktadır.
OBJECTIVE:The aim of this case report is to describe the multidisciplinary treatment approach for a patient with a left unilateral cleft lip and palate also affecting the nose and alveolar crest with fixed orthodontic appliance and prosthetic restoration.CASE:A 12-year- old male patient attended orthodontic department of marmara university with a unilateral cleft lip and palate. The intra oral examination revealed an anterior open bite with a class II molar and canine relationship on both sides. Upper left lateral incisor adjacent to the cleft area was missing.On the panoramic radiograph the cleft line was observed on the left side including the alveolar crest and the hard palate. According to cephalometric analysis the patient is of class I skeletal relationship with decreased incisor inclination as the patient was in his late mixed dentition and due to the insufficient space in the maxilla treatment was initiated with lingual arch in the lower jaw and quad-helix in the upper jaw,after leveling and aligning with fixed orthodontic treatment we started opening space for prosthetic rehabilitation of tooth 22, class I molar and canine relationship was achieved using intermaxillary elastics, The upper and lower incisors inclinations were brought to their ideal values and tooth 22 was restored with metal-supported ceramic bridges for teeth 13-24.CONCULUSION:Cleft lip and palate patients are challenging to treat not only because of the eruption problems of teeth, dental deformities and tooth anomalies detected in the cleft region, but also because of the reduced bone support and gingival recession. In this case, the desired level of lip projection was achieved by bringing the incision angles to their ideal values. At the end of the treatment, retention protocol included with Hawley retainer in addition to fixed retainers.
OBJECTIVE:The aim of this case report is to describe the multidisciplinary treatment approach for a patient with a left unilateral cleft lip and palate also affecting the nose and alveolar crest with fixed orthodontic appliance and prosthetic restoration.CASE:A 12-year- old male patient attended orthodontic department of marmara university with a unilateral cleft lip and palate. The intra oral examination revealed an anterior open bite with a class II molar and canine relationship on both sides. Upper left lateral incisor adjacent to the cleft area was missing.On the panoramic radiograph the cleft line was observed on the left side including the alveolar crest and the hard palate. According to cephalometric analysis the patient is of class I skeletal relationship with decreased incisor inclination as the patient was in his late mixed dentition and due to the insufficient space in the maxilla treatment was initiated with lingual arch in the lower jaw and quad-helix in the upper jaw,after leveling and aligning with fixed orthodontic treatment we started opening space for prosthetic rehabilitation of tooth 22, class I molar and canine relationship was achieved using intermaxillary elastics, The upper and lower incisors inclinations were brought to their ideal values and tooth 22 was restored with metal-supported ceramic bridges for teeth 13-24.CONCULUSION:Cleft lip and palate patients are challenging to treat not only because of the eruption problems of teeth, dental deformities and tooth anomalies detected in the cleft region, but also because of the reduced bone support and gingival recession. In this case, the desired level of lip projection was achieved by bringing the incision angles to their ideal values. At the end of the treatment, retention protocol included with Hawley retainer in addition to fixed retainers.
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Sağlık Bilimleri, Diş Hekimliği, Klinik Bilimler, Ortodonti, Protetik Diş Tedavisi, Health Sciences, Dentistry, Clinical Sciences, Orthodontics, Prosthetic Dentistry, Klinik Tıp (MED), Klinik Tıp, DİŞ HEKİMLİĞİ, ORAL CERRAHİ VE TIP, Clinical Medicine (MED), CLINICAL MEDICINE, DENTISTRY, ORAL SURGERY & MEDICINE, Periodontoloji, Ağız Cerrahisi, Diş Hijyeni, Dişçilik Hizmetleri, Diş Hekimliği (çeşitli), Periodontics, Oral Surgery, Dental Hygiene, Dental Assisting, Dentistry (miscellaneous), General Dentistry
Citation
Yıldırım G., Acar Y. B., \"Tek Taraflı Dudak-Damak Yarıklı Hastada İdeal Gülüş Estetiği Kazandırılmasında Ortodontik-Protetik İşbirliği - Olgu Sunumu\", 17. TOD ULUSLARARASI SANAL KONGRESİ, İstanbul, Türkiye, 12 - 14 Mart 2021, ss.259-260