Asimetrik Premolar Çekimli Ortodontik Tedavilerin Ark Formu ve Simetrisi Üzerine Etkilerinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı farklı çekim protokollerinin ark formu ve simetrisi üzerine etkilerinin değerlendirilmesidir. Materyal ve Metod: Bu retrospektif model çalışmasında, katılımcılar yaş ortalaması 14,6 (± 2,3) yıl olan 86 hasta idi. Çalışma gruplarımız: asimetrik çekim (bir tarafta birinci premolar ve karşı tarafta ikinci premolar); tek taraflı çekim (tek taraflı birinci premolar); çift taraflı çekim (her iki tarafta birinci premolar) şeklindeydi. Üst ve alt dental modeller; önceden belirlenmiş çekim protokollerine dayanarak ayrı ayrı değerlendirildi. Sonuç olarak, 86 hastaya ait 172 dental modelden 115 üst ve alt model seçildi. Tüm ölçümler dijital olarak yapıldı. Median palatal sutur ve anterior referans düzlemi, dijital model analizi için temel düzlemler olarak kullanıldı. Dişsel ölçümlerin sefalometrik analizleri de yapıldı. Bulgular: İki taraflı çekim protokolü, alt çenenin ön bölgesinde transversal yönde asimetrinin istatistiksel olarak azalmasına neden oldu. Tek taraflı çekim sonucunda ise üst çenenin arka bölgesinde anteroposterior asimetrinin arttığı gözlendi, bu arada alt çenede aynı parametre için asimetrinin azaldığı belirlendi (p<0.05). Sonuç: Asimetrik ve çift taraflı çekim protokolleri üst çenenin ark uzunluğundaki asimetrinin azalmasına neden olurken; ark asimetrisi üzerindeki etkilerinin benzer olduğu bulundu. Bu çekim protokolleri genellikle ark asimetrisinde önemli bir değişikliğe neden olmasa da, bazı durumlarda asimetrinin azalmasında olumlu etkileri olduğu izlendi. Tek taraflı çekim protokolünün ise ark uzunluğu asimetrisi üzerinde arttırıcı bir etkisi bulunmaktadır

Keywords

• dental ark
• asimetri
• diş çekimi
• ortodontik tedavi

Evaluation of the Effects of Asymmetric Premolar Extraction Treatment on Arch Form and Symmetry

Abstract

Abstract: Objectives: The study aimed to evaluate the effects of different extraction protocols on arch form and symmetry. Material and Methods: In this retrospective dental cast study, participants included 86 patients with a mean age of 14, 6 (± 2, 3) years. Our study groups were: asymmetric extraction (first premolar on one side and second premolar on the opposite side); unilateral extraction (one-sided first premolar); bilateral extraction (first premolar on both sides).Upper and lower dental casts were evaluated separately, based on previously noted extraction protocols. Consequently, 115 upper and lower dental casts were selected among the 172 dental casts of 86 patients. All measurements were performed digitally.The median palatal suture and the anterior reference plane were used as the primary planes for digital model analysis.Cephalometric analyses of dental measurements were also performed. Results: The bilateral extraction protocol resulted in a statistically significant decrease in transverse-direction asymmetry in the anterior region of the lower jaw. Due to unilateral extraction, an increase in anteroposterior asymmetry was observed in the posterior region of the upper jaw, whereas in the lower jaw, asymmetry was decreased for the same parameter (p<0.05). Conclusions: Asymmetric and bilateral extraction protocols reduced the asymmetry of the arch length in the upper jaw. The effects of asymmetric and bilateral extraction protocols on arch asymmetry were found to be similar. While these extraction protocols do not generally cause a significant change in arch asymmetry, in some cases, they had a positive effect on reducing asymmetry. The unilateral extraction protocol had an increased effect on arch length asymmetry.

Keywords

• dental arch
• asymmetry
• tooth extraction
• orthodontic treatment

References

1. 1. Angle EH Treatment of Malocclusion of the Teeth: Angle's System. Greatly Enl. and Entirely Rewritten, with Six Hundred and Forty-one Illustrations. SS White dental manufacturing Company, 1907.
2. 2. Case CS. The question of extraction in orthodontia. Am J Orthod 1964; 50 (9):660-91.
3. 3. Hahn GW. Orthodontics: its objectives, past and present. Am J Orthod Oral Surg 1944; 30 (8):401-4.
4. 4. Brandt S, Safirstein GR. Different extractions for different malocclusions. Am J Orthod 1975; 68 (1):15-41.
5. 5. Proffit WR. Forty-year review of extraction frequencies at a university orthodontic clinic. The Angle Orthod 1994; 64 (6):407-14.
6. 6. Crossman I, Reed R. Long term results of premolar extractions in orthodontic treatment. Br J Orthod 1978; 5 (2):61-6.
7. 7. De Castro N. Second-premolar extraction in clinical practice. Am J Orthod 1974;65 (2):115-37.
8. 8. Steyn C, Du Preez R, Harris A. Differential premolar extractions. Am J Orthod Dentofac Orthop 1997; 112 (5):480-6.

9. 9. Burstone CJ. Diagnosis and treatment planning ofpatients with asymmetries. In: Semin Orthod 1998; 4 (3): 153-64.
10. 10. Rebellato J Asymmetric extractions used in the t reatment of patients with asymmetries. In: Semin Orthod 1998; 4 (3): 180-8.
11. 11. Lindauer SJ. Asymmetries: diagnosis and treatment. In: Semin Orthod 1998; 4 (3): 133.
12. 12. Turpin DL. Correcting the Class II subdivision malocclusion. Am J Orthod Dentofacial Orthop 2005;128:555-6.
13. 13. Tayer BH. The asymmetric extraction decision. The Angle Orthod 1992; 62 (4):291-97.
14. 14. BeGole EA, Fox DL, Sadowsky C. Analysis of change in arch form with premolar expansion. Am J Orthod Dentofacial Orthop 1998; 113 (3):307-15.
15. 15. Dahiya G, Masoud AI, Viana G, Obrez A, Kusnoto B, Evans CA. Effects of unilateral premolar extraction treatment on the dental arch forms of Class II subdivision malocclusions. Am J Orthod Dentofacial Orthop 2017; 152 (2):232-41.
16. 16. Kim E, Gianelly AA. Extraction vs nonextraction: arch widths and smile esthetics. The Angle Orthod 2003;73 (4):354-58.
17. 17. Struhs TW. Effects of Unilateral Extraction Treatment on Arch Symmetry and Occlusion.2005.
18. 18. Maurice TJ, Kula K. Dental arch asymmetry in the mixed dentition. The Angle Orthod 1998; 68 (1):37-44.
19. 19. Scanavini PE, Paranhos LR, Torres FC, Vasconcelos MHF, Jóias RP, Scanavini MA. Evaluation of the dental arch asymmetry in natural normal occlusion and Class II malocclusion individuals. Dental Press J Orthod 2012; 17 (1):125-37.
20. 20. Alavi DG, BeGole EA, Schneider BJ. Facial and dental arch asymmetries in Class II subdivision malocclusion. Am J Orthod Dentofacial Orthop 1988; 93 (1):38-46.
21. 21. Veli I, Yuksel B, Uysal T. Longitudinal evaluation of dental arch asymmetry in Class II subdivision malocclusion with 3-dimensional digital models. Am J Orthod Dentofacial Orthop 2014; 145 (6):763-70.
22. 22. Lundström A. Some asymmetries of the dental arches, jaws, and skull, and their etiological significance. Am J Orthod 1961; 47 (2):81-106.
23. 23. Uysal T, Kurt G, Ramoglu SI. Dental and alveolar arch asymmetries in normal occlusion and Class II Division 1 and Class II subdivision malocclusions. World J Orthod 2009; 10 (1).
24. 24. Bishara SE, Bayati P, Zaher AR, Jakobsen JR. Comparisons of the dental arch changes in patients with Class II, division 1 malocclusions: extraction vs nonextraction treatments. The Angle Orthod 1994; 64 (5):351-58.
25. 25. Sampson P, Little RM, Årtun J, Shapiro PA. Long-term changes in arch form after orthodontic treatment and retention. Am J Orthod Dentofacial Orthop 1995; 107 (5):518-30.
26. 26. Strang RH. The fallacy of denture expansion as a treatment procedure. The Angle Orthod 1949; 19 (1):12-22.
27. 27. Işık F, Sayınsu K, Nalbantgil D, Arun T. A comparative study of dental arch widths: extraction and non-extraction treatment. Eur J Orthod 2005; 27 (6):585-89.
28. 28. Luppanapornlarp S, Johnston Jr LE. The effects of premolar-extraction: a long-term comparison of outcomes in “clear-cut” extraction and nonextraction Class II patients. The Angle Orthod 1993; 63 (4):257-72.
29. 29. Rübendüz M, Altunay AS. Çekimli ve çekimsiz tedavilerde dental ark değişiklikleri. Turk J Orthod 2001;14(3):132-7.
30. 30. Bravo LA, Canut JA, Pascual A, Bravo B. Comparison of the changes in facial profile after orthodontic treatment, with and without extractions. Br J Orthod 1997; 24 (1):25-34.
31. 31. Saelens NA, De Smit AA. Therapeutic changes in extraction versus non-extraction orthodontic treatment. Eur J Orthod 1998; 20 (3):225-36.
32. 32. Chen K, Han X, Huang L, Bai D. Tooth movement after orthodontic treatment with 4 second premolar extractions. Am J Orthod Dentofacial Orthop 2010; 138 (6):770-77.
33. 33. Al-Nimri KS. Vertical changes in class II division 1 malocclusion after premolar extractions. The Angle Orthod 2006;76(1):52-8.