Akrilik Bloklu ve Bloksuz Hızlı Üst Çene Genişletme Protokollerinde Molar Devrilmesinin Posteroanterior Filmler Üzerinde Karşılaştırılması

Abstract

ÖZET Amaç: Bu retrospektif çalışmanın amacı, bloklu (akrilik blok) ve bloksuz hızlı üst çene genişletme (HÜÇG) uygulamalarının üst molar dişlerin bukkale devrilmesi üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntemler: Bloklu ve bloksuz HÜÇG uygulanmış olan vakalar taranarak yaşları 12-15 arası değişen 15 erkek 15 kadın olmak üzere toplam 30 birey çalışmaya dahil edilmiştir. Genişletme öncesi ve sonrası rutin olarak alınmış PA filmler, araştırmanın gerecini oluşturmaktadır. Belirlenen doğru, düzlem, noktalar yardımıyla tedavi öncesi ve sonrası 10’ar adet ölçüm PA filmler üzerinde gerçekleştirilmiştir. Bulgular: Bloklu HÜÇG yapılan bireylerde üst molar dişlerin uzun aksları arasındaki açı ortalama (ort.) 6,4˚ artarken, bloksuz HÜÇG yapılmış bireylerde 10˚ artmıştır (p<0,05). Üst sağ ve sol 1. molar dişlerin uzun akslarının, yatay referans düzlemiyle yaptığı açıların ortalaması bloklu HÜÇG yapılmış bireylerde ort. 3,2˚ artarken bloksuz HÜÇG yapılmış bireylerde 6,2˚ artmıştır (p<0,05). Sonuç: Hem bloklu hem de bloksuz grupta HÜÇG sonrası molar devrilmesi görülmüştür. Bloklu grupta molar devrilmesinin bloksuz gruba göre daha az gerçekleşmiş olması istatistiksel olarak anlamlıdır. Çalışma, akrilik bloklu apareylerin üst molar dişlerdeki devrilme miktarını azaltsa da tamamen ortadan kaldırmadığını göstermektedir. Vertikal büyüme yönü olan bireylerde her iki aparey kullanımının da molar devrilmesiyle sonuçlanarak dik yön boyutlarında artışa neden olabileceği göz önünde bulundurulmalıdır.

Keywords

• Diş Hareketi
• Ortodontik Apareyler
• Üst çene genişletmesi

Comparison of Molar Tipping in RPE Protocols With and Without Acrylic Block on Posteroanterior Films

Abstract

ABSTRACT Objectives: This study aimed to evaluate and compare the effects of rapid maxillary expansion (RME) with and without blocks (acrylic) on buccal tipping of maxillary molars using posteroanterior (PA) films. Materials and methods: This retrospective study included 30 individuals (15 males and 15 females; aged 12–15 years) who underwent RME with either block or non-block appliances. PA films obtained before (t0) and immediately after expansion (t1) were analyzed. Ten linear and angular measurements were performed using predefined landmarks, reference lines, and planes. The U6MZ angle was considered the primary outcome variable. Statistical analyses were conducted using appropriate parametric and non-parametric tests, and effect sizes were calculated, p<0,05 was considered statistically significant. Results: Molar tipping was observed in both groups following RME. The increase in the angle between the long axes of the maxillary molars was greater in the non-block group (10°) compared to the block group (6,4°) (p<0,05). Similarly, the increase in molar inclination relative to the reference plane was higher in the non-block group (6,2°) than in the block group (3,2°) (p<0,05). A statistically significant difference was found between the groups for the primary outcome variable (U6MZ), with a large effect size (Cohen’s d = 1,53), indicating a clinically significant difference. Conclusion: Both block and non-block RME protocols result in molar tipping; however, block appliances significantly reduce the magnitude of this effect. Despite this reduction, molar tipping is not completely eliminated. These findings suggest that appliance selection should be carefully considered, particularly in patients with vertical growth patterns, where increased molar tipping may contribute to unfavorable vertical changes.

Keywords

• Orthodontic Appliances
• Maxillary Expansion
• Tooth Movement

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