Tek taraflı dudak ve damak yarığına sahip hastalarda alt çene ark boyu uyumsuzluğu: ortodontik model analizi

Abstract

Amaç: Tek taraflı dudak ve damak yarığına (DDY) sahip hastalarda alt çene ark boyu uyumsuzluğunu belirlemektir.

Gereç ve Yöntem: Non-sendromik tek taraflı total DDY’ye sahip olup, alt çenede büyük dolgu/kronlu diş bulunmayan, diş eksikliği, gömülü veya fazla dişi olmayan kronolojik yaşı 9 ile 19 yıl arasında değişen 23 hastaya ait tedavi öncesi panoramik radyograf ve ortodontik modeller değerlendirildi. Hastaların dudak ve damak yarığı opere edilmiştir. Alt ark boyu uyumsuzluğunu belirlemede Hayes-Nance analizi kullanıldı. Geç karışık dişlenme dönemindeki hastalar için daimi premolar boyutları panoramik radyograflarla değerlendirildi. Pozitif ark boyu uyumsuzluğu diastema, negatif ark boyu uyumsuzluğu çapraşıklık olarak kabul edildi. Tanımlayıcı istatistikler sıklık ve yüzde oranları kullanılarak yapıldı ve farklar binomial test ile değerlendirildi.

Bulgular: İncelenen 23 hasta içinde sadece bir hastada ark boyu uyumsuzluğu görülmedi. Kalan 22 hastanın % 47.8’inde (n = 10) diastema saptandı; bu miktar ortalama 3.6 ± 1.9 mm olarak bulundu. Alt ark çapraşıklığı ise %52.2 (n = 12), prevalans ile ortalama -2.9 ± 1.4 mm olarak bulundu. Çapraşıklık ve diastema prevalansları bakımından istatistiksel olarak önemli bir fark bulunmadı (p =  0.832).

Sonuç: Tek taraflı DDY’ye sahip hastalarda, alt çenede, diastema ve çapraşıklığa aynı prevalansta rastlanabilmektedir. Görülen çapraşıklık hafif ile orta şiddettedir.

Keywords

• Arkus dentalis,çapraşıklık,diyastem

Discrepancy in the lower arch perimeter in patients with a unilateral cleft lip and palate: orthodontic model analysis

Abstract

Objective: This study aimed to assess the lower arch length discrepancy in a group of patients with unilateral cleft lip and palate (UCLP).

Materials and Method: Pretreatment dental casts and panoramic radiographs of 23 patients (aged 9–19 years) with a nonsyndromic complete UCLP, without having large restorations/crowns, tooth agenesis, impacted or supernumerary teeth in the lower arch, and previous orthodontic and/or prosthetic treatment, were evaluated. All patients underwent lip and palate repair. Lower arch discrepancies were determined using the Hayes-Nance analysis. Panoramic radiographs were used to estimate the size of permanent premolars for the patients with late mixed dentition. The positive discrepancy defined diastema, whereas the negative discrepancy defined crowding in the lower arch. Descriptive statistics were presented using frequencies and percentages, and the differences were evaluated using the binomial test.

Results: One out of 23 patients had no discrepancy in the lower arch. For the remaining patients (n = 22), the prevalence of diastema was 47.8% (n = 10), with a mean value of 3.6 ± 1.9 mm, and lower arch crowding was observed in 52.2% (n = 12), with a mean value of –2.9 ± 1.4 mm. No significant difference was found between the prevalence of crowding and diastema (p = 0.832).

Conclusion: In patients with a UCLP, diastema can be encountered approximately at the same frequency as crowding in the lower arch. Crowding was at a low to mid-level.

Keywords

• Crowding,dental arch,diastema

References

1. Antonarakis GS, Tsiouli K, Christou P. Mesiodistal tooth size in non-syndromic unilateral cleft lip and palate patients: a meta-analysis. Clin Oral Invest 2013;17:365–77.
2. Walker SC, Rye Mattick C, Hobson RS, Steen IN. Abnormal tooth size and morphology in subjects with cleft lip and/or palate in the north of England. Eur J Orthod 2009;31:68–75.
3. Heidbuchel KL, Kuijpers-Jagtman AM. Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients form 3 to 17 years of age. Cleft Palate Craniofac J 1997;34:21–6.
4. Lewis BR, Stern MR, Willmot DR. Maxillary anterior tooth size and arch dimensions in unilateral cleft lip and palate. Cleft Palate Craniofac J 2008;45:639–46.
5. Rawashdeh MA, Bakir IF. The crown size and sexual dimorphism of permanent teeth in Jordanian cleft lip and palate patients. Cleft Palate Craniofac J 2007;44:155–62.
6. Akcam MO, Toygar TU, Özer L, Özdemir B. Evaluation of 3-dimensional tooth crown size in cleft lip and palate patients. Am J Orthod Dentofacial Orthop 2008;134:85-92.
7. Peterka M, Müllerová Z. Tooth size in children with cleft lip and palate. Cleft Palate J 1983;20:307–13.
8. Werner SP, Harris EF. Odontometrics of the permanent teeth in cleft lip and palate: systemic size reduction and amplified asymmetry. Cleft Palate J 1989;26:36–41.

9. Ye B, Ruan C, Hu J, Yang Y, Ghosh A, Jana S. et al. A comparative study on dental arch morphology in adult unoperated and operated cleft palate patients. J Craniofac Surg 2010;21:811–5.
10. Athanasiou AE, Moyers RE, Mazaheri M, Toutoutzakis N. Frontal cephalometric evaluation of transverse dentofacial morphology and growth of children with isolated cleft-palate. J Craniomaxillofac Surg 1991;19:249–53.
11. Celikoglu M, Buyuk SK, Ekizer A, Sekerci AE. Evaluation of mandibular transverse widths in patients affected by unilateral and bilateral cleft lip and palate using cone beam computed tomography. Angle Orthod 2015;85:611–5.
12. Fudalej P, Obloj B, Dudkiewicz Z, Hortis-Dzierzbicka M. Mandibular Morphology and Spatial Position Following One-Stage Simultaneous Repair of Complete Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2008;45:272-7.
13. Swennen G, Berten JL, Kramer FJ, Malevez C, De Mey A, Schwestka-Polly R, et al. Mandibular morphology in complete unilateral cleft lip and palate. Cleft Palate Craniofac J 2004;41:403–9.
14. Erdemir U, Yucel T, Yildiz E, Germec Cakan D, Sayinsu K. Dental Analysis. Erdemir U, Yildiz E, editors. Esthetic and Functional Management of Diastema. Zurich: Springer; 2016. p.101-20.
15. Bunyarit SS, Asma AA, Abdul Rahman NA, Adri SS, Rahman MM. Dental Anomalies and Gender Dimorphism in Tooth Size of Malay Patients. Bangladesh Journal of Medical Science 2017;16:115-21.
16. Kumar TVP, Chitra P. Determination of Bolton Norms for Indian Population Sample. Orthodontic Journal of Nepal 2018;7:33-6.
17. Wolfart S, Menzel H, Kern M. Inability to relate tooth forms to face shape and gender. Eur J Oral Sci 2004;112:471-6.
18. Smith SS, Buschang PH, Watanabe E. Interarch tooth size relationships of 3 populations: “does Bolton’s analysis apply?” Am J Orthod Dentofacial Orthop 2000;117:169-74.
19. Santoro M, Ayoub ME, Pardi VA, Cangialosi TJ. Mesiodistal crown dimensions and tooth size discrepancy of the permanent dentition of Dominican Americans. Angle Orthod 2000;70:303-7.
20. Sugiki Y, Kobayashi Y, Uozu M, Endo T. Association between skeletal morphology and agenesis of all four third molars in Japanese orthodontic patients. Odontology 2018;106:282-6.
21. Bailit HL. Dental variation among populations. An anthropologic view. Dent Clin North Am 1975;19:125–39.
22. Bishara SE, Garcia AF, Jakobsen JR, Fahl JA. Mesiodistal crown dimensions in Mexico and the United States. Angle Orthod 1986;56:315–23.
23. Omar H, Alhajrasi M, Felemban N, Hassan A. Dental arch dimensions, form and tooth size ratio among a Saudi sample. Saudi Med J 2018;39:86-91.
24. Fernandes TM, Sathler R, Natalício GL, Henriques JFC, Pinzan A. Comparison of mesiodistal tooth widths in Caucasian, African and Japanese individuals with Brazilian ancestry and normal occlusion. Dental Press J Orthod 2013;18:130-5.
25. Garn SM, Osborne RH, McCabe KD. The effect of prenatal factors on crown dimensions. Am J Phys Anthropol 1979;51:665–78.
26. Foster TD, Lavelle CL. The size of the dentition in complete cleft lip and palate. Cleft Palate J 1971;8:177-84.
27. Lai MC, King NM, Wong HM. Abnormalities of maxillary anterior teeth in Chinese children with cleft lip and palate. Cleft Palate Craniofac J 2009;46:58–64.
28. Wahaj A, Ahmed I. Comparison of Intercanine and Intermolar Width Between Cleft Lip Palate and Normal Class I Occlusion Group. J Coll Physicians Surg Pak 2015;25:811-4.