Sınıf 3 maloklüzyonlarda hızlı üst çene genişletmesi ile birlikte yüz maskesi uygulamasının ve takiben yapılan sabit ortodontik tedavinin etkileri

Year 2021, , 49 - 55, 01.05.2021

Erdal Bozkaya , Arife Nihan Toğral , Sema Yüksel

https://doi.org/10.17214/gaziaot.793228

Abstract

Amaç: Bu çalışmada üst çene gelişim yetersizliği bulunan Sınıf 3 maloklüzyonlarda hızlı üst çene genişletilmesi ve yüz maskesi ile sonrasında yapılan sabit ortodontik tedavinin etkilerinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Bu çalışmada, hızlı üst çene genişletmesiyle birlikte yüz maskesi uygulanmış ve sonrasında sabit ortodontik tedavi görmüş 20 bireyin (11 kadın, 9 erkek, kronolojik yaş medyan değeri 11.29 yıl) arşiv materyalleri kullanıldı. Çalışmaya dâhil edilen bireylerin tedavi öncesi (T0), hızlı üst çene genişletilmesi ile birlikte yüz maskesi uygulaması sonrası (T1) ve sabit tedavi sonrasında (T2) alınan lateral sefalometrik radyografiler üzerinde değerlendirmeler yapıldı. Elde edilen verilerin istatistiksel analizinde Friedman testi ile Bonferroni düzeltmeli Wilcoxon testi kullanıldı. Bulguların yorumlanması sırasında p<0.05 istatistiksel olarak anlamlı kabul edildi.

Bulgular: Yüz maskesi uygulama süresi 13 ay (T1-T0), sabit ortodontik tedavi 2 yıl 1 ay (T2-T1), toplam tedavi süresi ise 3 yıl 2 aydı (T2-T0). SNA açısındaki ve Co-A mesafesindeki artış, T1-T0 (p<0.001) ve T2-T0 (SNA: p<0.001, Co-A: p<0.01) dönemlerinde anlamlı bulundu. SNB açısı T1-T0 döneminde anlamlı azalma (p<0.01); Co-Gn uzunluğu ise her üç dönemde de anlamlı artış gösterdi (T1-T0 ve T2-T1: p<0.05, T2-T0: p<0.001). SN/GoGn açısı T1-T0 (p<0.05) ve T2-T0 (p<0.001) dönemlerinde anlamlı düzeyde arttı. ANB açısında T1-T0 ve T2-T0 dönemlerinde anlamlı artış elde edildi (p<0.001).

Sonuç: İskeletsel Sınıf 3 maloklüzyonların tedavisinde, hızlı üst çene genişletmesi ve yüz maskesinin birlikte uygulanması etkili bir yöntemdir. Sabit ortodontik tedavi sonrası üst ve alt çenenin uyumlu bir biçimde büyümeye devam etmesiyle kalıcı sonuçlar elde edilmiştir.

Keywords

Angle Sınıf 3, Maloklüzyon, Ortodontik gereçler

Effects of rapid maxillary expansion and facemask therapy followed by fixed orthodontic treatment in Class 3 malocclusions

Abstract

Objective: The aim was to evaluate the effects of rapid palatal expansion and facemask therapy followed by fixed orthodontic treatment in Class 3 malocclusions with maxillary hypoplasia.

Materials and Method: The study was constituted from archive materials of 20 patients (11 females, 9 males, median of chronological age: 11.29 years) who were treated with rapid palatal expansion and facemask therapy followed by fixed orthodontic treatment. Lateral cephalometric radiographs of the patients were evaluated before treatment (T0), after rapid palatal expansion and facemask therapy (T1), and after fixed orthodontic treatment (T2). Friedman and post-hoc Wilcoxon tests with Bonferroni correction were used, and p<0.05 was considered as significant.

Results: The duration of rapid palatal expansion and facemask therapy was 13 months (T1-T0), fixed orthodontic treatment was 2 years and 1 month (T2-T1), and total treatment was 3 years and 2 months (T2-T0). The increase in SNA angle and Co-A dimension at T1-T0 (p<0.001) and T2-T0 (SNA: p<0.001, Co-A: p<0.01) periods were statistically significant. SNB angle showed a significant decrease at T1-T0 (p<0.01) while Co-Gn dimension increased significantly at all periods (T1-T0 and T2-T1: p<0.05, T2-T0: p<0.001). SN/GoGn angle also increased significantly at T1-T0 (p<0.05) and T2-T0 (p<0.001) periods. A significant increase was obtained in the ANB angle at T1-T0 and T2-T0 periods (p<0.001).

Conclusion: In the treatment of skeletal Class 3 malocclusions, rapid palatal expansion and facemask therapy is an effective method. Stable treatment outcomes were obtained after fixed orthodontic treatment with a harmonious maxillo-mandibular growth.

Keywords

Angle Class III, Malocclusion, Orthodontic appliances

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