Effects of combined rapid palatal expansion and face mask therapy on mandibular dentition

Year 2019, Volume: 36 Issue: 3, 81 - 86, 01.09.2019

Fatma Deniz Uzuner Şenol Gülşen Selin Kale Varlık Tuba Tortop

https://doi.org/10.17214/gaziaot.551225

Abstract

Objective: The study aimed to evaluate the effects of combined rapid maxillary expansion
(RPE) and face mask (FM) application on the mandibular dentition.

Materials and Method: In this retrospective study pre- and post-treatment cephalometric
radiographs and orthodontic models of 25 patients (10 female, 15 male) with a
mean skeletal age of 12 years and 1 month, being in permanent dentition, having
skeletal Class 3 anomaly (ANB<0) accompanying with maxillary retrognathism
and posterior crossbite who had been treated with a combined application of
bonded Hyrax RPE and FM were evaluated. The mean duration for the RPE-FM
application was 8.7 months. The lower arch intermolar and intercanine widths,
arch depth and the amount of crowding between canines were evaluated using Littles’
Irregularity Index (LII) on the 3D images of the models utilizing the 3Shape
OrthoAnalyzer 2013-1 program. Mandibular incisors’ inclination (IMPA degree)
were determined on cephalometric radiographs. The statistical evaluation was
done with paired t-test, and the statistical significance was set at p<0.01.

Results: In the lower
dental arch, a significant increase of 1.38 mm was found in the intermolar
width (p<0.001). While no significant difference was observed in the intercanine
width, there was a significant decrease in the arch depth (1.45 mm; p<0.001)
and a significant increase in the LII value (1.46 mm; p<0.01). Besides, there
was no significant difference in the IMPA degree.

Conclusion: Combined
RPE-FM application in the treatment of skeletal Class 3 malocclusion provides
an increase in mandibular intermolar width that may increase the arch length. On
the contrary, a decrease in the arch depth results in shortening of the arch
length. Clinicians should be conscious of a mandibular anterior crowding during
this type of combined therapy.

Keywords

Angle Class III, crowding, dental arch, extraoral traction appliances, palatal expansion technique

Hızlı üst çene genişletmesi ve yüz maskesi kombine uygulamasının mandibular dentisyona etkisi

Abstract

Amaç: Bu
çalışmanın amacı, Hızlı
Üst Çene Genişletmesi (HÜÇG) ve Yüz maskesi (YM) kombine uygulamasının mandibular
dentisyona etkisini değerlendirmektir.

Gereç ve Yöntem: Bu retrospektif
çalışmada daimi dişlenme döneminde olan, ortalama iskelet yaşı 12 yıl 1 ay
olan, posterior çapraz kapanış ve maksiller retrognatinin eşlik ettiği
iskeletsel Sınıf 3 anomaliye (ANB<0) sahip olup tedavi protokolü gereği
yapıştırmalı tip Hyrax vidalı HÜÇG aygıtı ile Petit tip YM’nin kombine uygulandığı
25 bireye (10 kız, 15 erkek) ait tedavi başı ve sonu sefalometrik film ve
ortodontik modeller değerlendirildi. HÜÇG-YM kullanımı ortalama 8.7 aydı.
Ortodontik modellerin 3D görünümünde 3Shape Ortho Analyzer 2013-1 programıyla
alt çenede intermolar, interkanin genişlik, ark derinliği ve alt anterior bölge
kanin-kanin arası çapraşıklık miktarı Little düzensizlik indeksi (LDİ) metodu
kullanılarak ölçüldü. Lateral sefalometrik filmlerde alt keser eğimi (IMPA
açısı) ölçüldü. Verilerin istatistiksel olarak değerlendirilmesinde
eşleştirilmiş t-testi kullanıldı. İstatistiksel anlamlılık değeri p<0.01 olarak
kabul edildi.

Bulgular: Kombine uygulama
sonunda alt dental arkta intermolar genişlikte ortalama 1.38 mm anlamlı artış
bulundu (p<0.001). Buna karşılık, interkanin genişliğinde değişim saptanmadı.
Ark derinliğinde ise 1.45 mm anlamlı azalma (p<0.001) ve LDİ değerinde 1.46
mm anlamlı artış görüldü (p<0.01). Alt keser eğiminde (IMPA açısı)
istatistiksel olarak anlamlı değişim saptanmadı.

Sonuç: HÜÇG-YM kombine uygulaması sonunda
alt çenede oluşan intermolar genişlikteki artış ark boyunu arttırırken, buna
karşılık ark derinliğindeki azalma ark boyunu azaltmaktadır. Klinisyenler bu
kombine uygulamayla alt çenede kesici dişlerde çapraşıklık miktarının artabileceğini
göz önünde bulundurmalıdır.

Keywords

Ağız dışı çekme aletleri, Angle sınıf 3, arkus dentalis, çapraşıklık, damak genişletme tekniği

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