Konjenital Maksiller Lateral Kesici Eksikliğinin Boşluk Açma ve Kapama Yöntemleriyle Ortodontik Tedavisi Sonrası Trabeküler Değişikliklerin Fraktal Analiz Yöntemiyle Değerlendirilmesi

Year 2024, Volume: 8 Issue: 1, 43 - 51, 28.04.2024

Orhan Çiçek , Samet Özden , Deniz Arslan

https://doi.org/10.29058/mjwbs.1426984

Abstract

Amaç: Çalışmanın amacı, konjenital maksiller lateral kesici eksikliğinin (KMLKE) boşluk açma ve
kapama yöntemleri ile tedavisi sonrası alveoler kemik yapısında meydana gelen trabeküler değişiklikleri
fraktal boyut (FD) analizi ile karşılaştırmaktır.
Gereç ve Yöntemler: Çalışmaya 48 hasta dahil edildi ve üç grup oluşturuldu: kontrol grubu (Grup 1),
boşluk açma grubu (Grup 2) ve boşluk kapama grubu (Grup 3). Maksiller santral kesici dişin distal apikal
bölgesinde belirlenen trabeküler alveolar kemiğin ilgi alanında tedavi öncesi (T0) ve sonrası (T1) alınan panoramik görüntüler üzerinde FD
analizi uygulanmıştır. Gruplar arası karşılaştırmalarda Kruskal-Wallis testi kullanılırken grup içi karşılaştırmalarda Wilcoxon testi kullanıldı.
İstatistiksel olarak anlamlılık düzeyi p<0.05 olarak belirlenmiştir.
Bulgular: Hem T0 hem de T1’de, tüm grupların FD değerleri arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0.05). Grup 2’de
T0’a kıyasla T1 döneminde FD değerlerinde anlamlı bir düşüş gözlenirken, Grup 3’te anlamlı bir artış görülmüştür (p<0.05).
Sonuç: KMLKE için ortodontik tedavi sonrası alveoler kemik trabekülasyonunun her iki yöntemle de ortodontik tedavi görmeyen bireylerdeki
kemik yapısına benzer olduğu görüldü. Ayrıca, boşluk açılan vakalarda stabiliteyi arttırmak amacıyla implant cerrahisi öncesinde alveolar
yapıların mineralizasyonu için bir konsolidasyon periyodunun gerekli olduğuna veya mümkünse bunlara ihtiyacı ortadan kaldıran boşluk
kapatma yönteminin tercih edilmesi sonucuna varılmıştır.

Keywords

Ortodonti, maloklüzyon, boşluk kapama, fraktal, kansellöz kemik

Evaluation of Trabecular Changes Using Fractal Analysis After Orthodontic Treatment for Congenital Maxillary Lateral Incisor Missing with Space Opening and Closure Methods

Abstract

Aim: The aim of the study was to compare the trabecular changes in alveolar bone structure after the
treatment of congenital maxillary lateral incisor missing (CMLIM) with space-opening and -closure methods
by fractal dimension (FD) analysis.
Material and Methods: The study included 48 patients and three groups were formed: control (Group
1), space-opening (Group 2), and space-closure groups (Group 3). FD analysis was performed on
panoramic images taken before (T0) and after (T1) treatment in the area of interest of trabecular alveolar
bone determined in the distal apical region of the maxillary central incisor. For inter-group comparisons,
the Kruskal-Wallis test was employed, while the Wilcoxon test was utilized for intra-group comparisons.
The statistical significance was determined as p<0.05.
Results: No statistically significant differences were observed in the FD values of all groups at both T0
and T1 (p>0.05). In Group 2, a significant decrease in FD values was observed during the T1 period
compared to T0, whereas Group 3 showed a significant increase (p<0.05).
Conclusion: It was observed that the alveolar bone trabeculation after orthodontic treatment for CMLIM
was similar to the bone structure in patients who did not receive orthodontic treatment with both methods.
It has also been concluded that in order to increase stability in space-opening cases, a consolidation
period is needed for the mineralization of the alveolar structures before implant surgery, or, if possible,
a space-closure method that eliminates the need for these should be preferred.

Keywords

Orthodontics, malocclusion, space closure, fractals, cancellous bone

References

• 1. Khalaf K, Miskelly J, Voge E, Macfarlane TV. Prevalence of hypodontia and associated factors: a systematic review and meta-analysis. Journal of Orthodontics. 2014;41(4):299-316.
• 2. Polder BJ, Van’t Hof MA, Van der Linden FP, Kuijpers‐Jagtman AM. A meta‐analysis of the prevalence of dental agenesis of permanent teeth. Community Dentistry and Oral Epidemiology. 2004;32(3):217-26.
• 3. Rakhshan V. Meta-analysis and systematic review of factors biasing the observed prevalence of congenitally missing teeth in permanent dentition excluding third molars. Progress in Orthodontics. 2013;14:1-12.
• 4. Muller T, Hill I, Petersen A, Blayney J. A survey of congenitally missing permanent teeth. The Journal of the American Dental Association. 1970;81(1):101-7.
• 5. Arandi NZ, Mustafa S. Maxillary lateral incisor agenesis; a retrospective cross-sectional study. The Saudi Dental Journal. 2018;30(2):155-60.
• 6. Jasim HH. Prevalence of congenitally missing teeth (radiographic study). Annals of Dental Specialty. 2020;8(1-2020):10- 9.
• 7. Fekonja A. Hypodontia in orthodontically treated children. European Journal of Orthodontics. 2005;27(5):457-60.
• 8. Silva Meza R. Radiographic assessment of congenitally missing teeth in orthodontic patients. International Journal of Paediatric Dentistry. 2003;13(2):112-6.
• 9. Celikoglu M, Kamak H, Yildirim H, Ceylan I. Investigation of the maxillary lateral incisor agenesis and associated dental anomalies in an orthodontic patient population. Medicina Oral, Patologia Oral,Cirugia Bucal. 2012;17(6):e1068-73.
• 10. Öztürk T, Topsakal KG, Yağcı A. The Effect of Missing Lateral Incisor and Incisor Tooth Positions on Lower Front Face Soft Tissue Thickness. Journal of Health Sciences. 2019;28(3):148- 57.
• 11. Acar O, Tuncer D, Sahinoglu Z, Ozcirpici AA, Arhun N. Assessing Treatment Options of Congenitally Missing Lateral Incisors: Shall We Create or Eliminate the Space? The Journal of Dentist. 2014;2(2):45.
• 12. Araújo EA, Oliveira DD, Araújo MT. Diagnostic protocol in cases of congenitally missing maxillary lateral incisors. World Journal of Orthodontics. 2006;7(4):376-88.
• 13. Cesur E, Bayrak S, Kursun-Çakmak EŞ, Arslan C, Köklü A, Orhan K. Evaluating the effects of functional orthodontic treatment on mandibular osseous structure using fractal dimension analysis of dental panoramic radiographs. The Angle Orthodontist. 2020;90(6):783-93.
• 14. Cicek O, Yilmaz H, Demir Cicek B. Comparison of the Mesiodistal Angulations of Canine and Molar Teeth in Different Types of Orthodontic Malocclusions: A Retrospective Study. Diagnostics. 2023;13(7):1351.
• 15. Ok U, Kaya TU. Fractal perspective on the rapid maxillary expansion treatment; evaluation of the relationship between midpalatal suture opening and dental effects. Journal of Stomatology, Oral and Maxillofacial Surgery. 2022;123(4):422-8.
• 16. Gümüşsoy İ. Application of Fractal Analysis Method on Panoramic Radiographs and Effect of Different X-Ray Devices on Fractal Dimension Value. Medical Journal of Sakarya. 2019;9(3):492-8.
• 17. Suer BT, Yaman Z, Buyuksarac B. Correlation of Fractal Dimension Values with Implant Insertion Torque and Resonance Frequency Values at Implant Recipient Sites. International Journal of Oral & Maxillofacial Implants. 2016;31(1):55-62.
• 18. Isman O. Evaluation of jaw bone density and morphology in bruxers using panoramic radiography. Journal of Dental Sciences. 2021;16(2):676-81.
• 19. Geraets WG, Jonasson G, Hakeberg M. Changing trabecular patterns in panoramic radiographs of Swedish women during 25 years of follow-up. Dentomaxillofacial Radiology. 2020;49(6):20190494.
• 20. Apolinário AC, Sindeaux R, de Souza Figueiredo PT, Guimarães AT, Acevedo AC, Castro LC, de Paula AP, de Paula LM, de Melo NS, Leite AF.Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofacial Radiology. 2016;45(4):20150400.
• 21. Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clinical Oral Investigations. 2015;19:519-24.
• 22. Bolat Gümüş E, Yavuz E, Tufekci C. Effects of functional orthopedic treatment on mandibular trabecular bone in class II patients using fractal analysis. Journal of Orofacial Orthopedics/ Fortschritte der Kieferorthopädie. 2023;84(Suppl 3):155-64.
• 23. Demirbaş AK, Ergün S, Güneri P, Aktener BO, Boyacıoğlu H. Mandibular bone changes in sickle cell anemia: fractal analysis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2008;106(1):e41-e8.
• 24. Bollen A, Taguchi A, Hujoel P, Hollender L. Fractal dimension on dental radiographs. Dentomaxillofacial Radiology. 2001;30(5):270-5.
• 25. Ergun S, Saraçoglu A, Guneri P, Ozpınar B. Application of fractal analysis in hyperparathyroidism. Dentomaxillofacial Radiology. 2009;38(5):281-9.
• 26. Ruttimann UE, Webber RL, Hazelrig JB. Fractal dimension from radiographs of peridental alveolar bone: a possible diagnostic indicator of osteoporosis. Oral Surgery, Oral Medicine, Oral Pathology. 1992;74(1):98-110.
• 27. Pothuaud L, Lespessailles E, Harba R, Jennane R, Royant V, Eynard E, Benhamou C-L. Fractal analysis of trabecular bone texture on radiographs: discriminant value in postmenopausal osteoporosis. Osteoporosis International. 1998;8:618-26.
• 28. Amuk M, Gul Amuk N, Yılmaz S. Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis. European Journal of Orthodontics. 2022;44(2):125-33.
• 29. McLaughlin, RP, Bennett, JC, Trevisi, HJ. Systemized Orthodontic Treatment Mechanics, 1st ed.; Mosby Ltd.: St. Louis, MO, USA, 2001.
• 30. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1999;88(5):628-35.
• 31. Güleç M, Taşsöker M, Şener S. Tıpta ve Diş Hekimliğinde Fraktal Analiz. Ege Üniversitesi Dişhekimliği Fakültesi Dergisi. 2019;40(1):17-31.
• 32. Oliveira ML, Pedrosa EFNC, Cruz AD, Haiter-Neto F, Paula FJA, Watanabe PCA. Relationship between bone mineral density and trabecular bone pattern in postmenopausal osteoporotic Brazilian women. Clinical Oral Investigations. 2013;17:1847- 53.
• 33. Sansare K, Singh D, Karjodkar F. Changes in the fractal dimension on pre-and post-implant panoramic radiographs. Oral Radiology. 2012;28:15-23.
• 34. Pothuaud L, Benhamou C, Porion P, Lespessailles E, Harba R, Levitz P. Fractal dimension of trabecular bone projection texture is related to three‐dimensional microarchitecture. Journal of Bone and Mineral Research. 2000;15(4):691-9.
• 35. Afzoon S, Hasani M, Ghorbani F. Evaluation of the Mandibular Condyles Trabecular Structure in Patients with Severe Class III Pattern: A CT Fractal Analysis Study. Scientific Reports 2023;13(1):18183.
• 36. Rothe LE, Bollen A-M, Little RM, Herring SW, Chaison JB, Chen CS-K, Hollender LG. Trabecular and cortical bone as risk factors for orthodontic relapse. American Journal of Orthodontics and Dentofacial Orthopedics. 2006;130(4):476-84.
• 37. Otis LL, Hong JS-H, Tuncay OC. Bone structure effect on root resorption. Orthodontics &Craniofacial Research. 2004;7(3):165-77.
• 38. Köse E, Ay Ünüvar Y, Uzun M. Assessment of the relationship between fractal analysis of mandibular bone and orthodontic treatment duration: A retrospective study. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2022;83(Suppl 1):102-10.
• 39. Haghnegahdar A, Najafi HZ, Sabet M, Saki M. Assessment of the changes in alveolar bone quality after fixed orthodontic therapy: A trabecular structure analysis. Journal of dental Research, Dental Clinics, Dental Prospects. 2016;10(4):201.
• 40. Heo M-S, Park K-S, Lee S-S, Choi S-C, Koak J-Y, Heo S-J, Han C-H, Kim J-D.Fractal analysis of mandibular bony healing after orthognathic surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;94(6):763-7.
• 41. Norçinli Z, Baka ZM. Accelaration Effect of Vibration On Orthodontic Tooth Movement: Review of Literature. Selcuk Dental Journal. 2021;8(1):245-54.
• 42. Pham D, Kiliaridis S. Evaluation of changes in trabecular alveolar bone during growth using conventional panoramic radiographs. Acta Odontologica Scandinavica. 2012;70(2):127-32.
• 43. Borzabadi-Farahani A. Orthodontic considerations in restorative management of hypodontia patients with endosseous implants. Journal of Oral Implantology. 2012;38(6):779-91.
• 44. Uribe F, Chau V, Padala S, Neace WP, Cutrera A, Nanda R. Alveolar ridge width and height changes after orthodontic space opening in patients congenitally missing maxillary lateral incisors. The European Journal of Orthodontics. 2013;35(1):87-92.
• 45. Nováčková S, Marek I, Kamínek M. Orthodontic tooth movement: bone formation and its stability over time. American journal of orthodontics and dentofacial orthopedics. 2011;139(1):37-43.
• 46. Cicek, O, Arslan, D. Investigation of the Mesiodistal Angulations of Maxillary Canines and Central Incisors for Missing Bilateral Maxillary Lateral Incisor. Journal of Clinical Medicine. 2024;13(7), 2110.
• 47. Korkmaz YN, Arslan S. Evaluation of the trabecular structure of the mandibular condyles by fractal analysis in patients with different dentofacial skeletal patterns. Australasian Orthodontic Journal. 2021;37(1):93-9.
• 48. Ertuğrul BY. Effect of fixed orthodontic treatment on mandibular condyle bone quality in different malocclusion groups. Cukurova Medical Journal. 2021;46(3):1160-7.
• 49. Beyer A, Tausche E, Boening K, Harzer W. Orthodontic space opening in patients with congenitally missing lateral incisors: Timing of orthodontic treatment and implant insertion. The Angle Orthodontist. 2007;77(3):404-9.
• 50. Alman A, Johnson L, Calverley D, Grunwald G, Lezotte D, Hokanson J. Diagnostic capabilities of fractal dimension and mandibular cortical width to identify men and women with decreased bone mineral density. Osteoporosis International. 2012;23:1631-6.
• 51. Kavitha MS, An S-Y, An C-H, Huh K-H, Yi W-J, Heo M-S,Lee S-S, Choi S-C. Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women. Oral surgery, oral medicine, oral pathology and oral radiology. 2015;119(3):346-56.
• 52. Camargo AJ, Cortes ARG, Aoki EM, Baladi MG, Arita ES, Watanabe PCA. Diagnostic performance of fractal dimension and radiomorphometric indices from digital panoramic radiographs for screening low bone mineral density. Brazilian Journal of Oral Sciences. 2016;15(2):131-6.