CERRAHİ DESTEKLİ HIZLI MAKSİLLER GENİŞLETME SONRASI DEĞİŞİKLİKLERİN DEĞERLENDİRİLMESİNDE RADYOGRAFİK GÖRÜNTÜLEMENİN ÖNEMİ: DERLEME ÇALIŞMASI

Year 2022, , 288 - 298, 27.04.2022

Elifhan Alagöz , Tuğba Ünver , Gökmen Kurt , Doğan Dolanmaz

https://doi.org/10.15311/selcukdentj.868325

Abstract

Kalıtımsal, fonksiyonel veya çevresel etkenler sonucu kafa yüz kemiklerinde ortaya çıkan iskeletsel bir anomali; maksillanın büyümesini olumsuz yönde etkileyerek sagittal, vertikal ve transversal yönde malokluzyonlara neden olabilmektedir. Maksiller transversal darlık, kraniofasiyal alanda görülen iskeletsel anomalilerin en sık olarak gözlendiği problemlerdir. Bu durum hem iskeletsel, hem de dişsel olarak karşımıza çıkabilmektedir. Maksiller darlık vakalarında tedavi alternatifleri yaşa bağlı olarak değişmektedir. İskeletsel maksiller darlık tanısı konmuş olup, gelişimi devam eden bireylerde ortopedik maksiller genişletme yapılmaktadır. Erişkin bireylerde ise maksiller darlıklar, ortopedik kuvvetler yetersiz kaldığı için cerrahi destekli hızlı maksiller genişletme (CDHMG) ile düzeltilebilmektedir. CDHMG prosedürü, plastik cerrahi uygulamasında bir tür kontrollü yumuşak doku genişletmesi olmakla beraber popüler bir kavram olan distraksiyon osteogenezi olarak ifade edildiği bildirilmektedir.
Transversal iskelet değişikliklerini değerlendiren çoğu çalışma, dental ölçülere veya konvansiyonel iki boyutlu (2D) radyografilere dayanmaktadır. Ancak 2D radyograflar ile karşılaştırıldığında, üç boyutlu (3D) görüntüleme diş ve iskelet hareketlerinin daha kesin değerlendirilmesini sağlayabilir. Özellikle dental volumetrik tomografi (DVT), invaziv olmama, yüksek erişilebilirlik, yüksek doğruluk ve iyi çözünürlük nedeniyle ağız, diş ve çene-yüz cerrahisinde, ortodontide tanı ve tedavi takibi için benzeri görülmemiş bir teknik haline gelmiştir.
2D görüntünün magnifiye olması, distorsiyona uğraması, anatomik yapıların süperpoze olması gibi bazı kısıtlamalar nedeniyle 2D görüntüler yerine günümüzde 3D görüntüler kullanılmaya başlanmıştır.

Keywords

Cerrahi Destekli Hızlı Maksiller Genişletme, DVT, BT

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