EVALUATION OF SOFT TISSUE AND AIRWAY CHANGES IN PATIENTS UNDERGOING COMBINED ORTHODONTIC AND ORTHOGNATHIC SURGERY

Year 2021, Volume: 8 Issue: 2, 344 - 351, 31.08.2021

Elif Dilara Şeker , Rabianur Baltacı , Melike Polat , Türker Yücesoy , Gökmen Kurt

https://doi.org/10.15311/selcukdentj.644887

Abstract

Background: Combined orthodontic
treatment and orthognathic surgery lead to changes in soft tissues and airway.
Prediction of postoperative changes is important for treatment planning. The
aim of this study was to investigate the changes in hard-soft tissue, and
airway in patients undergoing class III orthognathic surgery. 

Methods: In this study, pre- and post-operative
cephalometric films of 18 patients with Class III malocclusion were included.
The maxillary impaction-advancement and mandibular setback were performed. Hard-soft
tissue and airway measurements on lateral cephalometric radiographs which were
taken immediately before surgery(T1) and at least 6 months after surgery(T2)
were performed using Dolphin and Planmeca Romexis softwares, respectively. The data
distribution was analysed using Shapiro Wilk test. Comparisons of the data were
analysed using Paired t-test and
Wilcoxon test.

Results: A statistically significant
increase in Sn'-LLS/LLS-Me' value and E plane-lower lip distance and a
significant decrease in E-plane-upper lip distance were observed. No
statistical differences were observed in other soft tissue parameters. A
significant increase in SNA°, ANB° and a significant decrease in SN-GoGn° were
observed. There was an increase in V-LPW value in airway evaluations, however,
no significant difference was found in other airway parameters.

Conclusıon: In the literature, it is
difficult to obtain evidence-based results due to the retrospective character
of the studies examining soft tissue and airway changes after orthognathic
surgery, non-standard methods and the wide range of surgical movements applied.
However, combined orthodontic treatment and orthognathic surgery have positive
effects on soft tissue and airway in terms of aesthetics and function.

Keywords

Orthodontics, orthognatic surgery, Angle Class III, cephalometry

SINIF III ORTOGNATİK CERRAHİ HASTALARINDA YUMUŞAK DOKU VE HAVA YOLU DEĞİŞİMLERİNİN DEĞERLENDİRİLMESİ

Abstract

Amaç: : Kombine ortodontik tedavi ve ortognatik cerrahi
yumuşak dokularda ve havayolunda değişikliklere neden olmakta olup, ameliyat
sonrası oluşacak değişimlerin öngörülmesi tedavi planlaması açısından
önemlidir. Bu çalışmanın amacı sınıf III ortognatik cerrahi geçiren hastaların
sert doku, yumuşak doku ve havayolu değişimlerinin incelenmesidir.

Gereç ve Yöntemler: Bu
retrospektif çalışmaya, 18 adet sınıf III hastanın pre-operatif ve
post-operatif lateral sefalometrik kayıtları dahil edilmiştir. Çalışmaya dahil
edilen hastalarda maksiller gömme ve ilerletme, mandibular geri alma işlemleri
uygulanmıştır. Hastalardan cerrahiden hemen önce(T1) ve cerrahiden en az 6 ay
sonra(T2) alınan lateral sefalometrik radyografiler üzerinde yumuşak doku
ölçümleri Dolphin programıyla, havayolu ölçümleri ise Planmeca Romexis
yazılımıyla yapılmıştır. Elde edilen verilerin dağılımı Shapiro Wilk Testi ile
incelenmiş olup, T1 ve T2 döneminde elde edilen normal dağılım gösteren
verilerin karşılaştırmaları için Paired t-test, normal dağılım göstermeyen
verilerin karşılaştırmaları için ise Wilcoxon testi kullanılmıştır.

Bulgular: Hastaların
T1 ve T2 dönemlerinde elde edilen verileri karşılaştırıldığında yumuşak dokuda
Sn'-LLS/LLS-Me' değerinde ve E düzlemi-alt dudak mesafesinde istatistiksel
olarak anlamlı artış, E düzlemi-üst dudak mesafesinde olarak anlamlı azalma
gözlenmiştir. Diğer yumuşak doku parametrelerinde farklılık gözlenmemiştir. Sert doku değerlendirmesinde,
SNA°, ANB° değerinde anlamlı
artış, SN-GoGn° açısında anlamlı azalma gözlenmiştir. Havayolu
değerlendirmelerinde V-LPW değerinde artış meydana gelirken diğer
parametrelerde anlamlı fark bulunamamıştır.

Sonuçlar: Literatürde
ortognatik cerrahi sonrası yumuşak doku ve havayolu değişimlerini inceleyen
çalışmaların retrospektif karakteri, yöntemlerin standart olmaması ve uygulanan
cerrahi hareket miktarının geniş bir aralıkta değişmesi nedeniyle kanıta dayalı
sonuçlar çıkarmak zordur. Bununla birlikte kombine ortodontik tedavi ve
ortognatik cerrahi yumuşak doku ve hava yolu üzerinde estetik ve fonksiyon
bakımından olumlu etkileri vardır.

Anahtar Kelimeler: Ortodonti, Ortognatik cerrahi, Angle Sınıf III, Sefalometri

Keywords

Ortodonti, Ortognatik cerrahi, Angle Sınıf III, sefalometri

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