Long term results of double plate appliance and facemask combination in the treatment of Class III malocclusion: cephalometric analysis

Yıl 2018, , 62 - 68, 14.08.2018

Emine Kaygısız , Erdal Bozkaya Tuba Tortop , Dervis Emre Ercan , Sema Yuksel

https://doi.org/10.17214/gaziaot.345052

Öz

Objective: The aim of this
study was to evaluate the long term results of double plate appliance and
facemask combination (DPA-FM) in treating Class III malocclusions when growth
potential of the patients was close to cease or ceased.

Materials and Method: The material consisted
of the pretreatment (T1), posttreatment (T2), and long term (T3) lateral
cephalometric and the hand-wrist radiographs of 13 patients (5 females, 8 males;
mean chronological age: 11.1±1.40 years) with skeletal and dental Class III
malocclusion treated with DPA-FM combination. The mean DPA-FM treatment time
was 10.8±1.88 months. The hand-wrist growth and developmental stages were MP3u
or Ru at T3. The mean follow-up period was 5.0±1.98 years. Friedman’s Two-Way
ANOVA and Wilcoxon signed-rank tests were used to evaluate the treatment
(T2-T1), follow-up (T3-T2) and overall (T3-T1) results.

Results: With
the DPA-FM therapy, SNA and ANB angles increased (p<0.001); however, no
significant differences were found in these parameters during T3-T2 period
[p=0.655 (SNA), p=0.805 (ANB)]. Significant increases were found in N┴FH-A distance during
the treatment (p<0.01) and follow-up (p<0.05) periods. Molar relation showed
significant increases with DPA-FM in both the treatment and overall period
(p<0.001). Overjet increased significantly during the treatment
(p<0.001), follow-up (p<0.05), and overall (p<0.001) periods.
Significant protrusion of upper incisors (U1/NA) was observed during the
treatment, follow-up, and overall periods (p<0.05). U6/PP and L6/MP angles
did not change during the DPA-FM treatment; however, these parameters decreased
significantly during the follow-up and overall periods (p<0.05).

Conclusion: In the treatment of
Class III malocclusion, the DPA-FM appliance was effective. The skeletal and
dental sagittal changes achieved by orthopedic treatment were maintained in the
long term.

Anahtar Kelimeler

Angle Class III, extraoral traction appliances, follow-up studies, malocclusion, orthodontic appliances, orthodontics

Sınıf III maloklüzyonun tedavisinde ağız-içi çift plak ile yüz maskesi kombine uygulamasının uzun dönem sonuçları: sefalometrik analiz

Öz

Amaç: Sınıf III maloklüzyonun tedavisinde kullanılan ağız-içi çift plak
ile yüz maskesi (AÇP-YM) kombine tedavisinin uzun dönem sonuçlarının büyüme
potansiyeli bitmiş ya da bitmekte olan hastalarda değerlendirilmesidir.

Gereç ve Yöntem: Çalışmanın materyali AÇP-YM kombine tedavisi uygulanmış olan
iskeletsel ve dişsel Sınıf III maloklüzyona sahip 13 hastaya (5 kız, 8 erkek;
ortalama kronolojik yaş: 11.1±1.40 yıl) ait tedavi öncesi (T1), sonrası (T2) ve
uzun dönem takip (T3) lateral sefalometrik ve el bilek radyografilerinden
oluşturuldu. Ortalama AÇP-YM tedavi süresi 10.8±1.88 aydır. T3 döneminde, el
bilek büyüme ve gelişim safhası, MP3u veya Ru dönemidir. Ortalama takip süresi
5.0±1.98 yıldır. Tedavi (T2-T1), takip (T3-T2) ve toplam (T3-T1) değişiklikleri
değerlendirmek için Friedman iki yönlü ANOVA ve Wilcoxon işaretli sıralar
testleri kullanıldı.

Bulgular: AÇP-YM tedavisi ile SNA ve ANB açılarında artış bulundu (p<0.001). Ancak bu
parametrelerde T3-T2 döneminde önemli düzeyde bir değişiklik meydana gelmedi [p=0.655 (SNA), p=0.805
(ANB)]. N┴FH-A mesafesi tedavi
(p<0.01) ve takip (p<0.05) dönemlerinde önemli düzeyde arttı. Molar ilişkide, hem AÇP-YM tedavisi sırasında hem de toplam sürede
önemli düzeyde bir artış meydana geldi (p<0.001). Overjet ise, tedavi
(p<0.001), takip (p<0.05) ve toplam sürede (p<0.001) önemli düzeyde
arttı. Tedavi, takip dönemlerinde ve toplam sürede, üst keserlerde (U1/NA)
önemli düzeyde protrüzyon gözlendi (p<0.05). U6/PP ve L6/MP açıları AÇP-YM
tedavisi ile değişmezken, takip periyodunda ve toplam sürede bu parametrelerde
önemli düzeyde azalma meydana geldi (p<0.05).

Sonuç: AÇP-YM kombine tedavisi, Sınıf III maloklüzyonun tedavisinde etkili
bulundu. Bu ortopedik tedavi ile meydana gelen iskeletsel ve dişsel sagital
değişikliklerin uzun dönem takip periyodunda korunduğu gözlendi.

Anahtar Kelimeler

Angle Sınıf 3, ağız dışı çekme aletleri, maloklüzyon, ortodontik cihazlar, ortodonti, takip çalışmaları

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