Hızlı ve Yarı Hızlı Maksiller Ekspansiyon Uygulamalarının Dentofasiyal ve Periodontal Etkilerinin Karşılaştırılması

Year 2017, Volume: 18 Issue: 1, 33 - 46, 01.04.2017

Şefika Ruzin Gönüldaş Ömür Polat Özsoy Hande Pamukçu Feride Kural

Abstract

Amaç: Bu çalışmanın amacı, akrilik splintli bonded ekspansiyon apareyi ile yapılan yarı hızlı maksiller ekspansiyon (SRME) ve hızlı maksiller ekspansiyon (RME) ile meydana gelen iskeletsel, dentoalveolar ve periodontal etkileri; ayrıca tedavi sırasında destek dişlerde meydana gelen kök rezorpsiyonunun şiddetini karşılaştırmaktır.Gereç ve Yöntemler: Maksiller darlığa sahip ve üst 1. premolar çekimi planlanan 19 birey çalışma grubunu oluşturmuştur. SRME grubunu oluşturan 10 birey ve hızlımaksiller genişletme grubunu oluşturan 9 bireyden tedavi başı, genişletme sonu ve 3 aylık pekiştirme dönemi sonunda lateral ve
posteroanterior (PA) sefalometrik radyograflar alınmıştır. Kabul eden 11 hastadan tedavi başı ve pekiştirme dönemi sonunda düşük
dozlu bilgisayarlı tomografi (BT) kayıtları alınmıştır. Ayrıca genişletme tedavisi bitiminde çekilen dişlerde taramalı elektron mikroskobu
ile kök rezorpsiyonu incelemesi yapılmıştır.
Bulgular: Her iki grupta da PA ölçümlerinde nazal kavite genişliği ve total maksiller genişlikte hem aktif tedavi sonunda hem de tüm
retansiyon sonunda istatistiksel olarak anlamlı artış, sağ ve sol molar dişlerde ise anlamlı tiping meydana gelmiştir. BT görüntülerinde
yapılan ölçümlerde ise iki tedavide de posterior nazal kavite genişliği ve palatal maksiller genişlikte önemli artış gözlenmiş, molar ve
premolar dişlerin hepsinde bukkal kemik kalınlığı azalmış, palatinal kemik kalınlığı artmıştır. Kök rezorpsiyonu açısından iki grupta da
benzer derinlik ve miktarda rezorpsiyon kriterleri görülmüştür.
Sonuç: SRME ve RME protokollerinin kısa dönemde farklı etkilerinin bulunmaktadır ancak retansiyon dönemi sonunda bu farklılıklar
ortadan kalkmaktadır. Her iki gruptaki kök rezorbsiyonunun lokasyonu ve derecesi yönünden kalitatif değerlendirmede bir fark
bulunamamıştır.

Keywords

Hızlı maksiller ekspansiyon, yarı hızlı maksiller ekspansiyon, bilgisayarlı tomografi, kök rezorpsiyonu

Comparison of Dentofacial and Periodontal Effects of Rapid and Semi-rapid Maxillary Expansion

Abstract

Objective: The purpose of this study was to compare the skeletal, dentoalveolar and periodontal effects that occurred after rapid maxillary expansion (RME) and semi-rapid maxillary expansion (SRME) with an acrylic splint bonded expansion appliance and also to compare the degree of root resorption in the supporting teeth during expansion. Materials and Methods: The sample of the study included 19 patients having maxillary constriction requiring bilateral upper premolar extraction. The semi-rapid group consisted of 10 patients and the rapid group consisted of 9 patients. Lateral and posteroanterior (PA) cephalometric radiographs were taken at the beginning of the treatment, at the end of expansion and after 3 months of retention period. Eleven patients underwent low-dose computed tomography (CT) at the beginning of treatment and at the end of retention period, after giving informed consent. The evaluation of root resorption was made using a scanning electron microscope from the extracted teeth. Results: Both lateral and PA radiographs showed similar changes between the groups. Posterior nasal cavity width, palatal maxillary width, the distance between palatinal roots and the distance between incisor roots showed significant increase in the CT measurements. Buccal bone thickness decreased and palatal bone thickness increased in all molar and premolar teeth examined. Root resorption was seen in both groups, but no significant differences were observed between the groups. Conclusion: Some differences were seen in short-time effects between SRME and RME but these differences were temporary and disappeared at the end of the retention period. The qualitative evaluation of the roots showed that the location and degree of the root resorption were similar between the groups.

Keywords

Rapid maxillary expansion, semi-rapid maxillary expansion, computed tomography, root resorption

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