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

Öz

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.

Anahtar Kelimeler

• Orthodontics
• malocclusion
• space closure
• fractals
• cancellous bone

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

Öz

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.

Anahtar Kelimeler

• Ortodonti
• maloklüzyon
• boşluk kapama
• fraktal
• kansellöz kemik

Kaynakça

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