Farklı iskeletsel maloklüzyon tiplerinde derin Spee eğrisinin dentoiskeletsel karakteristiği

Amaç: Dişsel faktörlerin derin Spee Eğrisi (SE) üzerindeki etkisini incelemek ve farklı sagittal ve vertikal iskeletsel maloklüzyon gruplarında SE karakteristiğini karşılaştırmaktır. Gereç ve Yöntem: Bu çalışmaya SE 3 mm’den derin olan toplam 184 Koreli hasta dahil edildi. Hastalar sagittal ve vertikal iskeletsel paternlerine göre ayrı ayrı sınıflandırıldı. Alçı modeller ve lateral sefalometrik filmler üzerinde Spee Eğrisi derinliği (SED), overjet, overbite, keserler arası açı, alt keser, alt kanin ve alt molarların mandibular düzlem ve mandibular oklüzal düzlem ile yaptıkları açı, alt keser ve kaninlerin mandibular düzlemden uzaklıkları, kaninler arası genişlik, premolarlar arası genişlik, molarlar arası genişlik ve ark uzunluğu parametreleri ölçüldü. Gruplar arasında değişkenlerin karşılaştırılması Tukey post-hoc testi ile birlikte varyans analizi ile yapıldı (α=0.05). Bulgular: Derin SE, Sınıf 2’de keserlerin labioversiyonu, kanin ve molarların mezial angulasyonu ile; Sınıf 3’te ise kaninler arası genişliğin artması ve molarlar arası genişliğin artması, keserlerin linguoversiyonu, kanin ve molarların distal angulasyonu ile oluşmuştu. Her grup sagittal iskeletsel paterni doğrultusunda dişsel kompanzasyon gösterdi. Hipodiverjan grubunda derin SE; overbite fazlalığı, keserlerin labioversiyonu, kanin ve molarların mezial angulasyonu ile karakterizeydi. Optimum büyüme modeli ve hiperdiverjan gruplarının her ikisi de keser ve kaninlerde ekstrüzyon göstermekle birlikte hiperdiverjan grubu bunlara ilaveten keserlerde linguoversiyon göstermekteydi. Sonuç: Farklı sagittal ve vertikal iskeletsel maloklüzyon gruplarında transvers ark genişliği, keserlerin inklinasyonu, kanin ve molarların angulasyonu, keser ve kaninlerin ekstrüzyon miktarları gibi dişsel faktörler SE karakteristiğine etki edebilir.

The dentoskeletal characteristics of deep curve of Spee in different malocclusion patterns

Objective: To investigate the effect of dental factors on deep curve of Spee (COS) and to compare COS characteristics among different sagittal and vertical skeletal malocclusion groups. Materials and Method: Totally 184 Korean patients with a deep COS more than 3 mm were included in this study. The patients were classified according to their sagittal and vertical skeletal pattern separately. Parameters including COS depth, overjet, overbite, interincisal angle, angle of lower incisors, lower canines and lower first molars based on mandibular plane and mandibular occlusal plane, height of lower incisors and lower canines based on mandibular plane, inter-canine width, inter-premolar width, inter-molar width and arch-length were measured on lateral cephalometric radiographs and model casts. The comparison of the variables among the groups was performed using analysis of variance with Tukey post-hoc test (α=0.05). Results: Deep COS was formed through labioversion of incisors, mesially tipped canines and mesially tipped molars in Class 2; large inter-canine width, large inter-molar width, linguoversion of incisors, distally tipped canines and molars in Class 3. Each group showed dental compensation according to their sagittal skeletal patterns. Deep COS was characterized by increased overbite, labioversion of incisors, and mesially tipped canines and molars in the hypodivergent group. Both hyperdivergent and normodivergent groups showed extrusion of incisors and canines with additionally linguoversion of incisors in the hyperdivergent group. Conclusion: Dental factors such as transversal arch width, inclination of incisors, angulation of canines and molars, extrusion of incisors and canines could affect the characteristics of COS in different sagittal and vertical skeletal malocclusion groups.

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