Modifiye tandem traksiyon yüz arkı apareyinin hava yolu boyutuna etkisi

Amaç: Sınıf III maloklüzyon tedavisinde kullanılan modifiye tandem traksiyon yüz arkı (MTTYA) apareyinin faringeal hava yolu boyutları üzerine olan etkisini incelemekti. Gereç ve Yöntem: Çalışmanın materyalini, iskeletsel ve dişsel Sınıf III maloklüzyona sahip, MTTYA apareyi ile tedavi edilmiş olan 20 bireyin (8 kadın ve 12 erkek; yaş ortalaması 10 yıl 1 ay) tedavi öncesi (T1) ve sonrası (T2) lateral sefalometrik radyografileri oluşturdu. MTTYA apareyinin üst plağından yüz arkına oklüzal düzlemle 35-40° açı yapacak şekilde 400-500 g. kuvvet uygulayan elastikler asıldı. Ortalama 12 aylık tedavi uygulandı. Faringeal havayolu boyut ve alan ölçümleri yapıldı. İstatistiksel analizde, Kolmogorov-Smirnov ve eşleştirilmiş t testleri kullanıldı ve p<0.05 değeri anlamlı olarak kabul edildi. Bulgular: Tedavi ile maksillada ileri yönde harekette (p<0.001) ve efektif maksilla ve mandibula boyutlarında anlamlı artışlar ortaya çıktı (p<0.001). Mandibular düzlem eğiminin artışı (p<0.001) ile mandibulada posterior rotasyon saptandı. Orofaringeal alanda (OA) anlamlı düzeyde (p<0.05) ve nazofaringeal alanda (NA) anlamlı olmayan düzeyde artışlar gözlendi. Hyoid kemik, anlamlı olmayan düzeyde öne ve aşağıya yer değiştirdi. Sonuç: Sınıf III malokluzyon tedavisinde kullanılan MTTYA apareyi uygulaması ile orofaringeal havayolu alanında olumlu yönde değişiklik gözlendi.

Effect of modified tandem traction bow appliance on airway size

Objective: To investigate the effect of modified tandem traction bow appliances (MTTBA) on pharyngeal airway dimensions in Class III malocclusion treatment. Materials and Method: The material of this study consisted of pre-treatment (T1) and post-treatment (T2) lateral cephalometric radiographs of 20 subjects with skeletal and dental Class III malocclusion (8 females and 12 males; mean chronologic age; 10 years and 1 month) who had been treated with the MTTBA appliance. Elastics that exerted a force of 400-500 g were worn between the upper splint and the traction bow with an angle of 35-40°. The average treatment time was 12 months. Linear and area measurements were done to determine the pharyngeal airway dimensions. Kolmogorov-Smirnov and paired t-tests were used for the statistical analysis, and p<0.05 was considered as statistically significant. Results: Treatment changes indicated significant forward-movement of the maxilla (p<0.001) and significant increases in effective lengths of the maxilla and the mandible (p<0.001). The mandible showed a clockwise rotation because of the increase in mandibular plane angle (p<0.001). A significant increase in the oropharyngeal area (OA; p<0.05), and an insignificant increase in the nasopharyngeal area (NA) was found. Hyoid bone moved anterior and inferior insignificantly. Conclusion: A favorable improvement was observed in the oropharyngeal area by the MTTBA appliance that was used in the treatment of Class III malocclusion.

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  • Kaygisiz E, Taner L, Gungor K. Distribution of sagittal occlusal relationships in different stages of dentition. Braz Oral Res 2015;29:1-6.
  • Bozkaya E, Yüksel AS, Bozkaya S. Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class III malocclusion: A controlled clinical trial. Korean J Orthod 2017;47:118-29.
  • Baccetti T, Franchi L, McNamara JA Jr. Treatment and posttreatment changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop 2000; 118:404–413.
  • Toffol LD, Pavoni C, Bacetti T, Franchi L, Cozza P. Orthopedic treatment outcomes in Class III malocclusion: a systematic review. Angle Orthod 2008;78:561–73.
  • Vaughn GA, Mason B, Moon HB, Turley PK. The effects of maxillary protraction therapy with or without rapid palatal expansion: a prospective, randomized trial. Am J Orthod Dentofacial Orthop 2005;128:299–309.
  • Garattini G, Levrini L, Crozzoli P, Levrini A. Skeletal and dental modifications produced by the Bionator III appliance. Am J Orthod Dentofacial Orthop 1998;114:40–4.
  • Ulgen M, Firatli S. The effects of the Frankel’s function regulator on the Class III malocclusion. Am J Orthod Dentofacial Orthop 1994;105:561–7.
  • Kidner G, DiBiase A, DiBiase D. Class III twin blocks: a case series. J Orthod 2003;30:197–201.
  • Godt A, Zeyher C, Schatz Maier D, Göz G. Early treatment to correct Class III relations with or without facemasks. Angle Orthod 2008;78:44–9.
  • Ucem TT, Ucuncu N, Yuksel S. Comparison of double plate appliance and facemask therapy in treating Class III malocclusions. Am J Orthod Dentofacial Orthop 2004;126: 672–9.
  • Chun Y, Jeong SG, Row J, Yang SJ. A new appliance for orthopedic correction of Class III malocclusion. J Clin Orthod 1992;33:705–11.
  • Atalay Z, Tortop T. Dentofacial effects of a modified tandem traction bow appliance. Eur J Orthod 2010;32:655–61.
  • Tortop T, Kaygisiz E, Gencer D, Yuksel S, Atalay Z. Modified tandem traction bow appliance compared with facemask therapy in treating Class III malocclusions. Angle Orthod 2014;84:642-8.
  • Ngan P, Hagg U, Yiu C, Merwin D, Wei SH. Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. Am J Orthod Dentofacial Orthop 1996;109:38–49.
  • Kaygisiz E, Tuncer BB, Yüksel S, Tuncer C, Yildiz C. Effects of maxillary protraction and fixed appliance therapy on the pharyngeal airway. Angle Orthod 2009;79:660-7.
  • Oktay H, Ulukaya E. Maxillary protraction appliance effect on the size of the upper airway passage. Angle Orthod. 2008;78:209–14.
  • Hiyama S, Suda N, Ishii-Suzuki M, Tsuiki S, Ogawa M, Suzuki S, et al. Effects of maxillary protraction on craniofacial structures and upper-airway dimension. Angle Orthod 2002;72:43–7.
  • Mucedero M, Baccetti T, Franchi L, Cozza P. Effects of maxillary protraction with or without expansion on the sagittal pharyngeal dimensions in Class III subjects. Am J Orthod Dentofacial Orthop 2009;135:777-81.
  • Baccetti T, Franchi L, Mucedero M, Cozza P. Treatment and post-treatment effects of facemask therapy on the sagittal pharyngeal dimensions in Class III subjects. Eur J Orthod 2010;32:346-50.
  • Chen F, Terada K, Hua Y, Saito I. Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofacial Orthop 2007;131:372-7.
  • Dalmau E, Zamora N, Tarazona B, Gandia JL, Paredes V. A comparative study of the pharyngeal airway space, measured with cone beam computed tomography, between patients with different craniofacial morphologies. J Craniomaxillofac Surg 2015;43:1438-46.
  • Grauer D, Cevidanes LS, Styner MA, Ackerman JL, Proffit WR. Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofacial Orthop 2009;136:805-14.
  • Oz U, Orhan K, Abe N. Comparison of linear and angular measurements using two-dimensional conventional methods and three-dimensional cone beam CT images reconstructed from a volumetric rendering program in vivo. Dentomaxillofac Radiol 2011;40:492-500.
  • Zamora N, Llamas JM, Cibrián R, Gandia JL, Paredes V. Cephalometric measurements from 3D reconstructed images compared with conventional 2D images. Angle Orthod 2011;81:856-64.
  • Riley RW, Powell NB. Maxillofacial surgery and obstructive sleep apnea syndrome. Otolaryngol Clin North Am1990;23:809-26.
  • Akin M, Ucar FI, Chousein C, Sari Z. Effects of chincup or facemask therapies on the orofacial airway and hyoid position in Class III subjects. J Orofac Orthop 2015;76:520-30.
  • Pereira-Filho VA, Monnazzi MS, Gabrielli MA, Spin-Neto R, Watanabe ER, Gimenez CM, et al. Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2014;43:581-6.
  • Baik HS. Clinician results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop 1995;108:583–92.
  • Wells AP, Sarver DM, Proffit WR. Long-term efficacy of reverse headgear therapy. Angle Orthod 2006;76:915–22.
  • Hagg U, Tse A, Bendeus M, Rabie AB. Long-term follow-up of early treatment with reverse headgear. Eur J Orthod 2003;25:95–102.
  • Westwood PV, McNamara JA Jr, Baccetti T, Franchi L, Sarver DM. Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop 2003;123:306-20.
  • Sayınsu K, Isık F, Arun T. Sagittal airway dimensions following maxillary protraction: a pilot study. Eur J Orthod 2006;28:184–9.
  • Kilinç AS, Arslan SG, Kama JD, Ozer T, Darı O. Effects on the sagittal pharyngeal dimensions of protraction and rapid palatal expansion in Class III malocclusion subjects. Eur J Orthod 2008;30:61–6.
  • Aydemir H, Memikoğlu U, Karasu H. Pharyngeal airway space, hyoid bone position and head posture after orthognathic surgery in Class III patients. Angle Orthod 2012;82:993-1000.
  • Efendiyeva R, Aydemir H, Karasu H, Toygar-Memikoğlu U. Pharyngeal airway space, hyoid bone position, and head posture after bimaxillary orthognathic surgery in Class III patients: long-term evaluation. Angle Orthod 2014;84:773-81.
  • Tuncer BB, Kaygisiz E, Tuncer C, Yüksel S. Pharyngeal airway dimensions after chin cup treatment in Class III malocclusion subjects. J Oral Rehabil 2009;36:110-7.