Burcu BALOŞ TUNCER, Ebru Küçükkaraca, Cumhur TUNCER, Nilüfer DARENDELİLER

Ortopedik yüz maskesi tedavi etkilerinin counterpart analizi ile incelenmesi

AMAÇ: Çalışmanın amacı, ortopedik yüz maskesi (RH) tedavisinin orta kraniyal kaide ve üst ve alt çene kompleksindeki etkilerini counterpart (eşdeğer) analizi ile değerlendirmek ve tedavi görmemiş Sınıf 3 bireylerle karşılaştırmaktır.GEREÇ VE YÖNTEM: Tedavi grubu; üst çenede hızlı genişletme ile birlikte RH tedavisi görmüş ve üst çenesinde retrognati bulunan 20 iskeletsel Sınıf 3 bireyden (14 kız, 6 erkek; ortalama yaşları: 11 yıl 3 ay) oluşmaktadır. Ortalama tedavi süresi 9.6 aydır. Kontrol grubu ortalama 9.5 ay takip edilmiş 22 iskeletsel Sınıf 3 bireyden (9 kız, 13 erkek; ortalama yaşları: 10 yıl) oluşmaktadır. Sefalometrik değerlendirme eşdeğer analizi ile gerçekleştirilmiştir. Grup içi karşılaştırmalarda eşleştirilmiş t-testi; gruplar arası karşılaştırmalarda bağımsız t-testi kullanılmıştır.BULGULAR: SNA, ANB, SN-GoGn açıları, Co-A, Co-Gn boyutları tedavi ile önemli düzeyde artarken (p<0.001), SNB açısı azalmıştır (p<0.001). Tedavi grubunda orta kraniyal kaide boyutları (Ar-SE, p<0.05; So-Hor, p<0.001), üst çene (p<0.001) ve ön-arka nazomaksiller komplekste artış (p<0.001, p<0.05, sırasıyla) ile mandibuler korpus boyutunda azalma (p<0.05) bulunmuştur. Gruplar arası karşılaştırmada, üst çene ileri yön büyümesinin tedavi grubunda daha belirgin olduğu (p<0.001), alt çenede posterior rotasyon oluştuğu (p<0.001), kontrol grubunda orta kraniyal kaide boyutu değişmezken tedavi grubunda önemli artış olduğu (So-Hor, p<0.01) ve mandibuler korpus boyutundaki azalmanın p<0.001 düzeyinde olduğu bulunmuştur.SONUÇ: Büyüme dönemindeki iskeletsel Sınıf 3 bireylerde RH tedavisi ile orta kraniyal kaide boyutlarında artış ve mandibuler korpus boyutunda azalma ile önemli tedavi etkileri gözlenmektedir.

Anahtar Kelimeler:

Kafa Tabanı, Üst Çene, Alt Çene, Ortodonti, Ortodontik Cihazlar, Sefalometri

Treatment effects of orthopedic face mask assessed with counterpart analysis

OBJECTIVE: To evaluate the effects of face mask therapy (RH) on middle cranial base and maxillo-mandibular complexes, and to compare the responses with untreated class 3 subjects.MATERIALS AND METHOD: The treatment group comprised 20 skeletal class 3 children (14 girls, 6 boys; mean age: 11 years 3 months) treated with RH assisted by rapid maxillary expansion (mean treatment time: 9.6 months). The control group included 22 skeletal class 3 subjects (9 girls, 13 boys; mean age: 10 years) observed for 9.5 months. Cephalometric measurements were performed by counterpart analysis. For intragroup statistical comparisons paired t-test, and for intergroup comparisons independent t-test was used.RESULTS: The treatment group revealed significant increases for SNA, ANB, SN-GoGn, Co-A and Co-Gn (p<0.001), and decrease for SNB (p<0.001). The treatment group revealed significant increases in the effective dimension of the middle cranial base (Ar-SE, p<0.05; So-Hor, p<0.001), maxilla (p<0.001), and anterior-posterior nasomaxillary complex (p<0.001, p<0.05, respectively), and decrease in the effective dimension of the mandibular corpus (p<0.05). According to the intergroup comparisons, treatment group revealed more pronounced maxillary advancement (p<0.001), posterior rotation in the mandible (p<0.001), significant increase in the effective dimension of the middle cranial base (So-Hor, p<0.01) and decrease in the effective dimension of the mandibular corpus at a significance level of p<0.001.CONCLUSION: Revealed by the effects on the middle cranial base morphology, favorable treatment responses were achieved with the use of the RH technique.

Keywords:

Cephalometry, Cranial Base, Mandible, Maxilla, Orthodontics, Orthodontic Appliances,

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1. Anderson D, Popovich F. Relation of cranial base flexure to cranial form and mandibular position. Am J Phys Anthropol 1983;61:181-7. 2. Baccetti T, Franchi L, McNamara JA Jr. Growth in the untreated Class III subject. Semin Orthod 2007;13:130-42.
3. Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56:7-30.
4. Battagel JM. The aetiology of Class III malocclusion examined by tensor analysis. Br J Orthod 1993;20:283-95.
5. Bastir M, Rosas A. Correlated variation between the lateral basicranium and the face: a geometric morphometric study in different human groups. Arch Oral Biol 2006;51:814-24.
6. Enlow DH, McNamara JA Jr. The neurocranial basis for facial form and pattern. Angle Orthod 1973;43:256-70.
7. Bhat M, Enlow DH. Facial variations related to headform type. Angle Orthod 1985;55:269-80.
8. Enlow DH, Moyers RE, Hunter WS, McNamara JA. A procedure for the analysis of intrinsic facial form and growth. Am J Orthod 1969;56:5-23.
9. Enlow DH, Pfister C, Richardson E, Kuroda T. An analysis of Black and Caucasian craniofacial patterns. Angle Orthod 1982;52:279-87.
10. Dhopatkar A, Bhatia SN, Rock P. An investigation into the relationship between the cranial base angle and malocclusion. Angle Orthod 2002;72:456-63.
11. Lew KK, Foong WC. Horizontal skeletal typing in an ethnic Chinese population with true Class III malocclusions. Br J Orthod 1993;20:19-23.
12. Emrich RE, Brodie AG, Blayney JR. Prevalence of Class 1, Class 2, and Class 3 malocclusions (Angle) in an urban population. An epidemiological study. J Dent Res 1965;44:947-53.
13. Celikoglu M, Akpinar S, Yavuz I. The pattern of malocclusion in a sample of orthodontic patients from Turkey. Med Oral Patol Oral Cir Bucal 2010;15: e791-6.
14. Singh GD. Morphologic determinants in the etiology of class III malocclusions: a review. Clin Anat 1999;12:382-405.
15. Shanker S, Ngan P, Wade D, Beck M, Yiu C, Hägg U, et al. Cephalometric A point changes during and after maxillary protraction and expansion. Am J Orthod Dentofacial Orthop 1996;110:423-30.
16. Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class III children treated by a modified protraction headgear and a chin-cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993;15:211-21.
17. Bergersen EO. The male adolescent facial growth spurt: its prediction and relation to skeletal maturation. Angle Orthod 1972;42:319-38. 18. Roche AF, Lewis AB. Sex differences in the elongation of the cranial base during pubescence. Angle Orthod 1974;44:279-94.
19. Roche AF, Lewis AB, Wainer H, McCartin R. Late elongation of the cranial base. J Dent Res 1977;56:802-8.
20. Hopkin GB, Houston WJ, James GA. The cranial base as an aetiological factor in malocclusion. Angle Orthod 1968;38:250-5.
21. Kerr WJ, Adams CP. Cranial base and jaw relationship. Am J Phys Anthropol 1988;77:213-20.
22. Lozanoff S, Jureczek S, Feng T, Padwal R. Anterior cranial base morphology in mice with midfacial retrusion. Cleft Palate Craniofac J 1994;31:417-28.
23. Ma W, Lozanoff S. Morphological deficiency in the prenatal anterior cranial base of midfacially retrognathic mice. J Anat 1996;188:547-55.
24. Williams S, Andersen CE. The morphology of the potential Class III skeletal pattern in the growing child. Am J Orthod 1986;89:302-11.
25. Riolo ML, Moyers RE, McNamara JA Jr, Hunter WS. An atlas of craniofacial growth: cephalometric standards from The University School Growth Study, The University of Michigan. Craniofacial Growth Series, 2nd vol. Ann Arbor: MI, Center for Human Growth and Development; 1974. p.1-379.
26. Bacetti T, Franchi L, McNamara JA. Jr. Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop 2004;126:16-22.
27. Bell RA. A review of maxillary expansion in relation to the rate of orthopedics. Am J Orthod Dentofacial Orthop 1982;81:32-7.
28. Campbell PM. The dilemma of Class III treatment. Early or late? Angle Orthod 1983;53:175-91.
29. Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod 1970;57:219-55.
30. Haskell BS, Farman AG. Exploitation of the residual premaxillarymaxillary suture site in maxillary protraction. An hypothesis. Angle Orthod 1985;55:108-19.
31. Spolyar JL. The design, fabrication and use of full-coverage bonded rapid maxillary expansion appliance. Am J Orthod Dentofacial Orthop 1984;86:136-45.
32. Franchi L, Bacetti T, McNamara JA Jr. Shape-coordinate analysis changes induced by rapid maxillary expansion and face mask therapy. Am J Orthod Dentofacial Orthop 1998;114:418-26.
33. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop 1998;113:204-12.
34. McDonald KE, Kapust AJ, Turley PK. Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop 1999;116:13-24.
35. Nartallo-Turley PE, Turley PK. Cephalometric effects of combined palatal expansion and the face mask therapy on Class III malocclusion. Angle Orthod 1998;68:217-24.
36. Hiyama S, Suda N, Ishii-Suzuki M, Tsuiki S, Ogawa M, Suzuki S, et al. Effects of maxillary protraction on craniofacial structures and upperairway dimension. Angle Orthod 2002;72:43-7.
37. Mermigos J, Full CA, Andreasen G. Protraction of the maxillofacial complex. Am J Orthod Dentofacial Orthop 1990;98:47-55.
38. Singh GD, McNamara JA Jr, Lozanoff S. Finite element analysis of the cranial base in subjects with Class III malocclusion. Br J Orthod 1997;24:103-12.
39. Saadia M, Torres E. Sagittal changes after maxillary protraction with expansion in class III patients in the primary, mixed, and late mixed dentitions: a longitudinal retrospective study. Am J Orthod Dentofacial Orthop 2000;117:669-80.
40. Moyers RE, Bookstein FL. The inappropriateness of conventional cephalometrics. Am J Orthod 1979;75:599-617.