Sınıf III maloklüzyonun tedavisinde ağız-içi çift plak ile yüz maskesi kombine uygulamasının uzun dönem sonuçları: sefalometrik analiz
Amaç: Sınıf III maloklüzyonun tedavisinde kullanılan ağız-içi çift plak ile yüz maskesi (AÇP-YM) kombine tedavisinin uzun dönem sonuçlarının büyüme potansiyeli bitmiş ya da bitmekte olan hastalarda değerlendirilmesidir. Gereç ve Yöntem: Çalışmanın materyali AÇP-YM kombine tedavisi uygulanmış olan iskeletsel ve dişsel Sınıf III maloklüzyona sahip 13 hastaya (5 kız, 8 erkek; ortalama kronolojik yaş: 11.1±1.40 yıl) ait tedavi öncesi (T1), sonrası (T2) ve uzun dönem takip (T3) lateral sefalometrik ve el bilek radyografilerinden oluşturuldu. Ortalama AÇP-YM tedavi süresi 10.8±1.88 aydır. T3 döneminde, el bilek büyüme ve gelişim safhası, MP3u veya Ru dönemidir. Ortalama takip süresi 5.0±1.98 yıldır. Tedavi (T2-T1), takip (T3-T2) ve toplam (T3-T1) değişiklikleri değerlendirmek için Friedman iki yönlü ANOVA ve Wilcoxon işaretli sıralar testleri kullanıldı. Bulgular: AÇP-YM tedavisi ile SNA ve ANB açılarında artış bulundu (p<0.001). Ancak bu parametrelerde T3-T2 döneminde önemli düzeyde bir değişiklik meydana gelmedi [p=0.655 (SNA), p=0.805 (ANB)]. N┴FH-A mesafesi tedavi (p<0.01) ve takip (p<0.05) dönemlerinde önemli düzeyde arttı. Molar ilişkide, hem AÇP-YM tedavisi sırasında hem de toplam sürede önemli düzeyde bir artış meydana geldi (p<0.001). Overjet ise, tedavi (p<0.001), takip (p<0.05) ve toplam sürede (p<0.001) önemli düzeyde arttı. Tedavi, takip dönemlerinde ve toplam sürede, üst keserlerde (U1/NA) önemli düzeyde protrüzyon gözlendi (p<0.05). U6/PP ve L6/MP açıları AÇP-YM tedavisi ile değişmezken, takip periyodunda ve toplam sürede bu parametrelerde önemli düzeyde azalma meydana geldi (p<0.05). Sonuç: AÇP-YM kombine tedavisi, Sınıf III maloklüzyonun tedavisinde etkili bulundu. Bu ortopedik tedavi ile meydana gelen iskeletsel ve dişsel sagital değişikliklerin uzun dönem takip periyodunda korunduğu gözlendi.
Anahtar Kelimeler:
Angle Sınıf 3, ağız dışı çekme aletleri, maloklüzyon, ortodontik cihazlar, ortodonti, takip çalışmaları
Long term results of double plate appliance and facemask combination in the treatment of Class III malocclusion: cephalometric analysis
Objective: The aim of this study was to evaluate the long term results of double plate appliance and facemask combination (DPA-FM) in treating Class III malocclusions when growth potential of the patients was close to cease or ceased. Materials and Method: The material consisted of the pretreatment (T1), posttreatment (T2), and long term (T3) lateral cephalometric and the hand-wrist radiographs of 13 patients (5 females, 8 males; mean chronological age: 11.1±1.40 years) with skeletal and dental Class III malocclusion treated with DPA-FM combination. The mean DPA-FM treatment time was 10.8±1.88 months. The hand-wrist growth and developmental stages were MP3u or Ru at T3. The mean follow-up period was 5.0±1.98 years. Friedman’s Two-Way ANOVA and Wilcoxon signed-rank tests were used to evaluate the treatment (T2-T1), follow-up (T3-T2) and overall (T3-T1) results. Results: With the DPA-FM therapy, SNA and ANB angles increased (p<0.001); however, no significant differences were found in these parameters during T3-T2 period [p=0.655 (SNA), p=0.805 (ANB)]. Significant increases were found in N┴FH-A distance during the treatment (p<0.01) and follow-up (p<0.05) periods. Molar relation showed significant increases with DPA-FM in both the treatment and overall period (p<0.001). Overjet increased significantly during the treatment (p<0.001), follow-up (p<0.05), and overall (p<0.001) periods. Significant protrusion of upper incisors (U1/NA) was observed during the treatment, follow-up, and overall periods (p<0.05). U6/PP and L6/MP angles did not change during the DPA-FM treatment; however, these parameters decreased significantly during the follow-up and overall periods (p<0.05). Conclusion: In the treatment of Class III malocclusion, the DPA-FM appliance was effective. The skeletal and dental sagittal changes achieved by orthopedic treatment were maintained in the long term.
Keywords:
Angle Class III, extraoral traction appliances, follow-up studies, malocclusion, orthodontic appliances, orthodontics,
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- Yayın Aralığı: Yılda 3 Sayı
- Başlangıç: 1984
- Yayıncı: Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi