Hande Pamukçu MD, Şefika Ruzin GÖNÜLDAŞ, Ömür Polat ÖZSOY, HANDE PAMUKÇU, FERİDE KURAL RAHATLI

Hızlı ve Yarı Hızlı Maksiller Ekspansiyon Uygulamalarının Dentofasiyal ve Periodontal Etkilerinin Karşılaştırılması

Amaç: Bu çalışmanın amacı, akrilik splintli bonded ekspansiyon apareyi ile yapılan yarı hızlı maksiller ekspansiyon (SRME) ve hızlı maksiller ekspansiyon (RME) ile meydana gelen iskeletsel, dentoalveolar ve periodontal etkileri; ayrıca tedavi sırasında destek dişlerde meydana gelen kök rezorpsiyonunun şiddetini karşılaştırmaktır.Gereç ve Yöntemler: Maksiller darlığa sahip ve üst 1. premolar çekimi planlanan 19 birey çalışma grubunu oluşturmuştur. SRME grubunu oluşturan 10 birey ve hızlı

Comparison of Dentofacial and Periodontal Effects of Rapid and Semi-rapid Maxillary Expansion

Objective: The purpose of this study was to compare the skeletal, dentoalveolar and periodontal effects that occurred after rapid maxillary expansion (RME) and semirapid maxillary expansion (SRME) with an acrylic splint bonded expansion appliance and also to compare the degree of root resorption in the supporting teeth during expansion.Materials and Methods: The sample of the study included 19 patients having maxillary constriction requiring bilateral upper premolar extraction. The semi-rapid group consisted of 10 patients and the rapid group consisted of 9 patients. Lateral and posteroanterior (PA) cephalometric radiographs were taken at the beginning of the treatment, at the end of expansion and after 3 months of retention period. Eleven patients underwent low-dose computed tomography (CT) at the beginning of treatment and at the end of retention period, after giving informed consent. The evaluation of root resorption was made using a scanning electron microscope from the extracted teeth. Results: Both lateral and PA radiographs showed similar changes between the groups. Posterior nasal cavity width, palatal maxillary width, the distance between palatinal roots and the distance between incisor roots showed significant increase in the CT measurements. Buccal bone thickness decreased and palatal bone thickness increased in all molar and premolar teeth examined. Root resorption was seen in both groups, but no significant differences were observed between the groups. Conclusion: Some differences were seen in short-time effects between SRME and RME but these differences were temporary and disappeared at the end of the retention period. The qualitative evaluation of the roots showed that the location and degree of the root resorption were similar between the groups.

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1. McNamara JA. Maxillary transverse deficiency. Am J Orthod Dentofacial Orthop 2000; 117: 567-70.
2. Sandıkçıoğlu M, Hazar S. Skeletal and dental changes after maxillary expansion in the mixed dentition. Am J Orthod Dentofacial Orthop 1997; 111: 321-7.
3. Suri L, Taneja P. Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop 2008; 133: 290-302.
4. Linder-Aronson S, Lindgren J. The skeletal and dental effects of rapid maxillary expansion. Br J Orthod 1979; 6: 25-9.
5. Akkaya S, Lorenzon S, Ücem TT. Comparison of dental arch and arch perimeter changes between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 1998; 20: 255-61.
6. İşeri H, Tekkaya E, Öztan Ö, Bilgiç S. Biomechanical effects of rapid maxillary expansion on the craniofacial skeleton, studied by the finite element method. Eur J Orthod 1998; 20: 347-56.
7. Orhan M, Üşümez S. A new method for the assessment of changes in molar inclination during RME. Cited: 15.10.2001. Availiable from: URL: http://www.vjo.it/042/molar.htm
8. Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 1961; 31: 73-89.
9. Erverdi N, Okar I, Küçükkeleş N, Arbak S. A comparison of two different rapid palatal expansion techniques from the point of root resorption. Am J Orthod Dentofacial Orthop 1994; 106: 47-51.
10. Haas AJ. Long term posttreatment evaluation of rapid palatal expansion. Angle Orthod 1980; 50: 189-217.
11. Chung CH, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop 2004; 126: 569-75.
12. Davis WM, Kronman JH. Anatomical changes induced by splitting of the midpalatal suture. Angle Orthod 1969; 39: 126-32.
13. Langford SR. Root resorption extremes resulting from clinical RME. Am J Orthod 1982; 81: 371-7.
14. Da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid maxillary expansion in the primary and mixed dentition: a cephalometric evaluation. Am J Orthod Dentofacial Orthop 1991; 100: 171-9.
15. Asanza S, Cisneros GJ, Nieberg LG. Comparison of Hyrax and bonded expansion appliances. Angle Orthod 1997; 67: 15-22.
16. Sarver DM, Johnston MW. Skeletal changes in vertical and anterior displacement the maxilla with bonded rapid palatal expansion appliances. Am J Orthod Dentofacial Orthop 1989; 95: 462-6.
17. Reed N, Ghosh J, Nanda RS. Comparison of treatment outcomes with banded and bonded RPE appliances. Am J Orthod Dentofacial Orthop 1999; 116: 31-40.
18. Byrum AG. Evaluation of anterior-posterior and vertical skeletal change vs. dental change in rapid palatal expansion cases as studied by lateral cephalograms. Am J Orthod 1971; 60: 419.
19. Özsoy FS. Semi-rapid üst çene genişletmesinin dentofasiyal yapılar üzerine olan etkilerinin incelenmesi: Ankara University, 2001.
20. Ramoğlu Sİ. Karma dentisyon döneminde modifiye akrilik bonded aparey ile yapılan hızlı ve yarı hızlı üst çene genişletmesinin dentofasiyal yapılar üzerine etkilerinin değerlendirilmesi: Selçuk University, 2006.
21. Haas AJ. Palatal expansion: Just the beginning of dentofacial orthopedics. Am J Orthod 1970; 57: 219-55.
22. Kılıç N. Yarı hızlı ve hızlı üst çene genişletmesinin dentofasiyal yapılar ve çiğneme kaslarının tonositelerinde yaptığı değişimlerinin incelenmesi: Atatürk University, 2005.
23. Baykara C. Banded ve bonded RME apareylerinin dentofasiyal sistemdeki etkilerinin karşılaştırılması: Hacettepe University. 1999.
24. Kılıç N, Kiki A, Oktay H. A comparison of dentoalveolar inclination treated by two palatal expanders. Eur J Orthod 2008; 30: 67-72.
25. Memikoğlu UT, İşeri H. Nonextraction treatment with a rigid acrylic, bonded rapid maxillary expander. J Clin Orthod 1997; 31: 113-8.
26. Ciambotti C, Ngan P, Durkee M, Kohli K, Kim H. A comparison of dental and dentoalveolar changes between rapid palatal expansion and nickel-titanium palatal expansion appliances. Am J Orthod Dentofacial Orthop 2001; 119: 11-20.
27. Erdinç AE, Uğur T, Erbay E. A comparison of different treatment techniques for posterior crossbite in the mixed dentition. Am J Orthod Dentofacial Orthop 1999; 116: 287-300.
28. Garib DG, Henriques JFC, Janson G, De Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop 2006; 129: 749-58.
29. Engelking G, Zachrisson BU. Effects of incisor repositioning on monkey periodontium after expansion through the cortical plate. Am J Orthod 1982; 82: 23-32.
30. Steiner GG, Pearson JK, Ainamo J. Changes of the marginal periodontium as a result of labial toorh movement in monkeys. J Periodontol 1981; 52: 314-20.
31. Thilander B, Nyman S, Karring T, Magnusson I. Bone regeneration in alveolar bone dehiscences related to orthodontic tooth movements. Eur J Orthod 1983; 5: 105-14.
32. Wennstrom JL, Lindhe J, Sinclair F, Thilander B. Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J Clin Periodontol 1987; 14: 121-9.
33. Rungcharassaeng K, Caruso JM, Kan JY. Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2007; 132: 428.e1- 428.e8.
34. Ballanti F, Lione R, Baccetti T, Franchi L, Cozza P. Treatment and posttreatment skeletal effects of rapid maxillary expansion investigated with low-dose computed tomography in growing subjects. Am J Orthod Dentofacial Orthop 2010; 138: 311-7.
35. Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2008; 134: 8.e1-8.e11.
36. Odenrick L, Karlander EL, Pierce A, Kretschmar U. Surface resorption following two forms of rapid maxillary expansion. Eur J Orthod 1991; 13: 264-70.
37. Barber AF, Sims MR. Rapid maxillary expansion and external root resorption in man: a scanning electron microscope study. Am J Orthod 1981; 79: 630-52.
38. Rygh P. Orthodontic root resorptions studied by electron microscopy. Angle Orthod 1977; 47: 1-16.
39. Casa MA, Faltin RM, Faltin K, Sander FG, Arana-Chavez. Root resorptions in upper first premolars after application of continuous torque moment. Intra-individual study. J Orofac Orthop 2001; 62: 285-95.