Elif Dilara ŞEKER, Rabianur BALTACI, Melike POLAT, Türker YÜCESOY, Gökmen KURT

SINIF III ORTOGNATİK CERRAHİ HASTALARINDA YUMUŞAK DOKU VE HAVA YOLU DEĞİŞİMLERİNİN DEĞERLENDİRİLMESİ

Amaç: : Kombine ortodontik tedavi ve ortognatik cerrahi yumuşak dokularda ve havayolunda değişikliklere neden olmakta olup, ameliyat sonrası oluşacak değişimlerin öngörülmesi tedavi planlaması açısından önemlidir. Bu çalışmanın amacı sınıf III ortognatik cerrahi geçiren hastaların sert doku, yumuşak doku ve havayolu değişimlerinin incelenmesidir.Gereç ve Yöntemler: Bu retrospektif çalışmaya, 18 adet sınıf III hastanın pre-operatif ve post-operatif lateral sefalometrik kayıtları dahil edilmiştir. Çalışmaya dahil edilen hastalarda maksiller gömme ve ilerletme, mandibular geri alma işlemleri uygulanmıştır. Hastalardan cerrahiden hemen önce(T1) ve cerrahiden en az 6 ay sonra(T2) alınan lateral sefalometrik radyografiler üzerinde yumuşak doku ölçümleri Dolphin programıyla, havayolu ölçümleri ise Planmeca Romexis yazılımıyla yapılmıştır. Elde edilen verilerin dağılımı Shapiro Wilk Testi ile incelenmiş olup, T1 ve T2 döneminde elde edilen normal dağılım gösteren verilerin karşılaştırmaları için Paired t-test, normal dağılım göstermeyen verilerin karşılaştırmaları için ise Wilcoxon testi kullanılmıştır.Bulgular: Hastaların T1 ve T2 dönemlerinde elde edilen verileri karşılaştırıldığında yumuşak dokuda Sn'-LLS/LLS-Me' değerinde ve E düzlemi-alt dudak mesafesinde istatistiksel olarak anlamlı artış, E düzlemi-üst dudak mesafesinde olarak anlamlı azalma gözlenmiştir. Diğer yumuşak doku parametrelerinde farklılık gözlenmemiştir. Sert doku değerlendirmesinde, SNA°, ANB° değerinde anlamlı artış, SN-GoGn° açısında anlamlı azalma gözlenmiştir. Havayolu değerlendirmelerinde V-LPW değerinde artış meydana gelirken diğer parametrelerde anlamlı fark bulunamamıştır.Sonuçlar: Literatürde ortognatik cerrahi sonrası yumuşak doku ve havayolu değişimlerini inceleyen çalışmaların retrospektif karakteri, yöntemlerin standart olmaması ve uygulanan cerrahi hareket miktarının geniş bir aralıkta değişmesi nedeniyle kanıta dayalı sonuçlar çıkarmak zordur. Bununla birlikte kombine ortodontik tedavi ve ortognatik cerrahi yumuşak doku ve hava yolu üzerinde estetik ve fonksiyon bakımından olumlu etkileri vardır.Anahtar Kelimeler: Ortodonti, Ortognatik cerrahi, Angle Sınıf III, Sefalometri

Anahtar Kelimeler:

Ortodonti, Ortognatik cerrahi, Angle Sınıf III, sefalometri

EVALUATION OF SOFT TISSUE AND AIRWAY CHANGES IN PATIENTS UNDERGOING COMBINED ORTHODONTIC AND ORTHOGNATHIC SURGERY

Background: Combined orthodontic treatment and orthognathic surgery lead to changes in soft tissues and airway. Prediction of postoperative changes is important for treatment planning. The aim of this study was to investigate the changes in hard-soft tissue, and airway in patients undergoing class III orthognathic surgery. Methods: In this study, pre- and post-operative cephalometric films of 18 patients with Class III malocclusion were included. The maxillary impaction-advancement and mandibular setback were performed. Hard-soft tissue and airway measurements on lateral cephalometric radiographs which were taken immediately before surgery(T1) and at least 6 months after surgery(T2) were performed using Dolphin and Planmeca Romexis softwares, respectively. The data distribution was analysed using Shapiro Wilk test. Comparisons of the data were analysed using Paired t-test and Wilcoxon test. Results: A statistically significant increase in Sn'-LLS/LLS-Me' value and E plane-lower lip distance and a significant decrease in E-plane-upper lip distance were observed. No statistical differences were observed in other soft tissue parameters. A significant increase in SNA°, ANB° and a significant decrease in SN-GoGn° were observed. There was an increase in V-LPW value in airway evaluations, however, no significant difference was found in other airway parameters. Conclusıon: In the literature, it is difficult to obtain evidence-based results due to the retrospective character of the studies examining soft tissue and airway changes after orthognathic surgery, non-standard methods and the wide range of surgical movements applied. However, combined orthodontic treatment and orthognathic surgery have positive effects on soft tissue and airway in terms of aesthetics and function.

Keywords:

Orthodontics, orthognatic surgery, Angle Class III, cephalometry,

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