ERKEN VE GEÇ DAMAK YARIĞI ONARIMLARININ MAKSİLLA GELİŞİMİ ÜZERİNDEKİ ETKİLERİNİN SEFALOMETRİK ANALİZ YÖNTEMİ İLE KARŞILAŞTIRILMASI

Damak yarığı onarımının zamanı ile ilgili tartışmalar, onarımın daha iyi bir konuşma elde edecek kadar erken, maksilla gelişimini en az etkileyecek kadar geç dönemde yapılması üzerinde yoğunlaşmaktadır. Erken damak onarımının (12. aydan önce) konuşma ve işitme fonksiyonları üzerindeki olumlu etkisi düşünülerek, son 10 yıl içerisinde erken onarım yapılan bir grup oluşturuldu ve bu gruptan seçilen hastaların maksilla gelişimleri 12-24. aylar arasında damak onarımı yapılan hastalardaki gelişimle karşılaştırıldı. Olgular tek taraflı tam dudak yarığı + tam damak yarığı olan hastalar arasından seçildi. Erken onarım grubuna, onarımın 12 aydan önce, geç onarım grubuna, onarımın 12-24. aylar arasında gerçekleştirildiği 10'ar hasta dahil edildi. Hastaların 4-6 yaşlarında sefalometrik analiz yöntemi ile ortayüz gelişimleri değerlendirildi. Çalışma gruplarından elde edilen lateral ve frontal sefalometrik değerler, sınıf I dentoiskelet ilişkisine sahip 15 bireyden oluşan kontrol grubu değerleriyle de karşılaştırıldı. Sonuçların gruplar arasında maksilla gelişimi açısından istatistiksel olarak anlamlı farklılık olmadığını gösterdiği görüldü. Bununla birlikte, tüm yarık olgularında maksillanın daha geniş olmaya yatkın olduğu ve daha superior ve retruzif pozisyonda bulunduğu saptandı ve bu bulguların geç onarım grubunda daha belirgin olduğu görüldü. Çalışmanın sonuçları, erken damak yarığı onarımının maksilla gelişimi üzerindeki etkilerinin konvansiyonel dönemdeki onarımlardan farklı olmadığını ve erken onarımın bir tedavi alternatifi olarak kabul edilebileceğini göstermektedir.

Anahtar Kelimeler:

Maksilla gelişimi, erken ve geç damak onarımları, sefalometrik analiz

CEPHALOMETRIC COMPARISON OF MAXILLARY GROWTH AND DEVELOPMENT IN PATIENTS WITH EARLY VERSUS LATE CLEFT PALATE REPAIR

The aim of this study was to compare the effects of early versus late palatal repair on maxillofacial growth. Two groups (10 patients in each) were designed according to palatal repair time, having early and late palatal repairs before 12 months of age and between 12-24 months, respectively. At 4-6 years of age, maxillofacial growth was evaluated based on cephalometric evaluation of the midface. Lateral and frontal cephalograms were obtained for both repair groups and for a control group of 15 agematched children with class I dentoskeletal relationships. The study revealed no statistically significant growth differences between the groups. Although not statistically significant, in cleft palate cases the maxillae tended to be larger in width, more superiorly positioned in the vertical plane, and more retrusive, with the late repair group being more influenced. The results of this study show that the early palatal repair has similar effects on maxillary growth as compared with the outcomes of the late repairs and early repair might be considered as a treatment alternative as far as the timing of the operation is considered.

Keywords:

Maxillary growth, early versus late palatal repair, cephalometric analysis,

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