İrem YOLCU, Orhan ÇİÇEK, Uğur GÜLŞEN, Nurhat ÖZKALAYCI

5622

Alt Çene Transversal İskeletsel Darlığın Orta Hat Distraksiyonu İle Tedavisi: İki Olgu Sunumu

Distraksiyon osteogenezisi (DO), birbirinden ayrılmış iki kemik parçası arasında kontrollü germe kuvvetiyle yeni kemik oluşmasını içeren biyolojik bir süreçtir. Alt çene orta hat distraksiyon osteogenezisi ise, transversal alt çene darlıklarının tedavisinde uygulanan distraksiyon osteogenezis işlemidir. Kolay ve etkili bir uygulama olmakla birlikte basınç ülseri, yara açılması ve sinir hasarı gibi komplikasyonlar görülebilmektedir. Bu sunumda transversal darlığı nedeniyle alt çene orta hat distraksiyon ostogenezisi ile genişletme endikasyonu olan iki hasta sunulmuştur. Olgu 1’de; on yedi yaşında erkek hasta, kötü ön estetik ve dişlerindeki çapraşıklık şikâyetiyle ortodonti kliniğine başvurdu. Yapılan ortodontik değerlendirmede iskeletsel sınıf II ve dişsel sınıf I ilişkisi, şiddetli çapraşıklığı, küçük azılar bölgesinde çift taraflı non-oklüzyon olduğu ve alt çenede transversal iskeletsel darlık olduğu görüldü. Olgu 2’de; on beş yaşında erkek hasta, köpek dişlerindeki çapraşıklık şikâyeti ile ortodonti kliniğine başvurdu. Yapılan ortodontik değerlendirmede iskeletsel sınıf I ilişki, sol tarafta sınıf II molar ilişki ve sağ tarafta çapraz kapanış, şiddetli çapraşıklık ve transversal darlık olduğu görüldü. İdeal ve stabil tedavi sonuçları için alt çene orta hat distraksiyon osteogenezisi yapılmasına karar verilip hastalara ve ebeveynlere anlatıldı. Olgu 1’de; hasta tedaviyi kabul edip distraksiyonun tamamlanması ve alt çene ön bölgede yeterli iskeletsel genişletmeyle küçük azı dişler bölgesindeki non-oklüzyon düzeltildi. Hastanın tedavisi hâlâ devam etmektedir. Olgu 2’de; hastanın komplikasyon riskleri endişesi nedeniyle distraksiyon ostegenezisi işleminden vazgeçildi. Hastada üst çene hızlı genişletilmesi ve küçük azı dişleri çekimli sabit ortodontik tedaviye karar verildi. Dişsel çapraşıklık ve iskeletsel transversal darlık başarılı bir şekilde tedavi edildi. Dişsel sınıf 1 molar ve kanin ilişki sağlandı. Fonksiyonel olarak sağlıklı bir kapanış elde edildi. Memnun edici bir estetik görünüş sağlandı.
Anahtar Kelimeler:

Çapraşıklık, Transversal darlık, Distraksiyon, Ortodonti

Treatment of the Mandibular Transversal Skeletal Deficiency with Midline Distraction: Two Case Reports

Distraction osteogenesis (DO) is a biological process that involves the formation of new bone with controlled stretching force between two separated bone fragments. The mandible midline distraction osteogenesis is the distraction osteogenesis procedure which applied in the treatment of transversal mandible deficiency. Although it is an easy and effective procedure, complications such as pressure ulcer, wound opening and nerve damage can be seen. In this report, two patients who have an indication of widening with the procedure of mandible midline distraction osteogenesis because of transverse deficiency were presented. In Case 1; A 17-year-old male patient with complaint of poor anterior aesthetics and crowding teeth was evaluated at department of Orthodontics. Orthodontic evaluation revealed that there was a skeletal class II relationship and dental class I relationship, severe crowding, bilateral non-occlusion in the premolar region and mandibular skeletal transversal deficiency. In Case 2; A 15-year-old male patient with a complaint of crowding in canine teeth was evaluated at department of Orthodontics. Orthodontic evaluation revealed that there was a skeletal class I relationship, a class II molar relationship on the left side and a crossbite molar relationship on the right side, severe crowding and transversal deficiency. For ideal and stable treatment results, it was decided to perform midline distraction osteogenesis and explained to patients and parents. In Case 1; The patient accepted the treatment and the non-occlusion in the premolar region was corrected by completing the distraction and obtaining adequate skeletal expansion in the mandible anterior region. Treatment of the patient is still continuing. In Case 2; Distraction osteogenesis procedure was abandoned due to the patient's concern about complication risks. It was decided to rapid maxillary expansion and fixed orthodontic treatment with premolars extraction. Dental crowding and skeletal transversal deficiency were successfully treated. Dental class 1 molar and canine relationship was achieved. Functionally sound occlusion was achieved. Satisfying esthetic appearance was obtained.
Keywords:

crowding, transversal deficiency, Distraction, Orthodontics,

PDF

___

  • 1. Uckan S, Guler N, Arman A, Mutlu N. Mandibular midline distraction using a simple device. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(6):711-7.
  • 2. Miresmaeili A, Zandi M, Farhadian N. Mandibular midline distraction osteogenesis: a complex case with severe crowding. World journal of orthodontics. 2008;9(1).
  • 3. Botzenhart U, Végh A, Jianu R, Gedrange T. Mandibular midline distraction osteogenesis. Oral health and dental management. 2013;12(4):305-12.
  • 4. Bell WH, Epker BN. Surgical-orthodontic expansion of the maxilla. American journal of orthodontics. 1976;70(5):517-28.
  • 5. Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. The Angle Orthodontist. 2000;70(2):129-44.
  • 6. Graber T, Vanarsdall R. Orthodontics Current Principles and Techniques 3rd ed St Louis: Mosby. 2000:523-32 .
  • 7. Von Bremen J, Schäfer D, Kater W, Ruf S. Complications during mandibular midline distraction: the first 100 patients. The Angle Orthodontist. 2008;78(1):20-4 .
  • 8. Daokar S, Agrawal G, Junaid S, Rajput R. Distraction Osteogenesis. Ann Int Med Den Res. 2016;2(6):DE14-DE8.
  • 9. Rossini G, Vinci B, Rizzo R, Pinho D, Deregibus A. Mandibular distraction osteogenesis: a systematic review of stability and the effects on hard and soft tissues. International journal of oral and maxillofacial surgery. 2016;45(11):1438-44.
  • 10. Glowacki J, Shusterman EM, Troulis M, Holmes R, Perrott D, Kaban LB. Distraction osteogenesis of the porcine mandible: histomorphometric evaluation of bone. Plastic and reconstructive surgery. 2004;113(2):566-73.
  • 11. Dinu C, Kretschmer W, Baciut M, Rotaru H, Bolboaca SD, Gheban D, et al. The effect of distraction rate on bone histological and histomorphometrical properties in an ovine mandible model. Rom J Morphol Embryol. 2011;52(3):819-25.
  • 12. Guerrero C, Bell W, Contasti G, Rodriguez A. Mandibular widening by intraoral distraction osteogenesis. British Journal of Oral and Maxillofacial Surgery. 1997;35(6):383-92.
  • 13. Chung Y-W, Tae K-C. Dental stability and radiographic healing patterns after mandibular symphysis widening with distraction osteogenesis. The European Journal of Orthodontics. 2007;29(3):256-62.
  • 14. Samchukov ML, Cope JB, Cherkashin AM. Craniofacial distraction osteogenesis: Mosby St. Louis; 2001. 256-62 p.
  • 15. King JW, Wallace JC, Winter DL, Niculescu JA. Long-term skeletal and dental stability of mandibular symphyseal distraction osteogenesis with a hybrid distractor. American journal of orthodontics and dentofacial orthopedics. 2012;141(1):60-70.
  • 16. Del Santo Jr M, Guerrero CA, Buschang PH, English JD, Samchukov ML, Bell WH. Long-term skeletal and dental effects of mandibular symphyseal distraction osteogenesis. American journal of orthodontics and dentofacial orthopedics. 2000;118(5):485-93.
  • 17. Bayram M, Özer M, Alkan A. Mandibular symphyseal distraction osteogenesis using a bone-supported distractor. The Angle Orthodontist. 2007;77(4):745-52.
  • 18. Harper DL. A case report of a Brodie bite. American Journal of Orthodontics and Dentofacial Orthopedics. 1995;108(2):201-6.
  • 19. Ozkalayci N, Ozer M, Sumer M. Treatment of unilateral buccal crossbite with mandibular symphyseal distraction osteogenesis. Korean Journal of Orthodontics. 2011;41(1):59-69.
  • 20. Sakamoto T, Hayakawa K, Ishii T, Nojima K, Sueishi K. Bilateral scissor bite treated by rapid mandibular expansion following corticotomy. The Bulletin of Tokyo Dental College. 2016;57(4):269-80.
  • 21. King JW, Wallace JC. Unilateral Brodie bite treated with distraction osteogenesis. American Journal of orthodontics and dentofacial orthopedics. 2004;125(4):500-9.
  • 22. Nojima K, Takaku S, Murase C, Nishii Y, Sueishi K. A case report of bilateral Brodie bite in early mixed dentition using bonded constriction quad-helix appliance. The Bulletin of Tokyo Dental College. 2011;52(1):39-46.
  • 23. Suda N, Tominaga N, Niinaka Y, Amagasa T, Moriyama K. Orthognathic treatment for a patient with facial asymmetry associated with unilateral scissors-bite and a collapsed mandibular arch. American journal of orthodontics and dentofacial orthopedics. 2012;141(1):94-104.
  • 24. Little RM, Riedel RA. Postretention evaluation of stability and relapse—mandibular arches with generalized spacing. American Journal of Orthodontics and Dentofacial Orthopedics. 1989;95(1):37-41.
  • 25. Alkan A, Özer M, Baş B, Bayram M, Celebi N, Inal S, et al. Mandibular symphyseal distraction osteogenesis: review of three techniques. International journal of oral and maxillofacial surgery. 2007;36(2):111-7.
  • 26. Durham JN, King JW, Robinson QC, Trojan TM. Long-term skeletodental stability of mandibular symphyseal distraction osteogenesis: Tooth-borne vs hybrid distraction appliances. The Angle Orthodontist. 2017;87(2):246-53.
  • 27. De Gijt J, Gül A, Sutedja H, Wolvius E, van der Wal K, Koudstaal M. Long-term (6.5 years) follow-up of mandibular midline distraction. Journal of Cranio-Maxillofacial Surgery. 2016;44(10):1576-82.
  • 28. Ploder O, Köhnke R, Klug C, Kolk A, Winsauer H. Three-dimensional measurement of the mandible after mandibular midline distraction using a cemented and screw-fixated tooth-borne appliance: a clinical study. Journal of oral and maxillofacial surgery. 2009;67(3):582-8.
  • 29. Starch-Jensen T, Kjellerup AD, Blæhr TL. Mandibular midline distraction osteogenesis with a bone-borne, tooth-borne or hybrid distraction appliance: a systematic review. Journal of oral & maxillofacial research. 2018;9(3).
  • 30. İşeri H, Malkoç S. Long-term skeletal effects of mandibular symphyseal distraction osteogenesis. An implant study. The European Journal of Orthodontics. 2005;27(5):512-7.
  • 31. Seeberger R, Kater W, Davids R, Thiele OC, Edelmann B, Hofele C, et al. Changes in the mandibular and dento-alveolar structures by the use of tooth borne mandibular symphyseal distraction devices. Journal of Cranio-Maxillofacial Surgery. 2011;39(3):177-81.
  • 32. Verlinden C, Van de Vijfeijken S, Tuinzing D, Jansma E, Becking A, Swennen G. Complications of mandibular distraction osteogenesis for developmental deformities: a systematic review of the literature. International journal of oral and maxillofacial surgery. 2015;44(1):44-9.
  • 33. Der‐M C, Gironda M, Black E, Leathers R, Atchison K. Decision‐Making Process for Treatment of Mandibular Fractures among Minority Groups. Journal of public health dentistry. 2006;66(1):37-43.
  • 34. Atchison KA, Black EE, Leathers R, Belin TR, Abrego M, Gironda MW, et al. A qualitative report of patient problems and postoperative instructions. Journal of oral and maxillofacial surgery. 2005;63(4):449-56.
  • 35. Little RM, Riedel RA, Artun J. An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. American Journal of Orthodontics and Dentofacial Orthopedics. 1988;93(5):423-8.
  • 36. Fidler BC, Artun J, Joondeph DR, Little RM. Long-term stability of Angle Class II, division 1 malocclusions with successful occlusal results at end of active treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 1995;107(3):276-85.
  • 37. Al Yami EA, Kuijpers-Jagtman AM, Van't Hof MA. Stability of orthodontic treatment outcome: follow-up until 10 years postretention. American Journal of Orthodontics and Dentofacial Orthopedics. 1999;115(3):300-4.
  • 38. Alam MK, Nowrin SA, Shahid F, Haque S, Imran A, Fareen N, et al. Treatment of Angle class I malocclusion with severe crowding by extraction of four premolars: A case report. Bangladesh Journal of Medical Science. 2018;17(4):683-7.
  • 39. Erdinc AE, Nanda RS, Işıksal E. Relapse of anterior crowding in patients treated with extraction and nonextraction of premolars. American journal of orthodontics and dentofacial orthopedics. 2006;129(6):775-84.
  • 40. Perssor M, Persson E, Skagius S. Long-term spontaneous changes following removal of all first premolars in Class I cases with crowding. The European Journal of Orthodontics. 1989;11(3):271-82.
  • 41. Little RM, Riedel RA, Engst ED. Serial extraction of first premolars—postretention evaluation of stability and relapse. The Angle Orthodontist. 1990;60(4):255-62.
  • 42. Yavari J, Shrout MK, Russell CM, Haas AJ, Hamilton EH. Relapse in Angle Class II Division 1 Malocclusion treated by tandem mechanics without extraction of permanent teeth: A retrospective analysis. American Journal of Orthodontics and Dentofacial Orthopedics. 2000;118(1):34-42.
  • 43. Freitas KM, de Freitas MR, Henriques JFC, Pinzan A, Janson G. Postretention relapse of mandibular anterior crowding in patients treated without mandibular premolar extraction. American journal of orthodontics and dentofacial orthopedics. 2004;125(4):480-7.
  • 44. Lima Filho R, Lima AL. Long-term outcome in a patient with Class I malocclusion with severe crowding treated without extractions. American journal of orthodontics and dentofacial orthopedics. 2004;126(4):495-504.
  • 45. Quaglio C, de Freitas KM, de Freitas M, Janson G, Henriques J. Stability and relapse of maxillary anterior crowding treatment in Class I and Class II Division 1 malocclusions. American journal of orthodontics and dentofacial orthopedics. 2011;139(6):768-74 .
Uluslararası Diş Hekimliği Bilimleri Dergisi-Cover
  • ISSN: 2149-8628
  • Yayın Aralığı: Yılda 3 Sayı
  • Yayıncı: Zonguldak Bülent Ecevit Üniversitesi
Arşiv
Sayıdaki Diğer Makaleler

İki Aşamalı Alveolar Kemik Split Tekniği Kullanarak Dar Mandibulanın Posterior Alveolar Kemiğin Genişletilmesi

Abdulkareem ALMARRAWİ

Alt Çene Transversal İskeletsel Darlığın Orta Hat Distraksiyonu İle Tedavisi: İki Olgu Sunumu

İrem YOLCU, Orhan ÇİÇEK, Uğur GÜLŞEN, Nurhat ÖZKALAYCI

Dişeti Gülümsemesi ve Papil Kaybına Sahip Bir Olgunun Tedavisinde Multidisipliner Yaklaşım: Olgu Sunumu

Doğu Ömür DEDE, Figen ÖNGÖZ DEDE, Sena BALKIZ

COVID-19 Pandemisinde Oral ve Maksillofasiyal Cerrahi Uygulamalarına Güncel Bakış

Koray Onur ŞANAL

Konya İli ve Çevresinde Yaşayan 5-14 Yaş Grubu Çocuklarda Konjenital Daimi Diş Eksikliğinin Prevelansı: Retrospektif Çalışma

Asu ÇAKIR, Sibel YILDIRIM

Sabit Ortodontik Tedavi ve Beslenme

Can TAT, Alev AKSOY, Hatice BAYGUT