Hareketli ve sabit fonksiyonel aparey tedavilerinin mandibular kemikteki etkilerinin fraktal analiz yöntemi ile değerlendirilmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, pubertal dönemde olan iskeletsel sınıf II maloklüzyonlu hastaların, hareketli ve sabit fonksiyonel aparey ile tedavisi sonrasında mandibular trabeküler kemikte meydana gelen değişiklikleri panoramik ve lateral sefalometrik radyografiler kullanılarak Fraktal Analiz (FA) yöntemi ile değerlendirmektir. Materyal Metot: İskeletsel sınıf II maloklüzyonu olan, normodiverjan dik yön paternine sahip, pubertal atılım döneminde olan 120 bireyin panaromik ve sefalometrik görüntüleri 4 gruba ayrılmıştır. Çalışma grupları Monoblok apareyi, Twinblok apareyi ve Herbst apareyi ile tedavi gören 30'ar hasta olacak şekilde 3 ayrı tedavi grubundan oluşmaktadır. Kontrol grubu ise tedavi görmemiş 30 bireyden oluşmaktadır. Tüm bireylerde fonksiyonel tedavi sonrası mandibulanın kondil, angulus, korpus ve simfizis bölgelerinde oluşabilecek değişiklikler FA yöntemi ile incelenmiştir. Bulgular: Tedavi gruplarında yer alan tüm bireylerin kondil, korpus ve simfizis bölgelerinin fraktal boyut (FB) değerlerinde istatiksel olarak anlamlı azalma gözlenmiştir (p<0,05). Tüm tedavi gruplarının angulus bölgesi FB değerlerinde ise istatiksel olarak anlamlı bir artış tespit edilmiştir (p<0,001). Kontrol grubunda yer alan bireylerin tedavi başı ve sonu FB değerlerinde istatiksel olarak anlamlı farklılık bulunmamıştır (p>0,05). Sonuç: Pubertal dönemde uygulanan sabit ve hareketli fonksiyonel aparey tedavileri mandibulanın kondil bölgesinin yeniden şekillenmesini ve böylelikle daha ileri bir pozisyonda konumlanmasını sağlamaktadır. Bununla beraber mandibulanın konumundan etkilenen masseter kasının liflerinin olduğu angulus bölgesinde rezorpsiyona dirençli bir alan olduğu gözlenmiştir. Hareketli aparey tedavilerinde, posterior dişlerin bölgedeki akrilik kütle ve bu bölgedeki dişlerin ekstrüzyonu için uygulanan selektif mölleme işlemine bağlı, mandibulanın korpus bölgesindeki trabeküler kemik yoğunluğunda azalma meydana gelmiştir. Hareketli ve sabit fonksiyonel tedavilerinin bir yan etkisi olarak gözlemlenen alt keser açılarındaki artışın, keser köklerinin bukkalinde yer alan trabeküler kemik yoğunluğunda azalmaya neden olduğu düşünülmektedir. Anahtar Kelimeler: Fonksiyonel Apareyler, Fraktal analiz, Trabeküler Kemik, Panoramik Radyografi, Sefalometrik Radyografi.
Aim: The aim of this study is to evaluate the changes occurring in the mandibular trabecular bone after treatment with removable and fixed functional appliances in patients with skeletal Class II malocclusion during the pubertal growth period, using the Fractal Analysis (FA) method with panoramic and lateral cephalometric radiographs. Materials and Methods: Panoramic and cephalometric images of 120 individuals with skeletal Class II malocclusion and normodivergent vertical growth patterns in the pubertal growth period were divided into four groups. The study groups consisted of three treatment groups of 30 patients each, treated with Monoblock, Twin-block, and Herbst appliances. The control group included 30 untreated individuals. Changes in the mandibular condyle, angle, corpus, and symphysis regions after functional treatment were evaluated using the FA method in all individuals. Results: A statistically significant decrease in fractal dimension (FD) values was observed in the condyle, corpus, and symphysis regions of all individuals in the treatment groups (p<0.05). However, a statistically significant increase in FD values was noted in the angle region for all treatment groups (p<0.001). No statistically significant difference was found in the FD values between the beginning and end of the study period for individuals in the control group (p>0.05). Conclusion: Fixed and removable functional appliance treatments applied during the pubertal period reshape the mandibular condyle, allowing it to be positioned more anteriorly. Additionally, it was observed that the angle region, influenced by the fibers of the masseter muscle attached to the mandible, forms a resistant area to resorption. In treatments involving removable appliances, a decrease in trabecular bone density in the mandibular corpus region occurred, likely due to the acrylic mass in the posterior region and selective grinding applied for the extrusion of posterior teeth. The increase in lower incisor angles observed as a side effect of removable and fixed functional treatments is thought to cause a reduction in trabecular bone density on the buccal side of incisor roots. Key Words: Functional Appliances, Fractal Analysis, Trabecular Bone, Panoramic Radiography, Cephalometric Radiography.
Aim: The aim of this study is to evaluate the changes occurring in the mandibular trabecular bone after treatment with removable and fixed functional appliances in patients with skeletal Class II malocclusion during the pubertal growth period, using the Fractal Analysis (FA) method with panoramic and lateral cephalometric radiographs. Materials and Methods: Panoramic and cephalometric images of 120 individuals with skeletal Class II malocclusion and normodivergent vertical growth patterns in the pubertal growth period were divided into four groups. The study groups consisted of three treatment groups of 30 patients each, treated with Monoblock, Twin-block, and Herbst appliances. The control group included 30 untreated individuals. Changes in the mandibular condyle, angle, corpus, and symphysis regions after functional treatment were evaluated using the FA method in all individuals. Results: A statistically significant decrease in fractal dimension (FD) values was observed in the condyle, corpus, and symphysis regions of all individuals in the treatment groups (p<0.05). However, a statistically significant increase in FD values was noted in the angle region for all treatment groups (p<0.001). No statistically significant difference was found in the FD values between the beginning and end of the study period for individuals in the control group (p>0.05). Conclusion: Fixed and removable functional appliance treatments applied during the pubertal period reshape the mandibular condyle, allowing it to be positioned more anteriorly. Additionally, it was observed that the angle region, influenced by the fibers of the masseter muscle attached to the mandible, forms a resistant area to resorption. In treatments involving removable appliances, a decrease in trabecular bone density in the mandibular corpus region occurred, likely due to the acrylic mass in the posterior region and selective grinding applied for the extrusion of posterior teeth. The increase in lower incisor angles observed as a side effect of removable and fixed functional treatments is thought to cause a reduction in trabecular bone density on the buccal side of incisor roots. Key Words: Functional Appliances, Fractal Analysis, Trabecular Bone, Panoramic Radiography, Cephalometric Radiography.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
