RME/FM treatment did not affect at all the volume of maxillary sinuses and actually inhibited the normal expected increase of the volume of the pharynx when compared with a control group comprising normal individuals.
The purpose of the present study was to evaluate upper airway changes related to craniofacial changes induced by a facemask (FM) combined with Le Fort I osteotomy without down-fracture in Class III maxillary retrusion subjects (group 1) when compared with a similar group of subjects treated with traditional rapid palatal expansion and FM therapy. Pre- (T1) and post- (T2) protraction cephalometric radiographs of group 1 (10 females and 6 males; mean age 12.75 ± 1.91 years) and group 2 (7 females and 9 males; mean age 12 ± 1.7 years) were traced. The treatment duration was 149 ± 14 days (approximately 5 months) and 270 ± 46 days (approximately 9 months) for groups 1 and 2, respectively. A paired t-test for intergroup comparisons of values at T1, an independent samples t-test for intragroup comparisons of values at T1 and T2, and a non-parametric Mann-Whitney U-test for intergroup comparisons were used. To evaluate the relationship between changes in upper airway dimension and craniofacial morphology, a multiple-regression analysis was performed. Significant maxillary protraction along with clockwise rotation of the mandible was achieved in both groups. Counter-clockwise maxillary rotation was significant in group 1 (P < 0.05) but not in group 2. While nasopharyngeal measurements (PNS-ad1, PNS-ad2) showed significant increases (P < 0.05) as a result of treatment in both groups, oropharyngeal measurements did not change. Maxillary protraction, which was achieved in both groups but in a shorter period of time in group 2, improved nasopharyngeal but not oropharyngeal airway dimensions.
Objective: To evaluate the periodontal health and tooth vitality of palatally impacted and buccal ectopic maxillary canines after completion of orthodontic treatment. Materials and Methods: Fifteen patients who had unilateral, palatally impacted canines and 15 patients who had unilateral, buccal ectopic canines comprised the subjects of the study. Clinical and radiographic data was collected by recalling the patients in both groups after a mean period of 3.82 6 1.54 years following completion of their orthodontic treatment. In both groups, the contralateral, normally placed canines served as controls. Results: Palatally impacted canines had greater pocket depths, higher gingival levels, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals. Buccal ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased clinical crown lengths, and higher electric pulp testing scores compared to their contralaterals. Buccal ectopic canines had lower electric pulp testing scores and higher bone levels compared to palatally impacted canines. Conclusion: All ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased crown lengths, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals. (Angle Orthod. 2014;84:18-23.)
Long-term results of surgically assisted maxillary protraction vs regular facemask Ş irin Nevzatog lu a ; Nazan Kü çü kkeleş b ABSTRACT Objective: To evaluate the short-and long-term treatment results of rapid maxillary expansion (RME) and surgical assistance during maxillary protraction with a facemask (FM). Materials and Methods: This study was carried out in 28 patients (12 male, 16 female) with maxillary retrognathism, anterior crossbite, and Class III skeletal and dental malocclusion characteristics. Seventeen patients (9 male, 8 female) with mild maxillary retrognathism were treated by RME and FM. The other 11 patients (8 female, 3 male), who had moderate to severe maxillary retrognathism, were treated with surgically assisted FM treatment. Patients treated with RME and FM were recalled after 5.64 years, and the surgically assisted FM group was recalled after 6.08 years. Cephalometric films taken before treatment (T 0 ), right after maxillary protraction (T 1 ), and at recall (T 2 ) were used to evaluate and compare the results.Results: In the short term, good maxillary advancement and a shorter treatment period were achieved with surgically assisted FM therapy. However, in the long term, maxillary advancement and some soft tissue improvements were lost. On the other hand, in the RME and FM protraction group, maxillary advancement and soft tissue improvement were well maintained. Conclusion: In the short term, statistically significant maxillary advancement was achieved with surgically assisted maxillary protraction. However, in the long term, these sagittal changes were not stable, whereas RME and FM provided stability.
Objective: To compare the treatment outcomes of rapid maxillary expansion (RME) plus face mask (FM) and LeFort 1 osteotomy + FM during maxillary protraction. Materials and Methods: This study was carried on 34 patients all having maxillary retrognathic, anterior cross-bite, Class III skeletal and dental malocclusion characteristics and a concave profile. Eighteen patients with milder maxillary retrognathism were treated with RME + FM. Sixteen other patients with moderate to severe maxillary retrognathism were treated with an incomplete LeFort 1 osteotomy + FM therapy. Cephalometric data were evaluated statistically. Results: Significantly higher values of maxillary advancement and reduced treatment time were achieved with surgically assisted FM therapy. Conclusions: The surgically assisted FM treatment was more rapid and effective in maxillary protraction compared to the RME + FM treatment. (Angle Orthod. 2011;81:42-49.)
Patients with cleft lip and palate (CLP) have commonly reduced nasal airways and are more prone to snoring, mouth breathing and hypopnea during sleep. Therefore, the morphometric evaluation of pharyngeal airway in patients with CLP is crucial. The purpose of this study is to evaluate the pharyngeal airway volumes of patients with CLP who underwent nasoalveolar molding (NAM) and to compare them with a well-matched control group without NAM. The study consisted of 40 patients with CLP divided into 2 main groups (26 with NAM; 14 without NAM) and 4 subgroups (15 unilateral CLP [UCLP] with NAM, mean age: 10.13 ± 1.30 years; 11 bilateral CLP [BCLP] with NAM, mean age: 10.55 ± 1.51 years; 7 UCLP without NAM, mean age: 9.86 ± 1.68 years; 7 BCLP without NAM, mean age: 10.28 ± 1.89 years). Nasopharyngeal, oropharyngeal, and total airway volumes of all the patients were calculated 3-dimensionally with cone-beam computed tomography. There were statistically significant differences in nasopharyngeal volume (P < 0.05) of NAM group compared to control group; however, volumetric differences in oropharyngeal and total pharyngeal airway were not significant (P > 0.05). The amount of nasopharyngeal, oropharyngeal, and total pharyngeal airway size in the BCLP with NAM group was significantly larger compared to BCLP without NAM group (P < 0.05). However, UCLP did not show any significant difference in NAM group (P > 0.05). This study implies that NAM can effectively enlarge the nasopharyngeal airway size in patient with CLP. In addition, the pharyngeal airway volume enlargement is more apparent in BCLP than UCLP individuals.
This case report presents the treatment of a patient with a simple anterior crossbite using a removable appliance in the permanent dentition. The chief complaint of the 12-year-old female patient was the ugly appearance of her front teeth. She had a symmetrical face with competent lips, dental Class I canine and molar relationships, upper and lower anterior crowding, and an anterior dental crossbite because of a lingually positioned upper left central incisor. The lower left central incisor was labially positioned and was prone to occlusal trauma. Gingival recession on the labial surface of the lower left central incisor was considered to be because of a traumatic occlusion. The patient was on the waiting list for fixed orthodontic treatment; therefore, it was decided to perform removable appliance treatment as soon as possible to correct the crossbite, resolve the crowding, and eliminate the occlusal trauma. The treatment plan included a removable orthodontic appliance with a biteplate and finger springs. At the end of the 5-month treatment, the crossbite was successfully corrected, crowding was resolved, occlusal trauma was eliminated, normal overjet and overbite were achieved, and the smile esthetics significantly improved. In properly selected cases (even in adolescents), with cases involving good and satisfactory patient compliance, correction of a simple anterior crossbite can be successfully achieved using a removable appliance. Keywords: Anterior crossbite, permanent dentition, removable appliance 98Case Report / Olgu Sunumu Öz Bu vaka raporunda, basit ön çapraz kapanışın müteharrik aparey kullanı-larak daimi dentisyon döneminde tedavi edilmesi anlatılmaktadır. Ön diş-lerinin kötü görünümü şikayeti olan 12 yaşındaki bayan hasta simetrik bir yüze ve yeterli dudak kapanışına sahipti. Ağız içi muayenesinde hastanın Sınıf I dişsel ilişki ile birlikte alt ve üst keser çapraşıklığının olduğu tespit edildi. Üst sol santral keser dişin lingual pozisyonlanmasına bağlı olarak diş-sel çapraz kapanışın meydana geldiği görülmüş, alt sol santral keser dişin labiyal pozisyonlanmasına bağlı olarak okluzal travmaya maruz kaldığı belirlenmiştir. Alt sol santral keser dişin labiyal yüzündeki dişeti çekilmesinin travmatik oklüzyondan kaynaklandığı belirlenmiştir. Hastanın sabit tedavi bekleme sırasında olması sebebiyle, çapraz kapanışın düzeltilmesi ve okluzal travmanın bir an önce elimine edilmesi amacıyla müteharrik aparey tedavisinin yapılması kararlaştırılmıştır. Tedavi planı ısırma düzlemi ve labiolingual zemberekleri içeren müteharrik aparey tedavisi olarak belirlenmiş-tir. Beş aylık tedavi sonunda çapraz kapanış başarılı bir şekilde düzeltilmiş, alt ve üst bölgedeki çapraşıklık giderilmiş, okluzal travma elimine edilmiş, gülüş estetiği anlamlı ölçüde düzeltilmiştir. Doğru seçilmiş vakalarda (ergen hastalar da dahil olmak üzere) yeterli hasta kooperasyonunun olması durumunda, ön çapraz kapanış müteharrik apareyler ile başarılı bir şekilde tedavi edilebilir. Anahtar kelimeler: Ön çapraz kapanış, daimi dentisyon, müteha...
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