摘要：Amaç: Bu çalışmanın amacı, Hızlı Üst Çene Genişletmesi (HÜÇG) ve Yüz maskesi (YM) kombine uygulamasının mandibular dentisyona etkisini değerlendirmektir. Gereç ve Yöntem: Bu retrospektif çalışmada daimi dişlenme döneminde olan, ortalama iskelet yaşı 12 yıl 1 ay olan, posterior çapraz kapanış ve maksiller retrognatinin eşlik ettiği iskeletsel Sınıf 3 anomaliye (ANB<0) sahip olup tedavi protokolü gereği yapıştırmalı tip Hyrax vidalı HÜÇG aygıtı ile Petit tip YM’nin kombine uygulandığı 25 bireye (10 kız, 15 erkek) ait tedavi başı ve sonu sefalometrik film ve ortodontik modeller değerlendirildi. HÜÇG-YM kullanımı ortalama 8.7 aydı. Ortodontik modellerin 3D görünümünde 3Shape Ortho Analyzer 2013-1 programıyla alt çenede intermolar, interkanin genişlik, ark derinliği ve alt anterior bölge kanin-kanin arası çapraşıklık miktarı Little düzensizlik indeksi (LDİ) metodu kullanılarak ölçüldü. Lateral sefalometrik filmlerde alt keser eğimi (IMPA açısı) ölçüldü. Verilerin istatistiksel olarak değerlendirilmesinde eşleştirilmiş t-testi kullanıldı. İstatistiksel anlamlılık değeri p<0.01 olarak kabul edildi. Bulgular: Kombine uygulama sonunda alt dental arkta intermolar genişlikte ortalama 1.38 mm anlamlı artış bulundu (p<0.001). Buna karşılık, interkanin genişliğinde değişim saptanmadı. Ark derinliğinde ise 1.45 mm anlamlı azalma (p<0.001) ve LDİ değerinde 1.46 mm anlamlı artış görüldü (p<0.01). Alt keser eğiminde (IMPA açısı) istatistiksel olarak anlamlı değişim saptanmadı. Sonuç: HÜÇG-YM kombine uygulaması sonunda alt çenede oluşan intermolar genişlikteki artış ark boyunu arttırırken, buna karşılık ark derinliğindeki azalma ark boyunu azaltmaktadır. Klinisyenler bu kombine uygulamayla alt çenede kesici dişlerde çapraşıklık miktarının artabileceğini göz önünde bulundurmalıdır. Objective: The study aimed to evaluate the effects of combined rapid maxillary expansion (RPE) and face mask (FM) application on the mandibular dentition. Materials and Method: In this retrospective study pre- and post-treatment cephalometric radiographs and orthodontic models of 25 patients (10 female, 15 male) with a mean skeletal age of 12 years and 1 month, being in permanent dentition, having skeletal Class 3 anomaly (ANB<0) accompanying with maxillary retrognathism and posterior crossbite who had been treated with a combined application of bonded Hyrax RPE and FM were evaluated. The mean duration for the RPE-FM application was 8.7 months. The lower arch intermolar and intercanine widths, arch depth and the amount of crowding between canines were evaluated using Littles’ Irregularity Index (LII) on the 3D images of the models utilizing the 3Shape OrthoAnalyzer 2013-1 program. Mandibular incisors’ inclination (IMPA degree) were determined on cephalometric radiographs. The statistical evaluation was done with paired t-test, and the statistical significance was set at p<0.01. Results: In the lower dental arch, a significant increase of 1.38 mm was found in the intermolar width (p<0.001). While no significant difference was observed in the intercanine width, there was a significant decrease in the arch depth (1.45 mm; p<0.001) and a significant increase in the LII value (1.46 mm; p<0.01). Besides, there was no significant difference in the IMPA degree. Conclusion: Combined RPE-FM application in the treatment of skeletal Class 3 malocclusion provides an increase in mandibular intermolar width that may increase the arch length. On the contrary, a decrease in the arch depth results in shortening of the arch length. Clinicians should be conscious of a mandibular anterior crowding during this type of combined therapy.
其他摘要：Objective: The study aimed to evaluate the effects of combined rapid maxillary expansion (RPE) and face mask (FM) application on the mandibular dentition. Materials and Method: In this retrospective study pre- and post-treatment cephalometric radiographs and orthodontic models of 25 patients (10 female, 15 male) with a mean skeletal age of 12 years and 1 month, being in permanent dentition, having skeletal Class 3 anomaly (ANB<0) accompanying with maxillary retrognathism and posterior crossbite who had been treated with a combined application of bonded Hyrax RPE and FM were evaluated. The mean duration for the RPE-FM application was 8.7 months. The lower arch intermolar and intercanine widths, arch depth and the amount of crowding between canines were evaluated using Littles’ Irregularity Index (LII) on the 3D images of the models utilizing the 3Shape OrthoAnalyzer 2013-1 program. Mandibular incisors’ inclination (IMPA degree) were determined on cephalometric radiographs. The statistical evaluation was done with paired t-test, and the statistical significance was set at p<0.01. Results: In the lower dental arch, a significant increase of 1.38 mm was found in the intermolar width (p<0.001). While no significant difference was observed in the intercanine width, there was a significant decrease in the arch depth (1.45 mm; p<0.001) and a significant increase in the LII value (1.46 mm; p<0.01). Besides, there was no significant difference in the IMPA degree. Conclusion: Combined RPE-FM application in the treatment of skeletal Class 3 malocclusion provides an increase in mandibular intermolar width that may increase the arch length. On the contrary, a decrease in the arch depth results in shortening of the arch length. Clinicians should be conscious of a mandibular anterior crowding during this type of combined therapy.
关键词：Ağız dışı çekme aletleri ; Angle sınıf 3 ; arkus dentalis ; çapraşıklık ; damak genişletme tekniği
其他关键词：Angle Class III ; crowding ; dental arch ; extraoral traction appliances ; palatal expansion technique
