Mevlut Celikoglu

Aim: To assess the sagittal soft and hard soft tissue morphology of growing C lass III patients in comparison with a Class I control subjects. Materials and Methods: Forty-one female children with Class III malocclusion and 30 C lass I female children were included in the study. Eight linear and 6 angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. Results: The subjects with Class III malocclusion showed a retrusive maxilla (A-y distance, 48.52±2.53) and upper lip (Ss-y distance, 64.14±3.26), a protrusive mandible (B-y distance, 56.15±5.49) a prominent chin (Pog’-y distance, 70.65±6.87), retroclined lower incisors (IMPA, 87.14±5.68) , and increased vertical dimensions (SN-GoMe, 36.49±5.29) compared to control subjects. Conclusions: Our findings indicated that soft and hard tissue characteristics of Class III subjects are distinct from Class I subjects in the middle region and lower third of the face. Orthopedic traction of mid-face arguably started earlier as a first treatment protocol to obtain balanced facial profile in Class III subjects. Keywords: Soft tissue profile, cephalometry, Class III malocclusion, Class I occlusion SINIF I VE SINIF III İLİŞKİLİ ÇOCUKLARDAKİ SERT VE YUMUŞAK DOKU YÜZ MORFOLOJİSİ FARKLILIKLARI: SEFALOMETRİK İNCELEME ÖZ Amaç: Bu çalışmanın amacı Sınıf III ilişkiye sahip ço- cukların sert ve yumuşak doku yüz morfolojisini Sınıf I ilişkiye sahip kontrol bireyleri ile karşılaştırmaktır. Gereç ve Yöntem: Bu çalışma Sınıf III maloklüzyonlu 41 ve Sınıf I oklüzyonlu 30 bayan çocuğu içermektedir. Bu bireylerin sert ve yumuşak doku karakteristiklerinin incelenmesi için sefalometrik filmler üzerinde 8 linear ve 6 açısal ölçüm yapılmıştır. Bulgular: Kontrol grubundaki bireylerle karşılaştırıldı- ğında, Sınıf III maloklüzyonlu bireylerin retrüziv üst çe- ne ve üst dudak, protruziv bir alt çene ve belirgin çene ucu, retrokline alt kesici dişler ile artmış dik yön boyut- lara sahip oldukları görülmüştür. Sonuç: Bu çalışmanın bulguları, Sınıf III bireylerin or- ta ve alt yüz bölgesindeki sert ve yumuşak doku yüz karakterlerinin Sınıf I bireylerden farklı olduğunu gös- termektedir . Sınıf III bireylerde dengeli bir yüz profile elde etmek için, maksiller protraksiyon ilk tedavi proto- kolü olarak daha erken başlatılmalıdır. Anahtar Kelimeler: Yumuşak doku profili, sefalometri, Sınıf III maloklüzyon, Sınıf I oklüzyon

Objective: To evaluate the changes in pharyngeal airway dimensions and the position of the hyoid bone after maxillary protraction with different alternate rapid maxillary expansion and construction (Alt-RAMEC) protocols in patients with skeletal class III malocclusion as a result of maxillary retrusion. Material and Methods: The patients with skeletal class III malocclusions were consecutively divided into two groups. Group 1 consisted of 17 patients (11 boys and 6 girls, mean age 11.31 ± 1.71 years) who had the Alt-RAMEC protocol for 5 weeks, and group 2 consisted of 17 patients (10 boys and 7 girls, mean age 11.64 ± 1.24 years) who had the Alt-RAMEC procedure for 9 weeks. In this study, 4 angular and 13 linear measurements were performed to evaluate the skeletal and pharyngeal airway changes that occurred after maxillary protraction. Results: A significant increase in the maxillary growth, inhabitation of mandibular growth, and clockwise rotation of the mandible caused the improvement of the maxillo-mandibular relationship in both groups. Those changes caused a significant increase in the upper pharyngeal airway dimension ( P < .01) and affected the vertical position of the hyoid bone in both groups ( P < .05 and P < .01, respectively). However, changes that occurred in both groups were found to be similar for all airway variables ( P > .05). Conclusion: Upper pharyngeal dimension and vertical position of the hyoid bone were affected by the maxillary protraction with different Alt-RAMEC protocols. There were no statistically significant differences between the groups.

Objective: To evaluate and compare the skeletal, dentoalveolar and soft tissue effects of two different alternate rapid maxillary expansion (RMEs) and constriction (Alt-RAMEC) procedures. Material and methods: Thirty-two consecutive patients presenting with a skeletal Class III malocclusion were placed into two comparative groups. Group 1 consisted of 16 patients (5 females and 11 males; mean age: 11.45 ± 1.87 years) who had an Alt-RAMEC procedure for five weeks and Group 2 consisted of 16 patients (6 females and 10 males; mean age: 11.52 ± 1.29 years) who had an Alt-RAMEC procedure for nine weeks. The parents of the patients were instructed to open the screw twice per day for one week and to close it twice per day for the following week (0.20 mm per turn). Nine angular and 20 linear cephalometric variables were measured. Results: The groups were well matched in relation to patient gender distribution, chronological age and initial cephalometric values. Both Alt-RAMEC procedures showed similar effects with no statistically significant differences. The maxillae moved slightly forward and the mandible moved slightly downward, the changes of which caused an improvement in the maxillo-mandibular relationship in both groups. The overjet slightly increased and the overbite decreased in both groups. The upper lip moved slightly forward during the nine-week treatment Alt-RAMEC group. Conclusion: Despite the favourable and similar effects of both procedures, neither seems to be sufficient for the complete correction of a skeletal Class III malocclusion.

Objective: : To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT). Materials and Methods: : CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson’s χ ² and Student’s t -test. Results: : The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides ( P < .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls ( P < .05), whereas the difference for maxillary lateral incisors was not statistically significant. Conclusions: : Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.

Objective: : To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus FRD appliance with miniplate anchorage inserted in the mandibular symphyses and to compare the findings with a well-matched control group treated with a Herbst appliance for the correction of a skeletal Class II malocclusion due to mandibular retrusion. Materials and Methods: : The sample consisted of 32 Class II subjects divided into two groups. Group I consisted of 16 patients (10 females and 6 males; mean age, 13.20 ± 1.33 years) treated using the Forsus FRD EZ appliance with miniplate anchorage inserted in the mandibular symphyses. Group II consisted of 16 patients (9 females and 7 males; mean age, 13.56 ± 1.27 years) treated using the Herbst appliance. Seventeen linear and 10 angular measurements were performed to evaluate and compare the skeletal, dentoalveolar, and soft tissue effects of the appliances using paired and Student's t -tests. Results: : Both appliances were effective in correcting skeletal class II malocclusion and showed similar skeletal and soft tissue changes. The maxillary incisor was statistically significantly more retruded in the skeletally anchored Forsus FRD group ( P < .01). The mandibular incisor was retruded in the skeletally anchored Forsus FRD group (−4.09° ± 5.12°), while it was protruded in the Herbst group (7.50° ± 3.98°) ( P < .001). Conclusion: : Although both appliances were successful in correcting the skeletal Class II malocclusion, the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors.

Objective: : To evaluate condylar and ramal vertical asymmetry in adult orthodontic patients with different vertical growth patterns and a clinically normal sagittal skeletal pattern using cone-beam computed tomography (CBCT). Materials and Methods: : The study sample consisted of 101 adult orthodontic patients (48 men and 53 women) divided into three groups according to their vertical growth patterns: high- (33 patients; mean age, 25.06 ± 6.05 years), low- (34 patients; mean age, 24.88 ± 5.22 years), and normal-angle (34 patients; mean age, 24.14 ± 4.26 years) groups. Condylar, ramal, condylar plus ramal height, and index measurements were performed using CBCT images and analyzed using one-way analysis of variance and post hoc Tukey tests. Results: : There was no statistically significant difference in height measurements between right and left sides in each group, except a slight difference of approximately 0.5 mm for condylar height (CH) in the low-angle group ( P < .05). No statistically significant gender differences were found for the values ( P > .05). In the high-angle group, the ramal height (RH) and condylar plus ramal height (CH + RH) on both sides were found to be less than those of the low- ( P < .001) and normal-angle groups ( P < .017 and P > .017, respectively), and the asymmetry index values were slightly higher than those of the low- and normal-angle groups ( P > .05). Conclusions: : The high-angle group showed statistically significantly smaller values of RH and CH + RH on both sides and statistically insignificantly higher asymmetry index values than the low- and normal-angle groups.