Hızlı üst çene genişletmesini takiben çevre yumuşak dokularda oluşan basınç değişikliklerinin değerlendirilmesi

Bu çalışmada hızlı üst çene genişletilmesinden sonra, çevre yumuşak dokularda oluşan basınç değişiklikleri, vertikal yüz gelişimi farklı olan 2 ayrı hasta grubunda toplam 6 aylık pekiştirme dönemi süresince incelenmiştir. Üst çene darlığına sahip 19 kız, 9 erkek toplam 28 hasta; vertikal yüz gelişimine göre 2 ayrı gruba eşit dağılabilmeleri açısından 14 high angle, 14 low angle olacak şekilde seçilmişlerdir. Bireylerin dil, dudak ve yanakları tarafından serbest pozisyon, yutkunma ve fonasyon sırasında üst dişler ve alveol kemiklerine uygulanan yumuşak doku basınçları, genişletmeden önce, sonra ve 6 aylık pekiştirme dönemi süresince ayda 1 kez ölçülmüş ve kaydedilmiştir. Genişletme sonrası, serbest pozisyon sırasında ölçülen yanak ve dudak basınçları, başlangıca oranla anlamlı derecede artmış, dil basınçları ise tam tersine anlamlı derecede azalmıştır. Dudak ve yanak basınçları pekiştirmenin ilk ayında düşmeye başlamış ve 1. ayın sonunda başlangıç değeriyle aradaki fark anlamsız hale gelmiştir. Bununla birlikte basınç değerlerinin tam olarak başlangıç seviyesine düşmesi 5. aydan sonra gerçekleşmiştir. Dil basınçları 2. ayın sonunda başlangıca göre anlamsız hale gelmiş ancak ortalama değerler molar bölgesinde 6. ay sonunda, santral kesici bölgesinde ise 5. ay sonunda başlangıç değerlerine ulaşmışlardır. Genişletme sonrası, yutkunma ve fonasyon sırasında ölçülen yanak ve dudak basınçlarında da anlamlı artışlar bulunurken, dil basınçları yine anlamlı derecede azalmıştır. Ortalama değerlere baktığımızda yutkunma sırasında molar bölgede ancak 6. ay sonunda, santral kesici bölgesinde 4. ay sonunda başlangıç değerlerine ulaşıldığı görülmektedir. Fonasyon sırasındaki ortalama basınçlara bakıldığında ise 6. ay sonunda başlangıç değerlerine halen ulaşılmadığı görülmektedir. EVALUATION OF CHANGES IN CHEEK, LIP AND TONGUE PRESSURES FOLLOWING RPE SUMMARY In the present study, the changes in the pressures of the surrounding soft tissues after rapid maxillary expansion, is examined for 6 months in retention, in two groups of different vertical face height. 28 patients (19 girls, 9 boys) were selected to perform 2 groups of 14 high angle and 14 low angle subjects. The cheek, lip and tongue pressures are recorded during rest position, swallowing and speech before and after expansion and during 6 months of retention. The pressures were measured at the buccal and lingual sides of upper 1. molar and upper central incisor. Epl Bo diaphgram type pressure transducer was used for the measurements and the results were monitorized by a strain indicator by means of gr/cm². After expansion, during rest position, the cheek and lip pressures increased, and lingual pressures decreased significantly. The pressures started decreasing after expansion and at the end of 1st month, the difference from the initial value was insignificant. However, the pressure values were still high and they were egualized with the initial values at the end of 5th month. Lingual pressures decreased after expansion , then started increasing, and they were statistically insignificant at the end of 2nd month but the pressures at the molar region were equalized at the end of 6th month and the pressures at the incisor region were equalized at the end of 5th month with the initial values. The cheek and lip pressures during swallowing and speech increased significantly after expansion. The mean values were still high and they were equalized with the initial values at the end of 5th month while the speech pressures did not. The tongue pressures decreased after expansion and then started increasing, and they were equalized at the end of 6 months during swallowing . During speech the pressures were still different than the inital values at the end of 6th month

Cephalometric Evaluation of Molar Distalization by a Compact RPE Screw Combined with a Modified Nance Appliance

The aim of this study is to evaluate the effects and results of a newly designed intra-oral molar distalization device. The study involves 8 (1 male and 7 females) patients with class II dental relationship. The mean age of the patients was 14.1. Molar distalization was achieved by intermittent forces, where the compact RPE screw is placed in mesiodistal direction between molars and premolars. After the completion of distalization, the appliance was kept in mouth passively for 3 months for retention purpose. Patients were instructed to turn the screw 1 time a week (meaning 1/4 turn each week) and activation continued until super class one dental relationship was achieved. The status will be retained with the same screw, kept in position, for approximately 3 months. Lateral cephalometric radiographs were taken at the day of insertion of the device (before opening the screw), and at the end of treatment. Tracing of these radiographs gave us a detailed view of the result of our study and the effectiveness of the new device. The significant changes achieved were as follows: The upper first molars were distalized in an average of 2.68 mm, tipped 2.62° distally. The upper central incisors were proclined by an average of 2.5 mm and tipped 4.9° labially. IMPA increased 1.09°, the lower molars extruded 1mm, and overjet increased 1,3mm. On the other hand, there were no significant skeletal changes