BİLATERAL POSTERİOR ÇAPRAZ KAPANIŞA SAHİP HASTADA HIZLI MAKSİLLER EXPANSİYON UYGULAMASI: OLGU SUNUMU

Kotan S., Tunca Y., Fahrzadeh N., Tunca M.

1. ULUSLARARASI DENTAL ARAŞTIRMALAR VE SAĞLIK BİLİMLERİ KONGRESİ, Diyarbakır, Türkiye, 20 - 22 Mayıs 2021, ss.195-196

Yayın Türü: Bildiri / Özet Bildiri
Basıldığı Şehir: Diyarbakır
Basıldığı Ülke: Türkiye
Sayfa Sayıları: ss.195-196
Van Yüzüncü Yıl Üniversitesi Adresli: Evet

Amaç: Bu olgu sunumunda amaç, bilateral posterior çapraz kapanışa sahip adolesan dönemdeki kadın hastada, sabit ortodontik tedavi öncesinde uygulanan Mc Namara tipi hızlı ekspansiyonun tedavi sonuçlarını sunmaktır.

Olgu Sunumu: Kronolojik yaşı 13 yıl 1 ay olan kadın hastanın ağız dışı muayenesinde yüz hatlarının orantılı ve simetrik, profilinin ise düz olduğu gözlenmiştir. Hastanın ağız içi muayenesinde Angle Sınıf 2 molar ilişki, bilateral posterior çapraz kapanış, -1 mm overjet, 1,5 mm overbite, alt ve üst orta hattın yerinde olduğu ve çift taraflı maksiller kanin dişlerin vestibülde konumlandığı belirlenmiştir. Model analizinde maksiller arkta 15 mm yer darlığı, mandibular arkta ise 2 mm yer fazlalığı vardır. Sefalometrik analizde iskeletsel Sınıf 1 ilişki ile beraber normodiverjan dik yön büyüme modeli gözlenmektedir. Posteroanterior sefalometrik radyografide maksiller genişliğin azaldığı belirlenmiştir. Ekspansiyon protokolü günde 2 tur olarak belirlenmiştir. 10 tur sonunda midpalatal suturun açıldığı klinik ve radyografik olarak gözlenmiş, overcorrection için ekspansiyona 1 tur ile devam edilmiştir. Toplam 36 turdan sonra retansiyon tedavisine geçilmiştir. Tedavi sonunda toplanan ortodontik materyalin analizi sonucunda arklarda simetrinin sağlandığı, maksiller genişliğin norm değerlere ulaştığı, posterior çapraz kapanışın düzeldiği, maksillada yer darlığının büyük ölçüde çözüldüğü, mandibulada yer fazlalığının olmadığı gözlenmiştir.

Sonuç: Hastamızın total tedavi süresi retansiyon fazı ile birlikte 7 ay sürmüştür. Hastanın sabit ortodontik tedavisi devam etmekte olup Mc Namara tipi bonded hızlı genişletme apareyi kullanımı ile transversal ilişki düzelmiştir.

Aim: The aim of this case report is to present the treatment results of Mc Namara type rapid expansion applied before fixed orthodontic treatment in a female adolescent with bilateral posterior cross-bite.

Case Report: A female patient, whose chronological age was 13 years, was observed to have a proportional and symmetrical facial shape and a straight profile in the extra-oral examination. In the intraoral examination of the patient, it was determined that Angle Class 2 molar relationship, bilateral posterior cross-bite, -1 mm overjet, 1.5 mm overbite, lower and upper midline were in place, and bilateral maxillary canine teeth were located in the vestibule. In model analysis, there is a 15 mm dental crowding in the maxillary arch and 2 mm excess space in the mandibular arch. In cephalometric analysis, a skeletal Class 1 relationship and normodivergent vertical growth pattern are observed. The posteroanterior cephalometric radiography showed that the maxillary width was decreased. The expansion protocol is set as twice a day. At the end of 10 tours, it was observed clinically and radiographically that the midpalatal suture was opened, and expansion was continued with one tour for overcorrection. Retention treatment was started after a total of 36 tours. As a result of the analysis of the orthodontic material collected at the end of the treatment, it was observed that the symmetry in the arches was achieved, the maxillary width reached normal values, the posterior cross-bite was corrected, the lack of space in the maxilla was largely resolved, and there was no excess space in the mandible.

Conclusion: The total treatment period of our patient, including the retention phase, lasted seven months. Fixed orthodontic treatment of the patient continues, and the transversal relationship has improved with the use of Mc Namara type bonded rapid expansion appliance.