Ayse Gulsen

Maxillary advancement with internal distraction device in cleft palate patients.

This study aimed to evaluate the results of maxillary advancement by using internal Le Fort 1 distractors on six patients with unilateral cleft lip and palate who had maxillary hypoplasia. The retrognathic maxilla of five patients were protracted with distractor bilaterally, and asymmetric advancement was performed in one patients. A removable intraoral acrylic appliance was used as an anchorage appliance in two patients, and Ragno fan-type expander appliance was used in the others to prevent maxillary collapse during the distraction period. The maxilla of one patient was not distracted successfully due to the maxillary collapse in result of breaking the removable anchorage appliance away. Lateral cephalograms were evaluated before 3 and 12 months after distraction. A desired level of advancement was attained in five patients. In one patient distraction was not performed due to the maxillary collapse. In one of the five patients with a wide oronasal fistula, the size of the fistula was decreased with asymmetric advancement of right and left maxillary segments. Following the retention period of 12 months, the results were stable. It was concluded that effective and easy distraction is possible with internal Le Fort 1 distractors in cleft lip and palate patients who requires maxillary advancement.

Evaluation of the nose profile after maxillary advancement with impaction surgeries.

ObjectiveThe aim of this study was to identify and quantify nasal profile changes following maxillary advancement (MA) and maxillary advancement with impaction (MAI) with Le Fort I osteotomies. MethodsThe study consisted of preoperative and postoperative lateral cephalograms of 42 class III adult patients. The study sample was divided into 2 groups, with the first group composed of 22 patients who underwent MA surgery and the second group composed of 20 patients who underwent MAI surgery. In total, 7 skeletal parameters and 17 soft-tissue parameters related to nasal projection, hump, dorsal convexity, and the nasolabial region were evaluated on the cephalograms, and hard- and soft-tissue relationships were assessed. ResultsNasal length, hump, nasal depths, distance from the most convex point of the Alar curvature to the most inferior point of the nostril, alar curvature-subnasale, and subnasale-pronasale measurements decreased postoperatively. In the MAI group, MA correlated with significant decreases in nasal length and hump. In the MA group, MA correlated with pronasale position (P < 0.05); significant decreases in nasal depth, columella convexity, and subnasale-pronasale length; and significant changes in subnasale position. ConclusionsThere is little difference in the effects of the 2 different maxillary surgeries on the postoperative nasal profile.

Head Posture in Cleft Lip and Palate Patients With Oronasal Fistula and Its Relationship With Craniofacial Morphology

Objective: This study aimed to evaluate the relationship between head posture and craniofacial morphology in nonsyndromic cleft lip and palate children with oronasal fistula. Patients: A total of 31 cleft lip and palate patients with a mean skeletal age of 7.59 (±2.11) years were involved. Fifteen had complete unilateral cleft lip and palate, 13 had complete bilateral cleft lip and palate, and three had complete cleft palate. Each of the cleft patients was matched with a noncleft Class I subject, on the basis of sex and skeletal age. Design: Lateral cephalograms were taken of all subjects in the standardized upright posture and in orthoposition. Sixteen postural parameters and 44 morphological parameters were evaluated. Results: The correlations with the cranio-cervical and mandibulo-cervical parameters indicated a trend of retrusion in the incisors with extention of the head. The positive nontopographical relationship between the nasolabial angle and some of the postural parameters supplemented the retrusion tendency in the upper incisors with head extension. Vertical skeletal morphological parameters correlated with the postural parameters. Cranio-cervical parameters seemed to be mostly related to mandibular position. Conclusion: Most of the cranio-cervical parameters measured confirmed an increased cranio-cervical angulation in the cleft sample when compared to controls. This head posture change was associated with alterations in tooth position and craniofacial morphology when comparisons were made to the control group.

Orthognathic treatment of facial asymmetry due to temporomandibular joint ankylosis

The aim of this study was to present a case series of the orthognathic treatment of facial asymmetry due to temporomandibular joint (TMJ) ankylosis and to characterize the current treatment modalities through a literature review. Four patients who presented with facial asymmetry due to TMJ ankylosis between 2010 and 2014 were included in this study. TMJ ankylosis was surgically treated before bimaxillary surgery with advancement genioplasty in some of the cases. In 2 cases, 3-dimensional (3D) models were used for diagnosis and treatment planning, as 3D models are very important tools for planning surgical maneuvers. Aesthetically pleasant facial symmetry and a good facial profile were obtained in all the cases.

The effect of corticotomy on tooth movements during canine retraction

Objectives: The objective was to evaluate the effect of corticotomy/corticectomy surgery combined with fixed appliances on tooth movement during the canine retraction phase. Materials and Methods: We assessed 13 postpubertal patients (3 males and 10 females) requiring extraction of both maxillary first premolars. One side of the upper dental arch was treated with a PG retraction spring as a control, while the other side was treated with combined corticotomy/corticectomy surgery and a PG spring. A force of 100 g was used for canine retraction on both sides, with activation of the spring monthly on the control side and once every 15 days on the combined treatment side. A paired t-test was used to assess the difference between the two sides. Results: There was a small but statistically significant reduction in the duration of canine retraction (P < 0.05) and an increase in the rate of canine retraction (P < 0.05) (mm/month) in the combined treatment group. No difference in anchorage loss was observed between the groups. Tipping per millimeter of retraction was significantly different between the groups (P < 0.05). Conclusion: Corticotomy-assisted orthodontics increased the rate of tooth movement during canine retraction in 20% ratio. Relative bodily tooth movement was achieved with the corticotomy combined treatment.