Hüsamettin Oktay

A study on the pharyngeal size in different skeletal patterns

In the present study, pharyngeal size was investigated on the lateral cephalometric head films of 90 subjects, 45 males and 45 females, having different ANB angles. All of the subjects were aged 13 to 15 years. The films were taken at natural head position, and all were divided into three groups according to the ANB angle: ANB angles smaller than 1 degree, between 1 degree and 5 degrees, and larger than 5 degrees. In addition, each group was also divided into two subgroups according to sex. The effects of the ANB angle and sex on the pharyngeal size were investigated by means of variance analysis. It has been observed that two measurements, hy-apw4 and oropharynx area measurements, were affected by the change of ANB angle, and two other measurements, t-ppw and hy-apw2 measurements, by the sex; and that hy-apw4 measurement and oropharynx area became smaller with the increase of ANB angle.

A comparison of ANB, WITS, AF-BF, and APDI measurements

In the present study, the relationships among ANB, Wits, AF-BF, and APDI measurements used in the assessment of the anteroposterior jaw disorders were examined on the cephalometric radiographs of 63 male and 82 female subjects, and high correlations were found among them. Furthermore, relationships were explored between these parameters and some measurements that were thought to have influenced them. The results of the geometric studies could not be proved on the basis of statistical evaluation.

Condylar asymmetry in unilateral posterior crossbite patients

INTRODUCTION Posterior crossbite is defined as an abnormal buccolingual relationship between opposing posterior teeth including the canines in centric occlusion. The most common form of posterior crossbite is unilateral with a functional shift of the mandible toward the crossbite side. Lateral shift of the mandible in functional crossbite patients results in mandibular skeletal deflection to the crossbite side. Thus, the asymmetrical position of the mandible in these patients can result in asymmetrical condylar heights. The purpose of this study was to investigate condylar and ramal asymmetries in unilateral crossbite patients as compared with normocclusive subjects. METHODS The study groups included 81 patients with unilateral posterior crossbite and a control group of 75 patients with normal occlusion. Condylar, ramal, and condylar-plus-ramal asymmetry values were computed for all subjects on panoramic radiographs. Data were analyzed statistically with ANOVA for repeated measures and univariate ANOVA. RESULTS The patients with unilateral posterior crossbite had more asymmetric condyles than did the controls. In addition, condylar, ramal, and condylar-plus-ramal heights on the crossbite side were smaller than those on the noncrossbite side. CONCLUSIONS Subjects with functional unilateral posterior crossbite have asymmetrical condyles.

Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: A literature review

OBJECTIVE Rapid maxillary expansion (RME) is a dentofacial orthopedic treatment procedure which has been routinely used in young patients. Main goal of RME is to correct the existing posterior crossbite and to widen the maxilla and maxillary dental arch. However, a concomitant and contributing benefit of this procedure is an improvement on nasal airway which facilitates nasal respiration. RME brings about not only an increase in nasopharyngeal airway dimensions and an improvement in nasal respiration but also a decrease in naso-respiratory problems of the patients having maxillary constriction and mouth breathing. The purpose of this article is to review the effects of RME on naso-respiratory and breathing problems caused by maxillary constriction and mouth breathing in growing children. CONCLUSION Although orthodontic treatment is carried out to correct dental and skeletal discrepancies, some authors showed that treatment outcomes of RME could also effective on naso-respiratory and sleep-disordered breathing problems of the growing children. However, it must be kept in mind that this respect of RME was evaluated in a little number of studies and had a low-level of evidence.

Maxillary protraction appliance effect on the size of the upper airway passage.

OBJECTIVE To test the hypothesis that maxillary protraction appliances (MPA) have no effect on the size of the upper airway passage and craniofacial structures in adolescent patients. MATERIALS AND METHODS Twenty patients (5 male and 15 female; mean age 11.5 years) with skeletal Class III malocclusion were included in this study. The records of all patients who had maxillary protraction treatment and had lateral head radiographs taken before and after their protraction treatments were obtained from the files of treated cases. Treatment changes were determined by means of linear, angular, and area measurements. Data were analyzed statistically by means of paired t-test and correlation analysis. RESULTS Significant increases were observed in the width and area of the pharyngeal airway. Significant increases also occurred in the sagittal growth of the maxilla, while a clockwise rotation and inhibition of sagittal growth were observed in the mandible. CONCLUSIONS The hypothesis was rejected. The size of the upper airway can be increased by means of MPA application.

Investigation of Transmigrated and Impacted Maxillary and Mandibular Canine Teeth in an Orthodontic Patient Population

PURPOSE The objectives of the present study were to determine the frequency and gender difference of transmigrated and impacted canines and to evaluate the characteristics and treatment protocols in a Turkish orthodontic patient population. MATERIALS AND METHODS We designed a retrospective study composed of pretreatment and post-treatment dental casts, intraoral photographs, and full mouth periapical and panoramic radiographs of 2,215 patients (1,275 females and 940 males). Observations were made regarding impacted mandibular and maxillary canines, retained deciduous canines, patient gender and age, side and number of transmigrated canines and associated pathologic features, and treatment of the impacted canines and transmigrated canines. The Pearson chi(2) test and Fishers exact test were used to determine the potential differences in the distribution of canine impaction and transmigration when stratified by gender. RESULTS The frequency of patients with impacted and transmigrated canines was 5.1% and 0.3%, respectively. None of the patients with a transmigrated mandibular canine had any pathologic changes; however, the maxillary transmigrated canine was associated with impacted mesiodens. All transmigrated canines were unilateral and impacted. Four canines migrated from the left to right, and 2 migrated from right to left. Of 6 patients, 2 had retained primary canines and 4 had exfoliated primary canines. Three of the transmigrated mandibular canines were type 1 and 2 were type 2. In the treatment protocol, 4 impacted mandibular canines and 78 maxillary canines were surgically exposed for orthodontic treatment, 4 of 6 transmigrated canines were surgically removed, and 2 were observed periodically. CONCLUSIONS If the diagnosis of canine impaction and transmigration in patients is made earlier, it is possible that the tooth might have been in a better position for orthodontic eruption into the arch. Careful patient selection and preparation are therefore essential, as is cooperation between the orthodontist and oral surgeon.

The effect of rapid maxillary expansion on conductive hearing loss.

OBJECTIVE To test the null hypothesis that rapid maxillary expansion (RME) with a rigid bonded appliance has no effect on conductive hearing loss (CHL) in growing children. MATERIALS AND METHODS Fifteen growing subjects (mean age 13.43 +/- 0.86 years) who had narrow maxillary arches and CHL participated in this study. Three pure-tone audiometric and tympanometric records were taken from each subject. The first records were taken before RME (T1), the second after maxillary expansion (T2) (mean = 0.83 months), and the third after retention (mean = 6 months) and fixed appliance treatment (approximately 2 years) periods (T3). The data were analyzed by means of analysis of variance (ANOVA) and least significant difference (LSD) tests. RESULTS Hearing levels of the patients were improved and air-bone gaps decreased at a statistically significant level (P < .001) during active expansion (T2-T1) and the retention and fixed appliance treatment (T2-T3) periods. Middle ear volume increased in all observation periods. However, a statistically significant increase was observed only in the T2-T3 period. No significant change was observed in the static compliance value. CONCLUSIONS The hypothesis is rejected. RME treatment has a positive and statistically significant effect on both improvements in hearing and normal function of the eustachian tube in patients having transverse maxillary deficiency and CHL.

A comparison of dentoalveolar inclination treated by two palatal expanders.

The objective of the present study was to evaluate buccal dentoalveolar inclinations in subjects treated with a Hyrax (tooth-borne) or acrylic-bonded (tooth-tissue borne) palatal expander. The sample comprised 39 patients (10 males and 29 females) aged between 11 and 16 years randomly assigned to two groups. Rapid maxillary expansion (RME) was carried out with a Hyrax appliance in one group (n = 21) and with an acrylic-bonded appliance in the other (n = 18). Their mean ages were 13 years 9 months and 13 years 6 months, respectively. Orthodontic study models were obtained before RME (T1) and approximately 1 week after completion of maxillary expansion (T2). A line of barium sulphate solution was drawn between the upper first molars on the models, and radiographs were taken. The radiographic images of the models were transferred to digital medium, and buccal tipping of the molar crowns and alveolar processes were evaluated by means of a software program. The data were analysed by paired and Students t-tests. Both RME appliances produced significant (P < 0.001) dentoalveolar tipping during RME, but this was greater in the Hyrax group (P < 0.05).

Condylar asymmetry in bilateral posterior crossbite patients.

OBJECTIVE To investigate whether patients with bilateral posterior crossbite have asymmetrically developed condyles. MATERIALS AND METHODS The study group consisted of 75 patients with bilateral posterior crossbite, and a control group of 75 subjects with normal occlusion. Condylar, ramal, and condylar plus ramal asymmetry values were computed for all of the subjects on orthopantomograms. Data were analyzed statistically by means of paired t-test and Students t-test. RESULTS The patients with bilateral posterior crossbite had more asymmetrical condyles relative to the controls. However, there were no statistically significant differences in condylar, ramal, or condylar plus ramal heights between left and right sides in both the control and crossbite groups. CONCLUSION Patients with bilateral posterior crossbite can have asymmetrical condyles and might be at risk for the development of future skeletal mandibular asymmetries.

The study of the maxillary sinus areas in different orthodontic malocclusions

In the present study, the maxillary sinus areas have been investigated on orthopantomographs of 103 male and 86 female subjects either with ideal occlusions or with malocclusions. It has been found that malocclusions and sex factors have no effect on the size of the maxillary sinuses, and that sex is a significant factor only in Angle Class II malocclusions. The female subjects with Angle Class II malocclusions have larger maxillary sinuses than the male subjects and the other groups of female subjects.