Metin Orhan

Effect of Rapid Maxillary Expansion on Nocturnal Enuresis

One of the effects of rapid maxillary expansion (RME) is a reduction in nighttime bed-wetting. The aim of this prospective study was to investigate the effects of RME on nocturnal enuresis (NE) in children who are liable to psychosocial stress conditions. Eight children (six boys and two girls) who had not responded to different conventional medical treatments were included in the study. The subjects were between eight and 11 years of age with a mean age of nine years five months, and were residents of a government orphanage. All the children wet the bed at least one time every night and previously had been subjected to unsuccessful conventional treatment modalities. Maxillary expansion was performed using a rigid acrylic RME device. Lateral and PA cephalometric films and dental casts were used in the assessment of the dentofacial and nasopharyngeal structures. Data were analyzed using a paired t-test. In seven of the eight children, remarkable improvement was observed in NE after three to six mm RME. At the end of eight months observation, the mean rate of improvement in bed-wetting in the seven successful subjects was 74.2% (57.6-87.5%). The findings also indicated significant changes in the nasomaxillary structures and nasopharyngeal airway dimensions with the use of RME. However, none of the subjects became completely dry, and the disorder is probably multicausal including psychological emotions and tensions. This study demonstrated that RME treatment could cause relief for the enuretic children. However, the long-term success rate is still questionable.

Influence of lower facial height changes on frontal facial attractiveness and perception of treatment need by lay people.

OBJECTIVE To test the hypothesis that lower facial height has no influence on frontal facial attractiveness and treatment need perception of lay people. MATERIALS AND METHODS Frontal facial silhouettes of a man and a woman with normal lower facial height values (male: 81.5 mm; female: 70.5 mm) were modified by increasing and decreasing their lower facial heights in steps of 1 mm to obtain frontal images with different lower facial height alterations ranging from +6 mm to -6 mm for each sex. A panel of 100 lay people scored each silhouettes attractiveness on a 100-mm visual analogue scale (VAS) and also indicated whether they would seek treatment if the image represented their own. The Wilcoxon signed rank test was used to compare the VAS scores. RESULTS Unaltered +/-1-mm and +/-2-mm silhouettes got the highest VAS scores. Scores were significantly lower (P < or = .001) as the divergence from the normal value exceeded 2 mm. Beyond +3 mm and -4 mm in females and +4 mm and -3 mm in males the difference between the scores became statistically insignificant. At +/-4 mm, more than 75% of the raters elected to have treatment. CONCLUSION The hypothesis was rejected.

Mandibular Symphyseal Distraction and Its Geometrical Evaluation: Report of a Case

In this report, the case of a patient who has been treated with a different use of a tooth-borne custom-made mandibular symphyseal distraction device is presented. The difference in the application is that the distal arm of the device was sectioned during the retention phase to allow the possible relapse of displaced condyles to their original positions while the labial segment expansion is being maintained. The effect of this procedure was also evaluated on a geometrical model using measurements from the patients cast. We conclude that symphyseal distraction is an effective and fast method of correcting orthodontic anomalies. The effect of the procedure on the condyle was only 3 degrees of distolateral rotation as calculated using the geometrical model.

Effect of complete dentures on dynamic measurement of changing head position: A pilot study.

STATEMENT OF PROBLEM Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited. PURPOSE The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking. MATERIALS AND METHODS The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05). RESULTS Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015). CONCLUSION The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically significant change. The overall effect of wearing dentures was an irregular flexion or extension pattern on dynamic head posture.

Selçuk type headgear-timer (STHT).

The Selçuk type headgear-timer (STHT) is described and tested under laboratory conditions first and then in a controlled patient study. The timing device was compared with real time measurements for 4 months. Accuracy was determined to be absolute (100%). The STHT was determined to be independent of force variables, easy to construct, rugged, and inexpensive. In the clinical test, 10 patients were instructed to wear the extraoral appliance for 16 hours a day. After a 2-month treatment period, the timing mechanisms were introduced to the patients and a subsequent 2-month treatment period was initiated. At the end of the second period, headgear wear was increased 26%. This significant improvement in patient compliance with the STHT timing device, attached to a standard breakaway type headgear, has the likelihood of enhancing treatment results. A foolproof method of assessing actual duration of wear is now available.

Effects of modified and conventional facemask therapies with expansion on dynamic measurement of natural head position in Class III patients

INTRODUCTION The aim of this prospective clinical trial was to assess the effects of varying force directions on the dynamic measurement of natural head position and orofacial airway dimensions of Class III patients during maxillary orthopedic protraction compared with an untreated control group. METHODS The conventional facemask group comprised 15 patients (8 girls, 7 boys; mean age, 9.6 ± 1.3 years), the modified facemask group comprised 15 patients (7 girls, 8 boys; mean age, 9.5 ± 1.5 years), and the control group comprised 15 subjects (7 girls, 8 boys; mean age, 9.8 ± 1.6 years). Natural head position measurements and cephalometric records were obtained from all subjects before and after treatment or the control period (approximately 1 year). An inclinometer and a portable data logger were used to collect the dynamic natural head position data. For statistical comparisons, paired samples t tests, analysis of variance (ANOVA), and post-hoc Tukey tests were used at the P <0.05 level. RESULTS Both treatment groups showed statistically significant changes in the sagittal (pitch) measurements of natural head position and upper pharynx, aerial, and total area of airway measurements during the treatment period. In the control group, the only statistically significant change was an increased upper pharynx measurement (P = 0.020). According to the intergroup comparisons, statistically significant natural head position differences were found in the conventional (6.4° flexion) and the modified (5.7° flexion) facemask groups when compared with the controls. The modified facemask group also showed significant changes in aerial (P = 0.003) and total (P <0.001) areas of the airway measurements compared with the control group. No statistically significant differences were observed between the 2 treatment groups. CONCLUSIONS These findings suggest that modified and conventional facemask therapy with expansion have significant cranial flexion effects on the dynamic measurements of natural head position. Additionally, the modified facemask procedure showed significant effects on the orofacial airway dimensions compared with the initial values and the values of the untreated controls.

Rapid maxillary expansion effects on dynamic measurement of natural head position

OBJECTIVE To identify the effect of rapid maxillary expansion (RME) procedure on dynamic measurement of natural head position (NHP). MATERIALS AND METHODS The treatment group comprised 23 patients, 12 girls and 11 boys (mean age: 10.1 ± 1.1 years), and the control group comprised 15 subjects, 8 girls and 7 boys (mean age: 9.7 ± 1.4 years). The test subjects underwent RME treatment using full cap acrylic device, and the mean amount of expansion was 5.48 mm. An inclinometer and a portable data logger were used to collect the NHP data. Intragroup changes were evaluated by using nonparametric Wilcoxon test, and intergroup changes were analyzed with Mann-Whitney U-test. P values less than .05 were considered statistically significant. RESULTS The mean difference between initial and final NHP was 0.31°, and this difference was not statistically significant. Also, there were no statistically significant differences between the RME and control groups before and after treatment. CONCLUSION Treatment with the RME procedure showed no statistically significant effects on dynamic measurement of NHP when compared with initial values or untreated control.

Correction of the Sizes and Forms of the Jaws

For the correction of skeletal malocclusions, conventional orthognatic surgical methods can be utilized in adults; however, these surgical procedures have limitations due to the acute advancement of bones [715–717]. Due to the resistance of the soft tissues to acute stretching and the difficulty of adaptation, sufficient bone advancement can not be achieved, thus resulting in relapse [718–721].

Dudak Damak Yarıklı Bireylerde Konuşma Bozukluklarının Önemi, Konuşma Terapisi ve Distraksiyon Osteogenezin Değerlendirilmesi: İki Olgu Nedeniyle

OZET Bu calismanin amaci, dudak damak yarikli bireylerde gozlenen konusma bozukluklarinin onlenebilmesi ve/veya duzeltilebilmesi icin ameliyat sirasinda ve sonrasinda dikkat edilmesi gerekenleri ortaya koymak, konusma terapisinin onemini vurgulamak, ameliyat sonrasi konusma terapisi yapilmazsa tedavinin yetersiz kalabilecegine ve konusma terapisi yapilinca elde edilen carpici degisimlere dikkat cekmektir. Bu amacla, yumusak damak yarigi gec opere edilmis sadece konusma problemleri olan, 21 yasinda bir bayan hasta ile bilateral dudak damak yarigi erken yaslarda cerrahi olarak onarilmis ancak halen oronazal fistulu, konusma, fonksiyon ve estetik problemleri olan 17 yasinda bir bayan hasta incelenmistir. Birinci hastaya uzman bir konusma terapisti tarafindan 8 aylik konusma terapisi uygulanmis, konusma hatalarinda belirgin bir azalma ve konusma anlasilabilirliginin arttigi gozlenmistir. Ikinci hastada ise maksiler birinci molarlar ile ikinci premolarlarin kokleri arasindan yapilan osteotomi ve “Posterior Mak...

MAKSİLLER ANTERİOR DİŞERİN “ANTERİOR HEADGEAR” İLE “KÜTLESEL” (EN MASSE) RETRAKSİYONU (YENİ BİR UYGULAMA)*

OZET: Bircok ortodontik tedavi yonteminde, maksiller 1. premolar cekimi sonrasinda keserlerin retraksiyonu, kanin distalizasyonunu takiben gerceklestirilmektedir. Maksimum ankraj vakalarinda ise, bu durum posterior ankrajin desteklenmesini gerektirmektedir. Bu tedavi yaklasimi halen gecerliligini surdurse de, ankraj kontrolu bu tur tedavilerin en onemli zorlugu olarak karsimiza cikmaktadir. Calismamizin amaci, 1. premolar dislerin cekimi sonrasinda, maksiller anterior segmentin, bir butun olarak retraksiyonu amaciyla gelistirdigimiz mekanigi sunmak ve bu teknikle tedavi ettigimiz 2 vakanin bulgulari ile birlikte yontemimizi tartismaktir. Maksiller anterior dislerin blok haline getirilmesi ile birlikte kanin dislere agiz disi traksiyon uygulamasindan ibaret olan mekanigimizin su avantajlari vurgulanmistir, 1. “Anterior Headgear” maksiller anterior dislerin retraksiyonunda, posterior ankrajin zorlanmasina yol acmaz. 2. Yuz arkinin dis kollarinin, premaksillanin direnc merkezine gore ayarlanabilirligi bu bol...