Tek ve Çift Taraflı Dudak ve Damak Yarıklı Hastalarda Maksiller Genişletme ve İlerletme Uygulamasının Değerlendirilmesi

Year 2021, Volume: 4 Issue: 3, 328 - 334, 01.09.2021

Luay Ali Zaidan , Alev Aksoy

https://doi.org/10.19127/bshealthscience.872315

Abstract

Dudak ve damak yarıkları; genetik ve çevresel nedenlerden dolayı ortaya çıkan en yaygın kraniyofasiyal anomalilerdir. Dudak ve damak yarıklı bireylerde solunum, işitme ve konuşma gibi fonksiyonel ve psikososyal sorunlar meydana gelmekte ve bu nedenle de bu bireyler multidisipliner tedavilere gereksinim duymaktadır. Dudak ve damak yarıklarının onarımı sonrası iyi bir fonksiyon, estetik ve yumuşak doku rekonstrüksiyonu elde etmek için erken yaşta alveolar yarıkların onarılması gerekmektedir. Alveolar kemik grefti uygulanan cerrahi işlemler, kemik formasyonunu oluşturur; oronasal fistülü ortadan kaldırır, ortodontik problemin nüksetmesini önler ve protetik tedavileri kolaylaştırır. Bu cerrahi işlemler, avantajlarına rağmen dudak damak yarıklı bireylerde skar oluşumuna sebep olur. Bu skar dokusu maksillanın sagital, vertikal ve transversal gelişimini ve pozisyonunu olumsuz yönde etkiler. Dolayısıyla maksiller diş kavsi daralır ve bu durum posterior çapraz kapanışa neden olur. Maksillanın genişletilmesi (maksiller genişletme apareyleri ile) ve ilerletilmesi (yüz maskesi ile) oluşan pozisyonel ve gelişimsel yetersizliklerin giderilmesinde kullanılır. Bu derlemenin amacı; tek veya çift taraflı dudak ve damak yarıklı bireylerin genişletme ve ilerletme uygulamaları sonucunda fasiyal morfolojilerinde meydana gelen iskeletsel, dentoalveolar ve yumuşak doku değişikliklerinin değerlendirilmesidir.

Keywords

Dudak ve damak yarıkları, Kemik grefti, Maksiller genişletme ve ilerletme

Evaluation of Maxillary Expansion and Protraction in Unilateral and Bilateral Cleft Lip and Palate Patients

Abstract

Cleft lip and palate are the most common craniofacial anomalies that occur due to genetic and environmental reasons. The deformities of the dentofacial system in patients with cleft lip and palate patients cause functional and psychosocial problems such as respiration, hearing and speech in the individual and therefore multidisciplinary work needs of specialization areas in different departments. İn early age; cleft lip and palate need to be repaired to obtain a good aesthetic and functional result and a good soft tissue reconstruction after repair. The defects in the bones can be removed by secondary bone grafting which considered as accepted treatment now. These surgical procedures, which form bone formation, eliminate oronasal fistulae and at the same time preventing the relapse of orthodontic treatment and facilitates prosthetic treatments, all of these consider a good advantageous, but in these patients, premature scar formation of the lip and palate repair caused by developmental or positional anomalies are seen in sagittal, vertical and transversal area in the upper jaw affected in the negative direction, caused by maxillary dental arch narrowing and posterior crossbite formation, mostly inhibiting maxillary development. Maxillary expansion and protraction are performed at the correction of this positional and developmental retardation by using maxsillary expandors and face mask respectivly. The purpose of this article is to evaluate skeletal, dentoalveolar and soft tissue changes in facial morphology of individuals with unilateral or bilateral cleft lip and palate with Class III malocclusion that treated with maxillary expantion and protraction.

Keywords

Cleft lip and palate, Bone grafting, Rapid maxillary expansion

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