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Biomedical subjects

Ahmet Keles

Publications and source records attributed to Ahmet Keles.

7 recordsLinked to original sources
PubMed2004

The use of skeletal anchorage in open bite treatment: a cephalometric evaluation.

The aims of the present study were to assess the effectiveness of skeletal anchorage for intrusion of maxillary posterior teeth, to correct open bite malocclusion, and to evaluate the usage of titanium miniplates for orthodontic anchorage. Anterior open bite is one of the most difficult malocclusions to treat orthodontically. Currently, surgical impaction of the maxillary posterior segment is considered to be the most effective treatment option in adult patients. Various studies have reported the use of implants as anchorage units at different sites of midfacial bones for orthodontic tooth movement. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. Ten patients, 17 to 23 years old and characterized with an anterior open bite and excessive maxillary posterior growth, were included in this preliminary study. Titanium miniplates were fixed bilaterally to the zygomatic buttress area, and a force was applied bilaterally with nine mm Ni-Ti coil springs between the vertical extension of the miniplate and the first molar buccal tube. The results showed that, with the help of skeletal anchorage, maxillary posterior teeth were intruded effectively. As compared with an osteotomy, this minimally invasive surgical procedure eased treatment and reduced treatment time and did not require headgear wear or anterior box elastics for anterior open bite correction. In conclusion, the zygomatic area was found to be a useful anchorage site for intrusion of the molars in a short period of time.

Adolescent↗
PubMed2003

Bodily distalization of molars with absolute anchorage.

Palatal implants have been used over the last two decades to eliminate headgear wear and to establish stationary anchorage. In this case report, the stability of a palatal implant for distalization of molars bodily and for anchorage maintenance was assessed. The implant was a stepped screw titanium (4.5 mm diameter x 8 mm length), and it was placed in the palatal region for orthodontic purposes. A surgical template containing a metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. The implant was placed using a noninvasive technique (incision, flap, and suture elimination) and left transmucosally to facilitate the surgical procedure and to reduce the number of operations. The paramedian region was selected (1) to avoid the connective tissues of the palatine suture and (2) because it is considered to be a suitable host site for implant placement. After three months of healing, the implant was osseointegrated and orthodontic treatment was initiated. For molar distalization, the Keles Slider appliance was modified and, instead of a Nance button, a palatal implant was used for anchorage. The results showed that the molars were distalized bodily at five months, and no anchorage loss was observed. At the end of the treatment, the smile was improved, and an ideal Class I molar and canine relationship, an ideal overbite, and an ideal overjet were all achieved. In conclusion, palatal implants can be used effectively for anchorage maintenance and in space-gaining procedures. Use of a three-dimensional surgical template eliminated implant placement errors, reduced chair time, minimized trauma to the tissues, and enhanced osseointegration. This method can be used effectively to achieve distalization of molars bodily without anchorage loss.

Adolescent↗
PubMed2002

Effect of varying the force direction on maxillary orthopedic protraction.

The aim of this study was to examine the effect of varying the force direction on maxillary protraction. A total of 20 patients with class III maxillary retrognathism were randomly divided into two groups. Group 1 was comprised of nine patients with a mean age of 8.58 years, and group 2 was composed of 11 patients with a mean age of 8.51 years. Both groups received a cap splint-type rapid palatal expander and the screw was activated twice a day for 10 days. After the expansion procedure the face mask protraction procedure was initiated. In group 1, we applied the force intraorally from the canine region with a forward and downward direction at a 30 degrees angle to the occlusal plane. In group 2, the force was applied extraorally 20 mm above the maxillary occlusal plane. In both groups a unilateral 500 g force was applied and the patients were instructed to wear the face mask for 16 h/d for the first three months and 12 h/d for the next three months. The Wilcoxon sign rank test was used to evaluate the effect of the two different face masks, and a Mann-Whitney U-test was carried out to evaluate the differences between the two groups. The results showed that both force systems were equally effective to protract the maxilla; however, in group I we observed that the maxilla advanced forward with a counter-clockwise rotation. In group 2 we observed an anterior translation of maxilla without rotation. The dental effects of both methods were also different. The maxillary occlusal plane did not rotate in group 1, in contrast to the clockwise rotation in group 2. The maxillary incisors were proclined slightly in group 1, but in contrast they were retroclined and extruded in group 2. In conclusion, the force application from near the center of resistance of the maxilla was an effective method to prevent the unwanted side effects, such as counter-clockwise rotation of the maxilla, in group 1. The group 2 results suggest that this method can be used effectively on patients who present as class III combined with an anterior open bite.

Biomechanical Phenomena↗
PubMed2002

Unilateral distalization of a maxillary molar with sliding mechanics: a case report.

INTRODUCTION: A unilateral Class II relationship could arise due to early loss of an upper second deciduous molar on one side during the mixed dentition period. This would allow the mesial drift of the molars, which may block the eruption of the second premolar. METHODS AND RESULTS: A 15-year 8-month-old male patient presented with a Class II molar relationship on the right, and Class I canine and molar relationship on the left side. His E was extracted when he was 5 years old. The 54 were impacted and the 3 was ectopically positioned due to the space loss from the mesial migration of the 76. In addition 21 1 were in cross-bite. Skeletally he had Class III tendency with low MMPA. He presented with a straight profile and retruded upper lip. For maxillary molar distalization, a newly developed 'Keles Slider' was used. The appliance was composed of one premolar and two molar bands, and the anchorage unit was composed of a wide Nance button. 46 were connected to the Nance button and, therefore, included into the anchorage unit. The point of distal force application was close to the centre of resistance of the 6 and parallel to the occlusal plane. Ni-Ti coil springs were used and 200 g of distal force was applied. Seven months later the space required for eruption of the permanent premolars and canine was regained, and the anterior cross-bite corrected. The appliance was removed and final alignment of the teeth was achieved with fixed appliances. CONCLUSION: At the end of the second phase treatment Class I molar and canine relationship was achieved on the both sides, the anterior cross-bite was corrected, inter-incisal angle was improved, and ideal overbite and overjet relationship was achieved. The active treatment time was 27 months.

Adolescent↗
PubMedDate not supplied

Method for the placement of palatal implants.

PURPOSE: Palatal implants have been used in the last 2 decades to eliminate headgear wear and to establish stationary anchorage. The aim of this investigation was to establish a method and easy protocol for palatal implant placement. MATERIALS AND METHODS: The study comprised 8 male and 15 female patients each having a 4.5 x 8-mm stepped screw titanium implant placed in the palatal region for orthodontic purposes. A surgical template containing metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. Implants were placed using a noninvasive technique (incision, flap, and suture elimination) and left transmucosally to facilitate the surgical procedure and reduce operations. The paramedian region was selected so as to avoid connective tissues of the palatine suture and because it was considered to be a suitable host site for implant placement. RESULTS: After 3 months of healing, all implants were osseointegrated and no implant was lost throughout the orthodontic treatment. DISCUSSION: Palatal implants can be used effectively for anchorage maintenance and space-gaining procedures. CONCLUSION: Usage of a 3-dimensional surgical template eliminated faulty implant placement, reduced chair time, and minimized trauma to the tissues while enhancing osseointegration.

Adult↗