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Biomedical subjects

Tülin Arun

Publications and source records attributed to Tülin Arun.

10 recordsLinked to original sources

Unilateral molar distalization with a modified slider.

Although there are numerous publications on bilateral non-compliance molar distalization appliances, there is limited information on problems such as asymmetrical unilateral Class II malocclusions. The aim of the present investigation was to examine the distalization of molars unilaterally in patients with a unilateral Class II molar relationship utilizing a Keles Slider, designed without a bite plane. Ten girls (mean age 13.94 +/- 2.13 years) and seven boys (mean age 13.12 +/- 1.51 years) comprised the study material. Following insertion of the appliance, the patients were seen monthly and the screw was reactivated every 2 months. After a super-Class I molar relationship was achieved, the appliance was removed and the molars were stabilized with a Nance appliance for 2 months before the second-phase of orthodontic treatment. The Nance appliance was maintained in the palate until the end of canine distalization. Lateral cephalometric radiographs were obtained before and immediately after insertion of the molar distalizer. The results showed that the maxillary first molars were distalized bodily on average by 2.85 mm. The maxillary first premolars moved forward bodily 2 mm and were extruded 2.03 mm. In all, 1.32 mm of protrusion, 1.12 mm of extrusion, and 1.79 degrees of proclination of the upper incisors were observed. The mandibular incisors and mandibular molars erupted 0.83 and 0.95 mm, respectively. The unilateral Keles Slider distalized molars successfully to a Class I molar relationship.

Adolescent↗

Sagittal airway dimensions following maxillary protraction: a pilot study.

The relationship between changes in the position of the maxillary structures caused by maxillary protraction therapy and airway dimensions have not been investigated as comprehensively as the accompanying skeletal changes. The purpose of this study was to examine the effects of rapid palatal expansion (RPE) used in conjunction with maxillary protraction headgear on the sagittal dimension of the airway. The treatment sample consisted of 19 Class III patients (12 girls, 7 boys) with a mean age of 10.51 +/- 1.15 years, presenting with maxillary retrognathism. A cap splint type rapid palatal expander that had hooks between the upper lateral and canine teeth was used intraorally, and a Petit type facemask device extraorally, for an average of 6.78 +/- 0.93 months. Pre- and post-treatment cephalometric radiographs were evaluated. The results of the study revealed that point A moved anteriorly. The palatal plane showed a counter-clockwise rotation matched by the clockwise rotation of the mandible and an accompanying decrease in SNB angle. The vertical parameters showed a statistically significant increase. The head was in a more extensive position in relation to the cervical vertebrae. The nasopharyngeal airway measurements (PNS-ad1, PNS-ad2) showed an increase of 2.71 +/- 3.35 and 3.03 +/- 2.37 mm, respectively. These results demonstrated that limited maxillary widening together with protraction of the maxilla, improve nasopharyngeal but not oropharyngeal airway dimensions in the short term.

Cephalometry↗

A comparative study of cephalometric and arch width characteristics of Class II division 1 and division 2 malocclusions.

The aim of this compound cephalometric and arch-width study was to determine any dental and/or skeletal differences between subjects with Class II division 1 and Class II division 2 malocclusions. The dento-skeletal characteristics of Class II subjects were evaluated using lateral cephalometric radiographs and dental casts of 90 untreated patients. The sample included 46 Class II division 1 patients (19 girls and 27 boys) with a mean age of 15.27 +/- 2.48 years, and 44 Class II division 2 patients (27 girls and 17 boys) with a mean age of 15.95 +/- 3.25 years. The intermolar, interpremolar and intercanine measurements were carried out on study models. The radiographs were digitized and processed using Dolphin Imaging software. In addition to standard descriptive statistical calculations, an independent samples t-test was carried out in order to compare the two groups. The non-parametric Mann-Whitney U test was utilized for the parameters for the data which were not normally distributed. The only statistically significant difference between the groups for the study model measurements was mandibular intercanine width. The cephalometric results revealed that SNB angle was responsible for the skeletal sagittal difference between the two groups. In addition, the Class II division 1 group had higher vertical proportions and the Class II division 2 group a more concave profile with a prominent chin. The sagittal skeletal pattern of Class II division 2 subjects was found to be very similar to the Class I skeletal relationship, with no evidence of any mandibular restriction.

Adolescent↗

The role of cervical headgear and lower utility arch in the control of the vertical dimension.

INTRODUCTION: This study was carried out to evaluate the treatment changes in skeletal and dental parameters in growing patients. METHODS: The sample consisted of 24 subjects with Class II Division 1 malocclusion. Half of the patients were treated with cervical headgear alone (group C, n = 12), and the other half received a combination of cervical headgear and lower utility arch (group CU, n = 12). The treatment groups were compared with a matched untreated control group (n = 12). The mean ages of the subjects at the beginning of the study were 8.85 +/- 1.19 years in group C, 9.23 +/- 0.76 years in group CU, and 8.62 +/- 0.78 years in the control group. The cervical headgear was used with an expanded inner bow and a 15 degrees to 20 degrees upward bend of the longer outer bow, worn 12 to 14 hours a day, with a force of 450 to 500 g per side. The lower utility arch was designed as described in the bioprogressive technique. Treatment changes were assessed on lateral cephalometric radiographs. RESULTS: The cervical headgear produced Class II correction through maxillary orthopedic and orthodontic changes. Anterior face height increased more in the treatment groups than in the control group. The treatment groups also displayed statistically significant increases in ramus height. Due to these effects, mandibular plane orientation stayed relatively unchanged. There was no opening rotation of the mandible in the treatment groups. The lower utility arch produced intrusion and lingual tipping of the mandibular incisors and distal tipping without extrusion of the mandibular molars. The treatment groups showed significant anterior descents of the palatal plane. Maxillary molar total extrusion produced by cervical headgear treatment was an average of no more than 1 mm as compared with the control group. The utility arch did not appear to influence mandibular rotational response.

Analysis of Variance↗

A comparative study of dental arch widths: extraction and non-extraction treatment.

The aim of this study was to determine the pre- and post-treatment width changes in the canine, premolar and molar regions in subjects treated with extraction of four first premolars, non-extraction, and non-extraction with rapid maxillary expansion (RME). Pre- and post-treatment orthodontic study models of 60 females (13.83 +/- 2.77 years) and 24 males (14.33 +/- 2.67 years) who underwent comprehensive orthodontic therapy were evaluated. Forty-two were treated non-extraction with fixed appliance therapy, 15 non-extraction with RME, and 27 with extraction of the first premolars. In addition to standard descriptive statistical calculations, one way ANOVA was used for comparison of the groups, and the post hoc Tukey multiple comparison test for comparison of the subgroups. The results revealed that the distance between the upper canines was not affected by the treatment modality. Upper premolar and molar arch widths increased more in the non-extraction subjects when compared with those with extractions, with the greatest increase in patients with RME. In the lower canine area the extraction group showed the widest arch width at the end of treatment. There was also a 0.60 mm decrease in the lower canine width in the non-extraction group. A decrease was found in lower inter-premolar and molar distances due to consolidation of the extraction spaces. When making a decision between non-extraction with maxillary expansion and extraction treatment modalities in borderline cases where there is constriction in the upper inter-premolar distance, apart from taking profile values into consideration, it should be borne in mind that expansion treatment can be helpful in achieving a wider arch form.

Adolescent↗

Comparative data on facial morphology and muscle thickness using ultrasonography.

The purpose of this investigation was to measure the thickness of the masseter, levator labii superioris, and zygomaticus major muscles; to examine the reproducibility of ultrasonographically measured muscle thickness; to evaluate the association between facial and masticatory muscle thickness and vertical facial pattern; and to test whether the variation in muscle thickness is related to the variation in the body mass index (BMI) of different individuals. The thickness of the masseter, levator labii superioris and zygomaticus major muscles was measured bilaterally by ultrasonography in 47 (23 females, 24 males) healthy, fully-dentate young adults who volunteered for the study. The measurements for each individual were performed twice for the masseter muscle: during relaxation and during maximal clenching. Standardized lateral cephalograms of the subjects were traced to determine their facial morphology. The data obtained from the lateral cephalograms were used to divide the subjects into three groups according to their vertical facial pattern: low angle (n = 14), high angle (n = 17) and normal (n = 16). In the low angle group, the mean masseter muscle thickness was 15.20 (+/- 1.90) mm under relaxed conditions and 16.31 (+/- 2.18) mm during maximal clenching. In the high angle group, the respective measurements were 13.29 (+/- 2.52) mm and 14.72 (+/- 2.63) mm. In the vertically normal group, they were 13.56 (+/- 1.95) mm and 14.57 (+/- 1.83) mm. There was no relationship between vertical growth of the face and the thickness of the investigated muscles of facial expression. Masseter muscle thickness was found to be significantly correlated to vertical facial pattern and BMI, showing that individuals with a thick masseter had a vertically shorter facial pattern, whereas the muscles of facial expression showed no relationship with vertical facial pattern.

Adult↗

Skeletal, dental and soft-tissue changes induced by the Jasper Jumper appliance in late adolescence.

The purpose of this study was to evaluate the skeletal, dental, and soft-tissue changes in late-adolescent patients treated with Jasper Jumpers applied with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 75 lateral cephalometric films. Among these radiograms, 15 were taken before the leveling stage in the treatment group. Half of the remaining 60 were taken before placement and after removal of the Jasper Jumper appliance in the treatment group and the other half at the beginning and six months after in the control group. The patient selection criteria were Class II malocclusion caused by retrognathic mandible, normal or low-angle growth pattern, and postpeak growth period. The statistical assessment of the data suggests that the sagittal growth potential of the maxilla was inhibited. There were no significant changes in the vertical skeletal parameters. The mandibular incisors were protruded and intruded, whereas the maxillary incisors were retruded and extruded. The upper molars tipped distally as the lower molars tipped mesially. Because of these changes, the occlusal plane rotated in the clockwise direction. Overbite and overjet were reduced, and the soft-tissue profile improved significantly. The results revealed that, in late-adolescent patients, the Jasper Jumper corrected Class II discrepancies mostly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.

Activator Appliances↗

Orthodontic approach for patients with severe periodontal disease.

Although comprehensive orthodontic treatment cannot preclude the possibility of periodontal disease developing later, it can be a useful part of the overall treatment plan for a patient who already has periodontal involvement. A careful clinical examination must determine the patient's dental health status, including any existing destruction or deficiencies of the teeth and their support, as well as the patient's ability to achieve and maintain good overall oral hygiene. Two major criteria should be considered in the treatment of these patients: (1) the patient should be seen frequently for periodontal maintenance and (2) minimal orthodontic forces should be applied. Segmented archwires could be used for the treatment mechanics. After treatment, splinting of the teeth is necessary both short- and long-term. With this orthodontic approach, both dental esthetics and function improve and can be maintained. A male patient, 50 years of age, with severe periodontal involvement was referred to the authors' clinic, from the periodontal department, for treatment. The mandibular incisors were intruded by using segmental archwires. At the end of treatment, permanent retention was required due to the severe bone loss.

Cephalometry↗

Vertical growth changes after adenoidectomy.

The purpose of this retrospective investigation is to compare vertical growth component of craniofacial structure of subjects with early and late adenoidectomy history. The study consisted of 93 lateral cephalometric radiographs of three groups of randomly selected patients. The first group was made up of 12 patients (10 male and two female) with an average age of 11.16 +/- 2.08 years, who had been operated upon between 1.5-4 years of age. The second group was made up of 54 patients (25 maleand 29 female) with an average age of 12.18 +/- 2.6 years, who had been operated upon after four years of age. The third group of 27 patients (7 male and 20 female) with clear airway with an average age of 11.18 +/- 2.35 years was used as the control. The data obtained from two adenoidectomy groups were compared and because no statistically significant difference was found except for ANSMe/NMe, the two groups were pooled and compared with the growth pattern in the control sample. There were statistically significant differences in the following parameters: SNGoMe, PPGoMe angle, Gonial angle, Gonial ratio, sigma of inner angles, ANSMe/NMe ratio, Jarabak ratio, PNS-adl distance, PNS-ad2 distance, OAW1 distance. When compared with the control group, the adenoidectomy group showed a more vertically directed growth pattern, however, there were no vertical growth pattern differences between the two groups of children who had adenoidectomy before and after four years of age.

Adenoidectomy↗

Treatment of condylar hypoplasia with distraction osteogenesis: a case report.

This report describes the surgical-orthodontic treatment procedures of a patient with condylar hypoplasia. Condylar hypoplasia is a major factor in any facial abnormality in a growing child. This case report describes a patient with a facial anomaly with an acquired unilateral condylar hypoplasia. His asymmetry was corrected by using functional therapy for the correction of muscle tonus and distraction osteogenesis for lengthening the mandibular ramal height. Fixed orthodontic appliances were used for conventional orthodontic therapy and final occlusal adjustment.

Bite Force↗