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Sınıf III malokluzyonlarında uygulanan tedavi sistemleri

Yıl 2008, Cilt: 11 Sayı: 1, 53 - 58, 11.11.2011

Burcu Balos Tuncer

Öz

Skeletal Class III malocclusion with a prognathic mandible is one of the most severe maxillofacial deformities. Esthetics and functions are strongly effected and the treatments are long and hard in these malocclusions. Mandibular prognathism or maxillary retrusion or both might cause this type of malocclusions. Treatment approaches depend on the etiology, the severity of the malocclusion and the developmental stage of the subject. In growing children facial growth modification can be an effective method. Orthopedic appliances such as chincup, face mask, maxillary protraction and the functional appliances are mainly used for the correction of Class III malocclusions. In adults fixed orthodontic treatment and orthognathic surgery is required. Within recent years, the number of studies have increased presenting the use of distraction osteogenesis. This review summarizes the etiology, treatment strategies and effects of the different treatment approaches in Class III malocclusions.

 

ÖZET

Sınıf III malokluzyonlar, maksillofasiyal deformiteler içinde en ciddi anomalilerden biridir. Bireylerde estetik ve fonksiyon açısından yetersizliğe yol açan ve tedavileri oldukça uzun ve zor anomalilerdir. Bu malokluzyonlara alt çene prognatisi, üst çene retruzyonu veya her ikisi birden sebep olabilir. Tedavi yaklaşımları malokluzyonun kaynaklandığı çeneye, etiyolojisine, malokluzyonun şiddetine ve bireyin içinde bulunduğu büyüme gelişim dönemine bağlı olarak

değişir. Büyüme dönemindeki çocuklarda yüz büyümesinin yönlendirilmesi etkili bir tedavi yaklaşımıdır. Bu amaçla; çenelik, yüz maskesi veya bazı fonksiyonel apareyler kullanılmaktadır. Erişkin dönemdeki bireylerde ise sabit ortodontik tedaviler ve ortognatik cerrahi yaklaşımları uygulanmaktadır. Son yıllarda distraksiyon osteogenezis yöntemi ile yapılan çalışmalara rastlanmaktadır. Bu derlemede, sınıf III malokluzyonların etiyolojileri, tedavi stratejileri ve farklı tedavi etkileri özetlenmiştir.

Anahtar kelimeler: Sınıf III malokluzyon, çenelik, yüz maskesi, fonksiyonel tedavi, distraksiyon osteogenezis

Anahtar Kelimeler

Class III malocclusion; chincup; face mask; functional therapy; distraction osteogenesis

Kaynakça

  • Chang HP, Tseng YC, Chang HF. Treatment of mandibular prognathism.Review. J Formos Med Assoc 2006; 105: 781-90.
  • Dibbets JMH. Mandibular Rotation and Enlargement. Am J Orthod Dentofacial Orthop 1990; 98: 29-32.
  • Williams S, Andreasen CE. The Morphology of Potential Class III Skeletal Pattern in Growing Child. Am J Orthod Dentofacial Orthop 1986; 89: 302-11.
  • Ellis E, MCNamara JA JR. Components of Adult Class III Malocclusion. J Oral Maxillofac Surg 1984; 42: 295-305.
  • Delaire J. Maxillary Development Revisited: Relevance to the Orthopedic Treatment of Class III Malocclusions. Eur J Orthod 1997; : 289-311.
  • Garattini G, Levrini L, Crozzoli P, Levrini A. Skeletal and Dental Modifications Produced by the Bianator III Appliance. Am J Orthod Dentofacial Orthop 1998; 114: 40-4.
  • Sakamoto T, Iwase I, Uka A, Nakamura S. A Roentgenocephalometric Study of Skeletal Changes During and After Chin cup Treatment. Am J Orthod Dentofacial Orthop 1984; 85: 341-50.
  • Deguchi T, Mc Namara JA. Craniofacial Adaptations Induced by Chin cup Therapy in Class III Patients. Am J Orthod Dentofacial Orthop 1999; 115: 175-82.
  • Deguchi T, Kuroda T, Minoshima Y, Graber TM. Craniofacial features of patients with Class III abnormalities: growth-related changes and effects of short-term and long-termchincuptherapy. Am J Orthod Dentofacial Orthop 2002; 121: 84-92.
  • Altug Z, Arslan AD. Skeletal and dental effects of a mini maxillary protraction appliance. Angle Orthod 2006; 76: 360-8.
  • Ko YI, Baek SH, Mah J, Yang WS. Determinants of successful chincup therapy in skeletal class III malocclusion. Am J Orthod Dentofacial Orthop 2004; 126: 33-41.
  • Ferro A, Nucci LP, Ferro F, Gallo C. Long-term stability of skeletal Class III patients treated with splints, Class III elastics, and chincup. Am J Orthod Dentofacial Orthop 2003; 123: 423-34.
  • Marx R. Various Types of Extra-Oral Anchorage Appliances. Dent Pract 1961; 11: 203-6.
  • Nelson FO. A New Extra-Oral Orthodontic Appliance. Int J Orthod 1968; 6: 24-7.
  • Dellinger EL. A Preliminary Study of Anterior Maxillary Displacement. Am J Orthod Dentofacial Orthop 1973; 63: 509-16.
  • Spolyar JL. The Design, Fabrication and Use of Full-Coverage Bonded Rapid Maxillary Expansion Appliance. Am J Orthod Dentofacial Orthop 1984; 86: 136-45.
  • Fogle L, Law SS, Mosling M, Kinser D. Nonsurgical treatment of a Class III malocclusion with maxillary skeletal retrusion using rapid maxillary expansion and reverse pull headgear. Am J Orthod Dentofacial Orthop 1998; 114: 60-5.
  • Alcan T, Keles A, Erverdi N. The effects of a modified protraction headgear on maxilla. Am J Orthod Dentofacial Orthop ; 117: 27-38. Ngan P, Hagg U, Yiu C, Merwin D, Wei SH. Treatment response to maxillary expansion and protraction. Eur J Orthod 1996; 18: 151-68.
  • Staggers JA, Germane N, Legan HL. Clinical Considerations in the Use of Protraction Headgear. J Clin Orthod 1992; 26: 87-91.
  • Ngan P, Hagg U, Yiu C, Merwin D, Wei SHY. Soft Tissue and Dentoskeletal Profile Changes Associated with Maxillary Expansion and Protraction Headgear Treatment. Am J Orthod Dentofacial Orthop 1996; 109: 38-49.
  • Akkaya S, Yüksel S, Hızlan S, Tortop T. İskeletsel Sınıf 3 Tedavisinde Maksiller Protraksiyon Uygulamasının Üst Yüz ve Dentoalveoler Yapılara Etkisi. Turk Ortodonti Derg 1994; 7: 1-6.
  • Merwin D, Ngan P, Hagg U, Yiu C, Wei SH. Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop 1997; 112: 292-9.
  • Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993; 15: 211-21.
  • Bacetti T, Franchi L, MCNamara JA. Treatment and Posttreatment Craniofacial Changes After Rapid Maxillary Expansion and Facemask Therapy. Am J Orthod Dentofacial Orthop ; 118: 404-41. Wells AP, Sarver DM, Proffit WR. Long-term efficacy of reverse pull headgear therapy. Angle Orthod 2006; 76: 915-22.
  • Arman A, Toygar TU, Abuhijleh E. Profile changes associated with different orthopedic treatment approaches in Class III malocclusions. Angle Orthod 2004; 74: 733-40.
  • Frankel R. Maxillary Retrusion in Class III and Treatment with the Function Corrector III. Rep Congr Eur Orthod Soc 1970; 249-59.
  • Baik HS, Jee SH, Lee KJ, Oh TK. Treatment effects of Frankel functional regulator III in children with class III malocclusions. Am J Orthod Dentofacial Orthop 2004; 125: 294-301.
  • Biren S, Erverdi N. Cephalometric Evaluation of Maxillary Retrognatism Cases Treated with FR-3 Appliances. Journal of Marmara University Dental Faculty 1993; 1: 354-60.
  • Loh MK, Kerr WJS. The Functional Regulator III: Effects and Indications for Use. Br J Orthod 1985; 12: 153-57.
  • Cozza P, Marino A, Mucedero M. An orthopaedic approach to the treatment of Class III malocclusions in the early mixed dentition. Eur J Orthod 2004; 26: 191-9.
  • Tollaro I, Bacetti T, Franchi L. Craniofacial Changes Induced by Early Functional Treatment of Class III Malocclusion. Am J Orthod Dentofacial Orthop, 1996; 109: 310-318.
  • Bacetti T, Tollaro I. A retrospective comparison of functional appliance treatment of Class III malocclusions in the deciduous and mixed dentitions. Eur J Orthod 1998; 20: 309-17.
  • Vardimon AD, Graber TM, Voss LR, Muller TP. Functional Orthopedic Magnetic Appliance (FOMA) III-Modus operandi. Am J Orthod Dentofacial Orthop 1990; 97: 135-48.
  • Vardimon AD, Stutzman JJ, Graber TM, Voss LR, Petrovic AG. Reaction of the Pterygomaxillary Fissure and the Condylar Cartilage to Intermaxillary Class III Magnetic Mechanics. Am J Orthod Dentofacial Orthop 1994; 105: 401-13.
  • Darendeliler MA, Chiarini M, Joho JP. Early Class III Treatment with Magnetic Appliances,. J Clin Orthod 1993; 563-69.
  • Tuncer C, Uner O. Effects of a magnetic appliance in functional Class III patients. Angle Orthod 2005; 75: 768-77.
  • Kondo E, Arai S. Nonsurgical and nonextraction treatment of a skeletal class III adult patient with severe prognathic mandible. World J Orthod 2005; 6: 233-47.
  • Alexander R, Sinclair P, Goates LJ. Differential Diagnosis and Treatment Planing for the Adult Nonsurgical Orthodontic Patient. Am J Orthod Dentofacial Orthop 1986; 89: 95-112.
  • Dolanmaz D, Karaman AI, Özyeşil GA. Maxillary anterior segmental advancement by using distraction osteogenesis: a case report. Angle Orthod 2003; 73: 201-5.
  • Denny AD, Kalantarian B, Hanson PR. Rotation advancement of the midface by distraction osteogenesis. Plast Reconstr Surg 2003; : 1789-99.
  • Matteini C, Momaerts MY. Posterior transpalatal distraction with pterygoid disjunction; A short-term study. Am J Orthod Dentofacial Orthop 2001; 120: 498-502.
  • Nadjimi N, Schutyser F,Van Erum R. Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results. Int J Oral Maxillofac Surg 2006; 35: 885-96.
  • Kumar A, Gabbay JS, Nikjoo R, Heler JB, O’Hara CM, Sisodia M, Garri JI, Wilson LS, Kawamoto HK Jr, Bradley JP. Improved outcomes in cleft patients with severe maxillary deficiency after Le Fort I internal distraction. Plast Reconstr Surg 2006; 117: 1499-509.
  • Cheung LK, Chua HD, Hagg MB. Cleft maxillary distraction versus orthognathic surgery: clinical morbidities and surgical relapse. Plast Reconstr Surg 2006; 118: 996-1008.
  • Rachmiel A, Aizenbud D, Peled M. Long-term results in maxillary deficiency using intraoral devices. Int J Oral Maxillofac Surg 2005; 34: 473-9.
  • Gerlach KL, Zahl C. Surgically assited rapid palatal expansion using a new distraction device: Report of a case with an epimucosal fixation. J Oral Maxillofac Surg 2005; 63: 711-3.
  • Tae K, Kang KW, Kim SC, Min SK. Mandibular symphyseal distraction osteogenesis with stepwise osteotomy in adult skeletal class III patient. J Oral Maxillofac Surg 2006; 35: 556-8.

SINIF III MALOKLUZYONLARINDA UYGULANAN TEDAVİ SİSTEMLERİ

Yıl 2008, Cilt: 11 Sayı: 1, 53 - 58, 11.11.2011

Burcu Balos Tuncer

Öz

Sınıf III malokluzyonlar, maksillofasiyal deformiteler içinde en ciddi anomalilerden biridir. Bireylerde estetik ve fonksiyon açısından yetersizliğe yol açan ve tedavileri oldukça uzun ve zor anomalilerdir. Bu malokluzyonlara alt çene prognatisi, üst çene retruzyonu veya her ikisi birden sebep olabilir. Tedavi yaklaşımları malokluzyonun kaynaklandığı çeneye, etiyolojisine, malokluzyonun şiddetine ve bireyin içinde bulunduğu büyüme gelişim dönemine bağlı olarak değişir. Büyüme dönemindeki çocuklarda yüz büyümesinin yönlendirilmesi etkili bir tedavi yaklaşımıdır. Bu amaçla; çenelik, yüz maskesi veya bazı fonksiyonel apareyler kullanılmaktadır. Erişkin dönemdeki bireylerde ise sabit ortodontik tedaviler ve ortognatik cerrahi yaklaşımları uygulanmaktadır. Son yıllarda distraksiyon osteogenezis yöntemi ile yapılan çalışmalara rastlanmaktadır. Bu derlemede, sınıf III malokluzyonların etiyolojileri, tedavi stratejileri ve farklı tedavi etkileri özetlenmiştir

Anahtar Kelimeler

Sınıf III malokluzyon çenelik yüz maskesi fonksiyonel tedavi distraksiyon osteogenezis

Kaynakça

  • Chang HP, Tseng YC, Chang HF. Treatment of mandibular prognathism.Review. J Formos Med Assoc 2006; 105: 781-90.
  • Dibbets JMH. Mandibular Rotation and Enlargement. Am J Orthod Dentofacial Orthop 1990; 98: 29-32.
  • Williams S, Andreasen CE. The Morphology of Potential Class III Skeletal Pattern in Growing Child. Am J Orthod Dentofacial Orthop 1986; 89: 302-11.
  • Ellis E, MCNamara JA JR. Components of Adult Class III Malocclusion. J Oral Maxillofac Surg 1984; 42: 295-305.
  • Delaire J. Maxillary Development Revisited: Relevance to the Orthopedic Treatment of Class III Malocclusions. Eur J Orthod 1997; : 289-311.
  • Garattini G, Levrini L, Crozzoli P, Levrini A. Skeletal and Dental Modifications Produced by the Bianator III Appliance. Am J Orthod Dentofacial Orthop 1998; 114: 40-4.
  • Sakamoto T, Iwase I, Uka A, Nakamura S. A Roentgenocephalometric Study of Skeletal Changes During and After Chin cup Treatment. Am J Orthod Dentofacial Orthop 1984; 85: 341-50.
  • Deguchi T, Mc Namara JA. Craniofacial Adaptations Induced by Chin cup Therapy in Class III Patients. Am J Orthod Dentofacial Orthop 1999; 115: 175-82.
  • Deguchi T, Kuroda T, Minoshima Y, Graber TM. Craniofacial features of patients with Class III abnormalities: growth-related changes and effects of short-term and long-termchincuptherapy. Am J Orthod Dentofacial Orthop 2002; 121: 84-92.
  • Altug Z, Arslan AD. Skeletal and dental effects of a mini maxillary protraction appliance. Angle Orthod 2006; 76: 360-8.
  • Ko YI, Baek SH, Mah J, Yang WS. Determinants of successful chincup therapy in skeletal class III malocclusion. Am J Orthod Dentofacial Orthop 2004; 126: 33-41.
  • Ferro A, Nucci LP, Ferro F, Gallo C. Long-term stability of skeletal Class III patients treated with splints, Class III elastics, and chincup. Am J Orthod Dentofacial Orthop 2003; 123: 423-34.
  • Marx R. Various Types of Extra-Oral Anchorage Appliances. Dent Pract 1961; 11: 203-6.
  • Nelson FO. A New Extra-Oral Orthodontic Appliance. Int J Orthod 1968; 6: 24-7.
  • Dellinger EL. A Preliminary Study of Anterior Maxillary Displacement. Am J Orthod Dentofacial Orthop 1973; 63: 509-16.
  • Spolyar JL. The Design, Fabrication and Use of Full-Coverage Bonded Rapid Maxillary Expansion Appliance. Am J Orthod Dentofacial Orthop 1984; 86: 136-45.
  • Fogle L, Law SS, Mosling M, Kinser D. Nonsurgical treatment of a Class III malocclusion with maxillary skeletal retrusion using rapid maxillary expansion and reverse pull headgear. Am J Orthod Dentofacial Orthop 1998; 114: 60-5.
  • Alcan T, Keles A, Erverdi N. The effects of a modified protraction headgear on maxilla. Am J Orthod Dentofacial Orthop ; 117: 27-38. Ngan P, Hagg U, Yiu C, Merwin D, Wei SH. Treatment response to maxillary expansion and protraction. Eur J Orthod 1996; 18: 151-68.
  • Staggers JA, Germane N, Legan HL. Clinical Considerations in the Use of Protraction Headgear. J Clin Orthod 1992; 26: 87-91.
  • Ngan P, Hagg U, Yiu C, Merwin D, Wei SHY. Soft Tissue and Dentoskeletal Profile Changes Associated with Maxillary Expansion and Protraction Headgear Treatment. Am J Orthod Dentofacial Orthop 1996; 109: 38-49.
  • Akkaya S, Yüksel S, Hızlan S, Tortop T. İskeletsel Sınıf 3 Tedavisinde Maksiller Protraksiyon Uygulamasının Üst Yüz ve Dentoalveoler Yapılara Etkisi. Turk Ortodonti Derg 1994; 7: 1-6.
  • Merwin D, Ngan P, Hagg U, Yiu C, Wei SH. Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop 1997; 112: 292-9.
  • Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993; 15: 211-21.
  • Bacetti T, Franchi L, MCNamara JA. Treatment and Posttreatment Craniofacial Changes After Rapid Maxillary Expansion and Facemask Therapy. Am J Orthod Dentofacial Orthop ; 118: 404-41. Wells AP, Sarver DM, Proffit WR. Long-term efficacy of reverse pull headgear therapy. Angle Orthod 2006; 76: 915-22.
  • Arman A, Toygar TU, Abuhijleh E. Profile changes associated with different orthopedic treatment approaches in Class III malocclusions. Angle Orthod 2004; 74: 733-40.
  • Frankel R. Maxillary Retrusion in Class III and Treatment with the Function Corrector III. Rep Congr Eur Orthod Soc 1970; 249-59.
  • Baik HS, Jee SH, Lee KJ, Oh TK. Treatment effects of Frankel functional regulator III in children with class III malocclusions. Am J Orthod Dentofacial Orthop 2004; 125: 294-301.
  • Biren S, Erverdi N. Cephalometric Evaluation of Maxillary Retrognatism Cases Treated with FR-3 Appliances. Journal of Marmara University Dental Faculty 1993; 1: 354-60.
  • Loh MK, Kerr WJS. The Functional Regulator III: Effects and Indications for Use. Br J Orthod 1985; 12: 153-57.
  • Cozza P, Marino A, Mucedero M. An orthopaedic approach to the treatment of Class III malocclusions in the early mixed dentition. Eur J Orthod 2004; 26: 191-9.
  • Tollaro I, Bacetti T, Franchi L. Craniofacial Changes Induced by Early Functional Treatment of Class III Malocclusion. Am J Orthod Dentofacial Orthop, 1996; 109: 310-318.
  • Bacetti T, Tollaro I. A retrospective comparison of functional appliance treatment of Class III malocclusions in the deciduous and mixed dentitions. Eur J Orthod 1998; 20: 309-17.
  • Vardimon AD, Graber TM, Voss LR, Muller TP. Functional Orthopedic Magnetic Appliance (FOMA) III-Modus operandi. Am J Orthod Dentofacial Orthop 1990; 97: 135-48.
  • Vardimon AD, Stutzman JJ, Graber TM, Voss LR, Petrovic AG. Reaction of the Pterygomaxillary Fissure and the Condylar Cartilage to Intermaxillary Class III Magnetic Mechanics. Am J Orthod Dentofacial Orthop 1994; 105: 401-13.
  • Darendeliler MA, Chiarini M, Joho JP. Early Class III Treatment with Magnetic Appliances,. J Clin Orthod 1993; 563-69.
  • Tuncer C, Uner O. Effects of a magnetic appliance in functional Class III patients. Angle Orthod 2005; 75: 768-77.
  • Kondo E, Arai S. Nonsurgical and nonextraction treatment of a skeletal class III adult patient with severe prognathic mandible. World J Orthod 2005; 6: 233-47.
  • Alexander R, Sinclair P, Goates LJ. Differential Diagnosis and Treatment Planing for the Adult Nonsurgical Orthodontic Patient. Am J Orthod Dentofacial Orthop 1986; 89: 95-112.
  • Dolanmaz D, Karaman AI, Özyeşil GA. Maxillary anterior segmental advancement by using distraction osteogenesis: a case report. Angle Orthod 2003; 73: 201-5.
  • Denny AD, Kalantarian B, Hanson PR. Rotation advancement of the midface by distraction osteogenesis. Plast Reconstr Surg 2003; : 1789-99.
  • Matteini C, Momaerts MY. Posterior transpalatal distraction with pterygoid disjunction; A short-term study. Am J Orthod Dentofacial Orthop 2001; 120: 498-502.
  • Nadjimi N, Schutyser F,Van Erum R. Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results. Int J Oral Maxillofac Surg 2006; 35: 885-96.
  • Kumar A, Gabbay JS, Nikjoo R, Heler JB, O’Hara CM, Sisodia M, Garri JI, Wilson LS, Kawamoto HK Jr, Bradley JP. Improved outcomes in cleft patients with severe maxillary deficiency after Le Fort I internal distraction. Plast Reconstr Surg 2006; 117: 1499-509.
  • Cheung LK, Chua HD, Hagg MB. Cleft maxillary distraction versus orthognathic surgery: clinical morbidities and surgical relapse. Plast Reconstr Surg 2006; 118: 996-1008.
  • Rachmiel A, Aizenbud D, Peled M. Long-term results in maxillary deficiency using intraoral devices. Int J Oral Maxillofac Surg 2005; 34: 473-9.
  • Gerlach KL, Zahl C. Surgically assited rapid palatal expansion using a new distraction device: Report of a case with an epimucosal fixation. J Oral Maxillofac Surg 2005; 63: 711-3.
  • Tae K, Kang KW, Kim SC, Min SK. Mandibular symphyseal distraction osteogenesis with stepwise osteotomy in adult skeletal class III patient. J Oral Maxillofac Surg 2006; 35: 556-8.
Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Review
Yazarlar

Burcu Balos Tuncer

Yayımlanma Tarihi 11 Kasım 2011
Gönderilme Tarihi 11 Kasım 2011
Yayımlandığı Sayı Yıl 2008Cilt: 11 Sayı: 1

Kaynak Göster

EndNote Balos Tuncer B (01 Kasım 2011) Sınıf III malokluzyonlarında uygulanan tedavi sistemleri. Cumhuriyet Dental Journal 11 1 53–58.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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