Üst Çene Genişletme Tedavisinin Fonksiyonel Etkisi
Özet
Maksiller genişletme tedavisi, süt, karma ve daimî dentisyon dönemlerinde sıkça görülen posterior çapraz kapanış malokluzyonunun stomognatik sistem dokuları ve fonksiyonları üzerindeki etkilerini değerlendirmek amacıyla uygulanmaktadır. Tedavinin temel hedefleri, okluzyondaki bozuklukların yol açtığı prematür kontaktların ve mandibular kaymaların elimine edilmesi, böylece glenoid fossa içerisindeki kondil konumunun stabilize edilmesidir. Tedavi edilmeyen vakalarda kondil ve glenoid fossada asimetrik konum adaptasyonları, yüz asimetrisi, çiğneme kaslarında koordinasyon bozuklukları ve iskeletsel anomaliler gelişebilmektedir. Araştırmalar, hızlı üst çene genişletme (HÜÇG) uygulamalarının ardından temporal ve masseter kas aktivitelerinin etkilendiğini, asimetrik çiğneme kası fonksiyonlarının ve kondil konumlarındaki sapmaların normale döndüğünü göstermektedir. Ayrıca, tedavi öncesinde çapraz kapanış olan tarafta daha düşük seyreden maksimum ısırma kuvveti ve okluzal kontakt sayısı, genişletme ve pekiştirme tedavileri sonrasında artış göstererek fonksiyonel simetrinin sağlanmasına katkıda bulunur. Sonuç olarak, fonksiyonel sapmaların morfolojik hale gelmesini önlemek ve dengeli bir çiğneme fonksiyonu kazandırmak amacıyla posterior çapraz kapanışın erken dönemde maksiller genişletme ile tedavi edilmesi önerilmektedir.
Maxillary expansion therapy is implemented to evaluate the effects of posterior crossbite malocclusion, frequently encountered during primary, mixed, and permanent dentition periods, on stomognathic system tissues and functions. The primary objectives of the treatment are to eliminate premature contacts and mandibular shifts caused by occlusal discrepancies, thereby stabilizing the condyle position within the glenoid fossa. Untreated cases may lead to asymmetric positional adaptations in the condyle and glenoid fossa, facial asymmetry, coordination disorders in masticatory muscles, and skeletal anomalies. Research indicates that following rapid maxillary expansion (RME) applications, anterior temporal and masseter muscle activities are affected, and asymmetric masticatory muscle functions as well as deviations in condylar positions return to normal. Furthermore, the maximum bite force and the number of occlusal contacts, which are lower on the crossbite side prior to treatment, demonstrate an increase after expansion and retention therapies, contributing to the establishment of functional symmetry. Consequently, early treatment of posterior crossbite with maxillary expansion is highly recommended to prevent functional deviations from becoming morphological and to ensure that the individual acquires a balanced masticatory function.
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