Daimi 1. molar diş çekiminin daimi 2. molar dişlerin sürme pozisyonlarına etkisinin retrospektif olarak incelenmesi ve klinik takibinin yapılması
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Dosyalar
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Daimi birinci molar diş çekiminden sonra çekim boşluğunun spontan olarak kapanmasında daimi üçüncü moların varlığı ve yokluğu, daimi ikinci molar dişin açılanması ve Demirjian sınıflamasına göre hesaplanan daimi ikinci moların gelişim aşamasının etkinliğinin radyolojik olarak araştırılmasıdır. Gereç Yöntem: Çalışmamıza Ege Üniversitesi Diş Hekimliği Fakültesine Başvurmuş 2015-2022 yılları arasında en az bir daimi birinci molar dişini çektirmiş hastaların röntgenleri dahil edilerek retrospektif olarak 2772 panoramik radyografi (OPG) incelenmiş ve çalışma kriterlerine uyan ve klinik muayeneyi kabul eden 221 hasta kliniğimize davet edilmiştir. OPG'de; daimi ikinci molar dişin angulasyonu, daimi ikinci molar dişin Demirjian diş gelişim evresine göre gelişim aşaması, üçüncü molar diş varlığı/yokluğu değerlendirilmiştir. Klinik muayene sırasında daimi ikinci molar diş ile ikinci premolar arasındaki mesafe ölçülmüş, orta hat sapması ve antagonisti olmayan dişin overerüpsiyon durumu incelenmiştir. Elde edilen verilerin istatistiksel analizi için, IBM SPSS 25.0 (Statistical Product and Service Solutions, IBM, New York, Amerika) programı kullanılmıştır. Bulgular: Çalışmaya katılan 112'si erkek, 109'u kız toplam 221 hastada 313 daimi birinci molar diş çekimi incelenmiştir. Daimi birinci molar dişini çektiren hastalarda cinsiyet dağılımı açısından fark bulunamamıştır (p=0,840). Tek dişini çektiren hastaların sayısı, çoklu çekim yaptıranlardan fazla bulunmuştur. Başarılı kapanmanın gözlenmesi üst çenede alt çeneye göre fazla ve istatistiksel olarak fark anlamlı bulunmuştur (p<0,001). Üst çenede 8-10 yaş arası tam kapanmanın başarısı %87,1 ve alt çenedeki kapanma oranına göre daha yüksek olarak bulunmuş, farkın da istatistiksel olarak anlamlı olduğu saptanmıştır (p<0,001). Daimi ikinci molar dişler Demirjian gelişim sınıflamasına göre gruplara ayrılmıştır. Üst çenede kapanma başarısının diş gelişim evrelerine göre anlamlı farklılık gösterdiği ve erken evrede en yüksek oranda (Demirjian D) başarılı kapanma gözlendiği tespit edilmiştir (p<0,001). Alt çenede kapanma başarısının diş gelişim evrelerine göre anlamlı farklılık göstermediği saptanmıştır (p=0,434). Üst çenede kapanma başarısı bakımından diş açıları arasındaki fark anlamlı bulunamamıştır (p=0,812) . Başarılı kapanma en yüksek oranda mesial açılanmada (%80) görülmüştür. Alt çenede kapanma başarısı bakımından diş açıları arasında anlamlı farklılık olmadığı ve başarılı kapanmanın en yüksek oranda mesial açılanmada (34,2) görüldüğü tespit edilmiştir (p=0,494). Üst ve alt çenede üçüncü molar dişin varlığı ile başarılı kapanma arasında anlamlı bir ilişki olmadığı bulunmuştur (p=0,185, p=0,504). fakat alt çenede üçüncü molar varlığında daha yüksek oranda (%29,3) başarılı kapanma gözlenmiştir. Üst çenede tek bir daimi birinci molar diş çekimi ile balanslı çekim yapılmış hastaların orta hat sapma durumları karşılaştırılmış ve tek daimi birinci molar dişi çekilen hastalarda görülen orta hat sapması ile (%41,7), iki daimi birinci molar dişi çekilen hastalar arasında (%50,0) orta hat sapması bakımından istatistiksel olarak anlamlı bir fark bulunamamıştır (p=0,356) . Alt çenede ise tek daimi birinci molar dişi çekilen hastalarda görülen orta hat sapması ile (%61,0) iki daimi birinci molar dişi çekilen hastalar arasında (%37,8) orta hat sapması bakımından istatistiksel olarak anlamlı fark bulunmuştur (p=0,003). Üst çenede daimi birinci molar dişi çekilen hastaların antagonist dişinde overerüpsiyon görülme oranı %15,3 alt çenede daimi birinci molar dişi çekilen hastaların antagonist dişinde overerüpsiyon görülme oranı ise %27,8 bulunmuş ve aradaki fark istatistiksel olarak anlamlı bulunmuştur (p=0,016). Sonuç: Üst çenede daimi birinci molar diş çekimi sonrası spontan kapanma alt çeneye göre daha başarılı bulunmuştur. Alt çenede dişlerde mesial açılanmanın fazla olduğu; ikinci molar dişin gelişim aşamasının Demirjian sınıflamasına göre D olduğu veya üçüncü molar dişin var olduğu durumlarda başarılı kapanma diğer gruplara göre fazla bulunmuş olup, gruplar arasındaki fark istatistiksel olarak anlamlı değildir. Bu konuda literatüre katkıda bulunacak daha fazla çalışmaya ihtiyaç vardır. Anahtar Kelimeler: Daimi birinci molar, diş çekimi, spontan yer kapanması
Objective: This study aims to investigate radiologically the effect of the presence or absence of permanent third molars and the efficacy of the opening of permanent second molars on the spontaneous closure of extraction sockets after permanent first molar extraction, as well as to assess the developmental stage of permanent second molars according to the Demirjian classification. Materials and Methods: A total of 221 patients who had undergone extraction of at least one permanent first molar between 2015 and 2022 and whose panoramic radiographs (OPG) were available at University of Ege Faculty of Dentistry were included in this retrospective study. A total of 2772 OPGs were examined. During the clinical examination, the distance between the permanent second molar and the second premolar were measured, and factors such as midline deviation and overeruption of the non-antagonistic tooth were evaluated. The statistical analysis of the obtained data were performed using IBM SPSS 25.0 (Statistical Product and Service Solutions, IBM, New York, USA). Results: A total of 313 extractions of permanent first molars were analyzed in 221 patients, including 112 males and 109 females. No significant difference was found in terms of gender distribution among patients who had their permanent first molars extracted (p=0.840). The number of patients who had a single extraction were higher than those who had multiple extractions. Successful closure was observed more frequently in the maxilla compared to the mandible, and this difference was statistically significant (p<0.001). The success rate of complete closure in the maxilla between the ages of 8-10 years was found to be 87.1%, which was higher than the closure rate in the mandible, and the difference was statistically significant (p<0.001). The developmental stages of permanent second molars were classified according to the Demirjian. Significant differences were observed in the success of closure in the maxilla according to the dental development stages, with the highest success rate observed in the early stages (Demirjian stage D) (p<0.001). In the mandible, no significant differences were found in the success of closure according to dental development stages (p=0.434). There was no significant difference in the success of closure in the maxilla among different tooth angulations (p=0.812), and the highest success rate was observed in mesial angulation (80%). In the mandible, there was no significant difference in the success of closure among different tooth angulations, and the highest success rate was observed in mesial angulation (34.2%) (p=0.494). There was no significant relationship between the presence of third molars and successful closure in both the maxilla and mandible (p=0.185, p=0.504), but a higher success rate (29.3%) was observed in the presence of third molars in the mandible. In the maxilla, the midline deviation was compared between patients who underwent extraction of a single permanent first molar and those who underwent extraction of two permanent first molars, and no statistically significant difference was found in terms of midline deviation between patients with a single extraction (41.7%) and those with two extractions (50.0%) (p=0.356). However, in the mandible, a statistically significant difference was found in terms of midline deviation between patients with single extraction (61.0%) and those with two extractions (37.8%) (p=0.003). The rate of overeruption in antagonist tooth was 15.3% in patients who underwent extraction of a permanent first molar in the maxilla and 27.8% in patients who underwent extraction in the mandible, and the difference between them was statistically significant (p=0.016). Conclusion: Spontaneous closure after extraction of permanent first molars was found to be more successful in the maxilla compared to the mandible. In mandible, a higher success rate of closure was observed in cases with mesial angulation, developmental stage D according to Demirjian classification, or the presence of third molars, although the differences among the groups were not statistically significant. Further studies are required on this topic. Keywords: Permanent first molar, tooth extraction, spontaneous space closure
Objective: This study aims to investigate radiologically the effect of the presence or absence of permanent third molars and the efficacy of the opening of permanent second molars on the spontaneous closure of extraction sockets after permanent first molar extraction, as well as to assess the developmental stage of permanent second molars according to the Demirjian classification. Materials and Methods: A total of 221 patients who had undergone extraction of at least one permanent first molar between 2015 and 2022 and whose panoramic radiographs (OPG) were available at University of Ege Faculty of Dentistry were included in this retrospective study. A total of 2772 OPGs were examined. During the clinical examination, the distance between the permanent second molar and the second premolar were measured, and factors such as midline deviation and overeruption of the non-antagonistic tooth were evaluated. The statistical analysis of the obtained data were performed using IBM SPSS 25.0 (Statistical Product and Service Solutions, IBM, New York, USA). Results: A total of 313 extractions of permanent first molars were analyzed in 221 patients, including 112 males and 109 females. No significant difference was found in terms of gender distribution among patients who had their permanent first molars extracted (p=0.840). The number of patients who had a single extraction were higher than those who had multiple extractions. Successful closure was observed more frequently in the maxilla compared to the mandible, and this difference was statistically significant (p<0.001). The success rate of complete closure in the maxilla between the ages of 8-10 years was found to be 87.1%, which was higher than the closure rate in the mandible, and the difference was statistically significant (p<0.001). The developmental stages of permanent second molars were classified according to the Demirjian. Significant differences were observed in the success of closure in the maxilla according to the dental development stages, with the highest success rate observed in the early stages (Demirjian stage D) (p<0.001). In the mandible, no significant differences were found in the success of closure according to dental development stages (p=0.434). There was no significant difference in the success of closure in the maxilla among different tooth angulations (p=0.812), and the highest success rate was observed in mesial angulation (80%). In the mandible, there was no significant difference in the success of closure among different tooth angulations, and the highest success rate was observed in mesial angulation (34.2%) (p=0.494). There was no significant relationship between the presence of third molars and successful closure in both the maxilla and mandible (p=0.185, p=0.504), but a higher success rate (29.3%) was observed in the presence of third molars in the mandible. In the maxilla, the midline deviation was compared between patients who underwent extraction of a single permanent first molar and those who underwent extraction of two permanent first molars, and no statistically significant difference was found in terms of midline deviation between patients with a single extraction (41.7%) and those with two extractions (50.0%) (p=0.356). However, in the mandible, a statistically significant difference was found in terms of midline deviation between patients with single extraction (61.0%) and those with two extractions (37.8%) (p=0.003). The rate of overeruption in antagonist tooth was 15.3% in patients who underwent extraction of a permanent first molar in the maxilla and 27.8% in patients who underwent extraction in the mandible, and the difference between them was statistically significant (p=0.016). Conclusion: Spontaneous closure after extraction of permanent first molars was found to be more successful in the maxilla compared to the mandible. In mandible, a higher success rate of closure was observed in cases with mesial angulation, developmental stage D according to Demirjian classification, or the presence of third molars, although the differences among the groups were not statistically significant. Further studies are required on this topic. Keywords: Permanent first molar, tooth extraction, spontaneous space closure
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry, Daimi birinci molar, diş çekimi, spontan yer kapanması, Permanent first molar, tooth extraction, spontaneous space closure
