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    Evaluation of Airway Volume in Cleft Lip and Palate Following Nasoalveolar Molding
    (Lippincott Williams & Wilkins, 2018) Astani, Seyed Amirhossein; Yilmaz, Hanife Nuray; Nevzatoglu, Sirin; Demirkaya, Arzu Ari; Acar, Zeynep Ahu
    Patients with cleft lip and palate (CLP) have commonly reduced nasal airways and are more prone to snoring, mouth breathing and hypopnea during sleep. Therefore, the morphometric evaluation of pharyngeal airway in patients with CLP is crucial. The purpose of this study is to evaluate the pharyngeal airway volumes of patients with CLP who underwent nasoalveolar molding (NAM) and to compare them with a well-matched control group without NAM. The study consisted of 40 patients with CLP divided into 2 main groups (26 with NAM; 14 without NAM) and 4 subgroups (15 unilateral CLP [UCLP] with NAM, mean age: 10.13 +/- 1.30 years; 11 bilateral CLP [BCLP] with NAM, mean age: 10.55 +/- 1.51 years; 7 UCLP without NAM, mean age: 9.86 +/- 1.68 years; 7 BCLP without NAM, mean age: 10.28 +/- 1.89 years). Nasopharyngeal, oropharyngeal, and total airway volumes of all the patients were calculated 3-dimensionally with cone-beam computed tomography. There were statistically significant differences in nasopharyngeal volume (P< 0.05) of NAM group compared to control group; however, volumetric differences in oropharyngeal and total pharyngeal airway were not significant (P> 0.05). The amount of nasopharyngeal, oropharyngeal, and total pharyngeal airway size in the BCLP with NAM group was significantly larger compared to BCLP without NAM group (P< 0.05). However, UCLP did not show any significant difference in NAM group (P> 0.05). This study implies that NAM can effectively enlarge the nasopharyngeal airway size in patient with CLP. In addition, the pharyngeal airway volume enlargement is more apparent in BCLP than UCLP individuals.
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    Three-dimensional evaluation of surgically assisted asymmetric rapid maxillary expansion
    (Mosby-Elsevier, 2019) Karabiber, Gulden; Yilmaz, Hanife Nuray; Nevzatoglu, Sirin; Ugurlu, Faysal; Akdogan, Tuna
    Introduction: Unilateral posterior crossbite is classified as true unilateral posterior crossbite (TUPC) or functional posterior crossbite (FPC). The differential diagnosis between TUPC and FPC is of utmost importance for the decision of expansion protocol because conventional expansion methods have some shortcomings for TUPC. The aim of this retrospective study was to 3-dimensionally evaluate the effects of asymmetric rapid maxillary expansion combined with unilateral osteotomy. Methods: This study sample comprised 16 patients (mean age 18.38 +/- 6 1.45) with TUPC. A Hyrax acrylic cap included the maxillary premolars and molars on the constricted side, and all teeth up to the central incisor were included on the other side to increase anchorage. Unilateral surgically assisted rapid maxillary expansion was performed and included anterior (aperture piriformis), lateral (zygomatic buttress), and posterior (pterygomaxillary junction) osteotomies on the constricted side and separation of the midpalatal suture. Cone-beam computed tomographic scans taken just before the operation and after 6 months of retention were used to assess skeletal, dental, and periodontal changes. Results: Expansion was seen on both sides; however, the amount of expansion and tipping was higher on the osteotomy+ side. Because the canines were not included in the acrylic cap on the osteotomy+ side, they did not present the same amount of tipping as the ipsilateral posterior teeth. More teeth were affected periodontally on the osteotomy- side; however, there were no clinically significant differences between the osteotomy+ and osteotomy+ sides (mean differences range +10.54 to -0.57 mm). The aperture piriformis width increased significantly on the osteotomy+ side. Conclusions: The treatment mechanics had no clinically detrimental effects on the supporting alveolar bone of the maxilla on either side, and it was thought to be effective in cases with TUPC; however, case selection is crucial.