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    Adherence frequency of CANDIDA ALBICANS on nasoalveolar molding (NAM) appliances
    (Elsevier, 2020) Yilmaz, Hanife Nuray; Hatipoglu, Sirin; Erdem, Buket; Can, Banu; Kadir, Tanju
    Background and Method: The aim of this prospective study was to evaluate the adherence frequency of Candida albicans and non-albicans Candida species in newborn babies with Cleft Lip and Palate (CLP) who receive presurgical orthopedic therapy with Nasoalveolar Molding (NAM) appliances. This study comprised of 25 CLP newborns including 8-right unilateral, 8-left unilateral and 7-bilateral CLP. First swab samples were taken from the hard palate when the baby was referred and renewed after 3 days. Following the 7th day of delivery of NAM appliance, the swab samples were retaken from both the hard palate and the NAM appliance. Samples were renewed with 2-month intervals. The last swab samples were taken one month after the surgery. Oral swabs were cultured on CHROMagar Candida medium for the growth of yeasts. Results: There were no statistically significant differences between the time points regarding C. albicans proliferation frequency and severity rates on the palate. No significant difference was found due to the type of cleft and sex in terms of candidal colonization. A constant increase in proliferation frequency of non-albicans on the palatal mucosa was observed between all of the time points. Although the results were insignificant, there was a constant increase in C. albicans proliferation which presented a decrease following primary lip surgery. Conclusion: The appliance might not only cause an increase in the colonization of C. albicans but also provide the continuation of the colonization. Therefore, mouth cleaning is important even after primary lip surgery. (C) 2020 Elsevier Masson SAS. All rights reserved.
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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.