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Browsing Doktora Tezleri by Subject "Alveolar kenar artırılması = Alveolar ridge augmentation"
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Publication Open Access Cerrahi Destekli Hızlı Üst Çene Genişletmesi Yapılan Hastalarda Ses Değişikliklerinin İncelenmesi(2020) Erdur, Onur Erdem; Yılmaz, BerzaThe sound is basically formed by the simultaneous function of three distinct components; the respiratory, vibratory and resonator chambers. The airflow issuing from the respiratory system vibrates the vocal cords, called the vibratory field, and the sound gains its characteristic in the resonator area, including the oral cavity. Various studies showed changes in voice due to hormonal effects or changes in the position and the size of anatomical structures caused by orthognatic surgery or growth-development. Maxillary transverse deficiency is a common malocclusion in patients with or without syndrome. Increase of the volume of the nasal cavity, decrease of the palate depth and some dental changes are observed following maxillary base expansion with surgically assisted or conventional rapid maxillary expansion. In addition to morphological changes in the base of the nasal cavity and the ceiling of the oral cavity, the position of the tongue changes and it is positioned more anteriorly. Therefore, it is assumed that maxillary expansion has an effect on the characters of the voice. The number of studies in the literature on the changes in sound related to rapid maxillary expansion is limited. Some studies investigated the effects of rapid maxillary expansion on voice, but as these were carried out on individuals at young ages, the voice changes that could occur due to growth and related to hormones were neglected. Based on our review, the only study that investigated the effects of surgically assisted rapid maxillary expansion among adult individuals was carried out on only 6 individuals. The aim of our study is to investigate the effects of surgically assisted rapid maxillary expansion on the acoustic characteristics of all vowel sounds in the Turkish language in adult patients. Only adult patients were included in the study to eliminate potential effects of growth-development could have on the voice. Our hypothesis is that there would be changes in the acoustic characteristics of the voice in relation to the changing vocal tract anatomy following surgically assisted rapid maxillary expansion. 5 male and 14 female patients aged between 17-31 years with maxillary transverse deficiency were included in the study. Voice records were taken before applying the appliance (T0), immediately after applying the expander (T1), 5 days after surgery (T2), after retention period (average 5.2 months) (T3), immediately after the debonding the appliance (T4) and an average of 5.8 weeks after the debonding the appliance (T5). The voice samples obtained at 6 different treatment times were analyzed using the program Praat version 6.0.43 (Paul Boersma University of Amsterdam, Netherlands). The isolated vowels were pronounced for 3 seconds and words containing those vowels were also recorded. Voice samples were analyzed with F0, F1, F2, F3, Shimmer, Jitter and NHR parameters and the data recorded at 6 different treatment periods were compared. In addition, these data were compared with the voice recordings collected from a control group of 19 subjects who didn't have orthodontic treatment. In conclusion, no statistically significant difference was observed between T0 and T5 recording times for the isolated vowels [a], e [ɛ], i [ɯ], i [i], o [ɔ], ö [œ] u [u] and ü [y] in any of the parameters; F0, F1, F2, F3, Shimmer, Jitter and NHR. The isolated a [a] sound F1 parameter showed a decrease immediately after applying the expansion device, but adaptation to the initial values occurred over time. Higher F2 frequency values were recorded for the isolated u [u] and ü [y] sounds immediately after the removal of the expansion device. Similarly, higher NHR parameter values were recorded for the isolated i [i] sound. However, adaptation to the initial values was observed over time. The F2 frequency values of the sounds i, o, ö in the word and the F3 frequency values of the i, o sounds after applying the expansion device. However, there was no difference between the initial and final records which indicates an adaptation over time. Isolated recorded F1 frequency of a [a] sound, F2 frequency of e [ɛ] sound, Jitter and NHR parameters of i [i] sound, NHR parameter of o [ɔ] sound and F0 and F1 values of u [u] sound showed more changes compared to the control group. The changes in the NHR parameter of the sound of e [ɛ] and the Shimmer parameter of the sound of i [i] were similarly higher than the control group.Publication Open Access Değişik enerji seviyelerinde diyod lazer uygulamasının ekspanse edilmiş midpalatal sutur üzerindeki etkilerinin histomorfometrik olarak incelenmesi / The effect of different doses on the efficiency of LLLT in midpalatal suture using histomorphometry(Bezmialem Vakıf University, 2017) Taş, Gül; Ramoğlu, Sabri İlhanWe aimed to investigate the effect of different doses 940 nm wavelength laser (InGaAsP) applied after midpalatal expansion in rats on sutural activity histomorphometrically at cellular level in rats. In our study, male Wistar rats weighing 180-220 grams were used for 80-12 weeks. The rats were irradiated with Biolase Epic Indium Gallium Arsenide Phosphor (InGaAsP) Diode Laser (wavelength 940 ± 10 nm, power output 0.1 W, continuous mode, frequency 50/60 Hz). The groups were formed as control group, low dose laser group (18 J), medium dose laser group (42 J), high dose laser group (60 J). On day 7, half of the groups in each group were sacrificed and the same laser application procedure as in the remaining rats was continued until the end of day 21. The expansion appliance was applied with a force of 70 grams lateral to the maxillary incisiors of the rats. Histological evaluation revealed that laser low-dose laser group (18 J) after maxillary expansion had a biostimulatory role of laser on bone healing compared to other groups. As a result of statistical evaluation, osteoblast, osteocyte, new bone formation values of low dose laser group were found to increase. According to these results, it might be possible that low-level laser application can shorten the duration of retantion treatment, which is one of the biggest problems in orthodontics.Publication Open Access Farklı yarık tipine sahip dudak damak yarıklı hastalarda üst çene genişletmesinin oluşturduğu stres alanlarının fem analizi ile incelenmesi / Evaluation of the stress distribution during maxillary expansion in patients with different types of cleft lip and palate using the finite element analysis(Bezmialem Vakıf University, 2017) Bölükbaşı, Esra; Yılmaz, BerzaDDY'li hastalarda sıklıkla kollabe maksillaya bağlı çapraz kapanış görülür ve bu sebeple hızlı üst çene genişletme işlemi uygulanmaktadır. Bu çalışmanın amacı, transversal yönde maksiller yetersizlik görülen farklı tipte yarığa sahip DDY'li hastada genişletme işlemi sonucunda oluşan değişikliklerin üç boyutlu sonlu elemanlar yardımı ile değerlendirilmesidir. Çalışmada genç adolesan dönemde, üst çene darlığı olan tek taraflı, çift taraflı komple dudak damak yarığı ve izole damak yarığı olmak üzere 3 farklı tipte yarığa sahip hastanın tomografi görüntülerinden elde edilen üç boyutlu sonlu elemanlar modeli kullanılmıştır. 0,2 mm'lik genişletme sonucu von Mises gerilme dağılımı ve 5 mm'lik genişletme sonucu yer değiştirme dağılımları incelenmiştir. Transversal yöndeki değişiklikler incelendiğinde en fazla ekspansiyonun çift taraflı yarığa sahip modelde gerçekleştiği gözlenmiştir. Benzer miktarda genişleme tek taraflı yarığa sahip modelin yarık içeren tarafında izlenmiştir. Daha az genişleme izole yarığa sahip hasta modelinde ve daha da az miktarda ise tek taraflı yarığa sahip hastanın yarık içermeyen tarafında kaydedilmiştir. Antero-posterior yönde tek taraflı yarığa sahip modelde incelenen yapıların posterior yönde yer değişimi eğilimi gösterdiği gözlenmiştir. İzole damak yarıklı modelde, orta hatta yer alan yapılar anterior yönde yer değiştirme eğilimi gösterirken, lateral bölgedeki yapıların ise posterior yönde yer değiştirme eğilimi gösterdiği gözlemlenmiştir. Çift taraflı komple dudak damak yarıklı modelde ise anterior yönde yer değiştirme eğilimi gözlenmiştir. Vertikal yönde çift taraflı yarığa sahip modelde anatomik yapıların inferior yönde yer değişimi eğilimde olduğu, izole damak yarığına sahip modelde ve tek taraflı yarığa sahip modelde orta hatta yakın yapıların inferior yönde yer değiştirme eğilimi gösterirken, lateral bölgedeki yapıların superior yönde yer değiştirme eğilimi gösterdiği saptanmıştır. İzole damak yarığına sahip hasta modelinde, stres en fazla nazal bölge civarında gözlenirken tek taraflı yarıklı hasta modelinde sutura zigomatikomaksillaris bölgesinde, çift taraflı yarığa sahip hasta modelinde ise sutura zigomatikotemporalis ve sutura zigomatikomaksillaris bölgelerinde biriktiği gözlenmiştir. Anahtar Kelimeler: Tek taraflı dudak damak yarığı; Çift taraflı dudak damak yarığı; İzole damak yarığı; Hızlı üst çene genişletmesi; Sonlu elemanlar analizi.