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    Assessment of correlation between hand-wrist maturation and cervical vertebral maturation: a fractal analysis study
    (2023) Eninanç, İlknur; Çoban Büyükbayraktar, Zeynep
    Background To investigate whether fractal dimension (FD) measurements from hand-wrist radiographs and lateral cephalometric radiographs are correlated with each other and with skeletal maturation stages. Methods In this retrospective study conducted on hand-wrist and lateral cephalometric radiographs obtained from patients between 2017 and 2023, hand-wrist maturation stages (HWMS) and cervical vertebral maturation stages (CVMS) of 144 subjects (6 to 17 years of age) were assessed radiographically. The participants were divided into nine groups (n = 16 each) based on HWMS. Fractal analysis was performed on the radiographs of the radius, the middle finger phalanges (proximal, medial and distal), and the cervical vertebral bodies (C2, C3, C4). Mean and standard deviation values, Spearman’s and Pearson correlation analyses, one-way ANOVA, Kruskal-Wallis H tests and Mann- Whitney-U test were used to evaluate the data. Results Positive correlations were found between the FD values of the radius and HWMS or CVMS (r = .559, P = .001, r = .528 P = .001 respectively). The FD values of the radius were positively correlated with those of all cervical vertebrae (C2, C3, C4), proximal and medial phalanges as well as age. FD values measured from the proximal phalanx, medial phalanx and radius showed significant differences among both HWMS and CVMS (P < .05). HWMS was strongly correlated with CVMS (r = .929, P = .001). Age was strongly correlated with HWMS (r = .795, P = .001) and CVMS (r = .756, P = .001). There was a significant difference in terms of age distribution among HWMS and CVMS (P < .05). Conclusions FD measurements on hand-wrist radiographs can provide useful information for the assessment of skeletal maturation stage. Especially, FD measurements from the radius are important and more reliable to predict skeletal maturation stage.
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    Dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate changes with Myobrace and Twin-block: a retrospective study
    (2023) Çoban Büyükbayraktar, Zeynep; Camcı, Hasan
    Background The primary aim of this study was to evaluate the dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate effects of the Myobrace and Twin-block appliances. The second was to compare them in terms of ease of use by assessing the factors that may influence patient compliance. Methods The study included thirty-six Class II division 1 patients (19 females, 17 males; mean age, 12.14 ± 1.23) who had previously been treated in the Orthodontic Clinic at Sivas Cumhuriyet University Faculty of Dentistry. The patients were divided into two groups: Group 1: Myobrace (n = 18), and Group 2: twin block (n = 18). The effects of the appli- ances on the skeletal, dentoalveolar, soft tissue, craniocervical, and other anatomic structures were assessed using 46 measurements (22 linear and 24 angular), on pre and post-treatment cephalometric radiographs. AudaxCeph 5.0 software (Ljubljana, Slovenia) was used for the analysis. To analyze the changes after one year of treatment, a paired sample t-test and Wilcoxon signed-rank test were used. Intergroup comparison was performed using the Student t-test and the Mann–Whitney U test. Results In the Myobrace and Twin-block groups, there was a significant increase in SNB (°) (p = 0.004, p = 0.001), IMPA (°) (p = 0.005, p = 0.001) and a significant drop in U1/SN (°) (p = 0.021, p = 0.005). The lengths of Cd–Gn (mm), Go–Pg (mm), and Cd–Go (mm) increased significantly in the Twin-block group (p = 0.003, p = 0.010, p = 0.001), whereas the Myobrace group did not change. Similarly, there was no significant difference in pharyngeal and soft palate measure- ments in the Myobrace group but a statistically significant decrease in SP length and angle in the Twin-block group (p = 0.001, p = 0.006). Increases in SN/OPT (°) (p = 0.032, p = 0.001) and SN/CVT (°) (p = 0.012, p = 0.001) were statisti- cally significant in both groups. Myobrace was more difficult to use while sleeping, whereas the twin block caused more nausea. Conclusions Both appliances can be used for mandibular advancement. The Twin-block appliance, on the other hand, was more effective and patient-friendly.
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    Evaluation of angular and positional changes of maxillary third molars following premolar extraction, molar distalization, and non-extraction treatments
    (BioMed Central Ltd, 2025) Çoban Büyükbayraktar, Zeynep; Camcı, Hasan; İçmen, Sultan; Yangın, Artun
    Background: To compare the effects of first premolar extraction, molar distalization, and non-extraction treatments on the angulation and vertical positions of maxillary second molars (MxM2s) and maxillary third molars (MxM3s). To our knowledge, this is the first study to compare the effects of three different treatment types on MxM3 simultaneously. Methods: Initial (T0) and final (T1) panoramic radiographs of three different patient groups were analyzed: first premolar extraction group (n = 26 patients, 52 MxM2, 52 MxM3), molar distalization group (n = 20 patients, 40 MxM2, 40 MxM3), and non-extraction group (n = 31 patients, 62 MxM2, 62 MxM3). Descriptive data, including growth pattern, crowding, overjet, overbite, and maxillary incisor inclination, were recorded. Angular changes of maxillary third molars (MxM3) relative to the Interorbital Plane (IOP) and Palatal Plane (PP), as well as changes in inclination and vertical position according to Archer’s classification, were also documented. Differences between T0 and T1 within the same group were assessed using the paired sample t-test and Wilcoxon signed-rank test. Comparisons between groups were evaluated with one-way analysis of variance (ANOVA) and Kruskal-Wallis H test. The threshold for statistical significance was set at p <.05. Results: IOP and PP values of MxM2 and MxM3 showed significant improvement in the extraction group (EG)(p <.001). The improvement in MxM3 IOP and PP values was not significant in the distalization group (DG)(p =.196 and p =.544, respectively). According to Archer’s classification, within-group comparisons revealed that the inclination and vertical position of MxM3 showed significant improvement in the EG, DG, and non-extraction groups (NEG)(inclination: p <.001 in EG, p =.032 in DG, p =.024 in NEG; vertical position: p <.001 in EG, p =.048 in DG, p <.001 in NEG). In between-group comparisons, the most significant improvement was observed in the EG. The number of MxM3 with vertical positions in Stages 1 and 2 at T1 were 19 in EG, 3 in DG, and 10 in NEG. Conclusion: Premolar extraction has a positive effect on the angular and positional changes of MxM2 and MxM3. The changes in the inclination and vertical position of MxM3 between NEG and DG were not statistically significant. © The Author(s) 2025.
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    Evaluation of rapid maxillary expansion or alternating rapid maxillary expansion and constriction on Eustachian tube function with audiological tests: A randomized clinical trial
    (Elsevier, 2023) Çoban Büyükbayraktar, Zeynep; Doğan, Mansur; Doruk, Cenk; Özel, Volkan Yüksel
    Objectives: Maxillary expansion improves the hearing function. This trial aimed to examine the effects of Eustachian tube function (ETF) with audiological tests in orthodontic patients who underwent rapid maxillary expansion (RME) or alternate rapid maxillary expansion and constriction (Alt-RAMEC) treatment. Methods: Forty individuals (mean age = 13.35 years) included in the trial had a healthy eardrum, no history of orthodontic treatment, maxillary constriction, mandibular constriction and were not affected by acute or chronic otitis. Patients were randomly assigned to one of two groups (n = 20 each): the RME protocol or the Alt-RAMEC protocol. ETF was evaluated using Williams’ test at three time points: before expansion (T0), after expansion (T1), and in the 3rd month of retention (T2). Results: In the RME group, Eustachian tube dysfunction (ETD) was observed in 18 of 40 ears before expansion (T0). The RME group showed significant improvement in tube function in the 3rd month of retention (T2) (p = 0.003). In the Alt-RAMEC group, ETD was observed in 22 of the 40 ears at baseline (T0). Significant improve- ments in tubal function were observed in the Alt-RAMEC group after expansion (T1) (p = 0.008) and in the 3rd month of retention (T2) (p < 0.001). In the RME group, 17 of 18 ears recovered, while in the Alt-RAMEC group, 21 of 22 ears recovered. Conclusion: Eustachian tube function improved in the RME and Alt-RAMEC groups compared to the pre- expansion period.
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    KORUYUCU DİŞ HEKİMLİĞİ Preventive Dentistry
    (Sivas Cumhuriyet Üniversitesi Rektörlük Matbaası (Sertifika No: 40954), 2023) Çoban Büyükbayraktar, Zeynep
    Koruyucu hekimlik uygulamaları tıpta olduğu kadar diş hekimliğinde de önem taşımaktadır. Sağlık alanında tedavi edici uygulamaların yanı sıra koruyucu uygulamaların yerleşmesini sağlamak son derece önemlidir. Koruyucu uygulamalar denilince akla genellikle çocuk hastalar gelir. Çocukların yeterli ve dengeli beslenebilmeleri ve büyüme ve gelişimlerinin sorunsuz devam edebilmesi için sağlıklı bir ağız yapısına sahip olmaları gerekir. Bu nedenle koruyucu uygulamaların tıp hekimleri tarafından da bilinmesi ve gerekli durumlarda hastanın bir diş hekimine yönlendirilmesi gerekmektedir. Bu kitap bölümünde hem genel diş hekimliği alanında hem de ortodonti özelinde mevcut koruyucu uygulamalar anlatılmıştır.