Expansão rápida da maxila: estudo longitudinal de 10 meses
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/26225 |
Resumo: | This thesis is composed of two scientific papers. Article I aimed to evaluate the effects of rapid maxillary expansion (RME) on sleep disorders in children with maxillary atresia using a case series longitudinal study. Article II evaluated the use of low-level laser (LLL) aplications as an adjuvant in RME regarding its effects on the bone repair of the midpalatal suture, and on the stability of the upper intermolar distance, through a randomized clinical trial. The study sample consisted of 27 patients, aged between 8 and 12 years, in the mixed dentition, with maxillary atresia, who underwent RME with a Hyrax expander. In the first study the patients were evaluated using a questionnaire answered by their guardians, the Sleep Disturbance Scale in Children (SDSC), at the following time points: T0 (pre-treatment phase), T1 (day of stabilization expansion screw), T2 (3 months after screw stabilization), T3 (immediately after removing the expander, after 6 months of retention) and T4 (3 months of post-retention). Poisson multilevel analysis adjusted for repeated measures was performed. RME influenced the reduction of SDSC total scores, and were statistically significant from T2 onwards, and below the cutoff point for risk of sleep disorders at T4. In Article II, the patients in the sample were randomly divided into two groups: laser group, n = 13, who underwent RME and LLL in the region of the midpalatal suture; and control group, n = 14, RME and LLL placebo. Ten LLL sessions were performed within a 35-day interval. At each session, 10 points were irradiated over the midpalatal suture and laterally to it. Bone density in the anterior region of the midpalatal suture was evaluated on occlusal digital radiographs, using the ImageJ software, using a grayscale at the following time points: T1, T2, T3 and T4; and the transverse stability of maxillary expansion was evaluated from the intermolar distance in millimeters using Meshmixer software, at time points T0, T1 and T4. Multilevel Poisson regression analysis was performed. The effect size for bone density was greater in the laser group, indicating greater bone repair in this group. Already the effect size for upper intermolar distance greater in the control group from T1 to T4, indicating a greater orthodontic relapse in this group, but with no statistically significant difference in both outcomes. In conclusion, RME had a positive effect on the reduction in SDSC total scores as of 3 months of screw stabilization. Although the proposed protocol trended toward benefitting the group irradiated by LLL, bone repair in the midpalatal suture and stability in the upper intermolar distance showed no clinical or statistical differences between the groups. |
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2022-09-22T12:31:07Z2022-09-22T12:31:07Z2022-07-25http://repositorio.ufsm.br/handle/1/26225This thesis is composed of two scientific papers. Article I aimed to evaluate the effects of rapid maxillary expansion (RME) on sleep disorders in children with maxillary atresia using a case series longitudinal study. Article II evaluated the use of low-level laser (LLL) aplications as an adjuvant in RME regarding its effects on the bone repair of the midpalatal suture, and on the stability of the upper intermolar distance, through a randomized clinical trial. The study sample consisted of 27 patients, aged between 8 and 12 years, in the mixed dentition, with maxillary atresia, who underwent RME with a Hyrax expander. In the first study the patients were evaluated using a questionnaire answered by their guardians, the Sleep Disturbance Scale in Children (SDSC), at the following time points: T0 (pre-treatment phase), T1 (day of stabilization expansion screw), T2 (3 months after screw stabilization), T3 (immediately after removing the expander, after 6 months of retention) and T4 (3 months of post-retention). Poisson multilevel analysis adjusted for repeated measures was performed. RME influenced the reduction of SDSC total scores, and were statistically significant from T2 onwards, and below the cutoff point for risk of sleep disorders at T4. In Article II, the patients in the sample were randomly divided into two groups: laser group, n = 13, who underwent RME and LLL in the region of the midpalatal suture; and control group, n = 14, RME and LLL placebo. Ten LLL sessions were performed within a 35-day interval. At each session, 10 points were irradiated over the midpalatal suture and laterally to it. Bone density in the anterior region of the midpalatal suture was evaluated on occlusal digital radiographs, using the ImageJ software, using a grayscale at the following time points: T1, T2, T3 and T4; and the transverse stability of maxillary expansion was evaluated from the intermolar distance in millimeters using Meshmixer software, at time points T0, T1 and T4. Multilevel Poisson regression analysis was performed. The effect size for bone density was greater in the laser group, indicating greater bone repair in this group. Already the effect size for upper intermolar distance greater in the control group from T1 to T4, indicating a greater orthodontic relapse in this group, but with no statistically significant difference in both outcomes. In conclusion, RME had a positive effect on the reduction in SDSC total scores as of 3 months of screw stabilization. Although the proposed protocol trended toward benefitting the group irradiated by LLL, bone repair in the midpalatal suture and stability in the upper intermolar distance showed no clinical or statistical differences between the groups.A presente tese é composta por dois artigos científicos. O primeiro teve como objetivo avaliar os efeitos da expansão rápida da maxila (ERM) nos distúrbios do sono em crianças com atresia maxilar, através de um estudo longitudinal do tipo série de casos. O segundo avaliou a utilização da laserterapia em baixa potência (LBP) como adjuvante na ERM quanto aos seus efeitos no reparo ósseo da sutura palatina mediana e na estabilidade da distância intermolares superior através de um ensaio clínico randomizado. A amostra dos estudos foi composta por 27 pacientes, de idades entre 8 e 12 anos, na dentição mista, com atresia maxilar submetidos a ERM com expansor de Hyrax. No artigo I, os pacientes foram avaliados através da Escala de Distúrbios do Sono em crianças (EDSC), respondido pelos responsáveis, nos tempos: T0 (fase pré-tratamento), T1 (dia da estabilização do parafuso expansor), T2 (3 meses após a estabilização do parafuso), T3 (imediatamente após a remoção do disjuntor, após 6 meses de contenção) e T4 (3 meses de pós-contenção). Análise multinível de Poisson ajustada para medidas repetidas foi realizada. A ERM influenciou a redução dos escores gerais da EDSC, sendo estatisticamente significativos a partir de T2 e abaixo do ponto de corte para risco de distúrbios do sono em T4. No artigo II os pacientes da amostra foram divididos aleatoriamente em dois grupos: grupo laser, n = 13, que realizaram ERM e LBP na região da sutura palatina mediana; e grupo controle, n = 14, ERM e LBP placebo. Dez sessões de LBP foram realizadas num intervalo de 35 dias. A cada sessão, 10 pontos foram irradiados sobre a sutura palatina mediana. A densidade óssea na região anterior da sutura palatina mediana foi avaliada em radiografias oclusais digitais, pelo software ImageJ, através de escala de cinzas nos tempos: T1, T2, T3 e T4; e a estabilidade transversal da expansão maxilar foi avaliada a partir da distância intermolares em milímetros no software Meshmixer nos tempos: T0, T1 e T4. Análise multinível de regressão de Poisson foi realizada. O tamanho do efeito para densidade óssea foi maior no grupo laser, indicando maior reparo ósseo nesse grupo. Já o tamanho do efeito para a distância intermolares superior foi maior no grupo controle de T1 a T4, indicando ser maior a recidiva nesse grupo, porém a análise multinível não apresentou diferença estatisticamente significativa entre os grupos em ambos desfechos. Como conclusões, a ERM teve efeito positivo na redução gradual dos escores gerais da EDSC a partir de 3 meses da estabilização do parafuso. Apesar do protocolo proposto ter apresentado uma tendência de benefício ao grupo irradiado por LBP, o reparo ósseo na sutura palatina mediana e a estabilidade na distância intermolares superior não apresentaram diferenças clínicas e estatística entre os grupos.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências OdontológicasUFSMBrasilOdontologiaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessCriançaDesordens do sonoEnsaio clínicoExpansão rápida da maxilaLaserterapia de baixa potênciaChildClinical trialLow-level laser therapyRapid maxillary expansionSleep bruxismSleep disordersCNPQ::CIENCIAS DA SAUDE::ODONTOLOGIAExpansão rápida da maxila: estudo longitudinal de 10 mesesRapid maxillary expansion: a 10-month longitudinal studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisMarquezan, Marianahttp://lattes.cnpq.br/3239936595140832Ferrazzo, Vilmar AntonioTomazoni, FernandaSerra-Negra, Júnia Maria CheibCarvalho, Felipe de Assis Ribeirohttp://lattes.cnpq.br/6416451657190788Chami, Vitória de Oliveira400200000000600600600600600600600c88a249c-5cfe-417b-8d29-9a41007ae06e0fc5e64c-9e0b-4e1d-b3f5-ee6bd489dc8a97872177-64e3-4594-93ee-ce372229dd2460c5c82d-05b6-45eb-a140-db9076244a8abf3df1bd-f7a7-43cb-8d21-e56d63515c669a170398-c4cf-4a9a-86ce-3f965b4d39fcreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALTES_PPGCO_2022_CHAMI_VITORIA.pdfTES_PPGCO_2022_CHAMI_VITORIA.pdfTeseapplication/pdf3063010http://repositorio.ufsm.br/bitstream/1/26225/1/TES_PPGCO_2022_CHAMI_VITORIA.pdf45238a8bd1cbd3d04f3e7b5f741dce16MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/26225/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81956http://repositorio.ufsm.br/bitstream/1/26225/3/license.txt2f0571ecee68693bd5cd3f17c1e075dfMD531/262252022-09-22 09:31:07.409oai:repositorio.ufsm.br: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ório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestopendoar:39132022-09-22T12:31:07Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
dc.title.alternative.eng.fl_str_mv |
Rapid maxillary expansion: a 10-month longitudinal study |
title |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
spellingShingle |
Expansão rápida da maxila: estudo longitudinal de 10 meses Chami, Vitória de Oliveira Criança Desordens do sono Ensaio clínico Expansão rápida da maxila Laserterapia de baixa potência Child Clinical trial Low-level laser therapy Rapid maxillary expansion Sleep bruxism Sleep disorders CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA |
title_short |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
title_full |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
title_fullStr |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
title_full_unstemmed |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
title_sort |
Expansão rápida da maxila: estudo longitudinal de 10 meses |
author |
Chami, Vitória de Oliveira |
author_facet |
Chami, Vitória de Oliveira |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Marquezan, Mariana |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3239936595140832 |
dc.contributor.referee1.fl_str_mv |
Ferrazzo, Vilmar Antonio |
dc.contributor.referee2.fl_str_mv |
Tomazoni, Fernanda |
dc.contributor.referee3.fl_str_mv |
Serra-Negra, Júnia Maria Cheib |
dc.contributor.referee4.fl_str_mv |
Carvalho, Felipe de Assis Ribeiro |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6416451657190788 |
dc.contributor.author.fl_str_mv |
Chami, Vitória de Oliveira |
contributor_str_mv |
Marquezan, Mariana Ferrazzo, Vilmar Antonio Tomazoni, Fernanda Serra-Negra, Júnia Maria Cheib Carvalho, Felipe de Assis Ribeiro |
dc.subject.por.fl_str_mv |
Criança Desordens do sono Ensaio clínico Expansão rápida da maxila Laserterapia de baixa potência |
topic |
Criança Desordens do sono Ensaio clínico Expansão rápida da maxila Laserterapia de baixa potência Child Clinical trial Low-level laser therapy Rapid maxillary expansion Sleep bruxism Sleep disorders CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA |
dc.subject.eng.fl_str_mv |
Child Clinical trial Low-level laser therapy Rapid maxillary expansion Sleep bruxism Sleep disorders |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA |
description |
This thesis is composed of two scientific papers. Article I aimed to evaluate the effects of rapid maxillary expansion (RME) on sleep disorders in children with maxillary atresia using a case series longitudinal study. Article II evaluated the use of low-level laser (LLL) aplications as an adjuvant in RME regarding its effects on the bone repair of the midpalatal suture, and on the stability of the upper intermolar distance, through a randomized clinical trial. The study sample consisted of 27 patients, aged between 8 and 12 years, in the mixed dentition, with maxillary atresia, who underwent RME with a Hyrax expander. In the first study the patients were evaluated using a questionnaire answered by their guardians, the Sleep Disturbance Scale in Children (SDSC), at the following time points: T0 (pre-treatment phase), T1 (day of stabilization expansion screw), T2 (3 months after screw stabilization), T3 (immediately after removing the expander, after 6 months of retention) and T4 (3 months of post-retention). Poisson multilevel analysis adjusted for repeated measures was performed. RME influenced the reduction of SDSC total scores, and were statistically significant from T2 onwards, and below the cutoff point for risk of sleep disorders at T4. In Article II, the patients in the sample were randomly divided into two groups: laser group, n = 13, who underwent RME and LLL in the region of the midpalatal suture; and control group, n = 14, RME and LLL placebo. Ten LLL sessions were performed within a 35-day interval. At each session, 10 points were irradiated over the midpalatal suture and laterally to it. Bone density in the anterior region of the midpalatal suture was evaluated on occlusal digital radiographs, using the ImageJ software, using a grayscale at the following time points: T1, T2, T3 and T4; and the transverse stability of maxillary expansion was evaluated from the intermolar distance in millimeters using Meshmixer software, at time points T0, T1 and T4. Multilevel Poisson regression analysis was performed. The effect size for bone density was greater in the laser group, indicating greater bone repair in this group. Already the effect size for upper intermolar distance greater in the control group from T1 to T4, indicating a greater orthodontic relapse in this group, but with no statistically significant difference in both outcomes. In conclusion, RME had a positive effect on the reduction in SDSC total scores as of 3 months of screw stabilization. Although the proposed protocol trended toward benefitting the group irradiated by LLL, bone repair in the midpalatal suture and stability in the upper intermolar distance showed no clinical or statistical differences between the groups. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-09-22T12:31:07Z |
dc.date.available.fl_str_mv |
2022-09-22T12:31:07Z |
dc.date.issued.fl_str_mv |
2022-07-25 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/26225 |
url |
http://repositorio.ufsm.br/handle/1/26225 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
400200000000 |
dc.relation.confidence.fl_str_mv |
600 600 600 600 600 600 600 |
dc.relation.authority.fl_str_mv |
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dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências Odontológicas |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Odontologia |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
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