Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular

Detalhes bibliográficos
Autor(a) principal: Avelar, Rafael Linard
Data de Publicação: 2013
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/1232
Resumo: OBJECTIVE: To evaluate and compare the differences and check the correlation that exists between the hyoid bone, the airways and the point B, in short and medium term preoperative and postoperative periods, after the mandibular setback and advancement surgery has taken place. MATERIAL AND METHOD: Preoperative radiography (T1), postoperative up to 3 months (T2), and postoperative after 12 months (T3) from 79 patients with facial pattern class II and III who had undergone orthognathic surgery. These radiographies were scanned, digitalized and inserted in the Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, California, EUA) to the evaluation of 6 points. All outlines were made by two evaluators and 10 % of them were repeated after two months. In order to verify the normality of the data it was used the non-parametric Kolomogorov-Smirnov test. It was considered the index of significance (p<0.05) and the GraphPad Prism statistic software was used for all analyses. RESULTS: It has been identified significant changes in all points of soft and hard tissue between the preoperative and the two postoperative periods (T2-T1) and a significant level of accommodation of tissues (T3-T1) on the hyoid bone and airways. In T3-T1 (accommodation movement of the hyoid bone) it is observed a gradual return of the hyoid bone after the realization of the orthognathic surgery, mainly in movements above 3mm (p<0.05). During the 12 months of monitoring, it was observed a posterior movement of the hyoid bone in setback jaw surgery and anterior movement in forward jaw surgery (p<0.05), with a consequent return to the preoperative position 12 months after the surgery. Regarding the airways, the medium and minimum setback did not show significant variation in long term period (p>0.05), what happened differently of the lower airway, in which there was a shortening of the airways after one year of monitoring (p<0.05). In the foward jaw movement there was a widening of airways, showing a return close to the initial one, 12 months after the surgery (p<0.05). CONCLUSION: It has been observed in this study that the hyoid bone tends to return to the original position, mainly when it is present a setback above 3 mm and greater ones. The same holds true regarding the airways, in which it is observed a shortening of the airways in greater mandibular setbacks; and widening of the airways in greater mandibular forward movement, with a gradual return after 12 months. The Pogonion point and the B point showed a far posterior positioning, presenting a greater recidivism when the mandibular movements were bigger. The opposite happened in the mandibular forward movement cases.
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spelling Oliveira, Rogério Belle deCPF:87527480904http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708433D6CPF:64925137387Avelar, Rafael Linard2015-04-14T13:30:30Z2014-01-132013-11-12AVELAR, Rafael Linard. Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular. 2013. 86 f. Tese (Doutorado em Odontologia) - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, 2013.http://tede2.pucrs.br/tede2/handle/tede/1232OBJECTIVE: To evaluate and compare the differences and check the correlation that exists between the hyoid bone, the airways and the point B, in short and medium term preoperative and postoperative periods, after the mandibular setback and advancement surgery has taken place. MATERIAL AND METHOD: Preoperative radiography (T1), postoperative up to 3 months (T2), and postoperative after 12 months (T3) from 79 patients with facial pattern class II and III who had undergone orthognathic surgery. These radiographies were scanned, digitalized and inserted in the Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, California, EUA) to the evaluation of 6 points. All outlines were made by two evaluators and 10 % of them were repeated after two months. In order to verify the normality of the data it was used the non-parametric Kolomogorov-Smirnov test. It was considered the index of significance (p<0.05) and the GraphPad Prism statistic software was used for all analyses. RESULTS: It has been identified significant changes in all points of soft and hard tissue between the preoperative and the two postoperative periods (T2-T1) and a significant level of accommodation of tissues (T3-T1) on the hyoid bone and airways. In T3-T1 (accommodation movement of the hyoid bone) it is observed a gradual return of the hyoid bone after the realization of the orthognathic surgery, mainly in movements above 3mm (p<0.05). During the 12 months of monitoring, it was observed a posterior movement of the hyoid bone in setback jaw surgery and anterior movement in forward jaw surgery (p<0.05), with a consequent return to the preoperative position 12 months after the surgery. Regarding the airways, the medium and minimum setback did not show significant variation in long term period (p>0.05), what happened differently of the lower airway, in which there was a shortening of the airways after one year of monitoring (p<0.05). In the foward jaw movement there was a widening of airways, showing a return close to the initial one, 12 months after the surgery (p<0.05). CONCLUSION: It has been observed in this study that the hyoid bone tends to return to the original position, mainly when it is present a setback above 3 mm and greater ones. The same holds true regarding the airways, in which it is observed a shortening of the airways in greater mandibular setbacks; and widening of the airways in greater mandibular forward movement, with a gradual return after 12 months. The Pogonion point and the B point showed a far posterior positioning, presenting a greater recidivism when the mandibular movements were bigger. The opposite happened in the mandibular forward movement cases.OBJETIVO: Avaliar e comparar as diferenças e verificar a correlação existente entre o osso hióide, vias aéreas em região de orofarínge e ponto B, nos períodos pré operatório e pós operatórios a curto (3 meses) e médio prazo (12 meses), após a realização da cirurgia de recuo e avanço mandibular MATERIAL E METODOS: Tele radiografias em perfil pré-operatórias (T1), pós-operatórias de até 3 meses (T2) e pós-operatórias com 12 meses (T3) de 79 pacientes com padrão facial classe II e III que foram submetidos à cirurgia ortognática foram escaneadas, digitalizadas e inseridas no software Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, Califórnia, EUA) para avaliação de 6 pontos. Todos os traçados foram realizados por dois avaliadores, sendo 10% deles repetidos após dois meses. Para a verificação da normalidade dos dados foi utilizado o teste de Kolmogorov-Smirnov. Considerou-se índice de significância p < 0.05 e foi utilizado o software estatístico GraphPad Prism 5.0® para todas as análises. RESULTADOS: Identificam-se mudanças significativas em todos os pontos de tecido mole e duro entre o período pré e nos dois períodos pós-operatórios (T2-T1) e grau significante de acomodação dos tecidos (T3-T1) nos pontos osso hióide e vias aéreas. Em T3-T1 (movimento de acomodação do osso hióide) observa-se um retorno gradual do osso hióide após a realização do recuo e avanço mandibular, principalmente em movimentos acima de 3 mm (p<0.05). Durante 12 meses de acompanhamento observou-se uma movimentação posterior do hióide nas cirurgias de recuo mandibular e movimentação anterior nas cirurgias de avanço mandibular (p<0.05), tendo um retorno ao posicionamento pré-operatorio após 12 meses da realização da cirurgia. Com relação as vias aéreas o Recuo médio e mínimo não apresentaram variação significante a longo prazo (p>0.05), o que ocorreu diferentemente do espaço aéreo inferior, onde houve um estreitamento das vias aéreas após 1 ano de acompanhamento (p<0.05). Nos movimentos de avanço mandibular houve um alargamento das vias aéreas, apresentando um retorno próximo ao inicial, 12 meses após a realização da cirurgia (p<0.05). CONCLUSÕES: Observou-se neste estudo que o hióide tende a retornar a posiçao original, principalmente em recuos acima de 3 mm, e em avanços de maior magnitude, o que é também observado em relação as vias aéreas onde observa-se um estreitamento das vias aéreas em recuos mandibulares maiores, e um alongamento das vias aéreas em avanços mandibulares maiores, com retorno gradual após 12 meses. O ponto Pogônio e ponto B apresentaram um posicionamento mais posterior, apresentando uma recidiva maior quando os movimentos mandibulares eram maiores, tendo ocorrido o inverso nos avanços mandibulares.Made available in DSpace on 2015-04-14T13:30:30Z (GMT). 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dc.title.por.fl_str_mv Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
title Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
spellingShingle Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
Avelar, Rafael Linard
ODONTOLOGIA
CIRURGIA BUCOMAXILOFACIAL
CIRURGIA ORTOGNÁTICA
CEFALOMETRIA
CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
title_short Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
title_full Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
title_fullStr Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
title_full_unstemmed Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
title_sort Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular
author Avelar, Rafael Linard
author_facet Avelar, Rafael Linard
author_role author
dc.contributor.advisor1.fl_str_mv Oliveira, Rogério Belle de
dc.contributor.advisor1ID.fl_str_mv CPF:87527480904
dc.contributor.advisor1Lattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708433D6
dc.contributor.authorID.fl_str_mv CPF:64925137387
dc.contributor.author.fl_str_mv Avelar, Rafael Linard
contributor_str_mv Oliveira, Rogério Belle de
dc.subject.por.fl_str_mv ODONTOLOGIA
CIRURGIA BUCOMAXILOFACIAL
CIRURGIA ORTOGNÁTICA
CEFALOMETRIA
topic ODONTOLOGIA
CIRURGIA BUCOMAXILOFACIAL
CIRURGIA ORTOGNÁTICA
CEFALOMETRIA
CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
description OBJECTIVE: To evaluate and compare the differences and check the correlation that exists between the hyoid bone, the airways and the point B, in short and medium term preoperative and postoperative periods, after the mandibular setback and advancement surgery has taken place. MATERIAL AND METHOD: Preoperative radiography (T1), postoperative up to 3 months (T2), and postoperative after 12 months (T3) from 79 patients with facial pattern class II and III who had undergone orthognathic surgery. These radiographies were scanned, digitalized and inserted in the Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, California, EUA) to the evaluation of 6 points. All outlines were made by two evaluators and 10 % of them were repeated after two months. In order to verify the normality of the data it was used the non-parametric Kolomogorov-Smirnov test. It was considered the index of significance (p<0.05) and the GraphPad Prism statistic software was used for all analyses. RESULTS: It has been identified significant changes in all points of soft and hard tissue between the preoperative and the two postoperative periods (T2-T1) and a significant level of accommodation of tissues (T3-T1) on the hyoid bone and airways. In T3-T1 (accommodation movement of the hyoid bone) it is observed a gradual return of the hyoid bone after the realization of the orthognathic surgery, mainly in movements above 3mm (p<0.05). During the 12 months of monitoring, it was observed a posterior movement of the hyoid bone in setback jaw surgery and anterior movement in forward jaw surgery (p<0.05), with a consequent return to the preoperative position 12 months after the surgery. Regarding the airways, the medium and minimum setback did not show significant variation in long term period (p>0.05), what happened differently of the lower airway, in which there was a shortening of the airways after one year of monitoring (p<0.05). In the foward jaw movement there was a widening of airways, showing a return close to the initial one, 12 months after the surgery (p<0.05). CONCLUSION: It has been observed in this study that the hyoid bone tends to return to the original position, mainly when it is present a setback above 3 mm and greater ones. The same holds true regarding the airways, in which it is observed a shortening of the airways in greater mandibular setbacks; and widening of the airways in greater mandibular forward movement, with a gradual return after 12 months. The Pogonion point and the B point showed a far posterior positioning, presenting a greater recidivism when the mandibular movements were bigger. The opposite happened in the mandibular forward movement cases.
publishDate 2013
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dc.identifier.uri.fl_str_mv http://tede2.pucrs.br/tede2/handle/tede/1232
identifier_str_mv AVELAR, Rafael Linard. Avaliação cefalométrica do espaço orofaríngeo e do osso hióide em pacientes submetidos a cirurgia ortognática mandibular. 2013. 86 f. Tese (Doutorado em Odontologia) - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, 2013.
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