Avaliação da idade e maturação óssea em crianças cardiopatas

• Autor(a) principal: Martins, Mariana Martins e
• Data de Publicação: 2012
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/13997
• topic: Skeletal maturation; Bone age; Cervical vertebrae; Heart disease; Maturação óssea; Idade óssea; Vértebras cervicais; Cardiopatia; Ortodontia - Técnica; Coluna cervical - Crescimento; Ossos - Crescimento; Cardiopatia congênita nas crianças - Aspectos fisiológicos; Determinação da idade pelo esqueleto; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::ORTODONTIA

The study of growth and development is essential for orthodontics, because each child has a unique pattern. In the presence of systemic diseases such as congenital heart disease, a more detailed examination must be made, since they may alter their growth and development. One of the methods used for this evaluation is bone ossification analysis of the hand and wrist region. However, changes in size and shape of the cervical vertebrae have been widely used in recent decades because it is performed in lateral cephalometric radiographs, routinely used in orthodontic diagnosis. Initially, our objectives were to assess the correlation between the methods for obtaining bone age and skeletal maturation stages using the indicators present in the hand and wrist region and in the cervical vertebrae in a group of children with and without heart disease. Based on the positive and significant correlation, the cervical vertebrae method was chosen to compare bone age, the difference between bone age and chronological and skeletal maturation stages between children with and without heart disease. The sample comprised 120 children aged 4.83 to 14.66 years, that attended the Pediatric Clinic of Pedro Ernesto University Hospital. Among these, 73 presented cyanotic congenital heart disease and 47 had no heart disease and were only on follow-up, with a mean age of 9.3 and 8.9 years respectively. The bone age and skeletal maturation were verified by lateral cephalometric radiographs and hand-wrist radiographs. The bone age determination was performed by the Mito et al. method on lateral cephalometric radiographs and by the Greulich and Pyle method on hand-wrist radiographs. The skeletal maturation stages were obtained by the Hassel and Farman method on lateral cephalometric radiographs and by the Singer method on hand-wrist radiographs. The correlation between the methods for obtaining bone age and skeletal maturation stages showed a positive and significant results, both for the heart disease group with r = 0.478 (p <0.001) for bone age and r = 0.616 (p <0.001) for skeletal maturation stages, and for non-heart disease group with r = 0.366 (p = 0.024) for bone age and r = 0.613 (p <0.001) for the skeletal maturation stages. The bone age did not differ significantly between groups (p = 0.394). The difference between chronological age and bone age showed no significant difference in both heart disease group (p = 0.418) and for non-heart disease group (p = 0.143). No significant differences were found between groups when the amount of children who had delayed bone age relative to chronological age (p = 0.395) were assessed. The same was found when males (p = 0.060) and females (p = 0.313) were evaluated. The sample distribution through skeletal maturation stages showed no significant differences between groups (p = 0.447). The results of this study suggest that congenital heart disease, in the evaluated age, does not alter skeletal maturation pattern examined by the cervical vertebrae method.