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Patrícia Carlos Caldeirahttp://lattes.cnpq.br/8426305216250974Elismauro Francisco MendonçaSílvia Ferreira de Sousahttp://lattes.cnpq.br/1007082793410303Natália Santos Barcelos2023-09-11T20:13:19Z2023-09-11T20:13:19Z2023-06-27http://hdl.handle.net/1843/58566https://orcid.org/0000-0002-0697-9323A radioterapia (RT) é amplamente utilizada para o tratamento do câncer em região de cabeça e pescoço. A osteorradionecrose (ORN) é uma das mais severas complicações desta modalidade terapêutica. Todos os pacientes tratados com radioterapia são considerados de alta risco para o desenvolvimento da ORN, devido à falta de fatores preditivos dessa comorbidade, a morbidade e a imprevisibilidade da resposta ao tratamento. A análise fractal é utilizada para descrever a complexidade de uma estrutura e avaliar anormalidades e gravidade de distúrbios da arquitetura óssea. Entretanto, poucos estudos utilizaram a análise fractal para avaliar a estrutura óssea de pacientes submetidos à RT em região de cabeça e pescoço. Portanto, o objetivo deste trabalho foi avaliar a dimensão fractal (DF) e lacunaridade do osso mandibular em indivíduos submetidos à RT para tratamento de câncer de cabeça e pescoço, comparando aqueles desenvolveram ORN (grupo caso) com aqueles que não desenvolveram ORN (grupo controle). O estudo foi aprovado pelo Comitê de Ética em Pesquisa da UFMG (CAAE 30560820.9.0000.5149). É um estudo transversal com grupo controle, no qual 34 pacientes foram incluídos e divididos em grupo caso (com ORN, n=17) e grupo controle (sem ORN, n=17). Uma radiografia panorâmica digital, adquirida após o término da RT, foi avaliada para cada paciente. A DF e lacunaridade do osso mandibular foram determinados usando o software ImageJ. Foi realizada análise estatística bivariada, bem como análise da curva ROC. A significância foi estabelecida em p< 0,05. Os valores médios de DF e lacunaridade não foram significativamente diferentes entre os grupos. A área sob a curva para DF foi de 0,576 e para lacunaridade foi de 0,626. O ponto de corte encontrado para DF foi ≤1,1736 e >0,4155 para lacunaridade, os quais classificaram corretamente casos e controles. A maioria dos pacientes com ORN (92.9%) tiveram DF> 1.1736 e todos os controles tiveram DF≤ 1.1736 (p< 0.001). Para a lacunaridade, a maioria dos pacientes com ORN (71.4%) apresentaram valor > 0.4155 e todos os controles tiveram valor ≤ 0.4155 (p< 0.001). Em conclusão, os pontos de corte da DF e lacunaridade do osso mandibular, estabelecidos pela análise de radiografias panorâmicas, puderam classificar corretamente pacientes com ORN e sem ORN.Fractal analysis of mandibular bone and occurrence of osteoradionecrosis: a cross-sectional study with control group Radiotherapy (RT) is widely used in the treatment of head and neck cancer. Osteoradionecrosis (ORN) is one of the most severe complication of this therapeutic modality. All patients treated with RT are considered at high risk for the development of ORN, due to the lack of predictive factors for ORN, the morbidity, and the unpredictable response to treatment. Fractal analysis is used to describe the complexity of a structure and to assess abnormalities and the severity of bone architecture disorders. However, few studies have used fractal analysis to assess the bone structure of patients undergoing RT in head and neck region. Therefore, the aim of this study was to evaluate the FD and lacunarity of the mandibular bone in individuals who received radiation therapy for HNC, comparing those who had developed ORN to those who had not developed ORN (control group). The study was approved by the Research Ethics Committee of the Universidade Federal de Minas Gerais (certificate number: 30560820.9.0000.5149). This is a cross-sectional study with a control group and thirty-four patients were included and divided into case group (with ORN, n=17) and control group (without ORN, n=17). One digital panoramic radiograph acquired after the end of RT was evaluated for each patient. FD and lacunarity of the mandibular bone were determined using ImageJ software. Bivariate statistics was done, as well as ROC curve analysis. Significance was stablished at p< 0.05. The mean FD and lacunarity values were not significantly different between the groups. The area under the curve for FD and lacunarity were 0.576 and 0.626, respectively. The cut-off point found for FD was ≤1.1736 and >0.4155 for lacunarity, allowing us to correctly classify cases and controls. Most participants in the case group (92.9%) had a FD >1.1736 and all participants in the control group had a FD ≤ 1.1736 (p < 0.001). For lacunarity, most individuals in the case group (71.4%) had a value >0.4155 and all participants in the control group had a value ≤0.4155 (p <0.001). Conclusion: The cut-off values of FD and lacunarity of mandibular bone, assessed on panoramic radiographs, differ between patients with and without ORN.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoporUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em OdontologiaUFMGBrasilFAO - FACULDADE DE ODONTOLOGIAhttp://creativecommons.org/licenses/by-nc-nd/3.0/pt/info:eu-repo/semantics/openAccessNeoplasias de cabeça e pescoçoFractaisOsteorradionecroseRadioterapia conformacionalRadiografia panorâmicaNeoplasias de cabeça e pescoçoFractaisOsteorradionecroseRadioterapia conformacionalRadiografia panorâmicaAnálise fractal do osso mandibular e a ocorrência de osteorradionecrose: um estudo transversal com grupo controleFractal analysis of mandibular bone and occurrence of osteoradionecrosis: a cross-sectional study with control groupinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALDissertação__Natália Santos Barcelos.pdfDissertação__Natália Santos Barcelos.pdfapplication/pdf1316482https://repositorio.ufmg.br/bitstream/1843/58566/1/Disserta%c3%a7%c3%a3o__Nat%c3%a1lia%20Santos%20Barcelos.pdf520c0c3f92558793a55781b30f51926aMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/58566/3/license.txtcda590c95a0b51b4d15f60c9642ca272MD53CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufmg.br/bitstream/1843/58566/2/license_rdfcfd6801dba008cb6adbd9838b81582abMD521843/585662023-09-11 17:13:19.798oai:repositorio.ufmg.br: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ório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-09-11T20:13:19Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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