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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2018.tde-01102018-172457
Document
Author
Full name
Jefferson Moura Vieira
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2018
Supervisor
Committee
Sant Ana, Eduardo (President)
Faria, Paulo Esteves Pinto
Gonçales, Eduardo Sanches
Sartori, Elisa Mattias
Title in Portuguese
A utilização do software Nemoceph 3D na predição do posicionamento do ângulo nasolabial e posição do lábio superior após avanço de maxila
Keywords in Portuguese
Cirurgia ortognática
Osteotomia maxilar
Software
Tomografia
Abstract in Portuguese
A cirurgia ortognática (CO) tem se tornado cada vez mais previsível devido ao avanço do diagnóstico e planejamento cirúrgico. A tomografia computadorizada possibilitou o aperfeiçoamento dos softwares que propiciam a realização do planejamento cirúrgico virtual, promovem melhor acurácia e menor tempo comparado ao planejamento manual tradicional. Com o surgimento de novos programas e novas versões, se torna necessária a avaliação da acurácia dos mesmos. O presente estudo tem como objetivo avaliar a acurácia do software Nemoceph 3D-OS, para determinar se o mesmo prevê com fidedignidade a posição do lábio superior e ângulo nasolabial após a realização da CO de avanço maxilar. Foram sobrepostos os traçados cefalométricos das reformatações de tomografias computadorizadas de feixe cônico em norma lateral, preditivos e pós-operatórios de 20 pacientes submetidos a cirurgia ortognática de avanço maxilar. Foram realizadas comparações das distâncias lineares em incisal do Incisivo Central Superior (IS), cervical do IS, e lábio superior, tanto no sentido vertical quanto horizontal, como também o ângulo nasolabial, inclinação do IS, exposição do IS e comprimento efetivo do lábio (LS). Após análise estatística, pôde-se notar que dentre as medidas lineares houve diferença estatística na incisal do IS e cervical do IS no sentido horizontal, lábio superior no sentido vertical e no ângulo nasolabial, entretanto podemos observar dentre os valores das diferenças, que de modo geral não houveram grandes discrepâncias: Incisal IS (horizontal 0,77 ± 0,94; 0,11 ± 1,08); Cervical IS (horizontal 0,42 ± 1,08; vertical 0,08 ± 1,05); LS (horizontal -0,15 ± 1,33; vertical 0,53 ± 0,99); Comprimento Efetivo do LS (0,68 ± 1,24); Exposição do IS (0,09 ± 1,15); Ângulo Nasolabial (2,41 ± 2,68); e Inclinação do IS (0,93 ± 2,97). Tanto o tecido duro quanto o tecido mole do lábio superior e ângulo nasolabial tiveram acurácia favorável quando comparados os traçados cefalométricos preditivos e pós-op.
Title in English
 
Keywords in English
Maxillary osteotomy
Orthognathic surgery
Software
Tomography
Abstract in English
Orthognathic surgery (OC) has become increasingly predictable due to advances in diagnosis and surgical planning. Computed tomography enabled the improvement of the software that allows the accomplishment of the virtual surgical planning and promote better predictability and less time compared to traditional manual planning. With the appearance of new programs and new versions, it becomes necessary to evaluate their accuracy. The present study aims to evaluate the accuracy of Nemoceph 3D-OS software, to determine if it accurately predicts the position of the upper lip and nasolabial angle after maxillary advancement OC. Cephalometric tracing of reformatting of cone beam computed tomography in lateral norm, predictive and post operative, of 20 patients submitted to maxillary advancement orthognathic surgery, were overlaid. Comparisons of linear distances were performed in incisal of the Upper Central Incisor (UI), UI cervical, and upper lip, both vertically and horizontally, as well as the nasolabial angle, UI slope, UI exposure and lip length. After statistical analysis, it was noted that among the linear measurements there was a statistical difference in the UI incisal and cervical UI in the horizontal direction, upper lip in the vertical direction and in the nasolabial angle, however we can observe among the values of the differences, that there were no major discrepancies. Based on the current literature and the results observed in this study, it can be concluded that the software has a high degree of predictability, which makes it clinically feasible to carry out the planning with safety and precision. The software showed a high degree of predictability, although the upper lip presented a statistically significant difference in its vertical measurements, it is clinically irrelevant and clinically correct.
 
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Publishing Date
2018-10-05
 
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