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Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2020.tde-22102021-120722
Document
Author
Full name
Eduardo Stedile Fiamoncini
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2020
Supervisor
Committee
Gonçales, Eduardo Sanches (President)
Assis, Diogo Souza Ferreira Rubim de
Guastaldi, Fernando Pozzi Semeghini
Nogueira, Alexandre Simões
Title in Portuguese
Análise tomográfica do volume e área do espaço aéreo faríngeo de pacientes submetidos a cirurgia ortognática
Keywords in Portuguese
Cirurgia Ortognática
Deformidades Dentofaciais
Obstrução das Vias Respiratórias
Tomografia Computadorizada de Feixe Cônico
Abstract in Portuguese
Os efeitos da cirurgia Ortognática vão além dos objetivos de corrigir a deformidade facial esquelética. Estes efeitos também se estendem para a morfologia do espaço aéreo faríngeo (EAF). Este estudo teve como objetivo analisar as alterações do EAF de indivíduos submetidos a diferentes procedimentos em cirurgia ortognática. As mensurações do EAF foram realizadas em exames de TCFC pré e pós-operatórias de 135 indivíduos submetidos à cirurgia ortognática. Para a análise a amostra foi inicialmente distribuída de acordo com o procedimento realizado, e, posteriormente, de acordo com alterações em referências cefalométricas. Mensurações volumétricas (mm³) em diferentes segmentos do EAF e da área de maior constrição (AMC) (mm²) foram realizadas utilizando o software Dolphin Imaging® 11.7. Os resultados mostraram aumento estatisticamente significativo do volume do EAF e da AMC nos movimentos de avanço maxilar, avanço mandibular e avanço bimaxilar, havendo influencia positiva da amplitude do avanço sobre o ganho dimensional. Embora tenham sido observadas correlações significativas das alterações dimensionais com a projeção de ambos os segmentos maxilares, A análise dos modelos lineares generalizados demonstrou que tanto as variáveis volumétricas quando a AMC foram preditas de maneira mais efetiva pela projeção mandibular (Pg-Nperp) e pela interação entre a projeção mandibular e alterações na inclinação do plano mandibular (Pg-Nperp*FMA). Com base na análise dos resultados obtidos, conclui-se que a cirurgia ortognática modifica consideravelmente as dimensões do espaço aéreo faríngeo, o que inclui um aumento significante nos movimentos de avanço e também uma redução nos movimentos de recuo, embora o último não apresente significância estatística.
Title in English
Keywords in English
Airway obstruction
Cone-Beam Computed Tomography
Dentofacial deformities
Orthognathic surgery
Abstract in English
The effects of orthognathic surgery go beyond the objectives of correcting the skeletal facial deformity. These effects also extend to the pharyngeal airway space (PAS) morphology. This study aimed to analyze changes in the PAS of individuals undergoing different procedures in orthognathic surgery. The measurements of the pharyngeal airspace were performed in pre- and postoperative CBCT exams of 135 individuals who underwent orthognathic surgery. For the analysis, the sample was initially distributed according to the procedure that was performed, and later, according to changes in cephalometric references. Volumetric measurements (mm³) in different segments of the PAS and the Maximum Constriction Area (MCA) (mm²) were obtained using Dolphin Imaging® 11.7 software. The results showed a statistically significant increase in the volume of the PAS and MCA in the movements of maxillary advancement, mandibular advancement and bimaxillary advancement, with a positive influence of the magnitude of the advancement on the dimensional gain. Although significant correlations of the dimensional changes with the projection of both maxillary segments have been observed, The analysis of the generalized linear models (GLM) demonstrated that both the volumetric variables and the MCA were more effectively predicted by the mandibular projection (Pg-Nperp) and by the interaction between the mandibular projection and changes in the inclination of the mandibular plane (Pg- Nperp * FMA). Based on the analysis of the results obtained, it is concluded that orthognathic surgery considerably alters the dimensions of the pharyngeal airway space, with a significant increase in advancement movements and also a reduction in setback movements, although the latter does not present statistical significance.
 
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Publishing Date
2021-10-22
 
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