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Master's Dissertation
DOI
https://doi.org/10.11606/D.58.2020.tde-06102022-150046
Document
Author
Full name
Felippe Almeida Costa
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2020
Supervisor
Committee
Trivellato, Alexandre Elias (President)
Romano, Fábio Lourenço
Sato, Fábio Ricardo Loureiro
Sverzut, Cassio Edvard
Title in Portuguese
Avaliação tridimensional da maxila após expansão rápida assistida cirurgicamente: estudo retrospectivo
Keywords in Portuguese
Deficiência transversal da maxila
Expansão maxilar
Osteotomia maxilar
Tomografia computadorizada de feixe cônico
Abstract in Portuguese
O presente estudo avaliou 28 prontuários, de forma retrospectiva, por meio de tomografia computadorizada de feixe cônico os efeitos tridimensionais dentoesqueléticos da maxila ocasionados em pacientes que foram submetidos à ERMAC, sem separação da placa pterigomaxilar: como Distância molares (16-26), Distância caninos (13-23), Distância interradicular (11-21), Distância intercoronária (11-21), Distância entre as placas pterigoideas, Largura do assoalho nasal, Distância interradicular (11-21), Deslocamento inferior da maxila (E.N.P./E.N.A.), Distância entre as placas pterigoideas, Distância plano Coronal/A (Ponto A), Angulação do incisivo em ralação ao Plano Palatino (11/PP), em três tempos distintos: antes da expansão (T0), ao final das ativações do aparelho Hyrax (T1) e seis meses após a imobilização do aparelho (T2). O padrão da abertura da sutura palatina mediana (T1) também foi avaliado por meio do software Dolphin Imaging v. 11.9. Os dados obtidos foram tabulados e submetidos à análise estatística pelo teste de Shapiro-Wilks, seguido pelo teste de Análise de Variância (ANOVA) para medidas repetidas e post hoc de Bonferroni, test t pareado e o coeficiente de correlação de Pearson foi aplicado para avaliar as possíveis correlações entre as análises com nível de significância 5% (p ≤ 0,05). Foi encontrada diferença estatisticamente significante em todos os pontos dentários analisados e plano Axial/ENP (T0-T1), plano Axial/ENA (T0-T1/T0-T2), distância entre as placas pterigoideas, largura do assoalho nasal, 11/PP (T1-T2/T0-T2). A ERMAC apresentou aumento no sentido transversal e deslocamento esquelético longitudinal, sendo a região anterior mais acometida do que a região posterior, porém não houve alteração no sentido ânteroposterior da maxila. Obteve-se ainda aumento das medidas dentárias lineares e redução da medida angular, com correlação positiva entre a quantidade de expansão óssea posterior e da distância molares decorrente do tratamento no período analisado.
Title in English
Three-dimensional assessment of the maxilla after surgically assisted rapid expansion: a retrospective study
Keywords in English
Cone-beam computed tomography
Maxillary
Maxillary expansion
Osteotomy
Transverse maxillary deficiency
Abstract in English
Transverse discrepancies of dental arches in patients are relatively common in clinical orthodontics, obtaining a stable and functional occlusion is essential for correct crossrelationship between dental arches. Surgically assisted rapid maxillary expansion (SARME) is an effective treatment to correct transverse maxillary deficiencies in adults. The present study evaluated in 35 medical records, retrospectively and by means of cone beam computed tomography, the three-dimensional dentoskeletal effects on the maxilla caused in patients who underwent modified SARME, without the separation of the pterygomaxillary plate. The analyzed data were: Molar distance (16-26), Canine distance (13-23), Interradicular distance (11-21), Inter-coronary distance (11-21), Distance between pterygoid plates, Nasal floor width, Interradicular distance (11-21), Lower dislocation of the maxilla (PNS/ANS), Distance between the pterygoid plates, Coronal plane Distance/ A (Point A), Angulation of the incisor in relation to the palatal plane (11/PP), at three different times: before the expansion (T0), at the end of the activation of the Hyrax device (T1) and six months after the immobilization of the device (T2). The opening pattern of the median palatal suture (T1) was also assessed using the Dolphin Imaging v. 11.9 software. The data obtained were tabulated and submitted to statistical analysis by the Shapiro-Wilks test, followed by the Analysis of Variance test (ANOVA) for repeated measures and Bonferroni post hoc test, paired t test and Pearson's correlation coefficient was applied to evaluate the possible correlations between the analyzes with a 5% significance level (p ≤ 0,05). A statistically significant difference was found in all the analyzed dental points and Axial Plane/ANS (T0 - T1), Axial Plane/ANS (T0 - T1 / T0 - T2), distance between the pterygoid plates, width of the nasal floor, 11/PP (T1-T2/T0-T2). The 67% opening pattern was Type II. The SARME showed an increase in the transversal direction and skeletal superoinferior displacement, the anterior region being more affected than the posterior region, however there was no change in the anteroposterior direction of the maxilla. There was also an increase in linear dental measurements and a reduction in angular measurement, with a positive correlation between the amount of posterior bone expansion and the molar distance resulting from the treatment in the analyzed period.
 
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Publishing Date
2022-10-07
 
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