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Doctoral Thesis
DOI
https://doi.org/10.11606/T.61.2022.tde-14102022-095603
Document
Author
Full name
Claudia Resende Leal
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Carreira, Daniela Gamba Garib (President)
Lauris, Rita de Cássia Moura Carvalho
Capelozza Filho, Leopoldino
Garcia Junior, Idelmo Rangel
Title in English
Early Le Fort I maxillary advancement retained postsurgically by bone-anchored Class III elastics in individuals with cleft lip and palate
Keywords in English
Cleft lip
Cleft palate
Orthodontics
Orthognathic surgery
Osteotomy
Abstract in English
Objective: To evaluate the stability of Le Fort I osteotomy with maxillary advancement in growing patients with complete unilateral cleft lip and palate (UCLP), retained postsurgically by elastics anchored on miniplates. Methods: Eighteen patients with UCLP and moderate to severe maxillary deficiency participated of this study. All required Le Fort I osteotomy for maxillary advancement. Experimental group consisted of 9 patients with a mean age of 14.0 year (7 males, 2 females) treated by orthognathic surgery at puberty. Comparison group included 9 patients with a mean age of 20.2 years (2 males, 7 females) treated by conventional maxillary advancement at skeletal maturity. During surgery, Bollard miniplates were installed in the experimental group. Class III elastics anchored on miniplates were worn overnight starting 60 days after orthognathic surgery. Cone-beam computed tomography scans were taken before surgery (T1) and 12 months (T3) after surgery. Digital lateral cephalometric radiographs were taken 2 months postoperatively (T2). The same examiner assessed cephalometric changes using Dolphin Imaging 11.95 software twice with an interval of 30 days. Comparisons between treatment phases and between groups were performed using analysis of variance (p<0,05). Results: In the experimental group, SNA angle was 76.1º, 81.4º and 80.7º and overjet was -4.9mm, 2.7mm and 2.5mm at T1, T2 and T3, respectively. Statistically significant changes for SNA and overjet were observed for T1-T2 and T1-T3 periods for both groups. There was no difference between groups for SNA and overjet at any interphase. Conclusion: Osteotomy for maxillary advancement at puberty showed adequate short-term stability when retained by Class III elastics anchored on miniplates.
Title in Portuguese
Cirurgia precoce para avanço maxilar em indivíduos com fissura labiopalatina: contenção pós-cirúrgica com elásticos de Classe III ancorados em miniplacas
Keywords in Portuguese
Cirurgia ortognática
Fenda labial
Fissura palatina
Ortodontia
Osteotomia
Abstract in Portuguese
Objetivo: Avaliar a estabilidade do avanço maxilar realizado por meio de osteotomia Le Fort I em pacientes em crescimento e com fissura labiopalatina unilateral completa. Esse avanço maxilar foi contido após a cirurgia por elásticos ancorados em miniplacas. Métodos: Dezoito pacientes com fissura labiopalatina completa unilateral e deficiência maxilar moderada a grave participaram desse estudo. Todos necessitavam de osteotomia Le Fort I para avanço maxilar. O grupo experimental foi composto por 9 pacientes com idade média de 14,0 anos (7 homens, 2 mulheres) submetidos à cirurgia ortognática na puberdade. O grupo de comparação incluiu 9 pacientes com idade média de 20.2 anos (2 homens, 7 mulheres) submetidos ao avanço convencional da maxila na maturidade esquelética. Durante a cirurgia, miniplacas Bollard foram instaladas no grupo experimental. Elásticos Classe III ancorados sobre miniplacas foram usados durante a noite, 60 dias após a cirurgia. Tomografias computadorizadas de feixe cônico foram realizadas antes da cirurgia (T1) e 12 meses (T3) após a cirurgia. Telerradiografias laterais digitais foram feitas 2 meses após a cirurgia (T2). O mesmo examinador avaliou as alterações cefalométricas usando o software Dolphin Imaging 11.95 duas vezes com um intervalo de 30 dias. As comparações entre as fases do tratamento e entre os grupos foram realizadas por meio da análise de variância (p<0,05). Resultados: No grupo experimental, o ângulo SNA foi de 76,1º, 81,4º e 80,7º e o overjet foi de -4,9mm, 2,7mm e 2,5mm em T1, T2 e T3, respectivamente. Alterações estatisticamente significativas para SNA e overjet foram observadas para os períodos T1-T2 e T1-T3 para ambos os grupos. Não houve diferença entre os grupos para SNA e overjet em nenhuma interfase. Conclusão: A osteotomia para avanço maxilar na puberdade apresentou estabilidade adequada em curto prazo quando retida por elásticos de Classe III ancorados em miniplacas.
 
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Release Date
2024-07-28
Publishing Date
2022-10-27
 
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