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Avalia??o da lordose cervical e da postura da cabe?a em pacientes classe III esquel?tica submetidos ? cirurgia ortogn?ticaAndriola, Fernando de Oliveira 24 January 2018 (has links)
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Previous issue date: 2018-01-24 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The purpose of this study was to evaluate cervical lordosis and head posture
changes using lateral cephalographs after bimaxillary orthognathic surgery for
mandibular prognatism by null hypothesis.
Twenty-five patients with skeletal class III dentofacial deformities (10 men, 15
women; mean age, 29.28 ? 8.22 years; range 18-48 years) were included in
this prospective clinical study. Lateral cephalographs were taken in natural head
position (NHP) 2 weeks before and 6 months after orthognathic surgery. The
reproducibility of the radiographer?s technique of taking radiographs in NHP was
investigated using a photographic method and found to be acceptable. All
measurements for cervical lordosis (CV1/CV2; CV3/CV7; CV1/CV7), head
posture (NSL/OPT; NSL/VER) and other cephalometric values (NSL/Go-Gn;
NSL/Ocl; Overjet) were repeated three times by the same investigator at 2-
week intervals and the average values of the three measurements were
calculated to use in statistical analysis. Intraclass correlation coefficients (ICC)
ranged between 0.996 to 1.000, demonstrating a high reliability of the
measures. Statistically significant differences were found for CV3/CV7
(P=0.006) and CV1/CV7 (P=0.005) and no significant differences were
identified in head posture for both cranio-cervical and cranio-vertical angles.
The null hypothesis was rejected. Orthognathic surgery resulted in significant
cervical lordosis extension, and a tendency for head extension could also be
observed. / O objetivo deste estudo foi avaliar, por hip?tese nula, a lordose cervical e as
altera??es da postura da cabe?a usando telerradiografias de perfil ap?s cirurgia
ortogn?tica bimaxilar para corre??o de prognatismo mandibular.
Vinte e cinco pacientes com deformidades dentofaciais esquel?ticas classe III
(10 homens, 15 mulheres, idade m?dia entre 29,28 ? 8,22 anos, intervalo de
18-48 anos) foram inclu?dos neste estudo cl?nico prospectivo. As radiografias
laterais dos pacientes foram obtidas na posi??o natural de cabe?a (PNC) 2
semanas antes e 6 meses ap?s a cirurgia ortogn?tica. A reprodutibilidade da
t?cnica do radiologista para realizar as tomadas radiogr?ficas na PNC foi
investigada usando um m?todo fotogr?fico e considerada aceit?vel. As medidas
para lordose cervical (CV1/CV2; CV3/CV7; CV1/CV7), postura da cabe?a
(NSL/OPT; NSL/VER) e outros valores cefalom?tricos (NSL/Go-Gn; NSL/Ocl;
Overjet) foram repetidas tr?s vezes pelo mesmo investigador em intervalos de
2 semanas e os valores m?dios das tr?s medidas foram calculados para serem
usados na an?lise estat?stica. Os coeficientes de correla??o intraclasse (ICC)
variaram entre 0,996 e 1,000, demonstrando uma alta confiabilidade das
medidas. Foram encontradas diferen?as estatisticamente significativas para
CV3/CV7 (P=0,006) e CV1/CV7 (P=0,005). N?o foram identificadas diferen?as
significativas na postura da cabe?a para os ?ngulos cr?nio-cervical e cr?niovertical.
A hip?tese nula foi rejeitada. A cirurgia ortogn?tica resultou em
aumento significativo da lordose cervical (extens?o) e tamb?m em uma
tend?ncia ? extens?o da postura da cabe?a.
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