Orientador: José Ricardo de Albergaria-Barbosa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba. / Made available in DSpace on 2018-08-20T01:39:48Z (GMT). No. of bitstreams: 1 Cabral-Andrade_Valdir_M.pdf: 2554505 bytes, checksum: 59b3398b4be124c9a3c5db0bc28f73f2 (MD5) Previous issue date: 2012 / Resumo: O objetivo deste estudo foi avaliar a influência da osteotomia da base mandibular nas osteotomias sagitais do ramo, comparando como ela modifica a resistência mecânica dos sistemas de fixação, bem como a distribuição de tensões, utilizando como metodologia os testes mecânicos, extensiométricos e de fotoelasticidade. Para os testes mecânico e extensométrico, foi utilizada uma amostra composta de 20 hemimandíbulas confeccionadas em poliuretano, sendo 10 hemimandíbulas para cada tipo de osteotomia fixadas com parafusos bicorticais posicionais em L invertido, as quais foram submetidas à incidência de carga analisada por extensometria até a falha do sistema de fixação através de teste de carregamento linear a uma velocidade de 1mm/min. Para o teste mecânico, não existiu diferença em termos de carga e deslocamento final. Para a análise extensométrica, não existiu diferença estatisticamente significante entre os parafusos 1 e 3 entre as amostras, somente para o parafuso 2. No caso da análise fotoelástica, a osteotomia da base mostrou apresentar melhor padrão de distribuição de tensões. Apesar dessas diferenças estatísticas, clinicamente elas não devem influenciar em termos de resistência mecânica, podendo ambas ser utilizadas dependendo do caso e da preferência de cada profissional / Abstract: The aim of this study was to evaluate the osteotomy of the inferior border of the mandible, comparing the mechanical resistance of the fixation system, as the tension distribuition, using the mechanical, extensiometric and photoelastic methodology. For the mechanical and extensiometic analysis, a sample of 20 polyurethane hemimandibles were made, 10 hemimandible for each type of osteotomy, fixed with positional bicortical screws in inverted L configuration, that were submitted to linear loading with a displacement of 1 mm/min until the fixation failure, with extensiometric analysis. The mechanical tests found no difference for final loading and displacement. For the extensiometric analysis, there was no statistical difference between the screws 1 and 3, just for the screw 2. In the photoelastic analysis, the osteotomy of the inferior border of the mandible presented better stress distribution pattern. Despite those differences in the in vitro tests, the inferior border osteotomy probably does not have clinical influence in the resistance and it should be done depending on the case and the preference of the professional / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Orientador: Roger William Fernandes Moreira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-20T05:27:44Z (GMT). No. of bitstreams: 1 Maliska_MaximianaCristinadeSouza_M.pdf: 978865 bytes, checksum: bda5de7a557c24f7bad2db92cbbead9f (MD5) Previous issue date: 2012 / Resumo: Os resultados em cirurgia ortognática dependem de um diagnóstico acurado e planejamento correto, portanto a cirurgia de modelo deverá ser com a menor quantidade de erros possível. Sabe-se que o uso do arco facial leva a diversos erros de aquisição do posicionamento tridimensional da maxila. Este estudo visou analisar se a alteração da angulação do plano oclusal influencia no resultado final após a cirurgia de modelos em avanços maxilares. Para esta análise dois tipos de avanço foram abordados: de 4 e de 8 milímetros. Foram montados 20 modelos maxilares com angulação de plano oclusal de 13 graus (grupo controle) e 20 modelos maxilares com angulação de 7 graus (grupo estudo) para cada grupo de avanço maxilar. A cirurgia de modelo com o respectivo avanço maxilar foi realizada utilizando-se o plano de 13 graus para a confecção do guia intermediário. Os 40 modelos foram remontados utilizando-se o mesmo guia. Mensurações foram realizadas com paquímetro digital utilizando plataforma de Erickson mais base metálica nos três planos: vertical, anteroposterior e médiolateral. A análise estatística revelou resultados significativos nos três planos. A alteração da angulação do plano oclusal em menos 6 graus alterou o resultado final nas medidas verticais: molar direito do grupo de avanço maxilar de 4 milímetros (p<0.0001) e molar esquerdo dos dois grupos de avanço (p<0.0001); na medida anteroposterior a partir do incisivo central superior do grupo de avanço de 4 milímetros (p<0.005) e do grupo de 8 milímetros (p<0.0001). Embora resultados estatisticamente significativos tenham sido encontrados, nenhuma significância clínica pode ser observada / Abstract: This study investigated whether an occlusal plane error of acquisition can influence in the treatment planning and result of maxillary advancement in double-jaw surgeries. Advancement of 8 and 4 millimeters were studied in different groups. For each group 20 maxillary models were mounted by a 13 degrees platform with superior articulator arm (control group) and another 20 models mounted with minus 6 degrees (study group). Intermediate splint was obtained by cast surgery performed in the control group. All the 40 maxillary models were remounted with this intermediate splint. Measurements in vertical and anteroposterior planes were accomplished pre and post-operatively by digital caliper rule and Erickson's platform. Statistical analysis showed significant results in all planes. The alteration of occlusal plane from 13 degrees to 7 degrees modified the final result in vertical measurements: right molar from group of 4 mm advancement (p<0.0001) and left molar from two groups of advancement (p<0.0001); in anteroposterior measurements: maxillary incisor from 4 mm of advancement (p<0.005) and 8 mm of advancement (p<0.0001). Notwithstanding the importance of statistical findings, this study was limited by a range of 4 mm of advancement and a range of 6 degrees of angle alteration because the sample were chosen by the laboratorial methodology. Clinical studies evolving these questions must be supplied in scientific literature / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Orientador: Márcio de Moraes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-20T12:59:05Z (GMT). No. of bitstreams: 1 Ritto_FabioGamboa_D.pdf: 4854546 bytes, checksum: 9fb3a4496d84ac69f450c97408ae204f (MD5) Previous issue date: 2012 / Resumo: O objetivo deste trabalho foi avaliar a precisão do posicionamento maxilar em cirurgias ortognáticas bimaxilares utilizando sequência cirúrgica convencional e sequência invertida, isto é, quando a mandíbula foi osteotomizada e fixada antes da maxila. Neste estudo retrospectivo, 80 telerradiografias obtidas em norma lateral de pacientes submeditos à cirurgia ortognática foram analisadas, sendo 40 obtidas no período pré-operatório e 40 no pós-operatório. A amostra foi dividida em 2 grupos de acordo com a sequência cirúrgica executada. No Grupo 1 constaram as radiografias de pacientes submetidos à cirurgia através da sequência convencional, enquanto no grupo 2 constaram as radiografias dos pacientes submetidos à cirurgia pela sequência invertida. Em ambos os grupos foi analisada posição final do incisivo central superior, tanto no sentido vertical quanto no ântero-posterior, sendo este resultado comparado com o que fora planejado, na busca da precisão cirúrgica. O resultado encontrado nos grupos 1 e 2 foram então confrontados na busca de diferenças entre as duas técnicas. Foi testada a hipótese nula de que não havia diferença entre os grupos analisados. Após aplicado o teste t de Welch para comparação das médias das diferenças entre o desejado e o obtido nos grupos 1 e 2, considerando significância estatística de 5% (alpha) e um teste bi-caudal, chegou-se a evidência estatística de que a hipótese não nula foi rejeitada dados os resultados obtidos das amostras (p>0,05). Sendo assim, não houve diferença no grau de precisão do posicionamento maxilar entre os grupos. Concluiu-se que tanto a sequência cirúrgica convencional quanto a sequência cirúrgica invertida mostraram ser técnicas confiáveis no posicionamento maxilar após osteotomia. tipo Le Fort I / Abstract: The objective of this study was to evaluate maxillary positioning accuracy of double jaw orthognathic surgery using conventional surgical sequence and inverted sequencing, ie, when the mandible was osteotomized and fixed prior to the jaw. In this retrospective study, 80 lateral radiographs obtained in patients that underwent orthognathic surgery were analyzed, 40 obtained in the preoperative and 40 in the postoperative period. The sample was divided into two groups according to the surgical sequence performed. Group 1 consisted of the radiographs of patients submitted to conventional surgical sequence, while group 2 consisted of the radiographs of patients that underwent surgery by the inverted sequencing. In both groups the final position of the maxillary central incisor was analyzed (in the vertical and anteroposterior planes), and this result was compared with what was planned in the pursuit of surgical precision. The results found in groups 1 and 2 were then compared in the search of differences between the two techniques. The null hypothesis, which stated that there was no difference between the groups, was tested. After applying the Welch t test for comparison of mean differences between the desired and obtained in groups 1 and 2, considering a statistical significance of 5% (alpha) and a two-tailed test, the null hypothesis was not rejected given the results of the samples (p> 0.05). Thus, there was no difference in the accuracy of maxillary positioning between the groups. It was concluded that the conventional surgical sequence as well as the inverted sequencing proved to be reliable in positioning the maxilla after Le Fort I osteotomy / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Orientador: Jose Ricardo de Albergaria Barbosa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T22:57:52Z (GMT). No. of bitstreams: 1 Santos_ZarinaTatiaBarbosaVieirados_M.pdf: 1096819 bytes, checksum: 2006f7be54ec5deb54b18701da9dca26 (MD5) Previous issue date: 2015 / Resumo: Objetivo: Avaliar a resistência mecânica de quatro métodos de fixação interna funcionalmente estável (FIFE) em dois desenhos de osteotomia sagital do ramo mandibular (OSRM), quando submetidos ao carregamento linear. Materiais e Métodos: Dois modelos de osteotomia foram feitos em hemimandíbulas de poliuretano e divididos em dois grupos, ambos com 20 amostras: Grupo I - osteotomia angular e grupo II - osteotomia linear. Depois de um avanço de 5 mm do segmento distal, os segmentos ósseos foram fixados com diferentes sistemas de placa/parafuso de 2,0 mm, estabelecendo os sub-grupos: (A), uma placa reta convencional de 4 furos, (B), uma placa reta convencional de 4 furos associado a um parafuso bicortical, (C), uma placa reta com travamento de 4 furos, (D), uma placa reta com travamento de 4 furos associado a um parafuso bicortical. As amostras, foram então, submetidas ao carregamento linear a uma velocidade de 1 mm/min, até alcançar a carga de pico e falha do sistema. Resultados: Pelo teste de Tukey, o grupo de uma placa convencional associado a um parafuso bicortical mostrou ter uma carga superior a 3 mm de deslocamento (87,42 ± 4,86 N) estatisticamente significativa em comparação com o de uma placa convencional com parafusos monocorticais (p <0,01) e uma placa com travamento com parafusos mocorticais (p <0,01). O grupo de uma placa de travamento associado a um parafuso bicortical mostrou ter uma carga superior a 3 mm de deslocamento (72,47 ± 4,86 N) estatisticamente significativa em comparação com o de uma placa convencional com parafusos monocorticais (p = 0,02) e uma placa com travamento com parafusos mocorticais (p = 0,01). Não houve diferença estatisticamente significativa entre os grupos: uma placa convencional com parafusos monocorticais e uma placa com travamento com parafusos mocorticais (p = 0,65); uma placa convencional associado a um parafuso bicortical e uma placa com travamento associado a parafuso bicortical (p = 0,15). A osteotomia angular apresentou maior resistência mecânica em 3 mm de deslocamento do que a linear. No entanto, o único grupo que apresentou diferença estatisticamente significante foi o grupo A (p = 0,05). Conclusão: não houve diferença entre o sistema de fixação placa/parafuso convencional e com travamento; a adição de um parafuso bicortical na região retromolar promoveu uma melhor estabilização dos sistemas de fixação. A OSRM angular apresentou melhor resistência mecânica / Abstract: Purpose: Evaluate the mechanical resistance of four different osteosynthesis in two different design of sagittal split ramus osteotomy (SSRO) when submitted to vertical forces. Materials and Methods: Two osteotomy models were made on polyurethane hemimandibles. Group I - angled osteotomy and group II - linear osteotomy, both with 20 specimes. After 5-mm advancement of the distal segment, the bone segments were fixed by different osteosynthesis methods using 2.0-mm plate/screw systems, establishing sub-groups: A, one 4-hole conventional straight plate, B, one 4-hole conventional plate and one bicortical screw, C, one 4-hole locking straight plate, D, one 4-hole locking straight plate and 1 bicortical screw. The samples were then subjected to a linear load at a speed of 1 mm/min until reaching peak load and system failure. Results: A Tukey post-hoc test revealed that the group of one conventional plate with bicortical screws showed higher load (87.42 ±4.86 N ) with statistically significantly compared to one conventional plate with monocortical screws (p<0.01 ) and one locking plate with mocortical screws (p<0.01). The group of one locking plate with bicortical screws showed higher load (72.47 ±4.86 N ) with statistically significantly compared to one conventional plate with monocortical screws (p=0.02) and one locking plate with mocortical screws (p=0.01). There was not a statistically significant difference between groups: one conventional plate with monocortical screws and one locking plate with mocortical screws (p=0.65); one conventional plate with bicortical screws and one locking plate with bicortical screws (p=0.15). The osteotomy with angle showed higher mechanical resistance than linear. However, the only group that showed statistically significant differences was the group A (p=0.05). Conclusion: no statistical differences were detected between locking and standard system, the placement of 2.0-mm¿diameter bicortical screws in the retromolar region, promoted a better stabilization of bone segments. The angular SSRO offers the best mechanical resistance / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestra em Clínica Odontológica

Introduction: Class II Division 1 malocclusions are characterized by a retrusive mandible and prominent upper incisors. Despite Class II malocclusions being one of the most frequently treated cases in orthodontists' office, there is no uniform consensus in the orthodontic community on the best treatment modality and biomechanical approach to use in treating patients with Class II malocclusions. Purpose: This paper examines the end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical versus non-surgical approaches. Study Design: This is a retrospective study of consecutively treated severe Class II Division I patients at the University of Iowa. Initial and deband lateral cephalometric radiographs were compared between 45 non-surgical and 21 surgical patients. All patients that were debanded between the ages of 13 to 19 years were included. Multivariable regression analyses were used to examine differences in outcomes between treatment groups. Results: Following adjustment for patient level confounders (age, gender, and race), those treated surgically had better end of treatment cephalometric outcomes. Those treated surgically had a more balanced skeletal profile, greater reduction in overjet, and improvement in ANB angle (p Conclusion: Orthodontic treatment in conjunction with orthognathic surgery is a more ideal treatment for patients with severe Class II Division I malocclusion. When treated surgically, a greater amount of overjet can be reduced while keeping lower incisors in a more stable position in bone.

ABSTRACT Background: Two-dimensional surgical planning does not adequately show the 3D aspect, which is important to assess in the planning of orthognathic surgery (OGS). In the last decade, 3D virtual surgical planning (VSP) has become an advantageous method and may replace conventional planning. Aim: To determine if the experience and implementation of VSP in OGS among professionals in oral and maxillofacial surgery in northern Sweden differs from the literature on the subject. Methods: A questionnaire was created for evaluation of the experience and implementation of VSP and a literature search was conducted through PubMed. Results: Fourteen of 17 respondents answered. Only fifty percent used VSP, even though all respondents were familiar with it. A bigger proportion of respondents would use VSP, but availability and lack of training prevented use. A sample of 33 articles were collected and described 1107 patients undergoing OGS, of which 1083 patients had undergone OGS with incorporation of VSP. Sixty-eight percent underwent bimaxillary surgery, 17 % maxillary surgery and 15 % mandibular surgery. Additionally, 169 patients were treated with genioplasty as well. Conclusion: The experience and implementation of VSP in northern Sweden are both in accordance and discordance with the literature. VSP has the advantage of accurate hard tissue prediction, but the literature describes the need of improvement concerning soft tissue imaging and postoperative assessment in VSP. More studies evaluating the accuracy and reliability of VSP software are needed. Disadvantages of VSP need to be resolved before VSP can replace conventional planning.

No description available.

No description available.

No description available.

Introduction: The objective of this retrospective longitudinal study was to assess and compare the surgical changes and stability of the maxilla, mandible, and mandibular condyle, in patients who have undergone surgery first approach (SFA) followed by conventional braces or Invisalign (Inv) treatment. Methods: Thirty patients had a cone beam computed tomography (CBCT) exam taken at three timepoints: T1 (presurgery), T2 (immediately after surgery), and T3 at the completion of orthodontics treatment. After the cranial base registration, twenty-seven landmarks were located on each time point using axial, sagittal, and coronal cross-sectional views in the ITK-SNAP software. In addition, seventeen skeletal angular and linear variables were measured using the 3D Slicer software. Result: In general, both Groups had similar sugical changes (T2-T1) and stability (T3-T2). There was a statistically significant longer postsurgical orthodontic time in the Fixed Group (x̅ = five months). Skeletally, comparing T3-T2 the B point showed a statistically significant inferior position in the Fixed Group compared to the Inv Group (1.3 mm), resulting in a larger increase in mandibular plane angle in the Fixed Group (x̅ = 2.7 degrees). Conclusion: The Fixed appliances and clear aligner therapy in the surgery first approach resulted in similar skeletal changes and stability, except for the mandibular plane angle, which showed a greater increase in the Fixed Group. This result may suggest that patients with hyperdivergent skeletal pattern could benefit from aligner therapy for the postsurgical orthodontic phase.