Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2017-02-06T12:47:09Z No. of bitstreams: 1 DIS_NEIMAR_SCOLARI_COMPLETO.pdf: 1049949 bytes, checksum: 34c4eb21fb744a249998c3c238ee02e1 (MD5) / Made available in DSpace on 2017-02-06T12:47:09Z (GMT). No. of bitstreams: 1 DIS_NEIMAR_SCOLARI_COMPLETO.pdf: 1049949 bytes, checksum: 34c4eb21fb744a249998c3c238ee02e1 (MD5) Previous issue date: 2015-03-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Objective: to evaluate the accuracy and precision of manual assessment method of results achieved from lateral cephalograms of 20 skeletal class II and III subjects who have undergone bimaxillary orthognathic surgery, comparing it to the three-dimensional evaluation performed from Cone-Beam Computed Tomography (CBCT) in the pre and postoperative period (6 months) in surgeries started by the maxilla. Materials and Methods: the surgeries were performed at Hospital S?o Lucas. Manual and three-dimensional tracings were made, respectively, in lateral cephalograms and CBCT with Dolphin Imaging Software by 2 independent evaluators, one of them was blinded to the proposed surgical movements for each patient. A custom cephalometric analysis was developed and applied to both forms of assessment (manual and three-dimensional). In the tracings, 9 pre and postoperative measures were evaluated. Four were vertical in relation to the PHF and were used to measure the maxillomandibular vertical changes, and five were in relation to the horizontal line N-perp, representing the anteroposterior maxillomandibular changes. Intraexaminer and interexaminer reliabilities were evaluated. The accuracy was measured by the RMSE. Precision was calculated from the comparison of standard deviations. Results: The three-dimensional assessment method showed better accuracy and precision when compared to the manual method. The mean scores of the differences between planned movements and performed movements in each method were lowerin three-dimensional assessment method group for five of the six variables (P <0.05). Conclusions: the planned movements are identified in the postoperative period. The three-dimensional assessment method is more precise and more accurate to evaluate and quantify these movements. Conclusions: the planned movements are identified in the postoperative period. The three-dimensional assessment method is more need and more accurate to evaluate and quantify These movements. It is Suggested que studies Evaluating results through manual assessment method overestimate the results. Perhaps the best way to Achieve this is through the three-dimensional assessment method. The knowledge and experience of the surgeon responsible for processing is fundamental in the treatment to be reproduced in patients in the trans-surgical, what was actually planned. / Objetivo: avaliar a acur?cia e a precis?o do m?todo de avalia??o manual dos resultados, realizado a partir de radiografias teleperfil em 20 pacientes padr?o facial classe II e III submetidos ? Cirurgia Ortogn?tica Bimaxilar, comparando-o com a avalia??o tridimensional realizada a partir de Tomografias Computadorizadas de face do tipo Cone-Beam (TCCB) nos per?odos pr? e p?s-operat?rio (6 meses), em cirurgias iniciadas pela maxila. Materiais e M?todos: As cirurgias foram realizadas no Hospital S?o Lucas da PUCRS. Tra?ados manuais e tridimensionais foram feitos, respectivamente, em telerradiografias de perfil e em Tomografias computadorizada cone-beam com o Dolphin Imaging Software, por 2 avaliadores independentes, sendo um deles cegado em rela??o aos movimentos cir?rgicos propostos para cada paciente. Foi desenvolvida uma an?lise cefalom?trica customizada e aplicada ?s duas formas de avalia??o (manual e tridimensional). Sobre os tra?ados, foram avaliadas 9 medidas pr? e p?s-operat?rias. Dessas medidas, quatro foram verticais em rela??o ao Plano horizontal de Frankfurt e serviram para mensura??o das mudan?as maxilomandibulares no sentido vertical, e cinco foram horizontais em rela??o ? Linha N-perp, representando as mudan?as maxilomandibulares no sentido ?ntero-posterior. Para avaliar a confiabilidade intra e inter-examinador metade dos tra?ados foi refeito ap?s 30 dias. A acur?cia foi medida atrav?s da raiz do erro quadr?tico da m?dia (RMSE). A precis?o foi calculada a partir da compara??o dos desvios-padr?o. Resultados: o m?todo tridimensional de avalia??o apresentou melhor acur?cia e precis?o quando comparado ao m?todo manual. As m?dias dos escores das diferen?as entre os movimentos planejados e os movimentos executados em cada um dos m?todos de avalia??o foram menores no grupo do m?todo de avalia??o tridimensional para todas as cinco vari?veis analisadas (P<0,05). Conclus?es: os movimentos previstos s?o identificados no per?odo p?s-operat?rio. O m?todo tridimensional ? mais preciso e mais acurado para avaliar e quantificar esses movimentos. O conhecimento e a experi?ncia do cirurgi?o respons?vel pelo tratamento representa parte fundamental no tratamento para que seja reproduzido no paciente no trans-cir?rgico, aquilo que realmente foi planejado.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-02T16:55:34Z No. of bitstreams: 1 TES_FERNANDO_ZUGNO_KULCZYNSKI_PARCIAL.pdf: 110674 bytes, checksum: 584e813640e5c92c98105d09981a5c88 (MD5) / Made available in DSpace on 2017-06-02T16:55:34Z (GMT). No. of bitstreams: 1 TES_FERNANDO_ZUGNO_KULCZYNSKI_PARCIAL.pdf: 110674 bytes, checksum: 584e813640e5c92c98105d09981a5c88 (MD5) Previous issue date: 2017-03-10 / The postural evaluation for patients submitted to orthognathic surgery is almost unheard of in the literature. The aim of this study was to determine the posture characteristics of patients with Class III pre and post orthognathic surgery through photogrammetry. In our study, we also evaluated the presence or absence of temporomandibular joint pain and the mean GAP distance in millimeters, making a direct correlation between both. First, we performed the outline of the posture profile and later compared the results before and after orthognathic surgery of these standard class III patients, so we started to have relevant data to guide us for future research, serving as the standard. The inclusion criteria for the sample were to present orthognathic surgery needs to correct class III dentofacial deformity and to undergo orthodontic preparation prior to surgery. All participants were recruited at the Facial Deformity Surgery Outpatient Clinic of the Faculty of Dentistry of PUCRS. They were submitted to a postural evaluation through photogrammetry through SAPO? software. The photos were taken by three people (two dentists and one physiotherapist) and were analyzed in SAPO? software by one person (a physical therapist). They were obtained with the patient in the standing position, and they were dressed in agreement that we could observe the 32 anatomical points, being: right and left swallow, right and left acromion, right and left antero-superior iliac spine, major trochanter Left and right femoral artery, right and left lateral femoral artery, right and left lateral artery, right and left lateral malleolus, right and left medial malleolus, point between the head of the 2nd and 3rd metatarsal Right and left lower scapula, right and left superior right iliac spine, spinous process C7, spinous process T3, point on the midline of the right and left leg, point on the right and left calcaneus tendon in the right and left Mean height of the two malleoli and right and left calcaneus. With our study it was possible to establish that the method of postural evaluation through photogrammetry demonstrated that the majorities of the corporal structures evaluated are out of the norms of normality in patients with Class III dentofacial profile and that the correction of the facial deformity through the Orthognathic surgery, reduced pain in the TMJ region and allowed systemic postural adjustments, mainly related to the posterior displacement of the head and trunk, as well as the right knee and heel valgus. / A avalia??o postural para pacientes submetidos a cirurgia ortogn?tica ? quase in?dito na literatura. O objetivo deste estudo foi determinar as caracter?sticas posturais dos pacientes classe III pr? e p?s-cirurgia ortogn?tica atrav?s de fotogrametria. No nosso estudo, tamb?m avaliamos, a presen?a ou aus?ncia de dor nas articula??es temporomandibulares e a dist?ncia m?dia do GAP em mil?metros, fazendo uma correla??o direta entre ambas. Num primeiro momento realizamos o delineamento do perfil posturas e posteriormente comparamos os resultados pr? e p?s-cirurgia ortogn?tica destes pacientes padr?o classe III, assim passamos ? ter dados relevantes para nos guiarmos para futuras pesquisas, servindo como padr?o. Os crit?rios de inclus?o para amostra foram apresentar necessidades de cirurgia ortogn?tica, para corre??o de deformidade dentofacial classe III e que estivessem realizando preparo ortod?ntico pr?vio ? cirurgia. Todos os participantes foram recrutados no Ambulat?rio de Cirurgia de Deformidade Facial, da Faculdade de Odontologia da PUCRS. Eles foram submetidos a uma avalia??o postural atrav?s de fotogrametria por meio do software SAPO?. As fotos foram realizadas por tr?s pessoas (dois cirurgi?es-dentistas e um fisioterapeuta) e foram analisadas no software SAPO? por uma pessoa (um fisioterapeuta). Elas foram obtidas com o paciente na posi??o de p?, e os mesmos estavam vestidos de acordo que pud?ssemos obsevar os 32 pontos anat?micos, sendo eles: trago direito e esquerdo, acr?mio direito e esquerdo, espinha il?aca ?ntero-superior direita e esquerda, troc?nter maior do f?mur direito e esquerdo, linha articular do joelho direito e esquerdo, ponto medial da patela direita e esquerda, tuberosidade da t?bia direita e esquerda, mal?olo lateral direito e esquerdo, mal?olo medial direito e esquerdo, ponto entre a cabe?a do 2? e 3? metatarso direito e esquerdo, ?ngulo inferior da esc?pula direito e esquerdo, espinha il?aca p?stero-superior direita e esquerda, processo espinhoso C7, processo espinhoso T3, ponto sobre a linha m?dia da perna direita e esquerda, ponto sobre o tend?o do calc?neo direito e esquerdo na altura m?dia dos dois mal?olos e calc?neo direito e esquerdo. Com o nosso estudo foi poss?vel estabelecer que o m?todo de avalia??o postural por meio da fotogrametria demonstrou que as maiorias das estruturas corporais avaliadas encontram-se fora dos padr?es de normalidade nos pacientes com perfil dentofacial Classe III e que a corre??o da deformidade facial, atrav?s da cirurgia ortogn?tica, reduziu a dor na regi?o da ATM e possibilitou ajustes posturais sist?micos, principalmente relacionados com o deslocamento posterior da cabe?a e do tronco, bem como do valgismo do joelho e calcanhar direitos.

Submitted by PPG Odontologia (odontologia-pg@pucrs.br) on 2018-03-19T17:25:43Z No. of bitstreams: 1 RENAN_ROBERTO_DA_COSTA_DIS.pdf: 1090443 bytes, checksum: 56040f9ad3251dfc8fb10d2a81d59187 (MD5) / Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-04-03T17:24:22Z (GMT) No. of bitstreams: 1 RENAN_ROBERTO_DA_COSTA_DIS.pdf: 1090443 bytes, checksum: 56040f9ad3251dfc8fb10d2a81d59187 (MD5) / Made available in DSpace on 2018-04-03T17:27:25Z (GMT). No. of bitstreams: 1 RENAN_ROBERTO_DA_COSTA_DIS.pdf: 1090443 bytes, checksum: 56040f9ad3251dfc8fb10d2a81d59187 (MD5) Previous issue date: 2017-12-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Anesthesia with induced hypotension is a technique used in orthognathic surgery in order to reduce the amount of bleeding, to improve the visualization of the operative field and to shorten the surgical time. The objective of this work was to carry out a systematic review about the topic, raising information on the main pharmacological agents used as well as the results of their applications. We collected studies published until November 2017 in the electronic databases Medline, Cochrane, Embase, Web of Science, in gray literature and by manual search. Of a total of 44 articles, only 21 were selected according to the inclusion criteria. The most commonly used hypotensive agents were nitroglycerin followed by remifentanil and sodium nitroprusside. The mean bleeding time in hypotension was 784,62?383,67 mL (p?0,944) whereas the mean surgical time was 298,26?76,22 minutes (p?0,000), only the latter with statistical significance. The use of local anesthetics produces significant results in reducing bleeding. It was not possible to conclusively determine the best pharmacological protocol for induced hypotension due to lack of data. The hypotensive agents sevoflurane associated with remifentanil, esmolol, isoflurane and remifentanil and only remifentanil showed better results in the reduction of bleeding. In addition, only the drugs esmolol and dexmedetomidine has shown significant reduction in operative time. In general, although there was a reduction in the amount of blood lost and in the operative time, only the latter presented a statistical difference compared to the normotensive technique. It is possible to conclude that the application of local anesthetics combined with induced hypotension generates less intraoperative bleeding. / A anestesia com hipotens?o induzida ? uma t?cnica utilizada em cirurgia ortogn?tica com a finalidade de diminuir a quantidade de sangramento, melhorar a visualiza??o do campo operat?rio e diminuir o tempo cir?rgico. O objetivo deste trabalho foi realizar uma revis?o sistem?tica sobre o assunto levantando informa??es acerca dos principais agentes farmacol?gicos utilizados bem como resultados de suas aplica??es. Foram coletados estudos publicados at? novembro de 2017 nas bases de dados eletr?nicas Medline, Cochrane, Embase, Web of Science, em literatura cinza e por busca manual. De um total 44 artigos, apenas 21 foram selecionados de acordo com os crit?rios de inclus?o. Os agentes hipotensivos mais empregados foram a nitroglicerina, seguida pelo remifentanil e nitroprussiato de s?dio. A m?dia de sangramento em hipotens?o foi de 784,62?383,67 mL (p?0,944) enquanto o tempo cir?rgico m?dio foi de 298,26?76,22 minutos (p?0,000), apenas o ?ltimo com signific?ncia estat?stica. A utiliza??o de anest?sicos locais produz resultados significativos na redu??o do sangramento. N?o foi poss?vel determinar de forma conclusiva qual o melhor protocolo farmacol?gico para hipotens?o induzida devido ? car?ncia de dados. Os agentes hipotensores sevoflurano associado a remifentanil, esmolol, isoflurano e remifentanil e apenas remifentanil mostraram os melhores resultados na redu??o de sangramento. Al?m disso, apenas os medicamentos esmolol e dexmedetomidina mostraram significante redu??o no tempo operat?rio. De forma geral, embora ocorra a redu??o na quantidade de sangue perdido e no tempo operat?rio, apenas este ?ltimo apresentou diferen?a estat?stica em compara??o ? t?cnica normotensiva. ? poss?vel concluir que a aplica??o de anest?sicos locais aliada a hipotens?o induzida gera menor sangramento intraoperat?rio.

Submitted by PPG Odontologia (odontologia-pg@pucrs.br) on 2018-06-27T12:27:04Z No. of bitstreams: 1 ORION_LUIZ_HAAS_JUNIOR_TES.PDF: 2204884 bytes, checksum: cac76e2b9d410650765f530d6290298d (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-07-03T12:16:53Z (GMT) No. of bitstreams: 1 ORION_LUIZ_HAAS_JUNIOR_TES.PDF: 2204884 bytes, checksum: cac76e2b9d410650765f530d6290298d (MD5) / Made available in DSpace on 2018-07-03T12:44:10Z (GMT). No. of bitstreams: 1 ORION_LUIZ_HAAS_JUNIOR_TES.PDF: 2204884 bytes, checksum: cac76e2b9d410650765f530d6290298d (MD5) Previous issue date: 2018-03-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / (Artigo ?Overview? de revis?es sistem?ticas em cirurgia ortogn?tica ? hierarquia da estabilidade cir?rgica) O objetivo do presente estudo ? avaliar por meio de uma ?overview? de revis?es sistem?ticas a estabilidade da cirurgia ortogn?tica em diferentes t?cnicas e movimentos cir?rgicos, a fim de estabelecer uma escala hier?rquica com o aux?lio do mais alto n?vel de evid?ncia cient?fica. A busca sistem?tica na literatura foi efetuada nas bases de dados PubMed, EMBASE e Biblioteca Cochrane. A literatura cinza foi investigada no Google Acad?mico e a busca manual foi realizada nas refer?ncias dos estudos inclu?dos. Quarenta e cinco estudos foram selecionados para leitura na ?ntegra e, desses, 15 foram inclu?dos na amostra final, sendo 8 revis?es sistem?ticas e 7 meta-an?lises. O n?vel de concord?ncia entre os autores para a sele??o e elegibilidade dos estudos foi considerado excelente, com os respectivos valores de kappa: k=0,827 e k=0,857. A escala hier?rquica da estabilidade em cirurgia ortogn?tica foi estabelecida com dois procedimentos cir?rgicos considerados muito inst?veis: a expans?o maxilar com fixa??o interna semi-r?gida avaliada a n?vel dent?rio na regi?o posterior e a rota??o hor?ria da mand?bula com fixa??o interna r?gida de parafuso bicortical no sentido sagital. Os estudos secund?rios foram considerados com qualidade metodol?gica de m?dia a alta pelos pesquisadores com base na ferramenta AMSTAR 2, e os estudos prim?rios inclu?dos nos estudos secund?rios foram classificados por esses, na sua grande maioria, com potencial para risco de vi?s moderado a alto. Sugere-se a produ??o de ensaios cl?nicos bem delineados para elevar a qualidade dos estudos prim?ros e de revis?es sistem?ticas que incluam an?lises tridimensionais para a estabilidade cir?rgica. / (Artigo Stability and surgical complications in segmental Le Fort I osteotomy : a systematic review) The aim of this study was to conduct a systematic review to evaluate the stability and surgical complications of segmental Le Fort I osteotomy. The search was divided in Main search (PubMed, EMBASE and Cochrane Library), Gray literature (Scholar Google) and Manual search. Twenty-three studies were included, 14 studies evaluated stability outcome and 9 studies surgical complications outcome. The level of agreement between the authors was considered excellent (k=0.893 ? study selection and k=0.853 ? study elegibility). Segmental Le Fort I osteotomy provides stable outcomes in the sagittal plane, is less stable dentally than skeletally in the transverse plane, and provides little stability in the posterior segment after downward movement. The most recurrent complications are oral fistula (6 studies) and damage to adjacent teeth (5 studies), but the most prevalent complication is postoperative infection (32.62%). Four studies evaluating stability outcome showed a medium potential risk of bias, whereas all studies addressing surgical complications showed a high potential risk of bias. Segmental Le Fort I osteotomy should not be proscribed from the technical armamentarium in orthognathic surgery. On the contrary, the consulted literature suggests it is a useful tool for the three-dimensional surgical correction of maxillary malposition. / (Artigo ?Overview? de revis?es sistem?ticas em cirurgia ortogn?tica ? hierarquia da estabilidade cir?rgica) The objective of the present study is to evaluate the stability of orthognathic surgery in different surgical techniques and movements by means of an overview of systematic reviews in order to establish a hierarchical scale with the aid of the highest level of scientific evidence. The systematic search in the literature was carried out in PubMed, EMBASE and Cochrane Library databases. The gray literature was investigated in Google Scholar and a manual search was made in the references of included studies. Forty-five studies were selected for reading the full text, and of these, 15 were included in the final sample, of which 8 were systematic reviews and 7 were meta-analyzes. The level of agreement between the authors for the selection and eligibility of the studies was considered excellent, with the respective kappa values: k = 0.827 and k = 0.857. The hierarchical scale of stability in orthognathic surgery was established with two surgical procedures considered very unstable, the maxillary expansion with semi-rigid internal fixation evaluated at the dental level in the posterior region and the mandible clockwise rotation with rigid internal fixation of bicorticals screws in the sagittal direction. The hierarchical scale of stability in orthognathic surgery was established with two surgical procedures considered very unstable, the maxillary expansion with semi-rigid internal fixation evaluated at the dental level in the posterior region and the mandible clockwise rotation with rigid internal fixation of bicorticals screws in the sagittal direction. Secondary studies were considered to be of medium to high methodological quality by the researchers based on the AMSTAR 2 tool and the primary studies included in the secondary studies were classified by them with the potential for risk of bias as moderate to high. The authors suggest the production of well-designed clinical trials to raise the quality of primary studies and systematic reviews that include threedimensional analyzes for surgical stability.

Made available in DSpace on 2015-04-14T13:30:06Z (GMT). No. of bitstreams: 1 437502.pdf: 1046273 bytes, checksum: 9cb9d6a7a6e8669da406b3daccd4a8a0 (MD5) Previous issue date: 2012-03-02 / OBJECTIVE: Evaluate the differences and the correlation between the points in hard and soft tissues of the facial profile and between measures in pharyngeal airway and jaw movements, in the pre-operative and post-operative at short and medium term, in Class III patients who underwent bimaxillary orthognathic surgery (maxillary advancement and mandibular setback).MATERIALS AND METHODS: Preoperative radiographs (T1), post-operative up to 3 months (T2) and post-operative after 6 months up to 12 months (T3) of 58 patients with Class III facial pattern who underwent bimaxillary orthognathic surgery were scanned, digitized and inserted into Dolphin Imaging software v. 3D 11.0 (Dolphin Imaging Software, Canoga Park, Calif?rnia, EUA) for evaluation of 11 points of hard and soft tissue of facial profile in relation to True Vertical Line (TVL) and for the measurement of five measures of pharyngeal airway and two point of hard tissue in relation to n-perp Line. All tracings were performed by a single calibrated examiner. The Student t-test for paired samples was used to determine if significant differences between preoperative and postoperative periods and differences between the two postoperative periods to evaluate recurrence. To verify a significant correlation between hard and soft tissue points for the same periods, were used the Pearson correlation coefficient. To verify a significant correlation between the measures of pharyngeal airway and the points in hard tissue in relation to n-perp line for the same periods, it was used the Spearman correlation coefficient. The results were considered at a maximum significance level of 5% and assessed using SPSS ? software, version 18.0.RESULTS: Significant changes are identified in all points of soft and hard tissue between preand and two postoperative periods (T2-T1, T3-1) and relapse (T3-T2) in points Nasal Projection, Lower Incisor, Lower lip, Pog and Pog '. The correlation observed between the movements of all points between all periods is greater in mandible than in maxilla. Similarly the correlations between hard and soft tissue, the correlations only between hard tissues and only between soft tissues present a strong correlation between the mandibular points in T2-T1 and T3-T1. In maxilla was identified correlation between A x Upper Lip in T2-T1. In relation to airways, it was identified significant changes in all measures of nasalpharynx, oropharynx and hypopharynx evaluated between preoperative and two postoperative periods (T2-T1, T3- T1). In general, measures increased in nasal and oropharynx and decreased in hypopharynx and lower oropharynx at the short and medium term. Correlation between jaw movements and change in measures of airway was found between nasopharynx and maxillary advancement and between low oropharynx and mandibular setback. Correlation between the movements in only airway measures, in T2-T1 and T3-T1, were found between measures anatomically near located. Among the periods (T3-T2), there were no significant correlations between any measures.CONCLUSIONS: The correlation between hard and soft tissues in the mandible is greater than the maxilla. The correlations only between hard tissues and only between soft tissues follow a pattern similar to the correlations between hard and soft tissues. The results of this work are similar to results found in works about monomaxilar surgeries for both the maxilla and the mandible. The influence of the movements in hard tissues is restricted to the soft tissues of the same jaw, although there are exceptions. Correlation between jaw movements and change in measures of airway was found between nasopharynx and maxillary advancement and between low oropharynx and mandibular setback. Correlation in airway were found between measures anatomically near located, demonstrating the importance of pharyngeal muscles in this relationship. / OBJETIVO: Avaliar as diferen?as e verificar a correla??o existente entre pontos de tecido mole e pontos de tecido duro do perfil facial e entre medidas em vias a?reas far?ngeas e os movimentos nos ossos gn?ticos, nos per?odos pr? operat?rio e p?s operat?rios, a curto e m?dio prazo, em pacientes com padr?o facial Classe III, submetidos ? cirurgia ortogn?tica (CO) bimaxilar (combinada-avan?o de maxila e recuo de mand?bula).MATERIAL E METODOS: Tele radiografias pr?-operat?rias (T1), p?s-operat?rias de at? 3 meses (T2) e p?s-operat?rias entre 6 e 12 meses (T3) de 58 pacientes com padr?o facial Classe III que foram submetidos ? CO bimaxilar foram escaneadas, digitalizadas e inseridas no software Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, Calif?rnia, EUA) para avalia??o de 11 pontos de tecido duro e mole do perfil facial em rela??o ? Linha Vertical Verdadeira (LVV) e mensura??o de 5 medidas de vias a?reas far?ngeas e 2 de tecido duro em rela??o ? Linha N-perp (n-perp). Todos os tra?ados foram realizados por um ?nico avaliador calibrado. O Teste t-Student para amostras pareadas foi utilizado para verificar se houve diferen?a significativa entre os per?odos pr? e p?soperat?rios e diferen?a entre os dois tempos p?s-operat?rios para avaliar o grau de acomoda??o dos tecidos. Para verificar correla??o significativa existente entre os pontos de tecido duro e os pontos de tecido mole para os mesmos per?odos utilizou-se o coeficiente de correla??o de Pearson e entre as medidas de vias a?reas far?ngeas e as de tecido duro em rela??o ? linha n-perp o coeficiente de correla??o de Spearman. Os resultados foram considerados a um n?vel de signific?ncia m?ximo de 5% e avaliados atrav?s do software SPSS?, vers?o 18.0.RESULTADOS: Identificam-se mudan?as significativas em todos os pontos de tecido mole e duro entre o per?odo pr? e os dois per?odos p?s-operat?rios (T2-T1, T3-1) e grau significante de acomoda??o dos tecidos (T3-T2) nos pontos de Proje??o nasal, Incisivo Inferior, L?bio Inferior, Pog e Pog. A correla??o verificada entre os movimentos dos pontos entre todos os per?odos ? maior na mand?bula do que na maxila. De forma semelhante ?s correla??es entre tecido duros e moles, as correla??es entre apenas tecidos duros e apenas tecidos moles apresentam, em T2-T1 e T3-T1, forte correla??o entre os pontos mandibulares. Na maxila foi identificada correla??o entre A x L?bio Superior em T2-T1. Em rela??o ?s vias a?reas far?ngeas, identificou-se mudan?as significativas em todas as medidas de naso, oro e hipofaringe avaliadas entre o per?odo pr? e os dois per?odos p?s-operat?rios (T2-T1, T3-T1). De modo geral, as medidas de naso e orofaringe aumentaram e as de hipofaringe e orofaringe baixa diminuiram a curto e m?dio prazo. Correla??o entre os movimentos dos ossos gn?ticos e a mudan?a nas medidas das vias a?reas far?ngeas foi encontrada entre nasofaringe e avan?o maxilar e entre orofaringe baixa e recuo mandibular. Correla??o entre os movimentos apresentados apenas entre medidas de vias a?reas, em T2-T1 e T3-T1, foram encontradas entre as medidas situadas anatomicamente pr?ximas. J? entre os per?odos (T3-T2), n?o foram observadas correla??es significantes entre quaisquer medidas.CONCLUS?ES: A correla??o entre tecidos duros e moles ? maior na mand?bula do que na maxila. As correla??es apenas entre tecidos duros e apenas entre tecidos moles seguem um padr?o semelhante ?s correla??es encontradas entre tecidos duros e moles. Os resultados deste trabalho assemelham-se aos resultados encontrados em trabalhos sobre cirurgias monomaxilares, tanto para maxila quanto para mand?bula, sendo que a influ?ncia dos movimentos de tecidos duros fica, em sua maioria, restrita aos tecidos moles do mesmo maxilar, embora haja exce??es. As correla??es encontradas entre os movimentos nos ossos gn?ticos e as modifica??es nas vias a?reas s?o do aumento da Nasofaringe com o avan?o maxilar e da diminui??o da Orofaringe Baixa com o recuo mandibular a curto e m?dios prazos. Correla??es foram encontradas nas medidas de vias a?reas entre as quais est?o localizadas com proximidade anat?mica, demonstrando a import?ncia da musculatura da faringe nessa rela??o.

Made available in DSpace on 2015-04-14T13:30:30Z (GMT). No. of bitstreams: 1 453106.pdf: 4497189 bytes, checksum: 68f0d5790726136b83f14661d441e762 (MD5) Previous issue date: 2013-11-12 / OBJECTIVE: To evaluate and compare the differences and check the correlation that exists between the hyoid bone, the airways and the point B, in short and medium term preoperative and postoperative periods, after the mandibular setback and advancement surgery has taken place. MATERIAL AND METHOD: Preoperative radiography (T1), postoperative up to 3 months (T2), and postoperative after 12 months (T3) from 79 patients with facial pattern class II and III who had undergone orthognathic surgery. These radiographies were scanned, digitalized and inserted in the Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, California, EUA) to the evaluation of 6 points. All outlines were made by two evaluators and 10 % of them were repeated after two months. In order to verify the normality of the data it was used the non-parametric Kolomogorov-Smirnov test. It was considered the index of significance (p<0.05) and the GraphPad Prism statistic software was used for all analyses. RESULTS: It has been identified significant changes in all points of soft and hard tissue between the preoperative and the two postoperative periods (T2-T1) and a significant level of accommodation of tissues (T3-T1) on the hyoid bone and airways. In T3-T1 (accommodation movement of the hyoid bone) it is observed a gradual return of the hyoid bone after the realization of the orthognathic surgery, mainly in movements above 3mm (p<0.05). During the 12 months of monitoring, it was observed a posterior movement of the hyoid bone in setback jaw surgery and anterior movement in forward jaw surgery (p<0.05), with a consequent return to the preoperative position 12 months after the surgery. Regarding the airways, the medium and minimum setback did not show significant variation in long term period (p>0.05), what happened differently of the lower airway, in which there was a shortening of the airways after one year of monitoring (p<0.05). In the foward jaw movement there was a widening of airways, showing a return close to the initial one, 12 months after the surgery (p<0.05). CONCLUSION: It has been observed in this study that the hyoid bone tends to return to the original position, mainly when it is present a setback above 3 mm and greater ones. The same holds true regarding the airways, in which it is observed a shortening of the airways in greater mandibular setbacks; and widening of the airways in greater mandibular forward movement, with a gradual return after 12 months. The Pogonion point and the B point showed a far posterior positioning, presenting a greater recidivism when the mandibular movements were bigger. The opposite happened in the mandibular forward movement cases. / OBJETIVO: Avaliar e comparar as diferen?as e verificar a correla??o existente entre o osso hi?ide, vias a?reas em regi?o de orofar?nge e ponto B, nos per?odos pr? operat?rio e p?s operat?rios a curto (3 meses) e m?dio prazo (12 meses), ap?s a realiza??o da cirurgia de recuo e avan?o mandibular MATERIAL E METODOS: Tele radiografias em perfil pr?-operat?rias (T1), p?s-operat?rias de at? 3 meses (T2) e p?s-operat?rias com 12 meses (T3) de 79 pacientes com padr?o facial classe II e III que foram submetidos ? cirurgia ortogn?tica foram escaneadas, digitalizadas e inseridas no software Dolphin Imaging 3D v. 11.0 (Dolphin Imaging Software, Canoga Park, Calif?rnia, EUA) para avalia??o de 6 pontos. Todos os tra?ados foram realizados por dois avaliadores, sendo 10% deles repetidos ap?s dois meses. Para a verifica??o da normalidade dos dados foi utilizado o teste de Kolmogorov-Smirnov. Considerou-se ?ndice de signific?ncia p < 0.05 e foi utilizado o software estat?stico GraphPad Prism 5.0? para todas as an?lises. RESULTADOS: Identificam-se mudan?as significativas em todos os pontos de tecido mole e duro entre o per?odo pr? e nos dois per?odos p?s-operat?rios (T2-T1) e grau significante de acomoda??o dos tecidos (T3-T1) nos pontos osso hi?ide e vias a?reas. Em T3-T1 (movimento de acomoda??o do osso hi?ide) observa-se um retorno gradual do osso hi?ide ap?s a realiza??o do recuo e avan?o mandibular, principalmente em movimentos acima de 3 mm (p<0.05). Durante 12 meses de acompanhamento observou-se uma movimenta??o posterior do hi?ide nas cirurgias de recuo mandibular e movimenta??o anterior nas cirurgias de avan?o mandibular (p<0.05), tendo um retorno ao posicionamento pr?-operatorio ap?s 12 meses da realiza??o da cirurgia. Com rela??o as vias a?reas o Recuo m?dio e m?nimo n?o apresentaram varia??o significante a longo prazo (p>0.05), o que ocorreu diferentemente do espa?o a?reo inferior, onde houve um estreitamento das vias a?reas ap?s 1 ano de acompanhamento (p<0.05). Nos movimentos de avan?o mandibular houve um alargamento das vias a?reas, apresentando um retorno pr?ximo ao inicial, 12 meses ap?s a realiza??o da cirurgia (p<0.05). CONCLUS?ES: Observou-se neste estudo que o hi?ide tende a retornar a posi?ao original, principalmente em recuos acima de 3 mm, e em avan?os de maior magnitude, o que ? tamb?m observado em rela??o as vias a?reas onde observa-se um estreitamento das vias a?reas em recuos mandibulares maiores, e um alongamento das vias a?reas em avan?os mandibulares maiores, com retorno gradual ap?s 12 meses. O ponto Pog?nio e ponto B apresentaram um posicionamento mais posterior, apresentando uma recidiva maior quando os movimentos mandibulares eram maiores, tendo ocorrido o inverso nos avan?os mandibulares.

Made available in DSpace on 2015-04-14T13:30:31Z (GMT). No. of bitstreams: 1 456867.pdf: 820189 bytes, checksum: d351ea4d0c340ff7b3f5a81f93822cca (MD5) Previous issue date: 2014-01-20 / The objectives of this study is to conduct a systematic review to evaluate the accuracy of computer-aided design and computer-aided manufacturing planning in orthognathic surgery, to determine the quality of the current literature and the need for new methods on this subject . A systematic literature search was performed in PubMed, EMBASE, Cochrane Library, LILACS and SciELO. The gray literature was investigated in Google Scholar and in the annals of the most important conferences of Oral and Maxillofacial Surgery. The papers found passed for a selection criteria and eligibility by two authors independently and blindly. After the selection of eligible studies, it was made a manual search in the references of the included papers and then data extraction and analysis of quality were performed. By searching in the databases 350 studies were found. So, 33 were selected for full reading and six were included in the study. Through the gray literature search, four papers were selected for full reading and only one was included. From the manual search one study was included. Thus, eight studies were included in this systematic review. The level of agreement among the authors for studies selection was substancial (kappa= 0.767) and studies eligibility was considered excellent (kappa= 0.863). The accuracy in computer-aided design and computer-aided manufacturing planning in orthognathic surgery in the translation were less than 1.2 mm in the maxilla (vertical) and less than 1.1 mm in the mandible (sagittal), and in the rotations were less than 1.5? in the maxilla (pitch) and less than 1.8? in the mandible (pitch). Two studies showed a medium potential for risk of bias and six studies showed a high potential for risk of bias. The computer-aided design and computer-aided manufacturing planning in orthognathic surgery is considered accurate to the studies included in this systematic review. However, the low quality of the studies makes that the development of randomized clinical trials are needed to assess whether it really brings major benefits to the patient and to the surgical procedure compared to conventional planning / Os objetivo do presente estudo s?o realizar uma revis?o sistem?tica para avaliar a acur?cia do planejamento assistido por computador em cirurgia ortogn?tica, averiguar a qualidade da literatura atual e a necessidade de novas metodologias sobre o assunto. A busca sistem?tica na literatura foi efetuada nas bases de dados PubMed, EMBASE, Biblioteca Cochrane, LILACS e SciELO. A literatura cinza foi investigada no Google Acad?mico e nos anais dos congressos mais importantes de Cirurgia e Traumatologia Buco-Maxilo-Facial. Os artigos encontrados passaram por um crit?rio de sele??o e elegibilidade por dois autores de maneira cega e independente. Ap?s a sele??o dos estudos eleg?veis, realizou-se uma busca manual nas refer?ncias desses, fez-se extra??o dos dados e a an?lise de qualidade dos mesmos. Atrav?s da busca nas bases de dados foram encontrados 350 artigos. Desses 33 foram selecionados para leitura na ?ntegra e seis foram inclu?dos no estudo. Atrav?s da busca na literatura cinza, quatro artigos foram selecionados para leitura na ?ntegra e apenas um foi inclu?do no estudo e a partir da busca manual um artigo foi inclu?do. Dessa maneira, oito estudos foram inclu?dos nesta revis?o sistem?tica. O n?vel de concord?ncia entre os autores para sele??o dos estudos foi considerado substancial (kappa= 0,767) e para elegibilidade dos estudos foi considerado excelente (kappa= 0,863). A acur?cia no planejamento assistido por computador em cirurgia ortogn?tica nos sentidos de transla??o foi menor do que 1,2 mil?metros na maxila (vertical) e menor do que 1,1 mil?metros na mand?bula (sagital), e nos sentidos de rota??o foi menor do que 1,5? na maxila (pitch) e menor do que 1,8? na mand?bula (pitch). Dois estudos apresentaram potencial m?dio para risco de vi?s e seis estudos apresentaram potencial alto para risco de vi?s. O planejamento assistido por computador em cirurgia ortogn?tica ? considerado acurado pelos estudos inclu?dos nesta revis?o sistem?tica. A baixa qualidade dos artigos, entretanto, faz com que seja necess?ria a elabora??o de ensaios cl?nicos randomizados para avaliar se ele realmente traz maiores benef?cios ao paciente e ? pr?tica cir?rgica quando comparado ao planejamento convencional

Made available in DSpace on 2015-04-14T13:30:32Z (GMT). No. of bitstreams: 1 456863.pdf: 1358105 bytes, checksum: 39523eef0c09605a8c2ac3ac9c47047b (MD5) Previous issue date: 2013-12-17 / Dentofacial deformities affect the jaws and teeth, and can lead to functional, social and psychological disorders. This study evaluated the impact of oral health problems in related quality of life in adults with dentofacial deformities, before and after orthognathic surgery, and its impact on quality of life in general and related to oral health. For this, there were used the questionnaires Whoqol-bref, OQLQ and OHIP-14. This study included 74 patients who presented for dentofacial deformity treatment and Angle malocclusion Class I, II and III, at the Department of Oral and Maxillofacial Surgery, School of Dentistry of Pontif?cia Universidade Cat?lica do Rio Grande do Sul between 2006 and 2012. The patients underwent previous orthodontic treatment and they were healthy. Patients with palate and lip cleft, syndromes, traumatic facial deformities or congenital malformation, pregnants, patients younger than 15 years and patients with pre-existing systemic diseases were excluded. The subjects were asked to answer a questionnaire with questions before surgery (T0) and another in an average of 4-6 months of postoperative follow-up (T1). The study group consisted of 49 women (66.2%) and 25 men (33.8%), with age between 15 and 53 years (mean 28.0 ? 9.0), 58 patients (78.4%) were Angle Class III, 11 patients (14.9%) Angle Class II and 05 patients (6.8%) were Class I. Through the Whoqol-bref, w e noticed a significant increase (WILCOXON, p &#8804; 0.01) of the scores in the domains between T0 and T1, indicating significant improvement in quality of life, with the exception of patients Angle Class I. There was also a significant reduction (WILCOXON, p &#8804; 0.01) between the average overall score OQLQ the preoperative (T0 = 48.0 ? 22.8) to the postoperative (T1 = 11.9 ? 7.8), and a significant improvement in quality of life related to oral health after surgery. There was a statistically significant reduction (WILCOXON, p &#8804; 0.01) between the average overall score of OHIP-14 preoperatively (T0 = 13.10 ? 6.1), for the post-treatment period (T1 = 3.20 ? 3.8), and also in the evaluated domains. This study demonstrated that the orthognathic surgery had a positive impact on the oral health of evaluated patients and it noted significant changes in overall and oral health-related quality of life after surgery. It was concluded that orthodontic treatment combined with orthognathic surgery is a treatment modality reliable, with positive impact on facial aesthetics, oral function, facial appearance and awareness of social benefits, such as improved self-confidence, indicating that orthognathic surgery is appropriate therapy for patients with dentofacial deformity, despite some risks and morbidity related to the procedure performed. / As deformidades dentofaciais afetam os ossos dos maxilares e denti??o, e podem levar a problemas funcionais, sociais e psicol?gicos. Este estudo avaliou o impacto dos problemas de sa?de oral na qualidade de vida de adultos com deformidades dentofaciais, antes e ap?s a cirurgia ortogn?tica, e o impacto desta na qualidade de vida geral e relacionada a sa?de bucal. Para isso, foram utilizados os question?rios Whoqol-bref, OQLQ e OHIP-14. Foram inclu?dos neste estudo 74 pacientes que se apresentaram para o tratamento de deformidades dentofaciais e maloclus?o tipo Classe I, II e III de Angle, no Departamento de Cirurgia da Faculdade de Odontologia da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, no per?odo de 2006 a 2012. Os pacientes realizaram tratamento ortod?ntico pr?vio e eram saud?veis. Foram exclu?dos deste estudo os pacientes com fissura labial e palatina, s?ndromes, deformidades faciais decorrente de traumatismo ou m?forma??o cong?nita, gestantes, menores de 15 anos e pacientes com doen?as sist?micas pr?-existentes. Os sujeitos foram convidados a responder um question?rio de perguntas antes do tratamento cir?rgico (T0) e num per?odo m?dio de acompanhamento p?s-operat?rio de 4 a 6 meses (T1). O grupo estudado era constitu?do de 49 mulheres (66,2%) e 25 homens (33,8%), com idade variando entre 15 e 53 anos (m?dia de 28,0 ? 9,0), sendo 58 pacientes (78,4%) portadores de deformidade do tipo Classe III de Angle, 11 pacientes Classe II (14,9%) e 05 pacientes Classe I (6,8%). Atrav?s do Whoqol-bref, foi observado aumento significativo (WILCOXON, p&#8804; 0,001) na pontua??o dos dom?nios entre T0 e T1, indicando melhoria significante da qualidade de vida, com exce??o dos pacientes classe I. Houve tamb?m redu??o significante (WILCOXON, p &#8804; 0,01) entre a pontua??o geral m?dia do OQLQ do per?odo pr? (T0 = 48,0 ? 22,8) para o p?soperat?rio (T1 = 7,8 ? 11,9), notando-se melhora significativa da qualidade de vida relacionada a sa?de oral ap?s o tratamento cir?rgico. Houve uma redu??o estatisticamente significante (WILCOXON, p &#8804; 0,01) entre a pontua??o geral m?dia do OHIP-14 do pr?-operat?rio (T0 = 13,10 ? 6,1) para o per?odo p?s-operat?rio (T1 = 3,20 ? 3,8), e tamb?m nos dom?nios avaliados. Este estudo demonstrou que a cirurgia ortogn?tica teve um impacto positivo sobre a sa?de dos pacientes avaliados e se observou mudan?as significativas na qualidade de vida geral e relacionada ? sa?de bucal ap?s o tratamento cir?rgico. Conclui-se que o tratamento ortod?ntico combinado ? cirurgia ortogn?tica ? uma modalidade de tratamento confi?vel, com impacto positivo na est?tica facial, fun??o do sistema estomatogn?tico, consci?ncia da apar?ncia facial e vantagens sociais, como melhoria da autoconfian?a, indicando que a cirurgia ortogn?tica ? uma terapia apropriada para pacientes com deformidade dentofacial, apesar de alguns riscos e morbidade inerentes ao procedimento realizado.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-06-03T14:30:11Z No. of bitstreams: 1 TES_OTAVIO_EMMEL_BECKER_PARCIAL.pdf: 3267458 bytes, checksum: b2d67fc8d4b3f7c8edcb8726eddc5fbc (MD5) / Made available in DSpace on 2016-06-03T14:30:11Z (GMT). No. of bitstreams: 1 TES_OTAVIO_EMMEL_BECKER_PARCIAL.pdf: 3267458 bytes, checksum: b2d67fc8d4b3f7c8edcb8726eddc5fbc (MD5) Previous issue date: 2016-01-27 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / PURPOSE: Present and evaluate a 3D cephalometric analysis of hard and soft tissues to describe, compare, correlate and predict changes in measures assessed in soft tissues in relation to bone changes resulting from double-jaw orthognathic surgery in Class III patients. Also to correlate changes observed only in soft tissues. The hypothesis is that skeletal changes may affect and are correlated to changes in facial soft tissues in different forms in several regions of the face and also differently in relation to each individual reference plane and in 3D. MATERIALS AND METHODS: Calibration of the measures was carried out using the intraclass correlation coefficient (ICC) and the absolute difference between intra and inter evaluators assessments. Cone beam tomography pre and postoperative of 23 (9 male, 14 female, average age of 28 years and 7 months) were evaluated in Dolphing Imaging 3D software. The t-Student test for paired samples was applied in order to compare the pre and postoperative values for all the analyzed measures and changes in soft tissue in relation to bone alterations. The analysis of the effect size was also applied by the Cohen?s "d" coefficient. Pearson correlation coefficient was used in order to correlate the bone movement with soft tissue changes and the latter only among themselves. The stepwise multiple regression analysis was applied to try to identify the degree of influence of each Independent Variables individually on each of the Dependent Variables. All analyzes were applied in relation to three reference planes individually and in 3D. The level of significance was set at 95%. RESULTS: The degree of correlation in intra and inter evaluators assessmens was high, with the average of Absolute Differences for the total set of each type of measurement ranging below the limits of clinical relevance of 2mm and 4 ?. Higher changes and higher correlations were identified more in the mandible than in the maxilla and more in the central region than in the peripheral face. The movements of the soft tissue correlated significantly with the movements of the underlying skeletal bone (midle third of the face in relation to the maxilla and inferior third of the face in relation to the mandible) and in relation to the same reference plane, although there were exceptions. Fully satisfactory values of prediction for the results of soft tissues after this type of surgery were not identified, especially in 3D. CONCLUSIONS: The results allow validation of the measures, except for Nasolabial and Labiomentual angles. The null hypothesis could be rejected, since the skeletal changes affected and were correlated to changes in facial soft tissues in different forms in several regions of the face and also differently in relation to each individual reference plane and in 3D. / OBJETIVO: Propor e validar uma an?lise cefalom?trica 3D de tecidos duros e moles, aplicando-a para descrever, comparar, correlacionar e prever as altera??es ocorridas nas medidas avaliadas em tecidos moles com as altera??es ?sseas decorrentes da cirurgia ortogn?tica bimaxilar em pacientes Classe III, al?m de correlacionar as altera??es em tecidos moles entre si. A hip?tese ? que altera??es esquel?ticas podem afetar e se correlacionam ?s altera??es dos tecidos moles faciais de forma diferente em diversas regi?es da face e tamb?m de forma diferente em rela??o aos planos de refer?ncia individuais e em 3D. MATERIAL E M?TODOS: A calibra??o das medidas foi realizada utilizando-se o Coeficiente de Correla??o Intraclasse (CCI) e a Diferen?a Absoluta entre as avalia??es intra e interexaminadores. Tomografia do cone beam pr? e p?s-operat?rias de 23 pacientes (9 homens, 14 mulheres, m?dia de idade de 28 anos e 7 meses) foram avaliadas no software Dolphing Imaging 3D. Com intuito de comparar os valores pr? e p?s-operat?rios para todas as medidas analisadas e as altera??es ocorridas em tecidos moles com as altera??es ?sseas, foi aplicado o teste t-Student para amostras pareadas. A an?lise do tamanho de efeito foi igualmente aplicada por meio do coeficiente ?d? de Cohen. A fim de correlacionar o movimento ?sseo com as altera??es de tecidos moles e estas ?ltimas apenas entre si, utilizouse o coeficiente de correla??o de Pearson. A an?lise de regress?o m?ltipla stepwise foi aplicada para tentar identificar o grau de influ?ncia de cada Vari?vel Independente individualmente sobre cada uma das Vari?veis Dependentes. Todas as an?lises foram aplicadas em rela??o a tr?s planos de refer?ncia individualmente e em 3D. O n?vel de signific?ncia foi estabelecido em 95%. RESULTADOS: O grau de correla??o na calibragem intra e interexaminadores foi alto, ficando as m?dias das Diferen?as Absolutas no conjunto total de cada tipo de medida abaixo dos limites de relev?ncia cl?nica de 2mm e 4?. Altera??es e correla??es maiores foram identificadas mais em mand?bula do que em maxila e mais na regi?o central do que na perif?rica da face. Os movimentos dos tecidos moles se correlacionaram mais com os movimentos esquel?ticos dos ossos subjacentes (ter?o m?dio em rela??o ? maxila e ter?o inferior em rela??o ? mand?bula) e em rela??o ao mesmo plano de refer?ncia, embora tenha havido exce??es. N?o foram identificados valores plenamente satisfat?rios de predic??o de resultados dos tecidos moles, especialmente em 3D. CONCLUS?ES: Os resultados encontrados permitem a valida??o das medidas, exceto as de ?ngulo Nasolabial e Labiomentual. A hip?tese nula p?de ser rejeitada, uma vez que as altera??es esquel?ticas afetaram e se correlacionaram ?s altera??es dos tecidos moles faciais de forma diferente em diversas regi?es da face e tamb?m de forma diferente em rela??o aos planos de refer?ncia individuais e em 3D.

Made available in DSpace on 2015-04-14T13:29:18Z (GMT). No. of bitstreams: 1 400927.pdf: 2370909 bytes, checksum: b53e1a26d8a1672ca08aea46ce6f3465 (MD5) Previous issue date: 2007-12-14 / O objetivo desta pesquisa foi avaliar as altera??es dent?rias e esquel?ticas ocorridas ap?s a expans?o r?pida maxilar assistida cirurgicamente (ERM-AC) quando comparadas duas t?cnicas de osteotomia Le Fort I: Bell (1976); Bennett e Wolford (1982). A amostra foi composta por 27 pacientes leucodermas, com idade variando entre 17 e 40 anos, sendo 12 do g?nero feminino e 15 do masculino. Todos os pacientes eram adultos com defici?ncia de crescimento maxilar transversal, n?o submetidos a tratamento ortod?ntico pr?vio e com indica??o de ERM-AC como parte de seu tratamento ortod?ntico. Medidas lineares e angulares foram obtidas a partir de tra?ados cefalom?tricos laterais e p?stero-anteriores e analisadas estatisticamente nas fases inicial, logo ap?s a estabiliza??o do aparelho tipo Hirax e com tr?s meses de conten??o. A ERM-AC promoveu aumento na dist?ncia da base ?ssea apical maxilar (p<0,01) e da cavidade nasal (p<0,01), que permaneceram constantes ap?s tr?s meses de conten??o em ambos os grupos e constatou-se aumento nas dist?ncias intermolares superiores (p<0,01) logo ap?s a estabiliza??o do aparelho. Ap?s tr?s meses de conten??o, verificou-se que os incisivos centrais superiores inclinaram para palatino (p<0,01) durante o per?odo de conten??o em ambos os grupos. Na avalia??o transversal, tanto a dist?ncia entre os ?pices como a dist?ncia entre as coroas desses dentes aumentaram (p<0,01) logo ap?s a estabiliza??o do aparelho. Ap?s tr?s meses de conten??o e constatou-se um aumento significativo do ?ngulo interincisal em ambos os grupos, avaliado na telerradiografia PA.