Objetivo: Estudar e compreender aspectos topográficos e temporais do osso pré-maxilar e da sutura pré-maxilar - maxilar, por serem elementos anatômicos fundamentais pouquíssimos explorados clinicamente. Material e métodos: Foram avaliados 1138 crânios secos humanos, sendo que 116 (10,19%) dos espécimes eram crianças, e 1067 (89,81%) adultos. Os crânios foram fotografados e determinada a porcentagem de abertura da sutura pré-maxilar - maxilar. Posteriormente os dados foram tabulados e submetidos a análise estatística, adotando-se nível de significância de 5%. Resultados: A progressão de fechamento da sutura pré-maxila - maxilar foi de 3,72% ao ano. Em 100% dos crânios até 12 anos observou-se a sutura pré-maxilar - maxilar abertas na região palatina, enquanto 6,16% dos adultos. Conclusões: A pré-maxila existe de forma independente dentro do complexo maxilar e a presença da sutura pré-maxila - maxilar justifica o sucesso de expansões anteroposterior para o crescimento do terço médio da face e solução problemas anatômicos e funcionais / Objective: To study and understand topographic and temporal aspects of premaxillary bone and premaxillary-maxillary suture, because they are fundamental anatomical elements that are rarely explored clinically. Material and methods: 1138 human dry skulls were evaluated, of which 116 (10,19%) of the specimens were children, and 1067 (89,81%) were adults. The skulls were photographed and the percentage of opening of the premaxillary - maxillary suture was determined. Subsequently the data were tabulated and submitted to statistical analysis, adopting a level of significance of 5%. Results: The progression of premaxillary suture closure was 3.72% per year. In 100% of the skulls up to 12 years the premaxillary suture was observed open in the palatal region, while 6.16% of adults. Conclusions: The premaxilla exists in an independ way within the maxillary complex and the presence of the premaxilla-maxillary suture justifies the success of anteroposterior expansions of the maxillary complex and solves anatomical and functional problems

PURPOSE: The purpose of this study was to analyze anatomical spatial limitations of the existing bone for maxillary anterior implant placement in normal subjects. MATERIALS AND METHODS: Fifty Two (52) Cone Beam Computed Tomography (CBCT) scans were selected. A 3i Osteotite (6 x 15mm) implant was superimposed on tooth positions from the right first premolar to left first premolar on reformatted cross sectional mages of maxillary anterior teeth. For the first trial, the implant was positioned following the alveolar bone axis. Utilizing Invivo 5 Software (Anatomage), the proximal overlaps between superimposed implants were evaluated at successive vertical steps of 2.5 mm. The prospective crown angulation or PCA (defined as the angulation between the crown axis and alveolar bone axis) was measured. The inter-canine distance across the arch, the palatal plane length and the palatal bony angulation (defined as the angulation between the palatal surface and the alveolar bone axis) were also measured. For the second trial, implant positioning followed a prosthetic driven position; the crown axis. The crown axis was defined as a line drawn from the midpoint of a line between the mid buccal/lingual CEJ to the incisal edge. The crest height and the apical height at which the implant's 1mm sleeve penetrated the buccal wall were calculated. RESULTS: The implant position at the central incisor and lateral incisor presented the highest percentage of overlap in both the biologically and prosthetically driven positions. The prospective crown angulation was higher at the location of the lateral incisor compared to the central incisor and canine position. The association between the remaining anatomical parameters and the prevalence of overlap was analyzed with bi-serial correlation. There was no significant relationship among any of these parameters. When the implant was simulated in a prosthetically driven position, the lateral incisor implant position frequently showed perforation at 5mm apical to the buccal crest margin demonstrating this position as highly sensitive. SUMMARY: The data demonstrated that the constriction of the alveolar bony volume in the anterior maxilla could affect implant placement. Understanding this bone morphology suggests a major limitation in the central/lateral positions which might require bone grafting. A new unique reference plane was utilized for this study. / 2018-09-28T00:00:00Z

One role of forensic anthropologists is to create a biological profile to help identify remains. This includes estimating ancestry. Many morphological and metrical methods of ancestry estimation have been created and utilized. This study was aimed at created a simple, metrical analysis of dental arch size and shape to aid in ancestry estimation. Maximum length and width of over 700 dental casts (both maxillary and mandibular) were recorded and statistically analyzed by one-way ANOVA. Measurements were taken using points on teeth rather than on the fragile bone of the maxilla and mandible. It was found that ancestry does affect the size of the maxillary arch but not the mandibular one, but discriminant function analysis showed that ancestry estimation is not possible with the present set of data for either the maxilla or the mandible. Further research will need to be conducted with larger sample sizes of certain populations in order to improve ancestry estimation using this method.

No tratamento das maloclusões, o diagnóstico e o planejamento dependem, entre outros aspectos, da avaliação das relações intermaxilares no sentido anteroposterior. Diversas análises cefalométricas foram elaboradas usando-se pontos intracranianos como referência para o estudo da relação anteroposterior entre maxila e mandíbula, levando a diversos conflitos na interpretação cefalométrica e a diagnósticos distintos. Adotando-se como referência a linha extracraniana horizontal verdadeira, em substituição ao plano oclusal de WITS, o presente estudo propôs definir o valor médio da relação maxilo-mandibular segundo a medida do WITS modificado, avaliar a correlação desta medida com as correspondentes do WITS original (Jacobson, 1988), AF-BF (Stoner et al., 1956), A-B (Taylor, 1969), Delta () (Ferrazzini, 1976) e comparar os gêneros masculino e feminino em relação às grandezas estudadas. Para tanto, selecionou-se amostra composta de telerradiografias em norma lateral de 48 indivíduos, leucodermas, brasileiros, com perfil equilibrado, relação entre as arcadas de Classe I de Angle, dentadura permanente completa, com idades entre 19 e 33 anos, sendo 22 do gênero masculino e 26 do feminino. Após análise descritiva das variáveis e aplicação do teste de coeficiente de correlação de Pearson, para a medida WITS modificado foram encontrados os valores médios de normalidade e desvio-padrão de 4,0 mm (± 3,07 mm) para as mulheres e 1,95 mm (± 2,16 mm), para os homens, identificando-se correlação positiva significativa entre a referida análise e as demais variáveis estudadas, tanto para o gênero feminino quanto para o masculino. O teste t-Student revelou diferenças estatisticamente significativas entre os gêneros masculino e feminino para as variáveis de Stoner et al. (1956), Ferrazzini (1976), Taylor (1969) e WITS modificado, apresentando valores médios mais altos para o feminino. Na comparação entre esse último e o WITS original (Jacobson, 1988), não foi encontrada diferença estatisticamente significativa. / In the treatment of malocclusions, diagnosis and planning depend, among other factors, on the evaluation of intermaxillary relationships in the anteroposterior direction. Various cephalometric analyses have been made using intracranial points as reference to study the anteroposterior relationship between the maxilla and mandible, leading to diverse conflicts in cephalometric interpretation and distinct diagnoses. In the present study the \"true horizontal\" extracranial line was adopted as reference, instead of the occlusal plane of WITS, with the purpose of defining the mean value of the maxillo-mandibular relationship according to the modified WITS measurement (true WITS), evaluating the correlation of this measurement with those corresponding to the WITS original (Jacobson, 1988), AF-BF (Stoner et al., 1956), A-B (Taylor, 1969), Delta () (Ferrazzini, 1976) and comparing the male and female gender with regard to the studied variables. For this purpose, a sample was selected, composed of lateral teleradiographs of 48 Brazilian, Leukoderma individuals, with balanced profile, Angle\'s Class I relationship between the arches, complete permanent dentition, in the age-range between 19 and 33 years, with 22 being of the male and 26 of the female gender. After descriptive analysis of the variables and application of Pearson\'s coefficient of correlation test, for the modified WITS measurement the mean values of normality and standard deviation of 4.0 mm (± 3.07 mm) were found for women and 1.95 mm (± 2.16 mm) for men, with a significant positive correlation being identified between the mentioned analysis and the other studied variables, for both the female and male gender. The Student\'s-t test revealed statistically significant differences between the male and female genders for the variables of Stoner et al. (1956), Ferrazzini (1976), Taylor (1969) and modified WITS, presenting higher mean values in women. In the comparison between the latter and original WITS (Jacobson,1975), no statistically significant difference was found. The true horizontal line was shown to be a reference in the analysis of soft and hard tissues, improving the reliability with regard to the variability in intracranial planes, providing the clinician with a more representative vision of the anteroposterior relationship between the maxilla and the mandible.

A reconstrução do rebordo atrófico da maxila pode ser feita por diversos materiais e técnicas. A utilização do enxerto ósseo em bloco retirado da sinfise ou do ramo mandibular tem sido empregado devido a qualidade óssea, reduzida morbidade e fácil acesso, sendo indicado na reconstrução dos defeitos localizados dos maxilares atróficos. O objetivo deste estudo foi determinar e comparar o índice de sobrevivência de implantes dentários instalados no remanescente osseo da maxila ou em áreas da maxila parcialmente reconstruídas utilizando-se enxerto ósseo em bloco retirado da sinfise ou ramo mandibular. Foram avaliados os prontuários de 731 pacientes atendidos entre agosto de 1999 a marco de 2009, sendo a amostra constituída por 255 pacientes. Dessa amostra, foram instalados 461 implantes dentários no tecido ósseo remanescente da maxila, 100 implantes dentários em áreas da maxila parcialmente reconstruídas com enxerto em bloco da sinfise (39 sitios) e 52 implantesdentarios em áreas da maxila parcialmente reconstruídas com enxerto em bloco do ramo mandibular (33 sitios). O índice de sobrevivência dos implantes dentários foram, respectivamente, 95%, 94% e 96% não havendo diferença estatisticamente significante (p>0,05) entre os grupos avaliados. Os procedimentos reconstrutívos da maxila, por meio do enxerto ósseo em bloco retirado da sinfise ou do ramo mandibular, não se constituem fator isolado relacionado a falha do tratamento com implantes dentários. / The reconstruction of atrophic maxillary ridge can be made with the use of different materials and techniques. The use of block bone grafts harvesting of the symphysis or mandibular ramus has been employed due to bone quality, low morbidity and access easy, being indicated in the reconstruction of atrophic jaws defects located. The aim of this study was to determine and compare the survival rate of dental implants inserted in the maxilla residual alveolar ridge or local alveolar defects in the maxilla reconstructed with block bone grafts of the symphysis or mandibular ramus. This study evaluated 731 patients files, who was treated between August 1999 and March 2009. The sample consisted in 255 patients, where 461 dental implants were installed in the maxilla residual alveolar ridge, 100 dental implants in local defects of the maxilla reconstructed with symphysis block bone graft (39 sites), and 52 dental implants in local defects of the maxilla reconstructed with block bone graft from the mandibular ramus (33 sites). The success rate of dental implants installed were, respectively, 95%, 94% e 96%, with no statistically significant difference (p>0.05). The reconstructive procedures of the maxilla, with block bone grafts harvesting of the symphysis or mandibular ramus, are not an independent risk factor for implant failure treatment.

published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Diss. med. dent. Zürich. / Literaturverz.

Diss. med. dent. Zürich. / Literaturverz.

Thesis (M.D.S.)--University of Hong Kong, 2005.