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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1154 |
| Date | 02 March 2012 |
| Creators | Becker, Ot?vio Emmel |
| Contributors | Oliveira, Rog?rio Belle de |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, BR, Faculdade de Odontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -8096554818733665164, 500, 600, 4673435736271820140 |
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