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Acur?cia em cirurgia ortogn?tica bimaxilar : avalia??o bidimensional e tridimensional

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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.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7117
Date27 March 2015
CreatorsScolari, Neimar
ContributorsOliveira, Rogerio Belle de
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, Brasil, Faculdade de Odontologia
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
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