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Avalia??o tridimensional das vias a?reas orofar?ngeas em pacientes com e sem fissura l?bio-palatal submetidos ? expans?o maxilar

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Previous issue date: 2014-02-26 / INTRODUCTION : Rapid maxillary expansion (RME) has an extensive history in the orthodontic literature, and the correction of transverse maxillary discrepancy in growing patients is its main objective. Patients with transverse maxillary deficiency may also have functional problems such as the narrowing of the nasopharyngeal and oropharyngeal airways. The RME can promote a breathing improvement, since the external walls of the nasal cavity are included in the maxilla, and the expansion increases the nasal capacity. OBJECTIVES : To review the literature associating aspects about RME and changes resulting from this kind of procedure on the upper airways, as well as to assess and compare the oropharyngeal airway dimensions in cleft and noncleft lip and palate growing patients with maxillary constriction, after and before RME. MATERIAL AND METHODS : Among different methods for airway assessment, as described in the literature, linear, area and volumetric measurements of oropharyngeal airway were taken from cone-beam computed tomography (CBCT) scans, in a sample composed of 63 patients (30 cleft and 33 non-cleft). Shapiro-Wilk normality test and Generalized Estimating Equations (GEE) with Bonferroni adjustment were used. The intrarater repeatability was calculated with intraclass correlation coefficient (ICC). RESULTS : The oropharyngeal airway dimensions were not significantly different when cleft and non-cleft patients were compared before the treatment. After RME, the total airway volume and the upper cross-sectional area were significantly increased in cleft patients. Non-cleft patients presented significant increases in the area and transverse measurements at the upper crosssectional plane of oropharynx. CONCLUSIONS : There were no dimensional differences in the oropharynx between cleft and non-cleft patients before the treatment. RME increased the airway volume, and it was significant in cleft patients. Non-cleft subjects presented increases in the transverse widths at upper limit and minimal crosssectional planes of oropharynx after RME. / INTRODU??O : A expans?o r?pida da maxila (ERM) apresenta longo hist?rico na literatura ortod?ntica, tendo como objetivo principal a corre??o da discrep?ncia maxilar transversa em pacientes em crescimento. O estreitamento das vias a?reas naso-orofar?ngeas ? um tipo de problema funcional, que pode estar presente em pacientes com defici?ncia maxilar transversa. A ERM pode trazer benef?cios ? respira??o, j? que as paredes externas da cavidade nasal est?o inclu?das na maxila, e a expans?o resulta em aumento da capacidade internasal. OBJETIVOS : Realizar uma revis?o de literatura abordando aspectos relacionados ? influ?ncia da ERM sobre as vias a?reas superiores, bem como avaliar e comparar as dimens?es das vias a?reas orofar?ngeas em uma amostra de pacientes em crescimento, com e sem fissura l?bio-palatal (FLP), portadores de atresia maxilar transversa, no per?odo inicial e ap?s a ERM. MATERIAIS E M?TODOS : Dentre os diferentes m?todos descritos pela literatura para avalia??o das vias ?ereas, foram realizadas medidas lineares, ?rea e volume da orofaringe a apartir de tomografia computadorizada conebeam (TCCB), em uma amostra de 63 pacientes (30 com FLP e 33 sem FLP). Foram aplicados o teste de normalidade Shapiro-Wilk e Equa??es de Estima??o Generalizadas (GEE), seguido pelo ajuste de Bonferroni para compara??es m?ltiplas. Para avalia??o da confiabilidade das medidas foi calculado o Coeficiente de Correla??o Intraclasse (ICC). RESULTADOS : As dimens?es das vias a?reas orofar?ngeas foram semelhantes na compara??o entre os grupos com e sem FLP no per?odo inicial. Ap?s a ERM, pacientes com FLP apresentaram aumento significativo no volume e na ?rea localizada no limite superior da orofaringe. Nos pacientes do grupo sem FLP foi observado aumento significativo na ?rea e di?metro transverso, ambas as medidas situadas no plano superior da orofaringe. CONCLUS?ES : N?o houve diferen?as dimensionais na orofaringe de pacientes com ou sem FLP antes da ERM. A ERM promoveu aumento no volume da orofaringe, sendo significativo em pacientes com FLP; al?m de promover aumento no di?metro transverso nas regi?es superior e de maior constri??o da orofaringe nos pacientes sem FLP.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1275
Date26 February 2014
CreatorsAzeredo, Fabiane
ContributorsMenezes, Luciane Macedo de
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, BR, 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
Relation-8096554818733665164, 500, 600, 4673435736271820140

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