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RESUMEN Antecedentes: Los beneficios de la lactancia materna exclusiva hasta los seis meses son ampliamente conocidos, pero aún falta profundizar los argumentos biológicos que respaldan la relación de la lactancia materna con el crecimiento craneofacial (CCF). Objetivo: Identificar los conceptos y atributos que permitan esclarecer los beneficios de la LM para el crecimiento craneofacial a partir de la metodología análisis de concepto de Walker y Avant. Método: La estrategia de búsqueda se realizó en bases de datos y artículos científicos entre 1980-2022, en inglés, portugués y español, que relacionaran el concepto lactancia materna hasta los 2 años de edad. Los términos utilizados fueron "lactancia materna", "lactancia materna exclusiva", "lactancia artificial", "análisis de concepto". Adicionalmente se buscaron los términos "lactancia materna exclusiva" y "crecimiento craneofacial". Se incluyeron estudios de revisión, revisiones sistemáticas, estudios observacionales prospectivos y de corte transversal. Resultados: Se identificaron 4 atributos para confirmar el concepto LM exclusiva para el CCF: adaptación fisiológica de la succión, succión nutricia, función motora oral y succión efectiva. Se describen definiciones, antecedentes, consecuencias, referentes empíricos. Caso modelo y casos contrario. Conclusión: La metodología utilizada sirvió para construir el análisis de concepto lactancia materna exclusiva para el CCF y aportar argumentos teóricos para la práctica clínica y consejería en lactancia relacionados con los beneficios de la función de succión para el desarrollo motor oral y crecimiento craneofacial.
ABSTRACT Background: The benefits of exclusive breastfeeding up to six months are well known, but the biological arguments that support the relationship between breastfeeding and craniofacial (CCF) still need to be deepened. Objective: To identify the concepts and attributes that allow clarifying the benefits of ML for craniofacial growth based on the concept analysis methodology of Walker y Avant. Method: The search strategy was carried out in databases, scientific articles between 1980-2022, English, Portuguese, and Spanish language, that related the concept of breastfeeding up to 2 years of age. The terms used were "breastfeeding", "exclusive breastfeeding", "artificial breastfeeding", "concept analysis". Additionally, the terms "exclusive breastfeeding" and "craniofacial growth" were searched. Review studies, systematic reviews, prospective observational studies and cross-sectional studies were included. Results: Four attributes were identified to confirm the exclusive LM concept for CCF: physiological adaptation of sucking, nutritive sucking, oral motor function and effective sucking. Definitions, background, consequences, empirical references are described. Model case and opposite cases. Conclusion: The methodology used served to construct the analysis of the exclusive breastfeeding concept for CCF and provide theoretical arguments for clinical practice and breastfeeding counseling related to the benefits of the sucking function for oral motor development and craniofacial growth.
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AIM: Hormones play a crucial role in growth development; however, the impact of testosterone suppression (TS) on craniofacial growth during puberty remains inconclusive. This study aimed to evaluate the impact of TS during puberty on cephalometric measurements and histological characteristics of facial growth centers. MATERIALS AND METHODS: Thirty-six heterogenic Wistar male rats were randomly allocated into experimental orchiectomy (ORX) and control (sham) groups. At an age of 23 days (prepubertal stage), orchiectomy and placebo surgery were performed. Cephalometric measurements were performed via lateral cephalograms during and after puberty. The animals were euthanized at an age of 45 days (pubertal stage) and 73 days (postpubertal stage). Histological slices of the growth centers (condyle, premaxilla, and median palatine suture) were stained with hematoxylin and eosin, and sirius red. Student's t or Mann-Whitney U tests were used to compare linear and angular cephalometric measurements across groups (α errorâ¯= 5%). RESULTS: Linear and angular measurements were statistically different in ORX animals (cranial bones, maxilla, and mandible) at 45 days and 73 days. Condylar histology showed a decrease in prechondroblast differentiation and a delay of mineralization in ORX animals. Vascularization of the medium palatine suture was lower in the ORX group at 45 days. Type I and III collagen fiber synthesis was lower in the ORX groups. In the premaxillary suture, collagen fibers were better organized in the sham groups. CONCLUSIONS: Our results suggest that testosterone suppression affects craniofacial growth during puberty.
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Maduración Sexual , Testosterona , Ratas , Animales , Masculino , Testosterona/farmacología , Ratas Wistar , Maxilar , ColágenoRESUMEN
INTRODUCTION: Craniofacial growth is a dynamic and unpredictable process influenced by genetic and environmental factors, presenting phenotypic and gender differences. OBJECTIVE: Evaluate the differences in craniofacial growth and development in a group of Colombian individuals with complete unilateral and bilateral cleft lip and palate (CLP) and without CLP, classified by gender and age. SETTING AND SAMPLE POPULATION: Five hundred forty-one profile radiographs of 126 patients with unilateral CLP, 126 with bilateral CLP, and 289 without CLP. All patients of affected groups had a history of CLP correction surgery without nasoalveolar molding with orthopedic and orthodontic treatments. MATERIALS AND METHODS: This cross-sectional study was performed comparing 8 cephalometric measurements on radiographs, 5 linear/3 angular. Analysis was performed by median and interquartile range for all cephalometric measurements. Comparison between the groups was performed using Kruskal-Wallis and Mann-Whitney U, with a 95% confidence. RESULTS: Significant differences between the groups of patients with and without CLP, between types of clefts and genders. The skeletal structures of patients with CLP were smaller than those of control but improved with growth. Patients with unilateral CLP presented flat profiles and predominant class III malocclusions, while patients with bilateral CLP, at early ages, were class II and in the prepubertal stage, the values were progressively negative until the end of the growth period, suggesting class III. Patients with CLP presented posteroinferior rotation of the mandible, vertical measurements increased, and deflection of the cranial base. CONCLUSION: Given their growth alterations, patients with CLP benefit from orthopedic and orthodontic treatment.
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Labio Leporino , Fisura del Paladar , Cefalometría , Labio Leporino/diagnóstico por imagen , Labio Leporino/cirugía , Fisura del Paladar/diagnóstico por imagen , Fisura del Paladar/cirugía , Colombia , Estudios Transversales , Femenino , Humanos , Masculino , Maxilar/cirugíaRESUMEN
OBJECTIVE: Describes dental, occlusal, and craniofacial characteristics of 3 children aged 3 to 4 years with microcephaly due to congenital Zika infection in Cali Valle del Cauca, 2020. DESIGN: Three children case report with congenital Zika virus microcephaly. SETTING: Institutional. PATIENTS: Three children with maternal viral infection confirmed by polymerase chain reaction during first trimester of pregnancy were included and were born from 2016 to 2017. INTERVENTIONS: Oral and mouth functional examination was performed including soft tissue examination; lingual and labial frenulum; evaluation of swallowing and chewing; craniofacial analysis; dimension of dental arch; intercanine and intermolar distance, palate form; relationship and growth of maxilla, mandible, and facial dental midline using plaster models; and complementary image analysis. MAIN OUTCOME MEASURES: Child and mother sociodemographic features, craniofacial measurements; dental and oral features; maxillary and mandibular measures; and speech, swallowing, and chewing disorders. RESULTS: Small head circumference at birth and at the time of clinical evaluation was compared to normal children of approximately their age. Upper third of the face was short, and presence of hypertonic masticatory muscles with hypotonic swallowing muscles, dysphagia, dyslalia, bruxism, lip incompetence, tongue interposition, and hypersalivation and epilepsy were the main medical problem. They have complete primary dentition with normal dental morphology, tooth eruption altered, dental caries, and dental malocclusion was identified. CONCLUSION: There are no changes in the dental formula and dental morphology in the deciduous dentition. They present severe chewing and speaking limitation, facial disproportion, and occlusal problems that warrant dental and medical attention.
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Caries Dental , Microcefalia , Infección por el Virus Zika , Virus Zika , Niño , Colombia , Femenino , Humanos , Recién Nacido , Embarazo , Infección por el Virus Zika/complicacionesRESUMEN
OBJECTIVE: To compare occlusal relationship in patients undergoing neonate versus conventional lip surgery (LS) with and without infant orthopedics (IO) by assessment of dental arch relationship in individuals with complete unilateral cleft lip and palate. MATERIAL AND METHODS: Three groups treated by different protocols; Group I: neonate LS (1-15 days) + IO and palatoplasty (13-31 months); Group II: LS (3-12 months) + IO and palatoplasty (15-35 months); and Group III: LS (3-6 months) without IO and palatoplasty (12-18 months). The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index for intraoral photograph rating. The groups were compared by the χ2 test. The correlation between surgical timing and the scores was tested by the Spearman test (P < .05). RESULTS: Group I presented the highest percentage of score 5, group II exhibited highest percentage of score 1, and group III presented the lowest percentage of score 5 according to the χ2 test (P = .029). The Spearman correlation test revealed statistically significant difference between timing of LS and the occlusal index. The earlier the surgical timing, the higher the occlusal index (P = .019). CONCLUSIONS: Infant orthopedics has demonstrated the possibility of postponing primary plastic surgeries. Patients submitted to late lip and palate repair had the best prognosis, while patients undergoing lip repair from 1 to 15 days of life, even operating the palate later, had the worst prognosis. Neonate LS negatively influenced the occlusal relationships.
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Labio Leporino , Fisura del Paladar , Procedimientos Ortopédicos , Ortopedia , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Humanos , Lactante , Recién NacidoRESUMEN
OBJECTIVE: This is a prospective study examining palatal casts from patients with unilateral cleft lip and palate (UCLP) in the first month of life, immediately before cheiloplasty, and immediately before palatoplasty. None of the patients receives presurgical orthopedics (nasoalveolar molding). DESIGN: In this prospective study, upper arch plaster models were taken 3 times during the treatment: in the first month of life (T1), before the cheiloplasty (T2), and before the palatoplasty (T3). Anatomic landmarks were defined and linear anthropometric measurements were obtained afterward. Dimensional analysis was performed using 3D software. Two-way analysis of variance followed by Tukey test was performed for statistical analysis. SETTING: Tertiary, institutional. PARTICIPANTS: Twelve patients with UCLP of either sex with less than 1 month of life and without any other syndrome. INTERVENTION: No intervention was performed. MAIN OUTCOME MEASURE: Reduction of the cleft without using orthopedics apparatus. RESULTS: There was a statistically significant reduction in the cleft gap comparing T1 to T3. There was also a significant reduction in the intercanine width comparing T2 and T3, and T1 and T3. There was significant increase in the posterior arch width comparing T2 and T3, and T1 and T3. The palatal plate's width increased in all times analyzed. CONCLUSION: The palatal cleft narrows spontaneously as well in both midpoint and posterior point during the first 6 months of patient's treatment. This event was enhanced by cheiloplasty. This surgery might have a greater influence on the anterior arch width than in the posterior arch region.
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Labio Leporino , Fisura del Paladar , Procedimientos de Cirugía Plástica , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Humanos , Estudios ProspectivosRESUMEN
Resumo As vias aéreas superiores (VAS) são influenciadas pelo crescimento e desenvolvimento do complexo craniofacial e posição espacial dos ossos maxilares durante o tratamento ortodôntico pode estreitar ou aumentar a dimensão dos espaços faríngeos. A análise tridimensional do volume e área axial mínima dos respectivos sub-espaços é benéfica para o planejamento do caso, pois permite identificar possíveis barreiras físicas que comprometem a passagem de ar e o fluxo respiratório, além de ser um método auxiliar de diagnóstico para desordens relacionadas a essa função. A solicitação de tomografias computadorizadas de feixe cônico (TCFC) é necessária para a correta avaliação digital, com os devidos protocolos de aquisição e reconstrução dos exames de imagem, calibração da metodologia e padronização de análise das mesmas. O objetivo deste trabalho é desmitificar o passo a passo específico dessa análise no software Dolphin Imaging® e descrever os fatores técnicos e anatômicos para delimitação dos espaços correspondentes às VAS. Para ilustrar o protocolo foram utilizadas TCFC de paciente com má oclusão de Angle Classe II, 1a divisão antes da instalação (T1) de propulsor mandibular (aparelho fixo cimentado de Herbst com ancoragem dentária) e após 12 meses de tratamento (T2). A partir da mensuração dos espaços correspondentes às VAS, comparando os dois tempos de tratamento, foi possível analisar as alterações do espaço faríngeo após o uso de propulsor mandibular e evidenciar a importância da avaliação tridimensional da dimensão aérea para um planejamento ortodôntico individualizado. (AU)
Abstract The upper airways (UA) are influenced by the growth and development of the craniofacial complex and any alteration in the maxillary bones during orthodontic treatment can narrow or increase the size of the pharyngeal spaces. The three-dimensional analysis of the volume and the minimum axial area of the respective sub-spaces is beneficial for case planning as it allows the identification of possible physical barriers that compromise the air passage and the respiratory flow, besides being an auxiliary diagnostic method for disorders related to this function. The request for cone-beam computed tomography (CBCT) is necessary for the correct digital evaluation with the appropriate protocols for the acquisition and reconstruction of the image exams, calibration of the methodology, and standardization of their analysis. The objective of this work is to demystify the specific step-by-step analysis in the Dolphin Imaging® software and to describe the technical and anatomical factors for delimiting the spaces corresponding to the UA. To illustrate this protocol, CBCT of a patient with Angle Class II malocclusion, first division were analyzed before the installation (T1) of a mandibular thruster (fixed cemented Herbst appliance with dental anchorage) and after 12 months of treatment (T2). From the measurement of the spaces corresponding to VAS, comparing the two treatment times, it was possible to analyze the changes in the pharyngeal space after the use of mandibular thruster and to highlight the importance of the three-dimensional assessment of the air dimension for individualized orthodontic planning. (AU)
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Tomografía Computarizada de Haz Cónico , Maloclusión Clase II de AngleRESUMEN
O objetivo deste ensaio clínico randomizado foi comparar os efeitos dentoesqueléticos associados ao tratamento da má oclusão de Classe II de Angle 1a divisão com propulsores mandibulares removíveis, fixos e associados à ancoragem esquelética. Após o exame de 1039 indivíduos, foram incluídos 34 pacientes Classe II de Angle, 1a divisão com overjet ≥ 6 mm, de 10 a 14 anos, no pico do surto de crescimento puberal e sem tratamento ortodôntico prévio. Estes pacientes foram distribuídos de forma randomizada em três grupos: (TB) tratado com aparelho removível de Twin Block (n = 13); (HAD) tratado com aparelho fixo cimentado de Herbst (n = 11); e (HAE) tratado com aparelho de Herbst associado a dois mini-implantes mandibulares (n = 10). Foram analisadas tomografias de feixe cônico antes da instalação do propulsor (T1) e após 12 meses de tratamento (T2). No programa ITK-SNAP®, foram construídos modelos 3D da maxila, mandíbula, incisivos centrais e 1os molares. No programa Dolphin Imaging®, foram gerados modelos 3D totais do tecido duro de T1 e T2, com orientação de cabeça padronizada e registro na base craniana anterior. O Modelo de Transferência de Coordenadas (MTC) foi obtido a partir do recorte padronizado do tecido mole de T1, nos planos axial, sagital e coronal. No programa Geomagic Qualify®, os modelos 3D parciais foram alinhados à posição espacial dos modelos 3D totais orientados e registrados. Foi utilizado um método automático para determinar os pontos centroides, que representaram a posição espacial de todas as estruturas anatômicas avaliadas. Os deslocamentos dos centroides entre T1 e T2 foram analisados no sistema de coordenados cartesiano elaborado com base no MTC. Para análise do crescimento maxilar e do mento foi utilizado o registro craniano; para a movimentação dentária e crescimento condilar, foram adotados os registros regionais em maxila e mandíbula. O teste de Wilcoxon avaliou as diferenças intra-grupo e o teste de Kruskal Wallis analisou as diferenças intergrupos das alterações esqueléticas e dentárias. Foram comparados os índices de sucesso na correção da sobressaliência e relação molar. Foi detectada restrição de crescimento anteroposterior da maxila (HAE: -0,26 ± 2,88 mm; TB -0,25 ± 0,66 mm; HAD: 0,18 ± 0,87 mm) e crescimento mandibular anteroposterior (HAE: 4,21 ± 2,96 mm; HAD: 3,49 ± 3,74 mm; TB: 1,24 ± 3,36 mm). No arco superior, foi observada mínima movimentação de incisivos e 1os molares (≤ 1 mm nos 3 planos). Os principais efeitos dentários ocorreram no arco inferior, na perda de ancoragem (HAD: 1,73 ± 0,64 mm; TB: 1,45 ± 1,13 mm; HAE: 1,07 ± 0,23 mm) e mínima projeção dos incisivos centrais (HAE: 0,93 ± 0,08 mm; HAD: 0,54 ± 0,36 mm; TB: 0,27 ± 0,18 mm). Quanto à eficácia, a maior correção do overjet foi obtida pelos grupos HAD (-4 ± 1,65 mm) e HAE (-4 ± 1,47 mm), seguidos pelo TB (-3 ± 3,25 mm). Na relação molar, a maior eficácia foi do grupo HAE (100% de sucesso, sobrecorreção de 85,7%), seguido pelo HAD (100% de sucesso, sobrecorreção de 70%), e TB (55,6% de sucesso). Concluiu-se que o aparelho de Herbst associado aos mini-implantes obteve maior eficácia na correção predominantemente esquelética da má oclusão de Classe II 1a divisão, do que os aparelhos de Herbst e Twin Block, após 12 meses de tratamento(AU)
The aim of this randomized controlled trial was to compare the dentoskeletal effects associated to the treatment of Angle Class II 1st division with removable, fixed and skeletal anchored functional appliances. After the clinical examination of 1039 individuals, 34 patients with Angle Class II, 1st Division, overjet ≥ 6 mm, 10 to 14 years old, at the peak of the pubertal growth spurt and no history of orthodontic treatment were included. These patients were randomized into three groups: (TB) treated with removable Twin Block appliance (n = 13); (HAD) treated with fixed cemented Herbst appliance (n = 11); and (HAE) treated with Herbst appliance associated to two mandibular mini implants (n = 10). Cone-beam CT scans were obtained before (T1) and after 12 months of treatment (T2). In the ITK-SNAP® software, 3D models of the maxilla, mandible, central incisors and 1st molars were built. In the Dolphin Imaging® software, full 3D models of T1 and T2 hard tissue were generated, with standardized head orientation and registration in the anterior cranial base. The Coordinate Transfer Model (CTM) was obtained from the T1 soft tissue, with standardized slices in the axial, sagittal and coronal planes. In the Geomagic Qualify® software, the partial 3D models were aligned to the spatial position of the oriented and registered full 3D models. An automatic method was used to determine centroid points, which represented the spatial position of all evaluated anatomical structures. Centroid displacements between T1 and T2 were analyzed using the Cartesian coordinate system based on the CTM. The cranial register was used to analyze the growth of maxilla and chin; to measure tooth movement and condylar growth, the regional register in the maxilla and mandible were adopted. The Wilcoxon test assessed intra-group differences and the Kruskal Wallis test analyzed intergroup differences in skeletal and dental changes. Success rates for overjet correction and molar relationship were compared. Anteroposterior maxillary growth restriction was detected (HAE: -0.26 ± 2.88 mm; TB -0.25 ± 0.66 mm; HAD: 0.18 ± 0.87 mm) and also anteroposterior mandibular growth (HAE: 4.21 ± 2.96 mm; HAD: 3.49 ± 3.74 mm; TB: 1.24 ± 3.36 mm). In the upper arch, minimal movement of incisors and 1st molars was observed (≤ 1 mm in the 3 planes). The main dental effects occurred in the lower arch, in the anchorage loss (HAD: 1.73 ± 0.64 mm; TB: 1.45 ± 1.13 mm; HAE: 1.07 ± 0.23 mm) and minimal projection of central incisors (HAE: 0.93 ± 0.08 mm; HAD: 0.54 ± 0.36 mm; TB: 0.27 ± 0.18 mm). The highest overjet correction was obtained by the HAD (-4 ± 1.65 mm) and HAE (-4 ± 1.47 mm) groups, followed by TB (-3 ± 3.25 mm). In the molar relationship, the highest efficacy was in the HAE group (100% successful, 85.7% overcorrected), followed by HAD (100% successful, 70% overcorrected), and TB (55.6% successful). It was concluded that the Herbst appliance associated with mini-implants had greater efficacy in predominantly skeletal correction of Class II 1st division malocclusion than the Herbst and Twin Block appliances after 12 months of treatment(AU)
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Humanos , Masculino , Femenino , Niño , Adolescente , Aparatos Ortodóncicos , Huesos Faciales/crecimiento & desarrollo , Maloclusión Clase II de Angle , Desarrollo Maxilofacial , Tomografía Computarizada de Haz CónicoRESUMEN
Introducción: durante el crecimiento y desarrollo craneofacial, la nutrición interviene en el logro del máximo potencial posible, en el desarrollo de la cara, los maxilares y los dientes. Objetivo: evaluar los indicadores antropométricos craneales, faciales e intrabucales, según el estado nutricional de los adolescentes. Métodos: se realizó un estudio transversal para evaluar los indicadores antropométricos craneales, faciales e intrabucales, atendiendo al estado nutricional y el índice de la masa corporal, en los adolescentes de 14 a 15 años, pertenecientes al policlínico Máximo Gómez, del municipio de Holguín, provincia Holguín, Cuba. La muestra estuvo constituida por dos grupos de adolescentes: nutridos y desnutridos, a quienes se les realizaron mediciones antropométricas generales del neurocráneo, viscerocráneo e intrabucales. Resultados: los valores promedio de peso y talla fueron: 49,3 ± 5,63 kg y 1,64 ± 0,06 m, en el grupo control, y de 34,9 ± 2,15 kg y 1,53 ± 0,03 m en los desnutridos. Las dimensiones craneales fueron mayores en el grupo control, con el diámetro transverso de la cabeza (14,0 ± 0,90 cm. -grupo control-, 13,0 ± 0,39 cm.-grupo desnutridos), y la circunferencia cefálica (55,9 ± 1,44 cm. - grupo control-, 53,9 ± 1,31 cm.-grupo desnutridos), las que presentaron diferencias significativas entre ambos grupos (p < 0,05). Los indicadores faciales e intrabucales fueron mayores en el grupo control, con diámetros transversos del maxilar de 35,4 ± 0,93, 41,4 ± 1,49 y 47,2 ± 0,80 mm y en el grupo de los desnutridos de 34,4 ± 0,58, 39,7 ± 1,15 y 45,8 ± 0,95 mm. Conclusiones: las variables antropométricas craneales, faciales e intrabucales presentaron diferencias significativas entre los grupos, con valores inferiores en el grupo desnutridos.
Introduction: craniofacial growth involves nutrition as the maximum possible potential of face, maxilla and teeth development. Objective: to evaluate cranial, face and intrabucals anthropometric indicators, according to teenagers´ nutritional conditions. Methods: a cross-sectional study was applied, to evaluate cranial, face and intrabucals anthropometric indicators of nutritional conditions, on teenagers from 14 to 15 years old, at Máximo Gómez polyclinic, from Holguín, Cuba. Sample was formed by 2 groups: well-fed and undernourished individuals. General, neurocranium, viscerocranium and intrabucals anthropometric measurements were taken. Results: control group weight and height rates were: 49.3 ± 5.63 kg and 1.64 ± 0.06 m. In the undernourished group: 34.9 ± 2.15 kg and 1.53 ± 0.03m. Cranial dimensions were major in the control group, being transverse head diameter (14.0 ± 0.90 cm - control group -, 13.0 ± 0.39 cm. undernourished group), and the cephalic circumference (55.9 ± 1.44 cm - control group -, 53.9 ± 1.31 cm at undernourished group), with significant differences between the groups (p < 0.05). Facial and intrabucals indicators were higher in the control group, being the transverse diameters of the maxilla in the control group: 35.4 ± 0.93, 41.4 ± 1.49 y 47.2 ± 0.80 mm, and in the undernourished group: 34.4 ± 0.58, 39.7 ± 1.15, and 45.8 ± 0.95 mm. Conclusions: cranial, facial and intrabucals anthropometric indicators showed significant differences between groups, obtaining low values in the undernourished group.
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ABSTRACT Objective: To correlate skeletal age, standing height, upper and lower body lengths, and selected craniofacial growth features in a sample of growing individuals, and to model craniofacial growth using multivariate regression. Methods: This was a retrospective cross-sectional study with 447 African black boys and girls, between the ages 8 and 16 years, who attended the dental clinic at one hospital. The skeletal maturational age was determined from hand-wrist radiographs using the Greulich and Pyle atlas. Craniofacial measurements representing maxillary length (Ar-ANS), mandibular length (Ar-Gn), and lower facial height (ANS-Me) were calculated from lateral cephalograms in habitual occlusion. Body lengths were clinically measured in centimeters. Results: Moderate correlations (r=0.42 to 0.68) were observed between skeletal age and the three selected craniofacial measurements. Statistically significant correlations were also found between the craniofacial measurements and both upper and lower body lengths. The mandibular length had a stronger correlation with the upper body length than with the lower body length. Multiple regression analyses to determine maxillary and mandibular lengths suggested that sex, upper and lower body lengths might be used to determine maxillary length; while skeletal age, upper and lower body lengths might help determine mandibular length. Conclusions: Based on the relatively strong correlation between upper body length and mandibular length, further research in this area may warrant its use as a predictor for mandibular growth modification timing.
RESUMO Objetivo: correlacionar a idade esquelética, a estatura, as alturas corporais superior e inferior, e algumas características específicas do crescimento craniofacial, em uma amostra de indivíduos em crescimento, e delinear o crescimento craniofacial usando regressão multivariada. Métodos: esse estudo transversal retrospectivo foi feito com 447 meninos e meninas negros africanos, com idades entre 8 e 16 anos, atendidos na clínica odontológica de um hospital. A maturação esquelética, em anos, foi determinada a partir de radiografias de mão e punho, usando o atlas de Greulich e Pyle. As medidas craniofaciais representando o comprimento maxilar (Ar-ENA), o comprimento mandibular (Ar-Gn) e a altura facial anterior inferior (ENA-Me) foram calculadas a partir de cefalogramas laterais em oclusão habitual. Os comprimentos corporais foram medidos clinicamente, em centímetros. Resultados: correlações moderadas (r = 0,42 a 0,68) foram observadas entre a idade esquelética e as três medidas craniofaciais selecionadas. Também foram encontradas correlações estatisticamente significativas entre as medidas craniofaciais e as alturas corporais superior e inferior. O comprimento mandibular teve uma correlação mais forte com a altura corporal superior do que com a inferior. As análises de regressão múltipla para determinar os comprimentos maxilar e mandibular sugeriram que o sexo e as alturas corporais superior e inferior podem ser usados para determinar o comprimento maxilar, enquanto a idade esquelética e as alturas corporais superior e inferior podem ajudar a determinar o comprimento mandibular. Conclusões: com base na correlação relativamente forte entre a altura corporal superior e comprimento mandibular, pesquisas adicionais nessa área poderiam justificar seu uso como indicador para o período de modificação do crescimento mandibular.
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Humanos , Animales , Masculino , Femenino , Niño , Adolescente , Cráneo/crecimiento & desarrollo , Estatura , Determinación de la Edad por el Esqueleto/estadística & datos numéricos , Oclusión Dental , Huesos Faciales/crecimiento & desarrollo , Mandíbula/crecimiento & desarrollo , Maxilar/crecimiento & desarrollo , Cráneo/anatomía & histología , Negro o Afroamericano , Modelos Lineales , Factores Sexuales , Cefalometría/estadística & datos numéricos , Estudios Transversales , Análisis Multivariante , Estudios Retrospectivos , Factores de Edad , Huesos Faciales/anatomía & histología , Mandíbula/anatomía & histología , Maxilar/anatomía & histologíaRESUMEN
Los trastornos respiratorios obstructivos del sueño corresponden a un amplio espectro de patologías que incluyen a los roncadores primarios, el síndrome de resistencia de vía aérea superior y al síndrome de apnea obstructiva del sueño (SAOS). Dentro de sus manifestaciones clínicas se encuentra la roncopatía y la respiración bucal, las cuales generan alteraciones en el crecimiento craneofacial del niño pudiendo ser la causa de un SAOS residual. El objetivo de esta revisión es analizar las alteraciones del crecimiento craneofacial en niños generadas por la roncopatía y respiración bucal.
Obstructive sleep breathing disorders correspond to a broad spectrum of diseases that include primary snorers, upper airway resistance syndrome and obstructive sleep apnea syndrome (OSAS). Its clinical manifestations include snoring and mouth breathing, which generates alterations in the craniofacial growth of the child that may be the cause of a residual OSAS. The objective of this review is to analyze the alterations of craniofacial growth generated by snoring and mouth breathing in children.
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Humanos , Cara/anatomía & histología , Ronquera/complicaciones , Respiración por la Boca/complicaciones , Cráneo/anatomía & histología , CefalometríaRESUMEN
OBJECTIVE: To test the hypothesis that maxillary development may be affected by occlusal support. MATERIALS AND METHODS: The sample was composed by Wistar rats (5 weeks old) divided into three groups: Control (n = 10), extraction of mandibular molar teeth - left side (n = 10), extraction mandibular molar teeth - left and right sides (n = 10). The rats were sacrificed 8 weeks postextraction. Cone beam computed tomography scan images were taken for posterior measurement of maxillary length and width. Data were analyzed by one-way analysis of variance (Tukey test as post-hoc test). RESULTS: Maxillary length was significantly shorter (P < 0.005) in both groups after tooth extraction. No difference was observed regarding maxillary width and body weight. CONCLUSION: Reduced occlusal support may impair the development of the maxilla in rats.
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El objetivo de este trabajo fue evaluar el desplazamiento de los puntos craneales: Nasion, Silla, Basion, Porion, Orbitario y Pterigoideo, utilizados como referencia en los análisis cefalométricos de Jarabak y Ricketts durante el crecimiento activo. Se seleccionaron 120 telerradiografías de perfil en formato digital, correspondientes a 60 pacientes con 2 telerradiografías cada uno, tomadas con un intervalo de tiempo mínimo de 1 año (T1 y T2), en donde T1 se encuentra antes o durante el peak de crecimiento según el Estado de Maduración Cervical Vertebral (CVM) I, II ó III de Baccetti y T2 en estadio CVM IV,V,VI (después del peak de crecimiento). Un examinador previamente calibrado, ubicó los puntos analizados y para evaluar su desplazamiento, se realizaron mediciones en T1 y T2 (3 variables para cada punto), usando como referencia 2 planos que no se modifican a partir de los 5 años de edad (LCB y Vert-T). Para determinar el desplazamiento de los puntos, se calculó la variación promedio observada entre T1 y T2 y se realizó la prueba t para muestras pareadas o Wilcoxon (según distribución) para determinar la existencia de diferencias significativas. Además, se comparó la muestra por sexo, CVM inicial y CVM final. Se encontraron variaciones entre T1 y T2 en todas las medidas, aunque sólo en 5 de ellas se encontraron diferencias significativas; no se encontró diferencias al comparar por sexo, CVM inicial y final. Es así como podemos concluir que todos los puntos craneales analizados sufren desplazamiento durante el crecimiento. Los puntos Basion y Orbitario son los que sufren mayor desplazamiento. Es necesario analizar las implicancias de estas variaciones en los resultados obtenidos de los análisis cefalométrico y evaluar la necesidad de utilizar puntos de referencia alternativos.
The objective of this study was to evaluate the displacement of cranial reference points: Nasion, Sella, Basion, Porion, Orbitale and Pterygomaxillary, used in Jarabak and Ricketts cephalometric analysis, during active growth. Hundred and twenty digitalized lateral telerradiographies, corresponding to 60 patients (2 teleradiographies each one), were collected. The radiographies were taken with a minimum interval of one year between them (T1 and T2), where T1 is taken before or during the pubertal growth peack according to the cervical vertebral maturation stages developed by baccetti (CVM) I, II or III and T2 in CVM IV,V,VI (after the growth peak). Then, a previously calibrated examinator marked reference points and cephalometric measurements were taken (2 variables for each landmark). Measurements were made using craniofacial stable structures as references (stable basicranial line and Vertical T). To detect displacement in the landmark positions, t test or Wilcoxon test according to the distribution of each variable, was used to compare the data between T1 and T2. Also, comparisons were made by sex, and by initial and final CVM. All of the variables have variations between T1 y T2, but only 5 have a statistically significant difference. There were no differences between sexes and at initial and final CVM. In conclusion, all of the reference landmarks analyzed had displacement during active growth. Point Basion and Orbitale suffered the largest displacement. It is necessary to analyze the clinical implications of this displacement in order to evaluate the convenience of using alternative reference landmarks.
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Humanos , Masculino , Femenino , Niño , Adolescente , Puntos Anatómicos de Referencia/anatomía & histología , Cefalometría/métodos , Cráneo/anatomía & histología , Cráneo/crecimiento & desarrolloRESUMEN
The aim of this paper is to update the current published content about the craniofacial long-term development disturbances of childhood hematopoietic stem-cell transplantation (HSCT) and the preparative regimens for the onco-hematological malignancies treatments. Methods: Two author sindependently reviewed the published articles about long-term effects of childhood HSCT that fitted into predetermined inclusion/exclusion criteria: clear definition of exposure or intervention, standard outcomes measurement and appropriate statistical analysis. Results: Twelve papers matched all the previous established eligibility criteria and were included in this review. The childrens age at HSCT were related to a higher risk of dental development disturbances, such as agenesis, dental hypoplasia, root stunting, crown-root proportion alterations, and microdontia. Craniofacial vertical growth was impaired in the irradiated patients without antero-posterior or latero-lateral impairment. Temporomandibular joint dysfunction was found to be more prevalent in the patients diagnosed withgraft-versus-host disease. Conclusion: The late effects of craniofacial development disturbances lead to several aesthetic and functional impairment, periodontal bone resorption with consequent impairment of chewing ability, and risk of early tooth loss often associated with lifes quality impairment. Further investigations should be performed to provide accurate information for patients, parent sand health care professionals...
Este artigo visa revisar o conteúdo publicado sobre as alterações tardias em crianças submetidas ao transplante de células-tronco hematopoiéticas(TCTH) e o regime pré-transplante para tratamento das doenças onco-hematológicas. Método: Dois autores independentes conduziram uma revisão simples dos artigos recentemente publicados sobre o tema, utilizando os critérios de exclusão/inclusão pré determinados: definição clara da intervenção clínica realizada, mensuração dos resultados padronizada e análise estatística adequada. Resultados: Doze artigos enquadraram-se em todos os critérios de avaliação pré-determinados para esta revisão. Houve correlação entre a idade da criança no momento do TCTH e maior risco de distúrbios de desenvolvimento dentário, como agenesia, hipoplasia dentária, encurtamento radicular,alterações da proporção coroa-raiz e microdontia.Houve alteração do crescimento craniofacial no sentido vertical sem, no entanto, alterar o crescimento anteroposterior e latero-lateral. Disfunção da articulação temporomandibular foi mais prevalente entre os pacientes com diagnostico de Doença do Enxerto contra o Hospedeiro. Conclusão: Os efeitos tardios do desenvolvimento craniofacial podem levara diversas alterações estéticas e funcionais, reabsorção óssea periodontal, diminuição da capacidade de mastigação e perda dentária precoce com possíveis impactos negativos sobre a qualidade de vida. Mais estudos são necessários para fornecer informações precisas aos pacientes, cuidadores e profissionais de saúde...
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Humanos , Niño , Anomalías Craneofaciales/tratamiento farmacológico , Anomalías Craneofaciales/radioterapia , Diente/crecimiento & desarrollo , Trasplante de Células Madre HematopoyéticasRESUMEN
Introducción: la mayoría de las investigaciones del crecimiento facial se enfocan hacia la documentación y predicción del crecimiento puberal opacando la descripción del crecimiento antes de los 12 años de edad. Aunque hay varias investigaciones en poblaciones caucásicas que han reportado los picos tempranos de crecimiento, ninguna lo ha ubicado y dimensionado con relación al pico puberal. En mestizos latinoamericanos no hay estudios reportados en la literatura. Métodos: desde 1992 el Grupo de Investigación de Labio y Paladar Hendido, Fisiología Oral y Crecimiento Craneofacial, CES-LPH, está haciendo un estudio longitudinal del crecimiento facial en 44 mestizos colombianos sin tratamiento con una muestra de 373 radiografías cefálicas laterales obtenidas durante 18 años de seguimiento. Resultados: de las 28 niñas de la muestra, 21 (75%) presentaron incrementos bienal mayores de 5 mm en la altura facial anterior (AFA) antes de los 12 años. En la altura facial posterior (AFP) hubo 9 (32%) niñas con incrementos bienales mayores a 5 mm antes de los 9 años. En 7 (43%) niños se presentaron incrementos bienales mayores a 5 mm en AFA antes de los 12 años y para la AFP hubo 9 (56%) niños con el mismo comportamiento antes de los 12 años. Para 5 de las niñas y 3 de los niños (18%), este fue el mayor pico de crecimiento en todo el seguimiento de la muestra desde los 6 hasta los 19 años, hallazgo no reportado anteriormente en la literatura. Conclusiones: los picos tempranos de crecimiento vertical (AFA y AFP) en niños menores de 9 años pueden explicar el éxito de las terapias tempranas de ortopedia funcional de los maxilares.
Introduction: most studies on facial growth focus on documenting and predicting pubertal growth, underestimating the description of growth before the age of 12. Although several studies on Caucasian populations have analyzed early growth peaks, none of the publications has related them with the pubertal peaks. Furthermore, no studies on Latin American mestizos are reported in the literature. Methods: since 1992, the Cleft Lip and Palate, Oral Physiology and Craniofacial Growth Research Group (CES-LPH for its Spanish initials) has been conducting a longitudinal study on facial growth in 44 untreated Colombian mestizos with a sample of 373 cephalic lateral radiographs obtained during a period of 18 years. Results: 21 of the 28 girls in the sample (75%) present major biennial increments of 5 mm in anterior face height (AFH) before age 12. In terms of posterior face height (PFH), there were 9 girls (32%) with biennial increases greater than 5 mm before 9 years old. 7 children (43%) presented biennial increases greater than 5 mm in AFH before the age of 12, and concerning PFH there were 9 children (56%) with the same behavior before the age of 12. For 5 girls and 3 boys (18%), this was the greatest growth peak throughout the follow-up period of a sample since the age of 6 until 19 yearsa finding not previously reported in the literature. Conclusions: early vertical growth peaks (AFH and PFH) in children younger than 9 years may explain the success of early functional jaw orthopedic therapies.
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Niño , Cráneo/crecimiento & desarrollo , Trabajo InfantilRESUMEN
Atualmente está aumentando o número de pessoas que usam suplementos nutricionais com a finalidade de obter melhores resultados nas suas atividades esportivas, perda de gordura, ganhos de massa muscular, ou na plasticidade do corpo. Tal fato merece atenção porque muito pouco é conhecido sobre a segurança ou eficácia destes produtos, e apenas 14% dos usuários buscam orientações com profissional da saúde sobre o uso destas substâncias. Dos mais de 200 suplementos que prometem estes efeitos apenas as suplementações de creatina HMB produzem os resultados prometidos, e o Comitê Olímpico qualifica o uso do HMB como legal. Embora a literatura atual mostre os benefícios no uso da suplementação com HMB, são poucas as informações sobre o seu efeito na morfofisiologia das fibras musculares como, por exemplo, o perfil histoenzimológico e a área dos diferentes tipos de fibras musculares. Baseado nestas informações pensou-se na realização desde trabalho para verificar se o uso de HMB provoca alterações morfológicas e histoenzimológicas nas fibras musculares dos músculos da mastigação; se estes efeitos alterariam o desenvolvimento e crescimento do esqueleto craniofacial; e se os efeitos sobre os componentes do sistema estomatognático seriam semelhantes nos indivíduos ambos os gêneros. Para realização deste estudo foram utilizados 58 ratos com idade de 60 dias, 29 animais de cada gênero, distribuídos nos seguintes grupos: Grupo Controle Inicial (GCI) que foram sacrificados no inicio do experimento; Grupo Controle Placebo (GCP) que receberam o mesmo volume do veículo do grupo experimental, e alimentação ad libitum; Grupo Experimental (GE) que receberam diariamente 0,3g/kg de HMB, por meio de gavagem e mesma quantidade de alimentos que GCP consumiu no dia anterior; Grupo Experimental Ad libitum (GEA) que receberam a mesma dose da droga, porém tiveram alimentação ad libitum. Após o tratamento, foram retiradas amostras dos músculos digástrico (ventre anterior) e masseter...
Nowadays is increasing the number of people who use nutritional supplements in order to achieve better results in their sports, fat loss, muscle gains, or the plasticity of the body. This deserves attention because very little is known about the safety or efficacy of such products, and only 14% of users seeking guidance with a health professional regarding the use of these substances. Of the more than 200 supplements that promise these effects only the HMB and creatine supplementation produce the promised effects, and the Olympic Committee qualifies the use of HMB as legal. While the literature shows benefits in the use of HMB supplementation, there is little information on its effect on muscle fibers morphophysiology as, for example, the profile and the area histoenzimológico of different types of muscle fibers. Based on this information, it was thought in performing this work to check whether the use of HMB causes morphological and histoenzimológicas changes in muscle fibers of the muscles of mastication, these effects alter the growth and development of craniofacial skeleton, and if the effects on the components of stomatognathic system would be similar in both genders individuals. For this study we used 58 rats aged 60 days, 29 animals of each gender, divided into four groups: Control Group Home (GCI) which were sacrificed at the beginning of the experiment; Placebo Control Group (GCP) that received the same volume Vehicle experimental group, and fed ad libitum; Experimental Group (EG) which received daily 0.3 g / kg of HMB, by gavage and the same amount of food they consumed on the previous day GCP; experimental group ad libitum (GEA) who received the same dose of the drug, but were fed ad libitum. After treatment, samples were taken of the digastric (anterior belly) and masseter (superficial part) for analysis histoenzimologic (m-ATPase with pre-incubations acid and alkaline) and removal of the head skeleton to taken the craniometric measures...
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Animales , Masculino , Femenino , Ratas , Cráneo/crecimiento & desarrollo , Cráneo , Suplementos Dietéticos , Desarrollo Maxilofacial , Leucina/análogos & derivados , Músculos Masticadores , Cefalometría , Ratas Wistar , Factores SexualesRESUMEN
Introduction and objectiveUnderstanding the anatomical and physiological modulation of the occlusal plane during growth is criticalin identifying some of the factors contributing to the establishment of malocclusion.To characterize the occlusal plane and the development of different dentoskeletal types in school childrenbetween 5 and 6 years.Materials and MethodsThis descriptive study considered a convenience sample of 107 schoolchildren who met the inclusioncriteria. The analyzed variables were Dental Framework, Kim, occlusal plane and FH plane, determined byusing anatomic and orbital positions, which served as reference points. Occlusal planes were determinedby considering deciduous and mixed dentition, respectively.ResultsThe classification of the occlusal plane identified in showed that in 65,7% of the school children there wasa stable occlusal plane, in 22,9% inclined and in 11,4% flat. In Class III, no data were found with respectto the inclined plane. All patients were between a stable and a flat occlusal plane. A greater proportionwas that of the angle of the acute maxillary plane. In the multivariate analysis identified a possible (11,5%) was found consistent of males with a Class II skeletal pattern, no occlusal plane angulation and obtuseangulation of the maxillary plane.ConclusionThere is a tendency for Class I children to have a stable occlusal plane, Class II individuals an inclinedocclusal plane, and Class III children a flat occlusal plane.
Introduction and objectiveUnderstanding the anatomical and physiological modulation of the occlusal plane during growth is criticalin identifying some of the factors contributing to the establishment of malocclusion.To characterize the occlusal plane and the development of different dentoskeletal types in school childrenbetween 5 and 6 years.Materials and MethodsThis descriptive study considered a convenience sample of 107 schoolchildren who met the inclusioncriteria. The analyzed variables were Dental Framework, Kim, occlusal plane and FH plane, determined byusing anatomic and orbital positions, which served as reference points. Occlusal planes were determinedby considering deciduous and mixed dentition, respectively.ResultsThe classification of the occlusal plane identified in showed that in 65,7% of the school children there wasa stable occlusal plane, in 22,9% inclined and in 11,4% flat. In Class III, no data were found with respectto the inclined plane. All patients were between a stable and a flat occlusal plane. A greater proportionwas that of the angle of the acute maxillary plane. In the multivariate analysis identified a possible (11,5%) was found consistent of males with a Class II skeletal pattern, no occlusal plane angulation and obtuseangulation of the maxillary plane.ConclusionThere is a tendency for Class I children to have a stable occlusal plane, Class II individuals an inclinedocclusal plane, and Class III children a flat occlusal plane.
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Humanos , Oclusión Dental , Epidemiología Descriptiva , Crecimiento , Servicios de Salud EscolarRESUMEN
BACKGROUND/AIM: Computed Tomography (CT) is a powerful tool in craniofacial research that focuses on morphological variation. In this field, an ontogenetic approach has been taken to study the developmental sources of variation and to understand the basis of morphological evolution. This work aimed to determine measurement error (ME) in cranial CT in diverse developmental stages and to characterize how this error relates to different types of landmarks. MATERIAL AND METHODS: We used a sample of fifteen skulls ranging from 0 to 31 years. Two observers placed landmarks in each image three times. Measurement error was assessed before and after Generalized Procrustes Analysis. RESULTS: The results indicated that ME is larger in neurocranial structures, which are described mainly by type III landmarks and semilandmarks. In addition, adult and infant specimens showed the same level of ME. These results are specially relevant in the context of craniofacial growth research. CONCLUSION: CT images have become a frequent evidence to study cranial variation. Evaluation of ME gives insight into the potential source of error in interpreting results. Neural structures present higher ME which is mainly associated to landmark localization. However, this error is irrespective of age. If landmarks are correctly selected, they can be analyzed with the same level of reliability in adults and subadults.
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Introducción y Objetivo: El crecimiento craneofacial posnatal es un proceso complejo que continúa aún después de los 20 años de edad. Cuantifi car por primera vez en una población mestiza latinoamericana y colombiana el desarrollo vertical facial anterior (AFA) y posterior (AFP). Materialesy Métodos: seguimiento cefalométrico bianual de 44 sujetos con apariencia facial normal y sin ningúntipo de tratamiento ortodóncico.Resultados: Hubo una disminución continua del ángulo del planomandibular (SN/PM) en ambos sexos. Se encontraron aumentos continuos de la AFA y AFP con diferencias signifi cativas por sexo a partir de los 16 años. El pico puberal para las mujeres de la AFA y AFP fue alrededor de los 13 años, para los hombres alrededor de los 15. Esta tendencia general mostró variaciones individuales importantes. Antes de los 11 años de edad el 63% de la muestra tuvo incrementos bianuales de más de 3 mm, después de los 16 años el 29,5% de los sujetos tuvo incrementos bianuales de más de 2 mm. Las mujeres después de los 18 años no tuvieron un patrón de rotación mandibular a favor de las manecillas del reloj, ni los hombres en contra. Conclusiones: se muestran diferencias importantes respecto a otros estudios reportados en poblaciones caucásicasen cuanto a la variabilidad individual, presencia de varias etapas de aceleración del crecimientovertical pre y pospuberalmente y rotación mandibular después de los 18 años. Estas diferencias no son debidas a características genéticas o nutricionales sino probablemente a cambios normalesdel crecimiento vertical facial.
Introduction and Objetive: The postnatal craniofacial growth is a complex process that continues even after 20 years of age. To quantify for the fi rst time, the anterior (AFA) and posterior vertical facial (AFP) developmental growth, in a mestizo Colombian and a latin-american population. Materials and Methods: Biannual cephalometric follow-up of 44 subjects with normal facial appearance and without any type of orthodontic treatment. Results: There was a continuous decrease of the mandibular plane angle SN / PM in both sexes. There were continuous increases in the AFA and AFP with signifi cant differences by sex after the age of 16. The pubertal peak for women in the AFA and AFP was about 13 years of age, and for men around the age of 15. This general trend showed signifi cant individual variations. Before the age of 11, 63% of the sample had biannual increments over 3 mm, after the age of 16, 29,5% of the subjects had biannual increases more than 2 mm. Women after the age of 18 had no clockwise mandibular rotation, neither did men had counterclockwise mandibular rotation. Conclusions: It is shown that there is an important difference between this study and other studies reported from Caucasian populations in terms of individual variability, presence of various growth spurt stages in the vertical facial height pre-and postpuberty. There was a non specifi c gender tendency of mandibular rotation after 18 years of age. These differences are not due to genetic or nutritional changes, but probably normal vertical facial growth changes.
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Humanos , Cefalometría , Colombia , Crecimiento , Estudios LongitudinalesRESUMEN
O objetivo deste estudo longitudinal foi identificar as diferenças no padrão de crescimento crânio-facial de pacientes portadores de cardiopatas congênitas. A amostra foi composta por 43 pacientes que encontravam-se na faixa etária inicial de 7 a 12 anos, em atendimento de rotina no Ambulatório de Pediatria do Hospital Universitário Pedro Ernesto, os quais foram reavaliados num período médio de 8 a 10 anos. Foram obtidas radiografias cefalométricas nos tempos inicial (T1) e final (T2) de todos os 43 indivíduos, sendo a amostra dividida em grupo cardiopata com 23 pacientes e grupo não cardiopata com 20 pacientes. Na comparação entre cardiopatia e não cardiopatia, foram constatadas diferenças significativas entre os grupos em relação as proporções das medidas cefalométricas verticais da altura facial anterior superior e inferior. O padrão esquelético foi caracterizado por uma protrusão maxilar mais acentuada para o grupo não cardiopata e uma protrusão mandibular mais acentuada em ambos os grupos. O padrão de crescimento foi caracterizado por uma tendência a crescimento horizontal e vertical equilibrada nos indivíduos de ambos os grupos. O padrão dentário foi caracterizado por uma protrusão dos incisivos inferiores em relação à base óssea em ambos os grupos. O padrão estético foi caracterizado por uma retrusão dos lábios superior e inferior, em ambos os grupos. O padrão vertical foi caracterizado por uma tendência vertical em ambos os grupos, sendo caracterizado por uma diminuição mais acentuada da proporção entre a altura facial anterior superior e a altura facial anterior total e um aumento mais acentuado da proporção entre a altura facial anterior inferior e a altura facial anterior total para o grupo cardiopata, de forma significativa.
The aim of this longitudinal study was to evaluate the changes in craniofacial growth pattern of patients with congenital heart diseases. The sample comprised 43 pacients aged between seven and twelve who were under routine clinical care at Pedro Ernesto University Hospital. All pacients were reavaluated between a period of eigth and ten years. While the cardiopatic group was composed of 50 males and 38 females, the rest of the sample showing no heart disease included 20 males and 23 females. When comparing the cephalometric measurements between the groups, a significant difference was found in vertical anterior superior and inferior facial height. The skeletal pattern showed a maxillary protrusion in the group without heart disease and a mandibular protrusion in both groups with and without heart disease. Both groups also showed a balanced horizontal and vertical growth tendency and the dental pattern revealed an incisor protrusion, with the lower ones being more proclined in relation to the basal bone. The aesthetic pattern showed a retrusion in the upper and lower lip position, considering both groups and when considering the vertical pattern, both group presented a vertical tendency, characterized by significant decrease of the anterior superior facial height and an increase of the anterior inferior facial height in group with heart disease.